Citation Nr: 18161281 Decision Date: 12/31/18 Archive Date: 12/31/18 DOCKET NO. 16-33 615 DATE: December 31, 2018 ORDER For the appeal period prior to September 13, 2016, entitlement to an initial rating of 70 percent, but no higher, for posttraumatic stress disorder (PTSD) is granted. For the appeal period from September 13, 2016, entitlement to an initial rating of 100 percent, for PTSD is granted. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities prior to September 13, 2016, is denied. FINDINGS OF FACT 1. For the appeal period prior to September 13, 2016, the Veteran’s PTSD was manifested by symptoms productive of occupational and social impairment with deficiencies in most areas; symptoms productive of total occupational and social impairment were not shown. 2. For the appeal period from September 13, 2016, the Veteran’s PTSD was manifested by symptoms of total occupational and social impairment. 3. The Veteran was not unable to secure or follow a substantially gainful employment due to his service-connected disabilities prior to September 13, 2016. CONCLUSIONS OF LAW 1. For the appeal period prior to September 13, 2016, the criteria for a rating of 70 percent, but no higher, for the Veteran’s service-connected PTSD were met. 38 U.S.C. §§ 1155, 5107(b), 5110 (2012); 38 C.F.R. §§ 3.102, 4.130, Diagnostic Code 9411 (2018). 2. For the appeal period from September 13, 2016, the criteria for a rating of 100 percent for the Veteran’s service-connected PTSD have been met. 38 U.S.C. §§ 1155, 5107(b), 5110 (2012); 38 C.F.R. §§ 3.102, 4.130, Diagnostic Code 9411 (2018). 3. The criteria for the assignment of a TDIU prior to September 13, 2016 were not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service in the Army from June 1967 to May 1969. This appeal comes to the Board of Veterans’ Appeals (Board) from a March 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the United States Court of Appeals for Veteran’s Claims (Court) held that VA must address the issue of entitlement to a TDIU in higher-rating claims when the issue of unemployability is raised by the record, as explained below. The record on appeal has raised the issue of entitlement to a TDIU. Thus, under Rice, the Board has jurisdiction over the Veteran’s TDIU claim and, for the purpose of clarity, has separately captioned the issue. In some cases, but not all, the assignment of a total schedular rating renders a TDIU claim moot. See Bradley v. Peake, 22 Vet. App. 280, 294 (2008). The Veteran may receive a total (100 percent) rating based on a combination of his service-connected disabilities, or for a single service-connected disability. Special monthly compensation (SMC) may be warranted in addition to his regular compensation if the Veteran has a total disability rating for a single disability, and additional service-connected disability or disabilities rated at 60 percent or more. The total rating for the single disability for SMC purposes may be schedular, or may be based on TDIU, so long as TDIU was granted solely because of that single disability. Thus, if the Veteran’s total rating is based on a combination of his service-connected disabilities, (which by definition would mean that his individual service-connected disabilities are each rated at less than 100 percent), then TDIU is not moot if it could be granted on a single disability, in turn making the Veteran eligible for SMC. If, however as here, the Veteran has a single disability already rated at 100 percent, entitlement to TDIU becomes moot, because he has already met that portion of the requirement for SMC. In this case, as explained further below, the Board has awarded the Veteran a 100 percent schedular evaluation for his PTSD, which renders the TDIU claim moot from September 13, 2016, the date assigned for the total rating forward. 1. Entitlement to an initial rating in excess of 50 percent for PTSD. Disability evaluations are determined by the application of the Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can practicably be determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual disorders in civil occupations. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321(a), 4.1 (2018). When a question arises as to which of two ratings applies under a particular diagnostic code, the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7 (2018). Otherwise, the lower rating will be assigned. Id. However, the evaluation of the same disability under various diagnoses, known as pyramiding, is to be avoided. 38 C.F.R. § 4.14 (2018). After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the veteran. 38 C.F.R. § 4.3 (2017); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Where (as here) the rating appealed is the initial rating assigned with a grant of service connection, the entire appeal period is for consideration, and separate ratings may be assigned for separate periods of time based on facts found, a practice known as “staged ratings.” See Fenderson v. West, 12 Vet. App. 119 (1999). The Veteran’s service-connected PTSD is rated at 50 percent under 38 C.F.R. § 4.130, Diagnostic Code 9411. Under these criteria, a 50 percent rating is warranted where the psychiatric condition produces 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; difficulty in establishing and maintaining effective work and social relationships. See 38 C.F.R. § 4.130, Diagnostic Code 9411 (2018). A 70 percent rating is warranted where the psychiatric condition produces 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 work like setting); inability to establish and maintain effective relationships. Id. A 100 percent rating is warranted where the psychiatric condition results in 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. Id. Evaluation under § 4.130 is symptom-driven, meaning that symptomatology should be the fact-finder’s primary focus when deciding entitlement to a given disability rating under that regulation. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013). In Vazquez-Claudio, the United States Court of Appeals for the Federal Circuit explained that the frequency, severity and duration of the symptoms also play an important role in determining the rating. Id. at 117. Significantly, however, the list of symptoms under the rating criteria are meant to be examples of symptoms that would warrant the rating, but are not meant to be exhaustive, and the Board need not find all or even some of the symptoms to award a specific rating. 38 C.F.R. § 4.21 (2018); Mauerhan v. Principi, 16 Vet. App. 436, 442-43 (2002). If the evidence shows that the Veteran suffers symptoms listed in the rating criteria or symptoms of similar severity, frequency, and duration, that cause occupational or social impairment equivalent to what would be caused by the symptoms listed in the criteria for a particular rating, the appropriate equivalent rating will be assigned. Mauerhan, 16 Vet. App. at 443; see also Vazquez-Claudio, 713 F.3d at 117. The Board finds that for the Veteran’s service-connected PTSD, a rating of 70 percent, but no higher, is warranted for the appeal period prior to September 13, 2016, and a rating of 100 percent is warranted for the appeal period from September 13, 2016. In November 2010, the Veteran’s wife reported that the Veteran was frequently jumpy in his sleep and would hold conversations while he was asleep. Sometimes, at night, he heard voices of people from Vietnam telling him things. In April 2010, the Veteran was afforded a VA examination for PTSD. The Veteran was diagnosed with anxiety disorder not otherwise specified (mixed anxiety and depressive symptoms). He reported that he took anti-depressants and went to therapy. He reported that he had both good days and bad days, and his mood swings were merely anger reactions. The Veteran reported low mood on a daily basis with social avoidance. The Veteran had unresolved grief or loss; his father, uncle, best friend, and son all died within a 12-month period in 1998. The Veteran was married and resided with his wife, and he had an adult son. He was close to his remaining family members; however, he denied having friends. He did not have any other hobbies than watching sports. The Veteran did not have a history of suicidal attempts or violence. Upon physical examination, he appeared clean and casually dressed. His thought process and content were unremarkable. He did not have delusions or hallucinations, obsessive ritualistic behavior, or inappropriate behavior. He understood the outcome of his behavior. He did not have homicidal or suicidal thoughts and was able to maintain minimal personal hygiene. The Veteran did not have any problems with performing activities of daily living. His mental disorder symptoms included recurrent distressing dreams of the event; persistent avoidance of thoughts; feelings, or conversations associated with the trauma; difficulty falling or staying asleep; irritability or outbursts of anger; hypervigilance; and exaggerated startle response. The VA examiner concluded that the Veteran had symptoms that were transient or mild and decreased work efficiency and ability to perform occupational tasks only during periods of significant stress. In June 2011, the Veteran had a psychiatry evaluation performed by Dr. J.H. at a VA outpatient clinic. The Veteran reported ongoing panic attacks when he was working. He had them 2 to 3 times a day. The Veteran reported ongoing social isolation, irritability, problems with attention and concentration, and emotional numbing and detachment. The Veteran reported ongoing irritability and anger, especially when he was working. He had a “blow-up” at work with another co-worker. He reported that he sometimes he heard voices at night of people from Vietnam telling him things like “be careful” or about how to operate his equipment. The Veteran’s thinking was somewhat pre-occupied, but overall was goal directed, but with some paranoia. The Veteran denied present suicidal or homicidal ideation, intent, history, or plan. The Veteran did not have any history of past psychiatric inpatient hospitalizations. In August 2013, the Veteran submitted a psychological independent medical examination report, dated June 2013, from Dr. A.J.H. Dr. A.J.H. reported that procedures included diagnostic interview and history and mental status examination. The psychologist concluded that the Veteran’s thought stream was coherent. However, his concentration was impaired. The Veteran’s PTSD was characterized by withdrawal, irritability, struggling to communicate, crying spells, suicidal ideation, and hopelessness. When the Veteran felt depressed, he forced himself to go to work. He had a history of panic attacks. The Veteran endorsed fear, restlessness, anxiety, nervousness, tension, and somatic symptoms associated with anxiety. He also endorsed hearing voices and having what he perceived as strange and peculiar thoughts. Occasionally, the Veteran felt suicidal and wondered why he was alive while others died in the military. He complained of concentration difficulties and of an intense startle response with unexpected noises. Dr. A.J.H. opined that the Veteran’s PTSD caused clinically significant distress in his marriage, interpersonal interactions, and on the job. He had numerous verbal altercations with co-workers. However, he kept his job because he was a hard worker. His immediate memory and judgment were impaired. He had no social relationships outside of his immediate family. The Veteran also had difficulty in understanding complex instructions. In July 2016, the Veteran was afforded a VA examination for PTSD. He was diagnosed with PTSD. The VA examiner concluded that the Veteran had occupational and social impairment due to mild or transient symptoms which decreased work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication. The Veteran reported that he was married, but they had some marital discord. He enjoyed working in his yard. He had an adult son who lived with him and his wife. One or two former work-related employees would stop by to see the Veteran. He worked for about 40 years at a paper mill, but retired in 2014. The Veteran’s symptoms included depressed mood, anxiety, and chronic sleep impairment. Upon behavioral observation, the VA examiner noted that the Veteran was quiet and had little to say. His affect was constricted. His thought processes were linear and goal-directed. He was not suicidal or homicidal. The Veteran was capable of managing his financial affairs. In September 2016, the Veteran submitted a PTSD Disability Benefits Questionnaire (DBQ), dated September 13, 2016, from a VA staff psychologist, Dr. J.H. Dr. J.H. diagnosed the Veteran with chronic PTSD. She noted that the Veteran had significant problems and impairments in social, occupational, and school functioning. The Veteran had suicidal ideation. The psychologist concluded that the Veteran had total occupational and social impairment. The Veteran’s symptoms included depressed mood; anxiety; suspiciousness; panic attacks more than once a week; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; chronic sleep impairment; mild memory loss; impairment of short- and long-term memory; impaired judgment; disturbances of motivation and mood; suicidal ideation; obsessional rituals which interfered with routine activities; intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene; persistent danger of hurting self or others; neglect of personal appearance and hygiene; and persistent delusions or hallucinations. In May 2018, the Veteran submitted a psychological independent medical examination report, dated March 2017, from Dr. A.J.H. Dr. A.J.H. reported that procedures included a diagnostic interview and history, mental status examination, and administration of the Mississippi Scale for Combat Related PTSD. Dr. A.J.H. diagnosed the Veteran with chronic PTSD, dysthymic disorder, and panic disorder with agoraphobia. The Veteran’s entire VA claims file was reviewed. Also, the Veteran’s wife was interviewed and she provided extensive collateral information concerning the Veteran’s status and functioning. Upon behavioral and mental status examination, the examiner noticed the Veteran was casually and appropriately dressed, but had a rather disheveled appearance. The Veteran was oriented to person, place, and time. The Veteran’s speech was limited with minimal spontaneous communication. Remote memory was impaired and he became easily confused. The Veteran’s judgment was impaired and insight was nil. He reported that he retired from work in April 2014 due to psychological stress. He endorsed paranoid ideation; believing that others were trying to do things behind his back. When he worked the day shift, he had panic attacks twice a day. When he was angered at work, he was able to restrain himself and never acted violently. Dr. A.J.H. reported that the Veteran was unable to be emotionally close to others and wondered why he was alive while others died in the military. The Veteran endorsed flashbacks, nightmares, a lack of enjoyment, flat affect and crying without cause. He continued to have panic attacks twice a week. The Veteran feared that he would lose control. He only occasionally went to the grocery store, and was unable to attend sporting events, church, or family reunions. Although he could drive short distances in the small town where he lived, he was unable to drive in traffic or for any distance, especially alone. Dr. A.J.H. noted that the Veteran had paranoia. Continually, throughout the day and night, he checked the doors and windows to be sure they were locked and scanned the perimeter of his residence. Dr. A.J.H. noted that the Veteran thought he was being followed when he was driving. He also believed he was being tapped through the phone. The Veteran was startled by loud noise. Dr. A.J.H. noted that blatant psychotic though processes were evident as the Veteran believed that he was being watched through the television whether it was on or off. The Veteran lost interest in his personal appearance, and only bathed three times a week and shaved twice a week. He changed his clothes every other day and his wife complained frequently about the way he dressed and his appearance. He also had a loss of appetite. The Veteran would forget to take his medication, unless his wife reminded him. He struggled with spoken and written instructions. He also struggled with reading comprehension. He had trouble understanding what people said to him and remembering important events. The Veteran admitted that he frequently exploded over minor everyday things. Any unexpected noise caused him to jump and exhibit a flight or fight response. Although, the Veteran’s paranoia and auditory hallucinations were most likely secondary to PTSD, the symptoms were of such severity to border on psychosis. He rarely worked in the yard due to a lack of motivation and energy complicated by his paranoia. One time, when he was driving, he opened the car door and threatened to jump out. He became so mad he started kicking his feet or kicking objects and shook all over with intense anger triggered by minimum provocation. The Veteran’s relationships were markedly impaired. He disliked being around people. He rarely interacted with neighbors, so there was no conflict. He has been characterized by former co-workers as irritable, unfriendly, and withdrawn. Dr. A.J.H. concluded that the Veteran was unable to function independently in an appropriate manner. He was dependent on his wife for basic self-care and activities of daily living. There was significant impairment in impulse control. The Veteran was unable to establish and maintain interpersonal relationships. Other than his wife, son, and a sister who lived nearby, he spoke to no one else. He was constantly afraid of losing control and causing harm to others. The psychologist stated that in his professional opinion, a preponderance of the evidence substantiated severe impairment. For the appeal period prior to September 13, 2016 (date of DBQ), a rating of 70 percent, but no higher, for the Veteran’s service-connected PTSD is warranted. The Veteran’s PTSD symptoms have been characterized by depressed mood, anxiety, chronic sleep impairment, panic attacks, ongoing anger and irritability, social isolation, exaggerated startle response, and difficulty sleeping. Overall, his PTSD symptoms most closely approximated occupational and social impairment with deficiencies in most areas. Although it was noted at the April 2010 VA examination that the Veteran did not have delusions or hallucinations, in a June 2011 VA treatment record, the Veteran reported that he sometimes heard voices. At that time, the psychologist noted that the Veteran’s thinking was pre-occupied, but was goal directed with some paranoia. Also, the Veteran had problems maintaining effective relationships and adapting to stressful circumstances. The Veteran had problems on his job due to his anger issues. Although the Veteran was married, he had marital problems. He was close to his family, but did not have any other friends. Also, the Veteran occasionally had suicidal ideation. On his June 2013 psychological independent medical examination report, the psychologist noted that the Veteran’s concentration, immediate memory, and judgment were impaired. The Veteran also had difficulty understanding complex instructions. A 100 percent evaluation, however, is not for assignment prior to September 13, 2016. The evidence of record does not support symptoms of total social and occupational impairment. As previously mentioned, although the Veteran had thoughts of suicide, the evidence of record did not show that he had any plan or intent to carry it out. Also, the evidence of record did not show that the Veteran had gross impairment in thought processes or communications. Furthermore, the evidence did not show that the Veteran was in persistent danger of hurting himself or others or was unable to perform activities of daily living. The Veteran went to work and was capable of managing his financial affairs. The Board has also considered the statements of the Veteran and his spouse regarding the severity of his PTSD, and acknowledges that they are competent to report the occurrence of observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C. § 1154(a) (2012); 38 C.F.R. § 3.159(a)(2) (2018); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). Ultimately, however, the opinions and observations of the Veteran and his spouse, when considered in the full context of his treatment records and VA examination reports, do not meet the burden for a higher rating imposed by the rating criteria under 38 C.F.R. § 4.130 with respect to determining the severity of the Veteran’s service-connected PTSD. Based on the foregoing, for the appeal period prior to September 13, 2016, when considering all the other symptoms of record, the Board finds that the Veteran’s symptoms most closely approximate a 70 percent evaluation. See 38 C.F.R. § 4.130, Diagnostic Code 9411 (2018). For the appeal period from September 13, 2016 (date of DBQ), a schedular rating of 100 percent rating for the Veteran’s service-connected PTSD is warranted. From this time, the record reflects that the Veteran’s symptoms worsened considerably. The Veteran’s PTSD symptoms were characterized by panic attacks more than once per week; anxiety; chronic sleep impairment; mild memory loss; impairment of short and long-term memory; suicidal ideation; disturbances of motivation and mood; intermittent inability to perform activities of daily living; persistent delusions or hallucinations; and neglect of personal appearance and hygiene. In his September 2016 DBQ, the VA psychologist noted that the Veteran had significant problems and impairments in social, occupational, and school functioning. The VA psychologist concluded that the Veteran had total occupational and social impairment. Further, in the Veteran’s March 2017 psychological independent medical examination report, Dr. A.J.H. concluded that the Veteran was unable to function independently in an appropriate manner. Dr. A.J.H. opined that the evidence substantiated severe impairment. The Veteran was dependent on his wife for basic self-care and activities of daily living. He was unable to establish and maintain interpersonal relationships. The Veteran had paranoia and auditory hallucinations, which were of such severity to border on psychosis. Also, the Veteran was overcome with intense anger triggered by minimum provocation. He disliked being around people and rarely interacted with neighbors. The Veteran was described as irritable, unfriendly, and withdrawn. The Veteran struggled with spoken and written instructions, and with reading comprehension. Continually, throughout the day and night, the Veteran checked the doors and windows. He lost interest in his personal appearance and in his appetite. Therefore, the Board finds that the assignment of 100 percent for the appeal period from September 13, 2016, is warranted. As this is the maximum rating that the Veteran can receive for his service-connected PTSD, a higher rating is not assignable for this period. 2. Entitlement to a TDIU prior to September 13, 2016. In order to establish entitlement to a TDIU due to service-connected disabilities, there must be impairment so severe that it is impossible for the average person to follow a substantially gainful occupation. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.340, 3.341, 4.16 (2018). 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 (1993). 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 or her age or to the impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19 (2018); Van Hoose v. Brown, 4 Vet. App. 361 (1993). “Substantially gainful employment” is that employment “which is ordinarily followed by the non-disabled to earn their livelihood with earnings common to the particular occupation in the community where the veteran resides.” Moore v. Derwinski, 1 Vet. App. 356, 358 (1991). As further provided by 38 C.F.R. § 4.16(a), “Marginal employment shall not be considered substantially gainful employment.” The regulatory scheme allows for an award of a TDIU when, due to service-connected disabilities, a veteran is unable to secure or follow a substantially gainful occupation, and has a single disability rated 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability rated 40 percent or more with additional disability sufficient to bring the combined evaluation to 70 percent. For the purposes of finding one 60 percent disability or one 40 percent disability in combination, disabilities resulting from a common etiology, affecting one or both lower extremities or affecting a single body system will be considered as one disability. 38 C.F.R. §§ 3.340, 3.341, 4.16(a) (2018). It is also the policy of the VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 4.16(b) (2018). Where the veteran fails to meet the applicable percentage standards enunciated in 38 C.F.R. § 4.16(a), an extraschedular rating is for consideration where the veteran is unemployable due to service-connected disability. 38 C.F.R. § 4.16(b) (2018); see also Fanning v. Brown, 4 Vet. App. 225 (1993). Currently, the Veteran is service-connected for PTSD, rated at 70 percent prior to September 13, 2016, and 100 percent from September 13, 2016, which the Board assigned in this decision. As mentioned previously, the claim for a TDIU is moot for the period from September 13, 2016 because the Veteran is already in receipt of a 100 percent rating for his PTSD for that period. Thus, the Board real only consider the evidence of record for the period prior to September 13, 2016. As such, the schedular requirements for a TDIU, under 38 C.F.R. § 4.16(a), were satisfied for the period prior to September 13, 2016. However, finding that a veteran meets the schedular requirements for TDIU is not where the inquiry ends. Instead, it must also be shown that the veteran’s service-connected disabilities render him unable to secure or follow a substantially gainful occupation. Following a review of the evidence of record, the Board finds that entitlement to a TDIU prior to September 13, 2016 is not warranted. In May 2018, the Veteran submitted a completed VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability. On the form, the Veteran indicated that he completed one year of college and was previously employed making paper. He stated that his service-connected PTSD prevented him from securing or following any substantially gainful occupation. The Veteran reported that he last worked full-time on November 15, 2013 and that he became too disabled to work on March 31, 2014. The Veteran stated that he could not get along with co-workers and would yell and get angry with them and his supervisors. He was “forced to retire” because of his worsening PTSD symptoms. His symptoms were so severe, he noted, that he could no longer be in a work situation. Indeed, the Veteran’s PTSD symptoms included depression, panic attacks, anxiety, anger outbursts, intermittent suicidal ideation, impaired judgment, and chronic sleep impairment during the relevant appeal period. However, despite the Veteran’s reports of numerous verbal altercations with co-workers during the psychological assessment in June 2013, he indicated that he was able to maintain his job because he was a hard worker. The Veteran reported that he would force himself to go to work when he felt depressed. A January 2014 VA treatment record shows that the Veteran did some work around the house. During his July 2016 VA examination, the Veteran reported that he worked for 40 years at the paper mill, but retired in 2014, and that he enjoyed doing yardwork. Based on the foregoing, a grant for a TDIU is not warranted. The Veteran worked for part of the appeal period and retired in 2014. Thereafter, the record does not show that the Veteran is unable to obtain and maintain substantially gainful employment based on his service-connected PTSD. While the Veteran’s PTSD clearly impacts his employment with respect to his ability to work with others, as acknowledged by the 70 percent disability rating assigned, it is not shown to preclude employment consistent with his education and employment history. The Board finds it especially persuasive that the Veteran continued to engage in, and even enjoy, more physical work around his house and yard that required limited contact with others. Therefore, the Board concludes that the Veteran is not shown to be unable to secure or follow a substantially gainful occupation due to his service-connected PTSD prior to September 13, 2016. Entitlement to a TDIU during this period is not warranted. Lindsey M. Connor Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Crawford, Associate Counsel