Citation Nr: 18147550 Decision Date: 11/05/18 Archive Date: 11/05/18 DOCKET NO. 16-12 356A DATE: November 5, 2018 ORDER Entitlement to service connection for a bilateral ankle disorder is denied. Entitlement to service connection for a lumbar spine disorder is denied. Entitlement to a rating higher than 50 percent for bipolar I disorder prior to April 6, 2015, is denied. Entitlement to a rating of 70 percent for bipolar I disorder from April 6, 2015, is granted. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities prior to April 6, 2015, is denied. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities from April 6, 2015, is granted. FINDINGS OF FACT 1. The Veteran has not demonstrated a current low back disability or functional loss due to lower back pain. 2. The Veteran’s bilateral ankle disorder is less likely than not due to service. 3. Prior to April 6, 2015, the Veteran’s bipolar I disorder manifested by occupational and social impairment with reduced reliability and productivity; it did not manifest by occupational and social impairment with deficiencies in most areas. 4. From April 6, 2015 to October 25, 2015, the Veteran’s bipolar I disorder manifested by occupational and social impairment with deficiencies in most areas; it did not manifest by total occupational and social impairment. 5. Prior to February 24, 2015, the Veteran was only service-connected for bipolar disorder, rated as 50 percent disabling. His total rating was 50 percent. 6. From February 24, 2015 to April 5, 2015, the Veteran was service-connected for bipolar disorder, rated as 50 percent disabling; tinnitus rated as 10 percent disabling; and bilateral hearing loss rated as noncompensable. His total rating was 60 percent. 7. Since April 6, 2015, by way of this decision, the Veteran is now service-connected for bipolar disorder, rated as 70 percent disabling; tinnitus rated as 10 percent disabling; and bilateral hearing loss rated as noncompensable. He meets the schedular criteria for a TDIU from April 6, 2015. 8. Prior to April 6, 2015, the Veteran’s service-connected disabilities alone did not preclude him from securing and following substantially gainful employment. 9. Since April 6, 2015, the Veteran’s service-connected bipolar I disorder precluded him from securing and following substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a bilateral ankle disorder have not been met. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 2. The criteria for entitlement to service connection for a lumbar spine disorder have not been met. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 3. The criteria for entitlement to a rating higher than 50 percent for bipolar I disorder prior to Apri 6, 2015, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.2, 4.7, 4.126, 4.130, Diagnostic Code 9432. 4. Since April 6, 2015, the criteria for a rating of 70 percent for bipolar I disorder have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.2, 4.7, 4.126, 4.130, Diagnostic Code 9432. 5. Prior to April 6, 2015, the criteria for a TDIU have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 3.340, 3.341, 4.3, 4.16. 6. Since April 6, 2015, the criteria for a TDIU have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 3.340, 3.341, 4.3, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service from April 1987 to June 1990. Service Connection A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in line of duty in active service. 38 U.S.C. §§ 1110, 1131. To establish a right to compensation for a present disability, a Veteran must show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service” - the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for a disease shown after service, when all of the evidence, including that pertinent to service, shows that it was incurred in-service. 38 C.F.R. § 3.303(d). 1. Entitlement to service connection for a lower back disorder. The Veteran contends that he has a lower back disorder as a result of service. A threshold requirement for service connection is whether or not there is a current disability. None of the medical evidence of record during the appeal period establishes a low back disorder; none of the VA treatment records of record document a diagnosis of a lower back disability. Instead, they are replete with complaints of subjective lower back pain; but do not establish any functional loss. Indeed his “problem list” throughout the entire appeal period has only indicated low back pain; with no additional indication of functional loss or a diagnosis. Because no functional impairment has been demonstrated for the Veteran’s lower back, the Board finds that he does not have a current low back disability related to an in-service injury. The Board emphasizes that Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C. §§ 1110, 1131, see also 38 C.F.R. §§ 3.303, 3.304. Thus, where, as here, no disability (to include pain causing functional loss) is shown, there can be no valid claim for service connection. In the absence of a diagnosis, the other elements of service connection need not be discussed, and service connection must be denied. 2. Entitlement to service connection for a bilateral ankle disorder. A VA examination from March 2014 shows that the Veteran has a diagnosis of bilateral ankle strain. In addition, the Veteran’s service treatment records document that he was seen in September 1987 for a “right ankle sprain” and in July 1988 for a “left ankle sprain”. As such, the first and second elements of service connection have been met. Therefore, the issue before the Board becomes whether there is a so-called “nexus” between the Veteran’s in-service injuries and his current bilateral ankle disorder. When considering all of the evidence of record, the Board finds that the preponderance is against the Veteran’s claim. In March 2014, after fully interviewing and examining the Veteran, the VA examiner opined that the Veteran’s bilateral ankle disorder was less likely than not due to service. He acknowledged that the Veteran had been seen once for each ankle in service and stated: There are no other references in the STRs to his ankles through his separation in 1990. The Veteran states that he did not develop bilateral ankle pain until 2000/01. He reports “popping” sounds from his ankles starting in 1995. There is a 7-8-year interval between his ankle sprains and popping in his ankles, and a 12-12-year interval between his ankle sprains and any ankle pains. With this long of an interval between the original injury and later symptoms, the original injury would not be the cause of his ankle pain starting in 2000/01. Therefore, the Veteran’s bilateral ankle strain is less likely than not incurred in or caused by his military service. Essentially, the examiner found that the current disabilities the Veteran has are not consistent with the type of injuries he was seen in service for as he would have developed these disabilities far sooner. This opinion provides a clear conclusion with supporting rationale and is based on a thorough review of the claims file. It additionally considered the Veteran’s lay statements. As such, the Board finds it highly probative. The Veteran has not submitted any medical opinion in support of his claim and there are no other medical opinions of record addressing his bilateral ankle disorder. To the extent the Veteran himself has attempted to relate his current disabilities to service, the Board notes that he is not competent. He has not established that he has the medical knowledge necessary to make these determinations and has stated that his pain and popping did not begin until many years post-service. As such, any opinion rendered by the Veteran in this regard is mere conjecture and lacks probative weight. Thus, the Board finds that service connection is not warranted for a bilateral ankle disorder. 3. Entitlement to a rating higher than 50 percent for bipolar I disorder prior to October 26, 2015. Disability evaluations are determined by application of criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § Part 4. When a question arises as to which of two ratings apply under a particular diagnostic code, the higher rating is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. The Veteran’s entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where entitlement to compensation already has been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). The current regulations establish a general rating formula for mental disorders. 38 C.F.R. § 4.130. Ratings are assigned according to the manifestation of particular symptoms. However, the use of the term “such as” in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Accordingly, the evidence considered in determining the level of impairment under 38 C.F.R. § 4.130, Diagnostic Code 9411, is not restricted to the symptoms provided in the diagnostic code. Instead, VA must consider all symptoms of a Veteran’s condition that affect the level of the Veteran’s occupational and social impairment. The Veteran filed a claim for an increased rating for his bipolar disorder in October 21, 2013. By a January 2016 rating decision, the RO increased the Veteran’s rating for his bipolar I disorder from 50 percent to 100 percent effective October 26, 2015, which is the date the RO received the Veteran’s claim for TDIU. The Veteran’s attorney contends that the Veteran should be rated higher for his bipolar I disorder prior to this date. In particular, his attorney has asserted: Dr. Smith found the Veteran suffers from marked impairments in judgment, thinking, and mood, such that his interactions are often marked by anger, irritability, and a chronic desire to “hurt someone.” He recommends a 70-percent disability rating from 2012 based on the veteran’s impairments in most major life areas linked to his mood instability, prolonged periods of depression with frequent suicidal and homicidal ideation. At his March 18, 2014 Compensation and Pension examination, [the Veteran] described “seeing people that weren’t there.” He explained “I think in my head that I hear things. It tells me to kill some people for no reason at all.” Such symptoms certainly warrant a higher rating. A rating of 50 percent is warranted 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 (retention of only highly learned material, forgetting to complete tasks); impaired judgment, impaired abstract thinking; disturbances of motivation and mood; and difficulty establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130, Diagnostic Code 9411. A 70 percent evaluation is warranted where there is objective evidence demonstrating that the Veteran has occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to suicidal ideation; obsessional rituals which interfere with his routine activities, speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately, or 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 the inability to establish and maintain effective relationships. Id. A 100 percent evaluation is warranted for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Id. When considering all of the evidence of record, the Board finds that a 70 percent rating is warranted for the Veteran’s bipolar I disorder from April 6, 2015; but a rating higher than 50 percent is not warranted prior to that date. VA treatment records from 2013 show that the Veteran was stable, sleeping well, had a good energy level, but had mild feelings of hopelessness and helplessness. He reported wanting to meet a girl. He went to church weekly; interacted with others at Bible study; and went to the library. He reported one suicide attempt prior to the appeal period; but otherwise, during the appeal period prior to April 6, 2015, he did not have any suicidal or homicidal ideations. He also had no plan or intent to harm himself or others. At his March 2014 VA examination, the Veteran reported having hallucinations about hearing things and voices that would tell him to “kill some people for no reason at all”; however, he did not report any plans or intent to actually do so. Indeed, at his VA examination, the Veteran reported that while he previously had homicidal ideation, he was hospitalized for this in 1998; almost 15 years prior to the appeal period. In addition, he specifically reported that his last suicidal thoughts had been a “couple of years back as he was feeling lonely.” Although “a couple of years back” could conceivably be within the appeal period, the Board notes that none of his contemporaneous VA treatment records document any suicidal ideation, thus suggesting that his suicidal ideations were occurring prior to the appeal period. In addition, the Board notes that the Veteran did not report persistent hallucinations; or that his hallucinations impact his ability to function. Thus, when considering the frequency, duration, and severity of his occasional hallucinations, the Board finds this more nearly approximates impaired abstract thinking and disturbances of motivation and mood, which is contemplated by the currently assigned 50 percent rating. The Board affords much probative weight to the March 2014 VA examiner’s opinion that the Veteran’s bipolar disorder could best be summarized as causing occupational and social impairment with reduced reliability and productivity. The examination report was based on a review of the Veteran’s entire record and included an in-person examination of the Veteran. The examiner considered the Veteran’s reports and provided a clear conclusion. As such, prior to April 6, 2015, the Board finds that after considering the frequency, duration, and severity of the Veteran’s symptoms, a 50 percent rating is appropriate for his bipolar disorder prior to April 6, 2015. However, VA treatment records from April 6, 2015, show that there was a change in the level of the Veteran’s bipolar I disorder symptoms. He reported struggling with intense depressed moods, feeling difficulty with getting out of bed, wanting to sleep more, isolating, and having a loss of appetite. He had little interest in things which once gave him pleasure. Then, on April 13, 2015, he reported hearing voices at that time telling him that “people are out to get [him].” He additionally reported hallucinations and stated, “it’s people out of my window and it feels real to me.” He reported no previous history of visual hallucinations. He ended his relationship with his girlfriend because “he didn’t want her to get involved with the individuals that were after him.” He also stopped volunteering at the VA and did not attend his mental health groups as frequently. His trigger was his niece getting pregnant, which caused his stress and anxiety to increase. Then VA treatment records from April 14, 2015, show that the Veteran reported becoming even more paranoid; and that he was very focused on his ex-brother-in-law who he believed had people watching him at his apartments that wanted to kill him. He heard voices telling him that his brother-in-law was also outside trying to get him. Then VA treatment records from a month later, in May 2015, show that the Veteran felt “much better” and that he was no longer hearing voices or seeing things including seeing other people. He went back to volunteering at VA and planned to volunteer at the school for the deaf in the afternoon so that he would have a day full of activities. He did not have any homicidal or suicidal ideation or plans. VA treatment records from June 2015 show that the Veteran’s mood had continued to improve; and that he was cooperative and pleasant. He was well-groomed and dressed; friendly and cooperative with good eye contact; his speech was normal; and he specifically denied any auditory or visual hallucinations. There was no evidence of delusions. He was asked about thoughts of homicide and suicide and he specifically denied any thoughts, intents, or plan. He did not have any gross cognitive impairment noted; instead, he reported life satisfaction and enjoyment. Later June 2015 VA treatment records show that the Veteran experienced paranoia when he forgot to take his medication. His mind began to race when he had idle time, so he tried to fill his days with activities. He had support from his family living in San Marcos. VA treatment records from July 2015 show that the Veteran’s paranoid thoughts were minimal and did not affect his daily living. He stated: “I only have those thoughts sometimes when I get lonely.” He experienced thoughts of his brother-in-law harming him only when he felt isolated. He was able to recognize and cite that his symptoms increase when isolated/lonely. Essentially, the evidence shows that beginning on April 6, 2015, the Veteran experienced sporadic but severe symptoms related to his bipolar I disorder, such that it can be said that it was manifested by occupational and social impairment with deficiencies in most areas. The evidence shows that while not consistent, the Veteran’s bipolar disorder caused periods of near-continuous panic affecting the Veteran’s ability to function; but was not of the duration to say that the Veteran experienced delusions or hallucinations persistently. Indeed, the Veteran himself identified that he only gets paranoia when he felt isolated and that during the appeal period, he did his best to keep his days filled with activities. Prior to October 26, 2015, the Veteran never demonstrated symptoms similar to or more nearly approximating gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Instead, as noted, the Veteran reported volunteering and having family support, such that it cannot be said that he demonstrated total occupational and social impairment. The Board acknowledges the private examiner’s findings that “it is therefore my opinion that the most appropriate VA disability rating from 2012 to the present is 70 percent. The 70 percent rating is recommended based on the marked and continuing impairments in most major life areas linked to mood instability and prolonged periods of depression with frequent suicidal and homicidal ideation.” As noted above, the Board agrees with the private examiner that a 70 percent rating is warranted from April 6, 2015; however, the Board does not find that the higher 70 percent rating is warranted before that time. As noted, the Veteran was afforded a VA examination in March 2014 whereby he had the opportunity to describe his symptoms. At his examination, he reported having friends at VA and maintaining close relationships with his siblings. He enjoyed going on the bus for entertainment and watching moves on the computer. He stopped working in 2012 because he was hurt on the job. His only reported symptoms were: depressed mood; anxiety; suspiciousness; chronic sleep impairment; flattened affect; and difficulty in establishing and maintaining effective work and social relationships. He did not report any inability to establish and maintain effective relationships. This is consistent with his reports of having friends at VA and consistent with the VA treatment records during that time that establish that he enjoyed volunteering in various positions. Importantly, at the time of VA examination the Veteran reported: If I do not take my medication, I go kind of wild. At least the crazy people know they are crazy, the ones that are straight they do not know it yet. I lose it. I am not thinking straight, my mind is spinning, I cannot concentrate. I am looking for a fight. Just because for no reason. I think in my head that I hear things. It tells me to kill some people for no reason at all. Sometimes, at nighttime I thought I saw something in my room, and it scared the sh*t out of me. It was a body in a sheet. As noted above, although the Veteran reported hallucinations of people telling him to kill people; he did not report any type of plan to actually carry these homicidal thoughts out. The private examiner’s report is based on the Veteran’s reports of symptoms as a whole; however, the Board can only grant the Veteran’s increased rating from the actual date of claim or the date that it is factually ascertainable that entitlement arose, whichever is later. Although the Veteran may have had the symptoms described to the private examiner at some point prior to the appeal period, to the extent the examiner has retroactively stated that this began in 2012, the report lacks probative weight. Specifically, the Veteran’s VA treatment records do not document many of the symptoms described by the Veteran, which the examiner then took to mean they occurred during the appeal period. For example, although the Veteran reported one previous suicide attempt prior to the appeal period and hospitalization for suicidal ideation; at no point during the pertinent time period did the Veteran report suicidal ideation. Although he did report a history of severe anger; this was not demonstrated during the appeal period. Because the private examination report was based on the Veteran’s reports of symptoms, but those symptoms were not demonstrated prior to April 6, 2015, the Board finds that a higher rating is not warranted. In sum, a rating higher than 50 percent for the Veteran’s bipolar disorder is not warranted prior to April 6, 2015; however, a rating of 70 percent for the Veteran’s bipolar disorder is warranted from April 6, 2015. In addition, as noted above, the Veteran is already in receipt of a 100 percent rating for his bipolar disorder from October 26, 2015. 4. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities prior to October 26, 2015. Total disability is considered to exist when there is any impairment that 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 ratings are authorized for any disability or combination of disabilities for which the VA’s Schedule for Rating Disabilities, 38 C.F.R. Part 4, prescribes a 100 percent evaluation. 38 C.F.R. § 3.340(a)(2). The law also provides that a total disability rating based on individual unemployability due to service-connected disability may be assigned where the veteran is rated at 60 percent or more for a single service-connected disability, or rated at 70 percent for two or more service-connected disabilities and at least one disability is rated at least at 40 percent, and when the disabled person is unable to secure or follow a substantially gainful occupation as a result of the service-connected disability. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). Marginal employment shall not be considered substantially gainful employment. 38 C.F.R. § 4.16(a). Factors to be considered are the veteran’s education and employment history and loss of work-related functions due to pain. Ferraro v. Derwinski, 1 Vet. App. 326, 330, 332 (1991). 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). See also 38 C.F.R. § 4.19 (2015) (age may not be a factor in evaluating service-connected disability or unemployability); Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). As noted above, prior to February 24, 2015, the Veteran was only service-connected for bipolar disorder, rated as 50 percent disabling. His total rating was 50 percent. From February 24, 2015 to April 5, 2015, he was service-connected for bipolar disorder, rated as 50 percent disabling; tinnitus rated as 10 percent disabling; and bilateral hearing loss rated as noncompensable. Since April 6, 2015, by way of this decision, the Veteran is now service-connected for bipolar disorder, rated as 70 percent disabling; tinnitus rated as 10 percent disabling; and bilateral hearing loss rated as noncompensable. He meets the schedular criteria for a TDIU from April 6, 2015, but not prior to that date. However, even when the rating percentage requirements are not met, as is the case here prior to April 6, 2015, entitlement to TDIU benefits may be nonetheless considered when the veteran is unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities. 38 C.F.R. § 4.16(b). When considering all the evidence, the Board finds that prior to April 6, 2015, the Veteran’s service-connected disabilities did not preclude him from securing and following a substantially gainful occupation. Since April 6, 2015, however, the Veteran was unemployable due to his service-connected bipolar disorder. Prior to April 6, 2015, the evidence shows that although the Veteran was not working, this was as a result of getting hurt on the job. Specifically, on VA examination in March 2014, he reported his work history as: After the military, he worked doing security for two years. He worked as a jailer in Zavala County and he worked there for 1 ½ years. He was laid off due to cut back in force. He then worked at a privately-owned prison as a jailer and he did this for 2 years. He was laid off due to cut back in force. He worked in temp agencies and did manual labor and construction for five years. The economy went under and there was not any more work. He worked for another company for six months and they let him go due to the economy. He worked doing Smith Security for one year. He got into an argument with a supervisor and he got into trouble for derogatory remarks to a supervisor. They cut his hours and he quit this position. He worked for Executive Security company for one year. He was getting sick and was having problems with diabetes and left this position. He last worked as a laborer at [a company] on contracts. He got hurt on the job and he had a worker’s comp case. Since stopping work in 2012, the Veteran was able to sustain volunteering. As noted above, he often volunteered in various positions and in different places to keep his day full. There is no indication that his volunteering posed a problem until April 6, 2015, when he began to isolate as a result of being paranoia due to what he felt was an extremely stressful situation. Indeed, the Veteran actually reported volunteering and being around others to be helpful in keeping his bipolar disorder symptoms at bay. The Board again acknowledges the private medical opinion submitted on the Veteran’s behalf in November 2015; but does not agree with the examiner’s findings that: In light of the Veteran’s statements of earnings, the date upon which he became unable to secure or follow substantially gainful employment is January of 2012, earnings records reflect no income earned at all during 2012 or 2013. First, the Board notes that the Court has specifically found that the applicable regulations place responsibility for the ultimate TDIU determination on VA, not a medical examiner. Geib v. Shinseki, 733 F.3d 1350 (Fed. Cir. 2013). Second, as noted in the increased rating for bipolar disorder section of this decision, the private examination report is based solely on the Veteran’s recounts of his symptoms prior to the appeal period, the most severe symptoms occurring in the 1990’s. Of note, the Veteran reported having these severe symptoms while he was also able to maintain employment. The Board does not dispute that the Veteran experienced severe symptoms prior to the appeal period; however, when comparing this evidence to the contemporaneous evidence of record, to include the voluminous amounts of VA treatment records, the Board is able to glean that the Veteran’s bipolar disorder ebbs between manic stages and depressive stages, as explained by the March 2014 VA examiner. At worst, during his previous severe manic stages, the Veteran was able to maintain employment. In addition, as noted above, he did not discontinue his employment as a result of his bipolar disorder; instead, he was hurt on the job. Indeed, even after getting into a verbal altercation with his boss, although his hours were cut, it was ultimately the Veteran who quit. Since April 6, 2015; however, the Board agrees with the private medical examiner. That is, the evidence shows that the Veteran began to isolate and he discontinued all volunteering. Although this was precipitated by an event viewed as extremely stressful by the Veteran, and soon resolved, it is not reasonable to assume that the Veteran would have been able to secure and maintain employment while also almost completely isolating for a short period of time. As such, a TDIU is warranted from April 6, 2015. N. RIPPEL Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Martha R. Luboch, Associate Counsel