Citation Nr: 20004829 Decision Date: 01/21/20 Archive Date: 01/21/20 DOCKET NO. 15-12 258 DATE: January 21, 2020 ORDER An effective date of June 3, 2012, for the award of an increased evaluation of 70 percent for the Veteran’s service-connected acquired psychiatric disability, to include panic disorder with agoraphobia, is granted. An effective date of June 3, 2012, for the award of a total disability evaluation based upon individual employability (TDIU) is granted. FINDINGS OF FACT 1. On June 3, 2013, the Veteran filed a claim for an increased evaluation in excess of 50 percent for his service-connected acquired psychiatric disability. 2. The record contains evidence sufficient to factually ascertain that, in the year prior to June 3, 2013, the Veteran’s service-connected acquired psychiatric disability resulted in occupational and social impairment with deficiencies in most areas. 3. The record contains evidence sufficient to factually ascertain that, in the year prior to June 3, 2013, the Veteran was in receipt of two service-connected disabilities, with one disability ratable at 70 percent, and a combined rating of 70 percent. 4. The record contains evidence sufficient to factually ascertain that, in the year prior to June 3, 2013, the Veteran’s service-connected acquired psychiatric disability resulted in the Veteran’s inability to secure or to follow a substantially gainful occupation. CONCLUSIONS OF LAW 1. The criteria for the assignment of an effective date of June 3, 2012, for an increased evaluation of 70 percent for the Veteran’s service-connected acquired psychiatric disability have been met. 38 U.S.C. §§ 5101, 5107, 5110; 38 C.F.R. §§ 3.155, 3.400. 2. The criteria for the assignment of an effective date of June 3, 2012, for the award of a TDIU have been met. 38 U.S.C. §§ 5101, 5107, 5110; 38 C.F.R. §§ 3.155, 3.400(b)(2), 4.15, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served honorably in the U.S. Navy from July 1992 to March 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2014 rating decision issued by a Department of Veterans Affairs Agency of Original Jurisdiction (AOJ), which granted an increased evaluation from 50 percent to 70 percent for the Veteran’s service-connected acquired psychiatric disability, effective October 18, 2012, and granted a TDIU, also effective October 18, 2012. The Veteran’s VA Form 9 indicates that he did not request a Board hearing. In June 2018, the Board remanded this appeal for further development, including the procurement of all outstanding VA treatment records, specifically, relevant VA treatment records from 2012 to 2014. To the extent that the directed VA treatment records have been obtained and associated with the Veteran’s claims file, the Board finds that substantial compliance with its remand directives has been accomplished. See Stegall v. West, 11 Vet. App. 268, 271 (1998); see also Dyment v. West, 13 Vet. App. 141, 146-47 (1999). 1. An effective date of June 3, 2012, for the award of an increased evaluation for the Veteran’s service-connected acquired psychiatric disability, to include panic disorder with agoraphobia, is granted. The Veteran contends that his service-connected acquired psychiatric disability, to include panic disorder with agoraphobia, warrants a 70 percent evaluation effective June 3, 2012, on the following grounds: (1) the Veteran submitted a claim for an increased evaluation on June 3, 2013; and (2) the evidence of record is sufficient to factually ascertain that, in the year prior to June 3, 2013, the Veteran’s service connected acquired psychiatric disability warranted a 70 percent evaluation, as it resulted in occupational and social impairment with deficiencies in most areas. Based upon the evidence of record as set forth below, the Board agrees and finds that the Veteran’s service-connected acquired psychiatric disability, to include panic disorder with agoraphobia, is entitled to an earlier effective date of June 3, 2012, one year prior to the date of his June 3, 2013, increased rating claim. Disability evaluations are determined by the application of the facts presented to VA’s Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. See 38 U.S.C. § 1155; 38 C.F.R. § § 3.321(a), 4.1. In evaluating the severity of a particular disability, it is essential to consider its history. See 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation; otherwise, the lower rating will be assigned. See Schafrath v. Derwinski, 1 Vet. App. 589, 592-93 (1991); 38 C.F.R. § 4.7. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is the primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). In determining the severity of a disability, the Board is required to consider the potential application of various other VA regulations, regardless of whether they were raised by the Veteran, as well as the entire history of the Veteran’s disability. See 38 C.F.R. § § 4.1, 4.2; see also Schafrath, 1 Vet. App. at 595. Separate evaluations may be assigned for separate periods of time, or staged, where factual findings show distinct time periods during which the Veteran’s disability exhibits symptoms that warrant the application of different ratings. See Fenderson v. West, 12 Vet. App. 119, 126-28 (1999); see also Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007). Once the evidence has been assembled in the record, the Board shall consider all competent lay and medical evidence of record, analyze the credibility and probative value of the evidence, and provide reasons for rejecting any favorable material evidence. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996); 38 U.S.C. § 7104(a). In addressing lay evidence and determining its probative value, the Board must assess both its competency, a legal concept determining whether testimony may be heard and considered, and its credibility, a factual determination regarding its probative value. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Board shall afford the claimant the benefit of the doubt, see 38 U.S.C. § 5107; 38 C.F.R. § § 3.102, 4.3, and where the evidence is in relative equipoise, the claimant shall prevail. See Gilbert v. Derwinski, 1 Vet. App. 49, 53-54 (1990). The preponderance of the evidence must weigh against the claim in order to warrant its denial. See Alemany, 9 Vet. App. at 519-20. The VA General Rating Schedule for mental disorders, including panic disorder with agoraphobia, provides as follows: A 10 percent rating contemplates occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. See id. A 30 percent rating contemplates occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). See id. A 50 percent rating contemplates 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; impaired judgment; impaired abstract thinking; disturbance of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. See id. A 70 percent evaluation contemplates 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 worklike setting); and inability to establish and maintain effective relationships. See id. A 100 percent evaluation contemplates 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; and memory loss for names of close relatives, own occupation, or own name. See id. The VA Secretary recently amended the portion of the Schedule for Rating Disabilities dealing with psychiatric disorders and the associated regulations to remove outdated references to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and replaced them with references to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). The DSM-V eliminated the DSM-IV’s reliance upon GAF scores, and accordingly, the Board will no longer afford GAF scores any probative value. See Golden v. Shulkin, 29 Vet. App. 221, 224-25 (2018). Evaluation under § 4.130 is symptom-driven; therefore, symptomatology should be the primary focus when assigning a rating to a given mental health disability, and the frequency, severity, and duration of a veteran’s symptoms must play an important role in determining the appropriate disability rating. See Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013). Significantly, the list of symptoms under the rating criteria is meant to be illustrative, not exhaustive; thus, the Board need not find all or even some of the listed symptoms in order to award a specific disability rating. See Mauerhan v. Principi, 16 Vet. App. 436, 442-43 (2002). In fact, it is the level of the veteran’s occupational and social impairment that determines the appropriate disability rating under Section 4.130; accordingly, if the evidence of record demonstrates that the veteran suffers from symptoms listed in the rating criteria or symptoms of a similar severity, frequency, and duration that cause occupational or social impairment equivalent to the criteria for a particular rating, then the corresponding rating shall be assigned. See id. at 443; see also Vazquez-Claudio, 713 F.3d at 117. In addition to the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran’s capacity for adjustment during periods of remission must also be considered, and the evaluation must rest upon all the evidence relating to occupational and social impairment, not solely the examiner’s assessment of the level of disability at the moment of the examination. See 38 C.F.R. § 4.126(a). Further, when evaluating the level of disability for a mental disorder, the extent of social impairment must be considered, but the evaluation shall not be assigned solely on the basis of social impairment. See 38 C.F.R. § 4.126(b). The effective date of an award of increased compensation shall be the earliest date as of which it is factually ascertainable based on all evidence of record that an increase in disability occurred, if the increased rating claim is received within one year from such date. See 38 U.S.C. § 5110(b)(3); 38 C.F.R. § 3.400(o)(2). In this case, an April 2002 rating decision awarded the Veteran service connection for his acquired psychiatric disability, to include panic disorder and agoraphobia, and assigned a 30 percent evaluation under Diagnostic Code 9499-9413, effective March 6, 2002, the date of his discharge from the U.S. Navy. See 38 C.F.R. §§ 3.400(b)(2), 4.130. Subsequently, a March 2005 rating decision granted an increased evaluation of 50 percent, effective January 14, 2005, in response to which the Veteran filed his June 3, 2013 notice of disagreement and claim for increased rating. A January 2014 rating decision awarded the Veteran a 70 percent evaluation, effective October 18, 2012, in response to which the Veteran filed his February 2015 notice of disagreement and claim for an earlier effective date of June 3, 2012. The Veteran contends he is entitled to an earlier effective date of June 3, 2012, one year prior to the date of his June 3, 2013, increased rating claim. As the Veteran does not contend that he filed a claim for an increased rating in excess of 50 percent any earlier than June 3, 2013, the sole issue on appeal therefore involves whether it is factually ascertainable based upon all the evidence of record that an increase in disability occurred during the year prior to the Veteran’s submission of his June 3, 2013, increased rating claim; i.e., whether the evidence of record supports a finding that the Veteran’s service-connected acquired psychiatric disability was more than 50 percent disabling as early as June 3, 2012. See 38 U.S.C. § 5110(b)(3); 38 C.F.R. §§ 3.400(o)(2); 4.30. The Veteran’s service treatment records (STRs) reflect that he was discharged from the U.S. Navy in March 2002 due to his in-service diagnosis of panic disorder with agoraphobia and the findings of a medical evaluation board that his psychiatric condition rendered him unfit for duty. The Veteran’s STRs further document his in-service psychiatric treatment, including prescription medication to treat his recurrent anxiety and panic attacks. Post-service, the Veteran’s VA treatment records document his continued psychiatric symptomatology, including a June 2004 VA treatment note reflecting that the Veteran continued to suffer from panic attacks, was receiving treatment from his VA psychiatrist, was separated from his spouse, and was living in a homeless shelter. April 2011 VA treatment records authored by a VA psychiatrist (Dr. F) indicate that the Veteran had been twice divorced, was unemployed, and was continuing his psychiatric treatment at VA, including the continuation of his anti-anxiety prescription medication. Dr. F further noted that the Veteran reported that his children had recently been removed from his home due to its lack of cleanliness, which the Veteran attributed to his low energy. VA psychiatric treatment records dated May 2012 authored by Dr. F indicate that the Veteran continued to be unemployed and stressed due to financial problems and was at that point living with his ex-girlfriend. The Board notes that in February 2005, the Veteran was afforded a VA psychiatric examination, which culminated in a report finding that the Veteran continued to suffer from panic disorder with agoraphobia manifesting in panic attacks that occur once or twice per week and last a few hours at a time despite his continued anti anxiety medication. The Veteran described the panic attacks as causing a strong sensation of fear in his body, difficulty swallowing and breathing, and tingling in the hands and face, and reported that he continues to be agoraphobic, worrying that if he leaves his home, he will suffer another panic attack. Consequently, the Veteran reported that he has greatly reduced his activities outside the home, which results in interference with his ability to work on a regular basis. In fact, his 2005 employment at a fast food restaurant had been negatively impacted by his psychiatric condition as he continued to miss work due to his agoraphobia, and his hours had subsequently been reduced to 20 hours per week. The February 2005 VA examination report further indicated that the Veteran was separated from his wife, and that the Veteran had been living in homeless shelters with his four young children for the prior 18 months. The February 2005 VA examination also indicated that the Veteran’s social abilities have been significantly diminished as he does not socialize with friends, he avoids large crowds, his family is not understanding, and he is not able to visit them due to heightened anxiety associated with travel. In November 2013, the Veteran was afforded another VA psychiatric examination, which culminated in a report finding that the Veteran’s panic attacks have worsened over the years, and that he currently has panic attacks anytime he leaves the house. The Veteran reported that he will only leave the house for an appointment, that he has to sufficiently medicate himself before leaving the house, and that if he has an appointment or other commitment scheduled, his anxiety starts increasing about four to five days in advance, manifesting in vomiting, shaking, and fears of dying. The Veteran further reported that his panic attacks last the entire time he is outside of the house, and that he has had suicidal thoughts, but no suicide attempts or active suicidal ideation. The Veteran further reported to the November 2013 VA examiner that he lives with his ex-girlfriend and their children, and that his relationship with his children is negatively impacted by his psychiatric condition, to include being homebound, as he cannot leave the house with them to take them places or participate in many aspects of their lives. The Veteran further reported that he does not have people who visit him, and that he spends most of his free time sleeping. The November 2013 VA report further indicates that the Veteran had not been employed since October 2008, when he was employed as an usher at a professional baseball park. The Veteran reported that he was eventually fired from that position because he missed too many days of work, approximately 4 to 5 days per month, due to his escalating anxiety and agoraphobia. The November 2013 VA report further found the Veteran to be suffering from the following psychiatric symptoms: depressed mood; anxiety; panic attacks more than once a week; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships; difficulty in adapting to stressful circumstances, including work or a worklike setting; and an inability to establish and maintain effective relationships. Regarding the Veteran’s employability, the November 2013 VA report concluded that the Veteran would “clearly” have “difficulty with gaining and retaining significant employment,” because his panic attacks inhibit his ability to leave the house, he can only endure leaving the house after taking medications, and he is extremely anxious until he returns home. The November 2013 VA Report further found that due to his panic attacks, the Veteran would not serve in any position that is located outside the home, noting that he lost his last job from missing too many days of work due to anxiety, and that he also suffers from impaired concentration and low energy. The October 2012 VA psychiatric treatment records, which serve as the basis for the October 18, 2012, effective date assigned by the January 2014 rating decision, reflect the Veteran’s report to Dr. F that he is still not able to work, he is still having anxiety and panic attacks when he tries to leave home, that he had a severe panic attack when leaving for the instant appointment with Dr. F, that he became nauseated at the thought of leaving home for his VA appointment, and that he rarely ever leaves his house. Dr. F noted that the Veteran continues to be “very symptomatic, and actually appears worse,” as he “can almost never leave his house.” The January 2014 rating decision awarding an increased evaluation of 70 percent found that Dr. F’s October 18, 2012 treatment notes supported such an award due Dr. F’s finding that the Veteran was “almost never able to leave [his] home due to worsening of [his panic disorder and agoraphobia],” and that he suffered from the following psychiatric symptoms: (1) near-continuous panic affecting the ability to function independently, appropriately and effectively; (2) flattened affect; (3) anxiety; (4) difficulty in adapting to work; (5) difficulty in adapting to a work-like setting; and (6) difficulty in adapting to stressful circumstances. The Board finds the conclusions of both Dr. F and the November 2013 VA examination report to be both competent and credible to the extent that they each evaluate the severity of the Veteran’s service-connected acquired psychiatric disability. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303-304 (2008); see also 38 C.F.R. § 3.159(a). In addition, although the record is silent for specific treatment notes during the period from June 3, 2012 to October 18, 2012, the Board further finds that due to the history and nature of the Veteran’s disability, the competent evidence of record supports a finding that his panic disorder and agoraphobia manifested symptoms during this period that more closely approximate a 70 percent evaluation, resulting in occupational and social impairment with deficiencies in most areas, such as work, family relations, judgment, thinking, and mood. As grounds, the Board finds that the evidence of record reflects that the Veteran continuously suffered from an inability to leave his home caused by the symptoms of his panic disorder and agoraphobia, manifesting in a near-continuous panic and resulting in his continued unemployment, intermittent homelessness, and impaired relationships with his spouses, girlfriends, children, and family. Moreover, based upon the entirety of the evidence of record and the decades-long history of the Veteran’s well-documented panic disorder and agoraphobia, the Board finds that the near-continuous panic noted by Dr. F in October 2012 and cited by the January 2014 rating decision as grounds for a 70 percent evaluation does not appear to have developed overnight, and further finds it entirely reasonable to conclude that the same level of panic and psychiatric symptoms would have manifested just four months earlier, in June 2012, preventing him from leaving the house without suffering a severe panic attack. Accordingly, in light of the foregoing, including the consistency of the Veteran’s symptoms, the relatively short period of time that passed between the commencement of the period on appeal in June 2012 and Dr. F’s October 2012 VA treatment note, and resolving all reasonable doubt in favor of the Veteran, the Board finds that Veteran’s acquired psychiatric disability resulted in occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood in the year prior to the receipt of his increased rating claim on June 3, 2013. Therefore, the Board hereby grants an effective date of June 3, 2012, for the Veteran’s 70 percent evaluation of his service-connected acquired psychiatric disability. See Gilbert, 1 Vet. App. at 55 56. 2. An effective date of June 3, 2012, for the award of a TDIU is granted. The Veteran also contends that his TDIU award warrants an effective date of June 3, 2012, on the following grounds: (1) the record contains evidence sufficient to factually ascertain that as of June 3, 2012, the Veteran was in receipt of two service-connected disabilities, with one disability ratable at 70 percent, and a combined rating of 70 percent; and (2) the record contains evidence sufficient to factually ascertain that as of June 3, 2012, the Veteran’s service-connected acquired psychiatric disability resulted in the Veteran’s inability to secure or to follow a substantially gainful occupation. Based upon the evidence of record as set forth below, the Board agrees and finds that the Veteran’s TDIU award is entitled to an earlier effective date of June 3, 2012, one year prior to the date of his June 3, 2013, increased rating claim. For purposes of assigning an effective date, generally, the award of TDIU is an award of increased disability compensation; therefore, the same analysis applies: if an increase in disability occurred within one year prior to the date of increased rating claim, then the increase is effective as of the date the increase was factually ascertainable. See Wood v. Derwinski, 1 Vet. App. 367, 369 (1991); 38 U.S.C. § 5110(b)(2); 38 C.F.R. § 3.400(o). Where a veteran’s schedular rating has been evaluated at less than 100 percent, total disability ratings for compensation may be assigned when the disabled person is, in the judgment of the rating agency, unable to secure or to follow a substantially gainful occupation as a result of one or more service-connected disabilities and without regard to advancing age or any nonservice-connected disabilities. See 38 C.F.R. §§ 3.340, 3.341(a), 4.16(a). The determination concerning unemployability must be made on the basis of service-connected disabilities alone; nonservice-connected disabilities must be disregarded. See Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). Even where the record contains evidence that a veteran’s unemployability is a result of other nonservice-connected factors such as age or nonservice-connected conditions, a finding must still be made, without regard to the nonservice-connected conditions, as to whether the veteran’s service-connected disabilities are sufficiently incapacitating as to render him unemployable. See id. The veteran’s service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue must be considered. See 38 C.F.R. § 4.16(b). Total disability will be considered to exist where there is any impairment of mind or body which is sufficient to render it impossible for the average person to secure or to follow a substantially gainful occupation. See 38 C.F.R. § 4.15. While the rating is based primarily upon the average impairment of earning capacity, full consideration must be given to unusual physical or mental effects in individual cases, to peculiar effects of occupational activities, to defects in physical or mental endowment preventing the usual amount of success in overcoming the handicap of disability, and to the effect of combinations of disability. See id. Substantially gainful employment is defined as work which is more than marginal and which permits the individual to earn a living wage. See 38 C.F.R. § 4.16(a); see also Moore v. Derwinski, 1 Vet. App. 356, 358-59 (1991). The ability to work only a few hours a day or only sporadically does not qualify as an ability to engage in substantially gainful employment. See id. Marginal employment shall generally be deemed to exist when a veteran’s earned income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. See 38 C.F.R. § 4.16(a). Marginal employment may also be established, on a facts found basis, when earned annual income exceeds the poverty threshold, including but not limited to employment in a protected environment such as a family business or sheltered workshop. See id. Consideration must be given in all claims to the nature of the employment and the reason for termination. See id. Certain percentage requirements must be satisfied in order to qualify for schedular consideration of entitlement to TDIU. Specifically, if unemployability is the result of only one service-connected disability, this disability must be ratable at 60 percent or more. See 38 C.F.R. § 4.16(a). If it is the result of two or more service-connected disabilities, at least one must be ratable at 40 percent or more, with the other disabilities sufficient to bring the combined rating to 70 percent or more. See id. The existence or degree of nonservice-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the veteran unemployable. See id. In this case, as noted above, the November 2013 VA examination report indicated that the Veteran reported he has been unemployed since October 2008, because he was unable to leave his home due to the symptoms of his service-connected acquired psychiatric disability and agoraphobia. The Veteran further reported that he previously worked as an usher for a professional baseball park and for a fast food restaurant, and that he was ultimately fired from that position because he missed too many days of work, approximately 4 to 5 days per month, due to his escalating anxiety and agoraphobia. The November 2013 VA report concluded that the Veteran would “clearly” have “difficulty with gaining and retaining significant employment,” because his panic attacks inhibit his ability to leave the house, he can only endure leaving the house after taking medications, and he is extremely anxious until he returns home. The November 2013 VA Report further found that due to his panic attacks, the Veteran would not serve in any position that is located outside the home, noting that he lost his last job from missing too many days of work due to anxiety, and that he also suffers from impaired concentration and low energy. Dr. F’s October 2012 VA treatment records also support these findings, noting that the Veteran was not able to work due to anxiety and panic attacks when he tries to leave home, and that he “can almost never leave his house.” As set forth above, the Board has herein granted an effective date of June 3, 2012, for the Veteran’s 70 percent evaluation of his service-connected acquired psychiatric disability; therefore, the Veteran met the schedular requirements for a TDIU as of June 3, 2012. In addition, the Board finds the conclusions of both Dr. F and the November 2013 VA examination report to be both competent and credible to the extent that they each evaluate the Veteran’s occupational impairment and, therefore, entitled to significant probative weight as to the impact of the Veteran’s service-connected acquired psychiatric disability on his economic adaptability. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303-304 (2008); see also 38 C.F.R. § 3.159(a). In addition, the Board finds that the severity of the Veteran’s service-connected acquired psychiatric disability, to include panic disorder and agoraphobia, which results in difficulty adapting to stress or to leave his home, results in a level of impairment that prevents the Veteran from securing or following substantially gainful employment. See 38 C.F.R. § 4.16(b). Accordingly, in light of the evidence reflecting that the Veteran has been unable to obtain or maintain substantially gainful employment from June 3, 2012, to October 18, 2012, and given the medical evidence reflecting that his sustained unemployment during such period is the result of the manifestations of his service connected acquired psychiatric disability, the Board finds that, resolving all reasonable doubt in the Veteran’s favor, an effective date of June 3, 2012 is warranted for the award of the Veteran’s TDIU. See Gilbert, 1 Vet. App. 49, 55. E. Blowers Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board H. Marsdale The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.