Citation Nr: 18151268 Decision Date: 11/19/18 Archive Date: 11/16/18 DOCKET NO. 08-24 372 DATE: November 19, 2018 ORDER Entitlement to a higher initial rating for posttraumatic stress disorder (PTSD), from April 3, 2007, currently evaluated as 30 percent disabling, is denied. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU), for the period from January 29, 2007, through May 9, 2010, is denied. FINDINGS OF FACT 1. The most probative evidence of record does not demonstrate that, from April 3, 2007, it is at least as likely as not that the Veteran’s PTSD is productive of functional impairment worse than occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. 2. From January 29, 2007, through May 9, 2010, the Veteran’s service-connected disabilities did not prevent him from securing or following a substantially gainful occupation. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial rating in excess of 30 percent for PTSD, from April 3, 2007, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.400, 4.3, 4.7, 4.14, 4.21, 4.130, Diagnostic Code 9411. 2. The criteria for entitlement to a TDIU for the period from January 29, 2007 through May 9, 2010 have not been met. 38 U.S.C. §§ 1155, 5103A, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1968 to February 1971. These matters come before the Board of Veterans’ Appeals (Board) on appeal of a September 2007 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Togus, Maine. The case is now under the jurisdiction of the Detroit, Michigan RO. This case was previously remanded by the Board in August 2010, December 2011, July 2014, September 2015, and February 2017. A review of the claims file shows that there has been substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). The case has been returned to the Board for review. The December 2011 Board decision denied an initial rating in excess of 30 percent for PTSD for the period on appeal prior to April 3, 2007. As such, that portion of the appeal is no longer before the Board. A January 2011 rating decision granted entitlement to a TDIU with an effective date of May 10, 2010. The issue on appeal is therefore characterized as entitlement to a TDIU from January 29, 2007 through May 9, 2010. This characterization is appropriate as the award of service connection for PTSD was granted with an effective date of January 29, 2007, and the Veteran was not service-connected for any disability prior to January 29, 2007. In September 2011, the Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge at the Detroit, Michigan RO. A transcript of the hearing is associated with the claims file. 1. Entitlement to a Higher Initial Rating for PTSD Increased Ratings – General Legal Criteria Disability ratings are determined by the application of VA’s Schedule for Rating Disabilities (Schedule), which is based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155 (2012); 38 C.F.R. Part 4 (2017). Pertinent regulations do not require that all cases show all findings specified by the Schedule, but that findings sufficient to identify the disease and the resulting disability and, above all, coordination of the rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21; see also Mauerhan v. Principi, 16 Vet. App. 436 (2002). When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 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. The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as “staged ratings,” in all claims for increased ratings. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999). Analysis The Veteran seeks a higher initial rating for his service-connected PTSD. The Veteran’s service-connected PTSD is rated as 30 percent disabling under 38 C.F.R. § 4.130, Diagnostic Code 9411, effective from January 29, 2017. As noted above, the applicable rating period is from April 3, 2007, through the present because the December 2011 Board decision denied an initial rating in excess of 30 percent for PTSD prior to April 3, 2007. See 38 C.F.R. § 3.400. Relevant to the issue on appeal, under the General Rating Formula for Mental Disorders, a 30 percent rating is assigned for 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, mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is assigned for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is assigned for 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. A maximum 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation or own name. The VA General Rating Formula for Mental Disorders is meant to provide a regulatory framework for placing veterans on a disability spectrum based upon their objectively observable symptoms. Vasquez-Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013). Symptomatology should be the fact finder’s primary focus when deciding entitlement to a given disability rating, and 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 others of similar severity, frequency, and duration. Id. The psychiatric symptoms listed in the above rating criteria are not exhaustive. Rather, they are examples of typical symptoms for the listed percentage ratings. Mauerhan, 16 Vet. App. 436. Accordingly, consideration will be given to all symptoms of the Veteran’s service-connected psychiatric disabilities that affect his level of occupational and social impairment. Turning to the relevant evidence of record, the Veteran was provided a VA examination in April 2007. The VA examiner reviewed the record, interviewed the Veteran and conducted an in-person examination. The Veteran reported that he has four adult children and has no contact with his two eldest sons. He further reported that he has contact with his two youngest children and with his siblings. The Veteran reported that he was unemployed since October 2006 and that his longest held civilian employment was for just under eight years. The Veteran denied ever having been fired from a job for any malfeasant reasons. The Veteran reported intrusive distressing recollections of Vietnam. He further reported weekly distressing dreams. The Veteran reported that he checks the doors and locks of his home ritualistically and compulsively. The Veteran reported he feels detached and estranged from others and reported having only one male friend. He reported difficulty with concentration, hypervigilance and an exaggerated startle response. The Veteran stated that he was depressed due to his experiences in Vietnam and denied current suicidal or homicidal ideation. The Veteran complained of memory and concentration problems, impatience, anxiety and insomnia. Upon examination, the Veteran appeared oriented and his concentration was excellent. His insight, formal operational judgment and problem-solving skills appeared good. The VA examiner noted that the Veteran presented as cooperative and alert. The Veteran was satisfactorily groomed and his motor activity appeared to be within normal limits. The Veteran’s mood was composed at times and anxious at other times, but it was always appropriate. The VA examiner opined that the Veteran’s industrial adaptability and capability were fair. A September 2011 statement from the Veteran’s former roommate reflects that the Veteran was hyperalert and a has a quick temper. An August 2011 statement from the Veteran’s daughter reflects that the smallest thing will prompt a verbal outburst and that he never sleeps. She further stated that his basic personal hygiene is marginal, at best. The Veteran’s daughter further stated that the Veteran is extremely security conscious and constantly checks windows and doors. She stated that the Veteran is a loner who simply stays in the house. In a September 2011 statement, the Veteran stated that due to his PTSD symptoms he would have run-ins with his bosses and would therefore quit before he was fired. He further stated that he often thinks about suicide and made plans. The Veteran stated that he does not like to go to doctors and that his only treatment for his PTSD is his self-medication with alcohol. At the September 2011 Board hearing, the Veteran testified that he never sleeps well at night and that he gets up several times to check the doors and windows and make sure his gun is under his pillow. He testified that he has a lot of anxiety and anger. The Veteran testified that he has acquaintances, but does not get close to a lot of people. During the Board hearing the Veteran became tearful describing how a friend ameliorates for him. The Veteran testified that he has a lot of anxiety at work and that he is stressed. He further testified that he has problems concentrating and staying on task. The Veteran testified that he has suicidal ideations and did not tell the April 2007 VA examiner since he did not want to be labeled as a “nut.” He further testified that he has nightmares approximately three times a week. The Veteran testified that he currently does not receive active treatment for his PTSD. The Veteran was provided a VA examination in June 2013. The VA examiner reviewed the record, interviewed the Veteran and conducted an in-person examination. The Veteran stated that he lives alone with his dogs and sleeps with two loaded guns. He stated that his depression worsened in 2007 after his wife died. The Veteran reported obsessional rituals of checking the doors before he goes to sleep. Upon examination, the Veteran was alert and made good eye contact. His thoughts were clear and goal directed. The Veteran’s mood was guarded and anxious. He did not report auditory or visual hallucinations. There were no suicidal or homicidal ideations. The VA examiner noted symptoms of difficulty falling or staying asleep, hypervigilance, depressed mood, suspiciousness, and obsessional rituals which interfere with routine activity. The VA examiner summarized the Veteran’s level of 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 Veteran was provided a private examination in June 2014. The private examiner reviewed the record, interviewed the Veteran and conducted an in-person examination. The private examiner noted that the Veteran has no contact with his two children from his first marriage. He noted that the Veteran maintained a relationship with his second wife for 34 years and that he has contact with his two children from his second marriage. The examiner noted that the Veteran has trouble maintaining and initiating friendships, and that he was quick to feel irritated if someone offers a differing opinion. Upon examination, the Veteran reported his mood as anxious and edgy. The Veteran reported that he spends most days alone at home, and that when he does leave, that he sits against the wall and watches the exits, and is especially uncomfortable in crowds. The Veteran reported that he checks the locks on the windows and doors up to six times. The examiner reported PTSD symptoms of disturbing memories, thoughts or images, repeated disturbing dreams, feeling as if a stressful military experience was happening, feeling upset and having physical reactions when reminded of stressful military experiences. The Veteran reported trouble falling or staying asleep, feeling irritable or having angry outburst, having difficulty concentrating, being super alert or watchful and feeling jumpy or easily startled. The Veteran reported suicidal thoughts regularly throughout the years. He reported depression and nightmares that happen several times a week. He further reported that his depression and persistent anxiety prevented him from interacting with others. The private examiner noted that the Veteran’s hair and hygiene were mildly unkempt. He was oriented to time and place and presented as agitated and mildly anxious. His speech was fluent and well-articulated. The Veteran did not report hallucinations or delusions. The private examiner reported that the Veteran demonstrates significant deficiencies in the areas of work, family relations and relationships, thinking and mood. The Veteran was provided a VA examination in February 2018. The Veteran reported that he lives by himself and has a decent relationship with his children. The Veteran denied being in therapy for his PTSD. He reported that he does not like crowds and that he likes to sit against the wall. The Veteran did not elicit manic or psychotic symptoms and had no active or passive suicidal or homicidal thoughts. The Veteran reported hypervigilance and sleep disturbances. The VA examiner noted symptoms of depressed mood and chronic sleep impairment. The VA examiner summarized the Veteran’s level of occupational and social impairment as mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during period of significant stress, or; symptoms controlled by medication. After considering the evidence of record under the laws and regulations set forth above, the Board finds that, throughout the relevant period on appeal, the Veteran’s PTSD manifestations were, at worst, no more severe than productive of functional impairment comparable to occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks and that the record does not show that it was factually ascertainable during that period that the Veteran’s PTSD was of a severity warranting a rating in excess of 30 percent. For example, the record shows that, during the period on appeal, the Veteran demonstrated depressed mood, anxiety, hypervigilance and chronic sleep impairment. He further endorsed symptoms of nightmares, flashbacks, and a dislike for being around crowds. However, the mental status examinations revealed him to be alert and oriented with normal speech, thought process, and thought content. Upon examination, the Veteran did not demonstrate impairment of short- and long-term memory, impaired concentration, impaired judgement, or impaired abstract thinking. He maintained relationships with his wife and adult children, although those relationships were adversely affected by the Veteran’s sleep impairment and anger. He interacted well with treatment providers, did not endorse suicidal ideation to any of the VA treatment providers, and had intact judgment and insight at all times. He did not have delusions or hallucinations. The Board concludes that the Veteran’s psychiatric symptomatology shown in the records most closely corresponds to the criteria for a 30 percent rating under 38 C.F.R. § 4.130, Diagnostic Code 9411, or occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. The Board further finds that the Veteran was not entitled to a 70 percent rating for PTSD at any time during the period on appeal. The disability was not manifested during that period by symptoms productive of functional impairment comparable to occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. The record shows that the disability caused difficulty in work, mood, and family. During that period, the Veteran presented with depressed mood and reported having anxiety, but he was able to perform activities of daily living and household chores, and he was able to perform household duties when his wife was ill. He endorsed impaired impulse control, such as unprovoked irritability, but the impaired impulse control did not result in periods of violence. He demonstrated obsessional rituals of checking the locks and doors but they did not interfere with routine activities; his speech was not intermittently illogical, obscure, or irrelevant; he did not have near-continuous panic or depression affecting his ability to function independently, appropriately and effectively; his spatial disorientation was intact; neglect of personal appearance and hygiene was not noted during the VA examination; and he did not demonstrate an inability to establish and maintain effective relationships. In regard to judgment, the mental status examinations rate the Veteran’s judgment as good on all occasions. In terms of thinking, the mental status examinations reflect that the Veteran had normal thought process and content on all occasions. The Veteran did not have any other symptoms comparable in severity, frequency, and duration to those specifically listed in the 70 percent rating criteria. The Board acknowledges that the Veteran stated he had suicidal ideations during the period on appeal. Specifically, at the September 2007 Board hearing, the Veteran testified that he did not report suicidal ideations at the April 2007 VA examination because he did not want to be labeled as a “nut.” Additionally, the June 2014 private examiner noted that the Veteran had suicidal ideations throughout the period on appeal. However, a review of the record reflects that the Veteran was provided three separate VA examinations, spanning the entire period on appeal. At the April 2007, June 2013, and February 2018 VA examinations, the Veteran denied any suicidal ideations. Additionally, and importantly, it is not merely the symptom listed which is the deciding factor in assigning an evaluation, but rather it is the affect that the symptom has on the Veteran’s functioning. Mauerhan v. Principi, 16 Vet. App. 436, (2002). Because the use of the term “such as” in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Id. at 442; see also Sellers v. Principi, 372 F.3d 1318 (Fed. Cir. 2004). Nevertheless, all ratings in the general rating formula are also associated with objectively observable symptomatology and the plain language of the regulation makes it clear that the veteran’s impairment must be “due to” those symptoms, a veteran may only qualify for a given disability rating by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d 112 (Fed. Cir. 2013). Although the Veteran testified that he had suicidal thoughts, the record does not reflect that his thoughts caused him to have occupational and social impairment with deficiencies in most areas. In addition, as noted above, the Veteran did not endorse suicidal ideations during his numerous VA examinations. The Board also finds that the Veteran was not entitled to a 100 percent rating for PTSD at any time during the period on appeal. The Veteran’s service-connected PTSD did not manifest in symptoms productive of functional impairment comparable to total occupational and social impairment. The evidence does not demonstrate functional impairment comparable to gross impairment in thought processes or communication; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); or disorientation to time or place. Rather, the Veteran exhibited normal thought process at all times during the period at issue. He was cooperative with healthcare providers and maintained relationships with his wife and children during that period. In short, the Veteran did not show symptoms productive of impairment comparable to total occupational and social impairment during that period. Therefore, the Veteran’s PTSD did not more closely approximate the severity, frequency, and duration contemplated by the criteria for a 100 percent rating during the period on appeal, and a rating in excess of 30 percent was not warranted during that period. See 38 C.F.R. § 4.7. The Board recognizes that the Veteran has a limited work history and has not worked since June 2008. The fact that the Veteran’s PTSD results in occupational impairment has been considered by the Board. Such impairment is explicitly contemplated by the schedular criteria. That the Veteran was not working during a portion of the period at issue does not by itself define his level of impairment, and does not by itself demonstrate that a rating in excess of 30 percent was warranted. Specifically, it does not, in and of itself, demonstrate that the Veteran had occupational and social impairment with reduced reliability and productivity, occupational and social impairment in most areas, or that the Veteran had total occupational and social impairment. See 38 C.F.R. § 4.130, Diagnostic Code 9411. In the above discussion, the Board detailed the factors constituting the Veteran’s overall disability picture during the period on appeal. The Board has coordinated the Veteran’s demonstrated level of impairment with the rating criteria. See 38 C.F.R. § 4.21; see also Mauerhan, 16 Vet. App. 436. Although the record shows that the Veteran has not worked since June 2008, it also shows that, overall, the Veteran’s psychiatric symptomatology did not more closely approximate the level of severity contemplated by the criteria for ratings in excess of 30 percent during the period at issue. Therefore, the Board finds that the Veteran is not entitled to a rating in excess of 30 percent for PTSD despite the fact that he has not worked since June 2008. In reaching its conclusion, the Board has considered the June 2014 private examination. The private examiner reported that the Veteran demonstrates significant deficiencies in the areas of work, family relations and relationships, thinking and mood. The private examiner based the opinion on the June 2014 private examination and a review of the Veteran’s record. However, the June 2013 VA examiner summarized the Veteran’s level of occupational and social impairment as occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, and the February 2018 VA examiner summarized the Veteran’s level of occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during period of significant stress, or; symptoms controlled by medication. Thus, the June 2014 private examiner’s assessment is inconsistent with the VA examinations conducted just prior and after the June 2014 private examination. The Board notes that the Veteran is competent to report symptoms of his service-connected PTSD as doing so requires only personal knowledge. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). The Board has considered his reported symptoms. However, the Veteran is not competent to render an opinion as to the relative severity of his service-connected PTSD in conjunction with the schedular rating criteria as doing so requires specialized medical knowledge or expertise the Veteran has not been shown to possess. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (2006). The Board instead relies on the competent findings of record provided by medical professionals during the period on appeal. The probative evidence does not support a finding that a rating in excess of 30 percent is warranted for the Veteran’s PTSD at any time during the period on appeal. Neither the Veteran nor his representative has raised any other issues with regard to the rating for the Veteran’s PTSD nor have any other such issues been reasonably raised by the record. See Yancy v. McDonald, 27 Vet. App. 484, 495 (2016); Doucette v. Shulkin, 38 Vet. App. 366, 369-70 (2017). The Board notes that the General Rating Formula for Mental Disorders, refer to symptoms “such as” those specifically listed. Therefore, as it has done in this decision, the Board must address and consider symptoms other than those specifically listed in the rating criteria, as well as the overall level of impairment. See, e.g., Vazquez-Claudio, 713 F.3d at 118; Mauerhan, 16 Vet. App. at 442. Thus, with respect to any psychiatric symptom that is not specifically listed as an example in the rating criteria, the symptom is contemplated by the criteria, as the criteria expressly allows for consideration of symptoms other than those specifically listed. In this case, the rating criteria are adequate and contemplate the Veteran’s symptomatology related to his service-connected acquired psychiatric disability. In light of the above, the Board finds that an initial rating in excess of 30 percent, from April 3, 2007, is not warranted for the Veteran’s PTSD. Because the preponderance of the evidence is against the Veteran’s appeal, the benefit-of-the-doubt rule is not for application, and the appeal must be denied. 38 U.S.C. § 5107 (b); Gilbert, 1 Vet. App. 55. 2. Entitlement to a TDIU The Veteran seeks entitlement to a TDIU. A TDIU may be granted where a veteran is unable to secure or follow a substantially gainful occupation as a result of a single service-connected disability ratable at 60 percent or higher, or as a result of two or more service-connected disabilities, provided at least one disability is ratable at 40 percent or higher, and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16 (a). Consideration may be given to a veteran’s level of education, special training, and previous work experience, but not to his or her age or to impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. Substantially gainful employment is defined as work that is more than marginal and that permits the individual to earn a living wage. See Moore v. Derwinski, 1 Vet. App. 356 (1991). Marginal employment is not considered substantially gainful employment. The determination of whether a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disability is a factual determination rather than a medical question. Therefore, responsibility for the ultimate determination of whether a veteran is capable of securing or following substantially gainful employment is placed on the VA, not a medical examiner. Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013); see also 38 C.F.R. § 4.16; Floore v. Shinseki, 26 Vet. App. 376, 381 (2013). For the period from January 29, 2007, through May 9, 2010, the Veteran was service connected solely for PTSD, rated as 30 percent disabling. His combined disability rating was 30 percent. Thus, the schedular percentage requirements for a TDIU were not met. Nevertheless, the Board will consider whether the Veteran’s service-connected disabilities have prevented him from securing or following a substantially gainful occupation such that referral for consideration of entitlement to a TDIU on an extra-schedular basis is warranted under 38 C.F.R. § 4.16 (b). The Veteran submitted a VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability, in May 2010, indicating that he has one-year college education, that he most recently worked from April 2007 through June 12, 2008 as a foreman, and that his PTSD, prostate cancer, diabetes mellitus, and ischemic heart disease prevents him from working. In June 2010, his most recent employer completed a VA Form 21-4192, Request for Employment Information in Connection with a Claim for Disability Benefits, confirming that the Veteran was employed as a supervisor from May 2007 through June 2008. The employer indicated that the Veteran lost time due to disability from March 27, 2008 through May 3, 2008 and from August 10, 2007 through October 29, 2007 and that the Veteran’s employment ended because he quit. At the September 2011 Board hearing, the Veteran testified that his PTSD caused problems in his employment because he had a lot of anxiety at work and that he was stressed. Additionally, he had problems with his boss since he would often disagree. The Veteran further testified that he left his last job due to a dispute with his boss over a safety issue. At the June 2013 PTSD examination, the Veteran stated that he was forced into quitting his previous employment because of a dispute with his boss regarding following proper safety procedure. The July 2014 private examiner reviewed the record and interviewed the Veteran and opined that the Veteran was unemployable since April 2007. As rationale, the private examiner stated that the Veteran’s level of psychological stress interferes with his ability to communicate, causes irritability and anger, and creates tension in public that interfered with his ability to engage in both family and social relationships and day-to-day activities. The Veteran was provided VA review of available evidence examination in September 2014. The VA examiner noted that the Veteran worked in the steel industry for over 30 years after his active military service and held a supervisory position. The VA examiner further noted that the Veteran left his last job following a dispute with his boss related to following proper safety procedures. The VA examiner opined that the effects of the Veteran’s PTSD at least as likely as not does not affect his social capacity. As rationale, the VA examiner noted that the Veteran was married for 32 years. The VA examiner further noted that the Veteran’s PTSD causes occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks and that the Veteran generally functions satisfactory with normal routine behavior, self-care, and conversation. The VA examiner further opined that the Veteran’s service-connected PTSD did not preclude the Veteran’s ability to obtain or retain substantially gainful employment consistent with his education and occupational history during the period from January 29, 2007, through May 10, 2010. The Veteran was provided a second VA review of available records examination in September 2015. The VA examiner reviewed the record and opined that based on the June 2013 examination, the Veteran’s service-connected PTSD did not preclude him from securing or following a substantially gainful occupation consistent with his educational and occupational history during the period from January 29, 2007 through May 10, 2010. As rationale, the VA examiner stated that the Veteran was married for 32 years. The VA examiner further stated that he left his previous job due to a dispute over proper safety. The Veteran was provided a VA examination in February 2018. The VA examiner opined that the Veteran’s PTSD does not affect his ability to hold gainful employment. As rationale, the VA examiner stated that the Veteran worked as a supervisor for over 30 years. In an April 2018 addendum opinion, the VA examiner stated that the conflict at work related to safety issues not a conflict related to his service-connected PTSD. Additionally, the VA examiner noted that the medical records show that the Veteran had a history of speaking his mind and getting into trouble even before his military service. He further noted that the Veteran’s PTSD did not affect his social and occupational functioning between 2007 and 2010. As rationale, the VA examiner noted that the Veteran was married for 32 years and that he did not seek any psychiatric treatment. The Board finds the VA examiners’ opinions to be probative because they were rendered by skilled medical professionals in view of an accurate understanding of the Veteran’s medical history and current medical condition. See Nieves-Rodriguez, 22 Vet. App. 295; Prejean v. West, 13 Vet. App. 444. The Board acknowledges that the private opinion indicated that the Veteran has been unable to work since April 2007 due to his service-connected PTSD. However, the statement is conclusory and does not provide any specific limitations caused by the service-connected PTSD that would reasonably prevent the Veteran from performing any substantially gainful occupation. Therefore, the Board affords less probative value to that opinion. See Stefl v. Nicholson, 21 Vet. App. 120, 123 (for a medical opinion to be adequate for decision-making purposes, it must be supported by a rationale and explanation for the conclusion reached). The Board does not doubt the Veteran’s reports that his service-connected PTSD would create challenges in interacting with employees and supervisors during the period from January 29, 2007 through May 10, 2010. In addition, the Board acknowledges that the Veteran’s then nonservice-connected disabilities, to include prostate cancer, diabetes mellitus, and ischemic heart disease, further limited his functioning such that he was unable to secure or follow a substantially gainful occupation. However, his nonservice-connected disabilities are not for consideration in determining whether he was entitled to a TDIU during the period from January 29, 2007 through May 10, 2010. See 38 C.F.R. § 4.16. When only his service-connected PTSD is considered, prior to May 10, 2010, the Veteran was not shown to be precluded from performing all types of substantially gainful employment. The Board has considered the Veteran’s level of education and previous work experience. See 38 C.F.R. §§ 4.16. As noted above, the Veteran has indicated that he has one-year college education and that he worked in supervisory positions. The Board finds that the Veteran’s education is consistent with an ability to perform work of an unskilled, semi-skilled or skilled nature, and he would not be precluded from performing inspection work, assembly work, supervisory work and any other such work. The Board also has considered the Veteran’s lay statements that his service-connected PTSD prevented him from securing or following substantially gainful employment from January 29, 2007 through May 9, 2010. The Veteran’s assertion that he had difficulty with supervisors and fellow employees is consistent with the probative medical findings and opinions of record. Thus, the Board finds the Veteran credible in that regard, and assigns probative value to his assertions. However, the Board notes that such difficulties are not inconsistent with a finding that the Veteran was able to secure or follow a substantially gainful occupation. As such, the probative evidence of record does not show that the Veteran was unable to secure or follow a substantially gainful occupation due to his service-connected PTSD during the period from January 29, 2007 through May 9, 2010. He has one-year college education and his occupational experience did not further limit his ability to secure and follow substantially gainful employment of an unskilled, semi-skilled or skilled nature. Therefore, the preponderance of the evidence is against a finding of entitlement to a TDIU for the period from January 29, 2007, through May 9, 2010, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. 49. VA’s Duty to Notify and Assist With respect to the Veteran’s claims herein, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (2012); 38 C.F.R. §§ 3.102, 3.156 (a), 3.159, 3.326 (2017); see also Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015). U. R. POWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. G. LeMoine, Associate Counsel