Citation Nr: 21061813 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 17-50 715 DATE: October 5, 2021 ORDER Prior to November 23, 2019, a rating in excess of 30 percent for posttraumatic stress disorder (PTSD) is denied. Prior to November 23, 2019, a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is denied. FINDINGS OF FACT 1. Prior to November 23, 2019, the Veteran's PTSD was manifested by psychiatric symptomatology resulting in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, without more severe manifestations that more nearly approximate occupational and social impairment with reduced reliability and productivity, occupational and social impairment with deficiencies in most areas, or total occupational and social impairment. 2. Prior to November 23, 2019, the Veteran's service-connected disabilities did not render him unable to secure or follow a substantially gainful occupational consistent with his education and work history. CONCLUSIONS OF LAW 1. Prior to November 23, 2019, the criteria for a rating in excess of 30 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. 2. Prior to November 23, 2019, the criteria for a TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1962 to June 1965. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in December 2014 by a Department of Veterans Affairs (VA) Regional Office. In April 2019, the Veteran and his spouse testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In July 2019, the Board, in pertinent part, remanded the issue of entitlement to a rating in excess of 30 percent for PTSD for additional development. In a rating decision issued in July 2020, the Agency of Original Jurisdiction (AOJ) awarded a rating of 70 percent for PTSD and entitlement to a TDIU, effective November 23, 2019. As noted in the Board's Remand, such awards constituted a full grant as to the issues for the period on and after November 23, 2019. See Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997); AB v. Brown, 6 Vet. App. 35, 38 (1993). Further, despite the absence of a notice of disagreement with the effective date assigned for the award of a TDIU, the Board, in an October 2020 decision, found the instant appeal period stemmed from the Veteran's claim for an increased rating for his PTSD, which was received on August 7, 2014. Therefore, the question of entitlement to a TDIU for the period prior to November 23, 2019, remained on appeal. Rice v. Shinseki, 22 Vet. App. 447 (2009); Harper v. Wilkie, 30 Vet. App. 345 (2018). Nonetheless, in such decision, the Board denied the issues on appeal. Thereafter, the Veteran appealed such decision to the United States Court of Appeals for Veterans Claims (Court). In May 2021, the Court granted a Joint Motion for Remand (JMR), which vacated the October 2020 decision and remanded the matters for further appellate review. 1. Entitlement to a rating in excess of 30 percent for PTSD prior to November 23, 2019. As an initial matter, the Board observes that the parties in the JMR agreed that the Board erred in the October 2020 decision when it failed to set forth an adequate statement of reasons or bases addressing whether the Veteran was entitled to a rating in excess of 30 percent for PTSD prior to November 23, 2019, based on a July 8, 2020, rating decision that awarded a 70 percent rating for such disability as of August 7, 2014. Specifically, the parties cited to the "binding nature of decisions" as set forth in 38 C.F.R. § 3.104, which provides that any finding favorable to the claimant made by either a VA adjudicator or the Board is binding on all subsequent AOJ and Board adjudicators, unless rebutted by evidence that identifies a clear and unmistakable error in the favorable finding. 38 C.F.R. § 3.104(c). Nevertheless, the Board finds determinative that the record does not show the AOJ issued written notification in accordance with 38 U.S.C. § 5104 so as to render the July 8, 2020, rating decision binding as required by 38 C.F.R. § 3.104(a). Therefore, as the July 8, 2020, rating decision was not promulgated, any findings made therein, favorable or otherwise, are not binding on any subsequent adjudicator. Instead, the record clearly reflects written notification dated on July 24, 2020, of the issuance of a July 16, 2020, rating decision, which unequivocally granted a 70 percent rating for PTSD and entitlement to a TDIU as of November 23, 2019, but no earlier. Consequently, the Board is bound only by the favorable findings as determined by the AOJ in the July 16, 2020, rating decision, and the Board's previous characterization and consideration of the issues in the October 2020 decision were proper. Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant's favor. 38 C.F.R. § 4.3. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. Separate ratings can be assigned for separate periods based on the facts found - a practice known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The appeal period before the Board begins on August 7, 2014, the date VA received the Veteran's claim for an increased rating for his PTSD, plus the one-year look-back period, and ends on November 23, 2019, the date a 70 percent rating was assigned. Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010); AB, supra. For the entire period, the Veteran's PTSD is rated as 30 percent disabling under Diagnostic Code 9411, which provides that such disability is evaluated pursuant to the General Rating Formula for Mental Disorders (General Rating Formula). 38 C.F.R. § 4.130. The General Rating Formula provides a 30 percent rating when there is 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; and mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is warranted when there is 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 difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is warranted when there is 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 work-like setting); and inability to establish and maintain effective relationships. A 100 percent rating is warranted when there is 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 ability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of closest relatives, own occupation, or own name. The United States Court of Appeals for the Federal Circuit has held that the evaluation under 38 C.F.R. § 4.130 is "symptom-driven," meaning that "symptomatology should be the fact-finder's primary focus when deciding entitlement to a given disability rating" under that regulation. See Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-117 (Fed. Cir. 2013). The symptoms listed are not exhaustive, but rather "serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating." Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In the context of determining whether a higher disability evaluation is warranted, the analysis requires considering "not only the presence of certain symptoms, but also that those symptoms have caused occupational and social impairment in most of the referenced areas" - i.e., "the regulation...requires an ultimate factual conclusion as to the Veteran's level of impairment in most areas." Vazquez-Claudio, 713 F.3d at 117-118; 38 C.F.R. § 4.130, Diagnostic Code 9411. Further, when evaluating a mental disorder, the Board must consider the "frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission," and must also "assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination." 38 C.F.R. § 4.126(a). Prior to November 23, 2019, the Veteran's service-connected PTSD is rated as 30 percent disabling. Therefore, to warrant a higher rating, the evidence must demonstrate manifestations that more nearly approximate occupational and social impairment with reduced reliability and productivity, occupational and social impairment with deficiencies in most areas, or total occupational and social impairment. Upon review, the Board finds the Veteran's PTSD was manifested by psychiatric symptomatology resulting in, at most, occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks for the entire appeal period prior to November 23, 2019. With respect to the Veteran's specific psychiatric symptomatology, the record reflects consistent reports of irritability, anxiety, depressed mood, loss of interest, and sleep impairment. On VA examination in October 2017, in particular, the Veteran reported unfocused anxiety that had been the same intensity despite past negative PTSD screenings. He and his spouse also specifically reported nightmares that formed into night terrors, and the VA examiner found testing suggested "a notable experience of psychiatric symptoms". In August 2019, he reported feeling anxious at times when he was feeling down, which could last for up to one day, as well as problems with initiating and maintaining sleep. He also stated that he had been feeling down "on and off" for many years. At various points during the relevant period, the Veteran has also reported feelings of worthlessness, mild memory loss, and obsessional rituals; however, the record does not show that his obsessional rituals are of a frequency, severity, or duration so as to interfere with routine activities or result in occupational and social impairment greater than occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. Additionally, while the Veteran had a remote history of a suicide attempt in 1969, the record demonstrates his repeated denial of any suicidal and homicidal ideations during the appeal period. Furthermore, the record does not demonstrate findings related to abnormal speech, panic attacks, difficulty in understanding complex commands, impaired judgment, impaired abstract thinking, or difficulty in establishing and maintaining effective work and social relationships, symptoms which are specifically contemplated in the criteria for a 50 percent rating. Moreover, following psychological examination of the Veteran in December 2014, the VA examiner opined that people within the Veteran's mild range of symptomatology have little difficulty obtaining and maintaining employment. The VA examiner further found the Veteran's symptoms were not severe enough to interfere with occupational functioning. At the time of the VA examination, the Veteran himself reported having retired six years prior from working as a bus driver for 19 years. With respect to social impairment, it was noted in the December 2014 VA examination report that some of the features of his psychiatric disability included social withdrawal, agitation, a sense of hostility, the appearance of apathy, and interaction with others in an abrasive or brusque manner. The Veteran was on his fifth marriage and had been married to his current wife for six years. Ultimately, however, the VA examiner found the Veteran had only mild limitations in the areas of social interaction, adaptation, concentration, persistence, or pace, and initiating and participating in activities of daily living. At the October 2017 VA examination, the Veteran was still married to his fifth wife and reportedly always wanted to help his children. The VA examiner specifically found the Veteran's PTSD was manifested by psychiatric symptomatology resulting in 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. At the April 2019 Board hearing, the Veteran testified that he enjoyed doing things with his wife and participating in activities with his friends. In addition, he denied isolating himself and reported an "okay" relationship with his children, seeing two of them in particular quite a bit. An August 2019 VA treatment record reflects the Veteran's report of less interest in socializing and activity when feeling down but a part of such decrease was related to financial constraints. He also repeated his reports of spending time with his wife and occasionally going to his friends' houses, and the VA treatment record indicates that he had social support from both his wife and kids. Further, VA treatment records dated in October 2019 and November 2019 indicate the Veteran had an improved mood when he was committed to an activity; in particular, he highlighted bowling and picking up his grandson as his current recreational activities. Nevertheless, in a November 2019 written statement, the Veteran reported frequent outbursts with his wife and isolating himself in such moments. He also stated that his mood fluctuated, and he experienced depression and anxiety "almost every day". He reported difficulty with crowds and having difficulty getting along with others, at times, and with starting and finishing things. In support of the appeal, the Veteran's representative points to a VA examination report dated November 23, 2019, which served as the basis for the award of a 70 percent rating as of such date. The representative asserts an award of 70 percent for PTSD is warranted prior to such date based on the Veteran's reports of his symptomatology, which he alleges have remained the same in severity over time. However, the Board notes the November 2019 VA examination report specifically reflects the Veteran's reports that his "issues related to socialization continued to worsen over time" and, although the diagnosis was unchanged, the VA examiner found the Veteran's symptoms had continued to worsen over time. Thus, the Board finds the November 2019 VA examination report does not support the premise that the severity of the Veteran's symptomatology remained the same throughout the pendency of the appeal. In a similar vein, the Board affords greater probative weight to the evidence contemporaneous to the period on appeal than any opinion provided thereafter. Curry v. Brown, 7 Vet. App. 59, 68 (1994) (noting the enhanced probative value of contemporaneous evidence). Moreover, with respect to the Veteran's later statements regarding his symptomatology, the Board notes that reports generated for the purposes of medical treatment may be afforded greater probative value than a veteran's statements made in support of a claim for compensation benefits because there is a strong motive to tell the truth in order to receive proper care at the time. See Federal Rule of Evidence 804(3); Cucuras v. Sec'y of Health and Human Servs., 993 F.2d 1525, 1528 (Fed. Cir. 1993). Here, the Board affords the VA examiners' determinations in December 2014 and October 2017 great probative value as they were based on psychological evaluations of the Veteran during the appeal period and consideration of his own contemporaneous lay statements of his symptoms in light of the rating criteria. Such evidence, with consideration of the totality of the nature, frequency, severity, and duration of the Veteran's psychiatric symptomatology as demonstrated by the contemporaneous medical evidence of record, indicates his psychiatric symptomatology resulted in no more than 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 prior to November 23, 2019. Consequently, a rating in excess of 30 percent is not warranted under the General Rating Formula for this period. The Board has considered whether additional staged ratings under Hart, supra, are appropriate for the Veteran's service-connected PTSD; however, the Board finds that his symptomatology had been stable throughout the appeal period. Therefore, assigning additional staged ratings is not warranted. Furthermore, neither the Veteran nor his representative have raised any other issues, nor have any other issues been reasonably raised by the record, with regard to the increased rating claim adjudicated herein. 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). 2. Entitlement to a TDIU prior to November 23, 2019. As noted above, the Veteran is in receipt of a TDIU as of November 23, 2019. However, the Veteran asserts that his service-connected PTSD and back disability have prevented him from securing and following a substantially gainful occupation since August 1, 2013. Additionally, although VA did not receive the Veteran's Application for Increased Compensation Based on Unemployability (VA 21-8940), until December 10, 2019, the appeal period before the Board stems from August 7, 2014, the date VA received the Veteran's claim for an increased rating for his PTSD, plus the one-year look-back period, and ends on November 23, 2019, the date a TDIU was awarded. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a veteran is 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, such disability shall be ratable as 60 percent or more, and 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). Rating boards should submit to the Director of 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 38 C.F.R. § 4.16(a). 38 C.F.R. § 4.16(b). Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, "entitlement to a TDIU is based on an individual's particular circumstances." Rice v. Shinseki, 22 Vet. App. 447, 452 (2009). Therefore, when adjudicating a TDIU claim, VA must take into account the individual veteran's education, training, and work history. Hatlestad v. Derwinski, 1 Vet. App. 164 (1991) (level of education is a factor in deciding employability); Friscia v. Brown, 7 Vet. App. 294 (1994) (considering Veteran's experience as a pilot, his training in business administration and computer programming, and his history of obtaining and losing 19 jobs in the previous 18 years); Beaty v. Brown, 6 Vet. App. 532 (1994) (considering Veteran's 8th grade education and sole occupation as a farmer); Moore v. Derwinski, 1 Vet. App. 356 (1991) (considering Veteran's master's degree in education and his part-time work as a tutor). Age may not be considered as a factor when evaluating unemployability or intercurrent disability, and it may not be used as a basis for a total disability rating. 38 C.F.R. § 4.19. There must be a determination that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age or a non-service-connected disability. 38 C.F.R. §§ 3.340, 3.341, 4.16. 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. The ultimate question, however, is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). In Ray v. Wilkie, 31 Vet. App. 58 (2019), the Court held that the initial extra-schedular referral decision under § 4.16(b) should address whether there is "sufficient evidence to substantiate a reasonable possibility that a veteran is unemployable by reason of his or her service-connected disabilities". Moreover, the Court defined the term "unable to secure and follow a substantially gainful occupation" in § 4.16(b) to include two components: one economic and one noneconomic. The economic component means an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person. The non-economic component includes consideration of the veteran's history, education, skill, and training; whether the veteran has the physical ability to perform the type of activities required by the occupation at issue; and whether the veteran has the mental ability to perform the activities required by the occupation at issue. With respect to the schedular criteria for a TDIU, for the reasons described above, the Board is bound only by the favorable findings determined by the AOJ in the July 16, 2020, rating decision, as issued on July 24, 2020. Therein, the AOJ awarded a 70 percent rating as of November 23, 2019, but no earlier. Thus, for the relevant appeal period, the Veteran's PTSD is rated as 30 percent disabling; his back disability is rated as 20 percent disabling; his left knee strain is rated as 10 percent disabling; his radiculopathy of the right and left sciatic nerve are each rated as 10 percent disabling; and his hemorrhoids are evaluated as noncompensably disabling. While his back disability and bilateral lower extremity radiculopathy are considered one disability as they result from a common etiology, his combined disability rating is 60 percent for the entire appeal period. Thus, he does not meet the schedular threshold for a TDIU. 38 C.F.R. § 4.16(a). Nonetheless, as noted previously, if it is shown that the Veteran is rendered unemployable during the appeal period by reason of service-connected disabilities, the Board may refer the case to the Director of Compensation Service for extra-schedular consideration. 38 C.F.R. § 4.16(b). According to the Veteran's VA Form 21-8940, he last worked full time in July 2008, but became too disabled to work in August 2013. He reported that his previous employment involved working as a bus driver for various companies from January 2008 to December 2008, March 2012 to October 2012, and January 2013 to July 2013. Additionally, VA examination reports show the Veteran worked for a bank for 16 years following service and eventually became a supervisor prior to his employment as a bus driver. Based on the above, the Board finds the record does not indicate the Veteran was gainfully employed at any point during the appeal period. Thus, the crux of the issue is whether the Veteran's service-connected disabilities rendered him unemployable during the period on appeal. In this regard, the Veteran does not contend, and the evidence does not show, that his hemorrhoids impact his ability to work. Additionally, a December 2014 VA examination report reflects a VA physician's opinion that the Veteran's back disability did not impact his ability to work. In this respect, the report shows the Veteran denied any functional loss or impairment of the thoracolumbar spine and did not have any radicular pain or other signs or symptoms due to radiculopathy. A January 2015 VA treatment record shows the Veteran reported being retired with long-standing lumbar and bilateral hip pain. He reported a most recent flare-up about a year ago without any trauma and now had increased pain bending forward, standing up from a seated position, and pain while mopping. Notably, he was independent with his activities of daily living and sat 75 percent of the day. He reported that his left knee buckled two months prior, which resulted in a fall, but there had been no such occurrence since that incident. Functionally, it was noted that the Veteran had difficulty standing up, squatting, reaching, and bending. He had good lower extremity strength but decreased lower extremity flexibility and trunk range-of-motion. An April 2015 VA treatment record noted the Veteran had no pain in the low back but did have a burning sensation in the left leg. An additional April 2015 physical therapy progress note shows the Veteran continued to have low back pain with bending forward and kneeling but that he reported his symptoms were improving. A physical therapy discharge note dated that same month shows the Veteran reported clinically meaningful improvement in his ability to perform squatting and lifting. A July 2017 VA treatment record reflects the Veteran's reports of lower back pain radiating down his left leg since a fall while walking downstairs at his home. Although he had some difficulty ambulating, he could walk without support. In August 2017, VA physicians noted the Veteran had posture deviations, a decrease in functional mobility, a decrease in lumbar range-of-motion and lower extremity flexibility, decreased lower extremity and core strength, and soft tissue restrictions/tenderness. However, the Veteran reported a clinically meaningful improvement in his ability to perform sitting, bending, and walking with minimal provocations of symptoms. Per a September 2017 Disability Benefits Questionnaire (DBQ) in pertinent to the Veteran's service-connected left knee strain, he reported that such disability prevented him from sitting and/or standing for long periods of time. When addressing functional impairment on occupational tasks, the VA examiner opined therein that the Veteran's "knee conditions" prevented long walking, sitting, and standing. A May 2018 VA treatment record shows the Veteran's knee pain and back pain remained unchanged, and a December 2018 VA treatment record reflects the Veteran's report that, although he sometimes felt as though his left knee gave out, he had no pain or weakness on examination. As explained in greater detail above, the Veteran's PTSD resulted in, at most, occupational impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks during the appeal period. In light of the above findings, the Board finds the probative evidence does not show the Veteran's service-connected disabilities were of sufficient severity so as to render him incapable of performing the physical and mental acts required by a substantially gainful occupation throughout the appeal period. Here, the Board affords significant probative weight to the aforementioned VA examiners' assessments of the functional impairment associated with the Veteran's service-connected disabilities, with the exception of the September 2017 VA examiner's assessment as to the functional impact associated with his left knee disability, as they were based on physical and psychological examination of the Veteran and a review of the record, to include his medical history, work history, and lay statements. Further, although the September 2017 VA examiner determined the Veteran's knee conditions prevented walking, sitting, and standing for long periods, the Board affords such opinion less probative value as such was based, at least in part, on the Veteran's non-service-connected right knee disability. Additionally, the Veteran's VA Form 21-8940 shows he focused solely on his back disability and PTSD as the basis for his TDIU claim. In this respect, the evidence shows that, even with back pain, the Veteran sat for large parts of the day and made clinically meaningful improvement with therapy throughout the appeal period. Moreover, the Board notes the absence of any contemporaneous assertions by the Veteran regarding the impact of his service-connected disabilities on his "retirement". Rather, he filed his claim for a TDIU in December 2019. Finally, the evidence shows the Veteran's work history included employment in both an office-type setting (bank) and a field requiring more rigorous physical activity (bus driving) and, thus, to the extent that his service-connected back and left disabilities impact his ability to perform physical or manual labor, there is no indication that such interfere to an extent that he is rendered unemployable in performing an occupation consistent with his prior experience working at a bank or as a supervisor. Moreover, as noted previously, his PTSD symptomatology clearly shows only a minimal impact on his occupational functioning. Consequently, the Board finds the Veteran's service-connected disabilities did not render him unable to secure or follow a substantially gainful occupation consistent with his level of education (one year of college) and history of both office/ supervisory work and bus driving prior to November 23, 2019. In reaching such determination, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against such claim, the benefit of the doubt doctrine is not applicable. Therefore, referral for extra-schedular consideration of a TDIU prior to such date is not warranted. A. JAEGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. M. Celli, 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.