POSTTRAUMATIC STRESS DISORDER (PTSD)

MARCUS N. FULTON · 2026 · Case ID: A26033070

GRANTED

Summary

The veteran, who served from December 1975 to December 1979, was represented by his surviving spouse, who was substituted into the appeal after the veteran's passing in May 2023. The veteran's appeal concerned entitlement to an increased rating for posttraumatic stress disorder (PTSD), an increased rating for hepatitis C, entitlement to total disability based on individual unemployability (TDIU), and an earlier effective date for Dependents' Educational Assistance (DEA). The Board granted service connection for PTSD at 70% and hepatitis C at 40%, effective January 28, 2019, based on the evidence and affording the veteran the benefit of the doubt. The Board found the veteran's PTSD symptoms, including anxiety, depressed mood, nightmares, and social impairment, warranted the 70% rating. For hepatitis C, the Board considered the veteran's reported daily fatigue, malaise, anorexia, and weight loss, along with the need for medication, to support the 40% rating. The Board also granted TDIU and an earlier effective date for DEA benefits from January 28, 2019, finding the veteran's combined service-connected disabilities precluded him from substantially gainful employment and rendered him permanently and totally disabled for DEA purposes.

Rationale

Benefit of the doubt afforded; Symptoms consistent with 70% rating; Found occupational and social impairment

Special Benefit

TDIU; EARLIER EFFECTIVE DATE

Docket No.

210721-379964

Full Decision Text

Citation Nr: A26033070
Decision Date: 04/09/26 Archive Date: 04/09/26

DOCKET NO. 210721-379964
DATE: April 9, 2026

ORDER

Entitlement to an increased evaluation of 70 percent for the entire appeal period for posttraumatic stress disorder is granted on the basis of substitution.

Entitlement to an increased evaluation of 40 percent for the entire appeal period for hepatitis C is granted on the basis of substitution.

Entitlement to a total disability rating based on individual unemployability (TDIU) from January 28, 2019 is granted on the basis of substitution.

Entitlement to an effective date for Dependents' Educational Assistance (DEA) from January 28, 2019 is granted on the basis of substitution.

FINDINGS OF FACT

1. Affording the Veteran the benefit of the doubt, for the entire appeal period, the Veteran's acquired psychiatric disorder was manifested by symptomology resulting in occupational and social impairment, with deficiencies in most areas.

2. Affording the Veteran the benefit of the doubt, for the entire appeal period, the Veteran's hepatitis C required continuous medication and was manifested by daily fatigue, daily malaise, near-constant anorexia, daily nausea, intermittent vomiting, daily arthralgia, and intermittent right upper quadrant pain, but not substantial weight loss.

3. The evidence of record persuasively establishes that the Veteran's service-connected disabilities precluded him from securing and following substantially gainful employment consistent with his education and experience from January 28, 2019.

4. The Veteran became permanently and totally disabled for purposes of DEA benefits on January 28, 2019.

CONCLUSIONS OF LAW

1. The criteria for an increased rating of 70 percent, but no higher, from January 28, 2019 for posttraumatic stress disorder have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411.

2. The criteria for an increased rating of 40 percent, but no higher, from January 28, 2019 for hepatitis C have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.114, Diagnostic Code 7354.

3. The criteria for entitlement to a TDIU from January 28, 2019 have been met. 38 U.S.C. §§ 5103A, 5107 (2012); 38 C.F.R. 3.102, 3.400, 4.16(b).

4. The criteria for entitlement to basic eligibility to DEA benefits from January 28, 2019, have been met. 38 U.S.C. §§ 3510, 5107, 5110, 5113; 38 C.F.R. §§ 3.102, 3.807, 21.3021

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from December 1975 to December 1979.

During the pendency of the appeal, the Veteran passed away in May 2023. The Appellant is the Veteran's surviving spouse and was granted substitution in August 2023.

This appeal is being processed in the modernized review system, commonly referred to as the "AMA," as established by the Veterans Appeals Improvement and Modernization Act of 2017. 115 Pub. L. No. 55, 131 Stat. 1105.

These matters come before the Board of Veterans' Appeals (Board) on appeal of a May 2021 rating decision issued by a Department of Veterans Affairs (VA) regional office, an agency of original jurisdiction (AOJ).

The Veteran initiated his appeal by submitting a July 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), and elected the Hearing docket. In accordance with the Veteran's election, a Board hearing was scheduled for September 18, 2024; however, the Appellant withdrew her request for a hearing that day through her representative. 38 C.F.R. §§ 20.302(b), 20.704(e). Therefore, the Board may only consider the evidence of record at the time the AOJ issued the May 2021 rating decision on appeal, as well as any evidence submitted by the Appellant or her representative within 90 days of receipt of the Appellant's hearing withdrawal. 38 C.F.R. § 20.302(b).

The
82, Decision Review Request: Board Appeal (Notice of Disagreement), and elected the Hearing docket. In accordance with the Veteran's election, a Board hearing was scheduled for September 18, 2024; however, the Appellant withdrew her request for a hearing that day through her representative. 38 C.F.R. §§ 20.302(b), 20.704(e). Therefore, the Board may only consider the evidence of record at the time the AOJ issued the May 2021 rating decision on appeal, as well as any evidence submitted by the Appellant or her representative within 90 days of receipt of the Appellant's hearing withdrawal. 38 C.F.R. § 20.302(b).

The Board further notes that there are currently active claims for an increased rating for the Veteran's acquired psychiatric disorder and entitlement to individual unemployability under the legacy system. A December 2023 Board decision was vacated in part and remanded for further development in an October 2024 Order by the Court of Appeals for Veterans Claims pursuant to a Joint Motion for Partial Remand. This appeal stream is not currently before the Board and will be addressed in a separate decision.

Increased Rating

Disability evaluations are determined by comparing a Veteran's present symptoms with criteria set forth in VA's Schedule for Rating Disabilities (Rating Schedule), which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. In order to evaluate the level of disability and any changes in condition, it is necessary to consider the complete medical history of the Veteran's condition. Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). If the disability more closely approximates the criteria for the higher of two ratings, the higher rating will be assigned; otherwise, the lower rating is assigned. 38 C.F.R. § 4.7. In general, it is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21.

"Staged" ratings are appropriate for an increased-rating claim when the factual findings show distinct time periods when the service-connected disability exhibits symptoms warranting different ratings irrespective of whether an initial or established rating. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). The effective date of an award of increased compensation should not be assigned mechanically based on the date of an examination. Rather, all of the facts should be examined to determine the earliest date that it is ascertainable that an increase in disability first manifested. Swain v. McDonald, 27 Vet. App. 219, 224 (2015). Further, where an increase in the rating assigned is at issue, if factually ascertainable, the effective date assigned may be up to one year prior to the date the application for increase was received. See 38 U.S.C. § 5110(b)(3); 38 C.F.R. § 3.400(o)(2); Gaston v. Shinseki, 605 F.3d 979, 982-83 (Fed. Cir. 2010).

1. Entitlement to an increased evaluation for posttraumatic stress disorder.

The Appellant contends the Veteran's acquired psychiatric disorder symptoms most closely approximated at least a 70 percent rating throughout the appeal period. The Veteran is rated at 70% from December 5, 2020, and at 50% from October 19, 2015.

As a procedural matter, the period on review before the Board is from January 28, 2019, the date VA received the Veteran's VA Form 21-8940, with consideration as to whether it is factually ascertainable that an increase in severity occurred within one year prior thereto. 38 U.S.C. § 5110(b)(3); Gaston, 605 F.3d at 982-83.

In April 2018, the Veteran was afforded a VA examination. The examiner noted recurrent, involuntary, and intrusive distressing memories of the traumatic event; recurrent distressing dreams; avoidance of distressing memories; persistent negative emotional state; markedly diminished interest or participation in significant activities; feelings of detachment or estrangement from others; irritable behavior and angry outbursts; problems with concentration; sleep disturbance; depressed mood; anxiety; chronic sleep impairment; disturbances of motivation and mood; difficulty in establishing and maintaining effective relationships; and difficulty in adapting to stressful circumstances. In terms of behavioral observations, the examiner noted the Veteran was alert, oriented, polite, and cooperative, neatly and casually dressed and groomed, showed a clear, linear, and goal directed thought process, and did not endorse or show signs of psychotic thought processes. The Veteran denied homicidal or suicidal ideation, plan, or intent. Finally, the examiner remarked that as part of his PTSD, the Veteran showed depressive symptoms, avoidance, hyperarousal, intrusive thoughts, and impaired frustration tolerance, ability to interact appropriately with others, attention, and concentration. Based on the foregoing, the examiner concluded that the Veteran showed occupational and social impairment with reduced reliability and productivity.

In a September 2018 examination, the examiner noted symptoms of depressed mood, anxiety, chronic sleep impairment, mild memory loss, flattened affect, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty adapting to stressful circumstances. The Veteran also reported symptoms of nightmares, sleep disruption, olfactory triggers, irritability, intrusive memories, daytime fatigue, lack of clarity in thinking, depressed mood, and avoidance behaviors. The Veteran further acknowledged social isolation. Based on the foregoing, the examiner opined that the Veteran showed occupational and social impairment with reduced reliability and productivity.

In May 2021, the Veteran was afforded another VA examination. The examiner noted that the Veteran displayed tangential thinking and vented about being angry at several recent incidents. The Veteran also reported staying in the house and not hanging out with friends, struggling with making decisions due to anxiety and putting things off because of this. The examiner indicated the Veteran experienced depressed mood; anxiety; suspiciousness; panic attacks more than once a week; near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively; chronic sleep impairment; mild memory loss; impairment of short and long term memory; speech intermittently illogical, obscure, or irrelevant; difficulty in understanding complex commands; impaired judgment; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships; difficulty in adapting to stressful circumstances; and impaired impulse control, such as unprovoked irritability with periods of violence. In terms of behavioral observations, the examiner noted the Veteran was alert and oriented. Based on the foregoing, the examiner concluded the Veteran's acquired psychiatric disorder causes occupational and social impairment with deficiencies in most areas.

Turning to the relevant treatment records during the period on appeal, 2018 private treatment records show the Veteran reported the Veteran reported depression and anxiety, and showed good judgment; normal mood and affect; was oriented to time, place, and person; and normal remote memory.

2019 private treatment records show the Veteran reported struggling with his mental health, complained of intrusive thoughts with distressing memories and nightmares, irritability and losing his temper, and avoidance of triggers that cause memories about stressors. The Veteran also reported a racing heart, shortness of breath, and tremor when he has flashbacks. The examiner observed the Veteran to have a saddened mood; irritability; anhedonia; insomnia; psychomotor agitation; fatigue; and diminished concentration, and stated the Veteran has frequent weekly outbursts of anger with verbal aggression or physical aggression which does not lead to destruction of property or physical injury, but is grossly disproportionate to the magnitude of the situation. In terms of behavioral observations, the Veteran was noted to show difficulty sitting still and was observed to be anxious, but was well-groomed, well nourished, and cooperative, with normal speech, normal associations, processes, abstraction, and computation thought process; intact and appropriate judgement and insight; oriented; intact memory; intact attention/concentration; fluent language; intact fund of knowledge; and euthymic affect. The Veteran did not report thoughts of suicide, homicide, hallucinations, or delusions.

In 2020 private and VA treatment records, the Veteran was observed to be casually dressed; appropriate hygiene skills; congruent, open, and honest affect; polite attitude; notable anxiety with fidgeting; oriented; cognizant; and no suicidal or homicidal ideation. The Veteran to be oriented; tangential and nonlinear thought process; sad mood with congruent affect; intact memory; loquacious speech with normal limits; cooperative and polite attitude; low insight
and computation thought process; intact and appropriate judgement and insight; oriented; intact memory; intact attention/concentration; fluent language; intact fund of knowledge; and euthymic affect. The Veteran did not report thoughts of suicide, homicide, hallucinations, or delusions.

In 2020 private and VA treatment records, the Veteran was observed to be casually dressed; appropriate hygiene skills; congruent, open, and honest affect; polite attitude; notable anxiety with fidgeting; oriented; cognizant; and no suicidal or homicidal ideation. The Veteran to be oriented; tangential and nonlinear thought process; sad mood with congruent affect; intact memory; loquacious speech with normal limits; cooperative and polite attitude; low insight; no suicidal or homicidal ideation. The Veteran reported that he continues to experience nightmares, middle insomnia, and hypervigilance. He stated he occasionally experiences visual hallucinations. The medical provider observed the Veteran to be oriented; have a tangential, non-linear, and difficult to redirect thought process; calm mood with congruent affect; intact memory; loquacious speech with normal limits of expressive and receptive language; poor attention and concentration; polite attitude; low insight; and no suicidal or homicidal ideation.

In 2021 VA treatment records, the Veteran indicated thoughts of engaging in suicide-related behavior within the past 30 days. The medical provider observed the Veteran to be oriented; show tangential thought process; calm mood with congruent affect; intact memory; speech was loquacious with normal limits of expressive and receptive language; attention and concentration within normal limits; polite attitude; moderate insight; and acknowledgement of fleeting suicidal ideation and plan but denied intent.

Based on the foregoing, affording the Veteran the benefit of the doubt, the Board finds that for the entire period on appeal, the Veteran's service-connected acquired psychiatric disorder was manifested primarily by symptoms of anxiety, depressed mood, suspiciousness, chronic sleep impairment, disturbances of motivation and mood, mild memory loss, panic attacks, nightmares, difficulty in adapting to stressful circumstances, and difficulty in establishing and maintaining relationships, which are consistent with the severity, frequency, and duration of the types of symptoms associated with the presently assigned 70 percent rating.

The Board acknowledges the Veteran's report in 2020 private treatment records of occasionally experiencing visual hallucinations, and fleeting suicidal ideation without intent in 2021 VA treatment records. The Board also acknowledges the Veteran's report of irritable behavior and angry outbursts with little or no provocation, typically expressed as verbal or physical aggression toward people or objects, at the April 2018 VA examination. However, the record does not show the severity, frequency, and duration of the types of symptoms associated with the next higher 100 percent rating, which would cause total occupational and social impairment, such as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; 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; or other manifestations on par with the severity, frequency, and duration of the types of symptoms associated a 100 percent rating.

Accordingly, a 70 percent rating is warranted for the Veteran's service-connected acquired psychiatric disorder from January 28, 2019

2. Entitlement to an increased evaluation for hepatitis C.

The Appellant contends that the Veteran's hepatitis C most closely approximated at least a 40 percent rating throughout the appeal period. The Veteran is rated at 40% from October 19, 2020, and prior to that at 20% from October 19, 2015.

As a procedural matter, as noted above, the period on review before the Board is from January 28, 2019, the date VA received the Veteran's VA Form 21-8940, with consideration as to whether it is factually ascertainable that an increase in severity occurred within one year prior thereto. 38 U.S.C. § 5110(b)(3); Gaston, 605 F.3d at 982-83.

The Board notes that VA recently amended the Rating Schedule for evaluating digestive system disabilities effective May 19, 2024. See 89 Fed. Reg. 19375 (March 18, 2024) (eff. May 19, 2024). These revisions apply to all applications for benefits received by the VA or that are pending before the AOJ on or after May 19, 2024. Claims pending prior to the effective date will be considered under both the old and new rating criteria and the criteria which is more favorable to the Veteran's claim will be applied. However, the Board may not apply a current regulation prior to its effective date unless the regulation explicitly provides otherwise. See Kuzma
982-83.

Prior to May 19, 2024, under DC 7354, a 10 percent evaluation is warranted for intermittent fatigue, malaise, and anorexia, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least one week, but less than two weeks, during the past 12-month period. A 20 percent evaluation is warranted for daily fatigue, malaise, and anorexia (without weight loss or hepatomegaly), requiring dietary restriction or continuous medication, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least two weeks, but less than four weeks, during the past 12-month period. A 40 percent evaluation is warranted for daily fatigue, malaise, and anorexia, with minor weight loss and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least four weeks, but less than six weeks, during the past 12-month period. 38 C.F.R. § 4.114.

Note (2) provides that, for purposes of evaluating conditions under Diagnostic Code 7354, an "incapacitating episode" means a period of acute signs and symptoms severe enough to require bed rest and treatment by a physician.

As of May 19, 2024, this diagnostic code instructs VA to rate hepatitis C under chronic liver disease without cirrhoses (DC 7354). 38 CFR § 4.114. Under DC 7345, a noncompensable rating is assigned for asymptomatic with a previous history of liver disease. A 20 percent rating is warranted for chronic liver disease with at least one of the following: (1) intermittent fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, or (5) pruritus. A 40 percent rating is warranted for Progressive chronic liver disease requiring continuous medication and causing minor weight loss and at least two of the following: (1) daily fatigue, (2) malaise, (3) anorexia, (4) hepatomegaly, (5) pruritus, and (6) arthralgia. 38 CFR § 4.114.

VA regulations provide that, for purposes of evaluating conditions in § 4.114, the term "substantial weight loss" means a loss of greater than 20 percent of the individual's baseline weight, sustained for three months or longer; and the term "minor weight loss" means a weight loss of 10 to 20 percent of the individual's baseline weight, sustained for three months or longer. The term "inability gain weight" means that there has been substantial weight loss with inability to regain it despite appropriate therapy. "Baseline weight means the average weight for the two-year-period preceding onset of the disease." 38 C.F.R. § 4.112.

Turning to the relevant evidence of record, the Veteran's treatment records are silent for complaints or treatment of his Hepatitis C during the period on appeal. In April 2019, the Veteran appeared for a VA examination. The examiner noted symptoms of daily fatigue, intermittent malaise, intermittent nausea, intermittent vomiting, intermittent arthralgia, and intermittent right upper quadrant pain. The examiner noted that continuous medication was not required for the condition. The Veteran did not report any incapacitating episodes in the prior 12 months.

In November
been substantial weight loss with inability to regain it despite appropriate therapy. "Baseline weight means the average weight for the two-year-period preceding onset of the disease." 38 C.F.R. § 4.112.

In November 2020, the Veteran appeared for a VA examination. The Veteran described his current symptoms as stomach pain if he didn't take his medication, waking up sick most mornings, contact skin problems, and no strength. The examiner noted symptoms of daily fatigue, daily malaise, near-constant and debilitating anorexia, daily nausea, intermittent vomiting, daily arthralgia, and intermittent right upper quadrant pain. The Veteran reported continuous medication was required for the condition, and reported at least two weeks but less than four weeks of total duration of incapacitating episodes in the prior 12 months.

In April 2021, the Veteran was afforded another VA examination. The Veteran stated that, since the onset of his condition, he lost weight due to anorexia and nausea/vomiting, and cited current symptoms of fatigue, malaise, nausea, anorexia, weight loss, and right upper quadrant pain with palpation. Although the Veteran reported use of medication, the examiner stated that the condition did not require continuous use of medication. The examiner noted symptoms of daily fatigue, intermittent anorexia, intermittent nausea, weight loss from a 205 pound baseline weight to 195 pounds, sustained for three months or longer, and intermittent right upper quadrant pain. The examiner further noted nausea and anorexia were treated with daily medication to help prevent vomiting and weight loss. The examiner opined that the Veteran had not experienced any incapacitating episodes over the prior 12 months. In terms of functional impact, the Veteran reported fatigue contributes to his lack of energy, limiting his productivity.

Considering the above, the Board finds that for the entire period on appeal, the Veteran's hepatitis C most closely approximates a 40 percent rating. At the November 2020 VA examination, the Veteran reported daily fatigue, daily malaise, near-constant and debilitating anorexia, daily nausea, intermittent vomiting, daily arthralgia, and intermittent right upper quadrant pain. The April 2021 VA examiner also noted sustained weight loss and that the Veteran's vomiting and weight loss were treated with daily medication. Based on the foregoing, the Board finds that, affording the Veteran the benefit of the doubt, these findings are indicative of the entire period on appeal, and a 40 percent rating is warranted for the entire period on appeal. The evidence does not show substantial weight loss to warrant the next higher 60 percent rating, as the April 2021 VA examiner documented the Veteran's weight loss to be less than 10 percent of the Veteran's baseline weight. Accordingly, the next higher 60 percent rating is not warranted.

Accordingly, a 40 percent rating is awarded from January 28, 2019.

3. Entitlement to an earlier effective date for the Veteran's total disability rating based on individual unemployability (TDIU).

The Appellant contends that the Veteran was rendered totally unemployable due to his service-connected disabilities prior to October 19, 2020.

The Board notes that the Veteran has been granted a TDIU effective October 19, 2020. However, as the period before the Board begins January 28, 2019, as detailed above, the Board will adjudicate entitlement to a TDIU from that date.

A claim for a TDIU is not a separate claim for benefits. In Rice v. Shinseki, the Court held that a claim for a TDIU is "part of the claim for benefits of the underlying disability" regardless of whether the claim is raised expressly or reasonably raised by the record. 22 Vet. App. 447, 453-54 (2009). As such, the issue of entitlement to a TDIU under Rice is not limited to claims reasonably raised by the record. Thus, the Board must adjudicate any claim for a TDIU in accordance with Rice when it has been raised during the initial adjudication of a claim or a claim for an increased rating for an underlying disability. Payne v. Wilkie, 31 Vet. App. 373 (2019); Harper v. Wilkie, 30 Vet. App. 356 (2018).

As a preliminary matter, for consideration of a
of the underlying disability" regardless of whether the claim is raised expressly or reasonably raised by the record. 22 Vet. App. 447, 453-54 (2009). As such, the issue of entitlement to a TDIU under Rice is not limited to claims reasonably raised by the record. Thus, the Board must adjudicate any claim for a TDIU in accordance with Rice when it has been raised during the initial adjudication of a claim or a claim for an increased rating for an underlying disability. Payne v. Wilkie, 31 Vet. App. 373 (2019); Harper v. Wilkie, 30 Vet. App. 356 (2018).

As a preliminary matter, for consideration of a TDIU on a schedular basis, the veteran must meet the requisite disability rating percentage threshold. 38 C.F.R. § 4.16(a). If a veteran is service connected for only one disability, that disability must be rated at 60 percent disabling or more. If a veteran is service-connected for two or more disabilities, at least one of the disabilities must be rated at 40 percent disabling or more and the additional service-connected disabilities must bring the combined disability rating to 70 percent or more. As the Board has found that the Veteran is entitled to a 70 percent rating for his service-connected acquired psychiatric disorder throughout the period on appeal, the Board finds that the Veteran meets this requirement.

With respect to his employment history, in his January 2019 VA Form 21-8940, the Veteran reported last working full-time in January 2010, when he worked as a handyman from January 2004. He reported leaving his job due to his service-connected disabilities. At the April 2021 VA Hepatitis C examination, the Veteran reported being unemployed and helping his wife at a daycare at home.

In terms of educational history, the Veteran reported completing four years of high school, and did not report any other education or training.

At the April 2018 VA examination the examiner found opined that the Veteran showed occupational and social impairment with reduced reliability and productivity, and at the May 2021 VA examination, the examiner concluded the Veteran showed occupational and social impairment with deficiencies in most areas. The November 2020 VA examiner opined the Veteran's hepatitis C affected his ability to work due to his fatigue and needing to rest in bed as needed. The April 2021 examiner also opined the Veteran's condition affects his ability to work due to his fatigue contributing to his lack of energy, limiting his productivity.

Based on the foregoing, the Board concludes that the evidence of record weighs in favor of a finding that the Veteran's service-connected disabilities precluded him from being able to maintain substantially gainful employment. Accordingly, the Board grants a TDIU from January 28, 2019 based on his service-connected disabilities.

4. Entitlement to an effective date for Dependents' Educational Assistance (DEA) from January 28, 2019.

DEA benefits under 38 U.S.C. Chapter 35 is an ancillary benefit for the eligible dependents of the Veterans who are considered totally and permanently disabled. 38 U.S.C. § 3501; 38 C.F.R. § 3.807(a).

As such, the issue of an earlier effective date for DEA benefits is inextricably intertwined with the effective date for a TDIU. Accordingly, an earlier effective date of January 28, 2019 is granted.

Marcus N. Fulton

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Marshall, J.

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.

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