Citation Nr: 21004706 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 14-02 141 DATE: January 27, 2021 ORDER Entitlement to a rating in excess of 50 percent prior to November 14, 2013 and in excess of 30 percent from November 14, 2013 to April 20, 2017 for posttraumatic stress disorder (PTSD) is denied. Entitlement to a rating of 70 percent, but no higher, from April 20, 2017 to January 30, 2018 for PTSD is granted. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) prior to January 3, 2015 is denied. Entitlement to a TDIU from April 20, 2017 to January 30, 2018 is granted. REMANDED Entitlement to a TDIU from January 3, 2015 to April 20, 2017 is remanded. FINDINGS OF FACT 1. Prior to November 14, 2013, the evidence indicates that the Veteran’s PTSD manifested in nightmares, hyperarousal, anger, irritability, startled response, hypervigilance, distractibility, and fatigue resulting in moderate severity, and from November 14, 2013 to April 20, 2017, the Veteran’s PTSD manifested in depressed mood, anxiety, chronic sleep impairment, restricted affect, nightmares, irritability, mild memory loss, panic attacks, and suspiciousness resulting in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. 2. From April 20, 2017 to January 30, 2018, the evidence indicates that the Veteran’s PTSD symptoms manifested in passive suicidal ideation, persistent and exaggerated negative beliefs about oneself, others and the world, feeling irritable or having angry outbursts, trouble sleeping; difficulty concentrating; hypervigilance, exaggerated startle response which resulted in clinically significant distress and impairment in social and other important areas of functioning. 3. Prior to January 3, 2015, the evidence indicates that the Veteran maintained substantially gainful employment. 4. From April 20, 2017 to January 30, 2018, resolving reasonable doubt in favor of the Veteran, his service-connected PTSD prevented him from finding and following substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 50 percent prior to November 14, 2013, and in excess of 30 percent from November 14, 2013 to April 20, 2017 for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. 2. The criteria for a 70 percent rating, but no higher, from April 20, 2017 to January 30, 2018 for PTSD have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. 3. The criteria for a TDIU prior to January 3, 2015 have not been met. 38 U.S.C. § 7105 (d)(5); 38 C.F.R. § 4.16. 4. The criteria for a TDIU from April 20, 2017 to January 30, 2018 have been met. 38 U.S.C. § 7105 (d)(5); 38 C.F.R. § 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty in the United States Marine Corps from July 1966 to April 1969. In April 2017, the Veteran testified before the undersigned Veterans Law Judge at a Video Conference hearing. A copy of the transcript has been associated with the claims file. In October 2017, the Board remanded the appeal for further development. 1. A rating in excess of 50 percent prior to November 14, 2013 for PTSD 2. A rating in excess of 30 percent from November 14, 2013 to January 30, 2018 for PTSD The Veteran contends that his PTSD is such that a higher rating is warranted. At the outset, the Board notes that, in an April 2020 rating decision, the RO granted a 100 percent rating, effective January 30, 2018. As the Veteran has not been granted maximum benefits during the entire appeal period, the issue of higher ratings prior to January 30, 2018 remains before the Board. The Veteran has a 50 percent rating prior to November 14, 2013, and a 30 percent rating from November 30, 2013 to January 30, 2018. Under Diagnostic Code 9411, which is governed by a General Rating Formula for Mental Disorders (General Rating Formula), a 30 percent rating is warranted for 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). 38 C.F.R. § 4.130. A 50 percent rating is warranted for 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/or difficulty in establishing and maintaining effective work and social relationships. Id. A 70 percent rating is warranted for 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/or inability to establish and maintain effective relationships. Id. A 100 percent rating is warranted for 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; inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and/or 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. 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. Turning to the evidence, in a December 2010 VA examination, the Veteran reported he had been having recurrent nightmares for years, waking up yelling, screaming, and in cold sweats. He stated that the nightmares resulted in ongoing restless nights causing disrupted sleep. He further reported that he became a workaholic in order to deal with his trauma from Vietnam. He stated that this caused him to neglect his children. The Veteran reported symptoms of insomnia, nightmares, hyperarousal, anger, irritability, startle response, hypervigilance, distractibility, fatigue and tiredness. The Veteran reported constant, continuous and ongoing symptomology that was moderate in severity. The Veteran stated that his symptoms affected his total daily functioning which resulted in difficulties in his marital relationship due to irritability and being quick to anger. He also reported stress in relationships with authority figures at work. He further reported that he had become withdrawn from many recreational activities such as hunting and fishing. The Veteran denied a history of violent behavior. He also denied a history of suicide attempts. The Veteran stated that after leaving service, he worked in the mechanical field for forty years. He reported that his relationship with his supervisor was usually adequate, and his relationship with coworkers was good. He reported occasional issues with authority figures at work. He reported that he had not lost any time from work while performing this job. The Veteran stated that he is withdrawn most of the time and did not have much enthusiasm for recreational activity. He reported isolation from others, stating that he had no close friends and has most of his social support and activity with his wife. The examiner reported that the Veteran’s orientation was within normal limits, and his appearance and hygiene were appropriate. The examiner observed that the Veteran maintained good eye contact throughout the examination. The examiner noted that the Veteran’s affect and mood showed anxiety and depressed mood. The examiner further noted that the Veteran’s mood was distinctly anxious about having to recount his trauma experiences. The examiner observed that the Veteran’s communication and speech were within normal limits. The examiner noted that the Veteran showed impaired attention and/or focus. The examiner reported that the Veteran could have difficulties with distractibility when overcome with distressing memories. The examiner stated that the Veteran did not have a history of delusion or hallucination, and no delusion or hallucination was observed at the time of examination. The examiner stated that panic attacks and obsessive-compulsive behavior were absent, and no suspiciousness was present. The examiner also stated that the Veteran’s thought processes were appropriate, and his judgment was not impaired. The Veteran was able to understand directions. The examiner stated that the Veteran’s memory was mildly impaired, noting that he forgets names, directions and recent events. The examiner reported that due to distractibility, he is often forgetful of more recent events or conversations, but this did not impact his work performance. The examiner stated that suicidal ideation and homicidal ideation were absent. The examiner endorsed the following persistent symptoms of increased arousal: difficulty falling or staying asleep, difficulty concentrating, irritability or outbursts of anger, hypervigilance, and exaggerated startle response. The examiner reported that the duration of the disturbance is more than one month, and the disturbance causes distress or impairment in social, occupational, and other areas of functioning. The examiner remarked that the Veteran showed reasonable judgement and cognitive function to manage his own benefits. The examiner also noted that the Veteran did not have difficulty performing activities of daily living. The examiner summarized the Veteran’s occupational and social impairment as occupational and social impairment with decrease in work efficiency and intermittent inability to perform occupational tasks, although generally the person is functioning satisfactorily with routine behavior, self-care, and normal conversation due to symptoms such as irritability, chronic sleep impairment, and mild memory loss, such as forgetting names, directions, or recent events. The examiner reported that the Veteran is able to establish and maintain effective work, school, and social relationships. The examiner also reported that the Veteran is able to maintain effective family role functioning. The examiner stated that the Veteran has intermittent inability to perform recreation or leisurely pursuits because he withdraws from many activities that are fulfilling and rewarding due to either fatigue or physical problems. The examiner went on to remark that, based upon the examination, the Veteran needed to seek follow up treatment, but noted that he did not appear to pose any threat of danger or injury to self or others. In a February 2013 Notice of Disagreement, the Veteran stated that his condition had worsened since the 2010 examination. He reported that his nightmares had returned with sleep impairment. He also stated that the sounds of the war along with the smells have returned. He further stated that his anger had returned, affecting his home and work life. He noted that he found himself depressed three to four times a week and having terrible mood swings. He noted that he wakes in cold sweats and doesn’t get much sleep anymore. He reported that he and his wife argue because he can’t remember the chores that she asked him to do. In a November 2013 VA examination, the Veteran reported a good relationship with his parents, siblings, and children. He also reported a good relationship with his wife, though they sleep separately due to his sleep impairment. The Veteran noted that his history of bouts of angry outbursts tempered his relationship with her. He also stated that his demeanor had an adverse impact on his children, noting that his inclination to escape emotional issues through personal immersion in work and emotional disengagement contributed to a pattern of social maladjustment reflected in criminal behavior and drug use. The Veteran reported that when he is not working, he spends time at home with his wife in conversation and watching tv. He also reported enjoyment of outdoor activities where he can spend time alone in the woods. He stated that during hunting season, he goes out with friends to hunt. The Veteran noted that he was thinking about retirement from the shipyard because of ease of irritability and anger has ceased to be a problem at home and sometimes crops up as an issue in the workplace. He noted, however, that he was reluctant to retire due to uncertainty about the course of his life in the future. The examiner reported symptoms of depressed mood, anxiety, chronic sleep impairment, restricted affect, nightmares, and irritability. The examiner summarized the Veteran’s occupational and social impairment as 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 medication. In an April 2017 Board hearing, the Veteran reported that his symptoms remained the same between his 2010 examination and his 2013 examination. He stated that he had insomnia, bad nightmares, hyperarousal, anger and irritability, heightened startle responses, hypervigilance, distractibility, fatigue, and tiredness. He reported that the only thing that changed was his wife stopped sleeping in their room due to his movement during his nightmares. The Veteran, through his attorney, asserted that the 2013 examination missed several symptoms, including mild memory loss, panic attacks, suspiciousness, and impaired impulse control. The Veteran also stated that his 2013 examination was shortened due to the examiner arriving late. The Veteran went on to state that he retired in January 2015 due to his PTSD. He reported that he probably would have been fired due to his anger issues and problems with senior management. In an April 20, 2017 VA psychology note, the Veteran reported by referral for treatment of anxiety, PTSD, and depression. The Veteran stated that when he was working, he was able to suppress the severity of symptoms, but since retiring two years prior, he has had an increase in symptoms. The Veteran endorsed symptoms of distressing nightmares occurring nightly, sleep avoidance, hypervigilance, hyperarousal, flashbacks, intrusive distressing memories, avoidance of people and reminders, feeling disconnected, depressed mood, hopelessness, agitation, frequent tearfulness, excessive worry, and being on edge. The Veteran further endorsed passive thoughts of death, though the examiner noted that he denied any suicidal ideation, plan, intent, or attempts, stating that his family (especially his wife) is his primary protective factor. The examiner reported that the Veteran has firearms and declined limiting access as he stated they are there for home protection. The examiner noted that the Veteran denied any thoughts of using firearms on himself or others. The examiner observed the Veteran’s appearance was neat, well-groomed and casually dressed. The examiner stated that the Veteran’s mood and affect were consistent with subjective report, noting frequent tearfulness and depressed and anxious mood. The examiner stated that the Veteran’s speech was logical, coherent, fluent and well-organized. The examiner also reported that the Veteran’s recent and remote memory appeared intact. The examiner further reported that the Veteran was oriented x3 and his thought processes were organized with no loose associations or flight of ideas. The examiner stated that there was no evidence of hallucinations, delusions, or distorted ideation. The examiner noted that the Veteran endorsed hopelessness and nihilistic thinking but denied any suicidal ideation, plan, or intent. The examiner stated that the Veteran had adequate impulse control and appropriate judgment and insight. In an April 28, 2017 VA record, the Veteran reported for a comprehensive mental health evaluation. The Veteran reported intrusive thoughts, flashbacks and memories. He also stated that he avoided public places. The Veteran noted that he avoided military media but occasionally forced himself to watch shows about Vietnam. The Veteran reported increased anxiety when it becomes dark and sleep avoidance to prevent nightmares. The Veteran stated that when he walks in the woods, he often sees North Vietnamese soldiers and dead Marines and hears sounds of battle. The Veteran described both images and sounds as a way of getting pulled into flashbacks. The examiner noted that the evaluation revealed very severe symptoms were supported. The Veteran went on to report depressed mood and little interest or pleasure in activities most of the day nearly every day for several years. The Veteran stated that he experienced fatigue, insomnia, and at times, hypersomnia during the day, low self-esteem, poor concentration and feelings of hopelessness. The examiner noted that the Veteran was appropriately dressed and groomed. The examiner noted that the Veteran was cooperative. The examiner observed that the Veteran’s eye contact was consistent and appropriate. The examiner also observed that the Veteran’s speech was of normal rate, rhythm, volume, and spontaneity. The Veteran’s mood and affect were depressed and anxious. The examiner noted that the Veteran was agitated at times during the interview. His flow of thought was coherent, and his thought content revealed feelings of irritability while talking about his experiences in Vietnam. The examiner stated that there were no indications of hallucinations, delusions, or perceptual disturbance other than related to his PTSD. This examiner remarked that the Veteran did not appear manic. The examiner reported that the Veteran admitted to past moments of passive suicidal ideation, (usually immediately after having a nightmare) that have occurred for several years but denied current ideation, active plans, or intent to self-harm. Moreover, the examiner noted that the Veteran denied prior suicide attempts. The examiner remarked that the Veteran’s orientation was good, noting that the Veteran knew the current date, place, and person. The examiner also noted that the Veteran’s recent and remote memory appeared good. The examiner stated that the Veteran showed adequate insight and judgment regarding his present situation and illness and need for help. The examiner stated that the violence risk screening did not show increased risk of violence toward another person. The examiner reported that the Veteran endorsed symptoms of persistent and exaggerated negative beliefs about oneself, others and the world, persistent and distorted cognitions about the causes and consequences of the traumatic events that led him to blame himself, persistent negative emotional state, feeling distant and detached, feeling irritable or having angry out bursts, trouble sleeping; difficulty concentrating; hypervigilance, exaggerated startle response, depressed mood, and loss of interest and pleasure in activities, fatigue, periods of insomnia and hypersomnia during the day, low self-esteem, poor concentration, and feelings of hopelessness. The examiner stated that the Veteran’s symptoms have endured longer than one month and cause clinically significant distress and impairment in social and other important areas of functioning. The examiner stated that the Veteran did not endorse symptoms of obsessive-compulsive disorder, mania, or psychotic symptoms. The Veteran’s medical records indicate that the Veteran continued treatment for his mental disability. In a November 2017 VA record, the examiner noted that the Veteran completed both the PTSD 101 and ERRTM groups. The Veteran stated that TSD 101 was informative and that he learned some helpful relaxation techniques in the ERRTM group, but that his PTSD symptoms remained the same. The examiner reported that the Veteran discussed interest in participating in the anger management group followed by the Unified Protocol group. The examiner stated that the Veteran discussed getting angry while driving and yelling at other drivers. He also discussed yelling at his wife, but noted he tried to minimize situations in which he gets angry with her around. The examiner reported that the Veteran denied ever hitting objects or others when angry. The examiner placed a referral for the Veteran to enroll in the anger management group. In a January 2018 buddy statement, the Veteran’s former coworker stated that they worked at the shipyard together for twenty-two years, prior to the Veteran’s retirement. The coworker stated that he noticed subtle changes in the Veteran’s behavior, such as him getting aggravated at things he would not have in years past. The coworker also stated that, prior to the Veteran’s retirement, the Veteran would have arguments with the management over things that would not upset other employees. The coworker noted that the arguments continued to the point that other employees and management began to comment on the effect they were having on the Veteran’s ability to complete his work. The coworker noted that the Veteran contemplated retirement a couple of years before doing so. In a January 2018 VA examination, the examiner observed that the Veteran’s clothing was tattered and stained, and his hair was unkempt. The examiner noted that the Veteran was cooperative throughout the process and was fully oriented to person, place, time, and purpose of evaluation. The examiner reported that the Veteran was frequently tearful and appeared depressed. The examiner noted that his anxiety heightened when talking about PTSD symptoms and the impact they have on his family, social, and work functioning. The Veteran reported increased irritability and stated that he was involved in an incident of road rage several months ago. The Veteran went on to state that he and another driver got out of their cars, at which time the Veteran hit the other driver and drove away. The examiner noted that the Veteran denied having current plans or intent to harm others and reported that he avoids leaving his house in order to prevent anger outbursts. The examiner also remarked that the Veteran reported no history of suicide attempts but stated that he has had passive thoughts of not wanting to wake up. The examiner noted that the Veteran stated that he was not currently thinking about harming himself. The examiner reported symptoms of depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, mild memory loss, such as forgetting names, directions, or recent events, flattened affect, impaired judgment, disturbances in motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, including work or a work like setting, and an inability to establish and maintain effective relationships. The examiner summarized the Veteran’s occupational and social impairment as total social and occupational impairment. After review of the record, the Board finds that prior to November 14, 2013, a 50 percent rating is appropriate. During this period, the medical record indicates that the Veteran experienced moderate PTSD symptoms, to include nightmares, hyperarousal, anger, irritability, startled response, hypervigilance, distractibility, and fatigue. The record does not indicate that the Veteran experienced symptoms which caused occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking or mood. During this period, the evidence does not indicate that the Veteran experienced suicidal ideation, speech intermittently illogical, obscure, or irrelevant, near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively, spatial disorientation, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances (including work or a work-like setting), and/or inability to establish and maintain effective relationships. Therefore, a 70 percent rating is not warranted during this period. Between November 14, 2013 and April 20, 2017, the Board finds that a 30 percent rating for the Veteran’s PTSD is appropriate. During this time period, the medical record indicates that the Veteran experience symptoms of depressed mood, anxiety, chronic sleep impairment, restricted affect, nightmares, and irritability. To the extent that the Veteran asserts that the 2013 VA examination did not include his symptoms of mild memory loss, panic attacks, and suspiciousness, the Board notes that the 30 percent rating contemplates these symptoms. Therefore, the Veteran’s symptoms more closely approximate to a 30 percent rating during this period. The Veteran’s symptoms did not approximate to a 50 percent rating during this period. The evidence does not indicate that during this period, the Veteran experienced symptoms such as flattened affect, circumstantial, circumlocutory, or stereotyped speech, panic attacks more than once a week, difficulty in understanding complex commands, impaired judgement, impaired abstract thinking, or disturbances in motivation and mood. The Board notes that the Veteran has asserted that during this period, he experienced impairment of memory such that he would forget tasks at home. The Veteran also asserts that during this time, he had difficulty maintaining relationships with management during this time period. While the Board acknowledges these reports, the evidence indicates that the Veteran was able to maintain work relationships with coworkers. Further, the Veteran’s symptoms did not manifest such that they caused occupational and social impairment with reduced reliability and productivity due to symptoms. Therefore, a 50 percent rating is not warranted. The Veteran’s symptoms did not approximate to a 70 percent rating prior to April 20, 2017. During this period, the evidence does not indicate that the Veteran experienced suicidal ideation, speech intermittently illogical, obscure, or irrelevant, near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively, spatial disorientation, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances (including work or a work-like setting), and/or inability to establish and maintain effective relationships. To the extent that the Veteran asserts that he experienced impaired impulse control, the medical evidence does not indicate that the Veteran’s symptoms arose to such a level of unprovoked violence. Moreover, the Veteran’s symptoms during this period did not result in occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. Therefore, a 70 percent rating is not warranted during this period. Between April 20, 2017 and January 30, 2018, the Board finds that a 70 percent rating, but no higher, is appropriate. During this period, the evidence indicates that the Veteran’s symptoms manifested in passive suicidal ideation, though no plan or intent, persistent and exaggerated negative beliefs about oneself, others and the world, persistent and distorted cognitions about the causes and consequences of the traumatic events that led him to blame himself, persistent negative emotional state, feeling distant and detached, feeling irritable or having angry outbursts, trouble sleeping; difficulty concentrating; hypervigilance, exaggerated startle response, depressed mood, and loss of interest and pleasure in activities, fatigue, periods of insomnia and hypersomnia during the day, low self-esteem, poor concentration, and feelings of hopelessness. The evidence further indicates that the Veteran’s symptoms caused clinically significant distress and impairment in social and other important areas of functioning. Moreover, during this period, the Veteran attended several group-therapy classes that did not improve symptoms. The Veteran enrolled in anger management class during this time due to his anger and lack of impulse control. Therefore, during this period, it is ascertainable that the Veteran’s symptoms more closely approximated to a 70 percent rating during this period. The evidence did not indicate that the Veteran’s symptoms warrant a 100 percent rating at any time prior to January 30, 2018. While the Veteran’s social functioning is impaired, he had not been found to be totally socially disabled, as he reported spending time with his wife and other family members. The record also does not establish that the Veteran has gross impairment in thought processes or communication, intermittent inability to perform activities of daily living, or disorientation to time or place, or persistent delusions or hallucinations. While the Veteran endorsed passive suicidal thoughts, he had no active intent or plans, and therefore his passive suicidal thoughts do not rise to the level of him being a persistent danger to hurting himself or others. Moreover, while the evidence indicates that the Veteran has experienced some mild memory problems, he has not had memory loss of his own name, own occupation, or close relatives. Therefore, a 100 percent rating is not warranted. In reaching this decision, the Board has considered the Veteran’s lay statements and the supporting statements submitted on his behalf. The Board notes that the Veteran is competent to report observations with regard to the severity of his symptomatology. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The Board finds these lay statements to be credible and consistent with the ratings now assigned. To the extent he argues his symptomatology is more severe, the Veteran’s statements must be weighed against the other evidence of the record. Here, the specific examination findings of trained health care professionals and documented medical treatment records are of greater probative weight than the more general lay assertions that higher ratings for PTSD are warranted. 3. A TDIU prior to January 30, 2018 The Veteran contends that his service-connected disabilities render him unable to obtain and maintain substantially gainful employment. It is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 4.16. A finding of total disability is appropriate “when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation.” 38 C.F.R. §§ 3.340(a)(1), 4.15. A threshold requirement for eligibility for a TDIU under 38 C.F.R. § 4.16(a) is that if there is only one such disability, it must be rated at 60 percent or more; if there are two or more disabilities, at least one disability must be rated at 40 percent or more, and sufficient additional disability must bring the combined rating to 70 percent or more. For the Veteran to prevail on a claim for a TDIU, the sole fact that the Veteran is unemployed or has difficulty obtaining employment is not enough. The question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. See Van Hoose v. Brown, 4 Vet. App. 361 (1993). In determining whether the Veteran is entitled to a TDIU, consideration may be given to the Veteran’s level of education, special training, and previous work experience, but not to his or her age or the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. Marginal employment is not considered substantially gainful employment. 38 C.F.R. § 4.16(a). Substantially gainful employment means, essentially, that the work provides income above the poverty level established by the United States Department of Commerce, without benefit of protected family employment or a sheltered workshop. 38 C.F.R. § 4.16(a). Turning to the record, as of the writing of this decision, the Veteran has the following compensable ratings: 50 percent rating for PTSD prior to November 14, 2013, 30 percent rating from November 14, 2013 to April 20, 2017, 70 percent rating from April 20, 2017 to January 30, 2018 for PTSD, and 100 percent rating from January 30, 2018 and thereafter for PTSD. At the outset, the Board notes that from January 30, 2018 and thereafter the Veteran has a 100 percent rating for PTSD. VA’s duty to maximize a claimant’s benefits includes potentially considering whether TDIU is warranted for a particular service-connected disability even when a schedular 100 percent rating is already in effect for other service-connected disabilities in order to determine the veteran’s eligibility for SMC under section 1114(s). 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 a veteran has a 100 percent disability rating for a single disability, and VA finds that TDIU is warranted based solely on a disability other than the disability that is rated at 100 percent. Bradley, 22 Vet. App. 280. Here, however, the Veteran has no other compensable ratings for service-connected disabilities and has not alleged that any of these disabilities prevent him from obtaining or maintaining substantial employment. Therefore, the issue of a TDIU is moot during this period. Thus, the analysis will turn to prior to January 30, 2018. In a December 2010 VA examination, the Veteran stated that he was currently employed. The Veteran reported that his symptoms caused stress in relationships with authority figures at work. In a November 2013 VA examination, the Veteran noted that he was thinking about retirement from the shipyard because of ease of irritability and anger has ceased to be a problem at home and sometimes crops up as an issue in the workplace. In an April 2017 Board hearing, the Veteran reported that he retired in January 2015 due to his PTSD. He reported that he probably would have been fired due to his anger issues and problems with senior management. In an April 2017 VA record, the examiner noted that the Veteran’s PTSD symptoms included persistent and exaggerated negative beliefs about oneself, others and the world, persistent and distorted cognitions about the causes and consequences of the traumatic events that led him to blame himself, persistent negative emotional state, feeling distant and detached, feeling irritable or having angry out bursts, trouble sleeping; difficulty concentrating; hypervigilance, exaggerated startle response, depressed mood, and loss of interest and pleasure in activities, fatigue, periods of insomnia and hypersomnia during the day, low self-esteem, poor concentration, and feelings of hopelessness. The examiner noted that these symptoms resulted in clinically significant distress and impairment in social and other important areas of functioning. In a January 2018 Application for a TDIU, the Veteran stated that his PTSD prevented him from securing and following any substantially gainful occupation. The Veteran noted that his highest education was two years of college. The Veteran stated that his last employment occurred at a shipyard where he performed crane maintenance from November 1988 to January 2015. The Veteran reported that he worked 40 hours a week. The Veteran noted that he did not lose time from his disability. The Veteran stated that his highest salary occurred in 2012 when he made $96,000 serving as a senior process manager. The examiner stated that his disability began to affect his full-time employment in January 2015. The Veteran also reported that he became too disabled to work in January 2015. The Veteran remarked that there were years of argument and disagreement with employees and management that climaxed to the point of the Veteran leaving his job in 2015. In a January 2018 buddy statement, the Veteran’s former coworker stated that they worked at the shipyard together for twenty-two years, prior to the Veteran’s retirement. The coworker stated that he noticed subtle changes in the Veteran’s behavior, such as him getting aggravated at things he would not have in years past. The coworker also stated that, prior to the Veteran’s retirement, the Veteran would have arguments with the management over things that would not upset other employees. The coworker noted that the arguments continued to the point that other employees and management began to comment on the effect they were having on the Veteran’s ability to complete his work. The coworker noted that the Veteran contemplated retirement a couple of years before doing so In an April 2020 Request for Employment Information, the Veteran’s last employer stated that he was last employed on January 2, 2015. The employer reported that the Veteran worked 40 hours a week as a crane maintenance supervisor. The employer stated that the Veteran’s reason for termination of employment was retirement. The employer indicated that the Veteran was eligible for sick, retirement or other benefits due to his prior employment as are all employees. After review of the record, the Board finds that, prior to January 3, 2015, a TDIU is not warranted. During this period, the evidence indicates that the Veteran maintained substantially gainful employment, and there is no evidence that his employment was marginal or in a sheltered or protected environment. Therefore, a TDIU during this period is not warranted. Between January 3, 2015 and April 20, 2017, the Veteran does not meet the schedular criteria for a TDIU. However, there is plausible evidence of record that the Veteran is unable to secure or follow a substantially gainful occupation due to his service-connected disabilities. Therefore, the Board finds a referral for extraschedular consideration is warranted for this period under consideration. See Bowling v. Principi, 15 Vet. App. 1, 10 (2001). From April 20, 2017 to January 29, 2018, the Board finds that a TDIU is warranted. During this time period, the medical evidence, the Veteran’s lay statements, and the January 2018 buddy statement indicate that the Veteran’s symptoms were such that they caused clinically significant distress and impairment in social and other important areas of functioning such that he was unable to continue his employment. Resolving reasonable doubt in favor of the Veteran, his PTSD symptoms resulted in his inability to find and follow substantially gainful employment during this period. Therefore, giving the Veteran the benefit of the doubt, a TDIU is warranted during this period. REASONS FOR REMAND Entitlement to a TDIU from January 3, 2015 to April 20, 2017 is remanded. The Veteran contends that his PTSD is such that, from January 3, 2015 to April 20, 2017, he was unable to find and follow substantially gainful employment. During this period, the Veteran did not meet the schedular criteria for a TDIU. In the present case, however, there is plausible evidence of record that the Veteran is unable to secure or follow a substantially gainful occupation due to his service-connected disabilities. Therefore, the Board finds that remand for referral for extraschedular consideration is warranted. See Bowling v. Principi, 15 Vet. App. 1, 10 (2001). The matter is REMANDED for the following action: Refer the Veteran’s claim to the Director of Compensation and Pension Service, for consideration of an extra-schedular TDIU award from January 3, 2015 to April 20, 2017 in accordance with 38 C.F.R. § 4.16(b). The Director should note that an extraschedular evaluation under 38 C.F.R. § 4.16(b) requires a determination that a Veteran is rendered unable to secure or follow a substantially gainful occupation by reason of his or her service-connected disabilities. The Veteran’s employment history, educational and vocational attainment, and all other factors having a bearing on his employability (or lack thereof) should be considered. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ford 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.