POSTTRAUMATIC STRESS DISORDER (PTSD)

Summary

The Veteran, who served from June 2004 to June 2006 and again from June 2008 to October 2008, including service in an imminent danger pay area in Iraq, appeals the rating assigned for his posttraumatic stress disorder (PTSD). The Veteran sought an increased rating beyond the 50 percent disability evaluation previously assigned. The Board reviewed the Veteran's service treatment records, a VA compensation and pension examination from April 2021, correspondence from the Veteran's spouse, and the Veteran's own testimony. The VA examiner diagnosed PTSD and noted symptoms including hyperarousal, hypervigilance, irritability, depressed mood, anxiety, and difficulty adapting to stressful circumstances, which impacted work and social relationships. The examiner also noted the Veteran's wife's observations regarding his discomfort in crowds, occasional neglect of personal appearance and hygiene, and strained relationships with some family members. The Board found that these symptoms, particularly the difficulty adapting to stressful circumstances and occasional neglect of personal appearance, corresponded to the criteria for a 70 percent rating. Applying the benefit of the doubt, the Board granted an initial rating of 70 percent for PTSD, finding that the Veteran's occupational and social impairment met the criteria for this level.

Rationale

Symptoms of hyperarousal, hypervigilance, and irritability assessed by examiner.; Difficulty adapting to stressful circumstances noted by examiner and spouse.; Occasional neglect of personal appearance and hygiene noted by spouse.

Full Decision Text

Citation Nr: A26041024
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 210811-178690
DATE: April 30, 2026

ORDER

An initial rating of 70 percent but not higher for posttraumatic stress disorder (PTSD) is granted.

FINDING OF FACT

The functional impact of the Veteran's PTSD manifests as no worse than occupational and social impairment, with deficiencies in most areas. 

CONCLUSION OF LAW

The criteria for an initial rating of 70 percent for PTSD have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.3, 4.7, 4.130 Diagnostic Code (DC) 6411.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from June 2004 to June 2006. The Veteran also served on active duty from June 2008 to October 2008. The Veteran served in an imminent danger pay area.

1. Initial rating for PTSD.

i.	Law and regulation.

Disability evaluations are determined by the application of a schedule of ratings, which is based on average impairment of earning capacity caused by the given disability. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4.

When a question arises as to which of two ratings applies under a particular Code, the higher rating is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining, including degree of disability, is to be resolved in favor of the Veteran. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. In deciding claims, it is the Board's responsibility to evaluate the entire record on appeal. See 38 U.S.C. § 7104(a). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The Veteran's PTSD is currently rated as 50 percent disabling under the General Rating Formula for Mental Disorders (General Formula). A 50 percent evaluation is warranted where there is occupational and social impairment with reduced reliability and productivity. This may be due to such symptoms as flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. Id.

A 70 percent evaluation is warranted where there is occupational and social impairment, with deficiencies in most areas (such as work, school, family relations, judgment, thinking, or mood). This may be due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; 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); inability to establish and maintain effective relationships. Id.

A 100 percent evaluation is warranted for total occupational and social impairment. This may be 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; memory loss for names of close relatives, own occupation, or own name. Id.

The list of symptoms in the General Formula is not intended to constitute an exhaustive list, but provides examples of the type and degree of symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). However, a Veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013). Furthermore, when evaluating
 place; memory loss for names of close relatives, own occupation, or own name. Id.

The list of symptoms in the General Formula is not intended to constitute an exhaustive list, but provides examples of the type and degree of symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). However, a Veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013). Furthermore, when evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment. 38 C.F.R. § 4.126. 

ii.	Facts and analysis.

The Veteran served in Iraq. His service was in an imminent danger pay area. The Veteran contends that a rating for PTSD in excess of 50 percent should be awarded. The Board agrees.

The Veteran first applied for service connection for PTSD in December 2008. The AOJ denied service connection in June 2009. This decision became final in June 2010.

The Veteran again applied for service connection for PTSD in March 2021. The AOJ granted service connection in in April 2021 and assigned a 50 percent rating, effective March 2021. The Veteran filed his VA form 10182 in August 2021. During the December 2024 hearing, the Veteran clarified that the scope of his appeal to the Board was includes his rating for PTSD but not the effective date that was assigned.

The Veteran underwent a compensation and pension examination of his mental health in April 2021. The examiner diagnosed PTSD. The examiner observed that a clinical note dated March 26, 2009, "indicates history of 3 blast exposures. He reports one was an IED to his vehicle. He felt dazed but doesn't recall LOC." The Veteran has remarried. His wife is his main support system.

During the examination, the Veteran discussed symptoms of hyperarousal, hypervigilance and irritability. The Veteran indicates that these symptoms cause tension with work. The Veteran's medical history includes a previous diagnosis for PTSD and prior treatment with prescription medications.

The examiner assessed symptoms of: depressed mood, anxiety, suspiciousness, chronic sleep impairment, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty adapting to stressful circumstances, including work or a worklike setting. 

The examiner also noted that the Veteran's wife does most of the shopping. This allows the Veteran to minimize time spent in crowded places, such as supermarkets. This avoidance helps the Veteran avoid situations likely to elicit PTSD symptoms. Due to his PTSD symptoms, the Veteran feels uncomfortable in crowds. The Veteran denied suicidal ideation. 

During his hearing testimony, the Veteran described how his PTSD symptoms cause difficulties at work. Nonetheless, the Veteran has been employed for at least a year and a half. The Veteran described symptoms of hypervigilance and how they impact his short term memory. The Veteran relayed that, due to nightmares, most evenings, he sleeps on the couch. The Veteran also described how blessed he is to have a supportive spouse. The Veteran's spouse also provided correspondence in February 2025. She describes the Veterans symptoms. The Veteran's spouse notes that although the Veteran maintains close connections with her and with his children, the Veteran struggles to stay close with other family members and loved ones. Further, the Veteran's spouse regularly has to remind the Veteran to maintain his hygiene. The Veteran's spouse attributes these symptoms to the Veteran's PTSD.

The Veteran's PTSD manifests as occupational and social impairment, with deficiencies in most areas. Although the Veteran's symptoms impact his ability to work, he is able to obtain and maintain jobs. At the time of his hearing in this case, the Veteran has been employed at the same position for more than one year. 

Similarly, the Veteran's PTSD symptoms impact his social life. His wife observes that he does not keep in close contact with loved ones. The Veteran relayed to the examiner that he no longer spends time with friends, as he does not want to be in crowds. Yet, the Veteran has the support of a dedicated spouse, and he remains an engaged and devoted father.

The symptoms that the examiner assessed would place the Veteran's rating between a 50 percent and a 70 percent overall rating. The examiner assessed that the Veteran has, "difficulty adapting to stressful circumstances, including work or a work like setting." This corresponds to a 70 percent rating. The other examiner-assessed symptoms correspond to a rating below 70 percent. Additionally
 year. 

Similarly, the Veteran's PTSD symptoms impact his social life. His wife observes that he does not keep in close contact with loved ones. The Veteran relayed to the examiner that he no longer spends time with friends, as he does not want to be in crowds. Yet, the Veteran has the support of a dedicated spouse, and he remains an engaged and devoted father.

The symptoms that the examiner assessed would place the Veteran's rating between a 50 percent and a 70 percent overall rating. The examiner assessed that the Veteran has, "difficulty adapting to stressful circumstances, including work or a work like setting." This corresponds to a 70 percent rating. The other examiner-assessed symptoms correspond to a rating below 70 percent. Additionally, the Veteran's spouse observed that the Veteran occasionally neglects his personal appearance and hygiene. While she is not a medical provider able to assess that this symptom is due to the Veteran's PTSD, she is capable of relaying her observations. Neglect of personal appearance is also a PTSD symptom that corresponds to a 70 percent rating.

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Affording the Veteran the benefit of the doubt, the functional impact of the Veteran's PTSD manifests as occupational and social impairment, with deficiencies in most areas. A rating in excess of 70 percent is not applicable. Such a rating requires a finding of total occupational and social impairment, which does not apply to the Veteran's circumstances. Accordingly, an initial rating of 70 percent but not higher for service connection for PTSD is granted.

 

 

MICHAEL LANE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Drum, Ryan S.

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.