Citation Nr: 21003568 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 16-16 128 DATE: January 22, 2021 ORDER Entitlement to a total disability individual unemployability (TDIU) rating based on service-connected disabilities is granted. FINDING OF FACT The Veteran’s service-connected disabilities have rendered him unable to secure or maintain a substantially gainful occupation. CONCLUSION OF LAW The criteria for entitlement to TDIU have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 4.16(a). (CONTINUED NEXT PAGE)   REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1969 to May 1971. This matter comes to the Board of Veterans’ Appeals (Board) from a rating decision of a Department of Veterans’ Affairs (VA) Regional Office (RO). A videoconference hearing was held before the undersigned in June 2019. A transcript is of record. 1. Entitlement to a TDIU. On May 10, 2013, RO received the Veteran’s VA 21-8940, wherein he asserted unemployability due to his service-connected disabilities. Applicable regulations provide that where a Veteran is service connected for more than one disability, at least one of those disabilities must be evaluated at 40 percent or more, and the Veteran’s combined evaluation must be 70 percent or more. 38 C.F.R. § 4.16 (a). The record shows that throughout the period on appeal, the Veteran met schedular requirements for TDIU consideration. From May 10, 2012, the Veteran’s combined evaluation was 70 percent, predicated on a 50 percent rating for posttraumatic stress disorder (PTSD), 30 percent rating for ischemic heart disease, s/p bypass graft, 10 percent rating for tinnitus, and noncompensable ratings for a mid-scar chest and right ear hearing loss. Beginning on May 10, 2013, the Veteran’s ischemic heart disease rating was increased to 60 percent disabling and he received a 10 percent rating for a left leg scar. His combined disability evaluation from May 10, 2013 was 80 percent. 38 C.F.R. §§ 4.16, 4.25. After reviewing pertinent evidence of record, the Board finds that the Veteran’s service-connected disabilities render him unable to secure and follow a substantially gainful occupation. The Veteran has not worked since 2009. His last full-time employment was as a self-employed stock trader. As to education, he is in receipt of an MBA and he is a CPA. As to employability, the record contains an August 2019 positive opinion from a VA Readjustment Counseling Therapist. The therapist opined that the Veteran’s combined service-connected disabilities rendered him unemployable. As to psychiatric symptoms, the therapist described chronic symptomatology of hyperarousal, social isolation, hypervigilance, irritability, anger, anxiety, and repeated disturbing memories and dreams. He explained that these symptoms, specifically chronic anxiety, rendered the Veteran habitually overwhelmed when trying to complete tasks. This feeling of being overwhelmed caused the Veteran to consistently lose track of assignments and “crumble at the first sign of” stress while working. Moreover, his psychiatric symptomatology resulted in severely impaired short-term memory and limited ability to focus. The therapist then explained that the Veteran’s service-connected psychiatric disability is essentially intertwined with his heart disability. Specifically, as explained by the therapist, the Veteran is in constant risk of suffering a heart attack if overly stressed and his anxiety only aggravates the condition. Correspondingly, his heart condition worsens his psychiatric state because it leaves him feeling depressed, anxious, and hopeless. Based on the above, it was concluded that the Veteran’s collective impairments were so great that “he can no longer fulfill the basic job requirements expected of any employee.” The therapist acknowledged the Veteran’s extensive education, but emphasized that even with such education, employment was not possible as his “mental acuity [was] compromised from trauma of war and poor health.” Hr also specified that a “return to work at any level would be too stressful and place him at risk for another heart attack.” The 2019 opinion from the counseling therapist is highly probative. The opinion is also well rationalized upon in-person treatment and consideration of the evidence of record. Moreover, there is no competent opinion to the contrary which addresses the collective findings in that report. That said, the Board finds that a TDIU has been warranted for the entirety of the period on appeal as the Veteran’s overall disability picture remained the same. The 2019 opinion essentially confirmed that the Veteran’s impairing symptomatology was not new, but longstanding. In that regard, the therapist cited to a July 2010 lay report of the Veteran’s significant other, S.V., to document the chronic and persistently severe nature of his PTSD condition. In brief, S.V. provided a “firsthand” account, that the Veteran has always displayed symptomatology which was regularly “unpredictable and frightening.” Medical records throughout the appeal essentially confirm that the Veteran’s heart symptomatology was precarious. Accordingly, the Board concludes that the Veteran’s service-connected disabilities preclude have precluded him from finding and pursuing a substantially gainful occupation throughout the period on appeal. Entitlement to TDIU is granted. See 38 C.F.R. § 4.16. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. L. Burroughs, 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.