Citation Nr: 21075864 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 14-00 333 DATE: December 21, 2021 ORDER Entitlement to a 70 percent rating, but no higher, for posttraumatic stress disorder (PTSD) from December 28, 2010, to December 10, 2013, is granted. Entitlement to a total rating based on individual unemployability (TDIU) from December 28, 2010, to December 10, 2013, is granted. FINDINGS OF FACT 1. From December 28, 2010, to December 10, 2013, the preponderance of the evidence showed that the Veteran's PTSD was productive of occupational and social impairment with deficiencies in most areas but not total occupational and social impairment. 2. From December 28, 2010, to December 10, 2013, the Veteran's service-connected disabilities precluded substantial gainful employment. CONCLUSIONS OF LAW 1. The criteria for a 70 percent rating, but no higher, for PTSD have been met at all times from December 28, 2010, to December 10, 2013. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.14, 4.130, Diagnostic Codes 9411. 2. The criteria for a TDIU have been met at all times from December 28, 2010, to December 10, 2013. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Air Force from July 1963 to June 1967. In April 2017, the Board of Veterans' Appeals (Board) Remanded the appeal. In July 2018, the Board granted the Veteran a 50 percent rating for PTSD for the period from December 28, 2010, to December 10, 2013, and denied a rating in excess of 70 percent for PTSD for the period from December 10, 2013, to February 21, 2018, as well as remanded a claim for a compensable rating for prostate cancer. As to the claim for a compensable rating for prostate cancer, the RO has yet to recertify this issue the Board and therefore no further action as to this issue is needed at this time. See 38 C.F.R. § 3.103; Gray v. McDonald, 27 Vet. App. 313, 327 (2015) (Due process protections apply to disability compensation proceedings before the Board) (citing Cushman v. Shinseki, 576 F.3d 1290 (Fed. Cir. 2009)); see also Carter v. McDonald, 794 F.3d 1342, 1346 (Fed. Cir. 2015) (regulatory requirement of notice in § 1.525(d) can only sensibly be construed to require that the notice to counsel be timely, which requires, at a minimum, notice before the expressly stated deadline has passed). As to the claim for higher ratings for PTSD, the Veteran appealed the July 2018 Board decision to the United States Court of Appeals for Veterans Claims (Court). This action, and the work of the Court, may have delayed the actions of the RO in the other claim, but this is not clear. In a June 2019 order, which incorporated the parties Joint Motion for Partial Remand (JMPR), the Court vacated and remanded the July 2018 Board decision but only to the extent that it denied a rating in excess of 50 percent for PTSD from December 28, 2010, to December 10, 2013. The JMPR also noted that the Veteran was not precluded from raising a claim for a TDIU for the period from December 28, 2010, to December 10, 2013. In October 2019, the Board again denied the claim for a rating in excess of 50 percent for PTSD from December 28, 2010, to December 10, 2013, and Remanded the claim for a TDIU from December 28, 2010, to December 10, 2013. The Veteran appealed the October 2019 Board decision to the Court. In a May 2020 order, which incorporated the parties Joint Motion for Remand (JMR), the Court vacated and remanded the October 2019 Board decision to the extent that it denied a rating in excess of 50 percent for PTSD from December 28, 2010, to December 10, 2013. In May 2021, the Veteran testified at a virtual hearing before the undersigned and a transcript of that record has been associated with the claims file. As to the characterization of the issues on appeal, given the fact that the claims have been pending since service connection was granted for PTSD on December 28, 2010, given the Court's holding in Rice v. Shinseki, 22 Vet. App. 447 (2009), and given the above final decisions, the Board finds that it only has jurisdiction over the claims as to whether the Veteran met the criteria for a higher evaluation for PTSD and the criteria for a TDIU for the period from December 28, 2010, to December 10, 2013. See 38 U.S.C. § 7104. Lastly, the Board notes that additional evidence was added to the claims final since the regional office (RO) issued the April 2018 supplemental statement of the case. However, the Board finds that none of this evidence is pertinent as to whether the Veteran met the criteria for a higher evaluation for PTSD and the criteria for a TDIU for the period from December 28, 2010, to December 10, 2013. Therefore, the Board finds that it may adjudicate these issues without first obtaining a waiver of agency of original jurisdiction (AOJ) review or Remanding for AOJ review. See 38 C.F.R. § 19.31 (a supplemental statement of the case will be furnished to the veteran when additional pertinent evidence is received after a statement of the case has been issued). The concerns raised in the JMPR and JMR as well as post-Remand compliance As to the concerns raised in in JMPR regarding the claim for an increased rating for PTSD being inextricably intertwined with the TDIU, the Board notes that the below decision adjudicates both claims. Therefore, the Board finds that no further discussion of this concerns is needed at this time. As to the concerns raised in the JMR, the current decision contains a full and thorough discussion of all the pertinent evidence of record in adjudicating whether the Veteran's "... symptoms resulting in occupational and social impairment with deficiencies in most areas as required for a 70% rating..." to include, but not limited to, the following: Dr. Michael Maher's May 1999 opinion "... that Appellant was 'totally disabled with regard to his capacity to return to his employment with the postal service...[h]e has impairment in the area of concentration, memory, ability to maintain consistent task oriented behavior, and was at risk for much more severe psychiatric decompensation, including suicidal depression, if forced to return to work;'" Dr. Gary K. Arthur's November 1999 opinion "... that Appellant had 'great difficulty concentrating and focusing attention on anything, including driving or even simple elements of conversation'; avoided of people; had nightmares; had intrusive memories; 'lack[ed]of control over his thought processes'; and become overwhelmed by anxiety and depression, and that Appellant 'is totally disabled for any work with any employer, even on a part time bases;'" and Dr. Conrad Weller's May 2001 opinion that the "...Appellant's 'functioning is poor . .. and is not able to function, interact socially or able to retain a job.'" Therefore, the Board finds that no further discussion of the concerns raised in the JMR is needed at this time. As to compliance with the April 2017 and October 2019 Remands, the Board finds that there has been substantial compliance because, while the appeal was at the RO, it obtained and associated with the record all identified and available private and VA treatment records, including all those generated prior to December 10, 2013, the RO obtained from the Veteran a March 2020 VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability, and in February 2018 and July 2020 the appellant was provided with VA examinations adequate to adjudicate the claims under applicable rating criteria and regulations because after a review of the record on appeal and/or an examination the examiners provided opinions as to the severity of the appellant's PTSD supported by medical reasoning. See 38 U.S.C. § 5103A(b), (d); Barr v. Nicholson, 21 Vet. App. 303 (2007); Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97 (2008) (holding that only substantial, and not strict compliance with the terms of a remand request, is required); Dyment v. West, 13 Vet. App. 141, 146-47 (holding that there was no Stegall violation when the examiner made the ultimate determination required by the Board's remand, because such determination more than substantially complied with the Board's remand order). Therefore, the Board finds that further delay by remanding the appeal to take further development is not required. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran are to be avoided). The Rating Claim The Veteran claims, in substance, that he is entitled to higher rating for his PTSD at all times from December 28, 2010, to December 10, 2013. Disability evaluations are determined by the application of a schedule of ratings which is based, as far as can practically be determined, on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Each service-connected disability is rated on the basis of specific criteria identified by a Diagnostic Code. 38 C.F.R. § 4.27. When rating the Veteran's service-connected disability, the entire medical history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Separate higher or lower compensable evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as "staged" ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). Regulations require that where there is a question as to which of two evaluations is to be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The Veteran's PTSD is rated as 50 percent disabling from December 28, 2010, to December 10, 2013, under 38 C.F.R. § 4.130, Diagnostic Code 9411 (the General Rating Formula for Mental Disorders (General Formula)). The General Formula provides a 50 percent rating is warranted when the evidence shows occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is warranted when there is occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depressive disorder affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); inability to establish and maintain effective relationships. A 100 percent rating is warranted when the evidence shows total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Id. Ratings are assigned according to the manifestation of particular symptoms. However, the use of the term "such as" in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). When determining the appropriate disability evaluation to assign, however, the Board's "primary consideration" is the Veteran's symptoms. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). Initially, the Board notes that because the claim has been pending since 2010, approximately three years before the issuance of the AMERICAN PSYCHIATRIC ASSOCIATION: DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, 5th Edition (2013) (DSM-5) and eight years before the Court issued its' decision in Golden v. Shulkin, 29 Vet. App. 221 (2018) it is unclear whether the Board's adjudication of the claim can include a discussion of the Global Assessment of Functioning (GAF) scores found in the record. Nonetheless, with giving the Veteran the benefit of doubt in this case, the Board finds that they below adjudication will include such a discussion. According to the AMERICAN PSYCHIATRIC ASSOCIATION: DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, 4th Edition (1994) (DSM IV), GAF is a scale reflecting the "psychological, social, and occupational functioning on a hypothetical continuum of mental health-illness." There is no question that the GAF score and interpretations of the score are important considerations in rating a psychiatric disability. See, e.g., Richard v. Brown, 9 Vet. App. 266, 267 (1996); Carpenter v. Brown, 8 Vet. App. 240 (1995). However, the GAF scores assigned in a case, like an examiner's assessment of the severity of a condition, is not dispositive of the evaluation issue; rather, the GAF scores must be considered in light of the actual symptoms of the Veteran's disorder, which provide the primary basis for the rating assigned. See 38C.F.R.§4.126(a). A GAF of 61-70 indicates some mild symptoms (e.g., depressed mood and mild insomnia) or some difficulty in social occupational or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well with some meaningful interpersonal relationships. A GAF of 51-60 indicates moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) or moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers). A GAF of 41-50 indicates serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) or any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job). A GAF of 31-40 indicates some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) or major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work). A GAF of 21-30 indicates behavior is considerably influenced by delusions or hallucinations or serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends.). See DSM IV. Initially, and as noted by the JMR, the record shows that the Veteran's adverse PTSD symptomatology included suicidal ideation. See. e.g., Dr. Maher opinion dated in May 1999. Moreover, and as also noted by the JMR, Dr. Maher in May 1999 opined, in relevant part, "... that Appellant was 'totally disabled with regard to his capacity to return to his employment with the postal service...[h]e has impairment in the area of concentration, memory, ability to maintain consistent task oriented behavior, and was at risk for much more severe psychiatric decompensation ... if forced to return to work.'" Similarly, and as noted by the JMR, Dr. Arthur in November 1999 opined, in relevant part, "... that Appellant had 'great difficulty concentrating and focusing attention on anything, including driving or even simple elements of conversation'; avoided of people; had nightmares; had intrusive memories; 'lack[ed]of control over his thought processes'; and become overwhelmed by anxiety and depression, and that Appellant 'is totally disabled for any work with any employer, even on a part time bases.'" It was thereafter opined that the Veteran had a GAF score of 55. Likewise, and as also noted by the JMR, Dr. Weller in May 2001 opined, in relevant part, that the "...Appellant's 'functioning is poor... and is not able to function, interact socially or able to retain a job.'" Similarly, Dr. Bala K. Rao in May 2011 opined, in relevant part, that the Veteran was sad, depressed, agitated, irritable/angry/had a temper which caused problems with road rage, paranoia, and crying spells and on examination he was anxious, agitated, volatile, and had poor concentration. It was thereafter opined that the Veteran had a GAF score of 55. In November 2001, Dr. Weller reported that the Veteran's PTSD continued to cause problems with anxiety and depression with frequent situational exacerbations which render him incapable of sustaining competitive employment. In June 2003, Dr. Weller reported that the Veteran's PTSD caused him problems with fear, helplessness, despair, flashbacks, no patience, difficulty functioning in a stable manner, anger, and paranoia. It was also opined that he was unemployable in any setting. Furthermore, at the May 2011 VA examination the Veteran endorsed symptoms of intrusive memories, distressing dreams, avoidance, emotional detachment, hypervigilance, irritability, extreme anxiety, a poor ability to cope, social isolation, an irritated, anxious, and sad mood, constricted affect, thought content being disjointed at times, and fair to poor insight and judgment In April 2012 Dr. Arthur reported that the Veteran's PTSD caused problems with panic attacks, anxiety, depression, difficulty concentrating, hypervigilance, and intrusive memories. It was thereafter opined that the Veteran was unemployable because he had impaired thinking and judgement, his ability to concentrate on a task was poor, and he did not relate well consistently with others. It was also noted that the Veteran generally displayed excess anxiety and depression daily. It was opined that the Veteran's GAF score over the past year had been a 45, despite medication and supportive psychotherapy. Similarly, in December 2013 Dr. Arthur reported that the Veteran endorsed symptoms of intrusive recollections of a traumatic experience, speech being intermittently illogical, obscure, or irrelevant, unprovoked hostility and irritability, deficiencies in judgment, depression, low self-confidence and self-esteem, anhedonia, varying degrees of helplessness and hopelessness, frequent nightmares, and a poor ability to focus, concentrate, and begin or attend to tasks. It was thereafter opined that the Veteran had a GAF score of 42. Tellingly, the Court has held that suicidal ideation generally rises to the level contemplated in a 70 percent evaluation. See Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017) (stating the language of 38 C.F.R. § 4.130 "indicates that the presence of suicidal ideation alone, that is, a veteran's thoughts of his or his own death or thoughts of engaging in suicide-related behavior, may cause occupational and social impairment in most areas."). The Court has also held that, "it is the information in a medical opinion, and not the date the medical opinion was provided that is relevant when assigning an effective date." Tatum v. Shinseki, 24 Vet. App. 139, 145 (2010) (discussing assignment of an effective date for a reduction in disability rating under Diagnostic Code 7528); see also Young v. McDonald, 766 F.3d 1348, 1352-53 (Fed. Cir. 2014). (holding that a medical opinion can diagnose the presence of the condition and identify an earlier onset date based on preexisting symptoms). Therefore, when considering the frequency, severity, and duration of the Veteran's impairment to assess his disability picture and when resolving all reasonable doubt in his favor, the Board finds that the most probative evidence of record are the above medical records that show that the Veteran's PTSD adverse symptomatology approximated the criteria for at least a 70 percent rating at all times from December 28, 2010, to December 10, 2013. See 38 C.F.R. § 4.130; Owens, supra; Fenderson, supra; Tatum, supra; Young, supra. The Board has reached this conclusion because the above medical records show that the Veteran's PTSD symptomatology included, among other things, suicidal ideation; impairment in the areas of concentration, memory, ability to maintain consistent task oriented behavior, thinking and judgement; avoidance; nightmares; intrusive memories; anxiety; depression; poor functioning; a poor ability to interact socially; distressing dreams; avoidance; emotional detachment; hypervigilance; irritability; unprovoked hostility; an irritated, anxious, and sad mood; a constricted affect; thought content being disjointed at times; fair to poor insight and judgment; speech being intermittently illogical, obscure, or irrelevant; low self-confidence and self-esteem, anhedonia; and varying degrees of helplessness and hopelessness as well shows that he was assigned, at its' worst, a GAF score of between 41 and 50. Id. However, the Board finds that the preponderance of the evidence shows that the criteria for a higher rating of 100 percent are not met at any time from December 28, 2010, to December 10, 2013. See Owens, supra. In this regard, the Board finds that that the most probative evidence of record shows his PTSD does not cause total social and occupational impairment despite the problems seen with, among other things, suicidal ideation at any time from December 28, 2010, to December 10, 2013. See 38 C.F.R. § 4.130; Owens, supra. In fact, the Board finds that the Veteran's own statements do not support such a finding. In this regard, while the criteria for a 100 percent rating specifically identifies problems with being a "persistent" danger of hurting self and while this is not exclusive symptomatology, the Board finds the fact that the record, including the opinions from Dr. Maher in May 1999, Dr. Arthur in November 1999, April 2012, and December 2013, Dr. Weller in May 2001, November 2001, and June 2003, Dr. Rao in May 2011, and the VA examiner in May 2011 as well as the treatment records, is negative for a suicide plan or attempt, weighs heavily against finding that the appellant's PTSD caused a "persistent" danger of hurting self despite the suicidal ideation reported in his medical records. See Owens, supra. The Board finds the Veteran's own words to Dr. Arthur in November 1999, Dr. Rao in May 2011, and the VA examiner in May 2011 when he denied, in substance, current thoughts of suicide or a plan weights against the claim. See Owens, supra. Simply stated, on this very limited issue, the Veteran himself provides evidence against this claim that is of high probative value. Next, while not exclusive symptomatology the criteria for a 100 percent rating also specifically identifies problems with "persistent danger of hurting ... others," in November 1999 Dr. Arthur noted that the Veteran has thoughts about hitting people, in December 2013 Dr. Arthur reported that the Veteran endorsed symptoms of unprovoked hostility and irritability, and at the May 2011 VA examination it was noted that the Veteran had a problem with irritability. However, the Board notes that the record, including the opinions from Dr. Maher in May 1999, Dr. Arthur in November 1999, April 2012, and December 2013, Dr. Rao in May 2011, Dr. Weller in May 2001, November 2001, and June 2003, and the VA examiner in May 2011 as well as the treatment records, are negative for homicidal ideation. In fact, when seen by Dr. Arthur in November 1999, Dr. Rao in May 2011, and the VA examiner in May 2011, the Veteran either specifically denied and/or the examiner found that the appellant did not have homicidal ideation. Therefore, the Board finds that the periodic problem the Veteran had with irritability, hostility, and anger along with road rage is not the type of problem contemplated by the criteria for a 100 percent rating from December 28, 2010, to December 10, 2013. See Owens, supra. Likewise, the Board notes that the criteria for a 100 percent rating specifically identifies problems with "memory loss for names of close relatives, own occupation, or own name" and some examinations and treatment records noted a problem with memory loss. See, e.g., Dr. Maher opinion in May 1999; Dr. Arthur opinions in April 2012 and December 2013; and the VA examination in May 2011. However, Dr. Arthur in November 1999 and Dr. Rao in May 2011 opined that the Veteran's memory was intact. Similarly, the May 2011 VA examiner opined the Veteran's memory was within normal limits. Moreover, the record on appeal is negative for evidenced showing that the Veteran's memory loss was ever "for names of close relatives, own occupation, or own name." Therefore, the Board finds the memory loss reported in some of the medical records is not the type of memory loss contemplated by the criteria for a 100 percent rating from December 28, 2010, to December 10, 2013. See Owens, supra. Additionally, while not exclusive symptomatology the criteria for a 100 percent rating also specifically identifies problems with an "intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene)." However, Dr. Arthur in November 1999 as well as Dr. Rao in May 2011 and the May 2011 VA examiner reported that the Veteran was dressed appropriately. Likewise, the Board finds that the Veteran's treatment records are negative for this type of adverse symptomatology. Therefore, the Board finds that the Veteran once again did not have adverse symptomatology contemplated by the criteria for a 100 percent rating and this is true at all times from December 28, 2010, to December 10, 2013. See Owens, supra. Similarly, while not exclusive symptomatology the criteria for a 100 percent rating also specifically identifies problems with "gross impairment in thought processes or communication," "persistent delusions or hallucinations," and "grossly inappropriate behavior" "disorientation to time or place." However, while the record documents the Veteran having problems with nightmares, intrusive memories, thought content being disjointed at times, and speech being intermittently illogical, obscure, or irrelevant at times, the Board finds that the record is negative for the type of adverse symptomatology contemplated by the rating criteria. See, e.g., Dr. Maher opinion in May 1999; Dr. Arthur opinions in November 1999, April 2012, and December 2013; Dr. Rao's opinion in May 2011; Dr. Weller opinions in May 2001, November 2001, and June 2003; and the VA examination in May 2011. In this regard, Dr. Maher in May 1999, Dr. Arthur in November 1999, Dr. Rao in May 2011, and the May 2011 VA examiner reported that the Veteran was oriented times four. Moreover, Dr. Maher in May 1999 and the May 2011 VA examiner opined that the Veteran neither had hallucinations or delusions. Likewise, the Board notes that the Veteran's treatment records are negative for this type of adverse symptomatology. Therefore, the Board finds that the Veteran once again did not have adverse symptomatology contemplated by the criteria for a 100 percent rating and this is true at all times from December 28, 2010, to December 10, 2013. See Owens, supra. Again, the Board finds the Veteran's own words and the medical opinions weigh heavily against finding that his PTSD caused the type of adverse symptomatology required for a 100 percent rating at all times from December 28, 2010, to December 10, 2013. See Owens, supra. Simply stated, it is important for the Veteran to understand that not all the evidence in this case supports the 70 percent finding, let alone a higher rating. Next, the Board finds that the preponderance of the evidence shows that the Veteran's PTSD did not cause total social and occupational impairment at all times from December 28, 2010, to December 10, 2013. See Owens, supra. In this regard, while Dr. Maher, Dr. Arthur, Dr. Rao, and Dr. Weller opined, in substance, that the Veteran's PTSD caused total occupational impairment and as will be explained in more detail in the below TDIU discussion, the Veteran's PTSD along with his other service-connected disabilities caused total occupational impairment from December 28, 2010, to December 10, 2013, the criteria for a 100 percent rating for PTSD also requires total social impairment. Tellingly, the Board finds that the preponderance of the evidence shows that his PTSD did not cause total social impairment. Id. The Board has reached this conclusion because while the record shows that the Veteran is divorced after having been married for 27 years, rarely leaves home, and does not like associating with people, it also shows that his almost 90 year old mother lives with him so he can care for her as well as shows he was able to maintain relationships with his three children and with a girlfriend at all times from December 28, 2010, to December 10, 2013. See, e.g., Dr. Maher opinion in May 1999; Dr. Arthur opinions in November 1999, April 2012, and December 2013; Dr. Rao's opinion in May 2011; Dr. Weller opinions in May 2001, November 2001, and June 2003; and the VA examination in May 2011. Tellingly, at the May 2011 VA examination the Veteran reported that his mother has been living with him for 10 years, he has an okay relationship with his children, and does not have many friends. The Board finds that the Veteran's reports of being able to maintain relationships with his mother, children, and with a girlfriend weighs against finding his PTSD caused total social impairment at all times from December 28, 2010, to December 10, 2013, despite his many social problems. See Owens, supra. While the Veteran clearly had problems due to his PTSD (this is not in dispute) which caused significant social and occupational impairment, the only question is the degree of the problem. Without taking into consideration his statements the 70 percent finding could not be justified based on this medical evidence. See Davidson, supra. Accordingly, the Board finds that the preponderance of the evidence shows that the Veteran's PTSD was not manifested by symptomatology that caused total social impairment at any time from December 28, 2010, to December 10, 2013. See Owens, supra. Therefore, the Board finds that the criteria for a 100 percent rating are not met for the Veteran's PTSD at any time from December 28, 2010, to December 10, 2013, because his PTSD did not cause both total occupational and social impairment. See 38 C.F.R. § 4.130; Fenderson, supra; Hart, supra. In reaching the above conclusions, the Board has also considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the probative evidence is against the claim to the extent outlined above, the Board finds that this doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert, 1 Vet. App. at 55-56. The TDIU Claim While the Veteran already received a TDIU from December 10, 2013, he claims' that his service-connected PTSD along with his other service connected disabilities prevented him from working at all times during the pendency of the appeal which runs from December 28, 2010, to December 10, 2013. Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. If the total rating is based on a disability or combination of disabilities for which the Schedule for Rating Disabilities provides an evaluation of less than 100 percent, it must be determined that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age. 38 C.F.R. § 3.341. If the schedular rating is less than total, a total disability evaluation can be assigned based on individual unemployability if the Veteran is unable to secure or follow a substantially gainful occupation because of a service-connected disability, provided that the Veteran has one service-connected disability rated at 60 percent or higher; or two or more service-connected disabilities, with one disability rated at 40 percent or higher and the combined rating is 70 percent or higher. In calculating if the Veteran met the above schedular criteria VA combines the Veteran's service-connected orthopedic disorders. The existence or degree of non-service-connected disabilities will be disregarded if the above-stated percentage requirements are met and the evaluator determines that the Veteran's service-connected disabilities render his incapable of substantial gainful employment. 38 C.F.R. § 4.16(a). A TDIU may be assigned where the schedular rating is less than total if a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). Generally, total disability will be considered to exist when there is present any impairment of mind or body that is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Further, marginal employment, defined as an amount of earned annual income that does not exceed the poverty threshold determined by the United States Department of Commerce, Bureau of the Census, shall not be considered substantially gainful employment. 38 C.F.R. § 4.16(a). The record shows that from December 28, 2010, to December 10, 2013, the Veteran was service-connected as follows: PTSD rated as 70 percent disabling from December 28, 2010, to December 10, 2013; Tinea versicolor rated as 10 percent disabling from June 17, 1967; and Hemorrhoids rated as 0 percent disabling from June 17, 1967. In summary, this record shows that the Veteran met the schedular requirements of 38 C.F.R. § 4.16(a) from December 28, 2010, to December 10, 2013, because he had two or more service-connected disabilities, with one disability rated at 40 percent or higher and the combined rating is 70 percent or higher. Thus, the question for the Board to consider is when, if ever, his service-connected disabilities rendered him incapable of substantial gainful employment at any time from December 28, 2010, to December 10, 2013. 38 C.F.R. § 4.16(a). In this regard, the Veteran in his July 2017 and/or March 2020 VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability (TDIU Claim Form), reported that he had not worked full-time and became too disabled to work in January 2000 because of his service-connected disability. As to his work history, the Veteran reported that from 1994 to 2000 he worked 40 hours a week as an aircraft mechanic for the United States Postal Service. As to his work history, the Board also notes that medical records found in claims file clarify the fact that post-service the Veteran used his training as an aircraft mechanic to work at an airline as an aircraft mechanic for approximately 21 years and, after the airline went out of business, he worked as a letter carrier for the United States Postal Service from 1993/1994 to 2000. As to his education, the Veteran reported that he had 4-years of high school. As to the Veteran's being able to work performing jobs that require sedentary employment and non-sedentary employment, including his past employment as an aircraft mechanic and a letter carrier for the United States Postal Service as well as other possible employment that could make use of his work experience and 4-years of high school, the Board finds that the medical records show that the problems caused by his service-connected PTSD, tinea versicolor, and hemorrhoids adversely impact his ability to work in any field because of the overall impairment they have to his body and mind to include the stamina needed to work a full-day, concentrate on the tasks required by employment, and interact effectively with co-workers and/or customers, and carry out the tasks required by employment at all times from December 28, 2010, to December 10, 2013. See Geib v. Shinseki, 733 F.3d 1350 (Fed. Cir. 2013) (holding that the determination of whether a Veteran is unable to secure or follow a substantially gainful occupation due to service-connected disabilities is a factual rather than a medical question and that it is an adjudicative determination properly made by the Board or the regional office). The Board also finds that his service-connected connected PTSD would make it very difficult to learn the new skills needed to work in most non-sedentary employments as well as make it dangerous for the Veteran and his co-workers for him to work in most non-sedentary employments from December 28, 2010, to December 10, 2013. Id. Similarly, the Board finds that that the PTSD would make it very difficult to continue working in most sedentary employments for the first time because of the problems it would cause interacting with co-workers as well as any customers and carry out the duties required by such employment from December 28, 2010, to December 10, 2013. Id. Given the above, the Board finds that the Veteran's service-connected disabilities prevented him from securing or following a "substantially gainful" occupation given his prior vocational history, work experience, and the impact his service-connected PTSD, tinea versicolor, and hemorrhoids had on obtaining and maintaining substantially gainful non-sedentary employment and sedentary employment, including in his past employment as an aircraft mechanic and a letter carrier for the United States Postal Service, because of the problems is would cause in any work environment from December 28, 2010, to December 10, 2013. See Owens, supra. Further development of this issue is simply not warranted in light of the history of this case. Therefore, the Board finds that the most probative evidence of record shows that the Veteran's service-connected disabilities rendered him incapable of substantial gainful employment given his prior vocational history, work experience, and the impact his service-connected disabilities had on all employment at all times from December 28, 2010, to December 10, 2013, and the claim for a TDIU for this time period is granted. See 38 C.F.R. § 4.16(a); Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N.T. Werner, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.