VALVULAR HEART DISEASE (INCLUDING RHEUMATIC HEART DISEASE)

B.T. KNOPE · 2026 · Case ID: A26040451

DENIED

Summary

The Veteran, an Army Veteran who served from July 1968 to July 1970, appeals the denial of increased disability ratings for valvular heart disease, peripheral vascular disease in both legs, and hypertension. He also appeals the denial of Total Disability based on Individual Unemployability (TDIU) and Dependency and Indemnity Compensation (DIC) benefits prior to February 10, 2022. The Board reviewed the evidence of record, including VA examinations from February 2021 and the Veteran's testimony from a September 2024 Board hearing. For valvular heart disease, the Board found the evidence did not support a rating higher than the existing 60 percent, as the Veteran experienced symptoms at activities requiring 3 to 5 METs and could climb stairs without issue, with no medical opinion supporting a higher rating. For peripheral vascular disease, the Board found the existing 20 percent ratings appropriate, as the Veteran experienced claudication after walking more than 100 yards and did not meet the criteria for higher ratings under either the older DC 7115 or the newer DC 7114. Regarding hypertension, the Board denied a compensable rating, noting blood pressure readings and lack of continuous medication use, consistent with the non-compensable rating. The Board denied TDIU and DEA benefits prior to February 10, 2022, finding the evidence did not factually ascertain that the Veteran was unable to secure substantially gainful employment due to his service-connected disabilities prior to that date, citing inconsistent statements and lack of supporting medical opinions. The Board also noted that DEA eligibility is predicated on a total disability rating, which was granted effective February 10, 2022.

Rationale

Symptoms experienced at 3-5 METs; No medical opinion supporting higher rating; Symptoms do not meet criteria for 100% rating

Service Branch

ARMY

Special Benefit

TDIU

Diagnostic Code

7000

Docket No.

250801-570102

Full Decision Text

Citation Nr: A26040451
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 250801-570102
DATE: April 30, 2026

ORDER

Entitlement to a rating in excess of 60 percent for valvular heart disease is denied.

Entitlement to a rating in excess of 20 percent for peripheral vascular disease, right leg, is denied.

Entitlement to a rating in excess of 20 percent for peripheral vascular disease, left leg, is denied.

Entitlement to a compensable rating for hypertension is denied.

Entitlement to a total disability rating based upon individual unemployability prior to February 10, 2022, is denied.

Entitlement to Basic eligibility to Dependents' Educational Assistance prior to February 10, 2022, is denied.

FINDINGS OF FACT

1. During the period on appeal, a workload of 3 to 5 METs resulted in the Veteran's experiencing shortness of breath symptoms; a workload of less than 3 METs resulting in heart symptoms is not shown.

2. During the period on appeal, the Veteran's bilateral lower peripheral vascular disease was manifested by symptomatology analogous to claudication on walking more than 100 yards; claudication on walking less than 100 yards and/or an ankle/brachial index of 0.54-0.66 or ankle pressure of 66-83 mm Hg are not shown.

3. During the period on appeal, the Veteran's hypertension does not more nearly approximate a history of diastolic pressure predominantly 100 or more that requires continuous medication for control, diastolic pressure 100 or more, or systolic pressure predominantly 160 or more.

4. Prior to February 10, 2022, the Veteran's service-connected disabilities, alone, did not prevent him from securing and following substantially gainful employment.

5. Eligibility for DEA benefits under 38 U.S.C. Chapter 35 arose on February 10, 2022, and no earlier.

CONCLUSIONS OF LAW

1. The criteria for a rating in excess of 60 percent for valvular heart disease have not been shown. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.102, 4.3, 4.7, 4.104 DC 7000.

2. The criteria for a rating in excess of 20 percent for peripheral vascular disease, right leg, have not been shown. 38 U.S.C. § 1155; 38 C.F.R. § 4.104, Diagnostic Code 7199-7115.

3. The criteria for a rating in excess of 20 percent for peripheral vascular disease, left leg, have not been shown. 38 U.S.C. § 1155; 38 C.F.R. § 4.104, Diagnostic Code 7114.

4. The criteria for a compensable rating for hypertension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101.

5. The criteria for an effective date earlier than February 10, 2022, for the award of TDIU are not met. 38 U.S.C. §§ 5107, 5110; 38 C.F.R. §§ 3.400, 3.340, 3.341, 4.16.

6. The criteria for an effective date earlier than February 10, 2022, for the award of basic eligibility to DEA benefits under Chapter 35 are not met. 38 U.S.C.A. §§ 5101, 5107, 5110; 38 C.F.R. §§ 3.151, 3.157, 3.341, 3.400.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in the Army, on active duty from July 1968 to July 1970. His awards include the Vietnam Campaign Medal, among others.

This claim comes before the Board of Veterans' Appeals (Board) on appeal from rating decisions dated March and June 2025, issued by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2025, the Veteran submitted a timely VA Form 10182, electing the Hearing docket. However, in November 2025, through counsel, he withdrew his request for a hearing before the Board. Thus, the hearing request is deemed withdrawn.

Given the Veteran's choice of docket, the Board may only consider the evidence of record at the time of the
in the Army, on active duty from July 1968 to July 1970. His awards include the Vietnam Campaign Medal, among others.

Given the Veteran's choice of docket, the Board may only consider the evidence of record at the time of the March and June 2026 rating decision on appeal. Moreover, the Board has reviewed evidence submitted by the Veteran in the 90 days following his November 2025 hearing request withdrawal. 38 C.F.R. § 20.302(a).

Increased Ratings

Disability ratings are determined by the application of a schedule of ratings, which is based on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The Veteran's entire history is reviewed when making disability evaluations. See generally, Schafrath v. Derwinski, 1 Vet. App. 589 (1991); 38 C.F.R. § 4.1. Where the question for consideration is the propriety of the initial evaluation assigned, consideration of the medical evidence since the effective date of the award of service connection is required. See Fenderson v. West, 12 Vet. App. 199, 125-26 (1999). Where entitlement to compensation already has been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Further, where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

Where entitlement to compensation has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Nevertheless, in cases where the Veteran's claim arises from a disagreement with the initial evaluation following the grant of service connection, the Board shall consider the entire period of claim to see if the evidence warrants the assignment of different ratings for different periods of time during these claims a practice known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999).

In March 2025, the Board granted service connection for valvular heart disease with peripheral vascular disease. That same month, the RO issued the rating decision on appeal effectuating the Board's decision, assigning an effective date of January 4, 2021, the date the Veteran submitted his initial claim. Therefore, the appeal period before the Board begins on January 4, 2021.

1. Entitlement to a rating in excess of 60 percent for valvular heart disease.

The Veteran seeks an increased rating for valvular heart disease. After a review of the evidence of record, the Board finds that an increased rating is not warranted.

In the rating decision on appeal, the RO assigned a 60 percent rating for the Veteran's heart disorder under DC 7000, effective January 4, 2021.

Under the current regulation, DC 7000 evaluates valvular heart disease, including rheumatic heart disease. For rating purposes, DC 7000 is included among the rating formula for Disease of the Heart ("Rating Formula") of 38 C.F.R. § 4.104. This rating formula provides for:

" A 60 percent rating for a workload of 3.1-5.0 METs results in heart failure symptoms;

" A 100 percent rating for a workload of 3.0 METs or less results in heart failure symptoms.

38 C.F.R. § 4.114, Note (3).

For this general formula, heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope. See 38 C.F.R. § 4.114, Note (3).

" A 100 percent rating for a workload of 3.0 METs or less results in heart failure symptoms.

38 C.F.R. § 4.114, Note (3).

For this general formula, heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope. See 38 C.F.R. § 4.114, Note (3).

Additionally, one MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. When the level of METs at which breathlessness, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, a medical examiner may estimate the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in those symptoms. See 38 C.F.R. § 4.114, Note (2).

Turning to the evidence, the Veteran underwent a VA examination in February 2021. Here, he was diagnosed with valvular heart disease and reported a history of fatigue and shortness of breath associated with activities such as walking briskly or climbing stairs. The examiner noted that he has not had any prior treatment for his heart disorder. Upon examination, the clinician noted he did not have a myocardial infarction, congestive heart failure, arrhythmias, or infections heart conditions. He was not able to perform an exercise stress test, as it was not without significant risk due to his condition. However, the examiner was able to perform an interview-based Metabolic Equivalents (METs) testing. After conducting the interview, the VA examiner determined the Veteran experienced symptoms of dyspnea when engaged in activities requiring greater than 3 to 5 METs. Overall, the examiner opined that his heart disorder caused functional impairment due to shortness of breath that limited his ability to walk, golf and mow the lawn.

As part of a separate appeal, the Veteran testified before the Board in September 2024. Here, he testified that he has shortness of breath and tires easily after walking about a quarter of a mile. While he had minor pain in his chest, he denied being hospitalized or having any procedures done. Moreover, he testified that he could walk without assistance and can go up a flight of stairs.

The evidence of record also includes VA and private treatment notes. Unfortunately, these do not contain other METs testing or a specific discussion of the Veteran's heart symptoms.

In reviewing the record, the Board finds that the evidence is persuasively against an increased rating in this case. Here, after performing an interview-based METs test, the February 2021 VA examiner opined that the Veteran experienced heart symptoms at activities requiring 3 to 5 METs. Moreover, he testified before the Board that he can walk without assistance, and climb a flight of stairs with no issues. Indeed, there are no clinicians in the record who have provided an opinion that he experiences heart symptoms at activities requiring 1 to 3 METs, as required for the next higher rating of 100 percent. For those reasons, a disability rating in excess of 60 percent is not for application.

Given the above, the Board finds that the Veteran's symptoms are more closely contemplated by the 60 percent rating found in the Rating Formula and already assigned. Therefore, an increased rating is not warranted.

2. Entitlement to a rating in excess of 20 percent for peripheral vascular disease, right leg.

3. Entitlement to a rating in excess of 20 percent for peripheral vascular disease, left leg.

The Veteran seeks increased ratings for his peripheral vascular disease of the left and right legs. After a review of the evidence, the Board finds that higher ratings are not for application.

As noted above, the period on appeal begins January 4, 2021, during which both of the Veteran's legs are each rated as 20 percent disabling. The right leg is rated under DC 7199-7115, while the left is rated under DC 7114.

Prior to November 14, 2021, there was no DC for peripheral vascular disease, and such was rated by analogy under DC 7115. 38 C.F.R. § 4.104. When an unlisted condition is encountered it will be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. 38 C.F.R. § 4.20. When rating by analogy, the un
, 2021, during which both of the Veteran's legs are each rated as 20 percent disabling. The right leg is rated under DC 7199-7115, while the left is rated under DC 7114.

Prior to November 14, 2021, there was no DC for peripheral vascular disease, and such was rated by analogy under DC 7115. 38 C.F.R. § 4.104. When an unlisted condition is encountered it will be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. 38 C.F.R. § 4.20. When rating by analogy, the unlisted condition need not be identical to the listed condition, nor must the condition precisely meet the requirements of a listed condition to be rated by analogy. Webb v. McDonough, 71 F.4th 1377, 1381 (Fed. Cir. 2023). The Veteran and his counsel have not averred that this is not the correct analogous rating criteria. Rather, they contend that under this rating criteria, a higher evaluation is warranted.

Effective November 14, 2021, the schedule of ratings for the cardiovascular system was amended, and DC 7114 for peripheral arterial disease was added. 86 Fed. Reg. 54093 (Sept. 30, 2021), 86 Fed. Reg. 62095 (Nov. 9, 2021). The newer or amended criteria cannot be used to rate a period prior to their respective effective dates, but if a law or regulation changes during the course of a claim or an appeal, the version more favorable to the Veteran will apply, to the extent permitted by any stated effective date in the amendment in question. 38 U.S.C. § 5110(g); VAOPGCPREC 3- 2000. See also Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003); VAOPGCPREC 7-2003. Consequently, the Board shall consider DC 7115 (2006) prior to November 14, 2021, and thereafter, the Board shall consider both DC 7115 (2006) and DC 7114 (2021) and assign a rating under the criteria most favorable to the Veteran.

Under DC 7115, a 20 percent rating, which is the minimum compensable rating available under this code, is assigned for thrombo-angitis obliterans with claudication on walking more than 100 yards, and; diminished peripheral pulses or ankle/brachial index of 0.9 or less.

A 40 percent rating is assigned for thrombo-angitis obliterans with claudication on walking between 25 and 100 yards on a level grade at 2 miles per hour, and; trophic changes (thin skin, absence of hair, dystrophic nails) or ankle/brachial index of 0.7 or less. 38 C.F.R. § 4.104, Diagnostic Code 7115.

Under DC 7114:

" a 20 percent rating is warranted with at least one of the following: ankle/brachial index of 0.67-0.79, ankle pressure of 84-99 mm Hg, toe pressure of 50-59 mm Hg, or transcutaneous oxygen tension of 50-59 mm Hg.

" A 40 percent rating is warranted for at least one of the following: ankle brachial index of 0.40-0.53, ankle pressure of 66-83 mm Hg, toe pressure of 40-49 mm Hg, or transcutaneous oxygen tension of 40-49 mm Hg.

" A 60 percent rating is warranted with at least one of the following: ankle/brachial index of 0.40-0.53, ankle pressure of 50-65 mm Hg, toe pressure of 30-39 mm Hg, or transcutaneous oxygen tension of 30-39 mm Hg.

" A 100 percent rating is warranted for at least one of the following: ankle/brachial index less than or equal to 0.39, ankle pressure less than 50 mm Hg, toe pressure less than 30 mm Hg, or transcutaneous oxygen tension less than 30 mm Hg.

38 C.F.R. § 4.104, DC 7114 (2021).

The ankle/brachial index (ABI) is the ratio of the systolic blood pressure at the ankle divided by the simultaneous brachial artery systolic blood pressure. For the purposes of this diagnostic code, normal ABI will be greater than or equal to 0.80. The ankle pressure (AP) is the systolic blood pressure measured at the ankle. Normal AP is greater than or equal to 100 mm Hg. The toe pressure (TP) is the systolic blood pressure measured at the great toe. Normal TP is greater than or equal to 60 mm Hg. Transcutaneous oxygen tension (Tc PO2) is measured at the first intercostal space on the foot. Normal Tc PO2 is greater than or equal to 60 mm Hg. All measurements must be determined by objective testing. If AP, TP, and Tc PO2 testing are not of record, evaluate based on ABI unless the examiner states that an AP, TP, or Tc PO2 test is needed in a particular case because ABI does not sufficiently reflect the severity of the Veteran's peripheral arterial disease. In all other cases, evaluate based on the test that provides the highest impairment value. Id. at Notes 1-2.

Analysis

Turning to the evidence, the Veteran underwent a VA examination in February 2021. Here, he was diagnosed with peripheral vascular disease and reported chronic bilateral lower extremity pain. He reported that his treating clinician informed him that he will need vascular surgery at some point in the future and treated his bilateral lower extremity disorders with daily clopidogrel. Upon examination, the VA examiner opined that he experiences claudication of both legs when walking more than 100 yards with diminished peripheral pulses. Ankle/brachial index testing was performed, and his right brachial pressure measured to 139 mm Hg, while his left measured to 104 mm Hg. Moreover, ABI calculation was 1.26 for the right leg, and 0.74 for the left leg.

Given the results of the February 2021 VA examination, the Board finds higher ratings for the Veteran's bilateral lower peripheral vascular disease. Indeed, upon examination, he did not exhibit claudication on walking between 25 and 100 yards as needed under DC 7115. Nor did he exhibit an ankle/brachial index of 0.4-0.53 as needed under DC 7114.

The Board has reviewed the record for additional evidence regarding the Veteran's bilateral lower peripheral vascular disease. Unfortunately, the other medical evidence of record does not include tests or examinations under the rating criteria.

As far as lay testimony, the Veteran testified before the Board in September 2024. Here, he reported his heart disorder, to include peripheral vascular disease, tires him after walking a quarter of a mile. However, he affirmed that he could walk without assistance, to include going up a flight of stairs.

Given the above, the Board finds that increased ratings for either lower extremity for peripheral vascular disease, are not warranted. Specifically, the Veteran experiences claudication on walking more than 100 yards. Therefore, his symptoms most closely approximate a 20 percent rating.

4. Entitlement to a compensable rating for hypertension.

The Veteran contends that his hypertension is worse than presently rated.

The Veteran's hypertension is currently rated under 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101. Under DC 7101:

" A 10 percent rating is warranted for diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control.

" A 20 percent rating is warranted for diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more.

" A 40 percent rating is warranted for diastolic pressure predominantly 120 or more.

" A 60 percent rating is warranted for diastolic pressure predominantly 130 or more.

38 C.F.R. § 4.104, DC 7101.

Predominantly is not defined in DC 7101, but one definition of this term is "for the most part, mainly." See Merriam-Web
predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control.

" A 20 percent rating is warranted for diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more.

" A 40 percent rating is warranted for diastolic pressure predominantly 120 or more.

" A 60 percent rating is warranted for diastolic pressure predominantly 130 or more.

38 C.F.R. § 4.104, DC 7101.

Predominantly is not defined in DC 7101, but one definition of this term is "for the most part, mainly." See Merriam-Webster Dictionary, https://www.merriam-webster.com/dictionary/predominant (last visited January 10, 2025). In the context of DC 7101, this means "above a certain level more often than it was below it."

Based on a review of the record, the Board finds that a compensable rating is not warranted.

Specifically, a February 2021 VA examination report shows that the Veteran's current sequenced blood pressure readings were 137/82, 135/75, and 99/70. While the Veteran told the VA examiner that he had been prescribed medication for hypertension, he clarified that this was in the distant past. Indeed, according to the examiner, the Veteran's treatment plan does not include continuous medication - or any medication, but only continued monitoring. Overall, the VA examiner opined that his hypertension caused no functional impact. As to the use of medication, the rating criteria for hypertension specifically contemplate the use of medication to ameliorate symptoms. McCarroll v. McDonald, 28 Vet. App. 267 (2016).

As to the Veteran's diastolic pressure, the evidence of record reflects does not reflect any diastolic pressure of 100 or more. As to the Veteran's systolic pressure, the evidence of record reflects does not reflect systolic pressure of 160 or more. Indeed, VA treatment notes dated July 2023, February 2024, and August 2024, show blood pressure readings of 129/83, 90/62, and 90/61, respectively. Moreover, in October 2024, his treating VA clinician noted that he is not on any blood pressure medication.

Indeed, the Veteran testified before the Board in September 2024. Here, he testified that he was not sure whether he was on blood pressure medication, although he is on some medication for one of his heart related disorders. As noted above, the Board acknowledges he is on medication for his peripheral vascular disorder. Moreover, the VA treatment note two weeks following his Board hearing, indicates that the Veteran is not on any blood pressure medication.

For the reasons outlined above, the Board finds that a compensable rating for the Veteran's hypertension is not warranted.

In considering the appropriate disability ratings, the Board has also considered the Veteran's statements that his disabilities are worse than the ratings he currently receives. In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990).

Competency of evidence differs from weight and credibility. While the Veteran is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability according to the appropriate diagnostic codes. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) ("although interest may affect the credibility of testimony, it does not affect competency to testify").

On the other hand, such competent evidence concerning the nature and extent of the Veteran's disabilities have been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the examination reports) directly address the criteria under which these disabilities are evaluated. Therefore, based on the evidence of record, the Board determines that ratings in excess of those provided for in this decision are not warranted.

Earlier Effective Dates

A claim for a TDIU is a type of increased rating claim, and the effective date rules for increased rating claims are therefore
24, 25 (1991) ("although interest may affect the credibility of testimony, it does not affect competency to testify").

Earlier Effective Dates

A claim for a TDIU is a type of increased rating claim, and the effective date rules for increased rating claims are therefore for application. Dalton v. Nicholson, 21 Vet. App. 23, 3234 (2007). Specifically, the effective date for an increased rating for disability compensation will be the latest of 1) the date entitlement arose, 2) the earliest date as of which it is factually ascertainable that an increase in disability occurred if a claim is received within one year from such date, or 3) the date of receipt of the claim. 38 U.S.C. § 5110 (b)(3); 38 C.F.R. § 3.400(o). This general rule applies equally under the legacy and AMA systems of review. See 38 C.F.R. § 3.2500(h)(1).

5. Entitlement to a TDIU prior to February 10, 2022.

6. Entitlement to DEA prior to February 10, 2022.

The Veteran contends that he has been unemployable since 2010, and thus, entitlement to a TDIU and DEA is warranted from that year. Alternatively, his attorney contends that entitlement to a TDIU and DEA is warranted from February 25, 2013.

Procedural Background

In a March 2025 decision, the Board granted a TDIU from February 10, 2022. However, it remanded entitlement to a TDIU on an extraschedular basis prior to that date. Specifically, the Board noted that appeal stemmed from a September 2022 rating decision. However, the Board also clarified that it was not making any determination as to the effective date, as there was also a February 2022 rating decision deferring entitlement to a TDIU.

Here, the February 2022 deferral stems from an earlier claim for benefits with a complicated history. Indeed, the February 2022 rating decision stemmed from a substantive appeal received in July 2019 under the Legacy appeals system. This appeal followed a Statement of the Case (SOC) that was issued in May 2016. Ordinarily, the substantive appeal would not have been accepted as it was outside the applicable time limit. However, the RO mistakenly sent the May 2016 SOC to the Veteran's prior representative. Given this, the RO accepted the untimely July 2019 appeal, resulting in the February 2022 TDIU deferral. Moreover, the May 2016 SOC adjudicates the Veteran's claim of service connection for PTSD received on February 25, 2013, and initially denied in a May 2014 rating decision.

Here, the Board finds that the Veteran's claim for TDIU has been part and parcel of his initial claim of service connection for PTSD in 2013. While the Board, in its March 2025 rating decision granted entitlement to TDIU in an appeal from a September 2022 rating decision, it also noted the Veteran's prior claim for TDIU was raised by the RO in its February 2022 deferral, with his underlying claim of service connection for PTSD.

Affording him the benefit of the doubt, the Board finds that the Veteran has continuously appealed his claim of service connection for PTSD since 2013. Indeed, a series of Board and RO decisions granted increased ratings back to that date. Moreover, the Board finds that TDIU was raised part and parcel of the Veteran's continuously appealed claim. Indeed, to RO raised it sua sponte in its February 2022 deferral of a claim dating back to 2013. Therefore, the Board finds that the period on appeal dates back to February 25, 2013, the date of his initial claim.

Analysis

Prior to February 10, 2022, the Veteran is in receipt of a 60 percent rating for valvular heart disease from January 4, 2021; 50 percent rating for PTSD from February 25, 2013; 30 percent rating for cheek scarring, from December 7, 2020; separate 20 percent ratings for peripheral vascular disease of the left and right leg, from January 4,
claim. Indeed, to RO raised it sua sponte in its February 2022 deferral of a claim dating back to 2013. Therefore, the Board finds that the period on appeal dates back to February 25, 2013, the date of his initial claim.

Analysis

Prior to February 10, 2022, the Veteran is in receipt of a 60 percent rating for valvular heart disease from January 4, 2021; 50 percent rating for PTSD from February 25, 2013; 30 percent rating for cheek scarring, from December 7, 2020; separate 20 percent ratings for peripheral vascular disease of the left and right leg, from January 4, 2021; and hypertension rated as noncompensable from January 4, 2021. Overall, the Veteran had a 50 percent rating from February 25, 2013, a 70 percent rating from December 7, 2020, and a 90 percent rating from January 4, 2021.

Therefore, the question before the Board is whether the Veteran's service-connected disabilities rendered him unable to find substantially gainful employment prior to February 10, 2022.

Unfortunately, the evidence of record is persuasively against finding entitlement to TDIU prior to the date already assigned.

Turning to the evidence, the Veteran underwent a VA examination in May 2014 for his claimed psychiatric disorder. Here, he was diagnosed with PTSD. Further, he reported symptoms of chronic sleep impairment and mild memory loss. He explained to the VA examiner that following service, he worked in a peanut plant and toy factory. Thereafter, he was employed as a teacher for 22 years, and worked at a center for persons with disabilities for another 13 years in Florida until his retirement. Overall, the May 2014 VA examiner opined that his psychiatric symptoms caused occupational and social impairment due to mild or transient symptoms.

Next, the Veteran underwent a VA examination in February 2021 for his service connected chloracne/scars. He complained that his acne had worsened, although he did not take medication or had undergone surgery. Following the examination, the VA examiner opined that his skin disorder caused no functional impairment.

That same month, the Veteran underwent VA examinations for his hypertension, valvular heart disease, and peripheral vascular disease of the left and right legs, as noted above. As for his hypertension, the February 2021 VA examiner opined that it caused no functional impairment. Regarding his valvular heart and peripheral vascular diseases, the examiner opined these disorders caused shortness of breath and leg pain, limiting his mobility to one to two blocks without breaks, mowing the lawn, or golfing without a cart.

Overall, the Board finds the VA examinations of record during this period do not show the Veteran was unable to find substantially gainful employment due to his service-connected disabilities. While his PTSD, valvular heart and peripheral vascular disease caused some impairment, no VA examiner opined that such symptoms prevented employment. Indeed, as to the physical conditions, no VA examiner determined that he was prevented from physical labor. While the PTSD examiner noted his psychiatric symptoms caused only mild or transient occupational impairment.

The evidence of record also includes a retrospective private vocational opinion dated December 2024. Here, specialist K.M.D. provided a determination that the Veteran's service connected conditions rendered him unemployable since at least February 2013. In support, K.M.D. notes the results of the May 2014 VA examination. However, the specialist also notes a private medical examination for the Veteran's PTSD conducted in January 2021. Here, the Board notes that this private examination is not of record, is not referenced in the attorney's argument nor referenced in prior Board decisions regarding the Veteran's increased rating for PTSD claim. Therefore, the Board will not consider statements from K.M.D. regarding an alleged private medical examination conducted in January 2021.

Regardless, the private vocational opinion focuses solely on his psychiatric symptoms. Specifically, the author explains that the May 2014 VA examination notes symptoms of chronic sleep impairment and mild memory loss. Together, according to K.M.D., these two symptoms prevent the Veteran from employment "at any skill or exertional level." Here, the Board places little probative value on the December 2024 private vocational opinion as it is inconsistent with the contemporaneous evidence of record. While the retrospective vocational opinion indicates that the Veteran's PTSD causes total occupational impairment due to his two symptoms, chronic sleep impairment and mild memory loss, this is inconsistent with the May 2014 VA examination and the Veteran's own statements. Indeed, in a September 2024 Board hearing, he testified that his symptoms do not impact his relationships with co-workers. Furthermore, the vocational opinion makes no mention of the Veteran's other service
of chronic sleep impairment and mild memory loss. Together, according to K.M.D., these two symptoms prevent the Veteran from employment "at any skill or exertional level." Here, the Board places little probative value on the December 2024 private vocational opinion as it is inconsistent with the contemporaneous evidence of record. While the retrospective vocational opinion indicates that the Veteran's PTSD causes total occupational impairment due to his two symptoms, chronic sleep impairment and mild memory loss, this is inconsistent with the May 2014 VA examination and the Veteran's own statements. Indeed, in a September 2024 Board hearing, he testified that his symptoms do not impact his relationships with co-workers. Furthermore, the vocational opinion makes no mention of the Veteran's other service-connected conditions during this period.

The Board notes that in the Veteran's April 2022 application for TDIU benefits, he stated that he last worked in 2010. Indeed, this is the basis for his January 2026 argument that his TDIU rating should be granted an earlier effective date of that year. However, in this same TDIU application, when asked if he left his last job due to his service-connected disabilities, he answered "no."

Given the above, the Board finds that it is not factually ascertainable that the Veteran's service-connected disabilities caused him to be unable to secure a substantially gainful occupation prior to February 10, 2022. Specifically, the VA examinations of record discussed at length in this decision did not find he was unable to maintain substantially gainful employment due to his service-connected disabilities during this period.

Lastly, a March 2025 administrative review from the Director of the Compensation Service determined that the Veteran's service-connected disabilities did not prevent him from substantially gainful employment. Similarly, another determination from the Director concluded the same in May 2025. The Board notes these determinations are not binding on the Board and are of little probative value.

Given the above, to include VA examinations of record prior to February 10, 2022, the Board finds it was not factually ascertainable that the Veteran's service-connected disabilities alone did not prevent him from substantially gainful employment prior to the date already assigned.

DEA

Next, the Veteran has been granted eligibility to DEA as of February 10, 2022, the date he is in receipt of a total disability rating. Because eligibility for DEA benefits under 38 U.S.C. Chapter 35 is predicated on a finding of a permanent and total disability rating, entitlement to an effective date earlier than February 10, 2022, is precluded by law. See 38 U.S.C. §§ 3501 (a)(1), 5113(a); 38 C.F.R. §§ 3.807 (a), 21.3021. See also Sabonis v. Brown, 6 Vet. App. 426 (1994).

In sum, the Board finds that entitlement to earlier effective dates for TDIU and DEA benefits are not warranted. Thus, the claims are denied. ?

In reaching these conclusions, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the evidence is persuasively against the claims, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. § 3.102.

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board McDonald, Thomas K.

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