BVA9500677 DOCKET NO. 93-06 477 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in San Juan, Puerto Rico THE ISSUE Entitlement to an increased rating for service-connected schizophrenia, currently rated as 70 percent disabling. REPRESENTATION Appellant represented by: American Red Cross ATTORNEY FOR THE BOARD A. S. Nemeth, Associate Counsel INTRODUCTION The veteran's active service extended from November 1973 to December 1977 and from April 1981 to November 1982. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 1991 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, Puerto Rico, which implemented an earlier Board decision granting the veteran a 70 percent disability rating for his service-connected schizophrenia. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he is entitled to a 100 percent disability rating due to total social and industrial inadaptability. 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 the evidence supports the claim for a 100 percent rating for service-connected schizophrenia. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained. 2. The veteran has schizophrenia which is manifested by symptoms which produce total social and industrial inadaptability. CONCLUSION OF LAW The veteran's service-connected schizophrenia meets the schedular criteria for a 100 percent disability rating. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. Part 4 Code 9203 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, the veteran has presented a claim which is plausible. All relevant facts have been properly developed. No further assistance to the veteran is required to comply with the duty to assist as mandated by 38 U.S.C.A. § 5107(a). A letter was submitted in September 1991 from the veteran's fee basis psychiatrist. The doctor found that during his August 1991 appointment, the veteran was delusional with persecutory and referential ideas and very irritable with extreme anger due to paranoid feelings. She also stated that he has "low tolerance to frustration and poor control of impulses...he cannot function adequately in social and industrial environment[s]." From September 16 to October 4, 1991, the veteran was hospitalized in a VA medical center, the records of which are attached to the claims file. Undated notes, presumably admission notes, reveal that the veteran, prior to admission, had threatened his neighbor with a knife because he heard him laughing at and talking about him. The admitting physician further noted that the veteran was "being admitted to prevent further deterioration from his mental condition." Treatment records dated September 17, 1991 state that he was admitted due to "problems with neighbors secondary to delusions of reference and persecution, also refers to hearing voices telling him to harm himself or others." September 19 treatment notes show the veteran to be rational, logical, mildly hyperactive, and anxious, with referential ideations and auditory hallucinations. The discharge papers diagnosed the veteran as follows: Axis I - Schizophrenia, chronic paranoid type; Axis II - None; Axis III - High blood pressure, inguinal hernia, low back pain, patellar osteophyte; Axis IV - Moderate; Axis V - 50. Also attached to the claims file is a report of an August 1992 VA examination. The examining physician described the veteran as having relevant, coherent, but illogical responses. It was indicated that the content of his responses revealed marked persecutory and referential ideas, which in turn caused the veteran to have minimal tolerance to frustration or control over his aggressiveness. He was said to be prone to impulsive and aggressive reactions. The veteran was found to have various ideas coming to mind, including, homicidal ideas and ideals of self-harm. He presented inappropriate affect and a hyperactive, restless, and depressed mood. It was further indicated that the veteran's judgment and insight were very poor. The examining psychiatrist diagnoses were as follows: Axis I - Schizophrenic disorder undifferentiated type with paranoid features, with acute exacerbation of symptoms; Axis II - None; Axis III - See medical records; Axis IV - Psychosocial stressors - not specified; Axis V - Level of functioning - very poor. When rating a veteran under Diagnostic Code 9203, Schizophrenia, paranoid type, a 100 percent rating will be granted if the veteran experiences active psychotic manifestations of such extent, severity, depth, persistence or bizarreness as to produce total social and industrial inadaptability; a 70 percent rating will be granted for lesser symptomatology such as to produce severe impairment of social and industrial adaptability; and a 50 percent rating will be granted for considerable impairment of social and industrial adaptability. 38 U.S.C.A § 1155 (West 1991); 38 C.F.R. Part 4, Code 9203 (1993). The VA must consider all of the evidence when deciding a claim for an increased rating. If the evidence supports the veteran's claim, then the claim will be allowed. Likewise, if the evidence is in equipoise, that is, equally balanced, the benefit of the doubt will apply to the veteran and the claim will be allowed. 38 U.S.C.A. § 5107(b) (West 1991); Gilbert v. Derwinski, 1 Vet.App. 49 (1990). The veteran has been found to be experiencing active psychotic manifestations, which include auditory hallucinations, fear, paranoia, homicidal and suicidal ideas, impulsiveness and aggressiveness, and an inability to relate to people. The Board finds that the preponderance of the evidence supports the assignment of a 100 percent disability rating. There is nothing in the record to suggest that this condition has improved or is anything short of totally disabling. The Board finds that the veteran's service-connected schizophrenia is of such severity so as to produce total social and industrial inadaptability. The record, as it now stands, supports a 100 percent disability rating for service-connected schizophrenia. ORDER A 100 percent disability rating for the service-connected schizophrenia is granted, subject to the law and regulations governing the payment of monetary awards. JOAQUIN AGUAYO-PERELES 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.