Case A26040968

FREDERIC P. GALLUN · 2026 · Case ID: A26040968

MIXED

Summary

The veteran, who served from July 1997 to September 1999, appeals the denial of an increased disability rating for his acquired psychiatric disorder, which was previously rated at 70 percent. The veteran also sought entitlement to Total Disability based on Individual Unemployability (TDIU). The Board granted entitlement to TDIU, finding that the evidence was in relative equipoise regarding the veteran's ability to secure and maintain substantially gainful employment due to his service-connected acquired psychiatric disorder, right shoulder disability, and bilateral knee disabilities. The Board applied the benefit-of-the-doubt rule, stating that the evidence was at least in equipoise, leading to the grant of TDIU. However, the claim for an increased rating above 70 percent for the acquired psychiatric disorder was denied. The Board reviewed VA examinations from June 2020 and July 2021, as well as the veteran's testimony from a July 2025 Board hearing and a lay statement from his mother. While the veteran reported significant limitations, including difficulty with standing, walking, and social interaction, and instances of agitation and arrests, the Board found that his symptoms did not meet the criteria for a 100 percent rating or demonstrate total occupational and social impairment. The Board concluded that the veteran's symptoms more closely approximated those for a 70 percent rating throughout the review period, and the evidence persuasively weighed against an increased rating.

Rationale

Evidence in relative equipoise regarding unemployability; Benefit of the doubt applied; Grant of TDIU

Special Benefit

TDIU

Docket No.

210901-182343

Full Decision Text

Citation Nr: A26040968
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 210901-182343
DATE: April 30, 2026

ORDER

Entitlement to individual employability (TDIU) is granted.

Entitlement to an increased evaluation for somatic symptom disorder with major depressive disorder, panic disorder, and alcohol abuse disorder, (hereinafter an acquired psychiatric disorder) which is currently 70 percent disabling, is denied.

FINDINGS OF FACT

1. The evidence is at least in relative equipoise as to whether the Veteran is unable to secure and maintain substantially gainful employment as a result of his service-connected acquired psychiatric disorder, right shoulder disability, and bilateral knee disabilities.

2. The severity, frequency, and duration of the Veteran's acquired psychiatric disorder symptoms did not more closely approximate total occupational and social impairment at any point during the review period.

CONCLUSIONS OF LAW

1. The criteria for TDIU have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a.

2. The criteria for a disability rating in excess of 70 percent for acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9421.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from July 1997 to September 1999. The Board recognizes the Veteran's service to our country, and the sacrifices it necessarily entailed.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2021 rating decision issued by the Agency of Original Jurisdiction (AOJ), Department of Veterans Affairs (VA) Regional Office (RO), which denied an increased rating greater than 70 percent for an acquired psychiatric disability. The Veteran submitted a VA Form 20-0996 Request for Higher-Level Review in August 2021. A higher level review conference was held in August 2021 followed by an August 2021 higher level rating decision which again denied an increased rating greater than 70 percent for an acquired psychiatric disability.

In September 2021, VA received the Veteran's VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), in which he timely appealed the August 2021 rating decision to the Board and selected the Board Hearing Lane under the Appeals Modernization Act (AMA) review system.

In July 2025, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ). The transcript is of record. As explained on the VA Form 10182, under the AMA, the Board hearing option entails review of the evidence of record of the time of the decision on appeal, in this case the July 2021 rating decision, as well as evidence submitted at the July 2025 hearing and within 90 days after the Board hearing. 38 U.S.C. § 7113(b).

The Board notes that evidence submitted prior to the Veteran's Board hearing has been incorporated by reference as it was discussed during the hearing. See VA Form 28-1902b, Counseling Record-Narrative Report, September 2022, VAF 28-1902f Feasibility Determination Narrative Report, September 2022, Hearing Transcript, July 2025.

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.

TDIU Legal Basis

Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a Veteran is unable to secure and follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a).

The phrase "unable to secure and follow a substantially gainful occupation" contains both economic and noneconomic components. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). The economic component is met when the Veteran is
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.

TDIU Legal Basis

The phrase "unable to secure and follow a substantially gainful occupation" contains both economic and noneconomic components. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). The economic component is met when the Veteran is unemployed or marginally employed. Marginal employment generally shall be deemed to exist when the Veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. 38 C.F.R. § 4.16(a). Marginal employment includes employment in a protected environment, such as a family business or sheltered workshop, which involves a lower-income position that, due to the Veteran's service-connected disabilities, is shielded in some respect from competition in the employment market. LaBruzza v. McDonough, 37 Vet. App. 111, 123-24 (2024). Consideration shall be given in all claims to the nature of the employment and the reason for termination. 38 C.F.R. § 4.16(a).

The non-economic component of the phrase "unable to secure and follow a substantially gainful occupation" includes consideration of the Veteran's history, education, skill, and training; whether the Veteran has the physical ability (both exertional and non-exertional) to perform the type of activities required by the occupation at issue (e.g., lifting, bending, sitting, standing, walking, climbing, 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 (e.g., memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity). Ray, 31 Vet. App. at 73.

The Board is not permitted to consider advancing age or a nonservice-connected disability when determining entitlement to a TDIU. 38 C.F.R. §§ 3.341(a), 4.16, 4.19.

A TDIU does not require a showing of 100 percent unemployability. Roberson v. Principi, 251 F.3d 1378, 1385 (Fed. Cir. 2001). The ultimate question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). In this regard, entitlement to a TDIU is a legal determination, not a medical one. Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013). Medical examiners may provide evidence regarding functional and occupational impairment, but the Board must decide whether a Veteran may "secure and follow a substantially gainful occupation" based on all evidence of record. See Delrio v. Wilkie, 32 Vet. App. 232, 243 (2019).

Entitlement to individual employability (TDIU) is granted.

The Veteran has asserted during his Board hearing that he can no longer work due to his service connected disabilities. See Hearing Transcript, July 2025. The Board finds a claim seeking TDIU was reasonably raised as part of the appeal. See Rice v. Shinseki, 22 Vet. App. 447 (2009).

The Board notes that the Veteran is service connected for somatic symptom disorder with major depressive disorder, panic disorder, and alcohol abuse disorder associated with left knee chondromalacia patella with degenerative arthritis and muscle atrophy, status post arthroscopy with limitation of flexion (an acquired psychiatric disability) at 70 percent disabling from August 10, 2011, right shoulder strain, to include rotator cuff tendonitis, and subacromial/subdeltoid bursitis, rated at 20 percent disabling from June 20, 2018, left knee moderate patellar subluxation with degenerative arthritis, rated at 20 percent disabling from June 4, 2013, patellar subluxation of the right knee, rated at 20 percent disabling from June 4, 2013, 10 percent disabling from October 7,
left knee chondromalacia patella with degenerative arthritis and muscle atrophy, status post arthroscopy with limitation of flexion (an acquired psychiatric disability) at 70 percent disabling from August 10, 2011, right shoulder strain, to include rotator cuff tendonitis, and subacromial/subdeltoid bursitis, rated at 20 percent disabling from June 20, 2018, left knee moderate patellar subluxation with degenerative arthritis, rated at 20 percent disabling from June 4, 2013, patellar subluxation of the right knee, rated at 20 percent disabling from June 4, 2013, 10 percent disabling from October 7, 2015, 0 percent disabling from June 1, 2018, and 20 percent disabling from May 2, 2021, chondromalacia patella right knee with limitation of flexion with muscle atrophy associated with left knee chondromalacia patella with degenerative arthritis status post arthroscopy with limitation of flexion associated with left knee chondromalacia patella with degenerative arthritis and muscle atrophy, status post arthroscopy with limitation of flexion, rated at 10 percent disabling from March 2, 2011, and left knee chondromalacia patella with degenerative arthritis and muscle atrophy, status post arthroscopy with limitation of flexion, rated at 10 percent disabling from October 1, 1999, 100 percent disabling from April 10, 2012, 10 percent disabling from June 1, 2012, 100 percent disabling from October 11, 2016, and 10 percent disabling from December 1, 2016.

The Veteran was 80 percent disabled from August 10, 2011, 100 percent disabled from April 10, 2012, 80 percent disabled from June 1, 2012, 90 percent disabled from June 4, 2013, 80 percent disabled from October 7, 2015, 100 percent disabled from October 11, 2016, 80 percent disabled from December 1, 2016, 90 percent disabled from June 20, 2018, 100 percent disabled from June 5, 2019, and has been 90 percent disabled from October 1, 2019. See Rating Decision - Codesheet, August 2021.

The Veteran has completed some college but dropped out due to seizures and alcohol use. See C&P Exam, July 2021, VA Form 28-0800, Vocational Readiness and Employment (VR&E) Program Orientation, September 2022.

The Veteran's work history showed the Veteran last worked as a sales associate for a total of three months in 2015. See VA Form 28-1902b, Counseling Record-Narrative Report, September 2022. The Veteran has been earning income as a professional poker player, asserting in May 2016 that he earned 3000 dollars a month playing poker, and stating he was self-employed as a poker player from 2018 to July 2022. The Veteran's earnings history is not in evidence. See CAPRI, July 2018, VA Form 28-0800, Vocational Readiness and Employment (VR&E) Program Orientation, September 2022.

A September 2018 VA shoulder examination noted the functional impact of the Veteran's right shoulder condition as, "affects Veteran's ability to lift, reach, do overhead work." See C&P Exam, September 2018.

In an October 2019 VA knee examination, the Veteran's knee disability was noted to limit kneeling. See C&P Exam, October 2019.

In a September 2020 VA knee examination, the Veteran's left knee disability was noted as causing the Veteran difficulty standing, sitting or walking for prolonged periods of time. The Veteran stated he was unable to walk up and down stairs without pain beyond one flight of stairs. See C&P Exam, September 2020.

In a July 2021 VA mental disorder examination, the Veteran confirmed standing and walking caused him discomfort and he could not carry heavy equipment. See C&P Exam, July 2021. These limitations caused difficulties carrying out his responsibilities at Best Buy, a retail chain, and while he self-reported being a professional poker player, his physical limitations made traveling poker tournaments unbearable. Id.

In a September 2022 vocational rehabilitation feasibility assessment, the VRC determined the Veteran had no education, training, transferrable skills or employment history that would allow him to find suitable employment. See VA Form 28-1902b, Counseling Record-Narrative
flight of stairs. See C&P Exam, September 2020.

In his July 2025 Board hearing, the Veteran testified that his injuries prevent him from travelling to poker games and he could only play locally. The Veteran testified that he cannot work, he cannot walk, sit or stand for long periods of time. He testified that he often used a walker and wore braces on his legs. The Veteran testified that he could no longer carry luggage due to his service connected injuries. The Veteran further testified that he gets easily agitated and rarely goes out in public, and was arrested a few times for fighting, most recently at the beginning of 2025. See Hearing transcript, July 2025.

With respect to whether the Veteran is unemployable, the evidence is at least in equipoise concerning whether he is unable to secure or follow substantially gainful employment due to his service-connected acquired psychiatric disorder, right shoulder disability, and bilateral knee disabilities. The TDIU determination ultimately is for the VA adjudicator, not the medical examiner. See Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013). Pursuant to the "benefit-of-the-doubt" rule, where there is "an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter," the Veteran shall prevail upon the issue. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3.

Given the Veteran's educational background, occupational history, and, most importantly, the impact that his service-connected disabilities had on his ability to work, the evidence is at least in equipoise as to whether the Veteran is precluded from securing or following substantially gainful employment due to his service-connected disabilities. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990) ("[T]he 'benefit of the doubt' standard is similar to the rule deeply embedded in sandlot baseball folklore that 'the tie goes to the runner'.... [i]f... the play is close, i.e., 'there is an approximate balance of positive and negative evidence,' the veteran prevails by operation of [statute].") Therefore, entitlement to TDIU is granted.

The Board notes that no income history is available for the Veteran, and while the Veteran is no longer able to work, the date that the Veteran became unemployable is not clear. Therefore, an effective date for TDIU will be assigned by the AOJ following this decision and may require additional development by the AOJ to determine when the Veteran ceased employment due to his service-connected disabilities.

The Veteran has asserted that his acquired psychiatric disorder warrants a rating in excess of 70 percent. See VA Form 10182 Notice of Disagreement, December 2025.

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, 114-18 (Fed. Cir. 2013).

The Veteran's unspecified trauma
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, 114-18 (Fed. Cir. 2013).

The Veteran's unspecified trauma and stressor-related disorder is rated under DC 9421. Under the DC, a 50 percent evaluation is warranted for occupational and social impairment with reduced reliability and productivity due to symptoms such as flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks occurring more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material or forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships.

A 70 percent evaluation is warranted for occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; 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 work like setting); inability to establish and maintain effective relationships.

A 100 percent disability evaluation is warranted where there is 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; memory loss for names of close relatives, own occupation, or own name.

Symptoms listed in VA's general rating formula for mental disorders are not intended to constitute an exhaustive list but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. See Mauerhan v. Principi, 16 Vet. App. 436 (2002).

Further, when evaluating a mental disorder, the Board must consider the "frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission," and must also "assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination." 38 C.F.R. § 4.126(a).

When determining the appropriate disability evaluation to assign, the Board's primary consideration is a Veteran's symptoms, but it must also make findings as to how those symptoms impact a Veteran's occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). Because the use of the term "such as" in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Mauerhan, 16 Vet. App. at 442.

In general, when 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). However, staged ratings are also appropriate in any increased rating claim in which distinct time periods with different ratable symptoms can be identified. Hart v. Mansfield, 21 Vet. App. 505 (2007). Here, analysis in this decision has therefore been undertaken with consideration of the possibility that different ratings may be warranted for different time periods as to the pending claim.

When the evidence is in approximate balance in the Veteran's favor or nearly equal regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S
is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). However, staged ratings are also appropriate in any increased rating claim in which distinct time periods with different ratable symptoms can be identified. Hart v. Mansfield, 21 Vet. App. 505 (2007). Here, analysis in this decision has therefore been undertaken with consideration of the possibility that different ratings may be warranted for different time periods as to the pending claim.

When the evidence is in approximate balance in the Veteran's favor or nearly equal regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

The Veteran was service connected at 70 percent disabled for his acquired psychiatric disorder from August 10, 2011. The Veteran's first VA mental health examination was conducted in June 2020. The examiner found the Veteran had occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. The Veteran's symptoms included anxiety, depressed mood, panic attacks that occurred weekly or less, chronic sleep impairment, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances, including work or a work like setting. The examiner stated,

The veteran was seen for a telehealth appointment. He appears husky and was casually dressed. Hygiene and grooming appeared to be good. General motor behavior and activity level were WNL (within normal limits). He was cooperative throughout the exam and answered questions in a forthright manner. He was fully oriented. Thought content was WNL. He denied SI/HI/AH/VH/ (Suicidal Ideation / Homicidal Ideation / Auditory or Visual Hallucinations) Ideas of Reference/Paranoia. There was no evidence of delusions. Thought processes were logical, linear, and reality based. See C&P Exam, June 2020.

The Veteran was afforded another VA mental conditions examination in July 2021. The examiner found the Veteran had occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. The Veteran's symptoms included depressed mood, anxiety, panic attacks that occur weekly or less often, chronic sleep impairment, mild memory loss, such as forgetting names, directions or recent events, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, including work or a work-like setting, and an inability to establish and maintain effective relationships. The examiner stated,

Hygiene and grooming were appropriate. Mood and affect were appropriate to context. Answered questions, followed directions with little assistance, and demonstrated intact hand-eye coordination. Completed multistep questionnaires with little assistance. Memory functioning was good for recent and remote events. Information processing speed was normal. See C&P Exam, July 2021.

At the Veteran's July 2025 Board hearing, the Veteran testified that he was easily agitated and rarely goes out in public. The Veteran testified he was arrested a few times for fighting, most recently at the beginning of 2025. The Veteran further testified he neglected his personal hygiene and did not shower daily. While the Veteran testified he had memory issues and sometimes forgot dates, he testified he did not forget the names of family and close friends and had about ten close friends. The Veteran testified he did not have hallucinations. See Hearing Transcript, July 2025.

In a July 2025 letter, the Veteran's mother asserted that due to her son's mental health, he can be irritable at times and has nothing to look forward to when he wakes up. The Veteran additionally was noted as having difficulty controlling his worry, which affected his sleeping and mood. See Buddy / Lay Statement, July 2025.

Based on the above, the Veteran was not shown to have total impairment from his acquired psychiatric disorder at any point during the review period. The Veteran did report getting into fights but was not assessed to be a persistent danger to himself or others during his VA psychological examinations. The Veteran did not experience disorientation to time or place. No spatial disorientation was noted. No persistent delusions or hallucinations were shown, and the Veteran testified that he did not have hallucinations. The Veteran displayed instances of poor hygiene but
nothing to look forward to when he wakes up. The Veteran additionally was noted as having difficulty controlling his worry, which affected his sleeping and mood. See Buddy / Lay Statement, July 2025.

Based on the above, the Veteran was not shown to have total impairment from his acquired psychiatric disorder at any point during the review period. The Veteran did report getting into fights but was not assessed to be a persistent danger to himself or others during his VA psychological examinations. The Veteran did not experience disorientation to time or place. No spatial disorientation was noted. No persistent delusions or hallucinations were shown, and the Veteran testified that he did not have hallucinations. The Veteran displayed instances of poor hygiene but was not deemed grossly inappropriate. Memory problems were indicated at the Veteran's VA examinations and Board hearing, but the Veteran did not forget the names of close relatives. Overall, the Veteran has not exhibited the symptoms listed in the examples for a 100 percent disability rating, and total social and occupational impairment has not otherwise been demonstrated. See e.g., C&P Exam, June 2020, C&P Exam, July 2021, Hearing Transcript, July 2025, Buddy / Lay Statement, July 2025.

While there may have been day-to-day fluctuations in the manifestations of the Veteran's service-connected acquired psychiatric disorder, the evidence shows no distinct periods of time when his acquired psychiatric disorder varied to such an extent that a rating greater than 70 percent would be warranted. See Hart v. Mansfield, 21 Vet. App. 505 (2007).

The Board is charged with weighing the positive and negative evidence; resolving reasonable doubt in the Veteran's favor when the evidence is in relative equipoise. In summary, the Board finds the severity, frequency, and duration of the Veteran's psychiatric symptoms more closely approximate the symptoms contemplated by a 70 percent rating for the entire review period. 38 C.F.R. § 4.126. For the above reasons, the evidence persuasively weighs against entitlement to an increased rating for an acquired psychiatric disorder. As the evidence is neither evenly balanced nor approximately so, the benefit of the doubt doctrine does not apply. Lynch, 21 F.4th 776. For these reasons, the claim is denied.

Frederic P. Gallun

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Axelrad, E

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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