PTSD DUE TO COMBAT

S. SORATHIA · 2026 · Case ID: A26040103

MIXED

Summary

The Veteran, an Army Veteran, appeals the denial of an increased rating for major depressive disorder and cervical spine degenerative joint disease, and the grant of TDIU. The Board reviewed the evidence for the period one year prior to the May 2020 intent to file for increase and TDIU. For major depressive disorder, the Veteran reported worsening symptoms including suicidal ideation, anxiety, apathy, concentration and memory issues, and hygiene problems. While the Board acknowledged the severity of symptoms and the Veteran's lay statements, it found the evidence did not establish total occupational and social impairment, with the current 70 percent rating being adequate. The Board noted the Veteran's denial of intent or plan for self-harm and the absence of other 100 percent criteria. For cervical spine degenerative joint disease, the Veteran claimed increased limitation due to pain and flare-ups. Despite lay reports of pain and functional loss, VA examinations showed full range of motion or pain without functional loss, and no abnormal gait or spinal contour. The Board found the evidence weighed against a rating higher than 10 percent. For TDIU, the Board found the Veteran met the schedular criteria and that the combined service-connected disabilities, including physical limitations from the spine and mental health symptoms impacting concentration and memory, rendered him as likely as not unable to secure and follow substantially gainful employment. Therefore, TDIU was granted.

Rationale

Evidence does not establish total occupational and social impairment.; Symptoms did not rise to the level for 100 percent rating.; Current 70 percent rating is adequate.

Service Branch

ARMY

Special Benefit

TDIU

Docket No.

210205-137912

Full Decision Text

Citation Nr: A26040103
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 210205-137912
DATE: April 29, 2026

ORDER

A rating in excess of 70 percent for the service-connected major depressive disorder is denied.

A rating in excess of 10 percent for cervical spine degenerative joint disease is denied.

Entitlement to a total disability rating based upon individual unemployability (TDIU) is granted.

FINDINGS OF FACT

1. The severity, frequency, and duration of the Veteran's major depressive disorder symptoms did not more closely approximate total occupational and social impairment at any time during the period on appeal.

2. The Veteran's cervical spine disability is manifested by pain causing some limited motion, but not resulting in limitation of motion more nearly approximating forward flexion of 15 degrees but not greater than 30 degrees or the combined range of motion of the cervical spine not greater than 170 degrees, and also not by muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis.

3. The Veteran has at least as likely as not been unable to secure and follow a substantially gainful occupation by reason of his combined physical and mental service-connected disabilities throughout the pendency of this claim.

CONCLUSIONS OF LAW

1. The criteria for a disability rating in excess of 70 percent for major depressive disorder are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9434.

2. The criteria for a rating in excess of 10 percent for the cervical spine disability are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5242.

3. The criteria for entitlement to a TDIU are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.16.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had various periods of active service in the United States Army.

This matter comes before the Board of Veterans' Appeals from an October 2020 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), hereinafter referred to as the Agency of Original Jurisdiction (AOJ). The Veteran filed a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in February 2021 and elected the Hearing docket. However, on October 21, 2024, the Veteran, by way of his former representative, withdrew the hearing request. Therefore, the Board may only consider the evidence of record at the time of the October 2020 AOJ decision on appeal, as well as any evidence submitted by the Veteran, or his representative, within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim(s), considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Major Depressive Disorder

The Veteran was initially service connected for major depressive disorder by way of a February 2014 rating decision. An initial 50 percent rating was assigned. This rating was not appealed. On June 10, 2019, VA received an intent to file from the Veteran. In February 2020, the Veteran submitted a statement requesting a rating increase for his major depressive disorder; however, it was not submitted on the appropriate form. Approximately one week later, the Veteran submitted both a VA Form 21-526EZ (Application for Disability Compensation and Related Compensation Benefits) and a VA Form 20-0995 (Decision Review Request: Supplemental Claim) listing the claim for increase for major depressive disorder. In April 2020, the AOJ issued a rating decision confirming and continuing the 50 percent rating for major depressive disorder. The Veteran filed the VA Form 10182 in May 2020 on which he listed the major depressive disorder appeal and elected the hearing docket. Also in May 2020, the Veteran submitted a VA Form 21-8940, requesting TDIU to include as due to his major depressive disorder. The AOJ then issued the October 2020 rating decision on appeal, which again confirmed and continued the 50 percent rating for major depressive disorder.

The May 2020 VA Form 10182 was addressed in a June 2024 Board decision. The Board awarded a 70 percent rating for the Veteran's major depressive disorder. The AOJ issued a decision in June 2024 to effectuate the Board's decision and assigned the 70 percent rating effective February 21, 2020.

Thus, the question now before the Board arises from the May 2020 submission of the VA Form 21-8940. The period for the current review is from the one year look-back period prior the May 2020 VA Form 21-8940. As the Board's assignment of the 70 percent rating in its June 2024 decision is in effect, the question for the Board at this time is whether a rating in excess of 70 percent is warranted for the period on appeal given the evidence available for the Board's review in this instant appeal.

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); 38 C.F.R. § 4.130. 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).

The 70 percent rating assigned is warranted 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 causing 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 for 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; or memory loss for names of close relatives, own occupation or own name.

The Board has reviewed the evidence for the period of one year prior to the May 2020 VA Form 21-8940 to determine whether a 100 percent rating was factually ascertainable at any time within that year prior to the claim, or at any time since. 38 C.F.R. § 3.400(o)(2) and Gaston v. Shinseki, 605 F.3d 979 (Fed. Cir. 2010).

In a February 2020 statement, the Veteran reported that even with his anti-depression medication, his disability was worsening. He reported an increase in his level of anxiety and apathy; thoughts of suicide; and an inability to concentrate and remember things, which was impacting his
has reviewed the evidence for the period of one year prior to the May 2020 VA Form 21-8940 to determine whether a 100 percent rating was factually ascertainable at any time within that year prior to the claim, or at any time since. 38 C.F.R. § 3.400(o)(2) and Gaston v. Shinseki, 605 F.3d 979 (Fed. Cir. 2010).

In a February 2020 statement, the Veteran reported that even with his anti-depression medication, his disability was worsening. He reported an increase in his level of anxiety and apathy; thoughts of suicide; and an inability to concentrate and remember things, which was impacting his work performance and his personal life. He reported often forgetting names of his closest friends leading him to withdraw from people, including his own family. A second similar statement was submitted in February 2020, but with more detail. In this statement the Veteran indicated the worsening of his disability began within the "past years." He also reported issues with personal hygiene, such as not showering or shaving and lack of care for how he dressed. The Board again notes the AOJ assigned the 70 percent rating effective February 21, 2020.

The Veteran was afforded a VA examination in March 2020. He again reported that even with anti-depression medication he gets very moody and down, as well as feeling a lot of fatigue and anxiety. The Veteran reported ongoing passive suicidal ideation and frequent feelings of hopelessness, but no intent or plan. The examiner observed the Veteran as having good grooming and hygiene, with normal speech and thought, and no signs of delusions or hallucinations. He was fully oriented to person, place, time and circumstance.

In a July 2020 statement related to his TDIU claim, the Veteran again noted increasing depression and anxiety due to his inability to concentrate and his memory impairment.

Just prior to the October 2020 rating decision on appeal, the Veteran was afforded another VA examination. The symptoms noted in this report include depressed mood, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and suicidal ideation. He presented with normal communication, appearance and memory on the date of the examination. The Veteran reported having suicidal ideation daily from about eight years prior until earlier in 2020 when the episodes decreased to approximately once per week. The examiner noted this report to be consistent with the Veteran's clinical records and prior examination reports.

Based on the foregoing, the Board finds that throughout the period on appeal, to include the one year period prior to the claim, the evidence does not establish that the severity, frequency, and duration of the Veteran's suicidal ideation has risen to the level contemplated by the 100 percent disability rating. The Veteran regularly denied thoughts, intent, or a plan involving self-harm in existing treatment records, and during the VA examinations. Further, no other symptoms were shown to be consistent with the criteria for a 100 percent rating. The evidence does not establish that the Veteran has, at any time, had 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; or memory loss for names of close relatives, own occupation or own name. Thus, a 100 percent rating is not warranted.

The Board does recognize the severity of the Veteran's symptoms. However, such symptoms are adequately represented in the currently assigned 70 percent rating. Additionally, the Board recognizes the Veteran's lay statements regarding worsening symptoms. However, the medical or lay evidence was not show that the worsening of any symptoms was factually ascertainable within one year prior to the claim.

For the foregoing reasons, the evidence of record persuasively weighs against the Veteran's claim for a rating in excess of 70 percent for the major depressive disorder. As the evidence of record persuasively weighs against a rating in excess of 70 percent, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (2021). This appeal is denied.

Cervical Spine - Degenerative Joint Disease

The Veteran was awarded service connection for degenerative arthritis of the cervical and lumbar spine with an evaluation of 10 percent by way of a February 2014 rating decision. He did not appeal this decision. He later filed the June 10, 2019 intent to file, after which he filed the February 2020 VA Form 21-526EZ and VA Form 20-0995, both of which listed the cervical and lumbar spine disabilities. In April 2020, the AOJ issued a rating decision separating the cervical and lumbar spine into two 10 percent ratings. Less than one year later, in May 2020, he filed a VA Form 21-8940 TDIU claim. On this form, he listed the neck condition, back condition, major depressive disorder, prostate condition and sleep apnea as disabilities causing his claimed unemployability. While the AOJ construed this as a claim for increase for each of the disabilities issued as well as a claim for TDIU, a supplemental claim is any complete claim for a VA benefit on an application form prescribed by the Secretary where an initial or supplemental claim for the same or similar benefit on the same or similar basis was previously decided. 38 C.F.R. § 3.1(p)(2). In certain circumstances, a supplemental claim need not be filed on a specified VA supplemental claim form and may be submitted on a separate form, such as the VA Form 21-8940. See Chisholm v. Collins, 38 Vet. App. 140 (2025). The Board, therefore, recognizes the VA Form 21-8940 as a supplemental claim for increase for the cervical spine disability. The rating was continued at 10 percent in the October 2020 decision on appeal. The February 2021 VA Form 10182 listed the cervical spine rating as being appealed. As the Veteran has been in continuous pursuit of the increased rating for the cervical spine since the filing of the June 10, 2019 intent to file, the period for this appeal begins one year prior to the filing of the June 10, 2019 intent to file.

The Veteran's cervical spine disability is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5242. Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is warranted for forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 30 percent rating is warranted for forward flexion of the cervical spine to 15 degrees or less; or favorable ankylosis of the entire cervical spine. A 40 percent rating is warranted for unfavorable ankylosis of the entire cervical spine. A 100 percent rating is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine.

Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1.

When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria.").

Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011).

In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint." The spine has no opposite joint.

In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination.

In February 2020, the Veteran reported aching when he overuses his neck. He reported looking up or down, left or right and bending his neck sideways all exacerbate the neck pain. He reported having flare ups that cause him to barely be able to move his neck and he reported hearing a grinding in his neck with movement. Private records submitted at this time include a November 2019 report indicating the Veteran was being treated for osteoarthritis in the cervical spine confirmed by x-ray. The October 2019 x-ray report is in the Veteran's claims file.

The Veteran was afforded a VA examination in March 2020. The diagnosis was confirmed as degenerative joint disease and the Veteran again reported having pain and cracking with range of motion. At the time of this examination, the Veteran reported having no flare-ups. Physical examination revealed full forward flexion to 45 degrees; extension limited to 35 degrees; right and left lateral flexion limited to 20 degrees; and normal right and left lateral rotation to 80 degrees. Pain was noted as the cause of the limited motion. There was no objective evidence of localized tenderness or pain on palpation, and no evidence of pain with weight bearing. There was no additional functional loss with repetitive testing and the examiner suggested the Veteran was being examined immediately after repetitive use over time and indicated this did not cause additional functional loss. Muscle strength, reflex and sensory testing were normal and there were no signs or symptoms of radiculopathy. As for impact on the ability of the Veteran to work, the examiner indicated this disability would limit occupations requiring full range of motion of the neck.

The Veteran was again examined in September 2020. The Veteran reported having daily neck pain, which is aggravated by overhead reaching, carrying heavy items, and being in one position for a long time. He reported having flare ups of the cervical spine symptoms several times per week, lasting a couple of hours. He reported avoiding strenuous activities and remaining as sedentary as possible during flare up. Range of motion testing at this time was all normal and it was confirmed in the report that active and passive range of motion were the same. Pain was noted as present on examination, but it did not result in limitation of motion. Repetitive testing also did not produce limited motion. The examiner indicated an estimation could not be made of limitations with repetitive use over time, but that pain would produce mild functional loss. During flare up, the examiner indicated pain would produce moderate functional loss due to the need to avoid strenuous activity. The examiner recognized tenderness to the bilateral upper traps and rhomboids and guarding, but no resulting abnormal gait or abnormal spinal contour. Muscle, reflex and sensory examinations were again normal and there were no signs or symptoms of radiculopathy or other neurologic abnormalities.

Treatment records added to the claims file in January 2025, within 90 days of the hearing withdrawal, show the Veteran being treated for ongoing cervical spine pain.

The record includes no additional records related to the cervical spine.

Based upon the foregoing, the Board finds that the evidence of record persuasively weighs against a rating in excess of 10 percent for the Veteran's cervical spine disability. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements and examination showing he sometimes has limited motion due to the pain, this limitation did not result in limitation of motion more nearly approximating forward flexion of 15 degrees but not greater than 30 degrees or the combined range of motion of the cervical spine not greater than 170 degrees. Additionally, the Veteran did not have muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis, which was confirmed in both VA examination reports.

Consideration has also been given to assigning a rating under the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes. However, the Veteran does not have IVDS and the evidence of record is against a finding that the Veteran was ever prescribed bed rest by a physician for a duration that meets the criteria for a higher rating. See 38 C.F.R. § 4.71a, Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes.

Regarding neurological impairment, the lay and medical evidence of record is against a finding that the Veteran has any other neurological abnormality associated with the spine disability.

For the foregoing reasons, the evidence of record persuasively weighs against the Veteran's claim for a rating in excess of 10 percent for the cervical spine degenerative arthritis. As the evidence of record persuasively weighs against a rating in excess of 10 percent, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (2021). This appeal is denied.

TDIU

As noted, the Veteran filed an intent to file on June 10, 2019, which was followed by his VA Form 21-8940 in May 2020.

A TDIU may be assigned, where the schedular rating is less than total, where a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). To qualify for schedular consideration of a TDIU, if there is only one such disability, this disability shall be ratable at 60 percent or more, and, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. Id.

For the purposes of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, one or both lower extremities, including the bilateral factor, if applicable; (2) disabilities resulting
38 C.F.R. § 4.16(a). To qualify for schedular consideration of a TDIU, if there is only one such disability, this disability shall be ratable at 60 percent or more, and, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. Id.

For the purposes of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) Disabilities of one or both upper extremities, one or both lower extremities, including the bilateral factor, if applicable; (2) disabilities resulting from common etiology or a single accident; (3) disabilities affecting a single body system, e.g., orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric; (4) multiple injuries incurred in action; or (5) multiple disabilities incurred as a prisoner of war. 38 C.F.R. § 4.16 (a); see Moody v. Wilkie, 30 Vet. App. 329, 339 (2018) (combining disabilities as "one disability" to meet the rating threshold of § 4.16(a) requires the use of the combined rating table).

Relevant to this appeal, the AOJ in the decision on appeal found that the Veteran meets the schedular criteria for TDIU and also found that the Veteran is not working. These are favorable findings, which the Board will not disturb. The question remains whether the Veteran's service connected disabilities cause the Veteran to be unable to secure and follow a substantially gainful occupation.

The AOJ also recognized in the October 2020 decision that the service connected lumbar and cervical spine preclude the Veteran from moderate or heavy physical labor, as noted by September 2020 VA examination reports. The AOJ also noted the October 2020 findings related to the major depressive disorder, including impairment of the ability to concentrate and manage distractibility while engaged in work related tasks, as well as mild memory loss which would contribute to problems with forgetting information and making small mistakes at work. This presumably represents impact on the ability to succeed in a sedentary job.

The Board also notes the Veteran's reports to a May 2020 VA examiner. He noted his history of obtaining education in videography after service and reported that he was a self-employed videographer, having had five jobs in 2020 by the time of the examination. He reported having had no other job since leaving the military. He reported his memory loss issues have impacted this work in that he has begun to interview someone and forgotten to turn on the camera several times, which led to anxiety with his work. In July 2020, he reported that it had become impossible to work earlier in 2020 and that he now does not work. He reported this to have happened due to increasing symptoms with his physical disabilities making it difficult to carry and set up video equipment, and increasing anxiety and depression causing concentration and memory loss. He reported that he would be unable to do other types of work, because he cannot stand on his feet or sit for long periods of time.

Private medical records submitted in July 2020 show a December 2019 report indicating concern for the Veteran having falls due to his gait and lumbar spine disability.

The private records, VA examination reports and lay statements show the Veteran's ability to secure and follow a physical job to be impaired due to his physical disabilities and his ability to secure and follow a sedentary job likely also impaired due to the symptoms of his mental disability. The combined nature of the Veteran's service connected disabilities result in the Veteran being as likely as not unable to secure and follow a substantially gainful occupation.

Based on the foregoing, the Board finds that in this case there is at least an approximate balance of positive and negative evidence as to whether the Veteran was unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. Accordingly, the Board finds a TDIU is warranted. 38 C.F.R. § 4.16.

S. Sorathia

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Adamson, 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.

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