Citation Nr: 21063411 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 15-06 573A DATE: October 14, 2021 ORDER Entitlement to a 70 percent rating, but no higher, for posttraumatic stress disorder (PTSD) from May 25, 2010, is granted. Entitlement to a total rating based on individual unemployability (TDIU) from May 25, 2010, to February 24, 2020, is granted. FINDINGS OF FACT 1. From May 25, 2010, the preponderance of the evidence shows that the Veteran's PTSD is productive of occupational and social impairment with deficiencies in most areas but not total occupational and social impairment. 2. From May 25, 2010, to February 24, 2020, the Veteran's service-connected disabilities precluded substantial gainful employment. CONCLUSIONS OF LAW 1. The criteria for a 70 percent rating, but no higher, for PTSD have been met at all times from May 25, 2010. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.14, 4.130, Diagnostic Codes 9411. 2. The criteria for a TDIU have been met at all times from May 25, 2010, to February 24, 2020. 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 in the United States Army from December 1971 to September 1973 which service included service in the Republic of Vietnam during the Vietnam War. In June 2018, a Veterans' Law Judge (VLJ) not the undersigned issued a Board of Veterans' Appeals (Board) decision that granted a 50 percent evaluation for PTSD and thereafter Remanded the issue of entitlement to an evaluation in excess of 50 percent for PTSD for further development as well as Remanded claims of service connection for a neck disorder and for a TDIU. In September 2019, a VLJ not the undersigned issued a Board decision that denied a rating in excess of 50 percent for PTSD and Remanded claims of service connection for a neck disorder and for a TDIU. In a May 2020 rating decision, the regional office (RO) increased the 50 percent rating for the Veteran's PTSD to 70 percent effective February 24, 2020. Therefore, because this claim has been pending since May 25, 2010, the Board finds that the issue on appeal covers the appropriate rating for PTSD at all times from May 25, 2010. See AB v. Brown,6 Vet. App. 35(1993); Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). The Veteran appealed the September 2019 decision to the United States Court of Appeals for Veterans Claims (Court). In an October 2020 order, the Court granted the parties Joint Motion for Partial Remand (JMPR) vacating and remanding the October 2019 Board decision to the extent that it denied a rating in excess of 50 percent for PTSD. In May 2021, a VLJ not the undersigned issued a Board decision that denied service connection for a neck disability, remanded the claim for an increased rating for PTSD rated as 50 percent disabling from May 25, 2010, to February 24, 2020, and 70 percent disabling from February 24, 2020, as well as remanded the TDIU claim. In an August 2021 rating decision, the RO granted the Veteran a TDIU effective February 24, 2020. Therefore, because this claim has been pending since May 25, 2010, the Board must still consider if the Veteran meets the criteria for a TDIU at any time from May 25, 2010, to February 24, 2020. See AB, supra; Fenderson, supra. Lastly, the Board notes that since the RO issued the August 2021 supplemental statement of the case (SSOC) it associated with the claims file additional VA treatment records in September 2021. Nonetheless, the Board finds that it need not further delay adjudication of the appeal to obtain a waiver of RO review of the evidence or Remand for such review. The Board has reached this conclusion because it finds the VA treatment records are not pertinent because they only show what is already found in the record-the Veteran does not meet the criteria for more than a 70 percent rating for PTSD at any time during the appeal period. See 38 C.F.R. § 19.31 (a SSOC will be furnished to the veteran when additional pertinent evidence is received after a statement of the case has been issued). The Board also finds that the Veteran is not prejudiced by it adjudicating the appeal without first obtaining a waiver or Remanding for RO review of these records because the below decision is, in essence, granting him the equivalent of the maximum benefit allowable by regulation-payment at the same rate of a Veteran with a 100 percent rating at all times during the pendency of the appeal. The concerns raised in the JMPR and post-remand compliance As to the concerns raised in in JMPR and the claim for an increased rating for PTSD, and as discussed in more detail below, the current decision contains a full and thorough discussion of, among other things, the evidence of the Veteran having suicidal ideation and the significance of this adverse symptomatology taking into account the Court's holding in Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017). As to the post-Remand development of the claim for an increased rating for PTSD, the Board finds that there has been substantial compliance because while at the RO it reviewed all the evidence added to the record since it issued the June 2019 SSOC, and the RO issued a new SSOC in August 2021. See 38 C.F.R. § 19.31. As to the post-Remand development of the claim for a TDIU, the Board finds that there has been substantial compliance. The Board has reached this conclusion because while the issue was at the RO it requested that the Veteran provide it with a new VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability, and the appellant thereafter failed to provide it. See Hyson v. Brown, 5 Vet. App. 262 (1993) (holding that VA does have a duty to assist the veteran in the development of a claim, that duty is not limitless."). Therefore, the Board finds that further delay by remanding the appeal to take further development is not required. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran are to be avoided). The Rating Claim The Veteran claims, in substance, that he is entitled to higher ratings for his PTSD at all times during the appeal period. Disability evaluations are determined by the application of a schedule of ratings which is based, as far as can practically be determined, on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Each service-connected disability is rated on the basis of specific criteria identified by a Diagnostic Code. 38 C.F.R. § 4.27. When rating the Veteran's service-connected disability, the entire medical history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Separate higher or lower compensable evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as "staged" ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). Regulations require that where there is a question as to which of two evaluations is to be applied, the higher evaluation 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. In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The Veteran's PTSD is rated as 50 percent disabling from May 25, 2010, and 70 percent from November 29, 2018, under 38 C.F.R. § 4.130, Diagnostic Code 9411 (the General Rating Formula for Mental Disorders (General Formula)). The General Formula provides a 50 percent rating is warranted when the evidence shows 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; 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 depressive disorder affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); inability to establish and maintain effective relationships. A 100 percent rating is warranted when the evidence shows 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. Id. Ratings are assigned according to the manifestation of particular symptoms. However, the use of the term "such as" in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). When determining the appropriate disability evaluation to assign, however, the Board's "primary consideration" is the Veteran's symptoms. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). Initially, the Board notes that this claim for a higher rating for PTSD was pending before the agency of original jurisdiction on or after August 4, 2014, because it was certified to the Board in September 2015. Therefore, the Board finds that the AMERICAN PSYCHIATRIC ASSOCIATION: DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, 5th Edition (2013) (DSM-5) applies to the current appeal. See 53 Fed. Reg. 14308 (March 19, 2015); 38 C.F.R. §§ 3.384, 4.125, 4.126, 4.127, and 4.130 (2017). Accordingly, the Board's adjudication of this claim cannot include any discussion of the Global Assessment of Functioning (GAF) scores found in the record. See Golden v. Shulkin, 29 Vet. App. 221 (2018). Next, and as noted by the JMPR, the record shows that the Veteran's adverse PTSD symptomatology includes suicidal ideation. See. e.g., VA examinations dated in March 2012 and April 2020; DBQ examination dated in March 2020. Moreover, at the March 2012 VA examination the Veteran endorsed symptoms of depression, passive and infrequent suicidal ideation, impaired impulse control, decreased appetite, weight loss, sleep disturbances, hypervigilance, and neglected hygiene. Additionally, at the April 2019 VA examination the Veteran endorsed symptoms of a depressed mood, anxiety, suspiciousness, chronic sleep impairment, flattened affect, disturbances of motivation and mood, as well as difficulty in establishing and maintaining effective work and social relationships. Similarly, at the March 2020 DBQ examination the Veteran's endorsed symptoms of a depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss (such as for getting names, directions or recent events), impairment of short and long term memory (such as retention of only highly learned material, while forgetting to complete tasks), circumstantial, circumlocutory, or stereotyped speech, impaired abstract thinking, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, including work or a work likes setting, inability to establish and maintain effective relationships, and obsessional rituals which interfere with routine activities. Likewise, at the April 2020 VA examination the Veteran endorsed symptoms of a depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, mild memory loss, flattened affect, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, including work or a work likes setting, and an intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene. Tellingly, and as noted in the JMPR, the Court has held that suicidal ideation generally rises to the level contemplated in a 70 percent evaluation. See Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017) (stating the language of 38 C.F.R. § 4.130 "indicates that the presence of suicidal ideation alone, that is, a veteran's thoughts of his or his own death or thoughts of engaging in suicide-related behavior, may cause occupational and social impairment in most areas."). The Court has also held that, "it is the information in a medical opinion, and not the date the medical opinion was provided that is relevant when assigning an effective date." Tatum v. Shinseki, 24 Vet. App. 139, 145 (2010) (discussing assignment of an effective date for a reduction in disability rating under Diagnostic Code 7528); see also Young v. McDonald, 766 F.3d 1348, 1352-53 (Fed. Cir. 2014). (holding that a medical opinion can diagnose the presence of the condition and identify an earlier onset date based on preexisting symptoms). Therefore, when considering the frequency, severity, and duration of the Veteran's impairment to assess his disability picture and when resolving all reasonable doubt in his favor, the Board finds that the most probative evidence of record are the above examinations that shows that the Veteran's PTSD adverse symptomatology approximates the criteria for at least a 70 percent rating at all times from May 25, 2010. See 38 C.F.R. § 4.130; Owens, supra; Fenderson, supra; Tatum, supra; Young, supra. The Board has reached this conclusion because the above examinations show that the Veteran's PTSD symptomatology includes, among other things, suicidal ideation, a depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, mild memory loss, impairment of short and long term memory, circumstantial, circumlocutory, or stereotyped speech, impaired abstract thinking, flattened affect, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, including work or a work likes setting, inability to establish and maintain effective relationships, obsessional rituals which interfere with routine activities, and/or an intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene. Id. However, the Board finds that the preponderance of the evidence shows that the criteria for a higher rating of 100 percent are not met at any time from May 25, 2010. See Owens, supra. In this regard, the Board finds that that the most probative evidence of record shows his PTSD does not cause total social and occupational impairment despite the problems seen with, among other things, suicidal ideation at any time from May 25, 2010. See 38 C.F.R. § 4.130; Owens, supra. In fact, the Board finds that the Veteran's own statements do not support such a finding. In this regard, while the criteria for a 100 percent rating specifically identifies problems with being a "persistent" danger of hurting self and while this is not exclusive symptomatology, the Board finds the fact that the record, including the March 2012, April 2019, and April 2020 VA examinations as well as the March 2020 DBQ examination and the VA treatment records, is negative for a suicide plan or attempt, weighs heavily against finding that the appellant's PTSD causes a "persistent" danger of hurting self despite the suicidal ideation reported in his medical records. See Owens, supra. In this regard, the Board finds the Veteran's own words to the March 2012, April 2019, and/or April 2020 VA examinations and/or the March 2020 DBQ examination when he denied, in substance, current thoughts of suicide or a plan weights against the claim. See Owens, supra. Simply stated, on this very limited issue, the Veteran himself provides evidence against this claim that is of high probative value. Likewise, the Board also notes that the criteria for a 100 percent rating specifically identifies problems with "memory loss for names of close relatives, own occupation, or own name" and the examinations and treatment records noted a problem with memory loss. See, e.g., VA examinations dated in March 2012, April 2019, and April 2020; DBQ examination dated in March 2020. However, the Board finds the fact that all the examiners opined that the memory loss was mild as well as because the VA treatment records are negative for more severe memory loss than was reported by the examiners weighs against finding that the memory loss reported by the examiners is the type of memory loss contemplated by the criteria for a 100 percent rating. See Owens, supra. Next, while not exclusive symptomatology the criteria for a 100 percent rating also specifically identifies problems with "persistent danger of hurting ... others," and the Veteran told the March 2020 DBQ examiner that he had problems with "road rage." However, the Board notes that the record, including the March 2012, April 2019, and April 2020 VA examinations as well as the March 2020 DBQ examination and the VA treatment records, are negative for homicidal ideation. In fact, at the March 2012, April 2019, and April 2020 VA examinations as well as the March 2020 DBQ examination the Veteran either specifically denied and/or the examiner found that the appellant did not have homicidal ideation. Therefore, the Board finds that the periodic problem the Veteran has with road rage is not the type of problem contemplated by the criteria for a 100 percent rating. See Owens, supra. Additionally, while not exclusive symptomatology the criteria for a 100 percent rating also specifically identifies problems with an "intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene)" and the March 2012 VA examiner noted that the Veteran neglected hygiene and the April 2020 VA examination reported that he had an intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene. However, the April 2020 VA examiner also opined that he arrived at the examination adequately groomed. Moreover, the April 2019 VA examination and the March 2020 DBQ examination are negative for such adverse symptomatology. Likewise, the Board finds that most of the Veteran's treatment records are negative for this type of adverse symptomatology. Therefore, the Board finds that the periodic problem the Veteran has with maintenance of minimal personal hygiene is not the type of problem contemplated by the criteria for a 100 percent rating. See Owens, supra. Similarly, while not exclusive symptomatology the criteria for a 100 percent rating also specifically identifies problems with "gross impairment in thought processes or communication," "persistent delusions or hallucinations," and "grossly inappropriate behavior" "disorientation to time or place." However, the Board notes that the record, including the March 2012, April 2019, and April 2020 VA examinations as well as the March 2020 DBQ examination and the VA treatment records are negative for such adverse symptomatology. In fact, at the March 2012, April 2019, and April 2020 VA examinations as well as the March 2020 DBQ examination the Veteran either specifically denied and/or the examiner found that the appellant did not have problems with most or all of the above types of adverse symptomatology. See Colvin, supra. Again, the Board finds the Veteran's own words and the VA examiners opinions weigh heavily against finding that his PTSD causes the type of adverse symptomatology required for a 100 percent rating at all times from May 25, 2010. See Owens, supra. Simply stated, it is important for the Veteran to understand that not all the evidence in this case supports the 70 percent finding, let alone a higher rating. Next, the Board finds that the preponderance of the evidence shows that the Veteran's PTSD does not cause total social and occupational impairment at all times from May 25, 2010. See Owens, supra. While, as will be discussed in more detail below in the TDIU discussion, the Veteran's PTSD causes total occupational impairment, the criteria for a 100 percent rating for PTSD also requires total social impairment and the Board finds that the preponderance of the evidence shows that his PTSD does not cause total social impairment because it shows that the Veteran is able to maintain relationships with his wife and friends at all times from May 25, 2010. Id. In this regard, the Board notes that at the March 2012 VA examination the Veteran reported that he stays in contact with his mother, has been married for over 30-years even though they have some problems, and he has a good relationship with his daughters but does not have any friends. Similarly, in a July 2018 VA treatment record it was noted that the Veteran had a supportive spouse. Likewise, the Board notes that at the April 2019 VA examination the Veteran reported that he had been married to his wife for 44 years; albeit with disagreements and arguments. In addition, while the April 2019 VA examiner indicated that the Veteran did not have relationships with his daughters or siblings, he still maintained two friends and would meet up with them outside of the group-setting. Likewise, while at the March 2020 DBQ examination the Veteran reported that he had a poor relationship with his daughters, he also reported that he is close with his wife. Additionally, while at the April 2020 VA examination the Veteran reported that he has a "lousy" relationship with family members and struggles to make and maintain social relationships, he also reported that he continues to live with his wife. The Board finds that the Veteran's reports of being able to maintain the long term marriage and live with and maintain a relationship with his wife for over four decades as well as maintained two friendships weighs against finding his PTSD causes total social impairment at all times from May 25, 2010, despite his many social problems. See Owens, supra. While the Veteran clearly has problems due to his PTSD (this is not in dispute) which cause significant social and occupational impairment, the only question is the degree of the problem. Without taking into consideration his statements the 70 percent finding could not be justified based on this medical evidence. See Davidson, supra. Accordingly, the Board finds that the preponderance of the evidence shows that the Veteran's PTSD is not manifested by symptomatology that causes total social impairment at any time from May 25, 2010. See Owens, supra. Therefore, the Board finds that the criteria for a 100 percent rating are not met for the Veteran's PTSD at any time from May 25, 2010, because his PTSD does not cause both total occupational and social impairment. See 38 C.F.R. § 4.130; Fenderson, supra; Hart, supra. In reaching the above conclusions, the Board has also considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the probative evidence is against the claim to the extent outlined above, the Board finds that this doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert, 1 Vet. App. at 55-56. The TDIU from May 25, 2010, to February 24, 2020, Claim While the Veteran already received a TDIU February 24, 2020, he claims' that his service-connected PTSD prevented him from working at all times during the pendency of the appeal which runs from May 25, 2010, because it is part of his claim for an increased rating for PTSD. See Rice v. Shinseki, 22 Vet. App. 447 (2009). 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. 38 C.F.R. § 3.340. If the total rating is based on a disability or combination of disabilities for which the Schedule for Rating Disabilities provides an evaluation of less than 100 percent, it must be determined that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age. 38 C.F.R. § 3.341. If the schedular rating is less than total, a total disability evaluation can be assigned based on individual unemployability if the Veteran is unable to secure or follow a substantially gainful occupation because of a service-connected disability, provided that the Veteran has one service-connected disability rated at 60 percent or higher; or two or more service-connected disabilities, with one disability rated at 40 percent or higher and the combined rating is 70 percent or higher. In calculating if the Veteran met the above schedular criteria VA combines the Veteran's service-connected orthopedic disorders. The existence or degree of non-service-connected disabilities will be disregarded if the above-stated percentage requirements are met and the evaluator determines that the Veteran's service-connected disabilities render his incapable of substantial gainful employment. 38 C.F.R. § 4.16(a). A TDIU may be assigned where the schedular rating is less than total if a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). Generally, total disability will be considered to exist when there is present any impairment of mind or body that is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Further, marginal employment, defined as an amount of earned annual income that does not exceed the poverty threshold determined by the United States Department of Commerce, Bureau of the Census, shall not be considered substantially gainful employment. 38 C.F.R. § 4.16(a). The record shows that from May 25, 2010, to February 24, 2020, the Veteran was service-connected as follows: PTSD rated as 70 percent disabling from May 25, 2010. In summary, this record shows that the Veteran meets the schedular requirements of 38 C.F.R. § 4.16(a) because he has one service-connected disability rated at 60 percent or higher at all times from May 25, 2010, to February 24, 2020. Thus, the question for the Board to consider is when, if ever, his service-connected disability rendered him incapable of substantial gainful employment at any time from May 25, 2010, to February 24, 2020. 38 C.F.R. § 4.16(a). In this regard, the Veteran's VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability (TDIU Claim Form), dated in December 2016, reported that he had not worked full-time and became too disabled to work in January 2009 because of his service-connected disability. As to his work history, the Veteran reported that from January1976 to January 2009 he worked 40 hours a week as a manager for the United States Postal Service. As to his education, the Veteran reported that he had 2-years of college. As to the Veteran's being able to work performing jobs that require sedentary employment and non-sedentary employment, including his past employment as a manager for the United States Postal Service as well as other possible employment that could make use of his work experience and 2-years of college, the Board finds that the medical records show that the problems caused by his service-connected PTSD adversely impact his ability to work in any field because of the overall impairment it has to his body and mind to include the stamina needed to work a full-day, concentrate on the tasks required by employment, and interact effectively with co-workers and/or customers, and carry out the tasks required by employment at all times from May 25, 2010, to February 24, 2020. See Geib v. Shinseki, 733 F.3d 1350 (Fed. Cir. 2013) (holding that the determination of whether a Veteran is unable to secure or follow a substantially gainful occupation due to service-connected disabilities is a factual rather than a medical question and that it is an adjudicative determination properly made by the Board or the regional office). The Board also finds that his service-connected connected PTSD would make it very difficult to learn the new skills needed to work in most non-sedentary employments for the first time as well as make it dangerous for the Veteran and his co-workers for him to work in most non-sedentary employments from May 25, 2010, to February 24, 2020. Id. Similarly, the Board finds that that the PTSD would make it very difficult to continue working in most sedentary employments because of the problems it would cause interacting with his co-workers as well as any customers and carry out the duties required by such employment from May 25, 2010, to February 24, 2020. Id. Given the above, the Board finds that the Veteran's service-connected disability prevented him from securing or following a "substantially gainful" occupation given his prior vocational history, work experience, and the impact his service-connected PTSD had on obtaining and maintaining substantially gainful non-sedentary employment and sedentary employment, including in his past employment as a manager for the United States Postal Service, because of the problems is would cause in any work environment from May 25, 2010, to February 24, 2020. See Owens, supra. Further development of this issue is simply not warranted in light of the history of this case. (Continued on the next page) Therefore, the Board finds that the most probative evidence of record shows that the Veteran's service-connected disability rendered him incapable of substantial gainful employment given his prior vocational history, work experience, and the impact his service-connected disability had on all employment at all times from May 25, 2010, to February 24, 2020, and the claim for a TDIU for this time period is granted. See 38 C.F.R. § 4.16(a); Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N.T. Werner, 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.