Citation Nr: 21074802 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 10-18 002 DATE: December 16, 2021 ORDER Entitlement to an increased evaluation in excess of 30 percent for post-traumatic stress disorder (PTSD) prior to April 14, 2016 is denied. Entitlement to an increased evaluation in excess of 70 percent for post-traumatic stress disorder (PTSD) on or after April 14, 2016 is denied. Entitlement to an effective date earlier than November 6, 2008 for the grant of service connection for PTSD is denied. REMANDED Entitlement to an effective date earlier than August 31, 2016 for the grant of a total evaluation based upon individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDINGS OF FACT 1. For the period prior to April 14, 2016, the Veteran's PTSD was productive of occupational and social impairment with an occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, but not productive of occupational and social impairment with reduced reliability and productivity. 2. Since April 14, 2016, the Veteran's PTSD has been productive of occupational and social impairment in most areas, but not total occupational and social impairment. 3. The criteria for an effective date earlier than November 6, 2008 for the grant of service connection for PTSD have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400. CONCLUSIONS OF LAW 1. The criteria for an evaluation in excess of 30 percent for PTSD prior to April 14, 2016, have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1-4.7, 4.10, 4.21, 4.126, 4.130, Diagnostic Code 9411. 2. The criteria for an evaluation in excess of 70 percent for PTSD on or after April 14, 2016, have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1-4.7, 4.10, 4.21, 4.126, 4.130, Diagnostic Code 9411. 3. The criteria for an effective date earlier than November 6, 2008 for the grant of service connection for PTSD have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served active duty in the United States Air Force from August 1981 to June 1983. These matters come before the Board of Veterans' Appeals (Board) on appeal from July 2016 and February 2017 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). The Board notes the Veteran originally requested a Board hearing but later withdrew the request in November 2020. Moreover, in September 2019, the Veteran's representative requested a 30-day extension to submit additional evidence relevant to the claim. While it does not appear a response was provided, the record remained open for more than the 30 days and, during that time, the Veteran's representative submitted a brief in support of the appeal along with additional evidence. See October 2019 Board brief. A waiver of the Agency of Original Jurisdiction's (AOJ) initial consideration of the evidence was also included. Moreover, the Veteran has not requested any additional extensions. As such, the Board may proceed with appellate review. Lastly, in July 2021, the Veteran's representative sent a request seeking a copy of the documents contained in the claims file dated after February 26, 2018. However, on that same day, in an email, her representative withdrew the request. She specifically stated that they were withdrawing the July 2021 document request. Law and Analysis The Board notes the Veteran has not been afforded a VA examination in connection with her claim since April 2016. Neither she nor her representative have asserted that her symptoms have worsened. Moreover, the evidence of record does not suggest a worsening in symptoms. Therefore, a remand for a new VA examination is not necessary. See Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007) (holding that passage of time does not warrant a new examination where the Veteran, or evidence of record, does not allege increased severity). Additionally, neither the Veteran nor her representative has raised any issues with the duty to notify or duty to assist with regard to the issues decided herein. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir.2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The rating schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. 38 C.F.R. § 4.7. In considering the severity of a disability, it is essential to trace the medical history of the veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41. Consideration of the whole-recorded history is necessary so that a rating may accurately reflect the elements of disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991). While the regulations require review of the recorded history of a disability by the adjudicator to ensure a more accurate evaluation, the regulations do not give past medical reports precedence over the current medical findings. Where the question for consideration is the propriety of the initial rating assigned, evaluation of the evidence since the effective date of the grant of service connection is required. Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). Where VA's adjudication of the claim for increase is lengthy and factual findings show distinct time periods where the service-connected disability exhibits symptoms which would warrant different ratings, different or "staged" ratings may be assigned for such different periods of time. Fenderson, 12 Vet. App. at 126-27. Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and when 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; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the weight of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). The Veteran's PTSD is currently assigned a 30 percent evaluation prior to April 14, 2016, and a 70 percent evaluation thereafter, pursuant to 38 C.F.R. § 4.130, Diagnostic Code 9411. Under Diagnostic Code 9411, a 30 percent evaluation is warranted when the psychiatric disorder results in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood; anxiety; suspiciousness; panic attacks (weekly or less often); chronic sleep impairment; mild memory loss (such as forgetting names, directions, recent events). A 50 percent evaluation is warranted when the psychiatric disorder results in 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 evaluation is warranted when the psychiatric disorder results in 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. A 100 percent evaluation is warranted when the psychiatric disorder results in 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. The use of the term "such as" in the general rating formula for mental disorders 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 symptoms, or their effects, that would justify a particular rating. See Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). It is not required to find the presence of all, most, or even some, of the enumerated symptoms recited for particular ratings. Id. The use of the phrase "such symptoms as," followed by a list of examples, provides guidance as to the severity of symptoms contemplated for each rating, in addition to permitting consideration of other symptoms, particular to each veteran and disorder, and the effect of those symptoms on the claimant's social and work situation. Id. In Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013), the Federal Circuit stated that "a veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration." It was further noted that "§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas." As noted above, the Veteran's PTSD is currently assigned an evaluation of 30 percent prior to April 14, 2016. In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran does not meet the criteria for a higher evaluation for her PTSD for this time period. A 50 percent rating is warranted when the psychiatric disorder results in 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. In this case, the record does not demonstrate that the Veteran's overall disability picture is consistent with a 50 percent rating or higher for the period before April 14, 2016. With regard to social impairment, the record shows she maintained relationships with some of her family and friends. During a December 2012 VA examination, she reported that she has only had a romantic relationship with women since service and they have been conflictual. She described her relationship at the time as strained because of her partner's jealousy. She indicated she had friends in the past, but the relationships ended because they took advantage of her. However, the Veteran reported that she spent time with her niece and friend. She also indicated that she keeps in touch with her living siblings. For her past time, she stated she watched movies, cooked, went out to a club, and was interested in joining a book club. She also indicated that she attended church services weekly. Regarding occupational impairment, the evidence shows the Veteran was employed during the appeal period prior to April 14, 2016. The Board notes that she reported her employment history was unstable because of her depression and flare in symptoms that caused her to miss work. She described her employment at various jobs as short-lived due to her depression and alcohol dependence which caused her to miss a lot of work. However, during the December 2012 VA examination, she reported that she got along with her co-workers and had good interactions with her supervisor. In April 2015, the Veteran's job was described as stable. See also November 2014 record that indicated her employment at the Internal Revenue Service was stable following a government shutdown. The Board acknowledges that the Veteran has reported that she had frequent absences at work because of her PTSD, received written warnings for missing too much work, could not be employed full time because of absences, and had difficulty concentrating at work. As to overall impairment, treatment records note the Veteran experienced anxiety, depression, flashbacks, nightmares, hypervigilance, avoidance, irritability, difficulty in relationships, and had a history of violence and abuse. See December 2008 and November 2012 treatment records. During appointments, she was most times observed to be alert and oriented with logical and goal-directed thoughts with no psychosis (delusions, visual hallucinations, or audio hallucinations) or suicidal or homicidal ideations. See November 2013, November 2014, and April 2015 treatment records. She also demonstrated good insight and judgment, normal thought processes, normal memory with no difficulty recalling information or concentrating, and average speech. See November 2010, and July and August 2013 treatment records. Moreover, during her appointments, she was observed to have a neat appearance and be well groomed. See November 2010, July 2013, and October 2015 treatment records. During a December 2012 VA examination, the Veteran did not meet the criteria to be diagnosed with PTSD. However, the examiner formally diagnosed her with a depressive disorder with alcohol dependence but found the symptoms of self-medicating with alcohol, sleep disturbance, hypervigilance, anxiety, recurrent thoughts, depressed mood, suspiciousness, and disturbance in motivation and mood were not severe enough to interfere with occupational or social functioning or require continuous medication. At that time, she reported have difficulties with work in the past due to depression and have suicidal ideations in May 2009. However, she denied having suicidal and homicidal ideations during the visit. Lastly, the Veteran indicated that she slept with a knife and scissors under her pillow and been arrested before the appeal period (1998, 1992, and 1995) due to violence. Furthermore, the Veteran's symptomatology has not been similar to that of the criteria for an evaluation of 50 percent prior to April 14, 2016. The record does not reflect that she exhibited flattened affect, circumstantial, circumlocutory, or stereotyped speech, panic attacks more than once a week, difficulty understanding complex commands, impaired judgement, or impaired abstract thinking prior to April 14, 2016. Treatment records show the Veteran's speech was normal, her insight and judgment were good, and her thinking processes were normal. Moreover, the December 2012 VA examiner did not endorse the Veteran experienced these symptoms. After considering the evidence of record, the Board finds that the Veteran's symptoms approximate the criteria for an evaluation of 30 percent for the period prior to April 14, 2016. Overall, the Veteran has not demonstrated a level of impairment consistent with the 50 percent criteria, nor have the Veteran's symptoms caused occupational and social functioning with reduced reliability or productivity; with deficiencies in most of the areas; or resulting in total occupational and social impairment as referenced by the 70 and 100 percent evaluation criteria. Mauerhan, supra, Vazquez-Claudio, supra. The criteria for the next higher rating of 50 percent have not been met or approximated for the period prior to April 14, 2016. See 38 C.F.R. § 4.130, Diagnostic Code 9411. The Veteran's PTSD is currently assigned an evaluation of 70 percent effective from April 14, 2016. In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran does not meet the criteria for a 100 percent evaluation for this time period. A 100 percent rating is warranted when the psychiatric disorder results in 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. The evidence of record does not show that the Veteran has 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. The Board emphasizes that the criteria for an evaluation of 100 percent requires both total social and occupational impairment. See Melson v. Derwinski, 1 Vet. App. 334 (1991) (use of the conjunctive "and" in a statutory provision meant that all of the conditions listed in the provision must be met); cf. Johnson v. Brown, 7 Vet. App. 95 (1994) (only one disjunctive "or" requirement must be met in order for an increased rating to be assigned). With regard to social impairment, the record shows that the Veteran has consistently maintained relationships with her family. During an April 2016 VA examination, the Veteran reported that she stays in touch with her sister. She also indicated that she had been in a relationship for the previous four years. As such, it cannot be said that he has total social impairment With respect to occupational impairment, during the April 2016 VA examination, the Veteran reported that she has a chemical engineering degree. She stated that she had multiple jobs and had worked with the Internal Revenue Service since 2010. She indicated that she had never been fired from a jog but rather quit on her own when she did not like the job or wanted a better paying job. The Board notes that a July 2016 record indicates the Veteran was unable to attend work for a period of 10 days during June 2016 because she had a flare up of issues. Additionally, in a September 2016 statement, the Veteran reported that she experienced many lost jobs due to her missing work because of her PTSD. She stated that she stumbled through her jobs, had difficulty concentrating at work, and was placed on Family Medical Leave before being asked to resign from her last employment in August 2016. Notably, the April 2016 VA examiner opined that the Veteran had occupational and social impairment with reduced reliability and productivity. Such an opinion is commensurate with a 50 percent evaluation, whereas the Veteran has already been granted a 70 percent evaluation. After considering the evidence of record, the Board finds that the Veteran's PTSD more closely approximates the criteria for the 70 percent disability rating for the period beginning April 14, 2016. Overall, the Veteran has not demonstrated a level of impairment consistent with the criteria for a total evaluation. Mauerhan, supra, Vazquez-Claudio, supra. The criteria for a total evaluation have not been met or approximated at any time during the appeal period. See 38 C.F.R. § 4.130, Diagnostic Code 9411. Thus, the Board concludes that the weight of the evidence is against a rating in excess of 70 percent for PTSD on or after April 14, 2016. As such, the benefit-of-the-doubt rule does not apply. Gilbert, 1 Vet. App. at 53. Earlier Effective Date Unless specifically provided otherwise, the effective date of an award based on an original claim, a claim reopened after final adjudication, or a claim for increase, of compensation, dependency and indemnity compensation, or pension, shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C. § 5110(a). Effective March 24, 2015, VA amended its regulations to require that all claims governed by VA's adjudication regulations be filed on a standard form. The amendments implement the concept of an intent to file a claim for benefits, which operates similarly to the informal claim process, but requires that the submission establishing a claimant's effective date of benefits must be received in one of three specified formats. The amendments also eliminate the constructive receipt of VA reports of hospitalization or examination and other medical records as informal claims to reopen under 38 C.F.R. § 3.157. See 79 Fed. Reg. 57,660 (Sept. 25, 2014) (now codified at 38 C.F.R. §§ 3.1 (p), 3.151, 3.155). The amendments apply only to claims filed on or after March 24, 2015. In this case, because the Veteran's claim for service connection for PTSD was received by VA prior to that date, the former regulations apply, as provided below. However, the Veteran's claim for service connection for PTSD was not received until November 6, 2008. Under the old regulations, a specific claim in the form prescribed by VA must be filed in order for benefits to be paid or furnished to any individual under the laws administered by VA. 38 U.S.C. § 5101(a); 38 C.F.R. § 3.151(a). The term "claim" or "application" means a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 C.F.R. § 3.1(p). Any communication or action indicating an intent to apply for one or more benefits under laws administered by VA from a claimant may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. 38 C.F.R. § 3.155(a). To determine when a claim was received, the Board must review all communications in the claims file that may be construed as an application or claim. See Quarles v. Derwinski, 3 Vet. App. 129, 134 (1992). The effective date of an award of increased compensation shall be the earliest date as of which it is factually ascertainable that an increase in disability had occurred if the claim is received within one year from such date. Otherwise, the effective date will be the date of receipt of the claim. 38 U.S.C. § 5110(b); 38 C.F.R. § 3.400(o)(2); see also Gaston v. Shinseki, 605 F.3d 979, 983 (Fed. Cir. 2010) ("It is clear from the plain language of [section] 5110(b)(2) that it only permits an earlier effective date for increased disability compensation if that disability increased during the one-year period before the filing of the claim."); Hazan v. Gober, 10 Vet. App. 511, 519 (1997) ("increase" for this purpose is one to the next disability level); VAOPGCPREC 12-98 (Sept. 23, 1998). In considering the evidence of record under the laws and regulations as set forth above, the Board concludes that the Veteran is not entitled to an effective date earlier than November 6, 2008, for the grant of service connection for PTSD. The Veteran first filed a claim for service connection for PTSD on November 6, 2008. No earlier record constituted a claim for these benefits. In a July 2016 rating decision, the AOJ granted service connection for PTSD, effective from the date of the November 6, 2008 claim. The record does not contain any earlier communication indicating an intent to file a service connection claim for PTSD. VA is obligated to consider all possible bases for compensation; however, this does not mean that it is required to anticipate any potential claim for a particular benefit where no intention to raise it was expressed. See Brannon v. West, 12 Vet. App. 32, 35 (1998) (holding that before VA can adjudicate a claim for benefits, "the claimant must submit a written document identifying the benefit and expressing some intent to seek it"); see also Talbert v. Brown, 7 Vet. App. 352, 356-57 (1995). Based on the foregoing, the Board concludes that, a claim for service connection for PTSD was not received prior to the claim submitted on November 6, 2008, which is the effective date currently assigned. As the weight of the evidence is against the Veteran's claim, the benefit-of-the-doubt rule does not apply, and the claim is denied. Gilbert, 1 Vet. App. 49, 53. REASONS FOR REMAND All veterans who are shown to be unable to secure and follow a substantially gainful occupation by reason of service-connected disability shall be rated totally disabled. For VA purposes, total disability exists 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, 4.16(b). A total disability rating for compensation may be assigned, where the schedular rating is less than total, when a veteran is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of a single service-connected disability ratable at 60 percent or more, or as a result of two or more disabilities, provided at least one disability is ratable at 40 percent or more, and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). April 14, 2016 to August 31, 2016 In this case, the Veteran currently has been assigned TDIU prior to August 31, 2016. The Veteran is currently service connected for one disability, PTSD. From April 14, 2016 to August 31, 2016, her disability is rated at 70 percent. Thus, for that period, the Board finds she meets the percentage requirements for TDIU under 38 C.F.R. § 4.16(a). During an April 2016 VA examination, the Veteran reported that she had been working with the Internal Revenue Service since 2010. She stated that she had a history of multiples jobs but was never fired from one; rather, she quit when she did not like the job or to get a better paying job. However, she reported that, while working at the Internal Revenue Service, she had to take frequent sick leave due to her anxiety, depression, and drinking. She was advised by her supervisor to request to have family sick leave to avoid being fired from her job. The examiner did not provide an opinion of whether the Veteran's service-connected disability impacted her ability to work. A July 2016 correspondence from the Vet Center indicated the Veteran need to be excused from work from July 20, 2016 to July 30, 2016 due to a flare up with her issues related to PTSD. In a September 2016 statement, despite her frequent absences which the Veteran attributes to her depression, she was promoted into a permanent position. However, in August 2016, she was asked to report to work or resign due to her absenteeism. She received a letter indicating she had failed to follow proper procedures to request leave. Therefore, she was placed on absence without leave status. As noted above, the April 2016 VA examiner did not provide a statement of whether and, if so, what degree the Veteran's service-connected PTSD impact her ability to work. Moreover, there is current no opinion that addresses this fact. For this reason, a retrospective opinion should be obtained for the period of April 14, 2016 to August 31, 2016 to determine if the Veteran's PTSD had an impact on her ability to work, and if so, to what degree. Prior to April 14, 2016 From November 6, 2008 to April 14, 2016, the Veteran was assigned a 30 percent evaluation for her PTSD. Therefore, she does not meet the percentage requirements for that period. Nevertheless, even when the percentage requirements are not met, entitlement to TDIU on an extraschedular basis may be granted in exceptional cases when the veteran is unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities. 38 C.F.R. § 4.16(b). A review of the claims file reveals the RO did not refer the TDIU claim to the Director of Compensation Services for this period. Moreover, it is recognized that the Board is precluded from assigning an extraschedular rating in the first instance; however, the Board must specifically adjudicate the issue of whether referral for TDIU on an extraschedular basis pursuant to 38 C.F.R. § 4.16(b) is warranted. Bowling v. Principi, 15 Vet. App. 1, 8-10 (2001). The Veteran indicated that, in 2008, she could not be employed full time because of absences related to her depression. She stated that she stumbled through her jobs and received several warnings because of her absences. She described her interaction with her co-workers as difficult. She also expressed that she had problems concentrating that affected her ability to work. Later, she resigned due to an economic situation in 2008 and 2009. See September 2016 statement. A December 2012 VA examiner found the Veteran's mental disorder was not severe enough to interfere with occupational and social functioning. In the examination report, it is noted that the Veteran did not work immediately after service for several years but rather "drank and sorta raised" her son. She indicated that when she did become employed, it was unstable and short-lived employment. She reported that she would work between eight to ten temporary or warehousing jobs or technical jobs (involving systems and production) per year because of her depression, frustration, impatience, and alcohol use. She also stated that she worked at the Internal Revenue Service from 1990 to 1992. While she remembers losing her job sometimes to downsizing, she indicated she typically lost her job because of absences, or her feeling of offence or tiredness of work. She indicated that her longest length of employment was from 1992 to 2002 at Penn Chemical, which she eventually left to pursue her education. Following completion of her engineering program, she was disappointed as she could not obtain work in her field, which she admits worsened her depression. In November 2010, she was rehired by the Internal Revenue Service for seasonal work, furloughed for several months, and then brought back where she had been working consistently for over a year at the time of the examination. She reported that her interactions with her co-workers and supervisor were good, but she missed too many days due to unscheduled leave. She attributed her absences to her depression and logistic challenges. While she was reprimanded for her absences, she reported during the examination that she significantly improved her attendance. The record shows that the Veteran remained employed with the Internal Revenue Service until August 2016. Based on the foregoing, the Board concludes that this case presents an unusual or exceptional circumstance that would justify a referral of the total rating claim to the Director of the VA Compensation Service for extra-schedular consideration pursuant to 38 C.F.R. § 4.16(b). Therefore, the claim is remanded. The matters are REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should first refer the case to VA's Director of Compensation (or a designee) for consideration of whether entitlement to a TDIU on an extraschedular basis pursuant to 38 C.F.R. § 4.16(b) is warranted prior to April 14, 2016. 2. After the foregoing, the AOJ should schedule the Veteran for a VA examination by an appropriate examiner in order to obtain a retrospective opinion. The ultimate purpose of the examination is to ascertain the impact of the Veteran's service-connected disability on her ability to work between April 14, 2016 and August 31, 2016. The examiner is requested to review all pertinent records associated with the claims file. The examiner should elicit and set forth the pertinent facts regarding the Veteran's medical history, education and employment history, day-to-day functioning between April 14, 2016 and August 31, 2016, and industrial capacity between April 14, 2016 and August 31, 2016. The report should also indicate if there was any form of employment that the Veteran could perform between April 14, 2016 and August 31, 2016, and if so, what type. A written copy of the report should be associated with the claims file. R.R. WATKINS Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.M. Walker 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.