Citation Nr: 18159416 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 16-56 846 DATE: December 20, 2018 ORDER Entitlement to a total disability rating based on individual unemployability (TDIU) is granted. FINDING OF FACT The Veteran’s service-connected disabilities, including posttraumatic stress syndrome, bilateral hearing loss, and coronary artery disease (CAD), preclude him from obtaining and maintaining substantially gainful employment. CONCLUSION OF LAW The criteria for entitlement to a total disability rating based on individual unemployability (TDIU) have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.16. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served from March 1967 to March 1970. The Veteran asserts that he is unable to work due to his service connected PTSD, heart condition, and hearing loss. Total disability is considered to exist when there is any impairment which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340(a)(1). A total disability rating for compensation purposes may be assigned on the basis of individual unemployability when the disabled person is, in the judgment of the rating agency, unable to secure or follow “substantially gainful employment” as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). In such an instance, if there is only one such disability, it must be rated at 60 percent or more; if there are two or more disabilities, at least one disability must be rated at 40 percent or more, and sufficient additional disability must bring the combined rating to 70 percent or more. Id. If a veteran fails to meet the threshold minimum percentage standards enunciated in 38 C.F.R. § 4.16(a), rating boards should refer to C&P for extra-schedular consideration all cases where the Veteran is unable to secure or follow a substantially gainful occupation by reason of service-connected disability. 38 C.F.R. § 4.16(b); see also Fanning v. Brown, 4 Vet. App. 225 (1993). In all cases, the Board must evaluate whether there are circumstances, apart from any non-service-connected conditions and advancing age, which would justify a TDIU. 38 C.F.R. §§ 3.341(a), 4.19. See Van Hoose v. Brown, 4 Vet. App. 361 (1993); see also Hodges v. Brown, 5 Vet. App. 375 (1993); Blackburn v. Brown, 4 Vet. App. 395 (1993). The Veteran’s service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue must be addressed. 38 C.F.R. § 4.16(b). Initially, the Board reflects that the Veteran is service connected for PTSD, which is 70 percent disabling since from December 9, 2015; bilateral hearing loss, which is 10 percent disabling since December 9, 2015; tinnitus, which is 10 percent disabling since December 9, 2015; and, CAD, which is 10 percent since April 27, 2018. His combined total rating is 80 percent disabling throughout the appeal period, and he therefore meets the schedular criteria for TDIU in this case. See 38 C.F.R. § 4.16(a). After a review of the record, the Board determines that TDIU is warranted for the period on appeal. In April 2016, the Veteran submitted an application for increased compensation based on unemployability. The Veteran stated that his hearing loss makes it difficult to work with people because it makes him slow to respond and express himself. Additionally, he stated that he gets disoriented and sometimes does not remember things, has body weakness, has leg and back pain, and gets dizzy and uncomfortable in crowded places. The Veteran’s application for TDIU indicates that he was last employed in March 2012 as a welder. During his September 2018 VA examination for PTSD, the examiner reported the Veteran’s service connected PTSD contributes to barriers for employment as follows: difficulties with work due to his PTSD related anxiety, irritability and isolation, confrontations with supervisors and coworkers, as well as memory and concentration difficulties leading to workplace errors. The examiner stated the Veteran displayed difficulties with mobilization and described multiple medical issues, hearing loss, chronic pain and physical limitations, which interfere with his ability to work. Taken together, it is the opinion of the examiner that the Veteran’s PTSD symptoms cause functional impairments that negatively impact his occupational functioning in a sedentary and physical work setting in the following manner: concentration and memory – severe interference; mood and motivation (to include energy, drive) - moderate to severe interference; social interaction - moderate to severe interference; adaptability and stress tolerance - severe interference. Further, the examiner noted that minimally adequate functioning for these facets is required for most employment settings. The Board additionally notes that a September 2018 VA examiner noted that the Veteran’s bilateral hearing loss and tinnitus, by themselves, would not render the Veteran unable to work, although such audiological disabilities would make working in very noisy environments and in environments that required non-face-to-face communications difficult. The Veteran additionally indicated that he had trouble communicating well with his co-workers due in part to his hearing loss and tinnitus, compounded by his non-fluency in English, which was his second language. The September 2018 VA heart examiner indicated that the Veteran’s CAD did not impact his ability to work. Based on the foregoing evidence, the Board finds that the Veteran’s PTSD, hearing loss and tinnitus, including his difficulty hearing, communicating, and interacting with his co-workers and others in occupations, would preclude the Veteran from substantially gainful employment in this case. Accordingly, by resolving reasonable doubt in his favor, the Board finds that TDIU is warranted based on the evidence of record in this case. See 38 C.F.R. §§ 3.102, 4.16. In so reaching that conclusion, the Board has appropriately applied the benefit of the doubt doctrine in this case. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. MARTIN B. PETERS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Vample, Associate Counsel