Citation Nr: 18149523 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 11-07 272 DATE: November 9, 2018 ORDER An initial rating for panic disorder with agoraphobia and depression and anxiety disorder (hereinafter “acquired psychiatric disability”) in excess of 50 percent is denied. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service connected disabilities is denied. FINDINGS OF FACT 1. For the entire initial rating period since January 16, 2010, the Veteran’s service connected acquired psychiatric disability has not been manifested by occupational and social impairment, with deficiencies in most areas. 2. The date of claim for entitlement to a TDIU due to service-connected disabilities is January 16, 2010, the date of the claim for an initial rating. 3. For the rating periods prior to December 16, 2010 and from December 16, 2010 to January 27, 2017, the Veteran’s combined schedular disability ratings did not meet the minimum percentage requirements in 38 C.F.R. § 4.16(a) for consideration of a TDIU on a schedular basis. 4. For the rating period since January 28, 2017, the Veteran’s combined schedular disability rating meets the minimum percentage requirements in 38 C.F.R. § 4.16(a) for consideration of a TDIU on a schedular. 5. The Veteran’s service-connected disabilities do not render him unable to secure or follow substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial rating for an acquired psychiatric disability in excess of 50 percent have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9412 (2018). 2. The criteria for entitlement to a TDIU due to service connected disabilities have not been met. 38 U.S.C. §§ 1155 (2012); 38 C.F.R. §§ 3.340, 3.341(a), 4.1, 4.16, 4.19, 4.25 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had a period of active duty service from May 2006 to September 2006 and from February 2009 to January 2010. The Board remanded the Veteran’s above claims for additional development in October 2017. As the requested development has been completed the case may move forward without prejudice to the Veteran. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board acknowledges the Veteran’s representative’s assertions regarding the adequacy of his disability ratings and VA examination reports in written briefs dated in September 2017 and October 2018. Neither the Veteran nor his representative has raised any other issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “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). 1. Entitlement to an initial rating for an acquired psychiatric disability in excess of 50 percent Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule). 38 C.F.R. Part 4 (2018). The Rating Schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All reasonable doubt as to the degree of disability will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Staged ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). The Veteran’s disability should be viewed in relation to its history. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Given the nature of the present claim for a higher initial evaluation, the Board has considered all evidence of severity since the effective date for the award of service connection on January 16, 2010. Fenderson v. West, 12 Vet. App. 119 (1999). The Veteran filed his initial claim requesting service connection for posttraumatic stress disorder and anxiety in March 2010. In a May 2010 VA rating decision, service connection for panic disorder with agoraphobia (claimed as anxiety) was granted. The Veteran was assigned a 30 percent disability rating for the entire appeal period effective from January 16, 2010 (the day following separation from active service). See 38 C.F.R. § 4.130, Diagnostic Code 9412. During the course of the appeal, in a March 2011 VA rating decision, a 50 percent disability rating was assigned effective from January 16, 2010. Id. The Decision Review Officer noted an overall increase in panic attacks noting the Veterans October 2010 mental assessment which revealed an overall increase in panic attacks with a scared mood, halting speech, and poor insight and judgment with a Global Assessment of Functioning (GAF) estimated between 50-55. The Board considers whether an initial rating for an acquired psychiatric disability in excess of 50 percent is warranted at any time since January 16, 2010. Under this General Rating Formula for Mental Disorders, a 50 percent rating is warranted when the evidence shows 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 effective work and social relationships. 38 C.F.R. § 4.130, Diagnostic Code 9412. The next-higher rating of 70 percent is warranted when the evidence shows 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 worklike setting); inability to establish and maintain effective relationships. Id. A 100 percent rating is warranted when the evidence shows 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. The nomenclature employed in the portion of VA’s rating schedule that addresses service-connected psychiatric disabilities is based upon the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, of the American Psychiatric Association (DSM-IV). See 38 C.F.R. § 4.130. The DSM-IV contains a GAF scale, with scores ranging between zero and 100 percent, reflecting the “psychological, social, and occupational functioning on a hypothetical continuum of mental health- illness.” See Carpenter v. Brown, 8 Vet. App. 240, 242 (1995); see also Richard v. Brown, 9 Vet. App. 266, 267 (1996) [citing the DSM-IV, p. 32]. The Board notes VA implemented usage of the DSM-5, effective August 4, 2014; however, the VA Secretary has determined that DSM-5 does not apply to claims certified to the Board prior to August 4, 2014. 79 Fed. Reg. 45,093, 45,094 (Aug. 4, 2014). As this case was initially certified to the Board in September 2012, the DSM-5 is not for application in this case. According to the applicable rating criteria, when evaluating a mental disorder, the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran’s capacity for adjustment during periods of remission must be considered. 38 C.F.R. § 4.126(a). In addition, the evaluation must be based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner’s assessment of the level of disability at the moment of the examination. Id. Further, when evaluating the level of disability from a mental disorder, the extent of social impairment is considered, but the rating cannot be assigned solely the basis of social impairment. 38 C.F.R. § 4.126(b). The Veteran asserts that the severity of his service-connected mental disorder has increased and an initial evaluation in excess of 50 percent is warranted. Review of the evidentiary record since January 16, 2010 documents the following psychiatric symptomatology of an acquired psychiatric disability. At a January 20, 2010 private treatment session, the Veteran reported complaints of nightmare, fatigue, weakness, and feeling like he is dying inside. The Veteran also reported having panic attacks seven to eight months into his tour. The examiner diagnosed the Veteran with an anxiety state. In an April 2010 VA examination, the examiner diagnosed the Veteran with panic disorder with agoraphobia noting chronic to mild severity. Regarding the Veteran’s occupational and social functioning, the examiner noted an occasional decrease in work efficiency or intermittent periods of an inability to perform occupational tasks due to his mental disorder signs and symptoms. The examiner noted that the Veteran’s generally satisfactory functioning in terms of routine behavior, self-care, and conversation are normal. The examiner explained that the Veteran’s symptoms do appear to require continuous medication. Although the Veteran reported that he has missed some time from work over the past twelve months due to his panic attacks, the examiner opined that the Veteran’s mild to moderate panic disorder would pose mild to moderate vocational limitations and would not prohibit the Veteran from obtaining or maintaining substantially gainful employment. In a July 2012 VA mental health examination, the examiner diagnosed the Veteran with a panic disorder and depression with a GAF score of 55 consistent with moderate symptomatic distress due to panic disorder and depression. The examiner also concluded the Veteran’s psychiatric disability was manifested by occupational and social impairment with reduced reliability and productivity. In an April 2016 VA outpatient treatment examination, the Veteran was diagnosed with a panic disorder. VA outpatient treat records from December 2013 to December 2015 repeatedly diagnose the Veteran with an anxiety disorder. Furthermore, the examiner reported that the Veteran is gainfully employed. Specifically, in December 2015, the Veteran reported panic attacks at a frequency of 3-4 times a week. In an October 2016 VA outpatient psychiatric examination, the examiner noted that the Veteran’s panic attacks have decreased in intensity and frequency. In a February 2017 VA Certification of Health Care Provider Employee’s Serious Health Condition, the examiner diagnosed the Veteran with a panic disorder and insomnia noted that the Veteran was unable to work as his conditions were severe. The examiner also noted that the Veteran suffered panic attacks 1 to 2 times per week or 12 times a month resulting in him being unbale to perform work. The examiner also noted that the Veteran would need time off to decrease his symptoms if he is to work to the best of his abilities. In a March 2017 VA mental health examination, the examiner diagnosed the Veteran with panic disorder without agoraphobia and an anxiety disorder. The examiner noted that the current severity level of the Veteran’s symptoms is moderate and impact his interpersonal, social, and occupational functioning. The examiner also noted that the Veteran insight and judgment were good. He also noted that the Veteran was capable of managing his affairs. In the Veteran’s most recent October 2017 VA mental conditions examination, the examiner diagnosed the Veteran with panic disorder without agoraphobia and an unspecified depressive disorder. The examiner opined that the current severity of the Veteran’s service connected mental disorders is mild to moderate and noted that the severity has not increased since his last examination. The examiner explained that the Veteran’s symptoms continues to impact his social, interpersonal, and occupational functioning. He also opined that the Veteran’s service connected mental health disabilities mildly impact his ability to function effectively in an occupational setting. He explained that the Veteran’s mental health issues mildly make it difficult for him to complete work-related tasks effectively and appropriately interact with coworkers/supervisors in a work environment. During the appeal period, the Veteran was assigned multiple GAF scores. A GAF score of 50 was assigned by VA treating physicians in April 2011 and December 2011. Scores ranging from 41 to 50 reflect serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting), or any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job). See 38 C.F.R. §§ 4.125, 4.130. A GAF score of 55 was assigned by the July 2012 VA examiner and VA treating physicians from June 2010 to May 2011, August 2012, January 2013, and March 2013; and a GAF score of 60 was assigned by the April 2010 VA examiner. Scores ranging from 51 to 60 reflect more moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co- workers). Id. Lastly, a GAF score of 65 was assigned by a VA treating physician in December 2010. Scores ranging from 61 to 70 reflect mild symptoms (e.g., depressed mood and mild insomnia) or some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful relationships. Id. The foregoing summary of the treatment records for the Veteran’s service-connected acquired psychiatric disability and the explanation of the method by which disability ratings are determined offer no possibility for a higher initial evaluation. Review of the pertinent evidence of record establishes the Veteran’s service-connected acquired psychiatric disability has not been manifested by occupational and social impairment, with deficiencies in most areas due to psychiatric symptomatology. As discussed above, the Veteran’s acquired psychiatric disability has been manifested by nightmares, panic attacks multiple times a week, anxiety, occasional decrease in work efficiency, use of continuous medication, and sleep impairment, as well as assigned GAF scores of 50, 55, 60, and 65. The Board has reviewed and carefully considered the Veteran’s lay statements asserting that the severity of his mental health disabilities has increased. This has assisted the Board in better understanding the nature and development of the Veteran’s disorder and its effect. Lay people are competent to report on matters observed or within their personal knowledge. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). Therefore, the Veteran is competent to provide statements of symptoms which are observable to his senses and there is no reason to doubt his credibility. However, the Board must emphasize that the Veteran is not competent to interpret accurately clinical findings pertaining to mental disorders as this requires highly specialized knowledge and training. 38 C.F.R. § 3.159(a)(1). See also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Based on the evidence of record, the Board find that the Veteran’s acquired psychiatric disability has been more closely 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; difficulty in establishing effective work and social relationships, thus warranting no more than the already assigned 50 percent evaluation. For these reasons, a rating in excess of 50 percent is not warranted at any time during the appeal period. See 38 C.F.R. § 4.130, Diagnostic Code 9424. The Board is aware that the symptoms listed under the next-higher ratings of 70 and 100 percent are essentially examples of the type and degree of symptoms for that rating, and that the Veteran need not demonstrate those exact symptoms to warrant a higher rating. See Mauerhan v. Principi, 16 Vet. App. 436 (2002). Moreover, entitlement to such an evaluation requires sufficient symptoms of the requirements, or others of similar severity, frequency, or duration, that cause the specific type of occupational and social impairment. See Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117-18 (Fed. Cir. 2013). In this case, the Board has considered these next-higher ratings for the entire appeal period but finds that it is rated appropriately. The Board has also considered the possibility of staged ratings and finds that the scheduler rating for the service-connected disability on appeal has been in effect for appropriate period on appeal. Accordingly, staged ratings are inapplicable. See Hart v. Mansfield, 21 Vet. App. 505 (2007). Lastly, the Board acknowledges that in an October 2018 Appellate Remand Brief, the Veteran’s representative asserts that due to the Veteran’s current symptomatology, an extra-schedular rating is warranted. In light of the October 2018 written brief, the Board considers the provisions of 38 C.F.R. § 3.321(b)(1) in this case. There is a three-step inquiry to determine whether a claim should be referred for extraschedular consideration. First, the Board must determine whether the rating criteria reasonably describe a veteran’s disability level and symptomatology. Second, if the rating criteria do not reasonably describe the veteran’s disability level and symptomatology, then the Board must determine whether the exceptional disability picture exhibits other related factors such as marked interference with employment or frequent hospitalization. Third, if such factors are present, then the case must be referred for extraschedular consideration to the Director, Compensation Services. Thun v. Peake, 22 Vet. App. 111, 115 (2008), aff’d sub nom. Thun v. Shinseki, 572 F.3d 1366 (Fed. Cir. 2009). A comparison between such level of severity and symptomatology of the Veteran’s assigned evaluation of 50 percent during the appeal period with the established criteria found in the rating schedule shows that the rating criteria reasonably describes the Veteran’s disability level and symptomatology for an acquired psychiatric disability for which service connection is in effect. See 38 C.F.R. § 4.130, Diagnostic Code 9412. The Board acknowledges that Veteran informed the April 2010 VA examiner of missing some time for work due to his panic attacks and the February 2017 VA Certification of Health Care Provider Employee’s Serious Health Condition noted the Veteran’s panic disorder resulted in the Veteran being absent from work; nevertheless, such symptomatology of occupational impairment is contemplated in the rating criteria. In fact, the subsequent October 2017 VA mental conditions examination noted that the Veteran’s mental health disability mildly impact his ability to function effectively in an occupational setting to be more probative and compelling. Again, the rating criteria contemplate the overall effect of all of his symptomatology on his occupational and social functioning. See also Mauerhan, 16 Vet. App. at 442. There are higher ratings available under the diagnostic code, but the Veteran’s disability is not productive of such manifestations. As such, it cannot be said that the available schedular evaluation for this disability is inadequate at any time during the initial appeal period. Because the rating criteria reasonably describe the claimant’s disability level and symptomatology, the Veteran’s disability picture is contemplated by the Rating Schedule, such that the assigned schedular evaluation is, therefore, adequate, and no referral is required. Thun v. Peake, 22 Vet. App. 111, 115-16 (2008); VAOPGCPREC 6-96 (August 16, 1996). The evidence does not show anything unique or unusual about the Veteran’s acquired psychiatric disability that would render the schedular criteria inadequate. Based on the foregoing, the Board finds that referral for consideration of an extra-schedular evaluation for the Veteran’s service-connected disability under the provisions of 38 C.F.R. § 3.321(b)(1) have not been met. Bagwell v. Brown, 9 Vet. App. 337 (1996). 2. Entitlement to a TDIU due to service connected disabilities Total disability ratings are authorized for any disability or combination of disabilities for which the Schedule for Rating Disabilities prescribes a 100 percent disability evaluation, or with less disability, if certain criteria are met. 38 C.F.R. § 3.340. Where the schedular rating is less than total, a total disability rating for compensation purposes may be assigned when the disabled person is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that, if there is only one such disability, this disability shall be ratable at 60 percent or more or if there are two or more disabilities, there shall be at least one ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). Nevertheless, even when the percentage requirements are not met, entitlement to TDIU on an extra-schedular basis may be granted in exceptional cases 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). In order to prevail on an extra-schedular basis, the record must reflect some factor that takes the case outside the norm. The sole fact that a veteran is unemployed or has difficulty obtaining employment is not enough. A disability rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether a veteran is capable of performing the physical and mental acts required by employment, not whether one can find employment. See Van Hoose v. Brown, 4 Vet. App. 361 (1993). Substantially gainful employment” is defined as an occupation that provides an annual income that exceeds the poverty threshold for one person, irrespective of the number of hours or days that a veteran actually works and without regard to a veteran’s earned annual income. See Faust v. West, 13 Vet. App. 342 (2000). The determination as to whether TDIU is appropriate should not be based solely upon demonstrated difficulty in obtaining employment in one particular field, which could also potentially be due to external bases such as economic factors, but rather to all reasonably available sources of employment under the circumstances. See Ferraro v. Derwinski, 1 Vet. App. 326, 331-32 (1991). In reaching such a determination, the central inquiry is “whether the Veteran’s service-connected disabilities alone are of sufficient severity to produce un-employability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). Consideration may not be given to the impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. A. Prior to January 28, 2017 During the course of the appeal for a higher initial rating for service-connected acquired psychiatric disability, the Veteran asserted in a March 2011 notice of disagreement (NOD) that his service connected disabilities render him unemployable and that he is therefore entitled to TDIU. See Rice v. Shinseki, 22 Vet. App. 447, 453 (2009). As a result, the Board finds that the date of claim for entitlement to a TDIU due to service-connected disabilities is January 16, 2010. Prior to December 16, 2010, the Veteran was service connected for an acquired psychiatric disability at 50 percent. Pursuant to 38 C.F.R. § 4.16(a) one disability is present, the Veteran’s schedular disability rating did not meet the minimum percentage requirements for consideration of a TDIU on a schedular basis from January 16, 2010 to December 15, 2010. From December 16, 2010 to January 27, 2017, the Veteran was service connected for the following disabilities: acquired psychiatric disability at 50 percent and irritable bowel syndrome with gastroesophageal disease evaluated at 10 percent. The combined disability evaluation is 60 percent for rating period from December 16, 2010 to January 27, 2017. See 38 C.F.R. § 4.25. Pursuant to 38 C.F.R. § 4.16(a) where two or more disabilities are present, the Veteran’s combined schedular disability rating did not meet the minimum percentage requirements for consideration of a TDIU on a schedular basis from December 16, 2010 to January 27, 2017. As a result, the Board considers whether there is evidence to remand this issue for consideration of a TDIU rating on an extra-schedular basis, pursuant to 38 C.F.R. § 4.16(b), at any time from January 16, 2010 to January 27, 2017. Review of the record includes the following pertinent documents related to the claim on appeal. In the April 2010 VA examination report, the examiner noted the Veteran’s occasional decrease in work efficiency or intermittent periods of an inability to perform occupational tasks due to his mental disorder signs and symptoms. The examiner also opined that the Veteran’s mild to moderate panic disorder would pose mild to moderate vocational limitations and would not prohibit the Veteran from obtaining or maintaining substantially gainful employment. At a January 2011 VA examination for digestive conditions, the Veteran reported his belief that his bowel problems affect his employment as a surveillance technician due to time spent in the bathroom while at work. A February 2011 VA examination report for the spine documents the Veteran’s employment at a casino. In a July 2012 VA intestinal conditions examination report, the examiner noted that the Veteran’s diagnosed irritable bowel syndrome does not impact his ability to successfully obtain or maintain gainful employment. At the July 2012 VA mental health examination, the Veteran reported that he was currently unemployed as he was dismissed after a week due to frequent panic attacks at work. Review of VA outpatient treatment records from December 2013 to December 2015 repeatedly diagnose the Veteran with an anxiety disorder and document that the Veteran is gainfully employed. While the Board does not wish to minimize the nature and extent of the Veteran’s overall disability picture from January 16, 2010 to January 27, 2017, after a full review of the record, the Board finds that the evidence is against the claim on appeal. The Board acknowledges the Veteran’s credible reported symptomatology of the service-connected disabilities, to include panic attacks, sleep impairment, and time spent in the bathroom while at work. The April 2010 VA examiner noted the Veteran’s panic disorder would pose mild to moderate vocational limitations. In addition, the Veteran reported being employed at the time of the January 2011 and February 2011 VA examinations. Nevertheless, the Board finds that the pertinent and more probative evidence of record does not demonstrate that the Veteran’s service-connected disabilities, alone, were of sufficient severity to render him unable to secure and follow substantially gainful employment at any time during the appeal period prior to January 28, 2017. In fact, the April 2010 VA examiner concluded the Veteran’s panic disorder would not prohibit him from obtaining or maintaining substantially gainful employment. The July 2012 VA examiner also concluded the Veteran’s irritable bowel syndrome does not impact his ability to successfully obtain or maintain gainful employment. Furthermore, the Veteran was provided a VA Form 21-8940 (Veteran’s Application for Increased Compensation Based on Unemployability) with an April 2017 notice letter; however, to date, he has not responded or provided the requested information. As a result, the Board finds this claim on appeal should not be submitted for extra-schedular consideration. A TDIU prior to January 28, 2017 is denied. B. Since January 28, 2017 Since January 28, 2017, the Veteran has been service connected for the following disabilities: an acquired psychiatric disability at 50 percent and irritable bowel syndrome with gastroesophageal disease evaluated at 30 percent. The combined disability evaluation is 70 percent for rating period since January 28, 2017. See 38 C.F.R. § 4.25. Pursuant to 38 C.F.R. § 4.16(a) where two or more disabilities are present, the Veteran’s combined schedular disability rating meets the minimum percentage requirements for consideration of a TDIU on a schedular basis since January 28, 2017. As a result, the Board considers whether there is evidence to warrant assignment of a TDIU rating on a schedular basis, pursuant to 38 C.F.R. § 4.16(a), at any time since January 28, 2017. Review of the record includes the following pertinent documents related to the claim on appeal. In a February 2017 VA Certification of Health Care Provider Employee’s Serious Health Condition, the examiner noted that the Veteran was unable to work as his conditions were severe. The examiner also noted that the Veteran suffered panic attacks 1 to 2 times per week or 12 times a month resulting in him being unbale to perform work. The examiner also noted that the Veteran would need time off to decrease his symptoms if he is to work to the best of his abilities. In the Veteran’s most recent March 2017 VA intestinal conditions examination, the examiner diagnosed the Veteran with irritable bowel syndrome noting that the Veteran has episodes of diarrhea at least once a day and bowel movement two to three times a day. Regarding occupational and functional limitations, the examiner noted that the Veteran’s irritable bowel syndrome does impact his ability to work. He noted that the Veteran’s diarrhea limits his ability to function in an occupational setting. He also noted that the Veteran’s fecal urgency requires that he maintain close proximity to a restroom. In the Veteran’s most recent October 2017 VA mental conditions examination, the examiner opined that the current severity of the Veteran’s service connected mental disorders is mild to moderate and noted that the severity has not increased since his last examination. The examiner explained that the Veteran’s symptoms continues to impact his social, interpersonal, and occupational functioning. He also opined that the Veteran’s service connected mental health disabilities mildly impact his ability to function effectively in an occupational setting. He explained that the Veteran’s mental health issues mildly make it difficult for him to complete work-related tasks effectively and appropriately interact with coworkers or supervisors in a work environment. After a full review of the record, the Board finds that the evidence is against the claim for a TDIU on a schedular basis since January 28, 2017. As discussed above, the pertinent evidence of record does not demonstrate that the Veteran’s service-connected disabilities, alone, are of sufficient severity to render him unable to secure or follow substantially gainful employment at any time during this appeal period. The Board acknowledges that the Veteran’s service-connected disabilities render him unable to perform certain types of labor; nonetheless, the evidence of record does not show he is rendered unable to physically or mentally obtain or maintain substantially gainful employment solely as a result of his service-connected disorders. The Board would note that “[t]he percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and their residual conditions in civil occupations.” 38 C.F.R. § 4.1. As a result, the Board concludes that the disability evaluations assigned to the Veteran’s disorders under the VA Schedule for Rating Disabilities accurately reflect the Veteran’s overall impairment to his earning capacity due to his service-connected disabilities, and TDIU since January 28, 2017 is not warranted. T. Blake Carter Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Elliot Harris, Associate Counsel