PTSD DUE TO COMBAT

MICHAEL A. HERMAN · 2026 · Case ID: A26040969

MIXED

Summary

The Veteran, an Army veteran who served from April 1970 to August 1973, appeals the denial of an increased rating for his service-connected other specified trauma and stressor related disorder and the effective date for his Total Disability based on Individual Unemployability (TDIU) award. The Veteran is currently rated at 70 percent for his other specified trauma and stressor related disorder, rated under DC 9411. The Board reviewed VA treatment records from March 2021 to May 2022, which generally indicated the Veteran was doing well, sleeping better, experiencing less stress, and engaging in activities like going to the gym and talking with his daughters, though he sometimes felt "jumpy" or preferred to be by himself. A March 2022 VA PTSD examination diagnosed PTSD and noted symptoms consistent with a 70 percent rating, including near-continuous depression affecting independent functioning, neglect of hygiene, and difficulty adapting to stressful circumstances, but also noted the Veteran was oriented, had clear speech, and was appropriately dressed. The Board found the March 2022 examination and treatment records most persuasive, concluding that the Veteran's symptoms did not meet the criteria for a 100 percent rating, as they more closely approximated a 70 percent rating with deficiencies in most areas, and thus denied the increased rating. Regarding the TDIU effective date, the Veteran submitted an intent to file on February 5, 2021, and a claim on March 24, 2021. While the Veteran had met the schedular criteria for TDIU prior to the period on appeal, VA treatment records from one year prior to the intent to file did not reflect a factually ascertainable increase in disability. Therefore, the Board granted the TDIU award effective February 5, 2021, the date of the intent to file, and denied an earlier effective date.

Rationale

Symptoms did not meet criteria for 100% rating.; Symptoms more closely approximated 70% rating criteria.; Deficiencies in most areas of functioning.

Service Branch

ARMY

Special Benefit

TDIU

Diagnostic Code

9411

Docket No.

220906-275232

Full Decision Text

Citation Nr: A26040969
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 220906-275232
DATE: April 30, 2026

ORDER

Entitlement to a rating in excess of 70 percent for service-connected other specified trauma and stressor related disorder is denied.

Entitlement to an effective date of February 5, 2021, but no earlier, for the award of total disability based on individual unemployability (TDIU) is granted.

FINDINGS OF FACT

1. The severity, frequency, and duration of the Veteran's symptoms did not more closely approximate total occupational and social impairment.

2. VA received an intent to file a claim for compensation from the Veteran on February 5, 2021, prior to VA's receipt of his VA Form 20-8940, on March 24, 2021, for entitlement to a TDIU rating.

CONCLUSIONS OF LAW

1. The criteria for a disability rating in excess of 70 percent for other specified trauma and stressor related disorder have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9411.

2. The criteria for an effective date of February 5, 2021, but no earlier, for the award of a TDIU rating have been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the United States Army from April 1970 to August 1973.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2022 rating decision by a Department of Veterans Affairs (VA) regional office, which is the Agency of Original Jurisdiction (AOJ).

The Veteran elected the Board's Hearing docket. See September 2022 VA Form 10182. In correspondence received on December 23, 2025, the Veteran withdrew the request for a hearing. This restricts the Board's review to the evidence of record at the time of the August 2022 rating decision and any evidence submitted by the Veteran or his representative within 90 days following the receipt of the withdrawal. 38 C.F.R. § 20.302(b).

The Board notes that evidence was associated with the claims file during a period that is outside the applicable evidentiary window - between the August 2022 rating decision and the December 2025 Board hearing withdrawal.

Therefore, the Board has not considered that evidence in its present decision. 38 C.F.R. § 20.300(a). If the Veteran would like VA to consider the additional evidence that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and identify the evidence for the AOJ's consideration. 38 C.F.R. § 3.2501. Specific instructions for filing a supplemental claim are included with this decision.

1. Entitlement to a rating in excess of 70 percent for service-connected other specified trauma and stressor related disorder

The Veteran asserts that his other specified trauma and stressor related disorder is more severe than the currently assigned rating. The Veteran is currently assigned a 70 percent rating from June 26, 2020, the date of service connection. The Veteran's other specified trauma and stressor related disorder is rated under DC 9411.

Increased Ratings

Disability evaluations are determined by evaluating the extent to which a Veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities and the criteria for specific ratings.

If two disability evaluations are potentially applicable, the higher evaluation will be assigned to the disability picture that more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C
residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities and the criteria for specific ratings.

Under the General Formula for Mental Disorders (General Formula), the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013).

A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.

A 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation, or own name.

Factual background

A March 2021 VA treatment record includes the Veteran's report that he was doing much better since the passing of his brother. He was experiencing unpleasant dreams but not nightmares and talking to his daughter. He denied recent panic attacks.

An April 2021 VA treatment record reflects that the Veteran reported doing much better: sleeping better; less stress; and no recent panic attacks. He reported talking to his daughter 2 to 3 times a week, and she has been a good support.

An August 2021 VA treatment record reflects that the Veteran reported doing great: sleeping well, eating well, going to the gym and walking in the park, and still talking and texting with his two daughters. He reported he believes his medication continues to help him: good mood and no panic attacks, although still feels a little "jumpy" sometimes.

A November 2021 VA treatment record reflects that the Veteran reported doing good: going to the gym, going to bed early and although waking early, eating well, and talking and texting with his daughters. He reported taking his medication as prescribed, no panic attacks, good mood, and that he was not stressed or depressed.

A February 2022 VA treatment record reflects that the Veteran reported doing good: eating well and going to the gym and trying to keep up with international news. He reported taking his medication as prescribed and noted he is not having panic attacks and is not "'jerky when the phone rings.'"

In the March 2022 VA posttraumatic stress disorder (PTSD) examination report, the Veteran was diagnosed with PTSD. The examiner opined that the Veteran's symptoms result in occupational and social impairment with reduced reliability and productivity. The examiner noted that the Veteran's PTSD is characterized by symptoms such as: anxiety; suspiciousness; panic attacks more than once a week; near-continuous depression affecting the ability to function independently, appropriately and effectively; chronic sleep impairment; flattened affect; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships; difficulty adapting to stressful circumstances, including work or a work
his medication as prescribed and noted he is not having panic attacks and is not "'jerky when the phone rings.'"

In the March 2022 VA posttraumatic stress disorder (PTSD) examination report, the Veteran was diagnosed with PTSD. The examiner opined that the Veteran's symptoms result in occupational and social impairment with reduced reliability and productivity. The examiner noted that the Veteran's PTSD is characterized by symptoms such as: anxiety; suspiciousness; panic attacks more than once a week; near-continuous depression affecting the ability to function independently, appropriately and effectively; chronic sleep impairment; flattened affect; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships; difficulty adapting to stressful circumstances, including work or a work like setting; obsessional rituals which interfere with routine activities; grossly inappropriate behavior; neglect of personal appearance and hygiene. Additionally, the examiner noted the Veteran has obsessive behaviors related to safety, and while the Veteran appeared appropriately dressed and groomed upon examination, "there are times that he will go a few days without engaging in some hygiene behaviors due to lack of motivation."

Moreover, during the examination, the examiner observed the Veteran was oriented to person, place, time, and situation; his speech was clear and fluent; his thoughts were linear and goal directed; had flat affect and was dysthymic; had appropriate motor behavior; did not have any issues with gait; and was able to do serial 7's from 100.

A May 2022 VA treatment record reflects that the Veteran reported doing okay; eating well, going to the gym and the park, taking medication as prescribed; and that exercise has become his new hobby. He reported no panic attacks or depression, though he does find that he prefers to be by himself.

In a July 2022 VA TDIU opinion, the examiner opined that

The veteran's mental health symptoms would likely cause severe discomfort when interacting with other people, and severely reduced communication effectiveness. This level of fatigue, concentration problems, and distracting thought processes would likely cause severe work inefficiency and lack of productivity, for example being distractible and being unable to focus because of disturbing thoughts about traumas. The amount of fatigue, apathy, and motivation problems conveyed would likely cause frequent severely reduced reliability. The amount of avoidance of social contact and confrontation would likely interfere severely with the ability to interact effectively in the workplace, and severely negatively affect general social functioning. The veteran's ability to maintain a logical thinking process appeared adequate and would not likely impact social or vocational functioning. The veteran had some severe reduction with the ability to adapt to stressful circumstances such as workplace, classroom, and other social environments. The veteran's mental health issues would likely have a severe negative impact on the ability to obtain and maintain full time competitive gainful employment. The veteran did not suffer from gross impairment in thought processes, delusions, or hallucinations. The veteran was not a danger to self or others.

Analysis

The Board concludes that the Veteran's symptoms did not cause the level of impairment required for a disability rating of 100 percent. The Veteran's symptoms more closely approximated the symptoms associated with a 70 percent rating and resulted in a level of impairment that most closely approximated occupational and social impairment, with deficiencies in most areas. Because of this, a disability rating in excess of 70 percent currently assigned is not warranted.

The March 2022 VA PTSD examination reflects that examiner thoroughly reviewed the Veteran's VA e-folder, acknowledged the Veteran's lay statements, and provided explanations supported by detailed observations of the Veteran during the examination. Moreover, the Board finds that the March 2022 VA PTSD examination is consistent with the Veteran's VA treatment records. Accordingly, the Board finds the March 2022 VA PTSD examination report and VA treatment are the most probative and persuasive evidence of record. See Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304-05 (2008).

Moreover, the March 2023 VA PTSD examination and the VA treatment records reflect that the Veteran's other specified trauma and stressor related disorder was manifested by symptoms associated with a 30 percent rating (anxiety; suspiciousness; and chronic sleep impairment), symptoms associated with a 50 percent rating (flattened affect; panic attacks more than once a week; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships), symptoms associated with a 70 percent rating (obsessional rituals which interfere with routine activities; near-continuous depression affecting the ability to function independently, appropriately and effectively; neglect of personal appearance and hygiene; and difficulty in adapting to stressful circumstances (including work or a worklike setting)), and a symptom associated with a 100 percent rating (grossly inappropriate behavior
VA treatment records reflect that the Veteran's other specified trauma and stressor related disorder was manifested by symptoms associated with a 30 percent rating (anxiety; suspiciousness; and chronic sleep impairment), symptoms associated with a 50 percent rating (flattened affect; panic attacks more than once a week; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships), symptoms associated with a 70 percent rating (obsessional rituals which interfere with routine activities; near-continuous depression affecting the ability to function independently, appropriately and effectively; neglect of personal appearance and hygiene; and difficulty in adapting to stressful circumstances (including work or a worklike setting)), and a symptom associated with a 100 percent rating (grossly inappropriate behavior). He also had symptoms that are not listed with a specific rating, such as self-isolation; hypervigilance; and nightmares.

Although grossly inappropriate behavior was noted, the Board finds the severity, frequency, and duration of the Veteran's unlisted symptoms more closely approximate the symptoms contemplated by a 70 percent rating, which are less severe, less frequent, and shorter in duration than those contemplated by a 100 percent rating. See 38 C.F.R. § 4.126. Further, self-isolation; hypervigilance; and nightmares are similar to anxiety; suspiciousness; difficulty in establishing and maintaining effective work and social relationships; chronic sleep impairment; and disturbances in motivation and mood; which are contemplated by the assigned 70 percent rating criteria or lower.

The Board also finds the level of impairment caused by the Veteran's symptoms overall more closely approximates the level associated with a 70 percent rating. The Veteran experienced occupational and social impairment with deficiencies in most areas. The March 2023 VA PTSD examination reflects that the Veteran reported perceived total isolation and social impairment. However, VA treatment records reflect that he communicates multiple times a week with his daughters and enjoying regular trips to the gym and the park. Such tends to belie the notion of total social impairment.

In short, the overall evidence of record persuasively weighs against finding that the severity, frequency, and duration of the Veteran's symptoms resulted in the level of impairment required for a 100 percent rating. The criteria for a 100 percent or higher rating are not met, and the appeal must be denied.

2. Entitlement to an effective date of February 5, 2021, but no earlier, for the award of TDIU

The Veteran contends that an earlier effective date for his TDIU rating is warranted. See January 2026 Third Party Correspondence. In the August 2022 rating decision, the Veteran was awarded a TDIU rating effective March 24, 2021.

A schedular TDIU rating may be assigned if the Veteran has two or more service-connected disabilities, when at least one is rated at 40 percent or more and the combined evaluation is 70 percent or more, or, if there is only one service-connected disability that is rated at 60 percent or more. 38 C.F.R. 4.16(a).

In general, the effective date of an award of disability compensation shall be the day following separation from active service or the date entitlement arose if the claim is received within one year of separation from service; otherwise, the effective date shall be the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C. § 5110; 38 C.F.R. § 3.400 (b)(2)(i).

Regarding effective dates, a claim for entitlement to a TDIU is a claim for increased compensation, and the effective date rules or increased compensation apply to a TDIU claim. See Hurd v. West, 13 Vet. App. 449 (2000). Therefore, an effective date of a TDIU claim may be awarded during the one-year period prior to receipt of the claim if it is factually ascertainable that an increase in disability had occurred during that one-year period. Otherwise, the effective date will be the date of the claim, or the date entitlement arose, whichever is later. 38 C.F.R. § 3.400 (o)(2).

Further, a claimant or his or her duly authorized representative may indicate a claimant's desire to file a claim for benefits by submitting an intent to file a claim to VA. 38 C.F.R. § 3.155 (b). If VA receives a complete application form within 1 year of receipt of the intent to file a claim, VA will consider the complete claim filed as of the date the intent to file a claim was received. Id.

On February 5, 2021, the AOJ received an intent to file from the Veteran. See February 2021 VA 21-0966. On March 24, 202
38 C.F.R. § 3.400 (o)(2).

On February 5, 2021, the AOJ received an intent to file from the Veteran. See February 2021 VA 21-0966. On March 24, 2021, the AOJ received the Veteran's VA Form 20-0995, supplemental claim, in which the Veteran sought an increased rating for PTSD, and his VA 21-8940 requesting a TDIU rating. The Board notes the Veteran has met the schedular rating criteria for a TDIU rating as of December 14, 2016, prior to the period on appeal. See May 2024 Rating Decision Codesheet.

In the March 2021 VA 21-8940, application for increased compensation based on unemployability, the Veteran reported that his service-connected PTSD disability prevents him from securing or following any substantially gainful employment. The March 2021 VA 21-8940 and the June 2022 VA 21-4192 reflect that the Veteran was employed by the Cleveland Metropolitan School District as a substitute teacher reportedly from 1998 to February 2020.

In the August 2022 rating decision, the Veteran was awarded a TDIU rating effective March 24, 2021: the date the AOJ received the Veteran's March 2021 VA 21-8940.

The Board has considered whether an earlier effective date is warranted for evidence of a factually ascertainable increase in disability within one year prior to receipt of the February 2021 VA 21-0966. However, a review of the Veteran's VA treatment records one year prior to the receipt February 2021 intent to file do not reflect evidence of a factually ascertainable increase in disability during that period. Notably, a January 2020 VA treatment record reflects that the Veteran reported being sick and not working due to school vacations. A March 2020 VA treatment record reflects that the Veteran reported "that he has not been working like he had planned to and feels that he may just want to retire from substitute teaching at the end of this school year," and noted "'I just don'[t feel that I can work anymore.'" He then stated "he looked forward to being at the point where he could travel." VA mental health treatment records from March 2020 to October 2020 reflect that the Veteran reported being okay, enjoyed exercising and being outside, took prescribed medication, and kept up with his activities of daily living. Accordingly, an earlier effective date is not warranted based on this theory.

However, the Veteran submitted an intent to file on February 5, 2021, followed by his March 24, 2021, VA Form 20-0995, supplemental claim, and his VA 21-8940 requesting a TDIU rating. Accordingly, the Board finds that the date of claim for entitlement to TDIU was February 5, 2021. 38 C.F.R. § 3.400 (b)(2)(i). An effective date of February 5, 2021, but no earlier, is granted for the award of a TDIU rating.

MICHAEL A. HERMAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Maxey, Gloria J.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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