BVA9500278 DOCKET NO. 93-07 602 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Providence, Rhode Island THE ISSUE Entitlement to an evaluation in excess of 50 percent for post- traumatic stress disorder from May 31, 1990, to January 14, 1992. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Jeffrey J. Schueler, Associate Counsel INTRODUCTION The veteran served on active duty from May 1970 to March 1973. The issue certified to the Board of Veterans' Appeals (Board) was entitlement to an earlier effective date of the grant of a total schedular evaluation for post-traumatic stress disorder (PTSD). A review of the claims folder reveals, however, that the veteran expressed disagreement with the regional office's (RO's) March 1991 rating decision granting service connection for PTSD and assigning a 50 percent evaluation effective May 31, 1990, the date the claim for service connection was received by the VA. This appeal was subsequently perfected. But in a March 1992 rating decision the RO assigned a total evaluation under 38 C.F.R. § 4.29 (1993) for a period of hospitalization, effective from January 15, 1992, the date of entry into the hospital, and determined that the total evaluation was to be returned to 50 percent disabling effective March 1, 1992, after the veteran's discharge from the hospital. Then in a subsequent May 1992 rating decision, the RO assigned a total schedular evaluation effective from March 1, 1992. Although the RO treated the veteran's representative's June 1992 statement as a notice of disagreement with the May 1992 rating decision, it properly is considered an argument in the still active appeal of the March 1991 rating decision assigning a 50 percent evaluation. Because the RO granted a total rating effective January 15, 1992, thereby in part granting the benefit sought by the veteran (an evaluation in excess of 50 percent), the issue is as stated on the title page of this decision. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that the symptomatology associated with the PTSD disability prior to the assignment of a 100 percent schedular evaluation effective January 15, 1992, was of such severity so as to warrant an evaluation in excess of 50 percent. He maintains that results of the VA psychiatric examinations in January and October 1991 support a total evaluation, and that the March 1991 rating action granting service connection and assigning a 50 percent evaluation disregarded the results of this examination. The veteran further contends "that it is difficult to understand the difference" between that the results of the February 1992 VA medical facility discharge summary, which the RO used as a basis for the grant of a total evaluation, and the results of the earlier January 1991 VA psychiatric examination. 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 preponderance of the evidence is in favor of a 100 percent evaluation for PTSD from May 31, 1990, to January 14, 1992. FINDING OF FACT 1. The veteran's PTSD symptomatology is manifested by virtual isolation from the community, depression, nightmares, flashbacks, intrusive thoughts, hypervigilance, and inability to obtain or retain employment. 2. The veteran's PTSD resulted in total incapacitation from May 31, 1990, to January 14, 1992. CONCLUSION OF LAW The criteria for a 100 percent evaluation for PTSD from May 31, 1990, to January 14, 1992, are met. 38 U.S.C.A. §§ 1155, 5107(a) (West 1991); 38 C.F.R. §§ 3.321(b)(1), 4.7, 4.10, 4.129, 4.130, 4.132, Diagnostic Code 9411 (1993). REASONS AND BASES FOR FINDING AND CONCLUSION The Board initially finds that the appellant's claims are well- grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991); that is, they are not inherently implausible. We also find that the facts relevant to the issues on appeal are properly developed and that the Department of Veterans Affairs (VA) satisfied its statutory obligation to assist the veteran in the development of facts pertinent to the claims. Id. As noted above, the veteran served in the U.S. Army from May 1970 to March 1973 and in the Republic of Vietnam from November 1970 to November 1971. Copies of his service records associated with the claims folder show that the veteran was an infantryman during his service in Vietnam and received several decorations, including the National Defense Service Medal, Vietnam Service Medal, Vietnam Campaign Medal, and the Combat Infantryman's Badge. Disability evaluations are determined by application of a schedule of ratings based on average impairment of earning capacity. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4 (1993). The inquiry into disability evaluations centers on the ability of the body or system in question to function in daily life with specific reference to employment. 38 C.F.R. § 4.10 (1993). In evaluating claims for increased ratings, we must evaluate the veteran's condition with a critical eye towards the lack of usefulness of the body or system in question to self support. If a question arises as to which of two evaluations are to be assigned, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. 38 C.F.R. § 4.7 (1993). PTSD is rated under Diagnostic Code 9411. 38 C.F.R. § 4.132 (1993). A 50 percent rating may be assigned where the veteran's PTSD shows that the veteran's ability to establish or maintain effective or favorable relationships with people is considerably impaired and that by reason of psychoneurotic symptoms the reliability and efficiency levels are so reduced as to result in considerable industrial impairment. A 70 percent evaluation may be assigned where it is demonstrated that the ability to establish and maintain effective or favorable relationships with people is severely impaired, and the psychoneurotic symptoms are of such severity and persistence that there is severe impairment in the ability to obtain or retain employment. A 100 percent evaluation may be assigned where the attitudes of all contacts except the most intimate are so adversely affected as to result in virtual isolation in the community, where there are totally incapacitating psychoneurotic symptoms bordering on gross repudiation of reality with disturbed thought or behavioral processes associated with almost all daily activities such as fantasy, confusion, panic and explosions of aggressive energy resulting in profound retreat from mature behavior, and where the veteran is demonstrably unable to obtain or retain employment. 38 C.F.R. § 4.132 (1993) (emphasis added). Impairment of one's social and industrial skills indicates an inability to adapt to various social and industrial environments. In evaluating the veteran's social and industrial adaptability, we must look to "those abnormalities of conduct, judgment, and emotional reactions which affect economic adjustment, i.e., which produce impairment of earning capacity." 38 C.F.R. § 4.129 (1993). See also 38 C.F.R. § 4.1 (1993) ("The percentage rating represents as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupation."). Social inadaptability, reflecting the ability to establish healthy interpersonal relationships, is evaluated only as it affects industrial adaptability. 38 C.F.R. § 4.129 (1993). The Board must take care, however, not to underevaluate an emotionally sick veteran with a good work record. Emphasis is placed on the full report of the examiner, descriptive of actual symptomatology. 38 C.F.R. § 4.130 (1993). The evidence of record shows that the veteran was virtually isolated from his community during the pertinent period from May 1990 to January 1992. The examiner, who prepared the September 1990 VA PTSD report, wrote that the veteran revealed no peer relationships, that he lived alone and had never married, and that, although he had 10 siblings, those relationships did not appear to be consistently positive or a reliable source of support. The examiner at the January 1991 VA psychiatric examination concluded that the veteran was clearly unemployable and totally disabled. The examiner at the October 1991 VA psychiatric examination also reported that the veteran had no social activity and was "virtually isolated" in his home and that he was unable to work or function, and that the PTSD "interferes totally and completely with his life." The evidence of record also demonstrates that the veteran was unable to obtain or retain substantially gainful employment. The September 1990 VA PTSD report noted that the veteran was not working and had had 25 different jobs since discharge form service. The examiner at the January 1991 VA psychiatric examination wrote that the veteran had been out or work for 19 months; a VA psychologist noted in an August 1991 letter that the veteran had been unable to work for the previous 20 months; and the examiner at the October 1991 VA psychiatric examination reported that the veteran was unable to work. The September 1990 PTSD report shows that the veteran was generally frustrated and upset at the time of the examination, was tense, and had poor personal hygiene and bad posture that seemed to reflect what he felt inside. The VA examiners preparing the evidence of record have generally reported that the veteran was totally disabled and unable to work. The September 1990 VA examiner, as indicated, stated that the veteran was "totally disabled." The August 1991 VA psychologist wrote that the veteran was completely disabled for the previous 20 months. On the basis of findings of the VA medical personnel who have interviewed and observed the veteran, the Board is unable to conclude that the weight of the evidence is against a total rating for the period involved in this appeal. This decision, assigning a 100 percent evaluation from the date of the veteran's claim, is a total grant of the benefits sought on appeal. Consideration need not, therefore, be given to the potential application of the various provisions of 38 C.F.R. § 3.321(b)(1) (1993) as mandated in Schafrath v. Derwinski, 1 Vet.App. 589 (1991). ORDER Entitlement to a 100 percent evaluation for post-traumatic stress disorder from May 31, 1990, to January 14, 1992, is granted. JOHN E. ORMOND 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.