Citation Nr: 21072504 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 19-26 889 DATE: December 3, 2021 ISSUES 1. Entitlement to a disability rating in excess of 50 percent for service-connected post-traumatic stress disorder (PTSD). 2. Entitlement to total disability based on individual unemployability due to service-connected disabilities (TDIU). ORDER Entitlement to an increased disability rating of 70 percent, but no higher, for service-connected post-traumatic stress disorder (PTSD) is granted. For the period prior to September 5, 2019, entitlement to total disability based on individual unemployability due to service-connected disabilities (TDIU) is denied. For the period from September 5, 2019, entitlement to total disability based on individual unemployability due to service-connected disabilities (TDIU) is dismissed as moot. FINDINGS OF FACT 1. For the entire period on appeal, the Veteran's service-connected post-traumatic stress disorder (PTSD) was manifested by depressed mood, anxiety, suspiciousness, nightmares and chronic sleep impairment, and suicidal ideation; all having the effect of occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. 2. For the period prior to September 5, 2019, the evidence of record does not show that the Veteran's service-connected disabilities alone precluded him from obtaining or maintaining substantially gainful employment consistent with his level of education and work history. 3. For the period from September 5, 2019, the Veteran has been in receipt of a 100 percent schedular rating for ischemic heart disease with congestive heart failure, and special monthly compensation (SMC) at the S-1 rate for additional service-connected disabilities independently ratable as 60 percent or more. CONCLUSIONS OF LAW 1. The criteria for an increased disability rating of 70 percent, but no higher, for service-connected post-traumatic stress disorder (PTSD) have not been met or approximated. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. 2. For the period prior to September 5, 2019, the criteria for entitlement to total disability based on individual unemployability due to service-connected disabilities (TDIU) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 4.3, 4.16. 3. For the period from September 5, 2019, the issue of entitlement to total disability based on individual unemployability due to service-connected disabilities (TDIU) is moot. 38 U.S.C. § 7105; Bradley v. Peake, 22 Vet. App. 280 (2008). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Air Force from May 1966 to March 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2017 rating decision, issued by a Department of Veterans Affairs (VA) Regional Office (RO) which denied entitlement to the benefits currently sought on appeal. By way of background, the Veteran was granted entitlement to service connection for post-traumatic stress disorder (PTSD) at 50 percent disabling, in a rating decision from October 2009. In June 2017, the Veteran filed a claim for an increase to that disability rating, and also claimed that he was unemployable due to his service-connected disabilities (TDIU). Both the increased ratings claim and the TDIU claim were denied in a November 2017 rating decision. In December 2017, the Veteran filed a timely Notice of Disagreement (NOD), and he was issued a Statement of the Case (SOC) in August 2019. In September 2019 the Veteran filed a timely VA Form 9, appealing the increased ratings claim to the Board only. The Veteran's increased ratings claim was eventually certified to the Board in June 2020. In September 2019, after the Veteran submitted his VA Form 9, the Veteran submitted a VA Form 20-0996 Request for Higher-Level Review. Generally, this would opt the Veteran's claim into the Appeals Modernization Act (AMA) system. 38 C.F.R. § 19.2(d). However, the Veteran was notified in October 2019 that the form he used was submitted prior to a change in the law that went into effect on February 19, 2019. He was notified of other options for opting into AMA, including that he could submit a VA Form 20-0995 Decision Review Request: Supplemental Claim. The Veteran did not submit that form, and instead, through his Representative, opted to continue the appeal in the current Legacy system. Despite the Veteran only listing the increased ratings claim on his VA Form 9, the Board still finds that entitlement to TDIU is still raised by the record. This is because, when a Veteran files a claim for an increased rating, they are presumed to be seeking the maximum benefit under any applicable theory, to include TDIU. See generally Roberson v. Principi, 251 F.3d 1378 (Fed. Cir. 2001); Rice v. Shinseki, 22 Vet. App. 447. When evidence of unemployability is submitted during the course of an appeal from an assigned disability rating, a claim for entitlement to TDIU will be considered to have been raised by the record as "part and parcel" of the underlying claim. Id. at 453-54. In this case, the Veteran asserts that he is unable to obtain or maintain substantially gainful employment due to his service-connected disabilities, to include PTSD. Therefore, the issue of entitlement to TDIU has been raised and is before the Board. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900 (c). 38 U.S.C. § 7107 (a)(2). 1. Entitlement to an increased disability rating of 70 percent, but no higher, service-connected post-traumatic stress disorder (PTSD) is granted. The Veteran claimed that his service-connected PTSD is worse than currently rated. See June 2017 Fully Developed Claim. Disability evaluations are determined by the application of the facts presented to VA's Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321 (a), 4.1. In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary importance. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154 (a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). If the evidence for and against a claim is in equipoise, the claim will be granted. 38 C.F.R. § 4.3. A claim will be denied only if the preponderance of the evidence is against the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Veteran is currently assigned a 50 percent rating for his PTSD under 38 C.F.R. § 4.130, Diagnostic Code 9411, which is part of the General Formula for Mental Disorders (General Formula). When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission. 38 C.F.R. § 4.126. The rating agency shall assign an evaluation based upon all the evidence of record that bears on occupational and social impairment, rather than solely upon the examiner's assessment of the level of disability at the moment of the examination. Id. When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment but shall not assign an evaluation solely on the basis of social impairment. Id. In relevant part, a 50 percent rating is warranted for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is assigned for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); inability to establish and maintain effective relationships. Id. A 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance or minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives and own occupation or name. Id. The "such symptoms as" language means "for example," and does not represent an exhaustive list of symptoms that must be found before granting the rating of that category. Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). The list of examples provides guidance as to the severity of symptoms contemplated for each rating. Id. However, this fact does not make the provided list of symptoms irrelevant. See Vasquez-Claudio v. Shinseki, 713 F.3d 112, 11617 (Fed. Cir. 2013). The Veteran must still demonstrate either the particular symptoms associated with the rating sought, or other symptoms of similar severity, frequency, and duration. Id. at 117. Turning to the available evidence, the Veteran wrote in his NOD from December 2017 that his "PTSD has increased in severity," and that it was "affecting [his] quality of life and ability to work." No specific symptoms were included in the NOD. In the Veteran's VA Form 9, he wrote that his symptoms were "getting worse as I get older." The Veteran described "severe" nightmares, and that he is "fighting in my sleep," which has caused him to fall from the bed in the past. The Veteran is competent to report the symptoms he experiences, such as those associated with his PTSD. See Jandreau v. Nicholson, 492 F. 3d 1372, 1376-77 (Fed. Cir. 2007). The Veteran's Representative also argued generally through an Appellate Brief submitted in July 2020 that the Veteran is entitled to a higher disability rating. Turning to the medical evidence, the Veteran was given a VA examination in July 2017. The Veteran was seen in person, and his claims file was reviewed. The examiner summarized the severity of the Veteran's PTSD as having an occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily with normal routine behavior, self-care and conversation. The Veteran told the examiner that he has a strong and healthy relationship with his wife, although they are both frequently depressed when remembering the death of their son. The Veteran is close to his two daughters, and he has several grandchildren. The Veteran indicated that he enjoys working in the garden, going fishing, and attending his local church. The examiner noted that the Veteran had no impairment to his ability of daily living, including the completion of domestic chores, cooking, bathing, grooming, etc. During the exam, the Veteran reported that he last worked in waste and recycling services, but he chose to retire in 2010 when he reached age 62, and that "they wanted me to stay ... but I had too much going on." The Veteran indicated that he left work to help his wife in her grief over the death of their son, but at the time the Veteran "explained that his physical health issue would be a primary deterrent for employability." The Veteran reported that he "enjoys the group therapy that he attends and feels that his mental health involvement has been beneficial." The Veteran reported insomnia and difficulty sleeping, which included nightmares. During the clinical evaluation, the examiner noted symptoms of depressed mood, anxiety, and suspiciousness. He was clean and casually dressed, with normal speech, and offered a "stable mood," and a "cooperative, friendly, attentive," attitude towards the examiner. Delusions, hallucinations, panic attacks, homicidal ideation and violent behavior were all denied. When asked about suicidal ideation, the Veteran stated that "I have these thoughts run through my head," but that they were not serious, as he then stated, "I can't be doing stuff like that." The Veteran stated that he avoids big crowds and fireworks, and that he does not get along with his brother, but that he generally functions well in small, comfortable settings. The Veteran was also given a VA examination in August 2019. The Veteran was seen in person, and his claims file was reviewed. The examiner confirmed the Veteran's PTSD diagnosis, and summarized the current severity as having an occupational and social impairment with occasional decrease in work efficiency. The examiner noted that the Veteran was depressed because his father had passed away "about 2 years ago," and that they had a good relationship. The Veteran also reported grief after the passing of his son, but that he had a good relationship with his daughters, and his wife of forty-eight years. The Veteran reported friendships with "some buddies who are Vietnam veterans." During the exam, the Veteran reported symptoms of sleeplessness and nightmares. The examiner noted further symptoms of depressed mood, anxiety and chronic sleep impairment. The Veteran was appropriately dressed, "willingly volunteered information," and he was "friendly ... broad, normal and appropriate ... [and] oriented in all spheres." The examiner noted that the Veteran had retired from his job in waste management when he reached age 62, but that currently he would have difficulty "remembering detailed instructions," and that he would experience fatigue if working today. The examiner also noted that there may be "problems with anger," which would interfere "with his adjustment in the workplace." The Veteran's claims file also contains a number of VAMC records, which include group therapy and counseling notes. VAMC counseling notes are generally consistent, indicating that the Veteran feels depressed and anxious, but that he is open and willing to discuss his experiences with counselors. See January 2018 to March 2019 VAMC notes. An isolated note from March 2017 indicates that the Veteran was sent to the ER for "suicidal thoughts," but that he had not presented with a plan to harm himself. Follow-up reports frequently indicate that the Veteran denies thoughts of suicide. See June 2017 to November 2020 VAMC notes. During group therapy sessions, the Veteran is generally seen as "attentive and active in discussions," and that he was "supportive of others." See November 2019 VAMC note. The Veteran actively shares with the group experiences related to stress, anger and/or depression, but he is noted to be alert and oriented, with unimpaired speech, thoughts and judgments, and no suicidal or homicidal ideation. More recent VAMC notes indicate that the Veteran experiences nightmares, depression, and grief following the loss of his son. See April 2020 VAMC note. There is no evidence that either the VA examiners, or the VAMC counselors were not competent or credible, and as the reports were based on accurate facts and objective examinations, the Board finds they are entitled to significant probative weight as to the severity of the Veteran's PTSD. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). In consideration of the above, the Board finds that the current severity of the Veteran's service-connected PTSD more nearly approximates the current 70 percent disability rating, but no higher. Throughout the period on appeal, the Veteran has complained of and his symptoms have manifested as sleep impairment, continuous depressed mood, avoidance of crowds and loud noises like fireworks, and suicidal ideations. While the Veteran has not expressed a plan in conjunction with his suicidal thoughts, throughout the period on appeal the evidence indicates suicidal ideations consistent with a 70 percent disability rating. Therefore, although the July 2017 and August 2019 VA examiners found occupational and social impairment with occasional decrease in work efficiency, the Board finds that given the Veteran's entire disability picture and symptomatology throughout the period on appeal, an increased rating of 70 percent is warranted. The Board does not find that an increased rating in excess of 70 percent is warranted in this case. The Board notes that the Veteran's symptoms do not more nearly approximate a rating in excess of 70 percent as the evidence does not indicate 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 or minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives and own occupation or name. Id. In fact, the evidence indicates appropriate communication and processes, orientation in all spheres, appropriate dress and hygiene, and memory loss only as it pertains to instructions at work. Moreover, the Board notes that the Veteran reported having a stable and happy relationship with his wife of nearly fifty years, and good relationships with his daughters and grandchildren. Although the Veteran has arguments with his brother, he is an active member of his church, he enjoys being outside and fishing, and he has "buddies who are Vietnam Veterans." While he avoids large crowds and fireworks, the Veteran is noted to be comfortable in many settings, including during group therapy sessions, where he openly discusses his feelings, and supports other group members. Moreover, while there is an isolated report in the Veteran's claims file indicating him being sent to the ER for suicidal thoughts, the evidence does not indicate that the Veteran is a persistent danger to himself, as there has never been a suicidal plan. Last, the Board notes that the Veteran was noted to have some irritability and anger in August 2019 examination report, however, the Board does not find this to rise to the level of unprovoked irritability with periods of violence or to present a persistent danger to others. The Veteran is frequently noted to be alert and oriented, with appropriate grooming and hygiene tendencies, and that he is capable of helping complete chores and jobs around the house. As such, the Board finds that the Veteran demonstrated the requisite symptomatology during this period on appeal for the higher 70 percent rating, but no higher. Thus, the Veteran's PTSD is more nearly approximated by 70 percent rating, but no higher, for the entire period on appeal and to this extent the appeal is granted herein. See Bankhead v. Shulkin, No. 15-2404, slip op. at 10 (U.S. Vet. App. Mar. 27, 2017); Vazquez-Claudio v. Shinseki, 713 F.3d 112, 115 (Fed. Cir. 2013). DC 9411. 2. For the period prior to September 5, 2019, entitlement to total disability based on individual unemployability due to service-connected disabilities (TDIU) is denied. 3. For the period from September 5, 2019, entitlement to total disability based on individual unemployability due to service-connected disabilities (TDIU) is dismissed as moot. The Veteran has claimed that he is unemployable due to his service-connected disabilities. See Fully Developed Claim. Most recently, in a rating decision from April 2020, the Veteran was granted entitlement to service connection for ischemic heart disease with congestive heart failure at a 100 percent disability rating, effective September 5, 2019. He was also granted entitlement to special monthly compensation (SMC) at the S-1 rate, effective September 5, 2019. Importantly, the U.S. Court of Appeals for Veteran's Claims (Court) held in Bradley v. Peake, 22 Vet. App. 280 (2008), that there could be a situation where a Veteran has a schedular total rating for a particular service-connected disability and could establish a TDIU rating for another service-connected disability in order to qualify for SMC under 38 U.S.C. § 1114 (s) by having an "additional" disability of 60 percent or more ("housebound" rate). See 38 U.S.C. § 1114 (s). Thus, Bradley made it such that even with the assignment of a total schedular rating, the issue of TDIU was potentially not moot. The Board concludes that the facts of Bradley are sufficiently differentiable from the facts of this case such that the holding in Bradley is inapplicable and the Veteran's TDIU claim is in fact moot for that period only. Specifically, from September 5, 2019 forward, the Veteran has already been granted an award of SMC based on additional service-connected disabilities independently ratable at 60 percent or more. As the Veteran has already been awarded SMC and therefore would have no need to establish a TDIU rating in order to qualify for SMC under 38 U.S.C. § 1114 (s), the holding in Bradley is not applicable in this case. Therefore, the Board finds that for the period from September 5, 2019 forward, the issue of entitlement to TDIU is moot. Having said that, entitlement to TDIU must be applied to the entire period on appeal, as it was raised in conjunction with the increased ratings claim. See Rice, Id. Therefore, the Board still must address the period prior to September 5, 2019. The Period Prior to September 5, 2019 As noted above, the Veteran has claimed that he is unemployable due to his service-connected disabilities. See June 2017 Fully Developed Claim. VA will grant a total rating for compensation purposes based on unemployability when the evidence shows that the Veteran is precluded, by reason of service-connected disabilities, from obtaining and maintaining any form of gainful employment consistent with their education and occupational experience. 38 C.F.R. § 4.16. Normally, consideration is given to such an award only if the Veteran has a single service-connected disability ratable at 60 percent or more, or if he has two or more such disabilities with a combined rating of 70 percent or more, with at least one disability ratable at 40 percent or more. 38 C.F.R. § 4.16 (a). However, failure to satisfy these percentage standards is not an absolute bar to an award of TDIU. It is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 4.16 (b). "Substantially gainful employment" is not currently defined in VA regulations. However, in Ray v. Wilkie, 31 Vet. App. 58 (2019), the Court defined the term "unable to secure and follow a substantially gainful occupation" in 38 C.F.R. § 4.16 (b) as having 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 following: 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. In other words, the noneconomic component requires consideration of a Veteran's ability to secure or follow that type of employment. In evaluating a Veteran's employability, consideration may be given to the level of education, special training, and previous work experience in arriving at a conclusion, but not to impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16. Age may not be considered as a factor in evaluating service-connected disability; and unemployability, in service-connected claims, associated with advancing age or intercurrent disability, may not be used as a basis for a total disability rating. 38 C.F.R. § 4.19. For the period prior to September 5, 2019, the Veteran was service connected for PTSD at 70 percent disabling (granted herein); diabetes mellitus, type II from (March 31, 2017 to December 1, 2018 only) at 20 percent disabling; tinnitus at 10 percent disabling; and bilateral hearing loss at a noncompensable disability rating. Because the Veteran has a single service-connected disability that has been rated 60 percent or higher during the period at issue, under the 38 C.F.R. § 4.16 (a) criteria outlined above, the Veteran meets the schedular criteria for a schedular TDIU rating. Having said that, if the percentage threshold is met, the Board must assess whether the evidence of record shows that Veteran is "unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities." 38 C.F.R. § 4.16 (b). The Veteran submitted a lay statement in May 2017, whereby he wrote that he would like to "file for unemployability" due to his service-connected disabilities. No further details were included. In his NOD from December 2017, he wrote that his "PTSD has increased in severity and it is affecting ... my ability to work." The Veteran submitted a VA Form 21-8940 Application for TDIU in May 2017. In his VA Form 21-8940, he listed that he was unable to maintain gainful employment due to his "diabetes, PTSD, neuropathy." The Board recognizes that the Veteran has at no point been service-connected for neuropathy. The Veteran wrote that he last worked full time in September 2016, although his listed employment history ends in April 2010. The Veteran stated that he worked at Rumpke Trash Service as a truck driver, working approximately 60 hours per week. The Veteran wrote that he did not leave his last job because of his service-connected disabilities. The Veteran graduated high school and completed one year of college but did not indicate that he had any subsequent job training. The Veteran's most recent employer, Rumpke Trash Services of Kentucky, submitted employment information in a VA Form 21-4192 in June 2017. The employer noted that the Veteran had performed "general labor," and that he last worked in April 2010. No concessions were noted to be given as a result of the Veteran's service-connected disability. The employer noted that the Veteran terminated his employment due to "retirement." The Veteran is competent to report how he believes his disabilities impact his ability to work. See Jandreau v. Nicholson, 492 F. 3d 1372, 1376-77 (Fed. Cir. 2007). The Board incorporates the discussion from above, particularly as it relates to the July 2017 and August 2019 VA examinations. The Veteran was given a VA examination in May 2018 for his service-connected diabetes mellitus, type II. The examiner did not provide an opinion as to the functional impact from the Veteran's diabetes. In fact, in the remarks portion of the exam, the examiner wrote that, as a result of his endocrinology results, they examiner "simply cannot say he has type II diabetes." The Veteran was given VA examinations for his bilateral hearing loss and tinnitus in January 2018. The examiner noted that each disability impacts the Veteran's ability to maintain gainful employment, insofar as his hearing loss causes the Veteran to ask people to repeat what they are saying. The examiner noted that the ringing caused by tinnitus was "irritating" to the Veteran, which causes sleep difficulties. The examiner did not indicate that the Veteran was unable to maintain gainful employment. There is no evidence that the VA examiners were not competent or credible, and as the report was based on accurate facts and objective examinations, the Board finds they are entitled to significant probative weight as to the Veteran's ability to function in an occupational setting. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). In consideration of the above, the Board finds that the Veteran was not unable to maintain gainful employment due to his service-connected disabilities prior to the period from September 5, 2019. To begin, the Veteran's lay statements and VA Form 21-8940 indicate that he was unable to work due to his diabetes, his PTSD, and neuropathy. The Veteran was not service connected for neuropathy, so the Board may not consider that as a factor in his ability to maintain gainful employment. The Veteran's diabetes was not noted by the VA examiner in May 2018 to have a functional impact, and instead, the examiner indicated that the Veteran did not actually have diabetes. It is from this examination that the Veteran's disability rating for diabetes mellitus, type II was severed by the RO in December 2018. The VA examinations related to hearing loss and tinnitus both indicated that the disabilities had a functional impact, but neither indicated that the Veteran would be unable to maintain gainful employment. Larger descriptions of the Veteran's employability are provided by the July 2017 and August 2019 VA examinations for the Veteran's service-connected PTSD. As noted in the preceding section, both examiners confirmed that the Veteran would have an occasional decrease in his work efficiency, but neither of them indicated he would be unable to maintain gainful employment. During those examinations the Veteran wrote that it was his physical disabilities that would prevent him from working, as opposed to his mental health. The Veteran also indicated that he left work when he reached the appropriate retirement age to help his wife when she was grieving the loss of their son. In fact, during the exam, the Veteran reported that he last worked in waste and recycling services, but he chose to retire in 2010 when he reached age 62, and that "they wanted me to stay ... but I had too much going on." The Veteran's VA Form 21-8940 also indicates that he did not leave work due to his service-connected disabilities, and his most recent employer at Rumpke Trash Services of Kentucky indicated that the Veteran had no reasonable accommodations for his disabilities, and that instead he "retired" due to age in April 2010. Based on the foregoing, the Board therefore finds that, for the period from September 5, 2019, entitlement to a TDIU on a schedular basis under 38 C.F.R. § 4.16 (b) is not warranted because the most credible, competent, and probative evidence of record does not reflect that the Veteran was unable to follow or secure substantially gainful employment due his service-connected disabilities. See also Johnson v. McDonald, 762 F.3d 1362 (Fed. Cir. 2014). In reaching these conclusions, the Board finds that the preponderance of the evidence is against the claim. Neither the Veteran nor his Representative have raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). As such, the benefit of the doubt rule is not for application, and the claim of entitlement to TDIU for the period prior to September 5, 2019 must be denied. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). J. TUNIS Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Mulrain, Associate 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.