Source: https://va-claim.com/2018/10/22/a-100-percent-schedular-rating-is-granted-for-posttraumatic-stress-disorder-ptsd-special-monthly-compensation-smc-is-granted-at-the-housebound-rate-under-38-u-s-c-%C2%A7-1114s-citation-nr/
Timestamp: 2019-04-22 16:31:22+00:00

Document:
A 100 percent schedular rating is granted for posttraumatic stress disorder (PTSD).
Special monthly compensation (SMC) is granted at the housebound rate under 38 U.S.C. § 1114(s).
1. The evidence is at least in equipoise as to whether the Veteran’s PTSD symptoms cause total occupational and social impairment.
2. By this decision, the Veteran is being granted a total (100 percent) rating for PTSD; he has additional disabilities independently ratable at 60 percent, separate and distinct from PTSD and involving different bodily systems.
1. The criteria for a 100 percent schedular rating for PTSD have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10. 4.130, Diagnostic Code (DC) 9411.
2. The criteria for an award of SMC at the housebound rate have been met.  38 U.S.C. §§ 1114(s); 38 C.F.R. § 3.350(i).
The Veteran served on active duty in the U.S. Air Force from May 1984 to April 1988.  He also served on active duty in the U.S. Army from April 1988 to November 2005, to include service in Southwest Asia.
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an April 2018 rating decision.
On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55 (to be codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017), also known as the Appeals Modernization Act (AMA).  This law creates a new framework of review for Veterans dissatisfied with VA’s decision on their claim(s).  The Veteran chose to participate in BEAAM, the Board of Veterans’ Appeals (Board’s) Early Applicability of Appeals Modernization research program.  This decision has been prepared consistent with the new AMA framework.
1. Entitlement to a rating in excess of 70 percent for PTSD.
The Veteran contends that his PTSD should be rated 100 percent disabling.
Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4.  The percentage ratings are based on the average impairment of earning capacity as a result of a service-connected disability, and separate diagnostic codes identify the various disabilities and criteria for specific ratings.  38 U.S.C. § 1155; 38 C.F.R. § 4.1.
If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates criteria for that rating; otherwise, the lower rating will be assigned.  38 C.F.R. § 4.7.  All reasonable doubt as to the degree of disability is resolved in favor of the claimant.  38 U.S.C. § 5107(b); 38 C.F.R. § 4.3.
Psychiatric disabilities are rated based on the General Rating Formula codified in 38 C.F.R. § 4.130, which provides disability ratings based on a spectrum of symptoms.  “A veteran may qualify for a given disability rating by demonstrating the particular symptoms associated with that percentage, or others of a similar severity, frequency, and duration.”  Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013).  VA must consider all symptoms of a claimant’s condition that affect the level of occupational and social impairment, including, if applicable, those identified in the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (4th ed. 1994) (DSM-IV) and (5th ed. 2013) (DSM-5).  See Mauerhan v. Principi, 16 Vet. App. 436, 442-43 (2002).
Under the General Rating Formula, the criteria for 100 percent rating are as follows: Total occupational and social impairment, due to such symptoms as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.  38 C.F.R. § 4.130, DC 9411.
Resolving reasonable doubt in the Veteran’s favor, the Board finds that his PTSD symptoms most closely approximate the criteria required for a 100 percent rating.  The Veteran underwent a VA examination in April 2018.  The examiner indicated that symptoms associated with the Veteran’s PTSD caused total occupational and social impairment.  In so doing, the examiner noted the presence of symptoms of persistent delusions or hallucinations, intermittent inability to perform activities of daily living, disorientation to time or place, and memory loss for names of close relatives, own occupation, or own name; all of which are enumerated in the DC as examples of symptoms that might warrant a 100 percent rating.
Subjectively, the Veteran reported being encouraged to leave his job in February 2018, after he experienced significant problems completing his work due to difficulties with focusing and remembering tasks.  He also reported memory problems with instances of, for example, losing his vehicle and forgetting that he had already taken medications; loss of interest in intimacy, causing great difficulty in his self-worth and marital relationship; having no social relationships apart from his family; no longer attending church; and becoming increasingly socially isolated.
Based on the severity of the Veteran’s symptoms, the Board finds that a 100 percent schedular rating is appropriate.  The evidence, at minimum, gives rise to a reasonable doubt on the matter.  38 C.F.R. § 4.3.
2. Entitlement to special monthly compensation at the housebound rate under 38 U.S.C. 1114(s).
A claimant is generally presumed to be seeking the maximum possible award of compensation in relation to his/her appeal.  See AB v. Brown, 6 Vet. App. 35, (1993).  As such, it is appropriate for the Board to consider and grant SMC at the housebound rate.
Under 38 U.S.C. § 1114(s), SMC is payable at the housebound rate if the Veteran has a single service-connected disability rated as 100 percent and either of the following are met: (1) there is additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems; or (2) he is permanently housebound by reason of service-connected disability or disabilities. 38 U.S.C. 1114(s); 38 C.F.R. § 3.350(i).
By this decision, the Veteran is being granted a total (100 percent) rating for PTSD.  His additional disabilities, to include sinusitis, gout, thoracolumbar spine degenerative disc disease, and cervical spine degenerative disc disease, are independently ratable at 60 percent, separate and distinct from PTSD and involving different bodily systems.  As such, the criteria for an award of SMC at the statutory housebound rate have been met.

References: § 1114
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 § 1155
 § 4
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 § 5107
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 § 1114
 § 3