Citation Nr: 1329600 Decision Date: 09/16/13 Archive Date: 09/20/13 DOCKET NO. 12-19 979 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Louisville, Kentucky THE ISSUES 1. Entitlement to an initial disability evaluation in excess of 30 percent for posttraumatic stress disorder (PTSD). 2. Entitlement to an effective date earlier than December 22, 2008, for the grant of service connection for PTSD. 3. Entitlement to a total disability evaluation based on individual unemployability due to the appellant's service- connected disorder (TDIU). REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Patrick J. Costello, Counsel INTRODUCTION The appellant had active service from November 1971 to May 1974. This matter comes before the Board of Veterans' Appeals, hereinafter the Board, from a rating decision of March 2012, of the Department of Veterans Affairs (VA) Regional Office (RO) in Louisville, Kentucky. In that action, the RO granted service connection for PTSD and assigned a 30 percent disability rating effective December 22, 2008. The appellant seeks an earlier effective date, along with a higher disability evaluation. As the appellant is challenging the initial rating assigned for his psychiatric disorder and the record raises the possibility that he is unemployable because of his service- connected disability, the determination as to whether he is entitled to TDIU, including the effective date for that award, is part and parcel of the determination of the initial rating claim. See Rice v. Shinseki, 22 Vet. App. 447, 453 (2009). As such, that issue has been noted on the front page of this action and will be discussed below. The issue of entitlement to special monthly compensation based on a need for regular aid and attendance or on housebound status has been raised by the record, but this issue has not been adjudicated by the Agency of Original Jurisdiction (AOJ). Therefore, the Board does not have jurisdiction over the issue, and it is referred to the AOJ for appropriate action. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). The issue of entitlement to a TDIU is addressed in the REMAND portion of the decision below and it is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. FINDINGS OF FACTS 1. The appellant's service-connected PTSD is manifested by symptoms of difficulty concentrating, anxiety, depression, extreme sleeplessness, and a Global Assessment of Functioning (GAF) score of 55 has been assigned. This condition has caused the appellant to be withdrawn from others, including his family. Nevertheless, the disability is not manifested by social and occupational impairment with deficiencies in most areas, or an inability (as opposed to merely being difficult, but not impossible) to establish and maintain effective relationships. 2. The RO received the appellant's original claim for service connection for a bipolar disorder on December 22, 2008, and service connection for PTSD was granted in a rating action issued in February 2009. 3. There was no formal or informal claim for service connection for a psychiatric disorder prior to December 22, 2008. CONCLUSIONS OF LAW 1. The criteria for a disability evaluation of 50 percent, but no higher, for the appellant's service-connected PTSD have been met. 38 U.S.C.A. §§ 1155, 5107(a) (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.321, 4.1- 4.14, 4.130, Diagnostic Code 9411 (2012). 2. The criteria for the assignment of an effective date earlier than December 22, 2008, for the award of service connection for PTSD are not met. 38 U.S.C.A. §§ 5101, 5103, 5103A, 5107, 5110 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.1, 3.102, 3.151, 3.155, 3.157, 3.159, 3.160, 3.400 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board has thoroughly reviewed all the evidence in the appellant's claims file. Although there is an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the extensive evidence submitted by the appellant, or on his behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (the Board must review the entire record, but does not have to discuss each piece of evidence). The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claim. The appellant must not assume that the Board has overlooked pieces of evidence that are not explicitly discussed herein. See Timberlake v. Gober, 14 Vet. App. 122 (2000) (the law requires only that the Board address its reasons for rejecting evidence favorable to the veteran). Also, the Board must assess the credibility and weight of all evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the appellant. Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). I. Increased Evaluation The appellant was granted service connection for PTSD in a rating action issued in March 2012. A 30 percent disability evaluation was assigned in accordance with the rating criteria found at 38 C.F.R. Part 4, Diagnostic Code 9411 (2011). The effective date of the award was listed as December 22, 2008. Upon receiving notification of that award, the appellant has expressed disagreement with the 30 percent rating assigned and has requested that a higher disability evaluation be awarded. A. The Veterans Claims Assistance Act of 2000 (VCAA) The Veterans Claims Assistance Act of 2000 (VCAA) enhanced VA's duty to notify and assist claimants in substantiating a claim for VA benefits, as codified in pertinent part at 38 U.S.C.A. §§ 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.159, 3.326(a) (2012). For the reasons to be discussed below, the Board finds that VA has satisfied its duties to the appellant under the VCAA. A VCAA notice consistent with 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) must (1) inform the claimant about the information and evidence not of record that is necessary to substantiate the claim; (2) inform the claimant about the information and evidence that VA will seek to provide; and (3) inform the claimant about the information and evidence the claimant is expected to provide. See Quartuccio v. Principi, 16 Vet. App. 183 (2002). VCAA notice requirements apply to all five elements of a service connection claim (1) veteran status; (2) existence of disability; (3) connection between service and the disability; (4) degree of disability; and (5) effective date of benefits where a claim is granted. Dingess v. Nicholson, 19 Vet. App. 473, 484 (2006). The Veteran's initial increased rating claim arises from an appeal of the initial evaluation following the grant of service connection. Courts have held that once service connection is granted the claim is substantiated, and additional notice is not required as any defect in the notice is not prejudicial. Hartman v. Nicholson, 483 F.3d 1311 (Fed. Cir. 2007); Dunlap v. Nicholson, 21 Vet. App. 112 (2007). Therefore, no additional development is required with respect to the duty to notify. Regarding the duty to assist, VA has made all reasonable efforts to assist the appellant in the development of his claim, has notified him of the information and evidence necessary to substantiate the claim, and has fully disclosed VA's duties to assist him. The appellant was notified of the information and evidence needed to substantiate and complete the claim on appeal. Additionally, he was also provided with the general criteria for the assignment of effective dates and initial ratings. Id. The Board further finds that VA has complied with the duty to assist by aiding the appellant in obtaining evidence. It appears that all known and available records relevant to the issues on appeal have been obtained and are associated with the appellant's claims files. The RO has obtained the appellant's treatment records, as well as VA medical records. Pertinent medical records have also been obtained from the Social Security Administration (SSA). See Baker v. West, 11 Vet. App. 163, 169 (1998); Murincsak v. Derwinski, 2 Vet. App. 363, 370-72 (1992). He was also afforded a VA medical examination in January 2012. The Board notes that the VA examination report contains sufficiently specific clinical findings and an informed discussion of the pertinent history and clinical features of the disability on appeal and is adequate for purposes of this appeal. For the above reasons, no further notice or assistance to the appellant is required to fulfill VA's duty to assist the appellant in the development of the claim. Smith v. Gober, 14 Vet. App. 227 (2000), aff'd, 281 F.3d 1384 (Fed. Cir. 2002; see also Quartuccio v. Principi, 16 Vet. App. 183 (2002). B. Laws and Regulations Ratings for service-connected disabilities are determined by comparing the veteran's symptoms with criteria listed in VA's Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. Separate diagnostic codes identify the various disabilities. 38 C.F.R. Part 4 (2012). When rating a service-connected disability, the entire history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two ratings shall be applied, the higher rating 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 (2012). The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Diagnostic Code 9411, of 38 C.F.R. Part 4 (2012), pertaining to PTSD, provides for a 30 percent disability rating where there is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self- care, and conversation normal), due to such symptoms as: depressed mood; anxiety; suspiciousness; panic attacks (weekly or less often); chronic sleep impairment; and mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is assigned when there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks 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, 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. Id. A 70 percent rating is assigned when the psychiatric condition produces 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); and inability to establish and maintain effective relationships. Id. A 100 percent rating is assigned when there is total occupational or 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; and memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. Part 4, Diagnostic Code 9411 (2012). The Board further notes that a Global Assessment Functioning (GAF) rating (or score) is a scale reflecting the psychological, social, and occupational functioning on a hypothetical continuum of mental-health illness. Richard v. Brown, 9 Vet. App. 266, 267 (1996), citing Diagnostic and Statistical Manual of Mental Disorders (4th ed. 1994). The Board notes that an examiner's classification of the level of psychiatric impairment, by a GAF score, is to be considered but is not determinative of the percentage rating to be assigned. VAOPGCPREC 10-95. GAF scores ranging between 81 and 90 reflect absent or minimal symptoms (e.g., mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns (e.g., an occasional argument with family members). GAF scores ranging between 71 and 80 reflect that if symptoms are present they are transient and expectable reactions to psychosocial stressors (e.g., difficulty concentrating after family argument; no more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork). GAF scores ranging between 61 to 70 reflect some mild symptoms (e.g., depressed mood and mild insomnia) or some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, and has some meaningful interpersonal relationships. Scores ranging from 51 to 60 reflect more moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co- workers). Scores ranging from 41 to 50 reflect serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in social, occupational or school functioning (e.g., no friends, unable to keep a job). See 38 C.F.R. § 4.130 (2012) [incorporating by reference the VA's adoption of the DSM-IV, for rating purposes]. Scores ranging from 31 to 40 reflect some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) or major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up other children, is defiant at home, and is failing at school). A score from 21 to 30 is indicative of behavior which is considerably influenced by delusions or hallucinations or serious impairment in communication or judgment or inability to function in almost all areas. A score of 11 to 20 denotes some danger of hurting one's self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement) or occasionally fails to maintain minimal personal hygiene (e.g., smears feces) or gross impairment in communication (e. g., largely incoherent or mute). A GAF score of 1 to 10 is assigned when the person is in persistent danger of severely hurting self or others (recurrent violence) or there is persistent inability to maintain minimal personal hygiene or serious suicidal acts with clear expectation of death. See 38 C.F.R. § 4.130 (2012). In determining whether an increased evaluation is warranted, the VA must determine whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether the preponderance of the evidence is against the claim, in which case an increased rating must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). C. Facts and Discussion Turning to the record, the appellant's VA medical treatment reports extending from 2000 to the present have been obtained and included in the claims folder. Also, his Social Security Administration (SSA) records are have been added to the claims file. In a February 2010 letter, a VA doctor who had treated the Veteran since 2005 indicated that the Veteran had depression, poor energy, and severe anxiety in crowds. His wife also described symptoms of irritability and hypomania. Medication did little to help his social withdrawal symptoms, though it did improve his insomnia, dysphoria, and irritability. In conjunction with his claim for benefits, the appellant underwent a VA Psychiatric Examination in January 2012. The report suggests that the appellant experiences depression and recurrent dreams of being sexually assaulted while on active duty. The appellant had markedly diminished interest in significant activities and a restricted range of affect. Additionally, it was reported that he suffered from irritability, difficulty falling or staying asleep, hypervigilance, difficulty concentrating, and an exaggerated startle response. Socially, he described having a good relationship with his wife, his adult children, and his grandchildren. He also had a few friends, but they had passed away. At present, he did not like to visit people and preferred to stay at home. Objectively, the appellant had a depressed mood, anxiety, mild memory loss, mild sleep impairment, disturbances in motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. His thought process and content was unremarkable. He was not delusional and was not suffering from hallucinations. He did not complain of homicidal or suicidal ideations, and had no desire to commit violence. Upon completion of the examination, the appellant was diagnosed with PTSD along with a bipolar disorder. A GAF score of 55 was assigned. Total occupational and social impairment was not found, but the examiner concluded that there was occupational and social impairment with reduced reliability and productivity. A June 2012 outpatient record indicated that the appellant had clear and coherent speech, and no suicidal or homicidal ideation. Per his report, he was generally free of anxiety and irritability. In determining whether an increased evaluation is warranted, the VA must determine whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether the preponderance of the evidence is against the claim, in which case an increased rating must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C.A. § 5107 (West 2002 & Supp. 2012). In evaluating the appellant's disability, the Board is mindful that when it is not possible to separate the effects of the service-connected condition from a non-service connected condition, 38 C.F.R. § 3.102 (2012), which requires that reasonable doubt be resolved in the appellant's favor, dictates that such signs and symptoms be attributed to the service-connected condition. See Mittleider v. West, 11 Vet. App. 181 (1998). Upon reviewing the record, it is the conclusion of the Board that the evidence supports the next-higher evaluation of 50 percent for PTSD, but no higher. The VA examination noted depression, isolation, sleep deprivation, nightmares, and anxiety. The appellant appears to have social relations with family members but very little social contact with others. Moreover, there is evidence of record that, over the course of this appeal, the appellant's ability to conduct social relationships with others has become more difficult. The record further indicates that the appellant suffered at least some, if minimal, concentration problems, restricted/constricted affect, and anxiety, but other manifestations were not documented. In addition, the appellant's GAF score of 55 indicating moderately serious symptoms. Nevertheless, those same records have reported that the appellant's ability to work has not been specifically affected by his PTSD. In sum, the Board concludes that the totality of the evidence in the file appears to be at least in approximate balance. Therefore, a 50 percent evaluation, but no higher, should be assigned for PTSD from the date in which the appellant submitted his claim. 38 C.F.R. § 4.7 (2012). Hence, the appellant's claim is granted. However, it is also the conclusion that the evidence fails to support an evaluation in excess of 50 percent. In this regard, he is capable of caring for his physical well-being and he has not complained of thought disorders. Moreover, his ability to communicate is not impaired and his relationships with his family are good, by his own report. Moreover, recent outpatient records reflect that medication has helped to manage some of his symptoms, including his insomnia and irritability. The Board has also considered whether it is appropriate to assigned "staged ratings," in accordance with Fenderson, supra. However, the Board finds that the medical evidence demonstrates consistently and throughout that the appellant meets the criteria for a 50 percent rating from the date of his claim. Therefore, the assignment of staged evaluations in this case is not necessary. Further, while the benefit of any doubt has been given to the appellant, it is the conclusion of the Board that his request for an evaluation in excess of 50 percent must be denied. D. Extraschedular Evaluation It must further be considered whether the appellant is entitled to an extraschedular evaluation for his psychiatric disorder. Ordinarily, the VA Schedule will apply unless there are exceptional or unusual factors which would render application of the schedule impractical. See Fisher v. Principi, 4 Vet. App. 57, 60 (1993). An extraschedular disability rating is warranted based upon a finding that the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization that would render impractical the application of the regular schedular standards. See 38 C.F.R. § 3.321(b)(1) (2012). An exceptional case is said to include such factors as marked interference with employment or frequent periods of hospitalization as to render impracticable the application of the regular schedular standards. See Fanning v. Brown, 4 Vet. App. 225, 229 (1993). Under Thun v. Peake, 22 Vet App 111 (2008), there is a three-step inquiry for determining whether an appellant is entitled to an extraschedular rating. First, the Board must first determine whether the evidence presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate. Second, if the schedular evaluation does not contemplate the claimant's level of disability and symptomatology and is found inadequate, the Board must determine whether the claimant's disability picture exhibits other related factors such as those provided by the regulation as "governing norms." Third, if the rating schedule is inadequate to evaluate a appellant's disability picture and that picture has attendant thereto related factors such as marked interference with employment or frequent periods of hospitalization, then the case must be referred to the Under Secretary for Benefits or the Director of the Compensation and Pension Service to determine whether, to accord justice, the appellant's disability picture requires the assignment of an extraschedular rating. With respect to the first prong of Thun, the evidence in this case does not show such an exceptional disability picture that the available schedular evaluation for the psychiatric disorder is inadequate. A comparison between the level of severity and symptomatology of the appellant's disability with the established criteria found in the rating schedule for mental disorders shows that the rating criteria reasonably describes the appellant's disability level and symptomatology. As such, the inquiry ends and entitlement to an extraschedular evaluation pursuant to 38 C.F.R. 3.321(b)(1) (2012) is not warranted. II. Earlier Effective Date - Grant of Service Connection A. Veterans Claims Assistance Act of 2000 (VCAA) The appellant has come before the Board asking that the effective date for the granting of service connection for PTSD be made earlier than December 22, 2008. The United States Court of Appeals of the Federal Circuit has held that once the underlying claim is granted, further notice as to downstream questions, such as the effective date, is not required. See Hartman v. Nicholson, 483 F.3d 1311 (Fed. Cir. 2007). As to VA's duty to assist, the Board thus finds that all pertinent treatment and examination records have been obtain and thus there is no further action to be undertaken to comply with the provisions of 38 U.S.C.A. §§ 5103(a), 5103A (West 2002 & Supp. 2012), or 38 C.F.R. § 3.159 (2012), and that the appellant will not be prejudiced by the Board's adjudication of his claim. B. Laws and Regulations Generally, the effective date of an evaluation and award of pension, compensation or dependency and indemnity compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is the later. 38 U.S.C.A. § 5110(a) (West 2002); 38 C.F.R. § 3.400 (2012). But unless otherwise provided, the effective date of compensation will not be earlier than the date of receipt of the claimant's application. 38 U.S.C.A. § 5110(a) (West 2002). If a claim for disability compensation is received within one year after separation from service, the effective date of entitlement is the day following separation or the date entitlement arose. 38 C.F.R. § 3.400(b)(2) (2012). The applicable statutory and regulatory provisions require that VA look to all communications from a veteran which may be interpreted as applications or claims - formal and informal - for benefits. In particular, VA is required to identify and act on informal claims for benefits. See 38 U.S.C.A. § 5110(b)(3) (West 2002); 38 C.F.R. §§ 3.1(p), 3.155(a) (2012). The Federal Circuit has emphasized that VA has a duty to fully and sympathetically develop the veteran's claim to its optimum, which includes determining all potential claims raised by the evidence and applying all relevant laws and regulations. See Szemraj v. Principi, 357 F.3d 1370, 1373 (Fed. Cir. 2004); Moody v. Principi, 360 F.3d 1306, 1310 (Fed. Cir. 2004); Roberson v. Principi, 251 F.3d 1378 (Fed. Cir. 2001). The Board is required to adjudicate all issues reasonably raised by a liberal reading of the appellant's substantive appeal, including all documents and oral testimony in the record prior to the Board's decision. See Brannon v. West, 12 Vet. App. 32 (1998); Solomon v. Brown, 6 Vet. App. 396 (1994). But in determining whether an informal claim has been made, VA is not required to read the minds of the veteran or his representative. Cintron v. West, 13 Vet. App. 251, 259 (1999). A specific claim in the form prescribed by the Secretary must be filed in order for benefits to be pain or furnished to any individual under the laws administered by the Secretary. See 38 U.S.C.A. § 5101(a) (West 2002); 38 C.F.R. §§ 3.151(a) (2012). A claim is a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 C.F.R. § 3.1(p) (2012). Any communication or action indicating an intent to apply for VA benefits from a claimant or representative may be considered an informal claim. Such informal claim must identify the benefit sought. 38 C.F.R. § 3.155(a) (2012). Again, VA is required to identify and act on informal claims for benefits. 38 U.S.C.A. § 5110(b)(3) (West 2002); 38 C.F.R. §§ 3.1(p), 3.155(a) (2012). But VA is not required to anticipate any potential claim for a particular benefit where no intention to raise it was expressed. See Brannon v. West, 12 Vet. App. 32, 35 (1998) (holding that before VA can adjudicate a claim for benefits, "the claimant must submit a written document identifying the benefit and expressing some intent to seek it"). See also Talbert v. Brown, 7 Vet. App. 352, 356-57 (1995). In short, the essential requirements of any claim, whether formal or informal, are (1) an intent to apply for benefits, (2) an identification of the benefits sought, and (3) a communication in writing. Brokowski v. Shinseki, 23 Vet. App. 79, 84 (2009). A pending claim is an application, formal or informal, which has not been finally adjudicated. 38 C.F.R. § 3.160(c) (2012). The pending claims doctrine provides that a claim remains pending in the adjudication process - even for years - if VA fails to act on it. Norris v. West, 12 Vet. App. 413, 422 (1999). The Court has confirmed that raising a pending claim theory in connection with a challenge to the effective-date decision is procedurally proper. Ingram v. Nicholson, 21 Vet. App. 232, 249, 255 (2007). "Date of receipt" generally means the date on which a claim, information or evidence was received by VA. 38 C.F.R. § 3.1(r) (2012). C. Facts and Discussion The appellant's informal claim for service connection for PTSD was received at the RO on December 22, 2008. The RO eventually granted service connection for PTSD in the March 2012 rating decision on appeal. The grant of service connection was based, in part, on a January 2012 VA psychiatric examination which diagnosed the appellant with PTSD. The RO established an effective date of December 22, 2008, the date of receipt of his informal claim for service connection. See 38 U.S.C.A. § 5110(a) (West 2002); 38 C.F.R. §§ 3.1(p), 3.155(a), 3.400 (2012). The appellant filed a March 2012 notice of disagreement (NOD) with the effective date assigned. The appeal has now reached the Board. The appellant contends that the effective date assigned for the award of service connection for PTSD is incorrect, contending that his service-connected PTSD has been disabling for many years. In order for the appellant to be entitled to an earlier effective date, the Board must determine whether the claims folder contains any prior informal claim for benefits for service connection for PTSD between the time of the discharge from service on May 14, 1974, until the current December 22, 2008, effective date now assigned. 38 C.F.R. §§ 3.1(p), 3.155(a) (2012); Lalonde v. West, 12 Vet. App. 377, 382 (1999). At the outset, there is no evidence that a claim for service connection for PTSD or any other psychiatric disorder was received within one year after the appellant's separation from military service in May 1974, so the effective date cannot be the day following his separation from service. 38 C.F.R. § 3.400(b)(2) (2012). In this regard, although the appellant filed a claim for a nonservice-connected pension in August 2008, there is no mention of PTSD in the context of this earlier claim. VA is not required to anticipate any potential claim for a particular benefit where no intention to raise it was expressed. Brannon, 12 Vet. App. at 35; Talbert, 7 Vet. App. at 356-57. In addition, the claims folder contains no other communication from the appellant or his representative indicating an intent to seek, or a belief in entitlement to, service connection for PTSD from the time of discharge from service in May 1974 until December 22, 2008, the current date assigned. 38 C.F.R. §§ 3.1(p), 3.155(a) (2012). In order for a statement to be construed as a claim, the claimant must identify the benefit sought. This means that the claimant must describe the nature of the disability for which he is seeking benefits. His identification of the benefit sought does not require any technical precision. See Ingram, 21 Vet. App. at 256-57. A claimant may identify the benefit sought by referring to a body part or system that is disabled or by describing symptoms of the disability. Brokowski v. Shinseki, 23 Vet. App. 79, 86-87 (2009). The record indicates that the appellant originally filed a claim for entitlement to service connection for a bipolar disorder - a psychiatric disorder that produces many of the same symptoms and manifestations produced by PTSD - on December 22, 2008. There is nothing in the record suggesting that he was seeking VA service connection benefits prior to that date. In other words, there is nothing in the SSA records or the VA medical treatment records that demonstrate that the appellant had "an intent to apply for benefits" per the requirements of 38 C.F.R. § 3.155(a) until December of 2008. Upon review of the evidence, the Board does not find that VA treatment records or SSA records produced prior to the December 2008 date constitute an informal claim for service connection for PTSD. They are simply records of treatment for a myriad of disorders, but not a bipolar disorder or PTSD, created by VA and SSA medical personnel - they are not a communication from the appellant, his representative, a Member of Congress, or an agent communicating an intent to file a claim for compensation benefits. See 38 C.F.R. §§ 3.1, 3.155(a), (b) (2012). In addition, these VA and SSA treatment records merely revealed that the appellant sought treatment for multiple disorders, including depression, prior to December 2008. There is no mention in any of these treatment records that the appellant was seeking or intended to seek VA compensation for PTSD. This evidence does not show an intent by the appellant to file a claim for PTSD or any other psychiatric disorder until December 2008. The mere existence of medical records generally cannot be construed as an informal claim; rather, there must be some intent by the claimant to apply for a benefit. See Criswell v. Nicholson, 20 Vet. App. 501, 504 (2006), citing Brannon, 12 Vet. App. at 35. The Court has also stated that a veteran's attempt to obtain treatment does not comprise a claim. Dunson v. Brown, 4 Vet. App. 327, 330 (1993). It is further noted that, under 38 C.F.R. § 3.157, a report of examination or hospitalization will be accepted as an informal claim for benefits. However, the provisions of 38 C.F.R. § 3.157 only apply once a formal claim for compensation or pension has been allowed or compensation disallowed because the disability is not compensable. Here, the appellant's December 2008 claim was not pre-dated by an adjudication of the type cited in 38 C.F.R. § 3.157(b), and, as such, that regulation does not afford a basis for finding that his claim, be it formal or informal, of entitlement to service connection for PTSD was filed earlier than December 22, 2008. 38 C.F.R. § 3.157; Crawford v. Brown, 5 Vet. App. 33 (1993). In summary, the Board finds that the appellant's VA and SSA treatment records and examinations dated from 2000 to December 2008, do not constitute pending, unadjudicated claims for service connection for PTSD. In addition, the claims folder contains no other communication from the appellant or his representative indicating intent to seek, or a belief in entitlement to, service connection for depression from the time of discharge from service in May 1974 until December 22, 2008, the current effective date assigned. 38 C.F.R. §§ 3.1(p), 3.155(a) (2012). Moreover, there is no provision in the law for awarding an earlier effective date based on evidence that the appellant exhibited symptoms of PTSD prior to that date. While VA is obligated to consider all possible bases for compensation, this does not mean that it must consider claims that have not been raised. Dunson, 4 Vet. App. at 330. Again, the general default rule is that the effective date of an award of a claim is the date of receipt of the claim application or the date entitlement arose, whichever is later. 38 U.S.C.A. § 5110(a) (West 2002); 38 C.F.R. § 3.400 (2012). Here, the date of claim (December 22, 2008), provides the earliest effective date possible when considering the facts of the present case. The Board need not determine whether the precise "date of entitlement" for PTSD is prior to the date of claim or subsequent to it, since in either case the date of claim (December 22, 2008) provides the earliest effective date possible. Therefore, the claim for an effective date earlier than December 22, 2008, for the award of service connection for PTSD must be denied. 38 U.S.C.A. § 5107(b) (West 2002 & Supp. 2012). ORDER A 50 percent disability rating, but no higher, for PTSD, for the entire appeals period, is granted, subject to the law and regulations governing payment of monetary benefits. The claim for an effective date earlier than December 22, 2008, for the grant of service connection for PTSD is denied. REMAND The appellant, through his written statements to the VA, has alleged that his ability to work has been greatly compromised due to his PTSD. In other words, it has been asked, in essence, that a total disability evaluation based on individual unemployability due to the appellant's service-connected disability (TDIU) be assigned. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the Court held that a TDIU claim is part of a claim for a higher rating when such claim is raised by the record or asserted by the claimant. The Court further held that when evidence of unemployability is submitted at the same time that the claimant is appealing the initial rating assigned for a disability, the claim for TDIU will be considered part and parcel of the claim for benefits for the underlying disability. Id. Here, a liberal reading of the record indicates that the issue of entitlement to a TDIU has been raised. The claim for the awarding of a TDIU is part of the claim for a higher rating stemming from an initial rating and as such, a determination must also be made with respect to this claim. Therefore, on remand, the appellant should be provided Veterans Claims Assistance Act of 2000 (VCAA) notice regarding the information and evidence necessary to substantiate a TDIU and be requested to complete and return VA Form 21-8940 (Veteran's Application for Increased Compensation Based on Unemployability). Additionally, as PTSD is his sole service-connected disability, an opinion regarding whether such disability render him unemployable should be obtained in connection with his VA examination. See Friscia v. Brown, 7 Vet. App. 294, 297 (1994). Accordingly, the case is REMANDED for the following action: 1. The appellant should be provided with proper VCAA notice regarding the evidence and information necessary to substantiate his TDIU claim. He should also be requested to complete and return VA Form 21-8940 (Veteran's Application for Increased Compensation Based on Unemployability). 2. The AMC shall review the record and ensure compliance with all notice and assistance requirements set forth in the VCAA and subsequent interpretive authority as it pertains to 38 C.F.R. § 3.321(b) (2012) and 38 C.F.R. § 4.16 (a) and (b) (2012). The claims file must also include documentation that there has been compliance with the VA's duties to notify and assist a claimant as set forth in the VCAA as specifically affecting the issue of entitlement to a TDIU to include as being granted via an extraschedular rating. 3. The AMC should contact the appellant and ask that he identify all sources of medical treatment received from 2010 to the present for his psychiatric disorder, and to furnish signed authorizations for release to the VA of private medical records in connection with each non-VA source identified. Copies of the medical records from all sources (not already in the claims folder) should then be requested. Any response received should be memorialized in the appellant's claims folder. All records obtained should be added to the claims folder. If requests for any private or non-VA government treatment records are not successful, the AMC should inform the appellant of the nonresponse so that he will have an opportunity to obtain and submit the records himself, in keeping with his responsibility to submit evidence in support of his claim. See 38 C.F.R. § 3.159 (2012). 4. Thereafter, the appellant should be scheduled for a VA psychiatric examination. The examiner should be provided a copy of this remand together with the appellant's entire claims folder, and the examiner is asked to indicate whether he or she has reviewed the claims folder. All appropriate tests should be conducted. The examiner should determine the extent and severity of the service-connected PTSD. Said examiner should assign a numerical code under the Global Assessment of Functioning Scale (GAF) provided in the Diagnostic and Statistical Manual for Mental Disabilities, and he/she should identify what symptoms the appellant currently manifests, or has manifested, that are attributable to his service-connected mental disorder. If other psychiatric conditions are diagnosed, the examiner should differentiate the symptoms of those disorders which the examiner determines are not related to PTSD. If this is not practicable, the examiner should so state in the examination report. The examiner must provide a comprehensive report including rationales for all opinions and conclusions. Also, the examiner should opine whether the appellant's PTSD precludes him from securing and following substantially gainful employment, without regard to any nonservice-connected disorders. 5. The AMC should review the claims folder and ensure that all of the foregoing development actions have been conducted and completed in full. If any development is incomplete, appropriate corrective action is to be implemented. Specific attention is directed to the report of examination. If the requested report does not include fully detailed descriptions of pathology and all test reports, special studies or adequate responses to the specific opinions requested, the report must be returned for corrective action. 38 C.F.R. § 4.2 (2012); see also Stegall v. West, 11 Vet. App. 268 (1998). 6. Thereafter, the AMC should readjudicate the claim on appeal. The AMC is reminded that in making a determination as to whether a TDIU may be granted based on extraschedular considerations, that the AMC must fully discuss why it is or is not sending the claim to the Director, VA Compensation and Pension. If the benefits sought on appeal remain denied, the appellant and his representative should be provided with a supplemental statement of the case (SSOC). The SSOC must contain notice of all relevant actions taken on the claims for benefits, to include a summary of the evidence and applicable law and regulations considered pertinent to the issue currently on appeal. An appropriate period of time should be allowed for response before the case is returned to the Board. Thereafter, the case should be returned to the Board, if in order. The Board intimates no opinion as to the ultimate outcome of this case. The appellant need take no action unless otherwise notified. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). The appellant is hereby placed on notice that pursuant to 38 C.F.R. § 3.655 (2012) failure to cooperate by attending the requested VA examination may result in an adverse determination. See Connolly v. Derwinski, 1 Vet. App. 566, 569 (1991). Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). ______________________________________________ Eric S. Leboff Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs