BVA9501490 DOCKET NO. 93-06 617 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Togus, Maine THE ISSUE Entitlement to a disability rating in excess of 50 percent for a neurosis, including entitlement to a 100 percent rating pursuant to the provisions of 38 C.F.R. § 4.16(c) (1993). REPRESENTATION Appellant represented by: Maine Bureau of Veterans Services ATTORNEY FOR THE BOARD L. B. Wirt, Associate Counsel INTRODUCTION The veteran served on active duty from May 1944 to December 1945. This appeal arises from an April 1992 rating decision of the Department of Veterans Affairs (VA) Togus, Maine, Regional Office (RO), which denied the veteran entitlement to a increased disability rating for his service-connected nervous condition. The psychiatric disorder is classified by the RO for rating purposes as anxiety neurosis with habitual excessive drinking. CONTENTIONS OF THE APPELLANT ON APPEAL It is contended in substance that the psychiatric disorder is 100 percent disabling and that reasonable doubt should be resolved on the veteran's behalf. 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 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 the evidence supports granting a 100 percent rating for anxiety neurosis with habitual excessive drinking pursuant to the provisions 38 C.F.R. § 4.16(c) (1993). FINDINGS OF FACT 1. All relevant evidence necessary for the disposition of the veteran's appeal has been obtained by the RO. 2. The veteran's service connected neurosis with habitual excessive drinking produces severe social and industrial impairment and precludes the veteran from securing or following a substantially gainful occupation. CONCLUSIONS OF LAW 1. The schedular criteria for a 70 percent rating for a neurosis with habitual excessive drinking have been met. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4, Code 9400 (1993). 2. A 100 percent rating for a neurosis with habitual excessive drinking is warranted on the basis that the only compensable service connected disorder is a psychiatric disorder, meeting the requirements for a 70 percent schedular rating, and also results in unemployability. 38 C.F.R. § 4.16(c) (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Initially, the Board finds that the veteran's claim is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). The Board is also satisfied that all relevant evidence has been properly developed. Under these circumstances, there is no further duty to assist the veteran in order to comply with the duty to assist him as mandated by 38 U.S.C.A. § 5107(a) (West 1991). The veteran was hospitalized by the VA for respite care in May 1991. It was noted that he had sustained a left occipital intracerebral hemorrhage in 1986. The stroke left him with some degree of aphasia, although this had improved. He also had some dementia with significant memory deficit. The right hemiplegia which he had sustained at the time of the stroke had also largely resolved. He had been in stable health prior to his respite care. Diagnoses included anxiety neurosis with chronic depression, a history of chronic alcoholism, and cerebral vascular disease with previous hemorrhagic stroke associated with aphasia and dementia. In October 1991, the RO proposed to rate the veteran incompetent. The veteran offered no opposition to this following notification, and, in December 1991 he was rated incompetent by the RO. The veteran's wife, was thereafter appointed his fiduciary. VA outpatient treatment records from March 1990 to March 1992 make reference to the existence of an anxiety neurosis with depression but do not reflect specific therapy for it. In February 1992 it was noted that he was taking Nortriptyline. On VA psychiatric examination in July 1992 it was reported that the veteran had not worked since 1976. He had been employed by a railroad as a mechanic prior to that time. The veteran and his wife had 6 children, all of whom were grown. The veteran and his wife were reportedly living together, in a home left to the wife by her parents. It was further reported that the veteran had no license to drive, and had no friends or acquaintances outside the family. The veteran stopped drinking completely in 1986. According to the veteran's wife, he was restless and was observed to pace back and forth a good deal. She noted that he is tense 75 percent of the time and exhibits periods of depression for one or 2 hours per day. It was further reported that the veteran slept well, but that his memory was bad and was getting worse. Clinical findings on examination included moderate expressive aphasia, attributed to the earlier stroke. He did not know the day of the week, the month, or the year. He did not know the occupation of the examiner. He failed to comprehend some questions even though they were repeated several times. He was relevant and coherent, but sometimes was irrelevant and rambling. He appeared moderately tense and anxious. His insight was limited and his judgment was defective. The physician diagnosed a generalized anxiety disorder with depressive features and indicated that the degree of impairment was severe. He also diagnosed organic brain syndrome with dementia secondary to a left occipital intracerebral hemorrhage. He considered this disorder to result in pronounced impairment. He further expressed the opinion that the veteran was not employable due to either condition. In connection with the appeal, the veteran's wife submitted a lay statement to the effect that the veteran's mental state was bad, and a private medical statement showing diagnoses which included a mixed anxiety neurotic disorder. There was a subsequent period of VA hospitalization for respite care from October 1992 to November 1992. Diagnoses included dementia secondary to cerebrovascular accident, anxiety neurosis and chronic depression. It was noted that the veteran was not employable. The evidence of record here is quite clear. The veteran has a severely disabling neurosis which is service-connected and a nonservice-connected organic brain syndrome which produces pronounced disability. In July 1992, based on an exceptionally through examination and review of the record, a VA psychiatrist stated that either condition rendered the veteran unemployable. There is no evidence to the contrary. The requirements for a 70 percent schedular rating have been met due to a neurosis which produces severe social and industrial impairment. The requirements for a 100 percent schedular rating are met because the only service connected disorder is a neurosis ratable at 70 percent disabling, which also produces unemployability. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4, 4.16(c), Code 9400 (West 1993). ORDER Entitlement to an increased rating for a neurosis including entitlement to a 100 percent rating pursuant to the provisions of 38 C.F.R. § 4.16(c) (1993) is granted subject to laws and regulations governing the payment of monetary awards. BRUCE E. HYMAN 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.