Citation Nr: 18148613 Decision Date: 11/08/18 Archive Date: 11/07/18 DOCKET NO. 15-43 009 DATE: November 8, 2018 ORDER Entitlement to an initial disability rating for bipolar disorder with substance abuse higher than 30 percent from December 18, 2000 to January 16, 2006 is denied. Entitlement to an initial disability rating for bipolar disorder with substance abuse higher than 50 percent beginning January 17, 2006 is denied. REMANDED Entitlement to a total disability rating for individual unemployability based upon service-connected disabilities (TDIU) is remanded. FINDINGS OF FACT 1. From December 18, 2000 to January 16, 2006, the Veteran’s service-connected bipolar disorder with substance abuse manifested as no worse than occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, irritability, panic attacks (weekly or less often), chronic sleep impairment, and difficulty concentrating and focusing. He generally exhibited good insight and judgment, and generally managed his symptoms effectively with regular outpatient psychiatric treatment and medications, maintained positive family and other social relationships, and had an employment opportunity. 2. Beginning January 17, 2006, the Veteran’s service-connected bipolar disorder with substance abuse manifested as no worse than occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, tension, and irritability. He generally exhibited good insight and judgment, and generally managed his symptoms effectively with regular outpatient psychiatric treatment and medications, and maintained positive family and other social relationships. CONCLUSIONS OF LAW 1. The criteria for a disability rating higher than 30 percent for bipolar disorder with substance abuse from December 18, 2000 to January 16, 2006 have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.102, 3.321, 4.1 - 4.7, 4.126, 4.130, Diagnostic Code (DC) 9432. 2. The criteria for a disability rating higher than 50 percent for bipolar disorder with substance abuse beginning January 17, 2006 have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.102, 3.321, 4.1 - 4.7, 4.126, 4.130, DC 9432. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is a surviving spouse of a deceased veteran (the Veteran) who had active service from November 1977 to October 1985. The Veteran died in 2012; the appellant is the Veteran’s surviving spouse, and she has been properly substituted by the VA Regional Office to complete the processing of the deceased Veteran’s appeal. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a Department of Veterans Affairs (VA) Regional Office (RO) rating decision dated January 2011, which granted the Veteran entitlement to service connection for bipolar disorder beginning December 18, 2000, and assigned an initial disability rating of 30 percent from December 18, 2000 to January 16, 2006, and 50 percent thereafter. VA received evidence subsequent to the final consideration of the claim by the RO, but the appellant’s representative waived RO consideration of that evidence in correspondence received in October 2018. The Board may consider the appeal. See 38 C.F.R. § 20.1304(c). The issue on appeal has a long procedural history that was summarized in the introduction of a Board order dated July 2015. The Board incorporates that summary by reference and will not repeat it here in full. In that order, the Board remanded the Veteran’s disagreement with his initial disability ratings to the Agency of Original Jurisdiction (AOJ) for issuance of a statement of the case. The case has since been returned for appellate review following a September 2015 supplemental statement of the case in which the RO continued the Veteran’s ratings for bipolar disorder with substance abuse at 30 percent prior to January 17, 2006, and 50 percent thereafter. The Board finds the AOJ substantially complied with the remand instructions, and the Board may adjudicate this matter on the merits. See Stegall v. West, 11 Vet. App. 268, 271 (1998); see also Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (noting that Stegall requires substantial compliance with remand orders, rather than absolute compliance). The Board has thoroughly reviewed all evidence in the claims file. Consistent with the law, the analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claim, and the Board’s reasons for rejecting evidence favorable to the appellant. See Timberlake v. Gober, 14 Vet. App. 122 (2000). The appellant must not assume the Board has overlooked evidence not explicitly discussed herein. In addition, pertinent regulations for consideration were provided in the September 2015 statement of the case and are not repeated here in full. Neither the appellant nor her representative raised any issues with the duty to notify or the duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding “the Board’s obligation to read filings in a liberal manner does not require the Board . . . to search the record and address procedural arguments when the veteran fails to raise them before the Board”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Thus, the Board need not discuss any potential issues in this regard. Finally, neither the appellant nor her representative has raised any other issues not addressed herein, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 69-70 (2017) (confirming Board not required to address issues unless specifically raised by claimant or reasonably raised by evidence of record). Laws and Analysis Disability evaluations are determined by comparing the Veteran’s symptomatology with criteria set forth in the VA’s Schedule for Rating Disabilities (Rating Schedule), which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Separate diagnostic codes identify the various disabilities and the criteria for specific ratings. Reasonable doubt as to the degree of disability will be resolved in favor of the claimant. 38 C.F.R. §§ 3.102, 4.3. Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. Acquired psychiatric disabilities are rated according to the Rating Schedule’s General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130. A 30 percent disability rating is assigned where there is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood; anxiety; suspiciousness; panic attacks (weekly or less often); chronic sleep impairment; and mild memory loss (such as forgetting names, directions, recent events). See 38 C.F.R. § 4.130, DC 9432. A 50 percent disability rating is assigned where 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. Id. A 70 percent disability rating is assigned where 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; intermittently illogical, obscure, or irrelevant speech; 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 disability rating is assigned where there is total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of close relatives, one’s own occupation, or one’s own name. Id. The symptoms enumerated in DC 9432 are not an exhaustive list, and VA must holistically consider all evidence in the record that bears on the Veteran’s occupational and social impairment, including the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran’s capacity for adjustment during periods of remission. See 38 C.F.R. § 4.126. However, evaluation of the Veteran’s condition is “symptom driven” and symptoms are the “primary focus when deciding entitlement to a given disability rating.” Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013). As such, a veteran may only qualify for a given disability rating under 38 C.F.R. § 4.130 by demonstrating the particular symptoms associated with that percentage, or other symptoms of similar severity, frequency, and duration. Id. at 117. Moreover, the evidence must show those symptoms have caused the degree of occupational and social impairment associated with the requested disability rating. See id.; 38 C.F.R. § 4.130, DC 9432. Rating Period from December 18, 2000 to January 16, 2006 The RO assigned the Veteran a 30 percent disability rating from December 18, 2000 to January 16, 2006 for his service-connected bipolar disorder with substance abuse under DC 9432, 38 C.F.R. § 4.130. The appellant seeks a higher rating. After a full review of the record, the Board finds the severity, frequency, and duration of the Veteran’s bipolar disorder with substance abuse symptoms and their effects on his occupational and social functioning during the appeal period were consistent with and most closely approximated the 30 percent disability rating criteria. As an initial matter, the Board finds that the Veteran’s statements regarding the existence of certain symptoms, and the severity, frequency, and duration of his symptoms lacked credibility. Prior to his death, the Veteran admitted that he claimed non-existent symptoms to exaggerate the severity of his condition. See December 1997 VA treatment record (admitting his claims of suicidal ideation and auditory and visual hallucinations are “all a big game” and that he claimed to be suicidal “because he knows from other veterans that if he says that he will be admitted to the hospital”); id. (physician noted Veteran “is an unreliable historian”). Moreover, as discussed below, two separate physicians who examined the Veteran in connection with his application for disability benefits from the Social Security Administration (SSA) found the Veteran’s claims regarding his symptoms and functional limitations to lack credibility. In a December 2000 functional assessment report prepared in connection with the Veteran’s request for disability benefits from the Social Security Administration (SSA), the examiner found the Veteran’s bipolar syndrome resulted in the following functional limitations: “mild” restriction of activities of daily living, “moderate” difficulties in maintaining social functioning, “moderate” difficulties in maintaining concentration, persistence, or pace, and no episodes of decompensation. The examiner also determined the Veteran had mood swings, was able to follow simple instructions, had the mental ability to complete simple repetitive tasks, and was able to complete self-care. The examiner noted the Veteran’s alleged inability to work due to his bipolar disorder, but found his allegations “not fully credible,” and that when on his medications appeared “fully stable.” The examiner assessed the Veteran as being either not significantly limited or only moderately limited in 20 areas of understanding and memory, sustained concentration and persistence, social interaction, and adaptation, including that the Veteran was not significantly limited in his ability to complete a normal workday and workweek without interruptions from psychologically based symptoms and to perform at a consistent pace without an unreasonable number and length of rest periods. The Board finds this evidence to be highly probative of the Veteran’s symptomology and degree of occupational and social impairment at the beginning of the appeal period because it is based on an examination of the Veteran and a review of relevant medical evidence, and contains sound reasoning for its conclusions. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board further finds the physician’s remark about the Veteran’s allegation being “not fully credible” is probative of the severity, frequency, and duration of the Veteran’s symptomology and functional impairments based on prior admissions by the Veteran that he claims non-existent symptoms to exaggerate the severity of his condition. In a January 2001 medical evaluation report prepared in connection with the Veteran’s request for SSA disability benefits, the Veteran reported an inability to concentrate, sleep issue, difficulty thinking clearly, daily panic attacks, fatigue, depression, and auditory and visual hallucinations. The examiner noted upon physical examination the Veteran was oriented normally, but was sad, made no eye contact, extremely restless, and that his mental status examination was “probably somewhat lower than expected for his level of education.” In a second January 2001 functional assessment evaluation report prepared in connection with the Veteran’s request for SSA disability benefits, the examiner noted the Veteran suffered from bipolar disorder, hepatitis, panic attacks, fatigue, and depression. The Veteran alleged he had no energy to do regular household activities, but the examiner noted the Veteran’s “statements regarding his functional restrictions are not credible.” In March 2001, the Veteran reported to a VA facility seeking medicine for his heroin use and for anxiety. At that time, he was alert and oriented, and found to have no objective evidence of a thought disorder. He expressed suicidal feelings, but had no plan and had made no recent attempts, and reported hearing voices. He became angry, confrontational, and verbally abusive when denied medicine. In May 2001, the Veteran voluntarily reported to a VA facility for heroin detoxification. Treatment records note he claimed to be hearing voices, but denied suicidal or homicidal ideation, and was discharged after one night after he had several altercations with staff (including throwing bottle of medication) and made racial and derogatory comments. He was referred to, and agreed to stay, in the psychiatric department for evaluation, where a VA mental status examination showed he was anxious, but reasonably calm, and cooperated with the interview, was oriented normally, with euthymic mood and affect, coherent and relevant speech, had no suicidal or homicidal ideation, and no evidence of overt thought disorder. He could concentrate and had fair memory. Two days after he initially reported for treatment, he checked himself out, at which time he denied suicidal or homicidal ideations, and denied hallucinations. In an October 2001 VA mental health treatment record, the Veteran reported feelings of suicide. He denied auditory or visual hallucination, and was found to have no apparent cognitive impairment. He reported marital discord with his wife. He reported symptoms of stress, depression, acute anxiety, increased irritability, mood swings, fatigue, and difficulty concentrating and focusing. He claimed to be unable to “comprehend or understand any reading materials, television program, or anything” due to his emotional and behavioral problems. Upon examination, the Veteran was noted to have appropriate appearance, labile affect, agitated and demanding behavior, entitled and sarcastic attitude, anxious mood, and poor insight, with intact memory, normal orientation, speech, and thought content, with no suicidal or homicidal ideation or auditory or visual hallucinations. The Veteran was noted later that same day to have reported feeling anxious and irritable, with auditory hallucinations, and that his wife reported he was irritable, with labile mood, but not dangerous or destructive. In November 2001, the Veteran underwent a VA mental health evaluation for complaints of manic episodes. The treatment record notes he was well-groomed, with attention to hygiene, alert, awake, and oriented, and was pleasant and cooperative. His mood was manic, with anxious affect but with broad range. His thought process was linear, with good insight and judgment. He reported no suicidal ideation, but had homicidal ideation regarding people he thought were not helping him. In April 2002, the Veteran underwent a psychiatric review in connection with his application for SSA disability benefits. The review covered the period from July 2000 to April 2002. The examiner noted symptoms of sleep disturbance, psychomotor agitation or retardation, decreased energy, feelings of guilt or worthlessness, difficulty concentrating or thinking, hyperactivity, pressures of speech, flight of ideas, decreased need for sleep, and easy distractibility. The Veteran did not have anhedonia or pervasive loss of interest in almost all activities, thoughts of suicide, or involvement in activities that have a high probability of painful consequences which are not recognized, but did report auditory hallucinations. The examiner opined the Veteran had “moderate” restriction of activities of daily living, “marked” difficulties in maintaining social functioning, “marked” difficulties in maintaining concentration, persistence, or pace, and four or more episodes of decompensation of extended duration. Also in April 2002, the Veteran underwent a hearing for his SSA disability benefits application. At that hearing, (a physician who did not examine the Veteran, but reviewed certain medical evidence) testified the Veteran had the following bipolar disorder symptomology: sleep difficulty, feelings of agitation, decreased energy, feelings of guilt and worthlessness, decreased concentration, suicidal ideation and hallucinations, manic symptoms including decreased need for sleep, and distractibility, as well as pathologic inappropriate suspicion and disturbances of mood and affect, a past episode of aggression, unstable relationships and involvement in impulsive and damaging behavior. The Board finds that the testimony has limited probative value because it is based, in part, on non-credible assertions by the Veteran that he had suicidal ideation and experienced hallucinations, was not based on a physical examination of the Veteran, and does not indicate the scope of medical evidence that served as the basis of the testimony. In a September 2002 VA treatment record, the Veteran reported having frequent severe nightmares that sometimes made him reluctant to sleep. In December 2002 VA treatment records, the Veteran was described as “overall stable” and that his medications were helping his mood and sleep, and helping decease his auditory hallucinations. He did not have suicidal or homicidal ideation. He was reported as neatly dressed, cooperative, and friendly, with good judgment and insight. In a January 2003 VA mental health treatment record, the Veteran reported “doing better” with no panic attacks. In a February 2003 VA mental health treatment record, he reported the voices he claimed to be hearing were almost gone, and that he had no suicidal or homicidal ideation. In a July 2003 VA mental health treatment record, the Veteran was noted as “overall stable” in mood and thought, with “[n]o complaints.” In a September 2003 VA mental health treatment record, the Veteran was again “overall stable” in mood and thought, with “[n]o complaints” and no suicidal or homicidal ideations, nor psychosis noted. In a March 2004 VA mental health treatment record, the Veteran was noted as overall stable, with complaints of lack of concentration, memory difficulties, and continued racing thoughts. He was noted as neatly dressed, cooperative, and friendly, alert, awake, and normally oriented, with euthymic mood and affect, goal directed thoughts, no suicidal or homicidal ideation, and good insight and judgment. He claimed auditory hallucinations. The Veteran reported being offered a job as a boiler operator (his previous occupation), and that he both attended and volunteered with rehabilitation support groups numerous times per week. In April 2004, the Veteran voluntarily reported to a VA facility for heroin detoxification, and remained hospitalized for 9 days. VA treatment records for that period note he had flattened to appropriate affect, had some anxiety, was cooperative and interacted with peers and staff, and did not have suicidal or homicidal ideation, or auditory or visual hallucinations. In an August 2004 VA mental health treatment record, the Veteran was noted as well-groomed, cooperative, and not having any thoughts of hurting himself or others. In VA mental health treatment records from March 2005 through January 2006, the Veteran was noted as maintaining his sobriety and compliance with his medication regimen since his April 2004 inpatient detoxification, with stable mental status and no acute complaints. Summarizing the foregoing, the Board finds the Veteran’s disability picture from December 18, 2000 to January 16, 2006 most closely approximated the 30 percent rating criteria. The Veteran consistently reported and was observed by medical professionals to have symptoms of depression, anxiety, chronic sleep impairment, difficulty concentrating, and occasional mild memory loss. He was also consistently noted to be well-groomed and neatly dressed, and cooperative and friendly with peers and staff. The evidence indicates that the Veteran experienced infrequent panic attacks that occurred less often than weekly, and were controlled by medication. Regarding occupational functioning, the Board acknowledges the Veteran was disabled for SSA purposes during the appeal period and did not work. However, SSA has different regulatory standards and considerations for determining whether someone is considered unable to work, which are not binding on VA. The Board finds the December 2000 functional assessment report prepared in connection with the Veteran’s SSA disability application to be highly probative as to the degree of occupational impairment resulting from the Veteran’s bipolar disorder with substance abuse. This report concluded that the Veteran was not significantly limited in his ability to complete a normal workday and workweek without interruptions from psychologically based symptoms and to perform at a consistent pace without an unreasonable number and length of rest periods, and was not more than moderately limited in any mental functional capacity ability. Moreover, as previously noted, the Veteran’s VA treatment records show that he was offered a job as a boiler operator in or about March 2004. Regarding social functioning, the evidence shows that the Veteran maintained his long-term marriage and was involved in multiple rehabilitation support groups several times each week, and his treating physicians regularly noted he was friendly. With respect to the symptoms relevant to a 50 percent rating for this portion of the appeal period, the evidence shows the Veteran’s affect was not primarily flattened, that he did not exhibit 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 abstract thinking; or difficulty in establishing and maintaining effective work and social relationships. The evidence does show some impaired judgment and some disturbances in motivation and mood in connection with the Veteran’s drug use, but not with such severity, frequency, and duration that those or other similar symptoms result in an overall disability picture that is more consistent with the 50 percent rating criteria than the 30 percent rating criteria. The Board acknowledges the Veteran often, yet inconsistently, claimed to have suicidal ideation and experience auditory hallucinations, namely voices. However, as set forth above, the Board finds those claims lack credibility. The Board also acknowledges the Veteran had episodic behavior that was more serious, and generally appears to have occurred when the Veteran was using drugs, such as impaired impulse control during the May 2001 altercation with VA staff when he checked himself in for heroin detoxification. However, such behavior, in connection with his other symptoms did not occur with such severity, frequency, and duration as to warrant a rating higher than 30 percent during this portion of the appeal period. The Board considered the applicability of the benefit-of-the-doubt doctrine and finds it inapplicable because the preponderance of the evidence is against the claim. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). Rating Period Beginning January 17, 2006 The RO assigned the Veteran a 50 percent rating beginning January 17, 2006, for his service-connected bipolar disorder with substance abuse under DC 9432, 38 C.F.R. § 4.130. The appellant seeks a higher rating. After a full review of the record, the Board finds the severity, frequency, and duration of the Veteran’s bipolar disorder with substance abuse symptoms and their effects on his occupational and social functioning during the appeal period do not warrant a higher rating. The Veteran underwent a VA examination in February 2010 for his bipolar disorder with substance abuse. The examination report notes he reported symptoms of chronic low mood, sadness, decreased appetite, difficulty with falling asleep and staying asleep, irritability and low energy, but denied any problems with motivation. The examiner reported the Veteran had low mood and sad affect, but was neatly dressed and well groomed, and able to perform activities of daily living. The Veteran’s speech was clear and normal in all aspects, he was well-oriented, with intellectual and cognitive functions within normal limits, and good judgment and insight. His memory was “very good for recall of remote and recent events.” The examiner noted no evidence for inappropriate behavior, and that the Veteran specifically denied having had any suicidal ideation. The Veteran reported having been in a common law marriage for 25 years and having worked in boiler maintenance for 15 years and a boiler inspector for 5 years. In VA mental health treatment records from January 2006 and June 2006, the Veteran was noted as maintaining his sobriety and compliance with his medication regimen since his April 2004 inpatient detoxification, with stable mental status and no acute complaints. VA mental health treatment records from April 2007 to January 2012 (the month the Veteran died) indicate the Veteran consistently reported symptoms of “varying degrees of depression and anxiety,” with depressive moods with tension and irritability. He was consistently noted as exhibiting clear and rational thought process, reality-oriented perceptions, and no suicidal ideation, and being pleasant and friendly, and neatly dressed and groomed. VA neurology consultation records from June 2009 and November 2009 note the Veteran as being oriented normally, able to follow 3-step commands, with normal reading, writing, repetition, naming, and calculation abilities. The Veteran was able to recall three out of three items after five minutes, and had positive abstract thinking abilities, as well as good judgment. Summarizing the forgoing, the evidence shows the Veteran managed his bipolar disorder with substance abuse symptoms effectively through regular VA outpatient treatment and psychotropic medications throughout this portion of the appeal period. The Veteran had been married for approximately 22 years at the time of his death in January 2012, and regularly spent the summer months at the Jersey Shore with her. See September 2011 VA mental health records; March 2015 wife lay statement. With respect to the symptoms relevant to a 70 percent rating for this portion of the appeal period, the evidence shows the Veteran did not exhibit the following symptoms, or other symptoms of similar severity, frequency, and duration, that would warrant that rating: 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 worklike setting); inability to establish and maintain effective relationships. The Board considered the applicability of the benefit-of-the-doubt doctrine and finds it inapplicable because the preponderance of the evidence is against the claim. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). REMAND The question of whether the Veteran’s service-connected bipolar disorder with substance abuse prevented him from maintaining long term employment has been raised by the record. See December 2011 Veteran lay statement. When a request for a TDIU is made during the pendency of a claim, whether expressly raised by a veteran or reasonably raised by the record, it is not a separate claim for benefits, but rather involves an attempt to obtain an appropriate rating for a disability as part of the initial adjudication of the claim. Rice v. Shinseki, 22 Vet. App. 447, 453-454 (2009). Thus, the issue of entitlement to a TDIU is before the Board. The matter is REMANDED for the following actions: 1. Send the appellant VCAA notice on how to substantiate a TDIU claim and ask her to complete VA Form 8940. 2. Conduct any other necessary development for the TDIU claim, such as verifying prior employment, if appropriate. 3. Provide the Veteran’s claims file to an appropriate VA examiner to obtain an opinion as to the functional effects of the service-connected disabilities alone on his ability to obtain or maintain substantially gainful employment, with a full supporting rationale. 4. Then, readjudicate the claim. ROMINA CASADEI Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Leamon, Associate Counsel