Citation Nr: 18146541
Decision Date: 10/31/18	Archive Date: 10/31/18

DOCKET NO. 16-47 480
DATE:	October 31, 2018
ORDER
1. Entitlement to a disability rating in excess of 50 percent for other specified trauma and stressor related disorder is denied.
2. Entitlement to a total disability evaluation based on individual unemployability (TDIU) due to service-connected disabilities is denied.
FINDINGS OF FACT
1. The Veteran’s other specified trauma and stressor related disorder has not been manifested by occupational and social impairment with deficiencies in most areas at any point during the appeal period.
2. The preponderance of the evidence is against a finding that the Veteran is precluded from obtaining and sustaining gainful employment due to service-connected disabilities.
CONCLUSIONS OF LAW
1. The criteria for a disability rating in excess of 50 percent for other specified trauma and stressor related disorder have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.125, 4.126(a), 4.130, DC 9411 (2017).
2. The criteria for entitlement to a TDIU rating have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.340, 3.341(a), 4.3, 4.16, 4.18, 4.19, 4.25 (2017).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran served on active duty from February 1970 to February 1994.
1. Entitlement to a disability rating in excess of 50 percent for other specified trauma and stressor related disorder.
Disability ratings are determined by evaluating the extent to which a veteran’s service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing the symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). The percentage ratings in the Rating Schedule represent the average impairment in earning capacity resulting from service-connected diseases and injuries and their residual conditions in civilian occupations. The percentage ratings are generally adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the disability.
Diagnostic Codes (DCs) are assigned by the rating officials to individual disabilities. DCs provide rating criteria specific to a particular disability. If two DCs are applicable to the same disability, the DC that allows for the higher disability rating applies. See 38 C.F.R. § 4.7 (2017). When a question arises as to which of two ratings apply under a particular DC, the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. See id. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of a veteran. 38 C.F.R. § 4.3. 
PTSD is evaluated under the General Rating Formula for Mental Disorders. See 38 C.F.R. § 4.130, DC 9411. Under the General Rating Formula for Mental Disorders, a 50 percent disability rating is assigned for PTSD manifested by 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.
A 70 percent disability rating requires 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); or inability to establish and maintain effective relationships. 
A 100 percent disability rating requires total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation, or own name. 
The Veteran’s records include evaluations based on the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (4th ed. 1994) (DSM-IV), which includes Global Assessment Functioning (GAF) scores, and the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013) (DSM-5), which does not use GAF scores. The United States Court of Appeals for Veterans Claims (Court) has held that the use of GAF scores to assign disability ratings in instances where the DSM-5 applies, as is the case here, is inappropriate. See Golden v. Shulkin, No. 16-1208, 2018 U.S. App. Vet. Claims LEXIS 202, at *1, *9 (Vet. App. Feb. 23, 2018). However, the Court acknowledged that the Secretary did not intend the provisions of this final rule to apply to claims that were pending before the Board (certified for appeal) on or before August 4, 2014. Id. The current Veteran’s claim was certified for appeal to the Board in October 2016, thus, the Board shall not discuss GAF scores below.
The Court in Mauerhan v. Principi stated that “when evaluating mental health disorders, the factors listed in the Rating Schedule are simply examples of the type and degree of symptoms, or their effects, that would justify a particular rating; analysis should not be limited solely to whether a veteran exhibited the symptoms listed in the Rating Schedule. Rather, the determination should be based on all of a veteran’s symptoms affecting his level of occupation and social impairment.” See Mauerhan, 16 Vet. App. 436, 442-43 (2002). The lists of symptoms under the Rating Schedule are meant to be examples of symptoms that would warrant the disability evaluation, but are not meant to be exhaustive. Id. If the evidence demonstrates that a claimant suffers symptoms or effects that cause occupational and social impairment equivalent to that which would be caused by those listed in the rating criteria the appropriate equivalent rating will be assigned. Id. at 442.
The Veteran contends that her other specified trauma and stressor related disorder should be rated higher than the assigned disability ratings of 50 percent under 38 C.F.R. § 4.130, DC 9411.
During the July 2014 VA mental disorders examination, the Veteran reported frequent depressed mood (not continuous), low energy, sleep disturbance, and passive thoughts of death or dying without intent or plan consistent with a diagnosis of unspecified depressive disorder. The examiner indicated that she did not meet full symptom criteria for a major depressive disorder. The examiner indicated that the Veteran’s psychiatric symptoms of other specified trauma and stressor related disorder and unspecified depressive disorder appeared to be mildly impacting her level of social and occupational functioning. The Veteran was not involved in a romantic relationship and indicated that she had minimal involvement in recreational and leisure activities besides socializing with family members but had one close friend who she saw regularly and was actively involved in church. The Veteran described close relationships with her friend, siblings, nieces and nephews, children, and grandchildren. The Veteran had depressed mood and distress related to not being able to see her oldest grandson.
The examiner noted that the Veteran was polite and compliant during the examination, had good hygiene, and had normal speech and appropriate eye contact. The Veteran was alert, attentive, and oriented to person, place, time, and situation, with intact attention and concentration. The examiner found that the Veteran’s immediate, short-term, and long-term memory appeared adequate, thought processes were logical and organized. There was no evidence of hallucinations, delusions, or paranoia. 
The examiner also noted, regarding the Veteran’s occupational functioning, that she had not worked since she retired in July 2013 and was promoted to a management position in 2010. The Veteran reported work-related stress throughout mental health treatment but had no history of job terminations and successfully worked in management from 2010 to 2013.
The examiner indicated that symptoms that actively applied to the Veteran’s other specified trauma and stressor related disorder included nightmares about military sexual trauma experiences; physical and psychological distress when exposed to cues and reminders of traumatic events; avoidance of thoughts, memories, and external reminders of traumatic events; and difficulty sleeping associated with traumatic events. Clinically significant symptoms of unspecified depressive disorder included frequent depressed mood, low energy, sleep disturbance, and passive thoughts of death or dying without intent or plan. The Veteran indicated that she had passive thoughts of wanting to hurt herself on occasion but would not act on her thoughts because of her feelings about her grandchildren and son. Specifically, she knew that “it would hurt them a lot,” and denied current thoughts of harming herself or others. The Veteran denied any problems completing activates of daily living, such as bathing, dressing, toileting, or eating, and had no problems maintaining personal hygiene. 
The examiner indicated that “occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation,” best summarized the Veteran’s level of occupational and social impairment regarding his mental diagnosis, which is the criteria for a 30 percent rating. The examiner also found that the Veteran was capable of managing her own financial affairs.
The Veteran proffered a letter from her private psychiatric care provider dated August 21, 2013. The private physician indicated that he had treated the Veteran from March 2006 to July 2009 and reexamined the Veteran psychiatrically on August 15, 2013. He diagnosed the Veteran with chronic PTSD and major depression, providing a GAF score of 40. However, as discussed above, the use of GAF scores is inappropriate in this application. See Golden, No. 16-1208, 2018 U.S. App. Vet. Claims LEXIS 202, at *1, *9.
The private physician stated that the Veteran had flashbacks two to three times per week, panic attacks three times per week, and averaged seven hours of sleep per night. It was also noted that the Veteran had intrusive thoughts, startled easily, was hypervigilant, and could not tolerate anyone behind her. The Veteran socialized at church. The private physician also noted that the Veteran’s recent memory was severely impaired with 50 percent impairment of working memory and 50 percent of the time experienced anger, sadness, and fear without her understanding why. The Veteran stated that she heard noises in the house and saw shadows moving out of the corner of her eyes two to three times per day. The Veteran was noted to feel depressed 60 percent of the time with low energy and little interest in things, angered and agitated easily, and felt helpless and suicidal at times. The private physician found that the Veteran was mentally competent to manage her own financial affairs and make life-changing decisions. He also opined that because of the service connected PTSD, the Veteran is unable to sustain social and work relationships, and therefore is permanently and totally disabled and unemployable.
The Veteran was most recently provided a VA examination in August 2016. The examiner diagnosed other specified trauma and stressor related disorder and major depressive disorder. The examiner indicated that it was not possible to differentiate the symptoms attributed to each diagnosis. Symptoms that actively applied to the Veteran’s diagnoses included depressed mood, anxiety, suspiciousness, panic attacks that occur weekly or less often, chronic sleep impairment, impairment of short- and long-term memory, and suicidal ideation. The examiner also noted that the Veteran looked sad and anxious with furrowed brow and was afraid to sleep due to fear that she would die in her sleep. The Veteran was occasionally sad and tearful and stated that she felt like damaged goods and disenfranchised. Except for church she was socially withdrawn, may get very lonely, and her one friend was difficult to get together with. The Veteran stated that she thought about suicide and wished that she could but she had a son and grandchildren so she tried to think of other things. The examiner found that the Veteran did not appear to pose any threat of danger or injury to self or others and was capable of managing her financial affairs.
The examiner indicated that “occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation,” best summarized the Veteran’s level of occupational and social impairment regarding his mental diagnosis, which is the criteria for a 30 percent rating.” The examiner noted that the Veteran retired in 2013 as a correctional officer secondary to her orthopedic problems and her reactions to the inmates. The examiner added that the Veteran had a clean legal and behavioral history except for a DUI in approximately 1993.
The weight of the evidence demonstrates that throughout the appeal period, the criteria for a disability rating in excess of 50 percent for the Veteran’s service-connected other specified trauma and stressor related disorder have not been met. Specifically, the Veteran’s other specified trauma and stressor related disorder has not been manifested by symptomatology more nearly approximating 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); or inability to establish and maintain effective relationships. 38 C.F.R. § 4.130, DC 9411. The Board has fully considered the frequency, severity, and duration of all of the Veteran’s psychiatric symptoms with respect to their effect on other areas of overall occupational and social functioning. 38 C.F.R. § 4.126(a).
Although the August 2013 private physician care provider opined that the Veteran is permanently and totally disabled and unemployable due to her acquired psychiatric disorder, the Board notes that VA adjudicators, not medical examiners, apply legal standards in rendering determinations. The determination of a mental health evaluation should be based on all of a veteran’s symptoms affecting her level of occupation and social impairment.” See Mauerhan, 16 Vet. App. at 442-43. Both the July 2014 and August 2016 VA examiners found “occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation,” best summarized the Veteran’s level of occupational and social impairment regarding her mental diagnosis, which is the criteria for a 30 percent rating. While the adjudicator makes the ultimate determination of what evaluation is warranted for the service-connected psychiatric disorder, the examiners’ conclusions that the Veteran’s other specified trauma and stressor related disorder was best summarized by the criteria described under the 30 percent evaluation is probative evidence as to the examiners’ assessment of the occupational and social impairment caused by the Veteran’s psychiatric disorder and is evidence against a finding that an evaluation in excess of 50 percent is warranted.
The symptoms exhibited by the Veteran are contemplated by the 50 percent disability rating in effect, which encompasses 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.
The preponderance of the evidence is against a finding that the Veteran’s depression resulted in occupational and social impairment, with deficiencies in most areas. The Veteran consistently denied suicidal or homicidal ideation, delusions, and hallucinations. Although she reported passive thoughts of wanting to hurt herself on occasion and suicidal thoughts during the July 2014 and August 2018 examinations, respectfully, she indicated that she would not act on her thoughts because of her feelings about her grandchildren and son. Specifically, she said she knew that “it would hurt them a lot,” and denied current thoughts of harming herself or others.
VA medical records including in February 2013, October 2015, December 2015, and April 2016 reflect that the Veteran posed no risk to herself or others and while in some records she indicated that she admitted to occasionally thinking about suicide, she stated that she would never hurt herself. The record shows that a protective factor is her love for her grandkids and that she experienced suicidal ideation only while driving and never in other circumstances, as indicated in an October 2015 VA medical record. The Veteran has consistently shown orientation in all spheres, an ability to perform activities of daily living including maintaining minimal personal hygiene and appropriate behavior. 
The Veteran maintains a relationship with siblings, nieces and nephews, children, and grandchildren, and a close friend; whom she indicated she had regular interaction with. Specifically, a February 2013 VA medical record reflects that the Veteran socialized with friends and family and went to church twice a week for bible study and Sunday service. In August 2015, the Veteran reported that she spent weekends with her grandsons and had driven to a family reunion. The Veteran also stated that she regularly drove her brother and nephew to their medical appointments and that helping others was gratifying for her. October 2015 VA medical records indicate that the Veteran had accessed support from her minister and other church members; had opted to stay connected with friends and family; remained involved in church activities; and provided care for her grandsons. She stated that she had made a concerted effort not to isolate herself and had recently watched a movie in the theater with members of her church. This is evidence against a finding of an inability to establish and maintain effective relationships. Furthermore, the Veteran had been consistently participating in group sleep psychology counseling. Medical records are unremarkable for any risk of self-harm and the Veteran has not been hospitalized for mental health. The record does not show that the Veteran has any intent of self-harm or harm to others. Such is evidence against a finding of deficiencies in family relations.
In addition, the Board has considered the Veteran’s risk of self-harm, the persistent danger of which VA generally considers indicative of a 100 percent disability evaluation. See Bankhead v. Shulkin, 29 Vet. App. 10 (2017); 38 C.F.R. § 4.130. The VA examination reports and clinical records are unremarkable for any risk of self-harm. The record reflects that the Veteran was able to maintain numerous interpersonal relationships including with her family, close friend, and church. The Veteran also attended sleep psychology support groups. This is evidence against a finding of total social impairment.
Following her retirement in July 2013, the Veteran reported that she had felt more relaxed, more rested, and less stressed. In November 2013, she reported some decline in mood and sleeping difficulty in October 2013 secondary to boredom, frustration, and missing going to work. The Veteran indicated that she retired due to her orthopedic problems and reaction to inmates during the August 2016 VA examination. Physical pain that contributed to her retirement would not be indicative that her acquired psychiatric disorder caused total occupational impairment.
Therefore, in consideration of the frequency, severity, and duration of the Veteran’s symptoms and their effect on the Veteran’s overall occupational and social functioning, the Board finds that the Veteran’s other specified trauma and stressor related disorder does not manifest in occupational and social impairment with deficiencies in most areas and a 70 percent disability rating is not warranted.
For these reasons, the Board finds the preponderance of the evidence weighs against entitlement to an increased disability rating in excess of 50 percent for other specified trauma and stressor related disorder. As the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application, and the claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3.
2. Entitlement to a total disability evaluation based on individual unemployability (TDIU) due to service-connected disabilities.
The Veteran filed a formal claim for a TDIU rating on July 11, 2013. The Veteran contends that a TDIU rating is warranted based on her service-connected posttraumatic stress disorder (PTSD), which she alleges prevents her from securing or following any substantially gainful occupation. On her formal application, she answered “July 1, 2013,” when asked the date her disability affected full time employment and “June 28,2013” as the date when she last worked full-time. Specifically, the Veteran indicated that she completed 4 years of high school. 
In an April 2014 VA Request for Employment Information in Connection with Claim for Disability Benefits (VA Form 21-4192), the Veteran’s employer indicated that the Veteran’s ending date of employment was June 30, 2013 and that the reason for the termination of employment was “retirement.” The employer answered “N/A” when asked if any concessions were made to the Veteran by reason of age or disability. Further, it was noted that the Veteran worked 8 hours daily and 40 hours weekly and that the Veteran did not lose any time during the 12 months preceding the last date of employment (due to disability). It is also noted that the employer checked “yes” indicating that the Veteran was in receipt or entitled to receive retirement benefits through her employment.
A TDIU rating may be assigned when the schedular rating is less than 100 percent and disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of one or more service-connected disabilities. If unemployability is claimed as a result of only one service-connected disability, it must be rated at 60 percent or more. If it is a result of two or more disabilities, at least one disability must be rated at 40 percent or more, with at least another sufficient disability to bring the combined rating to 70 percent or more. See 38 C.F.R. §§ 3.341(a), 4.16(a).
The Veteran is currently in receipt of compensation for other specified trauma and stressor related disorder at 50 percent disabling; right big toe bunionectomy at 10 percent disabling; thoracic spine strain at 10 percent disabling; vaginitis at 10 percent disabling; scar, left breast biopsy at 10 percent disabling; scar, right breast biopsy at 10 percent disabling; hemorrhoids at a noncompensable evaluation; post-operative inguinal hernia at a noncompensable evaluation; and fibrocystic breast disease at a noncompensable evaluation. The combined rating for these disabilities is 70 percent, effective February 21, 2006. See 38 C.F.R. § 4.25 Table I. The Veteran meets the schedular criteria for a TDIU rating. 38 C.F.R. § 4.16(a).
In reaching a determination of entitlement to a TDIU rating, it is necessary that the record reflect some factor that takes the Veteran’s case outside the norm with respect to a similar level of disability under the rating schedule. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993); 38 C.F.R. §§ 4.1, 4.15 (2017). The fact that a claimant is unemployed or has difficulty obtaining employment is not enough. The question is whether or not 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.
The central inquiry is “whether service-connected disabilities alone are of sufficient severity to produce unemployability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). The level of education, special training, and previous work experience may be considered as part of a TDIU claim. Age or impairment(s) caused by nonservice-connected disabilities may not be considered when determining whether such a total disability rating is warranted. See 38 C.F.R. §§ 3.341, 4.16, 4.19.
Mere theoretical ability to engage in substantial gainful employment is not a sufficient basis to deny benefits. The test is whether a particular job is realistically within the physical and mental capabilities of the claimant. Moore v. Derwinski, 1 Vet. App. 356, 359 (1991).
In consideration of all the lay and medical evidence, the Board finds that the preponderance of the evidence is against a finding that the Veteran was unable to secure and follow a substantially gainful employment due to his service-connected disabilities alone at any point during the appeal period.
The Veteran proffered a letter from her private psychiatric care provider dated August 21, 2013. He also opined that because of the service connected PTSD, the Veteran is unable to sustain social and work relationships, and therefore is permanently and totally disabled and unemployable.
Both the July 2014 and August 2016 VA examiners found “occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation,” best summarized the Veteran’s level of occupational and social impairment regarding her mental diagnosis.
The Board has considered the opinions of the VA examiners and physicians; however, the ultimate question of whether a veteran is capable of substantial gainful employment is not a medical one; that determination is for the adjudicator. See 38 C.F.R. § 4.16(a). The Board finds the preponderance of the evidence is against a finding that the Veteran’s service-connected disabilities alone prevented her from securing and following substantially gainful employment. 
While the Veteran asserts that she is unemployable due to her acquired psychiatric disorder, the opinions of the VA examiners discussed above do not support such assertion. In particular, in a February 2013 VA medical record, the Veteran indicated that she was looking forward to retiring on June 30, 2013. The July 2014 examiner referenced VA medical records, which supported her findings including a July 2013 record that reflected that the Veteran felt more relaxed, more rested, and less stressed since retirement. Further, a she cited a November 2013 record that indicates that the Veteran reported some decline in mood starting in October 2013 and difficulty sleeping secondary to boredom, frustration, and missing going to work. The Veteran stated that she was exploring work options, such as part-time work, or volunteering. A May 2014 record shows an overall decline in work-related anxiety since retirement. The Veteran remained active and spent weekends with her grandsons, drove to family reunions, and regularly drove her brother and nephew to their medical appointments, as shown in an August 2015 VA medical record. She also attended church activities and participated in a sleep psychology group.
The Veteran indicated that she retired due to her orthopedic problems and reaction to inmates during the August 2016 VA examination. An October 2018 VA medical record shows that the Veteran had chronic pain in her knees and hips. A September 2015 VA medical record shows a dashboard injury with left knee contusion, 15 years prior with knee pain afterwards, and hip pain that began after the injury. The August 2016 examiner stated that although the Veteran reported work-related stress throughout her mental health treatment, she had no history of job termination and successfully worked in management from 2010 to 2013. The Veteran and her employer indicated that she ended employment due to retirement. It is noted that the Veteran was not working due to retirement and was receiving retirement income in an October 2015 VA medical record. This tends to show that the Veteran’s acquired psychiatric disorder did not cause her to stop her gainful employment and that she was still interested and capable of employment, as she stated that she was bored and exploring work options even in her retirement.  The Veteran has a high-school education and was promoted in her job into a management position, and the preponderance of the evidence does not show that she is precluded from performing gainful employment.  She told a VA examiner that she did not like interactions with the inmates, but she could perform management positions in multiple employment circumstances, where she was not working with inmates.
The Board finds the opinions of the VA examiners to be highly probative as they provide competent evidence that weigh against the Veteran’s claim because the VA examiners reviewed the claims file, interviewed the Veteran, performed appropriate examinations, and provided a medical opinion supported by well-reasoned rationale. See Monzingo v. Shinseki, 26 Vet. App. 97, 105-106 (2012). 
The Board has considered the medical and lay evidence of record, including opinions of VA examiners, the Veteran’s lay statements, and the medical evidence available. The Board finds that the preponderance of the evidence is against a finding that the Veteran is rendered unable to secure and follow a substantially gainful employment due solely to service-connected disabilities. The Veteran’s last employment ended due to a planned retirement. There is evidence that some physical ailments, including orthopedic problems of bilateral knee pain, left hip pain, left sided back pain, and left calf pain, may contribute to unemployability. However, the Veteran is not in receipt of service connection for any knee, hip, or calf disability. The preponderance of the evidence of record is against a finding that the Veteran’s service-connected other specified trauma and stressor related disorder alone prevents employment and the Veteran’s other service-connected disabilities, do not, either alone or in combination, preclude employment.
Accordingly, the Board finds that entitlement to a TDIU rating is not warranted. The benefit-of-the-doubt doctrine is not for application and the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 4.3.
 
A. P. SIMPSON
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Cheng, Associate Counsel