Citation Nr: 18137504 Decision Date: 09/21/18 Archive Date: 09/21/18 DOCKET NO. 16-11 309 DATE: September 21, 2018 ORDER A 100 percent disability rating from January 28, 2015, but no earlier, for service-connected posttraumatic stress disorder (PTSD) is granted. A total rating based on individual unemployability (TDIU) from January 1, 2014, to January 27, 2015, but no earlier, is granted. A TDIU from January 28, 2015, is dismissed. Special monthly compensation (SMC) at the housebound rate is granted from April 21, 2015. FINDINGS OF FACT 1. Resolving reasonable doubt, the Veteran’s PTSD is shown to result in symptoms more closely approximating total occupational and social impairment from January 28, 2015, but no earlier. 2. Resolving all reasonable doubt in the Veteran’s favor, he was unable to secure or follow a substantially gainful occupation as a result of his service-connected PTSD from January 1, 2014, but no earlier. 3. As this decision grants a 100 percent rating for PTSD from January 28, 2015, the Veteran was not in receipt of service-connected disabilities other than PTSD considered independently combining to 60 percent or more prior to April 21, 2015, and this decision grants special monthly compensation under the provisions of 38 U.S.C. § 1114(s) from April 21, 2015, the issue of entitlement to TDIU is moot from January 28, 2015. 4. With this decision, the Veteran now has a single service-connected disability rated at 100 percent, effective January 28, 2015, with additional prostate related service-connected disability independently ratable at 60 percent, effective April 21, 2015, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems. CONCLUSIONS OF LAW 1. The criteria for a 100 percent disability rating for service-connected PTSD are met from January 28, 2015. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.7, 4.130 Diagnostic Code 9411 (2017). 2. The criteria for a TDIU have been met from January 1, 2014, to January 27, 2015. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.16 (2017). 3. Entitlement to a TDIU from January 28, 2015, is moot. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.16 (2017). 4. The criteria for special monthly compensation at the housebound rate have been met since April 21, 2015. 38 U.S.C. §§ 1114, 5107 (2012); 38 C.F.R. § 3.350 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1969 to April 1971. This matter is on appeal from an April 2014 rating decision. The Board notes that the issue of the Veteran’s entitlement to a total disability rating based on individual unemployability (TDIU) is also on appeal because the Veteran has alleged that his PTSD interfered with his employment. Rice v. Shinseki, 22 Vet. App. 447 (2009) (if the claimant or the record reasonably raises the question of whether the Veteran is unemployable due to the disability for which an increased rating is sought, then part and parcel to that claim for an increased rating is whether TDIU is warranted). The Board has therefore added a TDIU claim to the title page to reflect the Board’s jurisdiction over this matter. 1. A rating in excess of 70 percent for service-connected PTSD Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities and are intended to represent the average impairment of earning capacity resulting from disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. When there is a question as to which of two ratings apply, VA will assign the higher of the two where the disability picture more nearly approximates the criteria for the next higher rating. 38 C.F.R. § 4.7. Otherwise, the lower rating will be assigned. Id. Where service connection has been granted and the assignment of an initial evaluation is disputed, separate evaluations may be assigned for different periods of time based on the facts found. Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). Disabilities must be viewed in relation to their entire history. 38 C.F.R. § 4.1. VA is required to interpret reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability. 38 C.F.R. § 4.2. VA is also required to evaluate functional impairment on the basis of lack of usefulness and the effects of the disabilities upon the claimant’s ordinary activity. 38 C.F.R. § 4.10. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. PTSD is rated under 38 C.F.R. § 4.130, Diagnostic Code 9411, according to the General Rating Formula for Mental Disorders. Under the General Rating Formula, a 50 percent disability rating 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 (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. A 70 percent disability rating is awarded when 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; 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); and inability to establish and maintain effective relationship. A 100 percent rating is warranted when there is 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. When determining the appropriate disability evaluation to assign, the Board’s primary consideration is a veteran’s symptoms, but it must also make findings as to how those symptoms impact a veteran’s occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 436 (2002). Because the use of the term “such as” in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Id. at 442; see also Sellers v. Principi, 372 F.3d 1318 (Fed. Cir. 2004). Nevertheless, all ratings in the general rating formula are also associated with objectively observable symptomatology and the plain language of the regulation makes it clear that the veteran’s impairment must be “due to” those symptoms, 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, 713 F.3d at 118; Mauerhan, 16 Vet. App. at 442. Effective March 19, 2015, VA adopted as final, without change, an interim final rule amending the portion of its Schedule for Rating Disabilities dealing with mental disorders. The interim final rule replaced outdated references with references to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (“DSM-5”) and updated the nomenclature used to refer to certain mental disorders in accordance with DSM-5. Specifically, the rulemaking amended 38 C.F.R. §§ 3.384, 4.125, 4.126, 4.127, and 4.130. However, the provisions of this final rule do not apply to claims that were certified to the Board on or before August 4, 2014, even if such claims are subsequently remanded to the agency of original jurisdiction. As this appeal was certified to the Board in August 2017, the current versions of the regulations including references to DSM-5 apply. The Veteran contends that his PTSD is manifested by depressed mood, anxiety, chronic sleep impairment, recurrent nightmares, panic attacks, inability to establish and maintain effective relationships, impaired impulse control, inability to cope with daily life routine and demands, hypervigilance, disturbances of motivation and mood, passive suicidal ideation, and irritability. A June 2012 private treatment record noted the Veteran experienced flashbacks, nightmares, anxiety, and isolation. He worked odd jobs by himself at a warehouse, and did not seem able to have full-time employment. He did not socialize. A September 2012 private treatment record noted the Veteran experienced sleep impairment with nightmares and flashbacks. He continued to work at the warehouse, but had no interaction with other people. He was withdrawn and annoyed by people. He consumed alcohol in isolation. He did not do anything around the house. He denied any auditory or visual hallucinations, as well as any suicidal or homicidal ideation. In January 2013, the Veteran’s wife submitted a statement that noted the Veteran’s extreme moods, anger, outbursts, inability to concentrate, lack of socialization, and cold and uncaring demeanor. She further noted he had an increased inability to cope with daily problems. She noted avoidance of activities that produced a startle response that could lead to panic attacks or inappropriate behavior. He would not help around the house and she had to make him bathe and shave. He had flashbacks, nightmares, and was emotionally disconnected. In February 2013, the Veteran’s employer submitted employment information that noted the Veteran did not work well with others, and worked better alone. It was noted the Veteran seemed to have anger issues. The Veteran was afforded a VA examination in March 2014. The examiner noted that Veteran had occupational and social impairment with deficiencies in most areas. The Veteran reported he stopped working in December 2013. Since he stopped working he spent most of his time alone walking, sitting in a room or outside, or watching television. He did not socialize. He reported passive suicidal ideation, anxiety, and difficulty with concentration and memory. The examiner noted the Veteran’s symptoms as depressed mood, chronic sleep impairment, mild memory loss, flattened affect, disturbance of motivation and mood, difficulty establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, and suicidal ideation. The examiner noted the Veteran was casually dressed and had neatly groomed. The examiner further noted that the Veteran showed effort to task or attention to task was impaired. The examiner also noted there was no current active suicidal ideation. The Veteran turned frequently to his wife for confirmation and assistance in answering questions. A January 2015 private treatment record noted symptoms depression, racing thoughts, sleep disturbance, anxiety attacks, and isolation. The Veteran endorsed hallucinations by noting he was always looking for movement and sometimes believed he saw things move. He also endorsed suicidal ideation, but noted he would not act upon these thoughts. A February 2015 private treatment record noted symptoms of sleep disturbance, depression, anxiety, nightmares, paranoia, hypervigilance, low motivation, isolation, and difficulty with marriage. The Veteran denied having homicidal or suicidal thoughts. He denied hallucinations, but stated he was always looking out to make sure no one was trying to get him. A March 2015 private treatment record noted symptoms of flashbacks, nightmares, depressed mood, anxiety, panic attacks and hallucinations. In March 2015, the Veteran’s private psychiatrist, Dr. J.S., provided a PTSD disability benefits questionnaire. He diagnosed PTSD, panic disorder without agoraphobia, and major depressive disorder. He opined the Veteran had total occupational and social impairment due to his PTSD. He noted the Veteran’s symptoms as 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, flattened affect, difficulty understanding complex commands, disturbance of motivation and mood, difficulty establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, inability to establish or maintain effective relationships, persistent delusions or hallucinations, and neglect of personal appearance and hygiene. The Veteran’s wife submitted another statement in April 2015 that noted worsening sleep impairment, paranoia, hypervigilance, and isolation. She noted he did not interact with family and was irritated when someone spoke to him. She also noted he had always had a problem working around others. VA and private treatment records continued to show the Veteran struggled with his PTSD symptomatology. In February 2016, a letter from Dr. J.S. opined that as a result of the Veteran’s PTSD it was highly unlikely that the Veteran could obtain or maintain suitable gainful employment. Based on this evidence, the Board finds that a rating in excess of 70 percent for PTSD is warranted from January 28, 2015. The symptomology described consistently demonstrated issues with persistent hallucinations and an inability to perform activities of daily living to include maintenance of minimal personal hygiene. These symptoms, along with his other symptoms of 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, flattened affect, difficulty understanding complex commands, disturbance of motivation and mood, difficulty establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, and inability to establish or maintain effective relationships more nearly approximate the 100 percent rating criteria. The Board finds that the Veteran displayed the level of mental impairment associated with the higher 100 percent rating, and that his level of social and occupational functional impairment was total from January 28, 2015, the date hallucinations were first reported. Prior to January 28, 2015, the Veteran’s PTSD symptomatology more nearly approximated the 70 percent rating criteria. While the Veteran’s spouse noted in January 2013 she had to make him bathe and shave, this is the only symptomatology that approximated the 100 percent rating criteria. In fact, the Veteran remained employed until December 2013. 2. TDIU VA will grant a TDIU when the evidence shows that a veteran is precluded from obtaining or maintaining substantially gainful employment consistent with his education and occupational experience by reason of his service-connected disabilities. 38 C.F.R. §§ 3.340, 3.341, 4.16. A total rating for compensation purposes 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 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). In determining unemployability for VA purposes, consideration may be given to the veteran’s level of education, special training, and previous work experience, but not to age or any impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19; Hersey v. Derwinski, 2 Vet. App. 91, 94 (1992); Faust v. West, 13 Vet. App. 342 (2000). The question is whether the veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993) (citing 38 C.F.R. §§ 4.1, 4.15, 4.16(a)). The Veteran is no longer employed. In an application for increased compensation based on unemployability received in April 2015, he reported that he was last employed in December 2013 as a warehouseman. He had completed high school but denied receiving any other education or training. He contended that his service-connected PTSD and prostate disabilities prevented him from securing and maintaining substantially gainful employment. From September 28, 2012, to present, the combined rating was 90 percent. He is assigned a 70 percent disability rating for PTSD from September 28, 2012, to January 27, 2015, and 100 percent disability rating for PTSD from January 28, 2015, onward; 40 percent disability rating for residuals of prostate cancer from December 29, 2010 to April 21, 2015, and 60 percent disability rating from April 21, 2015, onward; 20 percent disability rating for diabetes mellitus type II; and a noncompensable disability rating for erectile dysfunction associated with residuals of prostate cancer. The Veteran had a total combined rating of 90 percent due to PTSD, diabetes, and residuals of prostate cancer. Hence, he has met the schedular criteria under 38 C.F.R. § 4.16(a) for consideration of TDIU for all periods under consideration. Therefore, the determinative issue is whether the Veteran is shown to be unable to secure and follow a substantially gainful occupation due to his service-connected disabilities. In this case, the evidence is at least in equipoise regarding the Veteran’s inability to obtain and maintain substantially gainful employment consistent with his education and occupational experience because of his service-connected disabilities. A March 2013 application for increased compensation based on unemployability noted the Veteran was still working in a warehouse, although he contended that his PTSD, prostate residuals, diabetes, and erectile dysfunction prevented him from securing or following substantially gainful employment. February 2013 employment information revealed that the Veteran did not work well with others and seemed to have anger issues. A March 2014 VA PTSD examination showed occupational and social impairment with deficiencies in most areas. March 2014 VA examinations for diabetes and residuals of prostate cancer revealed no functional impact on the Veteran’s ability to work. A January 2015 private treatment record noted symptoms depression, racing thoughts, sleep disturbance, anxiety attacks, and isolation. The Veteran endorsed hallucinations by noting he was always looking for movement and sometimes believed he saw things move. He also endorsed suicidal ideation, but noted he would not act upon these thoughts. A February 2015 private treatment record noted symptoms of sleep disturbance, depression, anxiety, nightmares, paranoia, hypervigilance, low motivation, isolation, and difficulty with marriage. The Veteran denied having homicidal or suicidal thoughts. He denied hallucinations, but stated he was always looking out to make sure no one was trying to get him. A March 2015 private treatment record noted symptoms of flashbacks, nightmares, depressed mood, anxiety, panic attacks and hallucinations. In March 2015, the Veteran’s private psychiatrist, Dr. J.S., provided a PTSD disability benefits questionnaire. He diagnosed PTSD, panic disorder without agoraphobia, and major depressive disorder. He opined the Veteran had total occupational and social impairment due to his PTSD. He noted the Veteran’s symptoms as 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, flattened affect, difficulty understanding complex commands, disturbance of motivation and mood, difficulty establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, inability to establish or maintain effective relationships, persistent delusions or hallucinations, and neglect of personal appearance and hygiene. The Veteran’s wife submitted a statement in April 2015 that noted worsening sleep impairment, paranoia, hypervigilance, and isolation. She noted he did not interact with family and was irritated when someone spoke to him. She also noted he had always had a problem working around others. VA and private treatment records continued to show the Veteran struggled with his PTSD symptomatology. In February 2016, a letter from Dr. J.S. opined that as a result of the Veteran’s PTSD it was highly unlikely that the Veteran could obtain or maintain suitable gainful employment. Appeal period prior to January 1, 2014 The record demonstrates that the Veteran was employed up to January 1, 2014. The Veteran does not assert and the evidence does not reflect that the Veteran’s employment up until this time was marginal or in a protected environment or was anything other than substantially gainful employment. In this case, the Veteran’s earnings from 2012 to 2013 (at least $31,000.00) and from 2013 to 2014 (exceeded the poverty threshold for that year ($31,000.00). See United States Census Bureau Poverty Thresholds 2012 and 2013. There is no indication that he was employed in a family-run business, sheltered workshop, or other protected environment suggestive of marginal employment. In Faust v. West, 13 Vet. App. 342 (2000), the Court defined “substantially gainful employment” as “an occupation that provides an annual income that exceeds the poverty threshold for one person, irrespective of the number of hours or days that the Veteran actually works and without regard to the Veteran’s earned annual income...”. As the Veteran was employed, TDIU is not for consideration prior to January 1, 2014. See Jackson v. Shinseki, 587 F.3d 1106 (Fed. Cir. 2009) (finding that a TDIU claim is not raised in this context unless there is evidence of associated unemployability). Appeal period from January 1, 2014, to January 27, 2015 VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. In the present case, the Board concludes that entitlement to TDIU is warranted for the period from January 1, 2014, to January 27, 2015. Based upon review of the evidence as a whole, including additional VA treatment records and examinations, as well as lay statements provided by the Veteran, the Board finds that the Veteran was unable to secure or maintain any substantially gainful employment due to his service-connected PTSD from January 1, 2014, to January 27, 2015. The overall conclusion to be drawn from the medical evidence of record is that the Veteran’s ability to perform physical or sedentary work at this point was severely impaired due to his PTSD. As a result, the Board finds that, affording the Veteran the benefit of the doubt and given his occupational history and educational level, he was unable to obtain or retain substantially gainful employment due to his service-connected disabilities from January 1, 2014, to January 27, 2015. Appeal period from January 28, 2015, to April 20, 2015 In the decision herein, the Board grants a 100 percent rating for the Veteran’s service-connected PTSD, effective January 28, 2015. A grant of a 100 percent disability does not always render the issue of TDIU moot. VA’s duty to maximize a claimant’s benefits includes consideration of whether his disabilities establishes entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114. See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011); Bradley v. Peake, 22 Vet. App. 280, 294 (2008). Specifically, SMC may be warranted if the Veteran has a 100 percent disability rating for a single disability, and VA finds that TDIU is warranted based solely on the disabilities other than the disability that is rated at 100 percent. See Bradley, 22 Vet. App. 280 (analyzing 38 U.S.C. § 1114(s)); See also 75 Fed. Reg. 11,229-04 (March 10, 2010) (withdrawing VAOPGCPREC 6-1999). With respect to the period from January 28, 2015, to April 20, 2015, since VA has granted a 100 percent schedular rating for his service-connected PTSD and TDIU was based on PTSD and not the Veteran’s disabilities other than PTSD, he is not eligible for a total rating for compensation based on individual unemployability for this period on appeal from January 28, 2015, to April 20, 2015. As such, an award of TDIU would not result in the Veteran having one disability rated 100 percent disabling, and the others when considered independently combining to 60 percent or more. Indeed, no additional benefit in the form of SMC would be warranted. Because the award of TDIU from January 28, 2015, to April 20, 2015, would result in no further benefit, the issue is rendered moot during that time period. Appeal period from April 21, 2015 As a total (100 percent) rating has been assigned for PTSD for the entire period from April 21, 2015, there remains no time during this period where the schedular rating is “less than total,” as required for a TDIU. See 38 C.F.R. § 4.16(a). The Board is cognizant of the fact that the receipt of a 100 percent schedular disability rating for a service-connected disability or disabilities does not necessarily moot the issue of entitlement to a TDIU because a TDIU rating may still form the basis for assignment of SMC pursuant to 38 U.S.C. § 1114(s). See Bradley v. Peake, 22 Vet. App. 280 (2008). In this case, however, the Veteran is awarded SMC pursuant to 38 U.S.C. § 1114(s) during the entire period from April 21, 2015 (see discussion below). For this reason, the issue of entitlement to a TDIU at any time from April 21, 2015, is now rendered moot, leaving no question of law or fact to decide regarding the TDIU issue during this period. 38 U.S.C. §§ 7104, 7105; 38 C.F.R. §§ 4.14, 4.16. In consideration thereof, the Board finds that the issue of entitlement to a TDIU from April 21, 2015, must be dismissed as moot. 3. SMC VA has a “well-established” duty to maximize a claimant’s benefits. See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011); AB v. Brown, 6 Vet. App. 35, 38 (1993); see also Bradley v. Peake, 22 Vet. App. 280 (2008). This duty to maximize benefits requires VA to assess all of a claimant’s disabilities to determine whether any combination of disabilities establishes entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114. See Bradley, 22 Vet. App. at 294 (finding that SMC “benefits are to be accorded when a Veteran becomes eligible without need for a separate claim” and remanding, pursuant to VA’s duty to maximize benefits, for VA to determine whether the Veteran’s posttraumatic stress disorder, rated as 70 percent disabling, would entitle him to a TDIU and, therefore, to SMC). Special monthly compensation is payable where the Veteran has a single service-connected disability rated as 100 percent and (1) has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or (2) is permanently housebound by reason of service-connected disability or disabilities. This requirement is met when the Veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i). Subsection 1114(s) requires that a disabled Veteran whose disability level is determined by the ratings schedule must have at least one disability that is rated at 100 percent in order to qualify for the special monthly compensation provided by that statute. Under the law, subsection 1114(s) benefits are not available to a Veteran whose 100 percent disability rating is based on multiple disabilities, none of which is rated at 100 percent disabling. Although a TDIU may satisfy the “rated as total” element of section 1114(s), a TDIU based on multiple underlying disabilities cannot satisfy the section 1114(s) requirement of “a service-connected disability” because that requirement must be met by a single disability. The Court declared, however, if a Veteran were awarded a TDIU based on multiple underlying disabilities and then later receives a scheduler disability rating for a single, separate disability that would, by itself, create the basis for an award of a TDIU, that the order of the awards was not relevant to the inquiry as to whether any of the disabilities alone would render the Veteran unemployable and thus entitled to a TDIU rating based on that condition alone. Buie v. Shinseki, 24 Vet. App. 242, 250 (2010). Appeal period prior to April 21, 2015 With respect to the appeal period prior to April 21, 2015, the Board notes that the Veteran’s claim has been based on his service connected psychiatric disability. The evidence showed TDIU warranted based on a single disability, PTSD. Additionally, the Veteran has been awarded a 100 percent disability rating for his service-connected PTSD since January 28, 2015. However, the Veteran did not have service-connected disabilities other than PTSD considered independently combining to 60 percent or more. As such, the Veteran does not have a single disability rated at 100 percent with additional disabilities rated at 60 percent or more involving different anatomical segments or bodily systems. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i); see Bradley v. Peake, 22 Vet. App. 280 (2008). Therefore, the Veteran is not entitled to SMC under 38 U.S.C. § 1114(s). Appeal period from April 21, 2015 In a case such as this, where the Board grants a 100 percent rating for a single disability, and the Veteran has other compensable disabilities, the Board is required to assess whether, as a result of its decision, the Veteran has ancillary entitlement to special monthly compensation at the housebound rate under 38 U.S.C. § 1114(s) and 38 C.F.R. § 3.350(i). See Buie, 24 Vet. App. at 250-51; Akles v. Derwinski, 1 Vet. App. at 121. As noted previously, the Veteran was assigned a 100 percent disability rating for PTSD from January 28, 2015, onward; 40 percent disability rating for residuals of prostate cancer from December 29, 2010 to April 21, 2015, and 60 percent disability rating from April 21, 2015, onward; 20 percent disability rating for diabetes mellitus type II; and a noncompensable disability rating for erectile dysfunction associated with residuals of prostate cancer. The prostate related service-connected disability ratings combine to 60 percent as of April 21, 2015. 38 U.S.C. § 4.25. In light of the Board’s present decision granting a 100 percent schedular rating for the Veteran’s service-connected PTSD from January 28, 2015, and the fact that his combined rating for his prostate related service-connected disabilities were 60 percent effective April 21, 2015, the Veteran is also entitled to special monthly compensation at the housebound rate, effective April 21, 2015, and that benefit is granted as well. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Kelly A. Gastoukian, Associate Counsel