BVA9506421 DOCKET NO. 92-18 632 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Buffalo, New York THE ISSUE Entitlement to an increase in the 50 percent evaluation currently assigned for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARINGS ON APPEAL The veteran, M. O'Connor and T. Rhodes ATTORNEY FOR THE BOARD Christopher Maynard, Associate Counsel INTRODUCTION The veteran had active service from November 1965 to December 1967. This matter comes before the Board of Veterans' Appeals on appeal from a July 1988 rating decision which granted service connection for PTSD and assigned a 10 percent evaluation. The veteran disagreed with the rating assigned and a subsequent rating action dated in October 1989, granted an increased rating to 30 percent, effective to the date of the original claim. The veteran again disagreed with the rating assigned and, by rating action dated in September 1990, was granted an increased rating to 50 percent. A personal hearing was conducted at the RO in September 1991. In October 1993, the Board remanded the case to the RO for additional development. In light of the decision below, the issue of entitlement to a total rating for compensation purposes based on individual unemployability, which had been developed and certified to the Board for appellate review, is now moot. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that his service connected PTSD is more severe than is reflected by the 50 percent evaluation currently assigned. The veteran argues that he has been unemployed since 1986 and is unable to maintain any type of gainful employment because of his psychiatric problems. 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(s). 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 preponderance of the evidence favors the grant of an increased schedular rating to 100 percent for PTSD. FINDING OF FACT The veteran's service connected PTSD is productive of severe disablement and probably renders him unemployable. CONCLUSION OF LAW The schedular criteria for an increased evaluation to 100 percent for PTSD are met. 38 U.S.C.A. § § 1155, 5107, 7104 (West 1991); 38 C.F.R. § § 4.3, 4.7, 4.10, 4.16(c), 4.132, Code 9411 (1994). REASONS AND BASES FOR FINDING AND CONCLUSION The Board notes that the veteran's claim is well grounded within the meaning of § 5107, and is satisfied that all relevant facts have been properly developed in accordance with this law. The evidentiary record indicates that the veteran was first hospitalized for psychiatric problems at a VA hospital beginning in 1986 and has received outpatient treatment from VA since 1987. When examined by VA in May 1988 the veteran reported that he had difficulty sleeping and was anxious and hyper-alert. When he could sleep, the veteran experienced nightmares relating to his Vietnam experiences and had night sweats. During the day, he reported flashbacks and panic attacks, occasionally losing contact with reality. The veteran reported that he had been unemployed since 1985 and was collecting Social Security disability benefits. He denied using drugs. The diagnosis was PTSD, chronic, delayed. Similar findings were noted on VA examinations in 1989, 1990 and 1991. On VA examination in September 1989, the veteran reported that his concentration and affect was erratic and his socialization was poor. The veteran reported that he stayed home most of the time and had difficulty relating to people. He again denied the use of drugs and reported that he had not used alcohol for 12 years. He reported experiencing panic attacks about five times a week and that he loses contact with reality for a couple of minutes when under the influence of flashbacks. The veteran reported that he had a low frustration tolerance and could not take the pressure of his job. He reported that he had about 25 jobs from the time of his discharge from service in 1967 until 1985. The diagnoses included PTSD, chronic, delayed and panic disorder. When examined by VA in June 1990, the veteran reported that he was separated from his wife and in the process of getting a divorce. He stated that he is easily angered and has broken the phone a couple of times, but did not physically harm any members of his family. The veteran reported that he loses contact with reality for anywhere from 10 minutes to 2 hours while under the influence of flashbacks and that he occasionally runs across the yard during panic attacks. The examiner indicated that the veteran showed signs of severe impairment of social and industrial adaptation. The diagnosis was unchanged. On VA examination in September 1991, the veteran reported mood swings and did not want to be around people. He reported outbursts of anger and stated that he had punched 2 people during the summer. He reported increased problems with flashbacks, intrusive thoughts during Operation Desert Storm. His appetite was erratic and his concentration was impaired while under the influence of intrusive thoughts. The examiner noted that the veteran was making only marginal adjustment in the community. The diagnosis was PTSD, chronic, delayed. At the direction of the Board, the veteran was examined by VA in April and June 1994. On the April examination, the veteran reported survival guilt and sleep disturbance, indicating that he slept only about 3 to 4 hours a night. He reported constant nightmares, flashbacks and that his concentration was poor. The veteran indicated that his appetite was poor and that he had lost 40 pounds in the last five years. He reported that he was hyper- alert and that loud noises bothered him. The examiner indicated that the veteran showed very poor social and industrial adaptation and was making only marginal adaptation in the community. In an addendum to the April 1994 VA examination report (dated in September 1994), the examiner stated that the veteran was not capable of being trained for employment and was unable to hold a job. Although the examiner reported that a GAF score was somewhere around 60, he stated that the veteran's PTSD was severe and opined that the veteran could not be gainfully employed. Similar findings were noted on the June 1994 VA psychiatric examination; however, the examiner did not report a GAF score, nor was an opinion offered as to the severity of the veteran's PTSD. In summary, the evidentiary record shows that the veteran's psychoneurotic symptoms are totally incapacitating and render him unable to obtain or retain employment. The medical records show increased symptoms manifested by heightened anxiety, depression and isolation. The veteran's frustration tolerance is low and it appears that he is more easily angered in recent years. The veteran has had some 25 jobs since his discharge from service in 1967 and has been unemployed since 1985. The VA examiner indicated that the veteran showed severe social and industrial inadaptability when examined in September 1991 and the same examiner reported that the veteran's PTSD was severe when examined in April 1994 and that he could not be gainfully employed. A finding of severe disability under Diagnostic Code 9411 equates to a 70 percent evaluation. However, as the veteran's only service connected disability is PTSD, and the examiner indicated that the veteran was unemployable, § 4.16(c) provides that a 100 percent schedular evaluation shall be assigned. Accordingly, it is the decision of the Board that an increased schedular evaluation to 100 percent for PTSD is warranted. ORDER An increased schedular rating to 100 percent for PTSD is granted, subject to VA laws and regulations concerning the payment of monetary benefits. BARBARA B. COPELAND 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.