POSTTRAUMATIC STRESS DISORDER (PTSD)

Summary

The veteran, who served in the U.S. Army from November 1964 to November 1967, was represented by his surviving spouse following his death in February 2020. The veteran appealed the denial of service connection for PTSD and sought entitlement to TDIU. The Board granted an initial rating of 70 percent for PTSD, finding that the severity, frequency, and duration of the veteran's symptoms, including suicidal ideation, obsessional symptoms, and difficulty maintaining relationships, more closely approximated the criteria for this rating. The Board considered the veteran's testimony, lay statements from his wife, and multiple VA examinations and treatment records. While some evidence suggested significant cognitive and memory deficits, the Board found these were not clearly related to service-connected conditions. The TDIU claim was denied. Although the veteran met the schedular criteria for TDIU (70% combined rating with a 70% PTSD rating), the Board found the evidence did not demonstrate that his service-connected disabilities rendered him unable to secure or follow substantially gainful employment. The Board cited the veteran's varied work history, lack of physical limitations, and inconsistent reports regarding unemployability. The Board found the preponderance of the evidence weighed against a finding of unemployability solely due to service-connected disabilities, thus the benefit of the doubt doctrine did not apply to the TDIU claim.

Rationale

Severity, frequency, and duration of symptoms approximated 70% criteria; Suicidal ideation, obsessional symptoms, and poor relationships noted; Preponderance of evidence weighed in favor of 70% rating

Full Decision Text

Citation Nr: 21017012
Decision Date: 03/24/21	Archive Date: 03/24/21

DOCKET NO. 15-20 822
DATE: March 24, 2021

ORDER

Entitlement to an initial rating of 70 percent, but no higher, for post-traumatic stress disorder (PTSD) is granted.

Entitlement to a total disability rating based on individual unemployability (TDIU) is denied.

FINDINGS OF FACT

1. During the entire period on appeal, the Veteran’s PTSD manifested by an occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.

2. During the period on appeal, the Veteran was not precluded from engaging in substantially gainful employment due to his service-connected disabilities. 

CONCLUSIONS OF LAW

1. The criteria for entitlement to a 70 percent rating, but no higher, for PTSD have been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, Diagnostic Code 9411.

2. The criteria for entitlement to TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.15, 4.16.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from November 1964 to November 1967.  

This appeal comes before the Board of Veterans’ Appeals (Board) from an April 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  The Veteran died in February 2020. The appellant is the Veteran's surviving spouse; she has been substituted for the Veteran pursuant to 38 U.S.C.A. § 5121A .

In December 2018, the Veteran testified at a video conference before the undersigned Veterans Law Judge. A transcript of the hearing is available in the record.

These matters were previously remanded in April 2019 for further development, to include requesting the Agency of Original Jurisdiction (AOJ) to provide the Veteran with notice, obtain VA treatment records, and obtain a VA examination. Unfortunately, the Veteran passed away before the VA examination could take place. However, the evidence of record is sufficient to render a decision as to the merits of the claims. Thus, the Board finds that its remand instructions were substantially complied with. Stegall v. West, 11 Vet. App. 268 (1998).

Increased Rating

Disability evaluations are determined by the application of VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. This Rating Schedule is primarily a guide in the rating of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and their residual conditions in civil occupations. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. For the application of this schedule, accurate and fully descriptive medical examinations are required, with emphasis upon the limitation of activity imposed by the disabling condition. Over a period of many years, a veteran’s disability claim may require re-ratings in accordance with changes in laws, medical knowledge and his or her physical or mental condition. It is essential, both in the examination and in the evaluation of disability, that each disability be viewed in relation to its history. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

It is the responsibility of the rating specialist to interpret reports of examination in the light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability present. 38 C.F.R. § 4.2. Consideration of factors wholly outside the rating criteria constitutes error as a matter of law. Massey v. Brown, 7 Vet. App. 204, 207-08 (1994).

The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).

Under the General Formula for Mental Disorders (General Formula), the Board must conduct a “holistic analysis” that considers all associated symptoms, regardless of whether they are listed as
2. Consideration of factors wholly outside the rating criteria constitutes error as a matter of law. Massey v. Brown, 7 Vet. App. 204, 207-08 (1994).

The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).

Under the General Formula for Mental Disorders (General Formula), the Board must conduct a “holistic analysis” that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017). “[T]he presence or lack of evidence of a specific sign or symptom listed in the evaluation criteria is not necessarily dispositive of any particular disability level.” Id. at 22. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013).

Under the General Formula, including for PTSD (Diagnostic Code 9411), a noncompensable rating is assigned when a mental condition has been formally diagnosed, but symptoms are not severe enough to either require continuous medication, or to interfere with occupational and social functioning.

A 50 percent rating is assigned when symptoms such as flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity.

A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.

A 100 percent rating is assigned when symptoms such 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; or memory loss for names of close relatives, own occupation or own name cause total occupational and social impairment.

It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case with all reasonable doubt to be resolved in favor of the claimant. However, the reasonable doubt rule is not a means for reconciling actual conflict or a contradiction in the evidence. 38 C.F.R. § 4.3.

1. Entitlement to an initial rating of 70 percent, but no higher, for post-traumatic stress disorder (PTSD) is granted. 

The appellant contends the Veteran was entitled to a higher initial rating greater than 30 percent, for his service-connected PTSD.

A December 2001 VA treatment record noted the Veteran was always tired; had lost interest in all activities; had sleep disturbances; had decreased energy; feelings of guilt and worthlessness; difficulty concentrating, thinking, and focusing; was unable to handle crowds or large groups; experienced hypervigilance; and experienced violent and explosive episodes. He also exhibited anxiety, depression, low endurance, sensitivity to strange and unusual noises, and did not adjust well. He had intrusive thoughts and nightmares. He socially isolated and tried to live away from people. He was unable to maintain friendships even with his combat buddies.

The Veteran underwent a VA examination in May 2002. The Veteran reported he had intrusive memories daily and nightmares every night. He further reported having flashbacks daily since he filed his VA claim. The VA examiner indicated that he believed the frequency of the symptoms reported to be exaggerated as he had never reported them at that frequency in the past. The VA examiner further stated it would be unusual given the nature and the extent of the reported stressors
ance; and experienced violent and explosive episodes. He also exhibited anxiety, depression, low endurance, sensitivity to strange and unusual noises, and did not adjust well. He had intrusive thoughts and nightmares. He socially isolated and tried to live away from people. He was unable to maintain friendships even with his combat buddies.

The Veteran underwent a VA examination in May 2002. The Veteran reported he had intrusive memories daily and nightmares every night. He further reported having flashbacks daily since he filed his VA claim. The VA examiner indicated that he believed the frequency of the symptoms reported to be exaggerated as he had never reported them at that frequency in the past. The VA examiner further stated it would be unusual given the nature and the extent of the reported stressors. The Veteran also reported avoidance such as avoiding things that remind him of the war and hunting. The VA examiner further stated the Veteran exhibited feelings of detachment and estrangement from others, but that the detachment and estrangement predated his military service. The Veteran reported sleep disturbances and irritability. He also reported problems with concentration and hypervigilance although the examiner indicated it is not clear that his Vietnam experiences accounts totally for these experiences. 

The Veteran underwent a VA examination in May 2002. The results of the Veteran’s mental status was that he was oriented to all spheres, his memory was intact, his mood was moderately depressed and irritable, his thinking was logical, sequential, and goal directed, there was no evidence of paranoid ideations of bizarre thinking or behavior, but there was so question as to the adequacy of his judgment. The Veteran filed a correction to his VA examination and indicated he experienced intrusive thoughts about Vietnam weekly and monthly instead of daily.

A May 2002 lay statement by the Veteran’s wife indicated the Veteran always sat with his back to the wall. He would be paranoid in crowds and did not like to be around people. He was very anti-social and wanted to be left alone. She further reported that the Veteran had a temper. She has witnessed the Veteran experience nightmares, night sweats, flashbacks, low self-esteem, temper, and alienation. He was also depressed and unable to concentrate.

A January 2003 VA treatment indicated the Veteran underwent a mental status examination. The Veteran appeared suspicious; with a neat appearance; exhibited average intelligence; had a flat affect; used appropriate speech; was oriented to time, place, and person; had memory was normal; his judgment was good; and his motor activity was tense. The box for delusions was checked yes but hallucinations and disordered thinking was checked no. The Veteran had an average appetite, sleep disturbance, low energy, and suicidal and homicidal thoughts.

The Veteran underwent a VA examination in February 2003. The VA examiner indicated the Veteran exhibited a tendency to drift into circumstantial and tangential material. The examiner noted inconsistencies between current statements and those in the record. A couple of times the Veteran lost his train of thought, but otherwise his speech was normal in rate and volume. There was no evidence of delusions or hallucinations aside from flashbacks. The Veteran reported experiencing occasional suicidal thoughts in the past but denied having any intent to act on them. He denied ever having homicidal thoughts. He was able to maintain his personal hygiene and other basic activities of daily living. The Veteran reported that his remote memory contained some significant gaps or inaccurate information. His concentration fluctuated and his short-term memory had become impaired. He had obsessional rituals. He reported having occasional panic attacks although he could not estimate how often. He also described anxiety, irritability, and guilt. He occasionally felt worthless and had a poor appetite and only ate one meal a day. He had nightmares about once a week. He denied having any close friends outside of his family. He did not like large crowds or loud noises. The examiner noted his memory and concentration were mildly to moderately impaired.

A December 2003 VA treatment record noted that after neuro physical testing, the Veteran was found the Veteran to be quite limited cognitively and unlikely to be either employable or probably able to live independently.

An August 2003 correspondence from a VA licensed clinical social worker indicated the Veteran was disabled and unemployable. 

In November 2003 the Veteran underwent a private neuro physical evaluation. The private treatment provider indicated the Veteran exhibited serious memory deficits. He further concluded that it was unlikely that the severity of the Veteran’s memory deficits was related to any developmental disabilities or educational limitations.

A December 2003 VA treatment record noted the Veteran’s thought process was linear, logical, and goal oriented; his affect was moderately dysphoric; no suicidal and homicidal ideation were present; no active psychotic material now or in the past was noted; but there was some paranoia. His cognition was alert and oriented to person, place, time and situation. 

The Veteran underwent a VA examination in March 2006. The VA examiner noted the Veteran
 unemployable. 

In November 2003 the Veteran underwent a private neuro physical evaluation. The private treatment provider indicated the Veteran exhibited serious memory deficits. He further concluded that it was unlikely that the severity of the Veteran’s memory deficits was related to any developmental disabilities or educational limitations.

A December 2003 VA treatment record noted the Veteran’s thought process was linear, logical, and goal oriented; his affect was moderately dysphoric; no suicidal and homicidal ideation were present; no active psychotic material now or in the past was noted; but there was some paranoia. His cognition was alert and oriented to person, place, time and situation. 

The Veteran underwent a VA examination in March 2006. The VA examiner noted the Veteran was casually dressed; his speech was loud at times, but not pressured; his mood was described as mildly depressed; his affect was often angry and irritable; his thoughts were presented in a linear fashion with a lot of direction; his cognitive examination was within normal limits; and he was able to state his full name, date, location, city, country, state, name of the governor, and name of the president.

An April 2006 statement by the Veteran indicated that when he has flashbacks, he does not know where he is and becomes disoriented as to person, place, and time.

A January 2008 VA treatment record noted the Veteran was still struggling with insomnia, anxiety, and mood symptoms. His thoughts were linear, logical, goal oriented, and at a normal rate. He denied suicidal and homicidal ideation and active psychotic material. He was alert and oriented.

In February 2009, the Veteran underwent a VA examination. The VA examiner indicated the Veteran could manage his own finances. The Veteran was well groomed; he had speech that was at a regular rate and rhythm; he was not depressed or anxious; his thoughts were linear with a lot of direction; he would pause and get off topic easily; his insight and judgment were limited; and his cognitive status was intact and fully oriented.

July 2010, September 2010, and January 2011 VA mental health records indicate that the Veteran was pleasant and cooperative with good eye contact and composure. His thoughts were linear, logical and goal directed. He denied suicidal or homicidal plans or intentions. He denied active psychotic material. He was alert and oriented while being very rational in his thinking.

The Veteran attended a decision review hearing in March 2012 and testified that he experienced symptoms such as being withdrawn, had a hard time with people, experienced flashbacks, liked having his back to the wall in a restaurant, kept weapons around just in case, had nightmares and woke up covered in sweat. He further testified that he flails in his sleep according to his wife, and he was not homicidal or suicidal, but hypervigilant.

The Veteran underwent a VA examination in June 2012. The VA examiner indicated the Veteran exhibited occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care, and conversation. The Veteran experienced anxiety and suspiciousness. When he had flashbacks, he would become disoriented to time and place. He had nightmares 3-4 times a month. About once a month he woke up in a panic. He tried to keep busy to avoid thinking about what happened to him. He avoided watching the news or hunting. He thought about Vietnam in an unusually detailed manner suggestive of an obsessive process. He experienced hyperarousal. Active psychotic symptoms such as hallucinations or delusions did not appear to be a prominent part of the clinical picture at that time.

An April 2013 VA examiner reported that while the Veteran had a diagnosis of PTSD, he also had a personality disorder which distorted his symptoms.

A November 2013 VA treatment record noted the Veteran reported no suicidal or homicidal thoughts or plans; he was oriented to time, place, and person; his memory function was impaired; his affect was anxious; his judgement was fair; he felt hopelessness or despair; he had excessive fatigue; reported disturbed sleep; experienced headaches; experienced temporary hearing loss; reported ringing in the ears; reported feeling irritable, aggressive, anxiety, depression, and apathy or lack of spontaneity; had changes in personality; and there was evidence of delusions but no hallucinations.

A January 2014 VA treatment record noted the Veteran was pleasant, cooperative, had good eye contact, more upbeat, and hopeful. His thoughts were linear, logical, goal directed, and at a normal rate. He denied suicidal or homicidal plans or intentions. The Veteran also denied active psychotic material. He was alert and oriented.

In a December 2015 VA treatment record, the Veteran had a normal mental status examination.

The Veteran testified at his Board hearing in December 2018 that
 headaches; experienced temporary hearing loss; reported ringing in the ears; reported feeling irritable, aggressive, anxiety, depression, and apathy or lack of spontaneity; had changes in personality; and there was evidence of delusions but no hallucinations.

A January 2014 VA treatment record noted the Veteran was pleasant, cooperative, had good eye contact, more upbeat, and hopeful. His thoughts were linear, logical, goal directed, and at a normal rate. He denied suicidal or homicidal plans or intentions. The Veteran also denied active psychotic material. He was alert and oriented.

In a December 2015 VA treatment record, the Veteran had a normal mental status examination.

The Veteran testified at his Board hearing in December 2018 that he experienced flashbacks, not sleeping, panic attacks once or twice a month, forgetting things, had difficulty understanding complex concepts, has trouble maintaining relationships with people, and had angry outbursts. He further testified that he left work due to his PTSD and other (possibly service connected) issues.

Based on the evidence of record, the Board finds the severity, frequency, and duration of the Veteran’s symptoms more closely approximate the symptoms contemplated by the 70 percent rating. VA treatment records from January 2003 show the Veteran reporting suicidal ideation. In addition, the Veteran was noted to have obsessional symptoms. Further the Veteran had consistently shown he did not have close relationships with those outside of his immediate family. 

The Board has considered the additional symptoms which are not listed in the diagnostic code and finds that they do not cause the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013).

The preponderance of the evidence weighs against finding that the severity, frequency, and duration of the Veteran’s symptoms resulted in the level of total occupational and social impairment required for a 100 percent rating. While the Veteran reported occasional disorientation to time or place during flashbacks, the Board finds overall his symptoms more nearly approximated the severity, frequency, and duration of the Veteran’s symptoms contemplated by the 70 percent rating. The criteria for a 100 percent or higher rating are not met.

2. Entitlement to a total disability rating based on individual unemployability (TDIU) is denied. 

The appellant contends a TDIU rating is warranted.  

A total disability rating may be granted where the schedular rating is less than 100 percent and the veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16.

Generally, to be eligible for TDIU, a percentage threshold must be met. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). If there is only one service-connected disability, or two or more with the same etiology or affecting the same body system, the disability rating must be 60 percent or more. 38 C.F.R. § 4.16 (a). If there are two or more disabilities, there shall be at least one disability rated at 40 percent or more, and sufficient additional disabilities to bring the combined rating to 70 percent or more.

Here, the Veteran is service connected for the following disabilities: small cell undifferentiated carcinoma of lung, rated 100 percent effective February 5, 2020; PTSD, rated 70 percent effective October 21, 2001; residual scar of left lower extremity, rated 10 percent effective July 29, 2013; and scar on the right leg, rated 0 percent effective November 18, 1967. The combined evaluation from October 23, 2001 is 70 percent, with at least one disability rated at 60 percent. Thus, the schedular criteria have been met.

At the May 2002 VA examination, the Veteran reported his last job was in 1997 and he had been receiving disability from the Social Security Administration (SSA) ever since. 

After a review of all the evidence, lay and medical, and consideration of the United States Court of Appeals for Veterans Claims (Court) opinion in Ray v. Wilkie, 31 Vet. App. 58 (2019), the Board finds that the evidence does not show that the Veteran’s service-connected disabilities rendered him unable to secure or follow substantially gainful employment.

In Ray, the Court held that in determining whether a Veteran can secure and follow a substantially gainful occupation, attention must be given to: (1) the Veteran’s history, education, skill and training; (2) whether the Veteran has the physical ability (both exertional and non-exertional) to perform the type of activities (e.g., sedentary, light, medium, heavy,
, lay and medical, and consideration of the United States Court of Appeals for Veterans Claims (Court) opinion in Ray v. Wilkie, 31 Vet. App. 58 (2019), the Board finds that the evidence does not show that the Veteran’s service-connected disabilities rendered him unable to secure or follow substantially gainful employment.

In Ray, the Court held that in determining whether a Veteran can secure and follow a substantially gainful occupation, attention must be given to: (1) the Veteran’s history, education, skill and training; (2) whether the Veteran has the physical ability (both exertional and non-exertional) to perform the type of activities (e.g., sedentary, light, medium, heavy, or very heavy) required by the occupation at issue, in which factors that may be relevant include, but are not limited to, the Veteran’s limitations, if any, concerning lifting, bending, sitting, standing, walking, climbing, grasping, typing, and reaching, as well as auditory and visual limitations; and (3) whether the Veteran has the mental ability to perform the activities required by the occupation at issue, in which factors that may be relevant include, but are not limited to, the Veteran’s limitations, if any, concerning memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity. Additionally, the Court held that, “By discussing [the] potentially relevant factors, we don’t create a checklist that must be run completely through in every case. Instead, discussion of any factor is only necessary if the evidence raises it.” See Ray, 31 Vet. App. at 62.

Regarding the Veteran’s work experience and education, an April 2003 correspondence from the Veteran indicated that since his military service he had worked as a lot boy, a counter man at an auto parts store, a snow groomer at a ski lodge, worked on water softeners for a water company, a maintenance man for a shopping center, a maintenance man for a market, owned a cattle ranch with cows and horses, was self-employed for a kitchen and bath remodeling company, and was self-employed as an independent electronics technician. The Veteran also reported he had enjoyed wood carving and leather braiding and engraving. In addition, in his December 2019 VA 21-8940, the Veteran reported his highest level of education was a military GED. 

Turning to the second Ray consideration, the Veteran’s physical ability to perform work, the medical evidence of record indicates the Veteran had no physical restrictions as a result of his service-connected disabilities. 

As to the third consideration under Ray, whether the Veteran’s mental abilities to perform work were limited by his service-connected disabilities, the Board finds the evidence does support some difficulty. An August 2003 statement from a VA licensed clinical social worker indicated the Veteran is disabled and unemployable. No rationale or facts were accompanied with this statement. In November 2003,  the Veteran underwent a private neuro physical evaluation. The private treatment provider indicated the Veteran exhibited serious memory deficits. He further concluded that it was unlikely that the severity of the Veteran’s memory deficits was related to any developmental disabilities or educational limitations.  The examiner did not relate the memory deficits to a service-connected disability.  In addition, a December 2003 VA treatment record noted that after neuro physical testing, the Veteran was found to be quite limited cognitively and unlikely to be either employable or probably able to live independently. This record did not relate the cognitive problems to a service-connected disability.  In contrast, the June 2012 VA examiner indicated the Veteran only exhibited occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care, and conversation.

The Board finds the preponderance of the evidence does not support a finding that the Veteran was unemployable solely due to his service-connected disabilities.

First, the Veteran indicated in his VA 21-8940 application for TDIU that the disabilities that rendered him unemployable were his back, left leg, and left hip. The Veteran is service-connected for a lower left extremity scar, however the rest of the disabilities he listed are not service-connected. Second, the evidence does not show that the Veteran had any physical limitations due to his service-connected disabilities. Third, while the Veteran reported receiving SSA disability as evidence of his unemployability, SSA indicated there were no medical records of the Veteran. Fourth, the statements by the August 2003 VA licensed clinical social worker indicating the Veteran is disabled and unemployable did not have any accompanying rationale or facts explaining how the social worker reached that conclusion, therefore the Board finds it less probative. While there is evidence of cognitive and memory deficits noted in November and December 2003, these reports did
 and left hip. The Veteran is service-connected for a lower left extremity scar, however the rest of the disabilities he listed are not service-connected. Second, the evidence does not show that the Veteran had any physical limitations due to his service-connected disabilities. Third, while the Veteran reported receiving SSA disability as evidence of his unemployability, SSA indicated there were no medical records of the Veteran. Fourth, the statements by the August 2003 VA licensed clinical social worker indicating the Veteran is disabled and unemployable did not have any accompanying rationale or facts explaining how the social worker reached that conclusion, therefore the Board finds it less probative. While there is evidence of cognitive and memory deficits noted in November and December 2003, these reports did not related those symptoms to a service-connected disability.  This evidence is weighed against the other evidence of record which does not demonstrate that the service-connected PTSD caused total occupational impairment.  While the Veteran’s service-connected PTSD caused some mental limitations with regards to obtaining and maintaining employment, the overall evidentiary record does not support a finding that the Veteran was unable to obtain or retain substantially gainful employment due to his service-connected disabilities alone. 

As the preponderance of the evidence is against a finding that the Veteran is unemployable, the benefit of the doubt doctrine does not apply, and the claim for TDIU is denied.

 

K. J. ALIBRANDO

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	L. Holcombe, Associate Counsel

The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.