Citation Nr: 20042425 Decision Date: 06/23/20 Archive Date: 06/23/20 DOCKET NO. 15-28 880 DATE: June 23, 2020 ORDER Beginning December 14, 2010, entitlement to an initial disability rating in excess of 20 for pseudoseizures associated with service-connected posttraumatic stress disorder (PTSD) is denied. Beginning December 14, 2010, entitlement to a disability rating in excess of 70 percent for service-connected PTSD is denied. REMAND Entitlement to an effective date earlier than February 2, 2011, for the award of a total disability rating based on individual unemployability (TDIU) is remanded. FINDINGS OF FACT 1. Beginning December 14, 2010, the Veteran’s pseudoseizures do not average at least one major seizure in the last six months or two in the last year; or averaging at least five–eight minor seizures weekly. 2. Beginning December 14, 2010, the Veteran’s service-connected PTSD more closely approximates occupational and social impairment in most areas. CONCLUSIONS OF LAW 1. Beginning December 14, 2010, the criteria for entitlement to an initial disability rating in excess of 20 for pseudoseizures associated with service-connected PTSD have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.10, 4.124a, Diagnostic Code (DC) 8914. 2. Beginning December 14, 2010, the criteria for entitlement to a disability rating in excess of 70 percent for service-connected PTSD have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.10, 4.130, DC 9411. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1996 to March 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. In a December 2011 rating decision, VA awarded service connection for PTSD, assigning a disability rating of 30 percent effective December 14, 2010; the Veteran was denied service connection for a seizure disorder. The August 2013 decision on appeal increased the Veteran’s PTSD rating to 50 percent effective March 12, 2012, and denied entitlement to TDIU. The Veteran timely appealed the effective date and evaluation of his PTSD and entitlement to TDIU. The Board then awarded the Veteran a 70 percent disability rating for the entire period on appeal (beginning December 14, 2010), and granted TDIU and special monthly compensation (SMC) under 38 U.S.C. § 1114(s) effective May 20, 2011. See May 19, 2017, Board Decision at 19 (“Decision I”). The Veteran appealed that determination to the United States Court of Appeals for Veterans Claims (Court). The Veteran and the Office of the General Counsel for VA (OGC) (collectively referred to as “the Parties”) resolved that appeal by way of a Joint Motion for Partial Remand (JMPR). First, the Parties agreed that the Board failed to provide an adequate statement of reasons and bases for finding that the Veteran was not entitled to (1) a schedular disability in excess of 70 percent for service-connected PTSD with pseudoseizures (as it was then rated), a separate rating altogether for pseudoseizures, an extraschedular rating for PTSD with pseudoseizures, or SMC under 38 U.S.C. § 1114(l) for regular aid and attendance; (2)an effective date earlier than December 14, 2010, for the grant of service connection for PTSD with pseudoseizures; and (3) an effective date earlier than May 20, 2011, for both the award of SMC under 38 U.S.C. § 1114(s) and TDIU. See March 1, 2018, JMPR at 1–2 (JMPR I). To the first issue, the Board was required, after considering the Veteran’s seizure symptoms, to assess whether a rating in excess of 70 percent, an extraschedular rating, or separate rating is warranted. The Parties specifically noted that the Board failed to discuss Social Security Administration (SSA) records and statement from the Veteran’s spouse in June 2011 and July 2012. To the second issue, the Parties agreed that the Board, in its conclusion that the evidence was at least in equipoise as to whether the Veteran’s pseudoseizures were symptoms associated with his service-connected PTSD disability, failed to consider Clemons v. Shinseki, 23 Vet. App. 1 (2009), as the Veteran previously filed a claim for service connection for seizures in February 2007, which were noted to be secondary to his PTSD. As to the issue of SMC at the (l) rate, the Parties concluded that the Board failed to address this issue as it reasonably was raised by the record from statements of the Veteran’s wife, which reflect that he cannot be left alone and that she takes care of all aspects of his life. For the TDIU issue, the Parties agreed that the Board improperly determined May 20, 2011, as the effective date because that was the last day the Veteran reported working at Lowe’s. That same evidence, however, indicated that the Veteran was earning $700 per month, which was below the poverty threshold for a single person under the age of 65 in 2011, that he lost six working days due to illness during that period, and that he believed he had been let go as a result of his pseudoseizures. Additionally, a July 2011 SSA disability report reflected that, since 2007, the Veteran’s PTSD caused him to lose his last three jobs and that his terminations occurred shortly after he began to have seizures. Given this evidence, the Parties agree that the Board did not provide an adequate statement of reasons or bases when it chose May 20, 2011, as the effective date for the award of TDIU. For SMC at the (s) level, the Parties agreed that it was proper that both that issue and TDIU be remanded because they inextricably are intertwined with the PTSD and pseudoseizure issue. When the Board again took up these claims, it awarded (1) a separate 20 percent rating for pseudoseizures, (2) an effective date of December 14, 2010, for the separate rating for pseudoseizures, (3) denied a rating in excess of 70 percent for service-connected PTSD, (4) denied an effective date earlier than December 14, 2010, for PTSD, (5) awarded an effective date of February 2, 2011, for TDIU, and remanded (6) the issue of SMC for regular aid and attendance, and (7) an effective date earlier than May 20, 2011, for the award of SMC at the housebound rate. See August 2, 2018, Board Decision (Decision II). With respect to the remanded claims, VA still is in the process of scheduling the Veteran for an examination. Thus, those issues will be discussed in a future Board decision once VA substantially has complied with the Board’s directives. The Veteran appealed issues (1)–(5) to the Court. In a December 2019 Stipulated Agreement, the Veteran stated that he would withdrawal his appeals before the Court as to issues (2) and (4); in return, OGC agreed to award the Veteran an effective date of February 2, 2007, for both conditions. The Parties made no agreement as to the level of disability that would be assigned for those conditions, which would be matters for initial adjudication by the agency of original jurisdiction (AOJ). The Parties asked the Court to dismiss those appeals in the accompanying Joint Motion to Terminate the Appeal, in Part (JMPT). With respect to the remaining issues, the Parties filed another JMPR. The Parties agreed that the Board failed to comply substantially with the directives in JMPR I: i.e., the Board failed to discuss the June 2011 and July 2012 statements from the Veteran’s wife and the July 2011 SSA Disability Report. The Board also failed to discuss a December 2011 SSA assessment that recorded the Veteran’s report that he experiences seizures every day. See December 20, 2019, JMPR at 2–3 (JMPR II). By Order, dated January 8, 2020, the Court adopted the JMPT and JMPR II and vacated and remanded back to the Board issues (1), (3), and (5). It is against this back drop that the Board now addresses those issues. Disability evaluations are determined by the application of a schedule of ratings, which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Where there is a question as to which of two separate evaluations shall be applied, the higher evaluation will be assigned if the disability more closely approximates the criteria required for that particular rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Where the appeal arises from the original assignment of a disability evaluation following an award of service connection, the severity of the disability at issue is to be considered during the entire period from the initial assignment of the disability rating to the present time. Fenderson v. West, 12 Vet. App. 119, 126 (1999). While a veteran’s entire history is reviewed when assigning a disability rating, where service connection has already been established and an increase in the rating is at issue, it is the present level of disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55 (1994). In determining the present level of a disability for any increased rating claim, the Board must consider the application of staged ratings. Hart v. Mansfield, 21 Vet. App. 505, 509 (2007). In other words, where the evidence contains factual findings that demonstrate distinct time periods in which the service-connected disability exhibited diverse symptoms meeting the criteria for different ratings during the course of the appeal, the assignment of staged ratings is necessary. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability, such doubt will be resolved in favor of the veteran. 38 C.F.R. § 4.3. 1. Beginning December 14, 2010, entitlement to an initial disability rating in excess of 20 for pseudoseizures associated with service-connected PTSD is denied. Under the General Rating Formula for Major and Minor Epileptic Seizures, a 100 percent rating is warranted for averaging at least one major seizure per month over the last year. An 80 percent rating requires averaging at least one major seizure in three months over the last year; or more than ten minor seizures weekly. A 60 percent rating is warranted for averaging at least one major seizure in four months over the last year; or nine–ten minor seizures per week. A 40 percent rating requires at least one major seizure in the last six months or two in the last year; or averaging at least five–eight minor seizures weekly. A 20 percent rating is warranted for at least one major seizure in the last two years; or at least two minor seizures in the last six months. A 10 percent rating is awarded simply for having a confirmed diagnosis of epilepsy with a history of seizures. In June 2011 the Veteran submitted various lay statements. The Veteran’s coworker—C.V.—stated that, on three occasions, she witnessed the Veteran experience severe seizures whereby he lost consciousness and experienced paralysis in his face. The Veteran’s wife—J.M.— conveyed that the Veteran’s seizures last anywhere from a few minutes to twenty-four hours, causing the Veteran’s left side facial muscles to seize up; he also experiences intense ringing in his ears. The Veteran is unable to move or walk but still is cognizant of what occurs around him. The seizures leave the Veteran feeling depressed and achy. Due to his seizures, J.M. is required to take over most aspects of the marriage (household maintenance, paying bills, cooking, etc.). In his own statement, the Veteran articulated that his seizures started out occurring four–five times per week. The Veteran took six months off work and returned in October 2007 only to be terminated three weeks later. By 2008, seizures were occurring once–twice a week, but sometimes the Veteran would go weeks without a seizure. By August 2010, the seizures were more common and occurred both at work and home. The Veteran reported left facial drooping, smelling dirt and blood with every breath, experiencing an alkaline taste, and shaking. The Veteran was terminated from one job in February 2011 and another in June 2011, both due to seizures. In the July 2011 SSA disability report, the Veteran indicated that his PTSD has caused him to lose his last three jobs; all of which terminated shortly after he experienced seizures. The SSA records also reflect a report by Dr. H.B.; in that report, the Veteran stated that he experiences seizures “every day, maybe more.” A December 2011 VA examination report noted neurological examination of the Veteran and review of the claims file and recited the Veteran’s complaints and medical history. Symptoms included episodes of sudden loss of postural control, complete or partial loss of use of one or more extremities, random motor movements, perceptual illusions, speech disturbance, gait disturbance, tremors, and occasional falls. The Veteran also reported tasting blood and dirt during a pseudoseizure and left side facial drooping with left hand contraction. If the pseudoseizure is severe, the Veteran reported his entire body “locked up.” The most recent episode occurred on November 30, 2011. No tonic clonic activity was found. The examiner also indicated that the Veteran’s “seizure” symptoms were “not due to a true seizure disorder,” but were pseudoseizures due to a well-document conversion disorder as documented in mental health treatment notes. The Veteran’s pseudoseizures had been witnessed by his spouse and children at home. The Veteran required continuous medications to control his pseudoseizures. The examiner reported the Veteran did not have minor pure petit mal or akinetic type seizures or major seizures associated with tonic clonic convulsions. The examiner did find the Veteran experienced psychomotor seizures 0–4 times per week. The Veteran did not have a psychotic disorder, psychoneurotic disorder, or personality disorder associated with the pseudoseizures. No scars associated with the Veteran’s pseudoseizures were found. An August 2007 electroencephalography was normal, and no seizure activity was seen. In an April 2012 VA treatment record, the Veteran indicated that he had pseudoseizures about once a week when he was reminded of his traumas. The Veteran’s children (H.K. and D.M.) and J.M. assert, in July 2012 statements, that the unpredictability and frequency of the Veteran’s pseudoseizures require constant care. Specifically, the Veteran’s wife reported that the Veteran had frequent pseudoseizures when he was left alone, but he also had them when he went out with her, such as trips to the grocery store. J.M. asserted that the Veteran would have a pseudoseizure any time he could not see her, and that the Veteran could not be left alone. H.K. reported that the Veteran once had a pseudoseizure in the pool when H.K. was twelve years old, requiring him to jump in to prevent his father from drowning. D.M. reiterated that the Veteran lost his previous jobs due to his seizure disorder. In a July 2013 VA PTSD examination, Veteran reported that he was fired, due to his pseudoseizures, from Lowe’s in June 2011 after working for three months. He also reported that his pseudoseizures had increased to the point that he was frequently unable to leave his house. Even considering the evidence highlighted by JMPR I and previously overlooked by the Board, the Board still finds that, beginning December 14, 2010, a disability rating in excess of 20 percent, and no higher, is appropriate for the Veteran’s pseudoseizure disorder. The Board notes that the Veteran, J.M., H.K., and D.M. all are competent to discuss the Veteran’s symptoms of his pseudoseizures, as the Veteran experienced them, and as the others witnessed them. Their competency with respect to the frequency at which the Veteran experienced these seizures also is conceded. DC 8914 provides ratings based on the type and frequency of the seizures. Neither the June 2011 nor the July 2012 statement from J.M. comment on the frequency of the Veteran’s pseudoseizures. While she notes that the Veteran sometimes experiences pseudoseizures when he accompanies her to the supermarket or other outings, she does not indicate how often these outings occur. The Veteran’s children likewise do not comment on the frequency at which the Veteran experiences his pseudoseizures. In his June 2011 statement, the Veteran implies that, by August 2010, his pseudoseizures were occurring more commonly than once–twice a week. While the record does contain a one-time report from the Veteran that he daily was experiencing pseudoseizures (December 2011 report from Dr. H.B. in the SSA records), this contention is contradicted by the other evidence of record. Statements received, both before and after Dr. H.B.’s report, by the Veteran and his family never mention that he daily was experiencing pseudoseizures. If that were the case, then surely that frequency would have been conveyed to the Board by someone other than the Veteran and certainly on more than one occasion. The Veteran himself, just four months later in the VAMC records, noted that his pseudoseizures occur about once a week. Furthermore, the December 2011 VA neurological examiner noted that the Veteran was experiencing pseudoseizures 0–4 times per week, which contradicts the Veteran’s assertions to Dr. H.B. that he daily was experiencing these seizures. Thus, the Board finds this one-time assertion to lack credibility and assigns it no probative value on appeal, assigning greater weight to the discussed medical and lay evidence. In sum, beginning December 14, 2010, the competent and credible evidence of record weighs in favor of the Veteran’s current 20 percent disability rating. There is no credible evidence of record to suggest that the Veteran experiences anything more than at least one major seizure in the last two years; or at least two minor seizures in the last six months. Thus, his appeal on this issue is denied. See 38 C.F.R. § 4.124a, DC 8419. 2. Beginning December 14, 2010, entitlement to a disability rating in excess of 70 percent for service-connected PTSD is denied. The Veteran argues that he is entitled to a total disability rating based solely on his service-connected PTSD. See June 13, 2018, Correspondence. For psychiatric disabilities, a 100 percent disability rating 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; memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130. A 70 percent rating is warranted for occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, 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 an 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 relationships. The list of symptoms under the rating criteria are meant to be examples of symptoms that would warrant a particular 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. Mauerhan v. Principi, 16 Vet. App. 436, 442–43 (2002). If the evidence shows that a veteran suffers symptoms or effects that cause occupational or social impairment equivalent to what would be caused by the symptoms listed in the criteria for a specific rating, the appropriate, equivalent rating will be assigned. Id. at 443. The rating code requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment at a level consistent with the assigned rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116–17 (Fed. Cir. 2013). Even if obvious, it is worth mentioning that, by virtue of the Board’s prior decision to assign a separate compensable rating for the Veteran’s pseudoseizures, the pseudoseizures may not be considered when evaluating the severity of, and appropriate rating for, the Veteran’s PTSD. Such action would constitute a violation of the rule against pyramiding. See 38 C.F.R. § 4.14. In her June 2011 statement, J.M. noted that the Veteran has severe anxiety that affects every aspect of his life; she also stated that the Veteran has no ability to concentrate or stay on task, has little memory of past events, and that his morals are affected. A November 2011 VA examination report noted mental examination of the Veteran and review of the claims file and recited the Veteran’s complaints and medical history. The examiner noted that the Veteran exhibited 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. The Veteran reported that he has a few friends with whom he talks on the phone and socializes via gatherings at his house; the Veteran also knows people at church. The Veteran and his wife enjoy shooting at ranges. It was noted that the Veteran denied suicide attempts but indicated “a few” physical altercations with people. The report indicates that the Veteran last worked in June 2010 where he had worked at Lowe’s for three months before being terminated due to his seizures. Current symptoms were noted to include anxiety and mild memory loss. The Veteran further indicated that his wife told him he had nightmares and some sleep disturbances. The examiner noted that the Veteran’s mood was dysthymic and mildly anxious. The Veteran denied suicidal or homicidal ideation, delusions, or perceptual distortion. In her July 2012 statement, J.M. indicated that the Veteran’s PTSD had spiraled out of control. The Veteran and his family no longer have fun outings together; the family walks on eggshells around the Veteran, and the Veteran continually is stressed over financial matters and his inability to provide for his family. J.M. reports an increase in the severity of the Veteran’s nightmares, which occur “all night long,” and result in him thrashing and crying out. The Veteran and J.M. no longer shoot at the range, as she keeps all the weapons locked away. The Veteran has contemplated suicide and expressed such ideation to J.M. but does not know how much longer he can “keep fighting.” A July 2012 VA examination report noted mental examination of the Veteran and review of the claims file and recited the Veteran’s complaints and medical history. The Veteran was diagnosed with PTSD and conversion disorder, and the examiner noted that the Veteran exhibited occupational and social impairment with reduced reliability and productivity. The examiner indicated that the PTSD symptoms were mild to moderate and could be differentiated from the conversion disorder, which include the pseudoseizures, as moderate to severe. The Veteran described his marriage as “wonderful” and the relationship with his children as “good”; he maintained a relationship with his parents but did not have contact with his half-siblings. The Veteran stated that he has one friend to whom he talks once or twice a month. There was no change to the description of the Veteran’s occupational history. Noted symptoms were depressed mood, anxiety, chronic sleep impairment, mild memory loss, disturbances in mood and motivation, and difficulty in establishing and maintaining effective work and social relationships. The Veteran was appropriately dressed, with good grooming and hygiene. He was oriented as to person, place, and time. His recall was good. The Veteran endorsed chronic moderate depressed mood. He reported occasional suicidal ideations. He experienced chronic sleep impairment, daytime fatigue, flashbacks, and nightmares every night. The Veteran felt irritable and secluded himself. The Veteran reported anxiety around other people and lately but inexplicably had been sucking his thumbs. The Veteran reported occasional audio and visual hallucinations of people yelling in Serbian when they are not. The overall PTSD symptoms alone were noted to be mild to moderate. An August 2013 VA examination report noted mental examination of the Veteran and review of the claims file and recited the Veteran’s complaints and medical history. The examiner confirmed a diagnosis of chronic, moderate PTSD and conversion disorder of moderate to serous impairment. The examiner noted that the Veteran exhibited occupational and social impairment with reduced reliability and productivity. The Veteran indicated that he continued to live with his wife and children. He denied having any friendships but maintained contact with his parents and occasionally attended family functions. There was no change to occupational history; however, if he were to be employed, the examiner stated that he would likely experience mild to moderate PTSD-related impairments relating to tolerating noise and groups of people. Noted symptoms were depressed mood, anxiety, panic attacks occurring weekly or less often, chronic sleep impairment, mild memory loss, flattened affect, disturbance of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. The Veteran also reported feeling emotionally “blank” and having a lot of aggression. He stated that he heard voices about once–twice a week and indicated that he sees a “group of people” that were related to one of his PTSD stressors. He reported staying in bed most of the day. VA treatment records, to include a June 2012 VA mental health note, reflects the Veteran’s report of occasional, transient suicidal thoughts. SSA records show that the Veteran was awarded disability benefits, effective June 10, 2011 for his anxiety and somatoform disorders. On a January 2012 SSA Psychiatric Review Technique report, a psychologist indicated that the Veteran had moderate to severe PTSD and conversion disorder. It was noted that the Veteran had “marked” difficulties in maintaining social functioning and “moderate” difficulty in activities of daily living and in maintaining concentration, persistence, and pace. A December 2011 psychiatric evaluation report from Dr. J.B. noted reports of nightmares, panic attacks, crying spells, and excessive hypervigilance. The Veteran also had racing thoughts and was unable to focus, with decreased attention span. In 2007, it was noted that the Veteran continued to be flooded with memories of his wartime experiences. He remained hypervigilant and socially withdrawn. The Veteran also previously had episodes of suicidal ideation without intent. Dr. J.B. noted that the Veteran’s medications caused drowsiness. Upon mental status examination, there were no difficulties in the Veteran’s receptive or expressive communication skills. His mood was moderately to severely depressed. He also was anxious and restless with some obsessive thinking. Dr. J.B. also indicated that the Veteran excessively slept but did attend church and had some friends. He also developed a hobby of painting guns. Dr. J.B. then opined that the Veteran would have “substantial difficulty performing most work-related tasks due to his psychiatric symptoms.” On a November 2011 Form SSA 3380-BK, the J.M. reported that the only social activity in which the Veteran participates is church but that he sits away from crowds. In sum, J.M. stated that the Veteran “no longer has a social life.” On a corresponding SSA Form SSA-3373-BK, the Veteran also reported that he attended church and stated that he “no longer socialize[s] with people outside of close family”; he used to be “outgoing and loved to be the center of attention.” Evaluating J.M.’s statements and the SSA evidence previously overlooked by the Board, in conjunction with the other evidence of record, the Board does not find that the Veteran’s service-connected PTSD alone manifests total occupational and social impairment. With respect to social functioning, the Board acknowledges that the evidence of record shows severe limitation in this area, but it is not total as the regulations require. The Veteran still interreacts with his close family and attends church. The medical evidence of record all noted that the Veteran has difficulty in maintaining or establishing relationships, but this does not mean that the Veteran has no social interaction whatsoever. Even assuming, for the sake of the argument, that the Veteran does experience total social impairment, it cannot be said that his PTSD alone causes total occupational impairment. The record is clear, even by the Veteran’s own account, that his loss of employment and inability to secure future employment stemmed/stems from his seizure disorder—a condition for which he now separately is compensated. Thus, as noted, it would be error to attribute the Veteran’s inability to work solely due to his PTSD. As the August 2013 examiner noted, if evaluating just the Veteran’s PTSD symptoms, then Veteran would experience mild to moderate impairments relating to tolerating noise and groups of people. Even noting Dr. J.B.’s opinion that the Veteran would have “substantial difficulty performing most work-related tasks due to his psychiatric symptoms,” the Board finds that such “substantial difficulty,” is not the same as a complete bar to being able to work, and that such “substantial difficulty” is contemplated and accounted for under the current 70 percent rating. Thus, the Board does not find that the Veteran experiences total occupational impairment attributable solely due to his service-connected PTSD. As such, it cannot be said that the Veteran’s service-connected PTSD manifests anything greater than occupational and social impairment in most areas, and his appeal on this issue is denied. See 38 C.F.R. § 4.130, DC 9411. REASONS FOR REMAND As part of the Stipulated Agreement, the Veteran is to be awarded an effective date of February 2, 2007, for both his pseudoseizures and his PTSD. OGC is to notify the Veterans Benefits Administration (VBA) of this agreement, and the AOJ is vested with the responsibility of assigning an evaluation from that date to December 14, 2010. VBA, however, has yet to assign the Veteran a rating for these conditions for that initial period. Thus, while the Veteran may have met the schedular criteria for consideration of TDIU as early as December 14, 2010, see 38 C.F.R. § 4.16(a), it is possible that, depending on VBA’s award, he could meet the schedular criteria much sooner. Thus, to afford the Veteran every possible avenue to maximize his benefits, the Board finds that determination of an earlier effective date for TDIU is inextricably intertwined with VBA’s adjudication of the issues contained in the Stipulated Agreement, requiring remand. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (the adjudication of claims that are inextricably intertwined is based upon the recognition that claims related to each other should not be subject to piecemeal decision-making or appellate litigation); 38 C.F.R. § 20.904(a). The matter is REMANDED for the following action: 1. After, and only after, VBA assigns disability ratings for the Veteran’s pseudoseizures and PTSD, beginning February 2, 2007, to December 14, 2010, readjudicate the Veteran’s appeal for an effective date earlier than February 2, 2011, for the award of TDIU. 2. Conduct any other development deemed necessary and then readjudicate the Veteran’s claim. If the claim cannot be granted in full, then issue to the Veteran a supplemental statement of the case. After allowing an appropriate amount of time for response from the Veteran, return the claim to the Board. The Veteran has the right to submit additional evidence and argument on the matter that the Board has remanded. See Kutscherousky v. West, 12 Vet. App. 369, 372 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded for additional development or other appropriate action by the Board or the Court must be handled in an expeditious manner. 38 U.S.C. §§ 5109B, 7112. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Trevor T. Bernard, Associate Counsel 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.