BVA9503943 DOCKET NO. 92-03 454 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUE Entitlement to an increased rating for schizophrenia, currently evaluated as 50 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD J. Andrew Ahlberg, Associate Counsel INTRODUCTION The veteran served on active duty from June 1980 to April 1985 and from August 1986 to January 1988. This case comes before the Board of Veterans' Appeals (hereinafter Board) on appeal from adverse rating action by the Chicago, Illinois, Regional Office (hereinafter RO). The development requested by the Board in the December 1992 remand has been accomplished and the RO increased the disability rating for the veteran's service connected schizophrenia from 30 percent disabling to 50 percent disabling in a September 1993 rating decision. CONTENTIONS OF APPELLANT ON APPEAL It is essentially contended that although the disability rating for the veteran's schizophrenia has been increased to 50 percent, a further increase in the disability rating to 70 percent is warranted. In addition, it is contended that because the criteria for a 70 percent rating for the veteran's schizophrenia are met, a 100 percent schedular evaluation under 38 C.F.R. § 4.16(c) is also warranted. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that there is sufficient evidence to support the assignment of a 100 percent disability rating for the veteran's schizophrenia. FINDINGS OF FACT 1. All relevant available evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The veteran's schizophrenia results in severe industrial impairment and precludes the veteran from securing or following a substantially gainful occupation. CONCLUSION OF LAW The criteria for a 100 percent rating for schizophrenia are met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.16(c), 4.129, 4.130, 4.132, Diagnostic Code (DC) 9203 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Board finds that the veteran has presented sufficient evidence to conclude that his claim is "well-grounded" within the meaning of 38 U.S.C.A. § 5107(a). The Board is also satisfied that the duty to assist mandated by 38 U.S.C.A. § 5107(a) has been fulfilled as there is enough evidence of record to make an equitable decision in the veteran's appeal. In adjudicating a well-grounded claim, the Board determines whether (1) the weight of the evidence supports the claim or, (2) the weight of the "positive" evidence in favor of the claim is in relative balance with the weight of the "negative" evidence against the claim: The veteran prevails in either event. However, if the weight of the evidence is against the veteran's claim, the claim must be denied. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet.App. 49 (1990). Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C.A. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a reasonable doubt as to the degree of disability, such doubt shall be resolved in favor of the claimant, and 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. 38 C.F.R. §§ 3.102, 4.3, 4.7. In addition, the Board will consider the potential application of the various other provisions of 38 C.F.R., Parts 3 and 4, whether or not they were raised by the veteran, as well as the entire history of the veteran's disorder in reaching its decision, as required by Schafrath v. Derwinski, 1 Vet.App. 589 (1991). Considerable impairment of social and industrial adaptability resulting from schizophrenia warrants a 50 percent disability rating. Severe impairment of social and industrial adaptability caused by schizophrenia warrants a 70 percent disability rating. Active psychotic manifestations of schizophrenia of such extent, severity, depth, persistence or bizarreness as to produce total social and industrial inadaptability warrant a 100 percent evaluation. The regulations relating to unemployability are not for application in cases in which the only compensable service- connected disability is a mental disorder assigned a 70 percent evaluation, and such mental disorder precludes the veteran from securing or following a substantially gainful occupation. In such cases, the mental disorder shall be assigned a 100 percent schedular evaluation under the appropriate diagnostic code. 38 C.F.R. § 4.16(c). Applying the provisions of 38 C.F.R. § 4.16(c) outlined above to the instant case, we note that the veteran's schizophrenia is his only service connected disability. Furthermore, based on our review of the clinical evidence of record obtained subsequent to the December 1992 remand, the Board concludes that the veteran's disability picture describes severe impairment of social and industrial inadaptability, thus entitling him to a 70 percent evaluation under DC 9203. This conclusion is based in part on the fact that as a result of difficulties associated with the service connected schizophrenia, the veteran has been living under the supervision of others since November 1990 in a boarding house. This supervision has included managing the veteran's funds. In addition, the reports from the most recent VA psychiatric examination conducted in March 1993 indicated that the veteran was complaining about auditory hallucinations and that his thought content revealed paranoid thinking. The August 1993 social work service report indicated the veteran was unemployed and had no friends outside the boarding house. As is discussed below, the evidence of record indicates that the veteran's ability to work has been significantly impaired by symptoms of schizophrenia. This evidence supports the assignment of a 70 percent disability rating as under 38 C.F.R. § 4.130, disability ratings for psychiatric disorders such as schizophrenia are to be based on the degree to which symptoms affect social and industrial adaptability (social inadaptability is to be evaluated only as it affects industrial inadaptibility under 38 C.F.R. § 4.129). 38 C.F.R. § 4.130 also provides that two of the most important determinants of disability are time lost from gainful work and diminished work efficiency. The Board concludes that at a minimum, the weight of the "positive" evidence summarized above and the "negative" evidence relevant to the issue of whether there is "severe" impairment of social and industrial inadaptability associated with the veteran's schizophrenia is in relative balance. Therefore, the Board concludes that a 70 percent rating for schizophrenia under DC 9203 is warranted. Gilbert, 1 Vet. App. at 49. While the Board finds that the criteria for a 100 percent disability rating enumerated under DC 9203 are not met, it concludes that the veteran is entitled to a 100 percent schedular rating under the provisions of 38 C.F.R. § 4.16(c). The most recent evidence of record indicates that the veteran is unemployed, and that he has had no steady employment since 1990. The evidence of record suggests that the veteran's schizophrenia, manifested by such symptoms as hallucinations in which the veteran hears voices, has played a significant role in his inability to secure or maintain gainful employment. This disability requires a significant amount of antipsychotic medication and as mentioned above has forced the veteran to live in a boarding house. His disability also requires frequent sessions with clinical social workers in order to cope with the stresses of daily life. Given this evidence and applying the provisions of 38 U.S.C.A. § 5107 and 38 C.F.R. § 3.102 regarding reasonable doubt as required by Gilbert, 1 Vet.App. at 49, the Board concludes that there is sufficient evidence of record to warrant a 100 percent disability rating. ORDER A 100 percent disability rating for schizophrenia is granted, subject to regulations governing the payment of monetary benefits. HOLLY E. MOEHLMANN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.