16-04 303

CourtBoard of Veterans' Appeals
DecidedJuly 30, 2019
Docket16-04 303
StatusUnpublished

This text of 16-04 303 (16-04 303) is published on Counsel Stack Legal Research, covering Board of Veterans' Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
16-04 303, (bva 2019).

Opinion

Citation Nr: 19159003 Decision Date: 07/30/19 Archive Date: 07/30/19

DOCKET NO. 16-04 303 DATE: July 30, 2019

ORDER

An initial rating of 70 percent, and no higher, for posttraumatic stress disorder (PTSD) is granted.

A total disability based on individual unemployability (TDIU) prior to July 7, 2015 is granted.

FINDINGS OF FACT

1. Resolving reasonable doubt in the Veteran’s favor, his PTSD symptoms have caused occupational and social impairment with deficiencies in most areas, but not total occupational and social impairment, since the grant of service connection.

2. Resolving reasonable doubt in the Veteran’s favor, PTSD precluded substantially gainful employment prior to July 7, 2015.

CONCLUSIONS OF LAW

1. The criteria for an initial rating of 70 percent, and no higher, for PTSD have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.1, 4.3, 4.7, 4.130, Diagnostic Code (DC) 9411.

2. The criteria for a TDIU prior to July 7, 2015 have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.1, 4.16.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from September 1949 to September 1953.

These matters are before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO), which granted for service connection for PTSD and assigned an initial 30 percent rating, effective April 25, 2013.

In an October 2015 rating decision, the RO awarded a 50 percent rating, effective July 7, 2015. In a January 2016 rating decision, the RO awarded a 70 percent rating for PTSD and also granted TDIU. Both awards were made effective July 7, 2015. An appeal was perfected from this rating decision.

The Board has recharacterized the higher rating issue as an initial rating claim. In July 2015, the Veteran filed a claim for a higher PTSD rating and a TDIU, but not a formal notice of disagreement. However, in September 2015 and November 2015, additional relevant evidence, in the form of VA treatment records, a medical opinion, and VA examination report were added to the file. Thus, although the appeal was not perfected from the initial rating decision, the new and material evidence must be considered as filed with the original claim. Accordingly, this appeal is characterized as an initial rating claim. See 38 C.F.R. § 3.156(b); see also Buie v. Shinseki, 24 Vet. App. 242, 252 (2010); Bond v. Shinseki, 659 F.3d 1362, 1368 (Fed. Cir. 2011).

The Board notes that the January 2016 statement of the case listed an issue on appeal as entitlement to an earlier effective date for a higher rating for PTSD. As discussed, a higher rating claim has been pending since the grant of service connection. As the entire rating period is subject to review, the effective date determination is part and parcel of the initial rating for PTSD that is currently on appeal and does not require separate adjudication. See Fenderson v. West, 12 Vet. App. 119, 126 (2001).

In May 2018, the Veteran testified at a videoconference hearing before one of the undersigned Veterans Law Judges (VLJ). Due to technical difficulties at that hearing, a transcript could not be produced. The Veteran therefore testified before a different undersigned VLJ on the same issue in November 2018. A copy of the transcript of the November 2018 hearing is of record.

Generally, a VLJ who conducts a hearing must participate in making the final determination of the claim involved. 38 U.S.C. § 7107(c); 38 C.F.R. § 20.707. By law, appeals may be assigned only to an individual VLJ or to a panel of not less than three members. 38 U.S.C. § 7102(a). Accordingly, a third VLJ, or in this case, an Acting VLJ, has been assigned to participate in a panel decision for this claim. The Veteran was offered another opportunity to testify before a third VLJ in May 2019 and waived this right in a written correspondence submitted in the same month. See Arneson v. Shinseki, 24 Vet. App. 379 (2011).

1. An initial rating of 70 percent for PTSD, and not higher, is granted.

Disability ratings are determined by applying a schedule of reductions in earning capacity from specific injuries or a combination of injuries that is based upon the average impairment of earning capacities. 38 U.S.C. § 1155. Each disability must be viewed in relation to its entire history, with emphasis upon the limitations proportionate to the severity of the disabling condition. 38 C.F.R. § 4.1. When rating the Veteran’s service-connected disability, the entire medical history must be reviewed. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of the two disability evaluations is 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. Where the question for consideration is the propriety of the initial evaluation assigned, evaluation of the medical evidence since the grant of service connection and consideration of the appropriateness of “staged rating” is required. Fenderson v. West, 12 Vet. App. 119, 126 (1999).

Service connection for PTSD was granted in a July 2015 rating decision. An initial 30 percent rating was assigned effective April 25, 2013, pursuant to 38 C.F.R. § 4.130, DC 9411. As previously noted, the appeal stems from this rating action.

While the appeal was pending, in an October 2015 rating decision, the RO awarded a 50 percent rating, effective July 7, 2015. In a January 2016 rating decision, the RO awarded a 70 percent rating, effective July 7, 2015. The Veteran seeks a higher rating.

Under the General Rating Formula for Mental Disorders, a 70 percent rating is warranted where objective evidence demonstrates occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, 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 work-like setting); inability to establish and maintain effective relationships. Id.

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Related

Bond v. SHINSEKI
659 F.3d 1362 (Federal Circuit, 2011)
Sterling T. Rice v. Eric K. Shinseki
22 Vet. App. 447 (Veterans Claims, 2009)
Robert H. Arneson v. Eric K. Shinseki
24 Vet. App. 379 (Veterans Claims, 2011)
Schafrath v. Derwinski
1 Vet. App. 589 (Veterans Claims, 1991)
Hatlestad v. Brown
5 Vet. App. 524 (Veterans Claims, 1993)
Fenderson v. West
12 Vet. App. 119 (Veterans Claims, 1999)
Buie v. Shinseki
24 Vet. App. 242 (Veterans Claims, 2010)

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Bluebook (online)
16-04 303, Counsel Stack Legal Research, https://law.counselstack.com/opinion/16-04-303-bva-2019.