Citation Nr: 18149668
Decision Date: 11/13/18	Archive Date: 11/13/18

DOCKET NO. 09-15 136A
DATE:	November 13, 2018
ORDER
Entitlement to a disability rating in excess of 70 percent for anxiety reaction is denied.
Entitlement to a total disability rating based on individual unemployability due to service connected disabilities (TDIU) is granted.
FINDINGS OF FACT
1. The Veteran’s anxiety reaction has resulted in no more than occupational and social impairment with deficiencies in most areas.
2. The Veteran’s service-connected disabilities preclude him from securing or following a substantially gainful occupation.
CONCLUSIONS OF LAW
1. The criteria for a disability rating in excess of 70 percent for anxiety reaction have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.125, 4.126, 4.130, Diagnostic Code (DC) 9400.
2. The criteria for TDIU have all been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.15, 4.16.
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran served on active duty from January 1965 to October 1968.
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a February 2008 rating decision of the Regional Office (RO) in St. Petersburg, Florida.
This matter was previously before the Board in April 2014. The Veteran appealed the April 2014 decision to the U.S. Court of Appeals for Veterans Claims (Court), and in an October 2015 memorandum decision, the Court vacated the April 2014 Board decision and remanded the case to the Board. The matter was returned to the Board and was remanded in a December 2016 decision for further development.
1. Entitlement a disability rating in excess of 70 percent for anxiety reaction
The Veteran contends that his anxiety reaction meets the criteria for a rating higher than currently assigned. The Veteran’s anxiety reaction is currently rated as noncompensable from October 16, 1968 and 70 percent from August 23, 2007.
Disability ratings are determined by applying the criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10.
In determining the severity of a disability, the Board is required to consider the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the Veteran, as well as the entire history of the Veteran’s disability. 38 C.F.R. §§ 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991).
If the disability more closely approximates the criteria for the higher of two ratings, the higher rating will be assigned; otherwise, the lower rating is 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.
In deciding this appeal, the Board has considered whether separate ratings for different periods of time are warranted, a practice of assigning ratings referred to as “staging the ratings.” See Fenderson v. West, 12 Vet. App. 119 (1999).
The criteria for rating anxiety reaction are found at 38 C.F.R. § 4.130, DC 9400. A 70 percent evaluation is warranted 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; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); and inability to establish and maintain effective relationships. Id.
A 100 percent evaluation requires total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of close relatives, own occupation, or own name. Id.
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). A veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage or others of similar severity, frequency, and duration. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). Other language in Vazquez-Claudio indicates that the phrase “others of similar severity, frequency, and duration,” can be thought of as symptoms of like kind to those listed in the regulation for a given disability rating. Id. 116.
If the evidence demonstrates that the claimant’s psychiatric disorder produces symptoms and resulting occupational and social impairment equivalent to that set forth in the criteria for a given rating in the General Rating Formula, then the appropriate, equivalent rating will be assigned. Mauerhan, 16 Vet. App. at 443. In this regard, the Board must consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran’s capacity for adjustment during periods of remission. 38 C.F.R. § 4.126. While VA considers the level of social impairment, it shall not assign an evaluation based solely on social impairment. Id.
For purposes of considering the evidence in connection with the PTSD issue, the Board notes that the Global Assessment of Functioning (GAF) scale is a scale from 0 to 100, reflecting the “psychological, social, and occupational functioning on a hypothetical continuum of mental health illness.” Diagnostic and Statistical Manual of Mental Disorders 32 (4th ed. 1994) (“DSM-IV”) (100 representing superior functioning in a wide range of activities and no psychiatric symptoms). See 38 C.F.R. §§ 4.125, 4.126, 4.130.
In this regard, the Board acknowledges that effective August 4, 2014, VA amended the regulations regarding the evaluation of mental disorders by removing outdated references to “DSM-IV,” American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (1994). The amendments replace those references with references to the recently updated “DSM-5,” and examinations conducted pursuant to the DSM-5 do not include GAF scores.
A GAF of 51-60 denotes moderate symptoms or moderate difficulty in social, occupational, or school functioning. A GAF of 61-70 denotes some mild symptoms or some difficulty in social, occupational, or school functioning, but generally functioning pretty well, has some meaningful interpersonal relationships.
While an examiner’s classification of the level of psychiatric impairment as reflected in a GAF score can be probative evidence, such a score is by no means determinative of the rating assigned by VA in evaluating a psychiatric disorder under the rating criteria. See 38 C.F.R. §§ 4.2, 4.126 (2017); VAOPGCPREC 10-95 (March 31, 1995). Rather, VA must take into account all of the Veteran’s symptoms and resulting functional impairment as shown by the evidence of record in assigning the appropriate rating, and will not rely solely on the examiner’s assessment of the level of disability at the time of examination. See 38 C.F.R. § 4.126.
The Board notes that in Golden v. Shulkin, 29, Vet. App. 221, 226 (2018), the Court held that given that the DSM-5 abandoned the GAF scale and that VA has formally adopted the DSM-5, the Board errs when it uses GAF scores to assign a psychiatric rating in cases where the DSM-5 applies. However, the Court added that it does not hold that the Board commits prejudicial error every time the Board references GAF scores in a decision. This appeal was pending before the Board prior to August 4, 2014. As such, the DSM-IV applies and the GAF scores, prior to August 4, 2014, will be noted, as appropriate since much of the relevant evidence in this case was obtained during the time period that the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) was in effect.
The Veteran underwent a VA examination in February 2008 for mental disorders and received an Axis I diagnosis of generalized anxiety disorder and major depressive disorder (MDD), in partial remission. His second wife died, and the Veteran indicated that he has had a hard time recovering from her loss. The examiner opined that the Veteran was diagnosed with anxiety disorder and reports feeling anxiety throughout his life.
VA treatment records from February 2008 include a February 12, 2008 record indicating a GAF score of 60. It indicates that the Veteran was well groomed, had adequate hygiene, was oriented, and had normal motor functions and speech. His thought processes were linear, insight and judgment were good, there were no delusions or perceptual disturbances, and he denied suicidal or homicidal ideation.
VA treatment records from May 2009 include a February 6, 2009 record indicating that the Veteran was assigned a GAF score of 70 and reported experiencing mild anxiety and depression but that he still remained active socially and had interest in activities. He denied symptoms of hypomania, mania, mood swings, or psychosis. The mental status examination indicated that the Veteran was adequately groomed, cooperative, and pleasant. His cognitive functioning was grossly intact, eye contact was good, motor function was intact, his mood was good with congruent broad affect, speech was clear, thought processes were linear, insight and judgment were fair, and there were no delusions or perceptual disturbances. The Veteran denied suicidal or homicidal ideation. A June 17, 2008 mental health outpatient note indicates that the Veteran was assessed a GAF score of 60 and that he had no delusions, and denied suicidal or homicidal thoughts, intent, or plan.
In the May 2009 VA Form 9, the Veteran stated that his medications increased because he was having panic attacks twice a week. He stated that he suffers from short and long-term memory loss and that his quality of life “has been shredded into pieces” because of his condition.
The Veteran underwent a VA examination for mental disorders in October 2010. The report indicates that the Veteran’s appearance was clean, he was casually dressed, and his psychomotor activity and speech were unremarkable. It indicates that the Veteran had no delusions, was cooperative, his affect was normal, and thought process and content were unremarkable. It indicates that the Veteran understands that he has a problem, has a sleep problem and decreased concentration. It indicates no hallucinations, inappropriate behavior, or obsessive/ritualistic behavior. It indicates that the Veteran has panic attacks of moderate intensity, lasting 5-10 minutes. The report indicates that the Veteran does not want to go out when he has an attack and that he does not like crowds or traveling. It indicates no presence of homicidal or suicidal thoughts, but that the Veteran, at times, questions his existence without plan or intent and the last time he had this thought was a week ago. The report indicates that his impulse control was fair and that he has had episodes of violence and is irritated easily but has not been in a physical fight in 20 years. The examiner noted that there is not total occupational and social impairment due to mental disorder signs and symptoms, but that his mental disorder results in deficiencies in family relations, work, and mood.
The Veteran underwent a VA examination in March 2015. The report indicates a diagnosis of generalized anxiety disorder and the examiner noted “with occasional anxiety and rated 5 out of 10 when he is idle and has a panic attack about once per month, lasting about 5 minutes.” The report indicates that the Veteran’s level of occupational and social impairment is best summarized as occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by medication. The report indicates symptoms of anxiety, panic attacks that occur weekly or less often, chronic sleep impairment, and difficulty in establishing and maintaining effective work and social relationships.
In the September 2016 private medical report, the examiner stated that the Veteran does not suffer from any serious physical conditions but that he experiences debilitating symptoms of generalized anxiety disorder and is irritable, angry, easily snaps, and endorses passive suicidal ideation. Any changes in his routine or stress levels lead to further anxiety, panic attacks, and an overall decline in functioning. The report indicates that his symptoms included all the classic signs and symptoms of generalized anxiety disorder including restlessness, fatigue, difficulty concentrating, irritability, sleep disturbance, suicidal ideation, panic attacks, and persistent fear and worry.
VA treatment records from September 2016 include a psychiatry note from August 4, 2015 indicating that the Veteran had appropriate eye contact, was well groomed, calm, cooperative, alert and oriented, his attention and concentration were fair, and his insight and judgment were good. His affect was congruent, thought processes were linear and goal oriented, and there were no preoccupations, delusions, or obsessions. He had no audio or visual hallucinations, and no homicidal or suicidal ideation, intent, or plans.
The Veteran underwent a VA examination for mental disorders in August 2017. The report indicates that the Veteran’s level of occupational and social impairment was best summarized as occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The examiner stated that since the last examination in 2015, the Veteran has continued to live alone and has been involved in a casual relationship for the past two years. He has no children, and his relationship with his only sister was described as “kind of rocky.” It indicates that since the Veteran’s only close friend passed away two years ago, he has become more isolated and rarely participates in social activities outside of seeing his female friend once a week. He stated that he spends most of his time alone and enjoys it. The report indicates that the Veteran has continued to participate in mental health treatment within the VA healthcare system, and that his treatment plan has consisted mainly of individual visits with his psychiatrist every one to three months. The Veteran has no history of psychiatric hospitalizations or treatment since his last examination. The report indicates that during his most recent psychiatric visit on May 18, 2017, the Veteran denied depressed mood, anxiety, mania, hypomania, obsessions, compulsions, AV hallucinations, delusions, or suicidal/homicidal thoughts, intent, or plan and that he lives in his own house, spends time with his friends, and likes to read in his free time. It indicates that his current symptoms are “periods of anhedonia, impaired concentration/focus, depressed mood one day per week, excessively chews his fingernails, frequent anxious thoughts about many things, difficulty controlling the anxiety, irritability, short-tempered, history of insomnia, panic attacks once per month usually triggered by strong emotions, self-doubt, social isolation.” The report indicates symptoms of depressed mood, anxiety, panic attacks that occur weekly or less often, mild memory loss, such as forgetting names, directions, or recent events, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. It indicates that the Veteran was oriented, speech was within normal limits, he was neatly dressed and groomed, polite and cooperative, had difficulty remaining focused and on topic, denied hallucinations and delusions, and his judgment and insight were adequate. He denied homicidal ideation, intent, or plan and denied present suicidal ideation, intent, or plan but admitted to experiencing suicidal ideation after the death of his wife in 2004; no history of past suicide attempts. 
VA treatment records from September 2017 include a record from February 23, 2017 indicating that the Veteran denied depressed mood, anxiety, mania, hypomania, obsessions, compulsions, AV hallucinations, delusions, or suicidal/homicidal thoughts, intent, or plan. It indicates that the Veteran was alert and oriented, attention, concentration, insight, and judgment were fair, mood was okay, speech was clear and coherent, language was normal, and thought processes were linear and goal oriented. It indicates no delusions, obsessions, or preoccupations, and no audio or visual hallucinations. The Veteran denied suicidal or homicidal ideation, intent, or plans.
In an October 2018 private medical opinion, the examiner stated that the Veteran has experienced a steady increase in psychiatric symptom intensity with pervasive anxiety, irritability, anger, low frustration tolerance, insomnia, and even a recurrence of depressive symptomatology not present for years. The report indicates that his mental disorder signs and symptoms result in deficiencies in most areas, including work, family relations, judgment, thinking, and mood.
Based on the foregoing, the Board finds that the Veteran’s overall disability picture is manifested by symptoms which falls squarely within the criteria for the assignment of a 70 percent rating. Thus, the evidence is against granting a disability rating higher than 70 percent for the Veteran’s anxiety reaction. The evidence does not show that the Veteran has had gross impairment in thought processes or communication, grossly inappropriate behavior, persistent delusions or hallucinations, or memory loss such as contemplated under the 100 percent rating criteria. There have been no symptoms of like kind to those listed for the 100 percent rating. Thus, the extent of his impairment has not been shown by the competent medical evidence of record to be that required for a 100 percent rating at any time during the appeal period. In short, the Veteran’s overall disability picture is not manifested by total occupational and social impairment. Accordingly, the assignment of a 100 percent rating is not warranted.
As the preponderance of the evidence is against the claim for a rating in excess of 70 percent during the appeal period, the benefit-of-the-doubt doctrine is not applicable and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990).
2. Entitlement to a total disability rating based on individual unemployability due to service connected disabilities
The Veteran contends that his service-connected disabilities prevent him from securing or following a substantially gainful occupation.
Entitlement to TDIU requires the presence of impairment so severe that it is impossible for the average person to follow a substantially gainful occupation. Consideration may be given to the Veteran’s level of education, special training, and previous work experience in arriving at a conclusion, but not to the Veteran’s age or the impairment caused by any nonservice-connected disabilities. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16, 4.19. In reaching such a determination, the central inquiry is “whether the Veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993).
TDIU may be assigned when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. The service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue will be addressed in both instances. 38 C.F.R. § 4.16(a),(b).
For a schedular TDIU, if there is only one such disability, it must be rated at 60 percent or more; if there are two or more disabilities, at least one disability must be rated at 40 percent or more, with sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. 38 C.F.R. § 4.16(a).
It is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Therefore, rating boards should submit to the Director, Compensation Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in § 4.16. 38 C.F.R. § 4.16(b). The rating board will include a full statement as to the veteran’s service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue. Id.
The Veteran has three service-connected disabilities. These include anxiety reaction rated as noncompensable from October 16, 1968 and 70 percent from August 23, 2007, residuals of contusion of the chest and legs rated as noncompensable from October 16, 1968, and loss of tooth rated as noncompensable from August 21, 2014.
The issue of TDIU was previously determined to have been raised by the record during the Veteran’s increased rating claim. Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009). On the June 2008 TDIU application, the Veteran stated that his anxiety reaction prevents him from securing or following any substantially gainful occupation, that he completed four years of college, and last worked full-time in 1994. The application indicates that the Veteran received his Master’s Degree in 1998 and had previously completed flight training and aerial photography training.
As discussed above, the February 2008 VA examination indicates that the “Veteran notes that over the years he has had a variety of occupations, none of them for very long. He has worked as a photographer, spent a number of years “drifting” in Mexico, and was trained as a pilot. The examiner opined that the Veteran was diagnosed with anxiety disorder and reported feeling anxiety throughout his life that has led to his having difficulty maintaining stable employment and occupational performance. The examiner stated that the prognosis for stability appears fair with continued treatment and that the Veteran is unemployed and unlikely to achieve gainful employment.
As discussed above, the Veteran underwent a VA examination for mental disorders in October 2010. The examiner stated that the Veteran continued to have generalized anxiety disorder and that his anxiety disorder does not preclude gainful employment consistent with his educational and occupational experience and that his age likely factors into his getting gainful employment in his area more than his anxiety disorder. It indicates that there is not total occupational and social impairment due to mental disorder signs and symptoms, and that there is not total occupational and social impairment but that his mental disorder results in deficiencies in family relations, work, and mood. The examiner noted that the Veteran is anxious in routine situations, has a short temper, and feels that he is too impatient to work for someone.
As discussed above, the Veteran underwent a VA examination in March 2015. The report indicates that the Veteran’s level of occupational and social impairment is best summarized as occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by medication. The report indicates difficulty in establishing and maintaining effective work and social relationships.
As noted above, in the September 2016 private medical report, the examiner stated that the Veteran has worked as a “cleaner, photographer, pilot trainer, in an office, and in the shipping industry in the past” and that he has received a master’s degree in the economics of development. The examiner stated that despite the Veteran’s background, knowledge of several fields, and education, he has still been unable to consistently work since service and was last employed in any significant capacity in 1994. He stated that the Veteran has tried to work since 1994 but has not been able to hold a job. The examiner explained that the Veteran does not suffer from any serious physical conditions but that he experiences debilitating symptoms of generalized anxiety disorder. Any changes in his routine or stress levels lead to further anxiety, panic attacks, and an overall decline in functioning. The examiner stated that the vast majority of the Veteran’s life after service was devoid of the capacity to earn a living wage in any of a number of occupational settings attempted by the Veteran. He stated that this was not due to any physical problems, the death of his wife, or his age but that the Veteran was an impaired individual from pervasive anxiety from 1968 through the present day. The examiner noted that the Veteran attempted to work in a variety of different jobs, attempted to better himself through education and vocational training, and tried to be an entrepreneur but that he failed at all of those things, “specifically and only due to mental illness associated with his service.”
As discussed above, the August 2017 VA examination indicates that the Veteran’s level of occupational and social impairment was best summarized as occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily. It indicates difficulty in establishing and maintaining effective work and social relationships. Regarding employability, the examiner stated that “due to Veteran’s low frustration tolerance and difficulty taking orders from others associated with his service-connected mental health condition.” He indicated that the Veteran may struggle when working for supervisors who are not supportive or not receptive to feedback and would need to work in a flexible environment where he could leave for short periods of time to calm his nerves as necessary. He stated that the Veteran’s “employers would need to be understanding of his anxiety and provide him with leniency with regards to attendance.” The examiner noted that “due to Veteran’s decreased concentration and problems maintaining concentration, he may have difficulty working in an environment where he is unsupervised for long periods of time and he may require additional time to complete tasks or learn new skills.”
In October 2018 correspondence, the Veteran’s representative stated that the Veteran has a proven history of sporadic employment due to his severe anxiety disorder, and that his later attempts at working on his own have failed because of his anxiety disorder.
In an October 2018 statement, the Veteran stated that after years of being unable to hold down a job he decided that the only way for him to overcome the stress of workplace demands and having to be around and cooperate with other people was to start an independent work project “or else cash in my chips and get out of the game.” He stated that he is attempting to launch a website, that he sets his own hours, and that his main outside interaction is with website developers and programmers but that it is only through phone or e-mail. He stated that he has never gotten any money for his time working on the website and that it still has not launched because of the many hurdles found on the way.
In an October 2018 private medical opinion, the examiner stated that the Veteran now has a “dwindling capacity to even manage minimalistic work and that it is not representative of any type of meaningful and gainful employment.” He stated that the Veteran would struggle with the interpersonal interactions with supervisors, coworkers, and the public. He indicated that the Veteran was able to obtain jobs as he is intelligent and well-educated, but that his behavior on the job site prevents him from maintaining jobs or advancing. The report indicates that the Veteran engaged supervisors, coworkers, and the public in an inappropriate, angry, irritable, defiant, and unreasonable manner which is inconsistent and volatile. He stated that there is no modern workplace willing to accept these types of behaviors and “even the 2017 VA examiner placed multiple stipulations on the Veteran’s capacity to function in the work environment.” The private examiner stated that the 2017 VA examiner essentially constructed an environment that would have to allow the Veteran leniency regarding work attendance, the ability to take multiple breaks during the day, and to ensure that coworkers and supervisors are willing to accommodate his mental illness.” He stated that, “essentially, the 2017 examiner is describing a therapeutic workshop for individuals with pervasive mental illness, not a setting involved in meaningful and gainful employment.” The private examiner stated that the Veteran is incapable of working and has declined in functionality. He noted that the Veteran is experiencing a decrease in capacity for task completion, and is no longer able to as many hours into his “unsuccessful project.” He stated that the Veteran could not function in a work setting due to his generalized anxiety disorder as he is irritable, angry, possesses a short attention span, lacks problem-solving capacity, and displays consistently poor judgment. The examiner indicated that the Veteran has lost most of his savings “on this project which is not viable, meaningful, or in any way gainful.” He stated that the Veteran is completely disabled and has been so since 1994 with the inability to properly engage in an occupational environment. The report indicates that mental disorder signs and symptoms result in deficiencies in most of the following areas, including work, family relations, judgment, thinking, and mood.
In light of the treatment records, medical opinions from her treating psychiatrist, lack of meaningful and gainful employment since 1994, the Board finds that, considering the record as a whole, and resolving reasonable doubt in favor of the Veteran, the claim for a TDIU should be granted from August 23, 2007. This is the date the Veteran meets the schedular requirements for TDIU.
The Board finds that the probative evidence of record reasonably shows that the Veteran’s service-connected anxiety reaction precludes him from securing or maintaining a substantially gainful occupation consistent with his work history and education.
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The Board resolves reasonable doubt in favor of the Veteran and finds that the evidence shows he is entitled to an award of a TDIU rating based on his service-connected anxiety reaction. See Geib v. Shinseki, 733 F.3d 1350 (Fed. Cir. 2013). Thus, the Veteran’s claim for entitlement to a TDIU is granted.
 
L. B. CRYAN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. Labi, Associate Counsel