Citation Nr: 18152136 Decision Date: 11/21/18 Archive Date: 11/20/18 DOCKET NO. 16-46 662 DATE: November 21, 2018 ORDER The claim of entitlement to a disability rating in excess of 30 percent for irritable bowel syndrome is denied. The claim of entitlement to a disability rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied. The claim of entitlement to an effective date prior to January 10, 2007, for a disability rating in excess of 30 percent for irritable bowel syndrome is dismissed. The claim of entitlement to an effective date prior to June 3, 2010, for a disability rating of 70 percent for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran is currently in receipt of the highest possible rating under the diagnostic code governing irritable bowel syndrome, and there is no applicable rating that would allow a higher disability rating. 2. The symptomatology of the Veteran’s service-connected PTSD did not present in such a manner as to demonstrate 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 his own name. 3. An August 2013 Board decision, assigning an initial 30 percent disability rating for irritable bowel syndrome is final. No allegation of clear and unmistakable error has been asserted as to this decision. 4. A claim for an increased rating for anxiety and depression, later amended as PTSD, was not received prior to June 3, 2010. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 30 percent for irritable bowel syndrome are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.159, 3.321(b)(1), 4.1, 4.2, 4.3, 4.7, 4.114, Diagnostic Code 7319 (2018). 2. The criteria for a disability rating in excess of 70 percent for PTSD are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.159, 3.321(b)(1), 4.1, 4.2, 4.3, 4.7, 4.130, Diagnostic Code 9411 (2018). 3. The claim for an effective date earlier than January 10, 2007, for the assignment of a 30 percent rating for irritable bowel syndrome, is dismissed. 38 U.S.C. § 5110, 7104, 7105 (2012); 38 C.F.R. § 3.104, 3.400, 20.302, 20.1103 (2018). 4. The criteria for an effective date earlier than June 3, 2010, for the assignment of a 70 percent rating for PTSD have not been satisfied. 38 U.S.C. § 5110 (2012); 5. 38 C.F.R. § 3.400, 20.301 (2018); Rudd v. Nicholson, 20 Vet. App. 296 (2006). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had honorable active duty service with the United States Army from January 1997 to January 2004. The Veteran is a Gulf War Era Veteran. This matter is before the Board of Veterans’ Appeals (Board) on appeal from September 2010 and September 2015 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Sioux Falls, South Dakota. In a February 2007 rating decision, currently not on appeal, the RO granted service connection for the Veteran’s irritable bowel syndrome with a 10 percent disability rating, effective January 10, 2007, the date of receipt of the Veteran’s claim. A July 2008 rating decision, also not currently on appeal, denied entitlement to an earlier effective date. In the September 2010 rating decision, the RO granted continued a 30 percent disability rating for the Veteran’s PTSD, which was recharacterized from a formerly diagnosed anxiety and depression. The Veteran perfected an appeal to the Board, and in May 2012, the Board remanded the case for further development. The Veteran appeared at a hearing before the Board, before a Veterans’ Law Judge different from the undersigned, in April 2012. The Veteran was notified that the judge he appeared before was no longer employed by the Board, and he requested a hearing before a new judge. See Hearing Request, dated August 2014. An August 2013 Board decision denied the Veteran’s claim for a disability rating in excess of 30 percent for his service-connected PTSD. In a separated August 2013 decision, the Board granted a 30 percent disability rating from the date of service connection for the Veteran’s irritable bowel syndrome, but the Board denied a disability rating in excess of 30 percent and a claim for an earlier effective date for service connection thereof. The RO effectuated the Board’s decision regarding the disability rating for the Veteran’s irritable bowel syndrome in a March 2014 rating decision. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In March 2014, the Court vacated and remanded the Board’s decision pertaining only to those aspects of the decision involving the claim for an increased disability rating for the Veteran’s PTSD. The Court dismissed the appeal as to the issues of increased disability rating and effective date for the Veteran’s service-connected irritable bowel syndrome. As such, with regard to the Veteran’s rating and effective date for service connection of his irritable bowel syndrome, the August 2013 Board decision became final. In October 2014, the Board remanded the claim to schedule the Veteran for a hearing before the Board. The Veteran withdrew his request for a hearing, in writing, in August 2016. As such, the Veteran waived his right to a hearing. Based upon the foregoing, the Board finds that the directives of the prior remand have been substantially complied with. See D’Aries v. Peake, 22 Vet App. 97 (2008). In a September 2015 rating decision, the RO granted the Veteran a 70 percent disability rating for the Veteran’s PTSD, effective June 3, 2010, the date of receipt of the claim for an increased disability rating. The RO also continued the Veteran’s 30 percent disability rating for his service-connected irritable bowel syndrome. The Veteran filed a timely notice of disagreement to the September 2015 rating decision, and the RO issued a statement of the case in July 2016. The Veteran perfected an appeal to the Board, to include the issues of effective date of service connection for irritable bowel syndrome and effective date of 70 percent disability rating of PTSD. Because the RO did not assign the maximum disability rating possible for the Veteran’s PTSD, the appeal for higher disability evaluation remains before the Board. AB v. Brown, 6 Vet. App. 35 (1993). The case concerning an increased disability rating for the Veteran’s PTSD has been returned to the Board for appellate consideration. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board notes that the Veteran was granted a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) in an October 2016 Board decision. This decision was effectuated in a December 2016 rating decision, issued by the RO, with an effective date of June 3, 2010. The Veteran has not provided a notice of disagreement with either the award or the effective date thereof. VA has a duty to notify and assist the Veteran in substantiating a claim for VA benefits. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2018). The Veteran has not raised any 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). Increased Rating Disability evaluations are determined by the application of the facts presented to VA’s Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4 (2018). The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321(a), 4.1 (2018). In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1 (2018); Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary importance. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). That said, higher evaluations may be assigned for separate periods based on the facts found during the appeal period. See Fenderson v. West, 12 Vet. App. 119, 126 (1999). This practice is known as staged ratings. Id. The evaluation of the same disability under several diagnostic codes, known as pyramiding, must be avoided; however, separate ratings may be assigned for distinct disabilities resulting from the same injury so long as the symptomatology for one condition is not duplicative of the symptomatology of the other condition. 38 C.F.R. § 4.14 (2018); Esteban v. Brown, 6 Vet. App. 259, 262 (1994). If the evidence for and against a claim is in equipoise, the claim will be granted. 38 C.F.R. § 4.3 (2018). A claim will be denied only if the preponderance of the evidence is against the claim. See 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2018); Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3 (2018). Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for the evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (2018). 1. Entitlement to a disability rating in excess of 30 percent for irritable bowel syndrome The Veteran claims entitlement to an increased initial disability rating for his service-connected irritable bowel syndrome. Here, the Veteran’s service-connected irritable bowel syndrome has been rated under the provisions of 38 C.F.R. § 4.114, Diagnostic Code 7319, which governs irritable colon syndrome and establishes the following criteria: A maximum 30 percent disability rating is warranted when the veteran experiences symptoms that are severe, to include diarrhea and constipation, with more or less constant abdominal distress. The Veteran contends that he is entitled to a rating in excess of 30 percent for his service-connected irritable bowel syndrome. However, as outlined below, a preponderance of the evidence is against this claim. In January 2014, the Veteran received a VA examination to determine the severity and his irritable bowel syndrome. The Veteran was diagnosed with irritable bowel syndrome without a diagnosis of colitis, enteritis, Crohn’s disease, or enterocolitis. The Veteran endorsed episodes of alternative diarrhea and constipation with abdominal pain since 2004, with diarrhea lasting for two to three days and constipation lasting three to four days. The Veteran was found to have frequent episodes of symptoms. No neoplasms, scars, or other pertinent physical findings, complications, conditions, signs, or symptoms were noted. The Veteran continued to complain of his irritable bowel symptoms, reporting alternating between diarrhea and constipation. See VA Treatment Records, dated March 2015. The Veteran received a second VA examination in February 2017. The Veteran was diagnosed with irritable bowel syndrome, but no other digestive system diagnosis was made. The Veteran reported that he had experienced the urge to defecate numerous times that day, but that when he was constipated, he could go four to five days without a bowel movement. The Veteran was found to have frequent episodes of abdominal distress, with cramping and diarrhea. The Veteran reported having seven or more episodes within the past 12 months. There was no attributable weight loss, no neoplasm, no scars, and no other pertinent physical findings, signs, or conditions of the digestive system. The Veteran is currently in receipt of a 30 percent disability rating for his irritable bowel syndrome. As such, the Veteran is currently in receipt of the highest disability rating for irritable bowel syndrome allowed by Diagnostic Code 7319. 38 C.F.R. § 4.114, Diagnostic Code 7319 (2018). While the Board acknowledges that the Veteran has symptomatology and limitations associated with irritable bowel syndrome, these have been fully considered by the Veteran’s current 30 percent disability rating. The Board has considered the applicability of alternative Diagnostic Codes, but finds that there is no Diagnostic Code, applicable to the Veteran, that would yield a higher rating. There is no evidence that the Veteran currently has a service-connected diagnosis of gastritis, an ulcer, cirrhosis, colitis, or any other gastrointestinal diagnosis that would yield a higher rating. 38 C.F.R. §§ 4.114, Diagnostic Codes 7305, 7306, 7307, 7312, 7323 (2018). As such, the Board finds that Diagnostic Code 7319 is the most appropriate Diagnostic Code for the Veteran’s irritable bowel syndrome and, as outlined above, no higher disability rating is available. 38 C.F.R. § 4.114, Diagnostic Code 7319 (2018). Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). Given the above, the preponderance of the evidence is against an increased rating in excess of 30 percent for the Veteran’s service-connected irritable bowel syndrome. As such, the benefit-of-the-doubt doctrine is inapplicable. See 38 U.S.C. § 5107 (2012); 38 C.F.R. §§ 4.3, 4.7 (2017). For these reasons, the claim is denied. 2. Entitlement to a disability rating in excess of 70 percent for posttraumatic stress disorder (PTSD) The Veteran claims entitlement to an increased initial disability rating for his service-connected PTSD. Here, the Veteran’s service-connected PTSD has been rated under the provisions of 38 C.F.R. § 4.130, Diagnostic Code 9411, which governs PTSD and establishes the following criteria: A 70 percent disability rating is warranted when the veteran experiences 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 work-like setting); and inability to establish and maintain effective relationships. 38 C.F.R. § 4.130, Diagnostic Code 9411 (2018). A maximum 100 percent disability rating is warranted for total occupational and social impairment due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger or hurting self or others; intermittent ability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of closest relatives, own occupation, or own name. Id. Considerations in evaluating a mental disorder include the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran’s capacity for adjustment during periods of remission. The evaluation must be based on all the evidence of record that bears on occupational and social impairment rather than solely on an examiner’s assessment of the level of disability at the moment of the examination. 38 C.F.R. § 4.126(a) (2018). Although the extent of social impairment is a consideration in determining the level of disability, the rating may not be assigned solely on this basis. 38 C.F.R. § 4.126(b) (2018). The Veteran contends that he is entitled to a rating in excess of 70 percent for his service-connected PTSD. However, as outlined below, a preponderance of the evidence is against this claim. In December 2009, the Veteran was seen by VA mental health. He reported having bad dreams related to his experience in Iraq. He reported that his medication had been helpful and his sleep had improved. He stated that he had mild depression related to the death of his father at the end of November. The Veteran was fully alert and oriented with good eye contact. He was cooperative. His affect did not present with dysphoria, anxiety, irritability, or euphoria. There was no evidence of psychosis, no suicidal or homicidal ideation. The Veteran presented without gross impairment in cognition and with adequate judgment and insight. In June 2010, the Veteran presented to the VA for mental health treatment. He was able to identify himself with his full name and social security number. He felt that his symptoms were getting somewhat worse, but improved with medication. He denied any ideation for self-harm or harming others. There was no evidence of psychotic symptoms or deterioration of his psychiatric symptoms. The Veteran was not eating properly, but his weight was constant. The Veteran reported that his brother-in-law wanted to fight with him, and he gave himself credit for avoiding an altercation. In August 2010, the Veteran received a VA examination to determine the severity of his PTSD. The Veteran, at that time, was divorced and unemployed. He stated that he had intrusive and distressing thoughts of past events in Iraq and that they were more pronounced when he was alone. He stated that he could interact with people, although he avoided it. He specifically avoided people and large crowds, shopping for groceries and clothing late in the evening. The Veteran reported feeling afraid and unable to express his emotions. He stated that he was detached from people, having few friends and being socially isolated. He also reported drinking numerous caffeinated beverages throughout the day. The examiner assessed the Veteran as being alert and oriented. He was cooperative with good eye contact. The Veteran’s attitude was somewhat neutral. The Veteran’s mood was reported as flat. His affect with euthymic without dysphoria or anxiety. The Veteran had a logical, organized, goal-directed thought process. There was no evidence of hallucinations. The Veteran had intact memory, comprehension, attention, and concentration. His fund of knowledge, intelligence, abstract thinking, insight, and judgment were also unimpaired. In August 2010, the Veteran was seen by mental health at the VA. He stated he was sleeping well with medication, but without medication his sleep was more disturbed. He woke up feeling some depression, but his mood improved when he was with his sister and playing with her pets. He had no evidence of suicidal ideation. He rated his mood at a four out of ten, but his affect was euthymic. He smiled easily when talking about issues, his speech was coherent, and he demonstrated intact memory, intelligence, with fair insight and judgment. He demonstrated no compulsive behaviors, delusions, suicidal ideation, or homicidal ideation. In November 2010, the Veteran presented to mental health treatment at the VA. He denied medication side effect. He noted conflict with his ex-wife regarding their children. He reported socializing with family several times per week. He reported poor to fair sleep with fair energy. He demonstrated mild anxiety without panic. He denied obsessions, but endorsed occasional auditory hallucinations. He denied suicidal ideation or homicidal ideation. Throughout 2011 and 2012, the Veteran continued to receive mental health services through VA. The Veteran consistently demonstrated appropriate dress and good eye contact. He was alert and oriented in all spheres. The Veteran was cooperative and polite during treatment. He had a good mood, with appropriate affect. He denied suicidal ideation or homicidal ideation. See VA Treatment Records, dated April 2012, December 2011, November 2011. The Veteran reported spending time with his brother in Texas for Christmas in December 2011. In April 2012, he stated that he was working for his apartment manager by mowing the lawn. In July 2012, the Veteran received a VA examination to determine the severity of his PTSD. The Veteran reported that he had been married for four years, but he had been divorced for the last six. He also reported that he had no contact with any of his four children, but that he was paying child support for all of them. He denied a history of psychiatric treatment or suicide attempts. The Veteran reported recurrent dreams and intense psychiatric distress from exposure to internal or external cues. He also reported feelings of detachment or estrangement from others. The examiner found that the Veteran’s PTSD caused clinically significant distress or impairment in social, occupational, or other important areas of function. Specifically, the examiner opined that the Veteran’s PTSD resulted in 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 the Veteran’s symptoms were controlled by medications. The examiner opined that the Veteran was capable of managing his own financial affairs. In October 2012, the Veteran participated in mental health treatment with VA. He reported that he was compliant with his medication, denying side effects. He stated that he felt that his symptoms were stable and that he had been sleeping well with his medication. He reported that he was planning to visit his brother in Texas for Christmas. The Veteran further noted that he had a few friends and that they went out at times. He demonstrated a good mood and denied feelings of hopelessness or worthlessness. He presented with a good mood and good eye contact. He had a congruent and appropriate affect, and he was pleasant and cooperative. The Veteran denied suicidal, homicidal, or self-injurious thoughts. His insight and judgment were intact. In January 2014, the Veteran received a VA examination to determine the severity of his PTSD. The Veteran stated that he had no real friends; he reported that his only real relationships were with his mother, his half-brother, and his cat. He stated that he remained unemployed and his prospects for employment were limited. He further noted recurrent dreams, dissociative reactions, intense prolonged psychological distress, and avoidance behaviors. The examiner opined that the Veteran had occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, and mood. The examiner, however, found that the Veteran was competent to manage his own financial affairs. Throughout 2015 and 2016, the Veteran was seen for mental health services at VA. He presented as having good hygiene and adequate grooming. He demonstrated a good mood, with appropriate and congruent affect. He had good eye contact with his provider. He had no evidence of a thought disorder. He had no thoughts of suicide, homicide, or self-harm. The Veteran’s insight and judgment appeared intact, and there were no psychotic manifestations. See VA Treatment Records, dated September 2016, January 2016, July 2015, March 2015. The Veteran reported socializing with his family and other veterans, as he expressed less interest in civilian company, and former neighbors. See VA Treatment Records, dated September 2016, January 2016, July 2015. He noted continuing to assist his landlord with mowing and fixing things, as needed, even after he moved in with his brother. Id. The Board notes that the Veteran had a positive suicide screen in which he stated that he had thoughts of “why did I wake up” in this morning, but further notes that the Veteran denied thoughts of self-harm at the time of that assessment and later stated that this was a misunderstanding. See VA Treatment Records, dated January 2016, March 2015. In February 2017, the Veteran received a VA examination to determine the severity of his PTSD. He reported symptoms including recurrent memories and dissociative reactions. He reported intense psychological and physiological reactional to reminders of the events. He made efforts to avoid memories and reminders of the traumatic experiences. Moreover, he reported self-blame, negative feelings about himself and others, persistent anger, and reduced participation in activities. The Veteran stated that he lived alone and had no significant relationships in recent years. He stated that he visited his mother several times per day, as she was blind and needed assistance, but that he did not go out into the community unless his mother or sister accompanied him. The Veteran said that he spent most of his time at home with his cat. He stated that he frequently checked the rooms in his house due to fear that someone may come into his house and steal his possessions, although he admitted that this had never occurred. The Veteran denied formal occupational or educational activities since his last evaluation, noting that he last worked in 2009. The Veteran denied suicidal ideation, but endorsed chronic ideation. He further stated the had not had any counseling or inpatient hospitalizations for psychiatric purposes since the last evaluation. Objectively, the Veteran presented with proper grooming and hygiene. He was alert and oriented. His affect was initially highly anxious but was generally flat during the evaluation. He was cooperative throughout with an intact memory. He had no evidence of cognitive problems or psychiatric symptoms. His answers were brief, but he elaborated as necessary. The Veteran reported chronic passive suicidal ideation but he denied either a plan or intent. The examiner opined that the Veteran’s symptoms caused significant impairment to his function. Specifically, the examiner opined that the Veteran’s PTSD symptoms caused occupational and social impairment with deficiencies in most areas, such as work, school, family relationship, judgment, thinking, and/or mood. The Board has considered the entirety of the Veteran’s symptoms, as found in the evidence, and finds that, based upon the medical and lay evidence, the Veteran’s symptoms do not more nearly approximate a 100 percent disability rating for his service-connected PTSD. The Veteran’s VA examiners opined, in January 2014 and February 2017, that the Veteran’s PTSD symptoms rendered him with occupational and social impairment deficiencies in most areas, such as work, school, family relations, judgment, thinking or mood. Additionally, both examiners opined that the Veteran was able to manage his own financial affairs. This is inconsistent with the requirement of total occupational and social impairment required for a maximum 100 percent disability rating. The January 2014 and February 2017 VA examiners are licensed providers, competent to make these findings and afford these opinions, and there is no evidence that they are not credible. Moreover, the examiner’s assessment is consistent with the evidence of record, in which the Veteran reports limitations in his ability to interact with others and going into public, but during treatment sessions, presents as alert, oriented, cooperative, and pleasant. See VA Treatment Records, dated October 2012, November 2011. Cognitively, the Veteran demonstrated normal memory, judgment, and fund of knowledge, findings which are in excess of the requirements for total occupational and social impairment, such as disorientation to time or place or memory loss for his own name or occupation. 38 C.F.R. § 4.130, Diagnostic Code 9411 (2017); see VA Examination, dated February 2017, August 2010; VA Treatment Records, dated January 2016, March 2015, October 2012, August 2010, December 2009. To the extent that the January 2014 and February 2017 VA examiners’ assessments are inconsistent with the evidence, the evidence demonstrates greater function than that ascribed by the examiners. Evidence that, byn example, demonstrates that the Veteran socializes with other veterans, due to preference over a non-veteran populous, continuing contact with former neighbors, and performing mowing and repair tasks for his landlord, even when no longer a tenant. See VA Treatment Records, dated September 2016, April 2012. As such, the Board assigns the January 2014 and February 2017 VA examiners’ opinions significant probative weight. The Board has considered the statements of the Veteran’s mother, submitted in support of the Veteran’s claim for an increased disability rating for his service-connected PTSD. The Veteran’s mother noted rapid mood changes and decreased interest in physical activity. See Buddy Statement, dated April 2012. She further asserted that he was argumentative and did not appear to respect opposing viewpoints. See Statement in Support of Claim, dated September 2013. The Veteran’s mother is competent to attest to the Veteran’s behavior and her perceived impact of that behavior and observable symptomatology on the Veteran’s life and there is no evidence that the Veteran’s mother is not credible. However, the Veteran’s mother has not demonstrated the medical expertise to opine as to the effects specific to the Veteran’s PTSD. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board is sympathetic to the Veteran’s mother, and recognizes that PTSD can cause changes in behavior. However, the Board further notes that the Veteran’s mother’s statements do not contradict the evidence of record, nor the Board’s findings that the Veteran’s symptomatology do not meet the criteria for a 100 percent disability rating, insomuch as the Veteran is capable of formulating and advancing an opposing viewpoint, a skill inconsistent with a 100 percent disability rating. As such, the Board assigns this statement some probative weight, but less than that of the January 2014 and February 2017 VA examiners. The record is silent for any evidence that the Veteran’s PTSD presents in such a manner to render 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); or disorientation to time or place; or memory loss for names of close relatives, own occupation, or own name. While the Board acknowledges that the Veteran has symptomatology and limitations associated with PTSD, these have been fully considered by the Veteran’s current 70 percent disability rating. Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette, 28 Vet. App. at 369-370. Given the above, the preponderance of the evidence is against an increased rating in excess of 70 percent for the Veteran’s service-connected PTSD. As such, the benefit-of-the-doubt doctrine is inapplicable. See 38 U.S.C. § 5107 (2012); 38 C.F.R. §§ 4.3, Diagnostic Code 9411, 4.7 (2017). For these reasons, the claim is denied. Effective Date Under VA laws and regulations, a specific claim in the form prescribed by VA must be filed for benefits to be paid or furnished to any individual under laws administered by the VA. 38 U.S.C. § 5101(a) (2012); 38 C.F.R. § 3.151(a) (2018). Generally, the effective date of an award of disability compensation based on an original claim shall be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110(a) (2012); 38 C.F.R. § 3.400 (2018). However, if the claim is received within one year after separation from service, the effective date of an award of disability compensation shall be the day following separation from active service. 38 U.S.C. § 5100(b)(1) (2012); 38 C.F.R. § 3.400(b)(2)(i) (2018). 3. Entitlement to an effective date prior to January 10, 2007, for a disability rating in excess of 30 percent for irritable bowel syndrome A Board decision becomes final and binding if the Veteran does not timely perfect an appeal of the decision. 38 U.S.C. §§ 7104, 7105 (2012); 38 C.F.R. §§ 3.104(a), 3.160(d), 20.200, 20.302, 20.1103 (2018). Previous determinations that are final and binding, including decisions of service connection, will be accepted as correct in the absence of collateral attack by showing the decision involved clear and unmistakable error). 38 C.F.R. § 3.105(a) (2018). The Court held that appellants are prohibited from collaterally attacking a prior final rating or Board decision by filing a freestanding earlier effective date claim. The Court explained that, once a rating decision which establishes an effective date becomes final, the only way that such a decision can be revised is if it contains clear and unmistakable error. The Court noted that any other result would vitiate the rule of finality. Rudd v. Nicholson, 20 Vet. App. 296 (2006). In other words, there are no freestanding claims for an earlier effective date. The Veteran must timely appeal the VA rating decision or Board decision that assigned the effective date in question. If an untimely freestanding claim for an earlier effective is raised, the Court has held that such an appeal should be dismissed. Id. at 299-300. Thus, the Board is required to dismiss freestanding claims for entitlement to earlier effective dates. Id.; see also DiCarlo v. Nicholson, 20 Vet. App. 52 (2006) (stating there is no such procedure as a freestanding challenge to the finality of a VA decision). A February 2007 rating decision granted service connection for the Veteran’s irritable bowel syndrome with a 10 percent disability rating effective January 10, 2007. The Veteran timely perfected an appeal to the Board. In August 2013, the Board granted the Veteran an initial disability rating of 30 percent, but denied an effective date prior to January 10, 2007. Pursuant to a November 2013 joint motion for remand, so ordered by the Court, the Veteran’s appeal of the August 2013 Board decision, with respect to the Veteran’s irritable bowel syndrome disability rating and effective date, were dismissed and the August 2013 Board decision regarding the effective date for service connection of the Veteran’s irritable bowel syndrome, and rating thereof, became final. 38 U.S.C. § 7104, 7105 (2012); 38 C.F.R. §§ 3.104, 20.302, 20.1103 (2018). The RO issued a rating decision in September 2015, continuing the Veteran’s 30 percent disability rating for his service-connected irritable bowel syndrome. The Veteran filed a notice of disagreement, seeking an earlier effective date for service connection for his irritable bowel syndrome. The RO notified the Veteran that his appeal of the effective date was not timely, but the Veteran’s representative asserted, in August 2016 communication, that the appeal of the effective date was in response to the September 2015 rating decision and, as such, was timely. Because the effective date for the assignment of the 30 percent rating decision became final, the Veteran’s only recourse is to have the final decision revised on the grounds of clear and unmistakable error. See 38 C.F.R. § 3.105 (2018); Rudd, supra. In this case, however, the Veteran has not claimed clear and unmistakable evidence in the August 2013 Board decision. In summary, the August 2013 Board decision, which assigned the effective date for a 30 percent rating for the Veteran’s service-connected irritable bowel syndrome, is final. The Veteran’s challenge to the effective date is a freestanding claim and must be dismissed. See Rudd; see also Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (holding that when the law is dispositive of the claim, it must be denied due to lack of legal entitlement). The Board is bound by the laws and regulations that apply to veterans' claims. 38 U.S.C. § 7104(c) (2012); 38 C.F.R. §§ 19.5, 20.101(a) (2018). For the reasons stated above, those laws and regulations preclude the Board from addressing the Veteran's earlier effective date claim on the merits. 4. Entitlement to an effective date prior to June 3, 2010, for a disability rating of 70 percent for posttraumatic stress disorder (PTSD) The Veteran claims entitlement to service connection for PTSD prior to June 3, 2010. See Notice of Disagreement, dated July 2016. The Veteran was originally assigned service connection for anxiety and depression with a 30 percent disability rating, in a January 2006 rating decision. The Veteran did not appeal this decision and no new and material evidence was received within one year. The Veteran filed a claim for an increased disability rating of his PTSD on June 3, 2010. In September 2010, the RO continued the 30 percent disability rating, denying an increase, and recharacterized the Veteran’s psychiatric disability as PTSD. The Veteran filed a timely notice of disagreement and a February 2011 statement of the case affirmed the September 2010 RO decision. The Veteran timely appealed to the Board. The Board remanded the case for further development in May 2012. Upon return to the Board, in August 2013, the Board upheld the September 2010 RO decision, denying an increased disability rating for the Veteran’s service-connected PTSD. The Veteran timely appealed to the Court, which ordered the Board decision be vacated and remanded in December 2013. The Board remanded the case, again, in October 2014, to obtain a hearing as requested by the Veteran. The Veteran subsequently withdrew his request for a hearing in August 2016. A September 2015 rating decision awarded a 70 percent disability rating effective June 3, 2010, the date that the Veteran filed for an increased disability rating. Having determined that the Veteran’s claim was filed on June 3, 2010, the Board must now determine when entitlement arose. Upon review, the evidence does not indicate, that a claim was filed, either formal or informal, prior to June 3, 2010. Moreover, the evidence of record does not indicate that a higher rating was warranted within one year prior to the June 3, 2010, filing date. Notably, the Veteran reported bad dreams, but only mild depression, which he related as surrounding a specific life event outside of service activities. He was alert and fully oriented, had no abnormal movement, and demonstrated good eye contact. He was cooperative. He appeared without dysphoria, anxiety, irritability, or euphoria, and there was no evidence of psychosis. There was no evidence of suicidal or homicidal ideation. His cognition was intact, and his judgment and insight were adequate. See VA Treatment Records, dated December 2009. The effective date of an award is based upon the date of the receipt of the claim or the date entitlement arose, whichever is later. Hence, on this record, an earlier effective date is not assignable by law. B. MULLINS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. E. Trotter, Associate Counsel