Citation Nr: 18156210 Decision Date: 12/07/18 Archive Date: 12/07/18 DOCKET NO. 12-11 314 DATE: December 7, 2018 ORDER Entitlement to an effective date earlier than August 13, 2015, for the grant of a 70 percent rating for posttraumatic stress disorder (PTSD) is denied. Entitlement to an effective date earlier than August 13, 2015, for the grant of a total disability rating based on individual unemployability (TDIU) is denied. FINDINGS OF FACT 1. Prior to August 13, 2015, it was not factually ascertainable that the Veteran’s service-connected PTSD warranted a rating in excess of the assigned ratings; entitlement to a 70 percent rating arose on that date; the RO assigned an effective date of August 13, 2015. 2. Prior to August 13, 2015, the evidence does not show that the Veteran’s service-connected disability precluded him from obtaining and retaining substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 10 percent (effective July 8, 2010) and 30 percent (effective April 10, 2013) prior to August 13, 2015, have not been met. 38 U.S.C. §§ 1155, 5107(b) (2012); 38 C.F.R. §§ 3.400, 4.1, 4.3, 4.7, 4.126, 4.130 Diagnostic Code (DC) 9411 (2017). 2. The criteria for an effective date prior to August 13, 2015, for an award of TDIU are not met. 38 U.S.C. §§ 1155, 5100(a), (b)(2) (2012); 38 C.F.R. §§ 3.340, 3.341, 3.4009(b)(2), 3.400(o)(1), 4.16(a), 4.29 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the United States Navy from August 1971 to February 1973, including service in the Republic of Vietnam. This matter returns to the Board of Veterans’ Appeals (Board) on appeal from a September 2010 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. The Veteran filed a request to reopen a previous claim for entitlement to service connection for PTSD in July 2010. In a September 2010 rating decision, the RO granted the Veteran’s claim for entitlement with a 10 percent disability rating, effective July 8, 2010. In October 2010, the Veteran filed a timely notice of disagreement; thereafter, the RO issued a March 2012 statement of the case. In May 2012, the Veteran filed, through counsel, a timely VA Form 9. The RO issued a June 2013 supplemental statement of the case and subsequently certified the Veteran’s appeal to the Board through a July 2013 VA Form 8. In September 2013, the Veteran testified at a video conference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. In the February 2015 Board decision, the PTSD claim was remanded to the RO to obtain a new psychological evaluation and to obtain an opinion regarding the claim for TDIU raised during the Veteran’s September 2013 Board hearing. Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009) (explaining that a request for TDIU, whether raised expressly by the veteran or reasonably by the record, is part of a rating issue). Prior to the RO’s issuance of the August 2018 supplemental statement of the case, the Veteran was hospitalized from January 2017 to March 2017 for treatment related to his service-connected PTSD disability. In April 2017, the Veteran filed a claim for a temporary evaluation of 100 percent due to his hospitalization. The RO issued a May 2017 rating decision granting a temporary evaluation of 100 percent effective January 31, 2017, and an evaluation of 30 percent effective April 1, 2017. The Veteran filed a timely June 2017 notice of disagreement. The RO issued an August 2018 rating decision and supplemental statement of the case that increased the Veteran’s disability rating to 70 percent effective from August 13, 2015, and granted an award of a total disability rating based on individual unemployability effective from August 13, 2015. In September 2018, the Veteran, through counsel, submitted further argument only seeking earlier effective dates for the 70 percent evaluation for PTSD and the award of TDIU. Thereafter, the RO certified the Veteran’s appeal to the Board in an October 2018 VA Form 8. 1. Earlier Effective Date for PTSD The Veteran seeks entitlement to an earlier effective date for the grant of a 70 percent rating for his service-connected PTSD disability. Specifically, the Veteran contends that evidence of record demonstrates his service-connected PTSD disability has met the criteria for a 70 percent rating from July 8, 2010. Generally, the effective date of an evaluation and award of pension, compensation, or dependency and indemnity compensation based on an original claim, a claim for increase, or a claim reopened after final disallowance, will be the date of receipt of the claim or the date entitlement arose, whichever is the later. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400. Unless otherwise provided, the effective date of compensation will be fixed in accordance with the facts found, but will not be earlier than the date of receipt of the claimant’s application. 38 U.S.C. § 5110(a). Disability evaluations are determined by the application of the Schedule for Rating Disabilities, which assigns ratings based on the average impairment of earning capacity resulting from a service-connected disability. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Where there is a question as to which of two evaluations shall be applied, the higher evaluation 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. In general, when an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). However, when the current appeal arises from the initially assigned rating, consideration must be given as to whether staged ratings should be assigned to reflect entitlement to a higher rating at any point during the pendency of the claim. Fenderson v. West, 12 Vet. App. 119 (1999). Moreover, staged ratings are appropriate in any increased rating claim in which distinct time periods with different ratable symptoms can be identified. Hart v. Mansfield, 21 Vet. App. 505 (2007). A 30 percent evaluation is warranted when there is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupation tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: a depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, and mild memory loss (such as forgetting names, directions, recent events). 38 C.F.R. § 4.130, Diagnostic Code 9411. A 50 percent evaluation is warranted when there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long-term memory (retention of only highly learned material, forgetting to complete tasks); impaired judgment, impaired abstract thinking; disturbances of motivation and mood; and difficulty establishing and maintaining effective work and social relationships. Id. 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; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); and inability to establish and maintain effective relationships. Id. Consideration is given to the frequency, severity, and duration of psychiatric symptoms, the length of remission, and the Veteran’s capacity for adjustment during periods of remission. An evaluation shall be assigned based on all the evidence of record that bears on occupational and social impairment, rather than solely on the examiner’s assessment of the level of disability at the moment of the examination. See 38 C.F.R. § 4.126 (2017). Furthermore, when evaluating the level of disability arising from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment. Id. The symptoms associated with the psychiatric rating criteria are not intended to constitute exhaustive lists, but rather 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, 443 (2002). Thus, the Board will consider whether “the evidence demonstrates that a claimant suffers symptoms or effects that cause occupational or social impairment equivalent to what would be caused by the symptoms listed in the diagnostic code,” and, if so, the “equivalent rating will be assigned.” Id. The Federal Circuit held previously that 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 v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013) (“Reading [38 C.F.R. §§ 4.126 and 4.130] together, it is evident that the ‘frequency, severity, and duration’ of a veteran’s symptoms must play an important role in determining his disability level.”). As an initial matter, the record shows that on June 12, 2007, the Veteran’s initial claim for service connection for PTSD was received by VA. An October 2007 rating decision denied service connection for PTSD. The Veteran did not appeal the October 2007 rating decision or submit new and material evidence within one year of that decision; therefore, the October 2007 is final and not subject to revision in the absence of clear and unmistakable error in the decision. 38 U.S.C. § 5109A, 7105; see Rudd v. Nicholson, 20 Vet. App. 296 (2006). As CUE in the October 2007 rating decision has not been alleged, that rating decision serves as a legal bar to an effective date prior to the date of the decision. The earliest document in the claims file received after the October 2007 rating decision that could be construed as a formal or informal claim for entitlement to service connection for PTSD is a February 2010 statement in support of claim submitted by the Veteran seeking to reopen his claim. Turning to the evidence of record, a July 2010 mental health intake consultation, noted that the Veteran had difficulty falling and staying asleep, irritability, anger outbursts, frequent nightmares related to in-service stressors, recurrent and intrusive distressing recollections of stressful in-service events, flashbacks, and feelings of isolation from other people. In September 2010, the Veteran underwent his first VA examination for PTSD. The examiner diagnosed him with chronic, weekly symptoms of mild PTSD, specifically noting the Veteran does not exhibit inappropriate behavior, have obsessive/ritualistic behavior, or have an impaired thought processes. Further, the Veteran presented to the VA examination appropriately dressed and neatly groomed, his speech was spontaneous, clear, and coherent, and he was oriented to person, time, and place. However, the examiner noted that he experienced panic attacks two to three times per week along with sleep disturbances. Moreover, the examiner noted passive thoughts of suicidal ideation, and the presence of homicidal thoughts without a plan or intent, and that he had fair impulse control and noted the reported episodes of violence consisted of non-physical domestic violence. With respect to the Veteran’s social functioning, the Veteran reported that he was in “kind of a dark place in [his] life,” and that he does not socialize or sleep much, and is easy to anger. A rating higher than 30 percent is not warranted, however, as the evidence does not indicate that the Veteran experiences moderate social impairment. Although the Veteran has some interpersonal difficulties due to his PTSD, he continued to live with his wife of approximately 15 years and maintained contact with friends in California after moving to Alabama. Crucially, applicable case law dictates that it is not the symptom itself, but the magnitude of the symptom and how it impacts the Veteran’s social and occupational functioning. Regarding the Veteran’s occupational functioning, the VA examiner noted that there was no occasional decrease in work efficiency or intermittent periods of inabilities to perform occupational tasks due to the Veteran’s PTSD signs and symptoms. Rather, the examiner noted that the Veteran’s PTSD signs and symptoms were transient and mild, and only decreased his work efficiency and ability to perform occupational tasks during periods of significant stress. The examiner’s overall assessment is consistent with the assigned 10 percent rating for this period. VA treatment records also show symptoms consistent with the 10 percent rating assigned this period. For example, in January 2011, VA treatment records from a group PTSD therapy session noted ongoing symptoms of anxiety and depression, and that he was not experiencing suicidal or homicidal ideation. In February 2011, VA treatment records note that the Veteran presented appropriately groomed, alert, cooperative, and made good eye contact. His speech was normal and his thoughts were coherent, logical, and goal-oriented. He denied suicidal or homicidal ideations and did not report any audio or visual hallucinations. In the examiner’s judgment, the Veteran was not a danger to himself or others. In April 2011, a VA mental health record reflects the Veteran presented well-groomed, casually-dressed, calm, cooperative, and with a bright and good range of affect that was appropriate to content. His speech was normal and he did not report any hallucinations. He denied having any suicidal or homicidal ideations. In August 2011, VA treatment records note the Veteran presented calm, euthymic affect, and made good eye contact. His speech was essentially fluent, and appeared alert and oriented, with intact judgment. He denied suicidal or homicidal ideations. The psychiatrist opined that the Veteran was primarily upset at the moment of his loss of mobility and appeared clinically stable, but noted the Veteran had some ruminative thoughts. In October and December 2011 PTSD Wellness Skills Group records, the Veteran presented appropriately groomed, casually dressed, cooperative, alert, and oriented, but also appeared depressed with a mood-congruent affect. He denied suicidal or homicidal ideations, as well as any audio or visual hallucinations or delusions. In a March 2012 PTSD Wellness Skills Group record, the Veteran presented appropriately groomed, cooperative, depressed with a congruent mood, alert, and coherent. His speech was normal and spontaneous, and his thoughts were coherent, logical, and goal-oriented. The Veteran denied having suicidal or homicidal ideations, or any hallucinations or delusions. In May 2012, VA treatment records note the Veteran’s report that his nightmares and night sweats “have come back with a vengeance,” but also note he presented well-groomed and casually dressed, fully oriented, calm and cooperative with normal/settled behavior, and a bright/good range of affect but was “a bit tired looking today – more than last time.” A July 2012 VA mental health record noted the Veteran reported his symptoms have “waxed and waned over the past few months related to having surgery and pain,” and that his nightmares and night sweats were less frequent and had gone away for about one full week without interruption. He presented fully oriented, well-groomed, calm and cooperative, with a bright/good range of affect. His speech was normal and his thoughts were logical and goal directed. He did not report hallucinations, delusions, or suicidal/homicidal ideations. In an October 2012 mental health record, it was noted the Veteran reported feeling dysphoric and purposeless, and that his depression was “creeping back in.” Further, it noted an improvement in the Veteran’s mood. In January 2013, VA treatment records indicate the Veteran presented well-groomed, fully oriented, calm, cooperative, and with a bright/good range of affect. He denied suicidal and homicidal ideation, hallucinations, or delusions. The psychiatrist noted that his “PTSD symptoms [are] under fair control and [his] mood is rebounding after [the] loss of his brother.” In April 2013, the Veteran was afforded a second VA PTSD examination. His PTSD was best summarized as causing occupational and social impairment with an occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal route behavior, self-care, and conversation. The Veteran’s symptoms included: anxiety, chronic sleep impairment, and mild memory loss (such as forgetting names, directions, or recent events). He was deemed capable of managing his financial affairs. The VA examiner opined that the “current medical evidence indicates only mild social and occupational impairment due to PTSD” and noted the Veteran commented during the examination that “I still have the symptoms, but [they are] not as intense.” With respect to the Veteran’s social functioning, the VA examiner noted no relevant changes in the Veteran’s social, family, or marital history and that the Veteran remained married to a supportive spouse. After a thorough review of the evidence of record, the Board finds that for the period beginning April 10, 2013 and prior to August 13, 2015, the frequency, severity, and duration of the Veteran’s PTSD symptoms were more closely approximate to symptoms contemplated by a 30 percent rating. As such, an increased rating is not warranted in the current appeal. In so finding, the Board considered occupational and social impairments resulting from his PTSD, and found that he experienced only occasional decreases in work efficiency and intermittent periods of inability to perform occupational tasks, and did not experience difficulty in establishing and maintaining effective work and social relationships. Prior to August 13, 2015, VA treatment records indicate that the Veteran regularly presented appropriately groomed, alert and oriented to person, time, and place for his general medical and mental health treatment sessions. The Veteran’s speech was consistently clear, his thoughts were logical and coherent, and his judgment was appropriate. The Veteran denied any audio/visual hallucinations or delusions. The evidence of record also indicates that the Veteran did not endorse obsessive rituals that interfered with his routine activities, as contemplated by a higher rating. Additionally, his depression did not reportedly affect his ability to function independently, appropriately, or effectively. The Board acknowledges that the Veteran did report some symptoms during the 2010 examination, such as suicidal and homicidal ideation, which can be associated with ratings in excess of 30 percent. However, applicable case law dictates that it is not the symptom itself, but the magnitude of the symptom and how it impacts the Veteran’s social and occupational functioning. See Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). The Veteran consistently denied suicidal or homicidal ideation outside of the September 2010 VA examination. Further, he was not deemed a threat or danger to himself or others. Despite the September 2010 VA PTSD examination report, which indicated that the Veteran reported panic attacks that occur two to three-times per week, subsequent VA treatment records throughout the appeal period do not reflect any reports of such symptoms by the Veteran. Moreover, while the September 2010 examination report notes that the Veteran’s PTSD caused 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, his overall occupational and social impairment did not cause deficiencies in most areas warranting a 70 percent rating. In fact, the VA examiner stated that the medical evidence indicated the Veteran suffered only from mild social and occupational impairment due to his PTSD. While the Veteran exhibited mild symptoms related to his PTSD, treatment records have not shown that the Veteran had a flattened affect, frequent panic attacks, impaired judgment or thinking, or difficulty establishing or maintaining effective work and social relationships. Further, VA treatment records show he has consistently presented with normal speech, alert, fully oriented, cooperative, and calm. Therefore, the Veteran’s treatment records first show that it was factually ascertainable that an increase in his PTSD disability occurred in August 2015. The frequency, duration, and severity of the Veteran’s PTSD symptoms prior to August 13, 2015, do not more nearly approximate moderate occupational and social impairment that would warrant a higher evaluation of 70 percent. As the date of entitlement (here, August 2015) is the later date, that should be the effective date assigned for the grant of an increased rating for his PTSD disability. See 38 C.F.R. § 3.400(o). Accordingly, the preponderance of the evidence is against the Veteran’s claim for an effective date prior to August 13, 2015, for the 70 percent rating for his service-connected PTSD disability, and the claim must be denied. 2. Earlier Effective Date for TDIU The Veteran has also claimed entitlement to an effective date prior to August 13, 2015, for the award of TDIU. Generally, the effective date of an increase “shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor.” 38 U.S.C. § 5110(a); see also 38 C.F.R. § 3.400(o)(1) (providing that the effective date will be the date of receipt of claim, or the date entitlement arose, whichever is later); Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010). Also, an earlier effective date may be assigned if there was an increase in disability during the one-year period prior to filing of a claim. Gaston, 605 F.3d at 984; 38 U.S.C. § 5110(b)(2); see also 38 C.F.R. § 3.400(o)(2). The applicable law is clear that the effective date of an increased rating shall be the “[e]arliest date as of which it is factually ascertainable that an increase in disability had occurred if claim is received within 1 year from such date[;] otherwise, [the effective date shall be the] date of receipt of claim.” See 38 C.F.R. § 3.400(o)(2). Moreover, a claim for an increased rating encompasses a claim for TDIU. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). Thus, where evidence of TDIU entitlement arose more than a year before the date of receipt of a formal or informal claim for unemployability benefits, the effective date of such benefits may not precede the date of the formal or informal claim. See 38 U.S.C. § 5110(b)(2); see also Gaston, 605 F.3d at 984 (explaining the legislative intent to provide veterans with a one-year grace period for filing their claims). “A claim to TDIU benefits is not a free-standing claim that must be pled with specificity; it is implicitly raised whenever a pro se veteran, who presents cogent evidence of unemployability, seeks to obtain a higher disability rating.” Rice v. Shinseki, 22 Vet. App. 447, 453 (2009) (quoting Comer v. Peake, 552 F.3d 1362, 1367 (Fed.Cir. 2009)). Where a veteran submits evidence of a medical disability, makes a claim for the highest rating possible, and provides cogent evidence of unemployability, the criteria for filing an informal TDIU claim under 38 C.F.R. § 3.155(a) are satisfied and VA must consider whether such veteran is entitled to such a total rating. Id. A request for TDIU, whether expressly raised by a veteran or reasonably raised by the record, is not a separate claim for benefits, but rather either as part of the initial adjudication of a service connection claim or as part of a claim for increased compensation. “The distinction between the two is important for purposes of assigning an effective date for an award of compensation. Different statutory and regulatory provisions apply depending on whether the claim is an original claim or one for increased compensation. For example, generally for an original claim, the effective date can be no earlier than the date of claim. 38 U.S.C. § 5110(a) (“[T]he effective date of an award based on an original claim... shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor.”); see 38 C.F.R. § 3.400(b)(2)(i). An effective date for an increased rating claim may date back as much as one year before the date of the claim for increase if it is factually “ascertainable that an increase in disability had occurred” within that timeframe. 38 U.S.C. § 5110(b)(2); see 38 C.F.R. § 3.400(o)(2); Harper v. Brown, 10 Vet. App. 125, 126 (1997) (stating that section 3.400(o)(2) applies to claim where increase in disability precedes claim, providing that that claim is received within one year after increase, otherwise general rule in section 3.400(o)(1) applies).” Rice, 22 Vet. App. at 453-54; Roberson v. Principi, 251 F.3d 1378, 1384 (Fed. Cir. 2001); Bernklau v. Principi, 291 F.3d 795, 799 (Fed.Cir. 2002); Norris v. West, 12 Vet. App. 413, 420-21 (1999). A TDIU may be assigned where, without regard to advancing age, the schedular rating is less than total, and the 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 more, or as a result of two or more disabilities, provided at least one disability is ratable at 40 percent or more, 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). The impact of nonservice-connected disabilities and the effect of advancing age may not be considered. 38 C.F.R. §§ 3.341(a), 4.16(a). As determined above, the Veteran is service-connected for PTSD with a 70 percent evaluation effective from August 13, 2015; with a 30 percent evaluation effective from April 10, 2013; and with a 10 percent evaluation effective from July 8, 2010. Thus, the Board finds that the Veteran does not meet the threshold minimum schedular percentage standards under 38 C.F.R. § 4.16(a) for a TDIU prior to August 13, 2015. Before August 13, 2015, the Veteran’s service-connected disability, which consisted solely of his PTSD disability was rated at 30 percent effective from April 10, 2013, and at 10 percent effective from July 8, 2010, and did not meet the minimum schedular rating requirement for a TDIU rating under 38 C.F.R. § 4.16(a). When a veteran is unemployable by reason of service-connected disabilities, but fails to meet the percentage standards set forth in 38 C.F.R. § 4.16(a), consideration is given for an extraschedular TDIU. In such a case, the Veteran’s claim is submitted to VA’s Director of Compensation Service for extraschedular consideration as the Board may not award TDIU on an extraschedular basis in the first instance. 38 C.F.R. § 4.16(b). Therefore, the Board’s analysis is limited to either granting or denying the (implied) request for referral for extraschedular consideration for the period prior to August 13, 2015. After consideration of the relevant evidence, the Board finds that the evidence does not demonstrate that the Veteran was unable to secure and follow a substantially gainful occupation prior to August 13, 2015, due to his service-connected disabilities. Accordingly, this case does not warrant referral to the Director of Compensation Service for extraschedular consideration under 38 C.F.R. § 4.16(b). The evidence shows that, as discussed in the section above, during the period prior to August 13, 2015, the Veteran received ongoing VA treatment for PTSD. Most of his mental health treatment consisted of group therapy. He took medication, and the reports of the group therapy sessions indicate that he was alert and fully oriented, had an occasional depressed mood with congruent affect, and had no suicidal/homicidal ideations or hallucinations. Such assessments, do not, in the Board’s judgment, support a finding that the Veteran’s PTSD symptoms prevented him from obtaining or maintaining substantially gainful employment for the period prior to August 13, 2015. The Board notes the Veteran’s statement averring that he last worked in 2004 and that he was unemployable due to PTSD. As noted above, the sole fact that a Veteran is unemployed or has difficulty obtaining employment is not enough. The question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. In determining employability, the Veteran’s level of education, special training, and previous work experience is for consideration. The Board is not persuaded that, given the Veteran’s level of education, training, and previous work experience, his PTSD disability alone rendered him unemployable prior to August 13, 2015. The Veteran’s statement that he was not able to work due to his PTSD, coupled with records that he could no longer work due to non-service connected disabilities is not persuasive evidence that his PTSD disability actually rendered him unable to secure and follow a substantially gainful occupation prior to August 13, 2015. Based on the consideration of all the evidence of record before and after August 13, 2015, the Board is not persuaded that the Veteran was unable to secure and follow a substantially gainful occupation due to his service-connected disability prior to August 13, 2015. Therefore, the Board finds that the particular circumstances of this case do not justify referral to the VA Director of Compensation Service for extraschedular consideration of a TDIU under 38 C.F.R. § 4.16(b). TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Ohlstein, Law Clerk