Citation Nr: 18143784 Decision Date: 10/22/18 Archive Date: 10/22/18 DOCKET NO. 16-19 296A DATE: October 22, 2018 ORDER The appeal for entitlement to an increased rating for bilateral hearing loss disability is dismissed. The appeal for entitlement to an increased rating for tinnitus is dismissed. The appeal for entitlement to an increased rating for anal/perianal fistula is dismissed. Entitlement to an increased rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied. Entitlement to a grant of total disability based on individual unemployability (TDIU) is granted. FINDINGS OF FACT 1. In December 2017, prior to the promulgation of a decision in the appeal, the Board received a request from the Veteran to withdraw the appeals for increased rating for bilateral hearing loss disability, tinnitus, and anal/perianal fistula. 2. The Veteran’s PTSD manifested in symptoms that were productive of occupational and social impairment with deficiencies in most areas, but not total occupational and social impairment. 3. The Veteran is unable to obtain and maintain substantially gainful employment due to his service-connected PTSD. CONCLUSIONS OF LAW 1. The criteria for withdrawal of an appeal for increased rating for bilateral hearing loss disability, tinnitus, and anal/perianal fistula by the Veteran have been met. 38 U.S.C. § 7105(b)(2), (d)(5); 38 C.F.R. § 20.204. 2. The criteria for entitlement to an increased rating in excess of 70 percent for posttraumatic stress disorder (PTSD) have not been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. § 4.126, 4.3, 4.7, 4.130, Diagnostic Code 9411. 3. The criteria for assignment of a TDIU are met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.340, 3.341, 4.1, 4.3, 4.16, 4.19, 4.25, 4.26. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from June 1971 to September 1973. Dismissal The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 20.204. In the present case, the Veteran, in a December 2017 written statement via his representative, has withdrawn the appeal for an increased disability rating for bilateral hearing loss disability, tinnitus, and anal/perianal fistula and, hence, there remain no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeals for an increased disability rating for bilateral hearing loss disability, tinnitus, and anal/perianal fistula, and the appeals with respect to these issues are dismissed. Increased Rating 1. Entitlement to an increased rating in excess of 70 percent for posttraumatic stress disorder (PTSD) The Veteran contends that his PTSD symptoms caused total occupational and social impairment during the period on appeal. After a review of the evidence of record, the Board finds that a disability rating in excess of 70 percent for PTSD is not warranted. Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities (Rating Schedule), which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. If there is a question as to which evaluation to apply to the Veteran’s disability, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in the Veteran’s favor. 38 C.F.R. § 4.3. Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings are sufficiently characteristic to identify the disease and the resulting disability and coordination of rating with impairment of function. 38 C.F.R. § 4.21. Therefore, the Board has considered the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the Veteran, as well as the entire history of his disability in reaching its decision. Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991). In considering the severity of a disability, it is essential to trace the medical history of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41. Consideration of the whole-recorded history is necessary so that a rating may accurately reflect the elements of any disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Although the regulations do not give past medical reports precedence over current findings, the Board is to consider the veteran’s medical history in determining the applicability of a higher rating for the entire period in which the appeal has been pending. Powell v. West, 13 Vet. App. 31, 34 (1999). Mental disorders are evaluated under the general rating formula for mental disorders, a specific rating formula presented under 38 C.F.R. § 4.130. In addition, the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) provides guidance for the nomenclature employed within 38 C.F.R. § 4.130. However, effective August 4, 2014, VA amended the portion of its Schedule for Rating Disabilities dealing with mental disorders and its adjudication regulations that define the term “psychosis” to remove outdated references to the DSM-IV and replace them with references to the recently updated Diagnostic and Statistical Manual (Fifth Edition) (the DSM-5). See 79 Fed. Reg. 45,094 (August 4, 2014). VA adopted as final, without change, this interim final rule and clarified that the provisions of this interim final rule do not apply to claims that have been certified for appeal to the Board or are pending before the Board on or before August 4, 2014. See Schedule for Rating Disabilities - Mental Disorders and Definition of Psychosis for Certain VA Purposes, 80 Fed. Reg. 14,308 (March 19, 2015). In the present case, the RO certified the Veteran’s appeal to the Board in September 2016, which is after August 4, 2014. Thus, the version of 38 C.F.R. § 4.125 conforming to the DSM-5 is applicable in the present case. In any event, the Board will still consider any private or VA examiner’s discussion of both the DSM-IV and DSM-5 in adjudicating the current Veteran’s PTSD claim, in order to provide the Veteran with every benefit of the doubt. When evaluating a mental disorder, the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran’s capacity for adjustment during periods of remission must be considered. 38 C.F.R. § 4.126(a). In addition, the evaluation must be 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 evaluating the level of disability from a mental disorder, the extent of social impairment is considered, but the rating cannot be assigned solely on the basis of social impairment. 38 C.F.R. § 4.126(b). As provided by the General Rating Formula, 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; difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130. A 70 percent rating is in order when there is 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 in order when 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; and memory loss for names of close relatives, own occupation, or own name. Id. A veteran need not exhibit “all, most, or even some” of the symptoms enumerated in the General Rating Formula for Mental Disorders to warrant the assignment of a higher rating. Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). Rather, the use of the phrase “such symptoms as,” followed by a list of examples, provides guidance as to the severity of symptomatology contemplated for each rating. Id. In particular, use of such terminology permits consideration of items listed as well as other symptoms and contemplates the effect of those symptoms on the claimant’s social and work situation. Mauerhan, 16 Vet. App. at 442. The Federal Circuit has clarified that the General Rating Formula for Mental Disorders requires not only (1) sufficient symptoms of the kind listed in the percentage requirements, or others of similar severity, frequency, or duration, but also (2) that those symptoms cause the level of occupational and social impairment specified in the regulation. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). The Federal Circuit endorsed an approach whereby the Board would identify the symptoms associated with the service-connected mental health disability, determine whether they are of the kind enumerated in the regulation, and if so, assess whether they result in the level of occupational and social impairment specified by a particular rating. Id. The Veteran’s service-connected PTSD is currently assigned a 70 percent evaluation pursuant to 38 C.F.R. § 4.130, Diagnostic Code 9411. The Veteran filed the initial request for service connection for PTSD in April 2014. The RO issued a rating decision in September 2014 granting service connection for PTSD at 70 percent since April 11, 2014. The notice to the Veteran was mailed on September 24, 2014. In February 2015, the Veteran submitted a claim for an increased rating for PTSD. The RO considered this as a new increased rating claim, not a notice of disagreement with the rating decision. The RO issued another rating decision in June 2015 continuing the 70 percent rating for PTSD. The Veteran submitted additional evidence in August 2015, which the Veteran’s representative argues in a December 2017 statement should be considered as new and material evidence per 38 C.F.R. § 3.156(b). The RO issued another rating decision in November 2015. The Veteran submitted notices of disagreement in March and April 2016. In response to the April 2016 statement of the case, the Veteran submitted a Form VA-9 in May 2016. The Veteran has been afforded three VA examinations for the PTSD claim, one each in September 2014, May 2015, and August 2015. The Veteran also receives regular mental health treatment and the treatment records are in the electronic claims file. At the September 2014 VA examination, the examiner confirmed a diagnosis of PTSD. The Veteran reported living alone at the time of examination with his dog, although he was still married to his second wife. The Veteran had worked for 29 years in law enforcement. The Veteran started PTSD treatment at the VA around 2013. The Veteran reported symptoms including prolonged periods of mood disturbances reducing motivation to participate in social activities, impaired impulse control and increased verbal altercations with others to include his wife, chronic sleep disturbances including nightmares, difficulty adapting to stressful circumstances due to heightened arousal and hypervigilance, and an inability to maintain effective relationships. In additional those symptoms, the examiner noted that the Veteran has periods wherein his ability to tend to basic activities of daily living (ADLs) is impaired. The Veteran was taking prescription medication for his PTSD symptoms. The symptoms related to the Veteran’s diagnosis included depressed mood, anxiety, suspiciousness, near-continuous panic or depression affecting the ability to function independently, chronic sleep impairment, mild memory loss such as forgetting names, directions, or recent events; flattened affect, disturbances of mood and motivation, difficulty in adapting to stressful circumstances, including work or a worklike setting, inability to establish and maintain effective relationships, impaired impulse control such as unprovoked irritability with periods of violence. The examiner observed that the Veteran maintained fair eye contact and his affect was constricted with minimal reactivity and his mood was, per Veteran, “numb, irritable, depressed.” There was no note of psychotic symptoms including audio/visual hallucinations or paranoid ideation. He denied suicidal and homicidal ideations, plans, or intent. The Veteran’s insight and judgment were good. The examiner chose the descriptor correlating the Veteran’s level of severity of PTSD symptoms to a 70 percent evaluation level, that is, symptoms productive of occupational and social impairment with deficiencies in most areas. The Veteran was afforded another VA examination in May 2015. The examiner was the same one who had examined the Veteran in September 2014 and she noted that the Veteran’s PTSD symptoms had not improved or stabilized since that time although he was receiving treatment and taking medication. The examiner noted that with reference to the three functional areas related to employment categorized as 1) activities of daily living, 2) social functioning, and 3) concentration, persistence or pace the Veteran was respectively rated as “mild, marked, moderate” out of a rating scale of none, mild, moderate, marked, extreme. The symptoms related to the Veteran’s diagnosis included depressed mood, anxiety, suspiciousness, near-continuous panic or depression affecting the ability to function independently, chronic sleep impairment; flattened affect, disturbances of mood and motivation, difficulty in adapting to stressful circumstances, including work or a worklike setting, inability to establish and maintain effective relationships, intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene. The Veteran reported his mood at the examination as “angry.” The Veteran was alert and oriented. There was no note of psychotic symptoms including audio/visual hallucinations or paranoid ideation. He denied suicidal and homicidal ideations, plans, or intent. The Veteran’s insight was fair and judgment was intact. The examiner chose the descriptor correlating the Veteran’s level of severity of PTSD symptoms to a 70 percent evaluation level, that is, symptoms productive of occupational and social impairment with deficiencies in most areas. The Veteran was afforded a VA examination in August 2015. The examiner reported that there was little evidence to suggest improvement in the Veteran’s PTSD symptoms since the previous examinations. The examiner noted the addition to the Veteran’s claims file of an August 2015 letter from the Veteran’s treating psychiatrist at VA that the Veteran was permanently disabled due to PTSD and unemployable. Court documents pertaining to orders of protection against the Veteran and violent behavior during his career as a police officer were also added. The Veteran retired from law enforcement in 2006 and the domestic restraining orders were from periods prior to 2006. The examiner noted that with reference to the three functional areas related to employment categorized as 1) activities of daily living, 2) social functioning, and 3) concentration, persistence or pace the Veteran was respectively rated as “moderate, marked, marked” out of a rating scale of none, mild, moderate, marked, extreme. The symptoms related to the Veteran’s diagnosis included depressed mood, anxiety, suspiciousness, near-continuous panic or depression affecting the ability to function independently, chronic sleep impairment, mild memory loss such as forgetting names, directions, or recent events; flattened affect, disturbances of mood and motivation, difficulty in adapting to stressful circumstances, including work or a worklike setting, inability to establish and maintain effective relationships, intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene, and impaired impulse control such as unprovoked irritability with periods of violence. The Veteran was alert and oriented. There was no note of psychotic symptoms including audio/visual hallucinations or paranoid ideation. He denied suicidal and homicidal ideations, plans, or intent. The Veteran’s insight was fair and judgment was intact. The examiner chose the descriptor correlating the Veteran’s level of severity of PTSD symptoms to a 70 percent evaluation level, that is, symptoms productive of occupational and social impairment with deficiencies in most areas. Although the Veteran’s treating psychiatrist stated in an August 2015 letter (and in various treatment notes, e.g. August 2015, January 2016) that the Veteran was unemployable and totally disabled due to PTSD, the treatment records and the VA examiner’s evaluations do not support such a conclusion. The Veteran’s treatment history documents psychosocial stressors with the family such as the Veteran’s wife losing her job and going on unemployment in November 2014, the Veteran’s wife being diagnosed with cancer and going for treatment in December 2015, the Veteran’s adult daughter moving back in with him in September 2014, the Veteran’s stepdaughter causing him stress in May 2014, and the Veteran becoming depressed after the death of an ex-girlfriend in February 2015. Throughout this time period, the Veteran reported not only caring for his wife to include driving her to cancer treatment appointments, but the Veteran also cared for a sick aunt for a period of time, e.g. April 2014. The treatment records document ongoing marital tension, including that the Veteran slept on the couch for more than five years (e.g. August 2013), lived alone at a point although he was married (e.g. September 2014), but then lived with his wife again (e.g. March 2017) and then his wife possibly moving out in April 2017. The Veteran reports a close relationship with his dog who accompanies him when he is solo. The February 2017 treatment note documents many factors contributing to the Veteran’s depression to include pain, winter, his ongoing case with VA, and his health. In December 2015, the Veteran reported to the treating psychiatrist that being turned down for TDIU made him feel “unfairness” and he was angry about the decision. Based on the medical evidence of record as discussed above, the Board finds that the Veteran’s PTSD symptoms are more productive of occupational and social impairment with deficiencies in most areas such as family relations, judgment, thinking, or mood, consistent with a 70 percent disability rating that is currently in effect. The Veteran’s PTSD symptoms do not more nearly approximate the criteria for a 100 percent disability rating. Throughout the Veteran’s mental health treatment records, there are regular notes that the Veteran is not suicidal or homicidal and that he does not have auditory or visual hallucinations or psychosis. The Veteran is not reported to have gross impairment in thought processes or communication. The treatment records do not document that the Veteran has disorientation to time and place. Although the Veteran has many psychosocial stressors, he also manages to care for family members in distress or ill health. Thus, the Board concludes that total social impairment is not shown as contemplated by a 100 percent evaluation. Accordingly, a 70 percent disability rating for the Veteran’s PTSD is appropriate and the appeal for a rating in excess of 70 percent is denied. 2. Entitlement to a grant of total disability based on individual unemployability (TDIU) The Veteran contends that he is unemployable based on his service-connected PTSD. Based on the evidence of record, the Board finds that the Veteran unemployable based solely on his PTSD, accordingly TDIU is not warranted. Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities (Rating Schedule), which is based on the average impairment of earning capacity. 38 U.S.C. § 1155. Total disability is considered to exist when there is any impairment which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340(a)(1). Total disability may or may not be permanent. Id. Total ratings are authorized for any disability or combination of disabilities for which the Rating Schedule prescribes a 100 percent evaluation. 38 C.F.R. § 3.340(a)(2). A TDIU may be assigned when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). If there is only one such disability, it must be rated at 60 percent or more; if there are two or more disabilities, at least one disability must be rated at 40 percent or more, with sufficient additional disability to bring the combined rating to 70 percent or more. Id. For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. Id. Entitlement to a total rating must be based solely on the impact of the Veteran’s service-connected disabilities on his ability to keep and maintain substantially gainful employment. See 38 C.F.R. §§ 3.340, 3.341, 4.16. In reaching such a determination, the central inquiry is “whether the Veteran’s service connected disabilities alone are of sufficient severity to produce unemployability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). For VA purposes, the term “unemployability” is synonymous with an inability to secure and follow a substantially gainful occupation. VAOPGPREC 75-91; 57 Fed. Reg. 2317 (1992). Consideration may be given to the Veteran’s level of education, special training, and previous work experience in arriving at a conclusion. However, individual unemployability must be determined without regard to any nonservice-connected disabilities or the Veteran’s advancing age. 38 C.F.R. §§ 3.341(a), 4.16, 4.19; Van Hoose v. Brown, 4 Vet. App. 361 (1993). A high rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he can find employment. Van Hoose, 4 Vet. App. at 363. If a Veteran fails to meet the threshold minimum percentage standards enunciated in 38 C.F.R. § 4.16(a), rating boards should refer to the Director of Compensation and Pension Service for extraschedular consideration all cases where the Veteran is unable to secure or follow a substantially gainful occupation by reason of service-connected disability. 38 C.F.R. § 4.16(b). See also Fanning v. Brown, 4 Vet. App. 225 (1993). Thus, the Board must evaluate whether there are circumstances in the Veteran’s case, apart from any non-service-connected conditions and advancing age, which would justify a TDIU rating. 38 C.F.R. §§ 3.341(a), 4.16(a), 4.19. See Van Hoose v. Brown, 4 Vet. App. 361 (1993); see also Hodges v. Brown, 5 Vet. App. 375 (1993); Blackburn v. Brown, 4 Vet. App. 395 (1993). The Veteran’s service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue must be addressed. 38 C.F.R. § 4.16(b). The ability to work sporadically or obtain marginal employment is not substantially gainful employment. 38 C.F.R. § 4.16(a); Moore v. Derwinski, 1 Vet. App. 356, 358 (1991). Marginal employment, i.e., earned annual income that does not exceed the poverty threshold for one person, is not considered substantially gainful employment. 38 C.F.R. § 4.16(a). When reasonable doubt arises as to the degree of disability, such doubt will be resolved in the Veteran’s favor. 38 C.F.R. § 4.3. In this case, the Veteran contends that he is prevented from performing substantially gainful employment due to his service-connected PTSD. The Veteran is service-connected for PTSD at 70 percent from April 11, 2014, anal/perianal fistula at 10 percent since September 21, 1973, tinnitus at 10 percent from October 18, 2010, and bilateral hearing loss at a noncompensable rating. The Veteran meets the TDIU minimum percentage requirements from April 11, 2014, at a total disability rating of 80 percent. 38 U.S.C. § 4.16. Consequently, the only remaining question is whether the Veteran is unable to secure or follow a substantially gainful occupation as a result of his service-connected disabilities. Id. The Veteran’s DD-214 documents that he finished high school and was in the infantry during active service. The Veteran’s records note that the Veteran was a law enforcement agent for 29 years until he retired in 2006. This included time working in the narcotics division and on task forces. The Veteran reported in August 2013 that he was looking for a part-time job but had not secured one. The Veteran submitted the Form 21-8940 to apply for TDIU in July 2015 and reported that he became too disabled to work as of September 2013 due to PTSD. The Veteran’s treating psychiatrist stated in an August 2015 letter (and in various treatment notes, e.g. August 2015, January 2016) that the Veteran was unemployable and totally disabled due to PTSD. The Veteran’s treatment history documents psychosocial stressors with the family such as the Veteran’s wife losing her job and going on unemployment in November 2014, the Veteran’s wife being diagnosed with cancer and going for treatment in December 2015, the Veteran’s adult daughter moving back in with him in September 2014, the Veteran’s stepdaughter causing him stress in May 2014, and the Veteran becoming depressed after the death of an ex-girlfriend in February 2015. Throughout this time period, the Veteran reported not only caring for his wife to include driving her to cancer treatment appointments, but the Veteran also cared for a sick aunt for a period of time, e.g. April 2014. The treatment records document ongoing marital tension, including that the Veteran slept on the couch for more than five years (e.g. August 2013), lived alone at a point although he was married (e.g. September 2014), but then lived with his wife again (e.g. March 2017) and then his wife possibly moving out in April 2017. The Veteran reports a close relationship with his dog who accompanies him when he is solo. The February 2017 treatment note documents many factors contributing to the Veteran’s depression to include pain, winter, his ongoing case with VA, and his health. In December 2015, the Veteran reported to the treating psychiatrist that being turned down for TDIU made him feel “unfairness” and he was angry about the decision. In February 2014, the Veteran reported that he thought his service-connected hearing loss was an obstacle to getting a job. At the May 2015 VA examination for hearing loss, the Veteran stated that he though work would be more difficult because it would be hard to hear in “most listening situations.” The Veteran is service-connected for anal/perianal fistula at 10 percent since 1973 during which time he worked as a law enforcement officer for 29 years. In April 2014, the Veteran reported that he had anxiety about finding a job, blaming the difficulty on a lack of available jobs or his advancing age. The Board notes that the availability of work is irrelevant to a TDIU determination. Smith v. Shinseki, 647 F.3d 1380, 1386 (Fed. Cir. 2011). The Board finds the opinion of the Veteran’s treating physician concerning his inability to work in any job as a result of his PTSD to be highly probative. Accordingly, the Board will grant a total disability evaluation due to individual unemployability. 38 C.F.R. § 4.16(b). DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Miller, Erin (BVA)