Case A26040679

PAUL R. CASEY · 2026 · Case ID: A26040679

MIXED

Summary

The Veteran, who served in the U.S. Navy from July 1972 to July 1973, appeals a March 2021 rating decision. The appeal concerns entitlement to Total Disability based on Individual Unemployability (TDIU) and an increased rating for his service-connected Posttraumatic Stress Disorder (PTSD). The Veteran asserts that his PTSD symptoms prevent him from maintaining substantially gainful employment. The Board reviewed evidence of record up to the March 2021 decision, including a March 2021 PTSD Disability Benefits Questionnaire (DBQ) and hearing testimony. The Board found the Veteran's PTSD symptoms, including disturbances in motivation and mood, depressed mood, anxiety, poor eye contact, and neglect of personal hygiene, caused occupational and social impairment with deficiencies in most areas. However, the Board determined these symptoms did not rise to the level of total occupational and social impairment required for a 100 percent rating. The Board found the Veteran's PTSD symptoms did not include gross impairment of thought or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger to self or others, disorientation, or memory loss of close relatives or his own name. The Board granted entitlement to TDIU, finding the Veteran's service-connected PTSD precluded him from securing and maintaining gainful employment throughout the appeal period. Entitlement to an increased rating for PTSD beyond 70 percent was denied.

Service Branch

NAVY

Special Benefit

TDIU

Docket No.

210514-159606

Full Decision Text

Citation Nr: A26040679
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 210514-159606
DATE: April 30, 2026

ORDER

Entitlement to a total disability evaluation due to individual unemployability (TDIU) is granted.

Entitlement to a disability rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied.

FINDINGS OF FACT

1. The Veteran's service-connected disability has prevented his securing and maintaining gainful employment throughout the review period.

2. During the claim period, the weight of the pervasive evidence does not indicate or support that the Veteran's service-connected PTSD disability resulted in total occupational and social impairment.

CONCLUSIONS OF LAW

1. The criteria for entitlement to TDIU have been met. 38 C.F.R. §§ 3.340, 3.341, 4.16.

2. The criteria for entitlement to a disability rating in excess of 70 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.6, 4.21, 4.126, 4.130, Diagnostic Code 9411.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Navy from July 1972 to July 1973.

This appeal is being processed under 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.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2021 rating decision issued by a Department of Veterans Affairs (VA) regional office, an agency of original jurisdiction (AOJ). The Veteran timely initiated an appeal by submitting a May 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), and elected the Hearing docket.

Therefore, the Board may only consider the evidence of record at the time the AOJ issued the March 2021 rating decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

TDIU

A total disability rating may be assigned, where the schedular rating is less than total, when it is found that the disabled person is unable to secure or follow a substantially gainful occupation as the result of service-connected disabilities. See 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. Consideration may be given to a veteran's level of education, special training, and previous work experience in arriving at a conclusion, but not to his age or the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19; see also Todd v. McDonald, 27 Vet. App. 79, 85-86 (2014).

To qualify for a total rating for compensation purposes, the evidence must show: (1) a single disability rated as 100 percent disabling; or (2) that the veteran is unable to secure or follow a substantially gainful occupation as a result of his service-connected disabilities and there is one disability ratable at 60 percent or more, or, if more than one disability, at least one disability ratable at 40 percent or more and a combined disability rating of 70 percent. 38 C.F.R. § 4.16(a). For the purpose of establishing one 60 percent disability, or one 40 percent disability in combination, disabilities affecting a single body system are considered as one disability. Id. Disabilities that are not service connected cannot serve as a basis for a total disability rating. 38 C.F.R. §§ 3.341, 4.19.

Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, "entitlement to TDIU is based on an individual's particular circumstance." Rice v.
, at least one disability ratable at 40 percent or more and a combined disability rating of 70 percent. 38 C.F.R. § 4.16(a). For the purpose of establishing one 60 percent disability, or one 40 percent disability in combination, disabilities affecting a single body system are considered as one disability. Id. Disabilities that are not service connected cannot serve as a basis for a total disability rating. 38 C.F.R. §§ 3.341, 4.19.

Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, "entitlement to TDIU is based on an individual's particular circumstance." Rice v. Shinseki, 22 Vet. App. 447, 452 (2009) (quoting Thun v. Peake, 22 Vet. App. 111, 116 (2008)); see also Todd, 27 Vet. App. at 85-86. Therefore, in adjudicating a TDIU claim, VA must take into account the individual veteran's education, training, and work history. Hatlestad v. Derwinski, 1 Vet. App. 164, 168 (1991) (level of education is a factor in deciding employability); see Friscia v. Brown, 7 Vet. App. 294 (1994) (considering veteran's experience as a pilot, his training in business administration and computer programming, and his history of obtaining and losing 19 jobs in the previous 18 years); Beaty v. Brown, 6 Vet. App. 532 (1994) (considering veteran's 8th grade education and sole occupation as a farmer); Moore v. Derwinski, 1 Vet. App. 356 (1991) (considering veteran's master's degree in education and his part-time work as a tutor).

In determining whether a veteran can secure and follow a substantially gainful occupation, attention must be given to: the veteran's history, education, skill, and training; whether the veteran has the physical ability (both exertional and nonexertional) to perform the type of activities (e.g., sedentary, light, medium, heavy, or very heavy) required by the occupation at issue. Factors that may be relevant include, but are not limited to, the veteran's limitations, if any, concerning lifting, bending, sitting, standing, walking, climbing, grasping, typing, and reaching, as well as auditory and visual limitations; and whether the veteran has the mental ability to perform the activities required by the occupation at issue. Factors that may be relevant include, but are not limited to, the veteran's limitations, if any, concerning memory, concentration, ability to adapt to change, handle workplace stress, get along with coworkers, and demonstrate reliability and productivity. Ray v. Wilkie, 31 Vet. App. 58, 73 (2019).

The issue of entitlement to a TDIU.

The Veteran asserts he is unable to maintain employment due to his service-connected disabilities, particularly his posttraumatic stress disorder (PTSD).

As the issue of TDIU is part and parcel of the increased rating claim for PTSD, the period on review is from November 2020, the date of claim for increased rating for PTSD, to the present.

In the March 2021 rating decision, the AOJ did not address the issue of TDIU.

The Veteran has met the schedular ratings for TDIU entitlement throughout the entire period on appeal as his PTSD has been 70 percent disabling since May 2015.

He last worked in 2014 as a manager at a transmission shop owned by a relative. See March 2025 Board Hearing Transcript. Since separation from the military, he obtained a bachelor's degree in business and mostly worked as a manager at automotive repair and retail shops. See id.; March 2021 Review PTSD Disability Benefits Questionnaire (DBQ). He retired from his last job due to inability to interact appropriately with coworkers and customers. See March 2025 Board Hearing Transcript.

The Veteran is service connected for PTSD and no other disabilities. The Veteran claims his mental health symptoms affect his capacity for gainful employment. Specifically, the Veteran notes that he has difficulty interacting professionally with coworkers and customers to include losing his temper. See March 2025 Board Hearing Transcript. These symptoms directly impacted his ability to maintain employment. See id.

In sum, the Board finds that the Veteran's service-connected PTSD precluded him from securing and maintaining gainful employment throughout the appeal period. Therefore, TDIU is warranted.

Increased Rating

Disability ratings are determined by evaluating the extent to which a veteran's service
inability to interact appropriately with coworkers and customers. See March 2025 Board Hearing Transcript.

In sum, the Board finds that the Veteran's service-connected PTSD precluded him from securing and maintaining gainful employment throughout the appeal period. Therefore, TDIU is warranted.

Increased Rating

Disability ratings are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. See 38 C.F.R. § 4.3.

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).

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

A 100 percent rating is assigned 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 issue of entitlement to a disability rating in excess of 70 percent for PTSD.

The Veteran asserts he is entitled to a higher rating for his PTSD.

This appeal stems from a March 2021 rating decision denying a claim for increase in disability rating for PTSD which was filed on November 18, 2020. Therefore, the period on review is from November 18, 2020 to the present.

There is one examination of record during the period on review. See March 2021 Review PTSD DBQ. The Board finds the report to credibly relate the Veteran's symptoms.

Based on the reports, the Board finds the Veteran's PTSD does not rise to the level of total occupational and social impairment but rather to the level of occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood.

The record does not show that the Veteran suffers from near-continuous panic, though he does suffer from disturbances in motivation and mood and has a depressed mood and anxiety.

The Veteran does not have gross impairment of thought or communication. The examiner noted that the Veteran's eye contact was poor initially but improved after rapport was established.

The Veteran does not have persistent delusions or hallucinations or engage in grossly inappropriate behavior.

The examiner found the Veteran to be unshaven and appearance was unkept and noted neglect of personal appearance and hygiene. However, the examiner did not conclude that the Veteran was intermittently inability to perform activities of daily living (including maintenance of minimal personal hygiene).
, family relations, judgment, thinking, or mood.

The record does not show that the Veteran suffers from near-continuous panic, though he does suffer from disturbances in motivation and mood and has a depressed mood and anxiety.

The Veteran does not have gross impairment of thought or communication. The examiner noted that the Veteran's eye contact was poor initially but improved after rapport was established.

The Veteran does not have persistent delusions or hallucinations or engage in grossly inappropriate behavior.

The Veteran reported suicidal ideation but denied plans or attempts. See id.; March 2025 Board Hearing Transcript. There is no evidence that the Veteran is a persistent danger to himself or others.

The record does not show that the Veteran forgets names of close relatives or his own name.

The Board does not believe the Veteran's symptomology rates a 100 percent rating. As detailed above, the record does not suggest that the Veteran experiences near-continuous panic, gross impairment of thought or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger to self or others, disorientation to time or place, forgetting names of close relatives or own name, or any other symptoms illustrative of total occupational and social impairment. Therefore, entitlement to a 100 percent disability rating for PTSD is not warranted.

Paul R. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board S.M. Disselkamp

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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