Citation Nr: 21061517 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 13-08 167 DATE: October 4, 2021 ISSUES 1. Entitlement to a disability evaluation in excess of 70 percent for post-traumatic stress disorder (PTSD) with unspecified depressive disorder and alcohol use disorder. 2. Entitlement to a total disability rating based on individual unemployability (TDIU). ORDER Entitlement to a disability evaluation in excess of 70 percent for post-traumatic stress disorder (PTSD) with unspecified depressive disorder and alcohol use disorder is denied. Entitlement to a total disability rating based on individual unemployability (TDIU) is denied. FINDINGS OF FACT 1. For the entire period on appeal, PTSD with unspecified depressive disorder and alcohol use disorder has been productive of occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood; due to such symptoms as anxiety, depressed mood, difficulty in adapting to a worklike setting and stressful circumstances, difficulty in establishing and maintaining effective work and social relationships, disturbances of motivation and mood, impairment of short and long term memory, intermittent inability to perform activities of daily living and maintenance of personal hygiene, near continuous panic or depression affecting the ability to function, panic attacks that occur more than once per week, and passive suicidal ideation without intent or plan. Total occupational and social impairment was not demonstrated. 2. The weight of competent, credible, and probative evidence is that the Veteran's PTSD with unspecified depressive disorder and alcohol abuse and gastroesophageal reflux disease (GERD) do not preclude him from procuring or following substantially gainful employment. CONCLUSIONS OF LAW 1. For the entire period on appeal, the criteria for the assignment of an initial disability rating in excess of 70 percent for service-connected PTSD with unspecified depressive disorder and alcohol use disorder have not been met or been approximated. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.10, 4.130, Diagnostic Code 9411. 2. The criteria for a TDIU have not been met or approximated. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1968 to June 1976. This matter is before the Board of Veterans Appeals (Board) on appeal from October 2011 and October 2018 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in Denver, Colorado. A March 2013 rating decision granted an increased evaluation of 50 percent for PTSD with unspecified depressive disorder and alcohol use disorder from October 5, 2012. As the claimant will generally be presumed to be seeking the maximum benefit allowed by law and regulation, the claim remained on appeal. AB v. Brown, 6 Vet. App. 35, 38 (1993). Next, the Veteran testified before the undersigned Veterans Law Judge (VLJ) in November 2018. A copy of the hearing transcript has been associated with the claims file. By way of procedural history, a March 2019 Board Decision denied the benefits sought on appeal. Later, a February 2020 Order from the United States Court of Appeals for Veterans Claims (Court) granted a February 2020 Joint Motion for Remand (JMR) with respect to the issues currently before the Board. The Court vacated the March 2019 Board Decision and remanded the matters for appropriate action. This is discussed further below. A July 2020 Informal Hearing Presentation (IHP) repeats the background and arguments from the February 2020 JMR. It concludes, "WHEREFORE, the parties request that the Court enter an order vacating the March 20, 2019, Board decision and remanding it for readjudication in accordance with the above discussion." Next, the issues were remanded by the Board in July 2020. Later, a January 2021 Rating decision favorably granted an increased 70 percent disability rating for post-traumatic stress disorder (PTSD) with unspecified depressive disorder and alcohol use disorder dating back to June 17, 2011. This is the original effective date of the claim. This grant extinguished the previously staged ratings for PTSD. Given the uniform evaluation, the issues are now listed as a single issue on the title page. The claim remains in controversy where less than the maximum available benefit is awarded. AB v. Brown, 6 Vet. App. 35, 38 (1993). In April 2021, the issues were again remanded by the Board for additional development. The Veteran was afforded a new VA examination. In addition, the Remand directives clearly required, "3. Send the Veteran a VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability and VA Form 21-4192, Request for Employment Verification. These must be completed in their entirety and returned to VA." (emphasis in original). To date, these have not been received. Lastly, the Board observes that a September 2021 VA Form 20-0995 Supplemental Claim Application is of record. This is still before the RO. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the Court held that a claim for total disability rating for compensation based on individual unemployability (TDIU) is part of an increased rating claim when such claim is expressly raised by the Veteran or reasonably raised by the record. The Court further held that when evidence of unemployability is submitted at the same time that the Veteran is appealing the initial rating assigned for a disability, the claim for TDIU will be considered part and parcel of the claim for benefits for the underlying disability. Id. Duties to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2018). First, on April 3, 2018, VA sent a development letter to the Veteran and asked him to return a completed VA Form 21-8940 Veteran's Application for Increased Compensation Based on Unemployability. No response was received. Second, on October 2, 2018, the RO issued a Rating decision identifying the critical evidentiary requirements necessary to fully develop his claim for a TDIU. The Veteran was informed: On 04/03/18 we wrote and asked you to send us a completed VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability. As of this date, we have not received a complete VA Form 21-8940. This form is required to further consider your claim. As we have not received a completed form from you, entitlement to IU is not established. Additionally, the evidence shows you are currently working full time as a welder and mechanic. Next, in the July 2020 Remand, the Board determined that in light of the Veteran and his attorney's explicit request in the February 2020 JMR, a remand was necessary for additional development. The Board emphasized that the Veteran still ultimately bears some burden of production. 38 U.S.C. § 5107 (a); Cromer v. Nicholson, 455 F.3d 1346 (Fed. Cir. 2006). The August 2021 Supplemental Statement of the Case (SSOC) continued to remind the Veteran and his representative of the evidentiary requirements necessary to substantiate his claims, including the outstanding forms for the TDIU claim. The Veteran in this case has not referred to any deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015, cert denied, U.S.C. Oct. 3, 2016) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board"); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to an appellant's failure to raise a duty to assist argument before the Board). The Board has reviewed all of the evidence in the Veteran's claims file. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-130 (2000). Increased Rating Disability evaluations are determined by the application of VA's Schedule for Rating Disabilities, which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. 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 rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. In order to evaluate the level of disability and any changes in condition, it is necessary to consider the complete medical history of the Veteran's condition. Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). In view of the number of atypical instances it is not expected, especially with the more fully described grades of disabilities, that all cases will show all the findings specified. Findings sufficiently characteristic to identify the disease and the disability therefrom, and above all, coordination of rating with impairment of function will, however, be expected in all instances. 38 C.F.R. § 4.21. Separate evaluations may be assigned for separate periods of time based on the facts found. In other words, the evaluations may be staged. Staged ratings are appropriate for any rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Here, the disability rating is not currently staged. As discussed below, a uniform evaluation is still warranted. In the instant case, PTSD with unspecified depressive disorder and alcohol use disorder is currently rated as 70 percent disabling pursuant to 38 C.F.R. § 4.130, Diagnostic Code (DC) 9411. DC 9411 and other DC's addressing psychiatric disabilities are addressed under the General Rating Formula for Mental Disorders. Ratings are assigned according to the manifestation of particular symptoms. 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 worklike setting); inability to establish and maintain effective relationships. A rating of 100 percent 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; 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. In Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013) the Federal Circuit stated that a veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. It was further noted that § 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas. The "such symptoms as" language means "for example," and does not represent an exhaustive list of symptoms that must be found before granting the rating of that category. Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154 (a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Veteran and his representative assert that the 70 percent disability evaluation for PTSD still does not accurately depict the severity of the disability. They continue to assert that the Veteran is entitled an increased evaluation. 1. Entitlement to a disability evaluation in excess of 70 percent for post-traumatic stress disorder (PTSD) with unspecified depressive disorder and alcohol use disorder The Board incorporates its discussion from the sections above by reference. By way of background, VA received the Veteran's claim for service connection in part for PTSD and depression in June 2011. An August 2011 lay statement from the Veteran's spouse shows that the Veteran fights in his sleep. He is jumpy and nervous. Another August 2011 lay statement shows that the Veteran has to be approached carefully or he will jump. Loud noises startle him. He has a hard time solving basic problems. Confrontations are difficult for him. It shows that he has begun smoking frequently and gambling. Additional lay statements from August 2011 are substantially the same. Next, the Veteran was afforded an August 2011 VA psychiatric examination. PTSD, depressive disorder, and alcohol abuse were identified. The VA examiner indicated that the Veteran's level of occupational and social impairment was best summarized by, "Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation." The VA examiner based this upon identifying such symptoms as depressed mood, anxiety, suspiciousness, panic attacks that occur weekly or less often, chronic sleep impairment, mild memory loss, flattened affect, and disturbances of motivation and mood. The VA examiner opined that the Veteran was capable of managing his own finances. It shows that the Veteran began treatment recently at the Vet Center and had been seen two times so far for one on one psychotherapy, originally for depression. He was held in the hospital that he cannot recall while drunk, and reported feeling depression about 12 years ago, with no related follow up. The VA physician noted a history of alcohol abuse. Also in August 2011, a VA Report of General Information shows, "Talked with Connie @ DVAMC in regards to the 7131 submitted records for the veteran going back to 1995. The first time 09/16/99." As discussed later, these have been associated with the claims file and considered. Shortly thereafter, a September 2011 VA Mental Health Medication Initial Visit Note from the Denver VA Medical Center (VAMC) shows that the Veteran presented to the Vet Center in August 2011 for help with PTSD and depression. He had a history of alcohol abuse, but quit in 2006, and had been essentially sober for five years. He had no history of suicidal attempts. The staff psychiatrist documented his social history, "Pleasant and friendly short, overwt male neatly dressed and groomed with trimmed mustache. Speech clear. A bit fidgety. Speech clear, fluent, normal rate, vol, prosody. Affect neutral. Thoughts organized, goal directed. No psychosis. No S/H ideation." Next, an October 2011 rating decision granted service connection for PTSD, depressive disorder, and alcohol abuse, and assigned a 30 percent rating effective June 17, 2011. A January 21, 2012 VA Emergency Department Triage Note from the Denver VAMC shows that the Veteran endorsed feeling down, depressed, or hopeless in the past two weeks. He had no thoughts of hurting himself, killing himself, or planning his own death during this time. Later, on October 5, 2012, the Veteran was afforded another VA psychiatric examination. The VA examiner indicated that the Veteran's level of occupational and social impairment was best summarized by, "occupational and social impairment with reduced reliability and productivity." Symptoms included depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances, including work or a worklike setting. The VA examiner documented in part, "There are no suicidal or homicidal thoughts, ideation, plans, or intent, or history of suicidal or homicidal thoughts, ideation plans or attempts." The Veteran filed a June 2012 Notice of Disagreement (NOD). The Veteran averred in part that there was "important information in the files at the Veteran Center that could have impacted your decision." He reported that he had been seeing Dr. C. T., psychiatrist, for approximately one year. This appeal followed. Later, the Veteran perfected his appeals in March 2013. He averred, "I have been seeing doctors and counselors all of the time and they feel I should not be working because of my condition jumpiness, always tired, not sleeping at night, nightmares, nervisnes (sic), can't be around crowds. I get real nervice (sic) when I am around people. I am very depressed. Dr. [T.] psychologist has me on a strong dose of depression meds, sleep aids. I see her often." Years later, the Veteran was afforded an April 2018 VA psychiatric examination. The Veteran reported increased depression. The Veteran reported that sleep medication is no longer effective. He reported that sometimes he lies awake all night, has little to no energy, and feels like his skin is crawling. The Veteran also reported occasional nightmares related to combat as well as other vivid dreams including about traveling and work. He has little contact outside of his home. He avoids people and loud noises. He complained of problems with concentration and memory. The VA clinical psychologist found that the Veteran has occupational and social impairment with reduced reliability and productivity due to chronic sleep impairment, mild memory loss, anxiety, depressed mood, disturbances of motivation and mood, impairment in short-term and long-term memory, and difficulty in understanding complex commands. The Veteran also denied suicidal ideation, though he reported that he often feels like he is "wasting air." The Veteran testified at a November 2018 hearing. Related to the period prior to October 5, 2012, the Veteran testified that he took three medications for PTSD. He testified that he has been seeing his psychiatrist, Dr. T. every other month at the Vet Center. He tries to talk to his wife, but she is angry with him. The Veteran described: Well, first of all, I've been married two times. And I have been kicked out two times. And I'm sure drinking had a lot to do with it. But I'm -- I get angry quick. I've got a short fuse. Even at work I've been called in a couple of times because I -- somebody says you guys did this or you guys did that and we didn't do it and I'd get I'd just blow up -- kind of blow up. And I've been talked to a couple of times. And my dreaming, I still have dreams, at nighttime. I mean, they're not as awful -- not as often as they were. But I almost hurt myself the other day when I cleaned off the table next to the bed. I mean, I just got up and swinging and stuff is flying all over the doggone place. That ain't, you know, being my age and my bones are really subject to break. I've got low iron. And I do have a lot of things wrong with me other than what the service connected was all about. But I shake all the time. I'm always looking over my shoulders to make sure, you know, I know my surrounding areas. The Veteran also testified that his symptoms had increased in severity since the October 2012 VA examination. Next, a January 22, 2020 VA Mental Health Medication Management Note shows that the Veteran originally presented to the Denver Vet Center in August 2011 for help with PTSD. Additional VA treatment records, including from Dr. C. T., show ongoing treatment for and impressions of PTSD and depression. They are substantially the same. Previously, by way of the February 2020 Joint Motion for Remand (JMR), the Veteran through appeals counsel reasserted that he is entitled to an increased disability evaluation for PTSD. He highlighted snippets from the record, and raised new contentions. Appeals counsel primarily cited a fleeting reference to one prior instance of hospitalization for suicidal ideation while inebriated. See February 2020 JMR, p. 2. The Board observes that counsel neglected to include that the cited September 2, 2011, VA Mental Health Medication Management Note has a second sentence that follows. "He has no h/o suicide attempts." Moreover, the fact that this is one reference over approximately ten years is not fully reconciled. Indeed, the Board is obligated to review the entirety of the record and interpret Veterans' claims liberally; however, need only make reasonable efforts to corroborate claims, and not search the record to raise arguments in a Veteran's stead. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). The law requires only that the Board address its reasons for rejecting evidence favorable to the Veteran. See Timberlake v. Gober, 14 Vet. App. 122 (2000). Also in the JMR, counsel cited caselaw and regulations in arguing for the grant of a 50 percent rating for PTSD prior to October 5, 2012. See February 2020 JMR, p. 3. The Veteran is now in receipt of a 70 percent disability evaluation. Nevertheless, the challenge to the adequacy of the October 2012 VA PTSD examination was vague, phrased in terms of, "However, the October 2012 VA PTSD examination included statements which may indicate that Appellant's symptomatology, which the Board found consistent with a 50 percent rating, began prior to the date of the examination." (emphasis added.) This is not conclusive. As the finder of fact, the Board is required to weigh and analyze all the evidence of record and to make determinations as to the credibility of the evidence. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1998). "The evaluation and weighing of evidence and the drawing of appropriate inferences from it are factual determinations committed to the discretion of the fact finder." Bastien v. Shinseki, F.3d 1301, 1306 (Fed. Cir. 2010). The Board may permissibly draw inferences from the medical evidence, including an overall reading of a VA report. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); see also Acevedo v. Shinseki, 25 Vet. App. 286, 293-94 (2012) (the Board is permitted to draw inferences based on medical reports so long as the inference does not result in a medical determination). Next, in a resulting July 2020 Remand, the Board highlighted that appeals counsel was essentially requesting that the Board reconsider its weighing of the evidence based upon a selective plucking of references in the claims file. The JMR additionally shows, "The record contains treatment records from the Denver Vet Center from August 2011 to November 2012, but no records from November 2012, onward. Because the duty to assist compels VA efforts to obtain adequately identified VA medical records, the Board was required to remand for the Vet Center records to be requested." See February 2020 JMR, p. 4. It was not certain that such records would demonstrate more severe symptomology than shown at the series of VA examinations. The Veteran through counsel only then identified potentially outstanding treatment records from the "Denver Vet. Center" from November 2012 to the present. The Board requested that the Veteran through counsel assist the Board in submitting any treatment records in his possession, including any from the Denver Vet. Center. Meanwhile, VA would attempt to obtain any additional VA treatment records from the Denver Vet. Center that had only then been identified. Lastly, the Board concluded in July 2020 that a VA examination with a retrospective medical opinion was necessary to capture the severity of the Veteran's PTSD disability for the entire appeals period. See Chotta v. Peake, 22 Vet. App. 80 (2008) (when there is an absence of medical evidence during a certain period of time, a retroactive medical evaluation may be warranted). The Veteran's lay statements regarding the frequency of any suicidal ideation were to be considered as part of this medical evaluation of the severity of PTSD over the appeals period. Ongoing VA treatment records contain a November 16, 2020 VA Mental Health Medication Management Note. It shows in part, "SUICIDAL OR VIOLENT IDEATION: occasional thoughts, not intent or plan and will get help if needed." Next, the Veteran was afforded a December 2020 VA PTSD examination. An in person examination was performed by A. D. R., PsyD. She also reviewed the claims file. PTSD was summarized by occupational and social impairment with reduced reliability and productivity. The VA examiner documented, "Since the time of the last evaluation in April 2018, Veteran was employed at All American Trailers as a Welder. In early 2020, he resigned from his position due to 'being too old and hurt' and no longer able to perform his job duties without fear of hurting himself or others." Regarding the Veteran's social history, the VA examiner described: Since the time of the last evaluation in April 2018, Veteran has remained unmarried and single. He currently lives alone in Thorton, Colorado. He considers his ex-girlfriend, boss, and a few close friends to be his support system. He currently spends the majority of his time at home playing Solitary (sic) on his computer or sleeping. He stated that he avoids most social interactions and prefers to spend the majority of his time at home aloe. He stated that he feels significantly anxious in social settings and "likes to just be away from everyone and everything." Next, in January 2021, VA received a VA medical opinion. A different examiner, S. J., PsyD, only reviewed the claims file. There is no indication that an in-person or telehealth examination was performed. The VA examiner created a summary of relevant treatment records from the claims file. The VA examiner concluded that PTSD is best summarized by, "Occupational and social impairment with reduced reliability and productivity." The Board observes that these examinations demonstrate possible improvement in the severity of the Veteran's impairment as compared to the current 70 percent rating recently granted by the RO. Nonetheless, this medical opinion does not show that an in person examination was performed or that the retrospective medical opinion was based upon a contemporaneous examination of the Veteran. Months later, the April 2021 Informal Hearing Presentation (IHP) concludes with a request for a total schedular evaluation for PTSD. The Veteran through his representative alleges, "Furthermore, the description of his symptoms seems to be at variance with the doctor's overall assessment." By way of the April 2021 Board Remand, the Board afforded the Veteran a new VA psychiatric examination. The July 2021 VA psychiatric examination with medical opinions was performed by a clinical psychologist. The VA examiner elicited a lay history from the Veteran, reviewed the entire claims file, and performed an in-person examination. The VA examiner ultimately indicated that PTSD is best summarized by occupational and social impairment with reduced reliability and productivity. Symptoms that apply to the diagnosis were indicated as depressed mood, anxiety, suspiciousness, panic attacks that occur more than once a week, near continuous panic or depression, chronic sleep impairment, mild memory loss, impairment of short and long term memory, flattened affect, speech impairment disturbances of motivation and mood, difficulty in relationships and stressful circumstances, and suicidal ideation. In relevant part, the VA examiner later clarified, "THOUGHT CONTENT: Passive thoughts about death endorsed. Denied Suicidal plans or intentions and Homicidal ideation, plans or intentions. No hallucinations nor thought disorders." There were no hallucinations or delusions, he was not a danger to himself or others, there were no obsessional rituals, and the Veteran was well-groomed. Turning to his occupational functioning, the VA examiner provided a synopsis: His current service-connected disability of PTSD does as likely as not render his unable to secure and maintain substantially gainful employment. His PTSD results in panic attacks more than once a week, the inability to make and maintain work and social relationships, significant deficits in memory, struggles with motivation, difficulties adapting to stressful circumstances. His poor affect regulations, hypervigilance, exaggerated startle response, distrust of others, trauma triggers, and strong discomfort being around other people--new people in particular- -would make it difficult for him to successfully interact with the public, co-workers, and supervisors. It is no longer safe for him to continue in his trained field of welding. His memory issues would make it unlikely that he could sufficiently learn the procedures of a new profession. His depression, poor sleep, suicidal thoughts, and struggles with motivation would likely result in excessive missed work and termination. The suicide risk level is not at elevated acute risk. The associated retrospective medical opinion document contains a comprehensive medical history and is substantially the same. The VA examiner highlighted in part: Furthermore, the PTSD DBQ states: The Veteran currently spends the majority of his time at home playing Solitary on his computer or sleeping. He stated that he avoids most social interactions and prefers to spend the majority of his time at home alone. He stated that he feels significantly anxious in social settings and "likes to just be away from everyone and everything." The Veteran was employed at All American Trailers as a Welder. In early 2020, he resigned from his position due to "being too old and hurt" and no longer able to perform his job duties without fear of hurting himself or others. The Veteran has been in treatment mental health treatment with VA. The VA examiner described, "In terms of his symptoms of PTSD, the Veteran experiences intrusive thoughts, sleep disturbance with recurrent distressing dreams/nightmares, difficulty concentrating and sustaining his focus, due to memory and concentration problems, hypervigilance, easily startled, avoidance behaviors, irritability, anxiety, tension and easily provoked to anger and detached and withdrawn behavior." Additional VA treatment records from the Denver Vet Center have been received and reviewed. For example, a July 21, 2021 VA Primary Care Emergency Department Triage Note from the Rocky Mountain Regional VA Medical Center (VAMC) shows that the Veteran had not wished that he were dead or go to sleep and not wake up. Days later, a July 23, 2021 VA Primary Care Outpatient Note reads in part, "Vocation: welder. of note has had significant smoke/asbestos exposure." The September 2021 Informal Hearing Presentation (IHP) recites the VA examination results and emphasizes that the Veteran "clearly and unmistakably has a severe anger issue." The Veteran through his representative contends that he is entitled to an increased disability evaluation for PTSD with unspecified depressive disorder and alcohol use disorder. Generally, the Veteran is competent to report his feelings, including jumpiness, anger, and nightmares. He is competent to report that he has been diagnosed with PTSD with depressive disorder and alcohol use disorder. The Veteran competently endorsed symptoms of difficulties related to his mood, social interaction, and workplace interactions, such as: depressed mood, anxiety, panic attacks, isolative behavior, mild memory impairment, anger, and chronic sleep impairment. The Board assigns significant probative weight to the Veteran's lay reports of his symptoms. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). While the Veteran's symptoms wax and wane across the appeal period, the Board finds that these records, taken together, describe a consistent picture of symptomatology associated with the Veteran's PTSD with unspecified depressive disorder and alcohol use disorder. The most probative evidence is the weight of the clinical findings in the VA examinations, including the July 2021 VA examination with retrospective medical opinion. The Board finds that given the medical and lay evidence of record, the Veteran's service-connected PTSD with unspecified depressive disorder and alcohol use disorder for the entire period on appeal most closely approximates the recently-granted 70 percent disability rating. PTSD with unspecified depressive disorder and alcohol use disorder has been productive of occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood; due to such symptoms as anxiety, depressed mood, difficulty in adapting to a worklike setting and stressful circumstances, difficulty in establishing and maintaining effective work and social relationships, disturbances of motivation and mood, impairment of short and long term memory, intermittent inability to perform activities of daily living and maintenance of personal hygiene, near continuous panic or depression affecting the ability to function, and panic attacks that occur more than once per week. There is generally documented suicidal ideation but without intent or plan. Although he has been married twice, the Veteran is in contact with people in his intimate circles. The findings of the July 2021 VA examination are largely consistent with the April 2018 October VA examination, and show a summary of occupational and social impairment with reduced reliability and productivity. Favorably, by way of the January 2021 rating decision, a 70 percent disability evaluation has been awarded, usually reserved for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. Therefore, the Board finds that given the Veteran's entire disability picture, PTSD with unspecified depressive disorder and alcohol use disorder is most closely approximated by the current 70 percent rating. Although the Veteran does not demonstrate all of the listed symptoms provided with a 70 percent rating, such as circumstantial, circumlocutory, or stereotyped speech, the provided symptoms are not to be treated as a checklist when determining what rating is appropriate. Mauerhan, 16 Vet. App. at 442. The current rating best summarizes reports of severe anger, as advanced in the recent IHP. Regarding a higher rating, however, the Veteran's symptoms are not of the severity, frequency, and duration to warrant a 100 percent rating. Simply put, while the Board acknowledges his severe impairment, total occupational and social impairment was not demonstrated at any time during the lengthy appeals period. The Veteran was gainfully employed during a majority of the appeals period. He can groom himself. He has fair judgment. We note other factors. The Board has found the statements and findings of treating doctors and the VA examiners best represent the Veteran's complete disability picture. To the extent the November 2018 hearing transcript contains reports of suicidal ideation getting worse daily, symptoms may wax and wane, and this alone is not determinative. Reported suicidal ideation at the November 2018 hearing does not necessarily equate to an increased rating by itself. See Mauerhan, 16 Vet. App. at 442. In the October 2012 and April 2018 VA examinations, the Veteran denied suicidal or homicidal ideation, as he had prior to the November 2018 hearing. The October 2012 VA examiner observed, "There are no delusions or hallucinations, or reported history of delusions or hallucinations. His eye contact was good and his behavior appropriate throughout the session. He was casually dressed, and he was courteous throughout the interview. His mood and affect were in the normal range of function. There are no suicidal or homicidal thoughts, ideation, plans, or intent, or history of suicidal or homicidal thoughts, ideation plans or attempts. He has the ability to maintain minimal personal hygiene and other basic activities of daily living." The April 2018 VA examiner similarly observed that the Veteran denied suicidal ideation, although he did report feeling like he was "wasting air." The December 2020 VA examiner described some remaining degree of functioning, despite severe impairment. In specifically addressing the earlier JMR, there was no indication of suicidal ideation. She documented: Veteran was on time to his appointment, causally dressed, and oriented times four. He made appropriate eye contact. His speech was normal in volume, rate, and tone. His mood and affect was within normal range. His insight and judgment appeared in tact. His thought process was linear and logical. He was alert, cooperative, and forthcoming throughout the evaluation. Suicidal and homicidal intent was denied. Veteran appeared to be an accurate historian. This represents some degree of functioning. The July 2021 VA examination indicated suicidal ideation, but this was limited to passive thinking about death. There has consistently been no intent or plan. Still, we have considered that the Veteran had one historical hospitalization approximately one decade ago while inebriated. The Veteran has not exhibited that he is a persistent danger to himself or others. Symptoms may wax and wane across the lengthy appeals period. We have considered all of the evidence in reaching this decision. Such interpretation of the severity of PTSD is consistent with the ongoing VA treatment records and findings of the VA examiners. Suicidal ideation aside, there was also no grossly inappropriate behavior or a complete inability to maintain hygiene. There were no persistent delusions or hallucinations. At the most recent July 2021 VA examination, the Veteran was still appropriate attired, well-groomed, with good hygiene, and appeared to be the stated age. He arrived on time and was cooperative. He was engaged. Insight and judgment were fair. We find this to be highly probative. Regarding the impact on his employment, the Board incorporates the Veteran's employer's November 2018 report of physical disability only recently leading to interference with employment by reference. Although the Veteran reported feeling angry and getting mad, there was no near-continuous panic. There is no indication that any intermittently reported suicidal ideation or depression has significantly interfered with the Veteran's occupation or social functioning. The Veteran reported that he is capable of playing solitaire on the computer, demonstrating technical prowess and cognitive ability, even if isolative. The Board acknowledges the severity of psychiatric impairment and the Veteran has a correspondingly high disability rating for PTSD that best summarizes his impairment. We also note other factors. The Veteran through appeals counsel and his representative has continued to challenge the clinical findings of the various VA examinations and those relied upon by the Board. There is now an accumulation of probative medical evidence which includes consideration of his lay reports. The findings are relatively consistent, although specific symptoms may wax and wane. During the course of the lengthy appeals period, no other probative evidence has been identified which would suggest that a total, 100 percent disability evolution for PTSD is warranted. Although we do not dispute that he experiences severe impairment, the weight of the evidence strongly suggests some degree of remaining function. At the recent VA examinations he did not hallucinate. He could recall his prior occupation. He can operate a computer to play a complex game. Most recently, he presented as well-groomed at the July 2021 VA examination. Once again, we acknowledge his reports of isolation and severe anger. We have considered this evidence. In sum, there is not sufficient evidence that the Veteran's disturbances of motivation and mood, impairment of memory, intermittent inability to perform activities of daily living and maintenance of personal hygiene, panic, anger, and depression are of the severity and frequency to cause the level of occupational and social impairment associated with a higher disability rating than the current 70 percent disability evaluation. The weight of the evidence demonstrates that a 70 percent disability evaluation best summarizes the Veteran's reports of impairment including hypervigilance, panic attacks, nightmares, anxiety, mild memory loss, difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances. See Bankhead v. Shulkin, No. 15-2404, slip op. at 10 (U.S. Vet. App. Mar. 27, 2017); Vazquez-Claudio v. Shinseki, 713 F.3d 112, 115 (Fed. Cir. 2013). This rating contemplates any fleeting reports of suicidal ideation, which were shown at the July 2021 VA examination to be limited to passive thoughts about death without a plan or intentions. In reaching this decision, we have considered 38 C.F.R. § 4.7 for the higher of two evaluations. The most recent VA examinations show only occupational and social impairment with reduced reliability and productivity. Ordinarily, that level of impairment could suggest a 50 percent disability evaluation, and a possible staged rating. Nevertheless, we will not disturb the current uniform disability evaluation and rating that have already been favorably granted by the RO since the JMR. It follows that the weight of the evidence, however, is against any additional increase. Consequently, a disability evaluation in excess of 70 percent for PTSD with unspecified depressive disorder and alcohol use disorder is not warranted. 2. Entitlement to a total disability rating based on individual unemployability (TDIU) The Board incorporates its discussion from the sections above by reference. Total disability will be considered to exist 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. See 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. In reaching such a determination, the central inquiry is "whether the veteran's service connected disabilities alone are of sufficient severity to produce unemployability." Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). Consideration may be given to the Veteran's level of education, special training, and previous work experience in arriving at a conclusion, but not to his age or to the impairment caused by non service-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19 (2006); Van Hoose v. Brown, 4 Vet. App. 361 (1993). Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: Provided that, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16 (a). It is the established policy of the Department of Veterans Affairs 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. Therefore, rating boards should submit to the Director, Compensation Service, for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in paragraph (a) of this section. The rating board will include a full statement as to the Veteran's service-connected disabilities, employment history, educational and vocational attainment and all other factors having a bearing on the issue. 38 C.F.R. § 4.16 (b). Separate evaluations may be assigned for separate periods of time based on the facts found. In other words, the evaluations may be staged. Staged ratings are appropriate for any rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Here, uniform evaluations are still warranted. The term "unemployability," as used in VA regulations governing total disability ratings, is synonymous with an inability to secure and follow a substantially gainful occupation. The issue is whether the Veteran's service-connected disabilities preclude him from engaging in substantially gainful employment (i.e., work which is more than marginal, that permits the individual to earn a "living wage"). See Moore v. Derwinski, 1 Vet. App. 356 (1991). The determination of whether a Veteran is unable to secure or follow a substantially gainful occupation is a legal one, to be undertaken on a case-by-case basis. See Withers v. Wilkie, 30 Vet. App. 139 (2018) (holding the meaning and relevance of the term sedentary work will have to be discerned on a case-by-case basis from the medical and lay evidence presented and considering each Veteran's education, training, and work history). The ultimate issue of whether TDIU should be awarded is not a medical issue, but is a determination for the adjudicator. Moore v. Nicholson, 21 Vet. App. 211, 218 (2007). The Veteran is service-connected for PTSD with unspecified depressive disorder and alcohol use disorder, rated 70 percent disabling from June 17, 2011; and GERD, rated 10 percent disabling from June 17, 2011. The Veteran has a combined disability evaluation of 70 percent from June 17, 2011, See 38 C.F.R. § 4.25. As such, the Veteran currently satisfies the minimum percentage rating requirements of 38 C.F.R. § 4.16 (a) for a TDIU during the entire appeals period. As a threshold issue, the Veteran has repeatedly failed to complete and submit the necessary paperwork to assist in substantiating his TDIU claim. By way of background, at the August 2011 VA psychiatric examination, the VA examiner noted the Veteran's Military Occupational Specialty (MOS) of port construction, engineer, welder, operator, mechanic. Regarding employment history, it shows, "Works as a mechanic and welder for a trailer company in Commerce City. On this job for 5 years. Some fatigue on the job but no other problems. Was without work for 6 years due to alcoholism. Prior to that time worked for many years in the gas and oil industry doing welding." Regarding the Veteran's daily schedule, it shows, "Rises at 5:00 a.m. Works 8:00 a.m. to 5:30 p.m. Eats about 1 meal per day. Complains of daily fatigue especially at the end of the day. He likes being alone. Works primarily on his own or with 1 other man throughout the day. He used to enjoy fishing and has a boat but has not been in at least 2 years. Used to hunt many, many years ago. Cannot name any close friends. Bedtime usually after eating an evening meal fairly early." In concluding, the physician documented, "Symptoms consistent with posttraumatic stress disorder and depression. History of severe alcohol abuse which is now in remission and is likely secondary to posttraumatic stress disorder. Symptoms described above. Veteran is employable from a psychiatric standpoint. He is competent for VA purposes." Later, an October 2012 rating decision denied service connection for polymyalgia rheumatica. Next, a March 2014 Treatment Update from the Denver Vet Center shows that the Veteran has been a client since August 2011. PTSD symptoms are listed as intrusive thoughts, nightmares almost nightly, strong feelings of remorse and guilt, a strong sense that the future is hopeless, daily suicidal ideation, flash anger with feelings of rage, and very serious major depression secondary to PTSD. The Veteran continued to receive medication and treatment from Dr. T. It shows that the Veteran's PTSD remains severe and he should be considered "unemployable" even though he is still going to work. The treatment record shows that the Veteran's employer is understanding and makes accommodations so that he really only needs to show up. The treatment record concludes by indicating that PTSD with depression "is not showing much improvement from his treatment or medication." On April 3, 2018 VA sent a development letter to the Veteran and asked him to send complete the required VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability. To date, this has not been received. The Veteran and his representative were notified of this critical evidentiary defect necessary to substantiate his claim by way of the Supplemental Statement of the Case (SSOC) dated October 2, 2018. At the April 2018 VA examination, the VA examiner elicited an occupational history from the Veteran. It shows: [The Veteran] had been employed for the past 12 years at a shop that does trailer repairs. [The Veteran] has been a welder for over 50 years. He reports, however, that he can no longer work due to problems with memory loss, shaking, and complaining of "my head just stops." He attributes his difficulty largely to increased depression. [The Veteran] expressed apprehension that he would make a mistake or hurt someone if he attempted to continue working. He did indicate that he is still on good terms with his employer, and they miss him at work. Turning to activities of daily living, it shows: [The Veteran] wakes between 5 and 6 AM and he fixes coffee, and he will play solitaire on the computer and either prepare breakfast or go to a nearby restaurant for breakfast. He spends most of the day watching TV or playing solitaire. He particularly enjoys watching Westerns. [The Veteran] will take a nap in the afternoon and does prepare dinner. He usually goes to bed between 9 and 10 PM. The clinical psychologist also elicited and commented on the Veteran's employment history: [The Veteran] reported during this examination that he can no longer work even though he has been kept on payroll or employee list at the trailer repair shop where he has been a welder for 12 years. According to [the Veteran], he has had problems with memory lapses and loss of concentration to the point that he is concerned he will make a mistake or hurt someone. During my examination of [the Veteran], he did evidence some mild problems with continuity of thought and concentration. He is able to live independently including preparing meals and attending to his own needs. Although he reports some difficulty in continuing his employment as a welder, it appears that he can perform at least some functions that might be required in an employment setting, though it should be expected that he would have problems at times with lapses of concentration and attention. The Board incorporates its discussion of the Veteran's reported daily activities from the November 2018 hearing. These included making breakfast and changing a furnace filter in the crawlspace. The Board observes that the Veteran also testified, "And I do have a lot of things wrong with me other than what the service connected was all about. But I shake all the time." Significantly, a January 22, 2020 VA treatment record shows that the Veteran worked full time as a welder and mechanic. He hoped to drive to Arizona to visit his son there in the future. He was looking around for possible part time work that was not physically demanding. Next, the February 2020 JMR shows in part that the Board "shall address whether Appellant's employment prior to 2017 took place in a protected work environment, or was otherwise marginal." See February 2020 JMR, p. 5. In July 2020, the Board afforded the Veteran an opportunity to fully develop this claim, including any contentions regarding employment in a protected environment. To the extent this is his position, the Veteran through his representative was requested to provide additional information beyond a conclusory statement that the work environment was "protected" or that the employment was "marginal." The Veteran was required to submit a complete VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability. Later, the Veteran was sent a September 8, 2020 VA Subsequent Development Letter. The VA Form 21-8940 was requested. No response was received. Separately, the Veteran was able to fill out and submit a vocational rehabilitation application. A November 2020 VA letter shows that the Veteran's vocational rehabilitation was denied. Later, the February 2021 Supplemental Statement of the Case (SSOC) informed the Veteran and his representative that the paperwork for a TDIU was not received, and the TDIU claim would remain denied. The April 2021 IHP fails to address the missing documentation. Indeed, "The duty to assist is not always a one-way street. If a veteran wants help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence." Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). On remand in April 2021, the Veteran was afforded yet another opportunity to submit the necessary forms to substantiate his TDIU claim. Next, the July 2021 VA examiner wrote in part, "It is no longer safe for him to continue in his trained field of welding. His memory issues would make it unlikely that he could sufficiently learn the procedures of a new profession. His depression, poor sleep, suicidal thoughts, and struggles with motivation would likely result in excessive missed work and termination. The suicide risk level is not at elevated acute risk." Similarly, the VA examiner in section 2B for Occupational and Educational History documented, "Claimant continues to be unemployed [since early 2020]. He is basically retired. He lives on social security his military disability. He wishes he could go back to work, but his body can't handle it. He had to quit his welding job due to fears of hurting himself or others." Additional VA treatment records from the Denver Vet Center have been received and reviewed. For example, a July 4, 2021 VA Cardiology note reads in part: Worked as a welder; currently retired. Subjective: Tired at all times even in the morning. Sleeps 8-10 hr. Nocturia 2x.Pt feels as his urinary pressure is not good; he does not empty his bladder completely. Finished ABX for diverticulitis; though, it help some"60-70% better". Still has abdominal discomfort almost immediately after eating, better after having BM. Pt also has a lot of gas. BMs small, daily, 2-3x. Diarrhea alternates with constipation. Pt denies fever. Pt denies nausea, vomiting. Can sleep at night on Trazodone. Recently, the August 2021 Supplemental Statement of the Case (SSOC) continued to remind the Veteran and his representative of the evidentiary requirements necessary to substantiate his claims, including the outstanding forms for the TDIU claim. The Veteran contends that he is entitled to a total disability rating based on individual unemployability due to his PTSD with unspecified depressive disorder and alcohol use disorder and disability. The sole fact that a claimant is unemployed or has difficulty obtaining employment is not enough. A high rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he can find employment. Van Hoose v. Brown, 4 Vet. App. 361 (1993). By way of lay history, the Veteran had been employed full time until recently, performing various jobs principally involving his skills as a welder/mechanic. He testified, "I've been a welder all my life since 1965." See November 2018 Hearing Transcript, p. 16. A review of his credible statements concerning his difficulty securing or following substantially gainful employment is instructive. First, as a threshold matter, the November 2018 letter from the Veteran's employer shows that he was unable to work due to physical difficulties. That same month, the Veteran provided testimony consistent with this. He indicated that he had polymyalgia rheumatica. Specifically, the Veteran testified, "I know I'm going downhill pretty fast. And they see it at work. I mean, I've got polymyalgia rheumatica that all of a sudden it showed up. It's in my nervous system. And it's I'm on I've been on Prednisone since 2010." At the April 2018 VA psychiatric examination, the VA examiner noted the Veteran is capable of using a computer, playing solitaire, and going out to breakfast. Regarding the impact of his psychiatric symptoms on his occupation, the VA examiner explained, "Although he reports some difficulty in continuing his employment as a welder, it appears that he can perform at least some functions that might be required in an employment setting, though it should be expected that he would have problems at times with lapses of concentration and attention." The January 22, 2020 VA treatment record shows that the Veteran hoped to drive to Arizona to visit his son in the future. He was looking around for possible part time work that was not physically demanding. As repeated at the July 2021 VA examination in the retrospective medical opinion, the Veteran reports playing solitaire on his computer, sleeping, and socially isolating. Additional records are substantially the same and show that he is essentially retired, living on Social Security Administration (SSA) and VA income. We have considered the Veteran's lay history and the clinical observations of the VA examiners. The August 2021 Supplemental Statement of the Case (SSOC) continued to remind the Veteran and his representative of the evidentiary requirements necessary to substantiate his claims, including the outstanding forms for the TDIU claim. Here, the Board finds that the weight of the evidence demonstrates that while the Veteran meets the schedular criteria, he is not precluded from obtaining and retaining substantially gainful employment on account of his service connected disabilities. The Veteran's consistent reports of previous decline in hours leading to termination of employment in 2018 were due to other factors. He variously reports he is retired and cites polymyalgia. While July 2021 VA examiner suggested that it is no longer safe for the Veteran to continue in his trained filed of welding, she did not specify the reason it was unsafe or the basis for this conclusion. Although we acknowledge some impairment, the VA examiner also indicated that the Veteran did not hallucinate, and was not a persistent danger to himself and others. He could continue as an assistant in a welding shop even if he does not operate dangerous machinery himself. This demonstrates some ability, even if limited to isolative tasks. Nothing else suggests that his two service connected disabilities have rendered him unable to secure or follow a substantially gainful occupation in another capacity. In this regard, he reports that he is able to use the computer and play solitaire. He can groom himself. It follows that the Veteran is not precluded from returning to the workforce in a new capacity performing clerical work on the computer. To the extent impairment in working is due to non-service-connected disabilities, we may not consider these. In his work as a welder, the Veteran had been with the same company since March 2006. The evidence only showed a recent decline. This is consistent with the Veteran's November 2018 hearing testimony. Although we acknowledge the Veteran's statements that he feels depressed and has difficulty concentrating, this does not rise to the level of precluding him from obtaining and retaining substantially gainful employment. He has variously reported in recent VA treatment records that he is a retired welder. This alone does not establish that he is precluded from returning to the workforce. Despite counsel raising this question in the JMR, there is no probative evidence of employment in a protected environment. Returning the missing forms would potentially clarify any contention in this regard. Still, the current evidence of record demonstrates that the Veteran has a work history as a welder, documented as recently as July 2021 from the Denver Vet Center. The report is uncertain whether he was still employed or whether this was his past vocational training. Regardless, the Veteran does not have physical and psychological impairment to such a degree that he is precluded from continued participation in the workforce. Meanwhile, he has demonstrated an additional ability to use the computer and play games involving some degree of thinking. To the extent that he has other non-service connected disabilities, VA may not consider such impairments. Although the March 2014 Treatment Update contains an opinion to the contrary, it is inconsistent with the letter from the Veteran's employer, and therefore afforded diminished probative weight. Regarding his functioning, the Veteran reported at the April 2018 VA psychiatric examination that he is able to make coffee in the morning, spend time watching Westerns, and prepare dinner. These reports are consistent with the findings of the April 2018 VA examiner as they relate to the Veteran's the occupational capacity and activities of daily living. In short, there is no probative evidence indicating that he has been precluded from securing and following substantially gainful employment by way of his service connected disabilities. Although the Veteran and his representative repeatedly did not return the VA Form 21-8940, he has been afforded VA psychiatric examinations during which the VA examiner elicited employment history from the Veteran. By way of history, the Veteran was sent a September 8, 2020 VA Subsequent Development Letter. The VA Form 21-8940 was requested. No response was received. Separately, the Veteran was able to fill out and submit a vocational rehabilitation application. A November 2020 VA letter shows that the Veteran's vocational rehabilitation was denied. The August 2021 Supplemental Statement of the Case (SSOC) continued to remind the Veteran and his representative of the evidentiary requirements necessary to substantiate his claims, including the outstanding forms for the TDIU claim. In the September 2021 IHP, the Veteran's representative questions how someone with such severe impairment be tasked with completing technical forms. The IHP fails to explain how the Veteran filed his initial claims, how he can play solitaire, why the Veteran has not attested to this obstacle (rather than not replying at all), and why his representative and appeals counsel have been unable to assist their client in completing these forms over several years. Even without the necessary VA Form 21-8940, we still considered the combined impact of the Veteran's service-connected disabilities. That impairment does not rise to the level of a TDIU. Lifting, ambulating, and other tasks are not shown to have been severely limited by PTSD or GERD, his only service-connected disabilities. The Veteran still has some degree of cognitive functioning to the extent he can dress himself, groom himself, and use a computer, even if he has anger and a limited ability to socially interact. The Board observes that Withers holds that the precise meaning of sedentary work in any specific case should be based on the context clues of the VA examination or medical report cited as authority. Critically, Withers declines to adopt a specific definition of the phrase "sedentary employment" for VA purposes when adjudicating entitlement to a TDIU, but instead holds, as noted above, that the Board must provide a definition on a case by case basis. Withers, supra. He can leverage his skills along with possible reasonable accommodations to continue employment. When taken holistically, this Veteran's two service-connected disabilities do not preclude participation in the workforce in a capacity that involves minimally interactive work. Furthermore, without the Veteran having completed any paperwork, he could currently be excelling in a new position as a welder. In short, the Board finds that the weight of competent, credible, and probative evidence demonstrates that his service connected disabilities, namely of a psychological nature, do not preclude him from securing or following all forms of substantially gainful employment. We acknowledge impairment in social interaction activity, as contemplated by the current disability evaluations. The weight of the evidence is still against a finding that the Veteran has been unable to secure or follow a substantially gainful occupation due to service connected disabilities. He could return to the workforce. There is no probative evidence establishing that his previous work was in a protected environment or was otherwise marginal. We note the absent forms. Therefore, entitlement to a total disability rating based on individual unemployability is denied. 38 C.F.R. § 4.16. Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). In reaching these conclusions, the Board finds that the preponderance of the evidence is against the claims. As such, the benefit of the doubt rule is not for application, and the claims must be denied. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Michael A. Pappas Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Bodi, 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.