Citation Nr: 18157551 Decision Date: 12/13/18 Archive Date: 12/12/18 DOCKET NO. 16-60 995 DATE: December 13, 2018 ORDER Entitlement to a total disability rating due to individual unemployability (TDIU) is granted. FINDING OF FACT The Veteran’s service-connected posttraumatic stress disorder (PTSD), coronary artery disease, and left knee disability render him unable to secure and follow a substantially gainful occupation. CONCLUSION OF LAW The criteria for TDIU have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.16. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from August 1966 to August 1968. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Indianapolis, Indiana. The Veteran contends that he is unemployable as a result of his service-connected PTSD, rated 50 percent disabling; coronary artery disease, rated 60 percent disabling; and left knee injury status post knee replacement, rated 30 percent disabling. Total disability is considered to exist when there is any impairment that is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340(a)(1). Consideration may be given to the Veteran’s level of education, special training, and previous work experience in arriving at a conclusion, but not to his age or to the impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. In reaching such a determination, the central inquiry is “whether the veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). The fact that a Veteran is unemployed or has difficulty obtaining employment is not enough to warrant a TDIU. See Van Hoose v. Brown, 4 Vet. App 361 (1993). A TDIU rating may be assigned where the schedular rating is less than total, when it is found that the disabled person 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 service-connected disabilities, provided at least one 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 C.F.R. §§ 3.340, 3.341, 4.16(a). The Board finds that the Veteran meets the schedular criteria for a TDIU rating. See 38 C.F.R. § 4.16(a). In his Application for Increased Compensation Based on Unemployability, the Veteran stated that he has a high school education and that he did not receive any additional education or training. He also indicated that he has been self-employed as an appliance repairman since 1972 and that his last date of full-time employment was December 2009. In a July 2010 statement, the Veteran’s spouse reported that the Veteran was unable to get down on his knees, which he is required to do when he is repairing various appliances. She also stated that due to his PTSD, the Veteran cannot repair newer computerized appliances because he is unable to comprehend schooling or “tech sheets” to run test modes. Lastly, the Veteran’s wife reported that he is unable to drive due to severe headaches and dizziness. In July 2010, the Veteran’s friend, K.D., reported that herself and her husband has had to help the Veteran on various service calls. She noted that the Veteran has had a hard time working since his knee surgery and that he is unable to pull, lift, or tug on anything heavy. She stated that the Veteran has a short attention span and little patience as well as difficulty remembering things. The Veteran underwent a VA examination in December 2010. The Veteran reported that he was working part-time due to his physical disabilities and pain. The examiner concluded that the Veteran’s PTSD symptoms did not preclude him from working at that time. The examiner reasoned that the Veteran’s orthopedic issues were the primary factor for his inability to maintain employment and that he denied being unable to work due to his PTSD symptoms. During a April 2011 VA examination, the Veteran reported that he could not lift heavy appliances without experiencing shortness of breath and/or chest pain. The VA examiner noted that the Veteran had difficulty standing, sitting or walking for any length of time and that he has used a cane since December 2008. Additionally, the examiner indicated that the Veteran had difficulty squatting, climbing or lifting heavy objects. The examiner opined that the Veteran’s ischemic heart disease and left knee residuals had moderate to severe impact on his ability to secure and maintain substantially gainful physical employment. The examiner noted that the Veteran was self-employed as an appliance repairman post-service and that he had not worked for about two years prior due to his service-connected disabilities. The examiner concluded that while the Veteran’s disabilities did not prevent him from doing sedentary work he did not have the required job skills or education needed for such type of employment. In November 2016, the Veteran’s private provider opined that due to the left knee total joint replacement, the Veteran was unable to get down to complete work tasks. She reasoned that the Veteran’s knee pain affects his mobility and flexibility as well as limits his ability to bend over and get back to the up-right position. In January 2017, the Veteran’s private cardiologist opined that the Veteran’s heart disability condition impacts his ability to maintain gainful employment because he gets tightness in his chest and shortness of breath with exertion. The doctor also noted that some ST depression was seen on the Veteran’s electrocardiogram (EKG). In January 2018, the Veteran underwent a VA PSTD examination. The Veteran reported that he was working part-time as an appliance serviceman and that he might go on a service run once a week. He stated that his coronary artery disease and left knee disability keep him from working and that he does not drive anymore because his medications make him dizzy. The examiner noted occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. The examiner reported depressed mood, anxiety, chronic sleep impairment, and disturbances of motivation and mood. The examiner opined that while the Veteran’s PTSD hinders him from being motivated to work it is the Veteran’s physical disabilities that hinder his ability to work. In a January 2018 VA Knee and Lower Leg examination, the examiner concluded that the Veteran’s left knee disability impacts his ability to perform occupational tasks. The examiner reasoned that the Veteran’s condition requires him to walk with a cane and that he has chronic pain, which is worse with flexion. In a January 2018 VA Heart Conditions examination, the examiner opined that the Veteran could not perform physical work due to shortness of breath, quick onset fatigue, knee pain, and reduced range of motion. The examiner noted that the Veteran should have no problem with sedentary work due to his good upper body and extremity control, strength, and motor function. The service-connected disabilities meet the schedular criteria for TDIU consideration under 38 C.F.R. § 4.16 (a). Regarding the remaining question, considering the severity of the Veteran’s service-connected disabilities, as well as his employment and education history, and in affording him the benefit-of-the-doubt, the Board finds that he is unemployable due to his service-connected PTSD, coronary artery disease, and left knee disability. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, a grant of TDIU is warranted. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Robinson, Associate Counsel