Citation Nr: 21069421 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 14-42 617 DATE: November 18, 2021 ORDER Before March 13, 2017, a rating in excess of 50 percent for posttraumatic stress disorder (PTSD) is denied. From March 13, 2017, to April 2, 2019, a rating in excess of 70 percent for PTSD is denied. Before April 2, 2019, a total disability rating based on individual unemployability (TDIU) is denied. FINDINGS OF FACT 1. Before March 13, 2017, the Veteran's PTSD was manifested, at worst, by occupational and social impairment with reduced reliability and productivity. 2. From March 13, 2017, to April 2, 2019, the Veteran's PTSD was manifested, at worst, by occupational and social impairment with deficiencies in most areas. 3. Before April 2, 2019, the Veteran's service connected disabilities did not preclude him from securing and following a substantially gainful occupation consistent with his education and work experience. CONCLUSIONS OF LAW 1. Before March 13, 2017, the criteria for a rating in excess of 50 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, Diagnostic Code 9411. 2. From March 13, 2017, to April 2, 2019, the criteria for a rating in excess of 70 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, Diagnostic Code 9411. 3. Before April 2, 2019, the criteria for the award of a TDIU have not been met. 38 U.S.C. §§ 1155, 5103, 5103A; 38 C.F.R. §§ 3.159, 3.340, 3.341, 4.16, 4.18. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1987 to November 1991 and from April 1993 to December 1993. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2012 rating decision of the Agency of Original Jurisdiction (AOJ) that granted service connection for PTSD and assigned an initial 30 percent rating. A September 2014 rating decision increased the initial rating for PTSD to 50 percent. A July 2016 rating decision denied a TDIU. An August 2019 rating decision increased the rating of the Veteran's PTSD to 70 percent effective April 2, 2019. A September 2020 rating decision granted an effective date of March 13, 2017, for the grant of a 70 percent rating for PTSD, and it granted a 100 percent rating for PTSD effective April 2, 2019. The Veteran participated in a hearing before the undersigned Veterans Law Judge in January 2018, and a transcript of this hearing has been associated with the record. This matter was most recently before the Board in March 2021, when it remanded the Veteran's claims in order to obtain outstanding medical records from the Tacoma Vet Center. Although medical records from VA Vet Centers are federal records, VA policy sets out that proper authorization from the veteran is nonetheless required to obtain them. Accordingly, in March 2021, the AOJ requested the Veteran's authorization on VA Form 21-4142 to obtain records from the Tacoma Vet Center. The AOJ again requested the Veteran's authorization to obtain such records in June 2021. To date, the Veteran has not responded to these requests for authorization. The duty to assist is not a one-way street, and it is the responsibility of veterans to cooperate with VA with regard to case development. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). The AOJ made reasonable attempts to obtain records from the Tacoma Vet Center, and as such, the AOJ has substantially complied with the Board's March 2021 remand directives. Increased Rating The Veteran argues that his PTSD warrants ratings in excess of 50 percent before March 13, 2017, and in excess of 70 percent from March 13, 2017, to April 2, 2019. The Veteran's PTSD is rated 100 percent disabling since April 2, 2019, and the Board's analysis thus will not consider the issue of an increased rating since that time. Under the General Formula for Mental Disorders (General Formula), the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). The General Formula provides for the following ratings, in pertinent part: A 50 percent rating is assigned when symptoms such 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; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity. A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; 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); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. A 100 percent rating is assigned when symptoms such 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; or memory loss for names of close relatives, own occupation or own name cause total occupational and social impairment. Turning to the facts in this case, the Veteran filed his underlying claim for service connection PTSD in September 2010. In November 2010, the Veteran reported that he had returned to his job as a security manager for a major retail company after taking leave since June 2010. The Veteran thought that his employer had transferred him to a more difficult assignment to attempt to "get rid of him". The Veteran underwent a VA examination in December 2010, at which time the Veteran reported living alone and having "strained" relationships with his adult children. The Veteran was not involved in a romantic relationship and he reported having few friends; the Veteran preferred to be alone. The Veteran engaged in few leisure activities other than watching movies. The Veteran experienced depression, anxiety, difficulty sleeping, occasional forgetfulness, and he engaged in obsessive and ritualistic cleaning of his apartment. The Veteran had a markedly diminished interest and participation in significant activities, feelings of detachment and estrangement from others, and a restricted range of affect. The Veteran was employed with a major retail company as a security manager. The Veteran found this position to be stressful both because the nature of his position had led other employees to threaten him, and because he did not have a set work schedule. The Veteran reported having to take medical leave from June 2010 to November 2010 as a result of overwhelming feelings of stress. The examiner found the Veteran to be competent to manage his financial affairs. In February 2011, the Veteran reported having "strained" relationships with his adult children and a conflictual relationship with a work supervisor. The Veteran desired to have closer friendships and a romantic relationship. In August 2012, the Veteran resided with a "supportive" girlfriend, and he was employed in the investigative department of a major clothing retailer. The Veteran had recently suffered an anxiety attack at work, and he feared that he could lose his job as a result of his medical issues. In September 2012, the Veteran applied for vocational rehabilitation services from VA's Veteran Readiness and Employment (VR&E) program. In October 2012, a physician opined that the Veteran had an "excellent" ability to work, noting that the Veteran was fully capable of performing job functions as long as the work environment was minimally to moderately stressful. In November 2012, the Veteran reported a worsening relationship with his girlfriend, and in December 2012, the Veteran reported that he had been fired from his job. The Veteran lived alone and was "distant from family". In December 2012, a Vocational Rehabilitation Counselor (VRC) with the VR&E program found that the Veteran's "overall ability to work [was] favorable". In December 2012, the Veteran was determined to be eligible to participate in VA's VR&E program. In May 2013, the Veteran reported that he was both attending school and working. The Veteran's leisure activities included running, working on his car, and spending time with a close friend. In September 2014, the Veteran reported dating a nurse but keeping it "low key". In October 2014, the Veteran reported that his interests included working out, his automobile, and school. The Veteran worked for a VA work-study program. The Veteran was not involved in a romantic relationship and indicated that he "had trouble with relationships". In June 2015, the Veteran reported having regular contact with his adult son and estrangement from his adult daughter. The Veteran was involved in a relationship with a woman who had three children, and he was considering proposing marriage that month. In March 2017, the Veteran reported that he was working part-time and going to school full-time, which he found to be very stressful. The Veteran's anxiety and depression were worsening, and the Veteran reported having a suicidal plan to overdose on pills. The Veteran had given these pills to his spouse, who disposed of them. A clinician assessed the Veteran with a moderate degree of suicidality. In April 2017, the Veteran reported having "some relationship difficulties" in his marriage, which left him feeling depressed and guilty. During his January 2018 hearing before the undersigned VLJ, the Veteran reported experiencing difficulty sleeping. The Veteran indicated that he had to withdraw from a graduate program in counseling because the subject matter triggered his PTSD symptoms. The Veteran reported that he had been married for over a year. The Veteran did not have relationships with his parents. In January 2018, a private physician noted that the Veteran was married and had three stepchildren. The Veteran had a temporary occupation helping veterans. The physician stated that the Veteran's psychiatric disability resulted in symptoms of: depressed mood, anxiety, suspiciousness, panic attacks weekly or less often, near continuous panic or depression, chronic sleep impairment, mild memory loss, impairment of short and long term memory, memory loss for names of close relatives/own occupation/own name, flattened effect, circumstantial, circumlocutory, or stereotyped speech, speech intermittently illogical/obscure/or irrelevant, difficulty understanding complex commands, impaired judgment, gross impairment in thought processes or communication, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances including work or work-like setting, inability to establish and maintain effective relationships, suicidal ideation, obsessional rituals that interfere with routine activities, impaired impulse control, spatial disorientation, persistent danger of hurting self, neglect of personal appearance and hygiene, intermittent inability to perform activities of daily living including maintenance of minimal personal hygiene, and disorientation to time or place. The physician stated that the Veteran was not capable of managing his financial affairs; instead, the Veteran's wife helped him with finances. The physician concluded that the Veteran's psychiatric symptoms resulted in total occupational and social impairment. In February 2018, the Veteran sought out emergency treatment for chest pain and was assessed with a severe anxiety attack. In March 2018, the Veteran stated that he had twice been terminated as the result of taking excessive sick leave. The Veteran stated that he was temporarily employed as a university admissions advisor. In September 2018 the Veteran is shown to have requested leave under FMLA from his employment (full-time) as an admissions advisor. A clinician noted that the Veteran was unable to perform "all essential job duties/functions" during his worsening episodes of headache and psychiatric symptoms. The clinician noted that the Veteran's symptoms commenced on March 13, 2017. In October 2018, the Veteran was "happily married" and worked as a university recruiter. The Veteran enjoyed carpentry and working on automobiles in his spare time. The Veteran underwent an additional examination in April 2019, at which time the Veteran reported "going through some tough times" with his spouse. The Veteran reported feeling "highly socially averse" and avoided crowds, malls, and grocery stores. The Veteran felt suspicious of others, "complete apathy", deadened emotions, and difficulty having loving feelings. The Veteran reported that though he still wished to work, he could only "give limited hours to any task", and he felt a loss of drive and lack of motivation. The Veteran reported experiencing sleep difficulties, depression, anxiety, guilt, and a loss of focus. While the Veteran frequently experienced suicidal ideation, he denied having any suicide attempts. The examiner indicated that the Veteran's psychiatric symptoms included a depressed mood, anxiety, suspiciousness, panic attacks that occurred weekly or less often, 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, and an inability to establish and maintain effective relationships. The examiner concluded that the Veteran's psychiatric symptoms resulted in occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking or mood. In an additional April 2019 examination, the examiner noted that the Veteran lived with his spouse of three years and three step-children. The Veteran reported having two adult children from a previous marriage. The Veteran stated that he was easily angered, and he argued with his spouse frequently. The Veteran felt safest at home, and he tried to stay home as much as possible. While the Veteran felt a chronic lack of interest in activities that he used to enjoy, he tried to stay busy and work in the yard. The Veteran reported that he had been employed as a university recruiter since 2016. The Veteran missed work weekly as the result of his migraines, anxiety, and panic, and he reported taking leave under FMLA since August 2018. The examiner noted that the Veteran's mood disorder interfered with his relationships with employers and other employees. The examiner indicated that the Veteran's psychiatric symptoms included: a depressed mood, anxiety, suspiciousness, panic attacks more than once a week, near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, and an inability to establish and maintain effective relationships. The Veteran denied experiencing suicidal ideation. The examiner concluded that the Veteran's psychiatric symptoms resulted in occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking or mood. In April 2019, the Veteran reported that he had been on leave under FMLA from his job as a university recruiter since August 2018. The Veteran required accommodations at work, including using a service dog. The Veteran had difficulty focusing and working on computers when he was anxious. In December 2019, the Veteran reported that he had been married for 5 years. In August 2021, the Veteran indicated that he had experienced passive or fleeting thoughts of suicide over the preceding week without a plan or other intent. The Veteran lived at home with his spouse and children, and he worked as a program manager for veterans' services at a university. The Veteran's PTSD is rated 50 percent disabling before March 13, 2017, and 70 percent disabling from March 13, 2017, to April 2, 2019. The Board finds that the weight of the evidence is against a finding that the Veteran's psychiatric symptoms have at any time produced the total occupational and social impairment that is associated with a 100 percent rating. The Veteran has maintained relationships with others throughout the appeal, even if such relationships have occasionally been strained. Since filing his claim, the Veteran has had relationships with at least one of his adult children, at least one close friend, and work colleagues. The Veteran had girlfriends before he was married, and he maintained a years-long marriage to his current spouse. He describes the overall marital relationship as supportive. The presence of these social relationships is contrary to a finding that the Veteran experienced total social impairment at any time. The weight of the evidence is likewise against a finding that the Veteran's psychiatric symptoms have at any time caused total occupational impairment. While it is well-documented that the Veteran's psychiatric symptoms impacted his occupational functioning, he maintained employment throughout the appeal as a security manager for two different retailers, as a participant in VR&E's work-study program, and as a university admissions advisor. VA's VR&E program consistently found the Veteran to be able to work, and examiners have consistently found the Veteran to be competent to manage his financial affairs. The weight of the evidence, including the Veteran's ability to maintain employment throughout the appeal and to participate in the VR&E program, is contrary to a finding that the Veteran experienced total occupational impairment at any time. The Board acknowledges that in January 2018, a private clinician opined that the Veteran's psychiatric symptoms resulted in total occupational and social impairment. However, as discussed above, the totality of the evidence shows that the Veteran has maintained social functioningincluding a years-long marriageand occupational functioning throughout the appeal. Furthermore, the January 2018 clinician noted that the Veteran was married and temporarily employed; the clinician did not reconcile these observations with the conclusion that the Veteran was totally socially and occupationally impaired. Without an explanation of these seemingly inconsistent findings, the Board places relatively little weight in the January 2018 opinion, and it finds that the weight of the evidence is against a finding that the Veteran's PTSD resulted in total social and occupational impairment at any time since filing his claim. With a 100 percent rating for the Veteran's PTSD unwarranted at any time, the Veteran is in receipt of a maximum 70 percent rating from March 13, 2017, to April 2019. The Board will next address whether a 70 percent rating is warranted at any time before March 13, 2017. Before March 13, 2017, the weight of the evidence is against a finding that the Veteran's psychiatric symptoms produced the occupational and social impairment with deficiencies in most areas that is associated with a 70 percent rating. The Veteran maintained romantic relationships and married his current spouse during this time. The Veteran has maintained a relationship with at least one of his adult children. The Veteran had relationships with a few friends, at least one of whom he considered to be a close friend. The Veteran worked as a security manager for two major retailers before March 13, 2017, he elected to participate in VA's VR&E program, and, for a time, he simultaneously participated in a work-study program and studied full-time in a graduate program. The Veteran additionally showed an ability to professionally advocate for himself; in August 2014, the Veteran argued for needed accommodations, and he successfully fought for his reinstatement at a job following a wrongful firing. Clinicians, including the December 2010 examiner, found the Veteran to be able to independently manage his financial affairs. No clinician characterized the Veteran's symptoms before March 13, 2017, as producing at least social and occupational impairment with deficiencies in most areas. As such, the Board finds that the weight of the evidence is against a finding that the Veteran's PTSD resulted in occupational and social impairment with deficiencies in most areas at any before March 13, 2017. In sum, a rating in excess of 50 percent for the Veteran's PTSD is unwarranted before March 13, 2017, and a rating in excess of 70 percent is unwarranted from March 13, 2017, to April 2, 2019. TDIU Before April 2, 2019 The Veteran has been in receipt of a combined 100 percent schedular rating since April 2, 2019. With that said, a 100 percent rating does not necessarily render the issue of entitlement to a TDIU moot, because the award of a TDIU may justify an award of SMC. See Bradley v. Peake, 22 Vet. App. 280 (2008). In this case, however, a September 2020 rating decision granted SMC effective April 2, 2019. With the Veteran in receipt of both a total schedular rating and SMC since April 2, 2019, the issue of entitlement to a TDIU is moot during this time. The Board will, however, consider whether a TDIU is warranted at any time before April 2, 2019. VA will grant a total disability rating for compensation purposes based on unemployability when the evidence shows that a veteran is precluded, by reason of his service-connected disabilities, from securing or following a substantially gainful occupation consistent with his education and occupational experience. 38 C.F.R. §§ 3.340, 3.341, 4.16. When, as in this case, there are two or more such disabilities, there must 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). The combined ratings of the Veteran's service connected PTSD, headaches, and tinnitus meet the schedular criteria for the award of a TDIU throughout the appeal period. A substantially gainful occupation is employment that is ordinarily followed by the nondisabled to earn a livelihood, with earnings common to the particular occupation in the community where the employee resides. The term suggests a living wage. Ferraro v. Derwinski, 1 Vet. App. 326 (1991). The ability to work sporadically or to obtain marginal employment is not substantially gainful employment. 38 C.F.R. § 4.16(a); Moore v. Derwinski, 1 Vet. App. 356 (1991). Employment is generally "marginal" when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce as the poverty threshold for one person. Employment may be marginal even when earned annual income exceeds the poverty threshold when, for example, the veteran is employed in a protected environment such as a family business or sheltered workshop. See Ortiz-Valles v. McDonald, 28 Vet. App. 65, 71 (2016). A veteran may be granted TDIU despite being employed and having an income in excess of the poverty threshold if his employment is sheltered. See Cantrell v. Shulkin, 28 Vet. App. 382, 389 (2017). Turning to the facts in this case, when the Veteran filed his underlying claim for service connection in September 2010, he reported working for a major retail company as an executive team leader in asset protection since May 2004. In October 2010, the Veteran reported that he had been on a leave of absence from his job since June 2010 as the result of job-related stress. The Veteran returned to this job in November 2010, and he continued working until May 2011, at which time the employer's management changed and the Veteran was given a different position title. Later in May 2011, the Veteran began working in the investigative department for a major clothing retailer. In August 2012, the Veteran reported that he had recently suffered an anxiety attack at work, and he feared that he could lose his job as a result of his medical issues. A VA clinician wrote a letter excusing the Veteran from work from August 2012 until October 2012 for treatment of his psychiatric symptoms. In September 2012, the Veteran applied for vocational rehabilitation services from VA's VR&E program. In connection with this application, in October 2012, a physician opined that the Veteran had an "excellent" ability to work, noting that the Veteran was fully capable of performing job functions as long as the work environment was minimally to moderately stressful. In November 2012, the Veteran resigned from his job with a major clothing retailer after taking 2 months off from work as the result of his disabilities. In December 2012, a Vocational Rehabilitation Counselor (VRC) with the VR&E program stated that the Veteran's overall ability to work was favorable. In December 2012, the Veteran was determined to be eligible to participate in the VR&E program, and a rehabilitation plan was created following a comprehensive vocational assessment; the Veteran indicated that he wished to pursue further training with the goal of entering a career in nursing. In May 2013, the Veteran attended school and worked part-time. In September 2013, the Veteran requested a reevaluation of his VR&E rehabilitation plan. Instead of pursuing nursing, the Veteran wished to obtain a bachelor's degree in criminal justice in order to become a security manager. The Veteran's request was approved, and in October 2013, the Veteran's VR&E vocational rehabilitation plan was changed accordingly. In July 2014, the Veteran reported that he had recently been fired from his job with a major home improvement retailer for whistleblowing. In August 2014, however, the requested accommodations from this employer in the form of additional breaks, an ability to attend medical appointments, a flexible start and end time, an ability to take telephone calls, and the elimination of rotating shifts. In September 2014, the Veteran reported that he had been reinstated at his job. The Veteran intended to leave this position and planned to do work-study through VA. In October 2014, the Veteran worked for VA in a work-study program. In November 2014, the Veteran was employed in a work-study program in human resources while obtaining his bachelor's degree in criminal justice. In February 2015, the Veteran continued to participate in a work-study program while attending school. In April 2015, an examiner noted that the Veteran missed a day of work every 3 to 4 months as the result of severe headaches. Clinicians in April 2015 and June 2015 noted the Veteran's continuing participating in a VA work-study program in human resources. In the Veteran's April 2016 claim for a TDIU, he stated that he became too disabled to work in September 2014. The Veteran stated that his psychiatric and headache symptoms had resulted in extensive absences from work. The Veteran otherwise stated that he had lost "multiple" jobs as the result of his psychiatric and headache symptoms. The Veteran did not, however, include pertinent information on this application form; for example, the Veteran did not identify each of his employers for the last 5 years, specify when he last worked full time, or specify the most he earned in a year. The Veteran began working as a university admissions officer in August 2016. In November 2016, the Veteran indicated that this was a temporary position that he would hold only until he began a graduate program in mental health counseling in January 2017. In March 2017, the Veteran continued to work in university admissions and attended graduate school full-time. In April 2017, the Veteran withdrew from this graduate program because the subject matter triggered his symptoms of PTSD. In May 2017, the Veteran changed his graduate field of study from counseling to criminal justice. During his January 2018 hearing before the undersigned VLJ, the Veteran stated that he continued to work as a university admission advisor. The Veteran reported that he had to miss approximately 2 days of work weekly as the result of his headaches. In January 2018, a private physician noted that the Veteran had a temporary occupation helping veterans. In March 2018, the Veteran stated that he had twice been terminated as the result of taking excessive sick leave, and he stated that he was temporarily employed as a university admissions advisor. Also in March 2018, the Veteran changed his VR&E vocational goal to obtaining a masters degree in criminal justice rather than social work, and in April 2018, the VR&E program found this vocational goal to be reasonably feasible. In August 2018, the Veteran stated that his work supervisor allowed him to work a flexible schedule to accommodate his migraine headaches. In September 2018, the Veteran withdrew from his university coursework. In September 2018, a clinician noted that the Veteran was employed full-time as an admissions advisor. The Veteran was unable to perform "all essential job duties/functions" during his worsening episodes of headache and psychiatric symptoms. The clinician noted that the Veteran's symptoms commenced on March 13, 2017. Records from October 2018 and November 2018 indicate that the Veteran continued his employment as a university recruiter. In December 2018, a counselor from a VA Vet Center stated that the Veteran desired to enter into a training program geared towards designing, construction, management, human resources, mechanics, hydraulics, and HVAC. The counselor opined that the Veteran would be successful in operating his own business. In March 2019, a clinician recommended the approval of the Veteran's request for leave from his employer under FMLA. In April 2019, an examiner found that the Veteran's frequent headaches and PTSD caused him to take many days off from work and led him to use FMLA. In April 2019, the Veteran reported that he had been employed as a university recruiter since 2016. In April 2019, the Veteran reported that he had been on leave under FMLA from his job as a university recruiter since August 2018. The Veteran required accommodations at work, including using a service dog. The Veteran had difficulty focusing and working on computers when he was anxious. The Veteran required a "very supportive" work environment that tolerated frequent absences and his need to leave work early. In May 2019, VR&E proposed to discontinue the Veteran's participation in the program because the Veteran had ceased to actively participate in the program in October 2018. In July 2019, the VR&E program informed the Veteran that it would discontinue action on his VR&E claim as the result of his September 2018 withdrawal from his university coursework and subsequent failure to remain in contact with the VR&E program. Turning to an analysis of these facts, the question of whether a veteran is capable of substantially gainful employment is not a medical one, but is rather a determination for the adjudicator. In other words, the Board is not bound by any particular opinion in making this assessment, but it must instead consider the probative value of the entirety of the evidence of record to determine whether the Veteran is capable of substantially gainful employment. In this case, despite VA's repeated requests (most recently in May 2021 and June 2021), the Veteran has not submitted a fully completed application for increased compensation based on employability (VA Form 21-8940) listing his employment history and reasons for unemployment. The Board's analysis is thus limited to the available evidence of record, which shows that the Veteran maintained substantially gainful employment from his September 2010 date of claim until November 2012. After that time, the record suggests that the Veteran worked for a major retailer until approximately October 2014, when, through the VR&E program, he attended school full time and participated in a work-study program. The Veteran was again substantially gainfully employed as a university admissions advisor from August 2016 until April 2, 2019. The record thus shows that the Veteran maintained substantially gainful employment at all times other than approximately October 2014 to August 2016, during which time he participated in a work-study program through the VR&E while attending school full time. Even if the Board were to find that the Veteran's employment during this time was "marginal" rather than "substantially gainful", the Veteran's service-connected disabilities did not preclude him from securing or following a substantially gainful occupation during this time. The Veteran balanced the demands of both full-time school and work-study during this time. Records from the VR&E program show that the Veteran consistently maintained an ability to work. In October 2012, the Veteran had an "excellent" ability to work and was fully capable of performing job functions in a work environment that was not more than moderately stressful. In December 2012, the Veteran's overall ability to work was found to be favorable. The Veteran himself, through his participation in the VR&E program, consistently maintained that he had a desire and ability to work in fields including counseling, criminal justice, human resources, nursing, and security. The weight of the evidence does not support a finding that the Veteran's service connected disabilities preclude him from securing and following a substantially gainful occupation at any time before April 2, 2019. With that said, the evidence clearly demonstrates that the Veteran's service connected disabilities indeed affected his employability before April 2, 2019, as evidenced by the Veteran's combined disability ratings of 80 percent before March 13, 2017, and 90 percent between March 13, 2017, and April 2, 2019. Loss of industrial capacity is the principal factor in assigning schedular disability ratings. 38 C.F.R. §§ 3.321(a), 4.1. Indeed, 38 C.F.R. § 4.1 specifically states: "[g]enerally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability." See also Moyer v. Derwinski, 2 Vet. App. 289, 293 (1992); Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993) (noting that the disability rating itself is recognition that industrial capabilities are impaired). Thus, upon a thorough review of the evidence of record, the Board finds that before April 2, 2019, the Veteran was not precluded from engaging in substantially gainful employment as a result of his service connected disabilities alone. The benefit of the doubt doctrine is inapplicable, and the claim for TDIU must be denied. 38 C.F.R. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.A. Flynn, 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.