Citation Nr: 21006093 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 20-13 932 DATE: February 3, 2021 ORDER Entitlement to service connection for alopecia is denied. Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. The appeal as to entitlement to service connection for anxiety disorder is dismissed. The appeal as to entitlement to service connection for memory loss is dismissed. Entitlement to an initial 70 percent rating, and no more, for major depression with anxious distress and traumatic brain injury (TBI) is granted, subject to the laws and regulations governing the award of monetary benefits. Entitlement to an initial rating greater than 20 percent for lumbosacral strain with intervertebral disc syndrome (IVDS) is denied. Entitlement to an initial 20 percent rating, and no more, for right lower extremity lumbar radiculopathy is granted, subject to the laws and regulations governing the award of monetary benefits. Entitlement to an initial 20 percent rating, and no more, for left lower extremity lumbar radiculopathy is granted, subject to the laws and regulations governing the award of monetary benefits. Entitlement to an initial rating greater than 10 percent for contact dermatitis with pseudofolliculitis barbae (PFB) is denied. Entitlement to an initial rating greater than 10 percent for migraine headaches is denied. For the period beginning January 1, 2018, entitlement to a total disability rating based on individual unemployability (TDIU) is granted, subject to the laws and regulations governing the award of monetary benefits. For the period from October 13, 2017 to December 31, 2017, entitlement to TDIU is denied. Entitlement to an effective date prior to October 13, 2017 for service connection for major depression with anxious distress and TBI is denied. Entitlement to an effective date prior to October 13, 2017 for service connection for lumbosacral strain with IVDS is denied. Entitlement to an effective date prior to October 13, 2017 for service connection for contact dermatitis with PFB is denied. Entitlement to an effective date prior to October 13, 2017 for service connection for right lower extremity lumbar radiculopathy is denied. Entitlement to an effective date prior to October 13, 2017 for service connection for left lower extremity lumbar radiculopathy is denied. Entitlement to an effective date prior to October 13, 2017 for service connection for migraine headaches is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran currently has alopecia. 2. The preponderance of the evidence is against finding that the Veteran has a confirmed diagnosis of PTSD. 3. The Veteran’s anxiety symptoms are subsumed in the already service-connected disorder described as major depression with anxious distress and TBI; thus, the appeal seeking service connection for anxiety disorder is moot. 4. The Veteran’s complaints of memory loss are subsumed in the already service-connected disorder described as major depression with anxious distress and TBI; thus, the appeal seeking service connection for memory loss is moot. 5. Resolving reasonable doubt in the Veteran’s favor, his major depression with anxious distress and TBI is manifested by occupational and social impairment with deficiencies in most areas; it is not manifested by total occupational and social impairment. 6. The Veteran’s lumbosacral strain with IVDS is not manifested by incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months, nor is it manifested by forward flexion of the thoracolumbar spine 30 degrees or less or favorable ankylosis of the entire thoracolumbar spine. 7. Resolving reasonable doubt in the Veteran’s favor, his right lower extremity lumbar radiculopathy is manifested by moderate incomplete paralysis of the sciatic nerve. 8. Resolving reasonable doubt in the Veteran’s favor, his left lower extremity lumbar radiculopathy is manifested by moderate incomplete paralysis of the sciatic nerve. 9. The Veteran’s contact dermatitis with PFB does not involve 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; and it does not require systemic therapy such as corticosteroids or other immunosuppressive drugs for 6 weeks or more during the past 12 month period. 10. The Veteran’s migraine headaches are not manifested by characteristic prostrating attacks occurring on an average once a month over the last several months. 11. The Veteran meets the schedular requirements for TDIU throughout the appeal period; and probative evidence indicates that his service-connected disabilities are of such severity to preclude all forms of substantially gainful employment when considering his education and work experience. 12. The Veteran’s earnings from employment in 2017 exceeded the poverty threshold; wages earned in 2018 and 2019 reflect marginal employment. 13. An intent to file for compensation was received on October 13, 2017 and a formal claim for a psychiatric disorder, lumbar spine disorder (to include associated neurologic abnormalities), skin disorder, and headaches was received October 10, 2018. CONCLUSIONS OF LAW 1. Alopecia was not incurred during active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 2. PTSD was not incurred during active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304(f). 3. The criteria for dismissal of the appeal as to service connection for anxiety disorder are met. 38 U.S.C. § 7105. 4. The criteria for dismissal of the appeal as to service connection for memory loss are met. 38 U.S.C. § 7105. 5. The criteria for an initial 70 percent rating, and no more, for major depression with anxious distress and TBI have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.3, 4.130, Diagnostic Code 9434. 6. The criteria for an initial rating greater than 20 percent for lumbosacral strain with IVDS have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.71a, Diagnostic Code 5243. 7. The criteria for an initial 20 percent rating, and no more, for right lower extremity lumbar radiculopathy are met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.3, 4.124a, Diagnostic Code 8520. 8. The criteria for an initial 20 percent rating, and no more, for left lower extremity lumbar radiculopathy are met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.3, 4.124a, Diagnostic Code 8520. 9. The criteria for an initial rating greater than 10 percent for contact dermatitis with PFB have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.118, Diagnostic Code 7806. 10. The criteria for an initial rating greater than 10 percent for migraine headaches have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Diagnostic Code 8100. 11. For the period beginning January 1, 2018, the criteria for an award of TDIU have been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.16. 12. For the period from October 13, 2017 to December 31, 2017, the criteria for an award of TDIU have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.16. 13. The criteria for an effective date prior to October 13, 2017 for service connection for major depression with anxious distress and TBI have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.155, 3.400. 14. The criteria for an effective date prior to October 13, 2017 for service connection for lumbosacral strain with IVDS have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.155, 3.400. 15. The criteria for an effective date prior to October 13, 2017 for service connection for contact dermatitis with PFB have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.155, 3.400. 16. The criteria for an effective date prior to October 13, 2017 for service connection for right lower extremity lumbar radiculopathy have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.155, 3.400. 17. The criteria for an effective date prior to October 13, 2017 for service connection for left lower extremity lumbar radiculopathy have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.155, 3.400. 18. The criteria for an effective date prior to October 13, 2017 for service connection for migraine headaches have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.155, 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1970 to January 1979. Additional evidence was submitted following the January 2020 statement of the case. In December 2020, the attorney waived Regional Office (RO) consideration. The Board acknowledges that on January 25, 2021, the Veteran’s attorney filed a VA Form 20-0996 Request for Higher Level Review with respect to two of the issues adjudicated in this decision: initial higher rating and earlier effective date for major depression with anxious distress and TBI. However, this is an untimely submission for the purpose of removing these issues from Board jurisdiction, as it was received more than one year following the February 2019 rating decision on appeal, and more than 60 days following the January 2020 statement of the case (SOC). That SOC granted an earlier effective date for major depression with anxious distress and TBI, effectuated in a rating decision with a February 2020 notification letter. To the extent that the VA Form 20-0996 purports to directly appeal the February 2020 rating decision, that was not an “initial decision” under the Appeals Modernization Act, as it was issued as part of an earlier effective date appeal pending in the legacy system. See 38 C.F.R. §§ 3.2400, 19.2; AB v. Brown, 6 Vet. App. 35, 38 (1993). Thus, the Board has jurisdiction and will adjudicate these claims under the legacy system. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). Entitlement to service connection for alopecia In February 2019, VA denied entitlement to service connection for alopecia. The Veteran disagreed with the decision and perfected this appeal. The Veteran generally contends that this disorder is related to service. Service treatment records are negative for any complaints or findings of alopecia. On separation examination in November 1978, the Veteran’s skin was reported as normal on clinical evaluation. On the associated report of medical history, the Veteran reported that he had skin problems described as pseudofolliculitis, a condition for which he is currently service connected. The Veteran underwent a VA skin examination in December 2018. He was not shown to have alopecia, scarring alopecia, or alopecia areata. Review of VA outpatient records is also negative for a diagnosis of alopecia. Other than his formal claim for service connection for alopecia, the Veteran has offered no argument or lay statements concerning this issue. Further, as a lay person, he has not shown that he has the medical training, experience, or expertise to be competent to diagnose alopecia. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). On review, there is no indication that the Veteran has alopecia. Without a current disability, service connection is not warranted. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. The claim is denied. Entitlement to service connection for PTSD In February 2019, VA denied entitlement to service connection for PTSD. The Veteran disagreed with the decision and perfected this appeal. Establishing service connection for PTSD requires: (1) medical evidence diagnosing the disorder in accordance with 38 C.F.R. § 4.125; (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. §§ 3.303, 3.304(f). VA requires a diagnosis that conforms to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to compensate for a psychiatric disability. Martinez-Bodon v. Wilkie, 32 Vet. App. 393, 401 (2020). The Veteran generally contends that he has PTSD related to active service. In a November 2018 statement, he reported that around January 1971 they were conducting torpedo testing and the submarine started flooding. The boat pitched and started listing and he fell and hit his head. He indicated that this was overwhelmingly traumatic for him. The Veteran is competent to report this incident and service records show that he was physically disqualified from submarine duty for acute anxiety reaction, severe, secondary to claustrophobia. The Board finds an in-service event/stressor is established. The Veteran underwent a VA examination in October 2018. He reported the above stressor, which the examiner stated was not adequate to support a diagnosis of PTSD. The examiner further stated that the Veteran’s symptoms did not meet the applicable diagnostic criteria for PTSD, but he did have another mental disorder diagnosis - major depression with anxious distress. On review, the preponderance of the probative evidence is against finding that the Veteran has a confirmed diagnosis of PTSD that conforms to the DSM-5. In making this determination, the Board finds the VA examination highly probative. It was based on a review of the record and physical examination and was conducted by a VA psychiatrist. Further, it included a discussion of the applicable diagnostic criteria. The Board has considered VA treatment records which include isolated diagnoses of PTSD. For example, a November 2017 primary care record indicates the Veteran was seen for a history of PTSD and depression and wanted a referral to mental health. A June 2019 record also notes a diagnosis of PTSD. These diagnoses, however, appear to have been based on the Veteran’s reported history without reference to applicable diagnostic criteria. Thus, they are not considered probative. The Board further notes that the Veteran had a positive screen for PTSD in November 2019, but this is insufficient to establish a confirmed diagnosis. The Board also acknowledges that VA records include a diagnosis of other specified trauma and stressor related disorder. See October 26, 2018 VA mental health consult. As above, this is not a PTSD diagnosis. Finally, the Board has considered the Veteran’s contentions, but as a lay person, he has not shown that he has the medical training, experience, or expertise to be competent to diagnose PTSD. See Jandreau. The doctrine of reasonable doubt is not for application and the claim for service connection for PTSD is denied. See 38 C.F.R. § 3.102; Brammer. Entitlement to service connection for anxiety disorder In February 2019, VA denied entitlement to service connection for anxiety disorder. The Veteran disagreed with the decision and perfected this appeal. The Veteran generally contends that this disorder is related to service. The October 2018 VA examination included a diagnosis of major depression with anxious distress and the Veteran is currently service connected for this disorder. The evaluation of the same disability under various diagnoses is to be avoided, as is the evaluation of the same manifestation under different diagnoses. 38 C.F.R. § 4.14; Amberman v. Shinseki, 570 F.3d 1377 (Fed. Cir. 2009). Notwithstanding, service connection may be available for an additional disorder of the psychiatric system if the additional disorder has different symptoms from the service-connected disability. In this case, the Veteran is seeking compensation for anxiety. His anxiety symptoms are subsumed in the already service-connected psychiatric disorder characterized as major depression with anxious distress and TBI. As service connection has effectively been granted for anxiety symptoms, there remains no specific determination for the Board to consider and the appeal is dismissed as moot. See 38 U.S.C. § 7105. Entitlement to service connection for memory loss In February 2019, VA denied entitlement to service connection for memory loss. The Veteran disagreed with the decision and perfected this appeal. In October 2018, the Veteran underwent a VA TBI examination which showed no complaints of impairment of memory, attention, concentration or executive functions. The examiner stated that for the claimed condition of loss of memory status post TBI, there was no pathology to render a diagnosis. VA records, however, indicate some complaints of memory impairment which appear to be part of the already service-connected psychiatric disorder with TBI. For example, an August 2019 mental health note indicates that the memory issues seem more related to depression and possibly chronic fatigue. In a September 2020 statement, the Veteran reported frequent memory problems. In this case, the Veteran is seeking compensation for memory loss. His complaints are subsumed in the already service-connected psychiatric disorder characterized as major depression with anxious distress and TBI. Indeed, the general rating formula for mental disorders considers memory impairment, and decreased memory is also contemplated in cognitive impairment as residuals of TBI. See 38 C.F.R. § 4.130, Diagnostic Code 9434, § 4.124a, Diagnostic Code 8045. As service connection has effectively been granted for memory loss, there remains no specific determination for the Board to consider and the appeal is dismissed as moot. See 38 U.S.C. § 7105. Increased Ratings Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (rating schedule), found in 38 C.F.R. Part 4. Disability ratings are intended to compensate impairment in earning capacity due to a service-connected disorder. 38 U.S.C. § 1155. VA regulations set forth at 38 C.F.R. §§ 4.40, 4.45, 4.59 provide for consideration of functional impairment due to pain on motion when evaluating the severity of a musculoskeletal disability. The United States Court of Appeals for Veterans Claims (Court) has held that a higher rating can be based on “greater limitation of motion due to pain on use.” DeLuca v. Brown, 8 Vet. App. 202, 206 (1995). Any such functional loss must be “supported by adequate pathology and evidenced by the visible behavior of the claimant.” 38 C.F.R. § 4.40. The Board acknowledges that in a September 2020 statement, the Veteran reported that his conditions have continued to worsen since he stopped working. While the Veteran is competent to report this information, it is not necessarily reflected in the outpatient records and the attorney does not argue that new examinations were needed. Rather, a private employability evaluation was submitted which discusses all conditions. The attorney argues entitlement to a 70 percent rating for the Veteran’s psychiatric disorder and for an award of TDIU, both of which are granted herein. The attorney did not provide argument on the remaining issues and the Board finds the record adequate to evaluate the claimed disorders at this time. Entitlement to an initial rating greater than 30 percent for major depression with anxious distress and TBI In February 2019, VA granted entitlement to service connection for major depression with anxious distress and TBI and assigned a 30 percent rating effective October 13, 2018. The effective date was subsequently changed to October 13, 2017. The Veteran disagreed with the rating and perfected an appeal of this decision. The Veteran contends that the assigned rating does not adequately reflect the severity of his disability. In December 2020, the Veteran’s attorney argued that he was entitled to a 70 percent rating for his psychiatric condition pursuant to the General Rating Formula for Mental Disorders. He did not argue that a higher rating was warranted under the rating criteria for TBI (Diagnostic Code 8045) or assert that this diagnostic code was more appropriate. The Board observes that the October 2018 VA TBI examination showed no impairment on any facet. Accordingly, the Board’s discussion will be limited to whether a higher rating is warranted pursuant to the schedule of ratings for mental disorders as set forth in 38 C.F.R. § 4.130. See Robinson v. Peake, 21 Vet. App. 545, 552-56 (2008). The Veteran’s service-connected psychiatric disorder is evaluated as major depressive disorder pursuant to the General Rating Formula for Mental Disorders. A 30 percent rating is warranted when there is 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). 38 C.F.R. § 4.130, Diagnostic Code 9434. A 50 percent rating is warranted when there is 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; and difficulty in establishing and maintaining effective work and social relationships. Id. 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 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); and the inability to establish and maintain effective relationships. Id. A 100 percent rating is assigned when there is total occupational and social impairment due to symptoms such as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name. Id. An evaluation under 38 C.F.R. § 4.130 is “symptom-driven,” meaning that “symptomatology should be the fact-finder’s primary focus when deciding entitlement to a given disability rating” under that regulation. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013). The symptoms listed under the referenced diagnostic code are not exhaustive, but rather “serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating.” Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In November 2017, the Veteran was seen by the VA primary care mental health team for an initial screening. He reported symptoms that may be consistent with moderate to severe anxiety. Patient health questionnaires indicated mild symptoms of depression and moderate symptoms of anxiety. He indicated that his depression and anxiety made it somewhat difficult to do his work, take care of things at home, or get along with others. An October 9, 2018 VA mental health record documents the Veteran’s report that he has had difficulties for the past year and an inability to cope. He was depressed with poor sleep and increased irritability. His wife reported he experiences mood swings, and this has taken a toll on their relationship. Depression scale score indicated severe depression and he reported that he had several days in the last 2 weeks where he had thoughts of being better off dead or of hurting himself in some way. The Veteran underwent a mental health consult on October 26, 2018. He reported continued depressed mood but denied suicidal ideation on the date of evaluation. He endorsed frequent nightmares and anxiety symptoms to include feelings of worry, fear, and situational panic. The Veteran and his wife both indicated low frustration tolerance and persistent irritability and anger with increase in frequency and severity over the last 4-5 months. The Veteran reported his wife was his strongest social support and he endorsed good relationships with his wife’s friends and some guys. He enjoys playing golf but spends most of his time watching TV. He attends church services. He continues to work in an auto parts department on an as needed basis. Diagnosis included major depressive disorder, recurrent, moderate, with anxious distress. On VA examination dated October 30, 2018, the Veteran reported that he has a good relationship with his mother and gets along fine with his siblings and two children. He was currently married, and he enjoys going to dinner, the movies, jazz shows and the beach with his wife. He was working part-time. He endorsed daytime lethargy, feeling down, irritability, monthly nightmares and vague suicidal thoughts. There were no symptoms consistent with mania, lethality, psychosis or panic. His irritability negatively impacts his personal relationships, but his symptoms reportedly did not negatively impact his effectiveness at work/school. Symptoms were listed as depressed mood, chronic sleep impairment, and disturbances of motivation and mood. On mental status evaluation, the Veteran was alert and oriented. Dress and hygiene were fair. There was no psychomotor agitation or retardation and speech was normal. There was no thought disorder and thoughts were goal directed. Affect was euthymic and appropriate. He denied hallucinations and no delusions or paranoia were noted. Insight, judgment, and impulse control were fair, and he was cognitively intact. The examiner summarized the level of occupational and social impairment as 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. VA records dated in May 2019 indicate the Veteran has chronic low-grade depression and might qualify for dysthymic disorder, or possibly major depressive recurrent mild, with partial treatment from medication. An August 2019 letter from a VA psychiatrist, Dr. J.M., indicates that the Veteran is chronically fatigued and has significant problems with depression. He was unable to work now and tends to spend at least half the day in bed. The other half he is not having fun or enjoyment. The psychiatrist believed that the Veteran was having much higher levels of depressive symptoms than the 30 percent rating currently assessed. He also thought he might be fully unemployable at this time. A December 2019 VA record notes that the Veteran was confused and overwhelmed with the VA disability process. He also described self-isolating which was somewhat in response to his tendency to react in anger and he said he often ends up “taking it out on [his] wife.” In a September 2020 statement, the Veteran reported that he was depressed due to his physical conditions and cannot do the things he used to enjoy, like golf. Being around people makes him uncomfortable. If he is in a crowd and someone bumps into him, he “want[s] to go off on them.” He doesn’t really go out except to get food and he spends most days sitting at home watching sports. He gets panic attacks on a weekly basis. He further stated that he sees his family once every 2 or 3 weeks because he does not get along with them. He does not have friends besides his old boss. He is easily irritated by politics and the pandemic and is afraid of death. He has problems with anger and yells at his wife. He also reported nightmares and sleep impairment. The Veteran was interviewed by a private vocational consultant in October 2020. He reported being argumentative and having road rage. He has many arguments with people but has not been involved in physical altercations. He has no friends other than his former boss. He also has trust issues and tends to isolate. She further noted he was hypervigilant and had problems with concentration and focus. He also experienced nightmares and interrupted sleep. The attorney argues that the Veteran exhibited suicidal ideation during the appeal period and that this symptom, along with the complete disability picture, more nearly approximates the criteria for a 70 percent rating. In considering whether an increased rating is warranted, the Board acknowledges that the October 2018 VA examiner summarized the Veteran’s level of occupational and social impairment as consistent with a 30 percent rating. Evidence of record, however, shows that he has difficulty adapting to stressful circumstances, including work, and while his depressive symptoms have varied somewhat (mild to severe) throughout the appeal period, the August 2019 VA medical statement suggests significant depression interfering with the ability to function. The Veteran is also shown to have irritability to such an extent it impacts his relationships and causes social isolation. Regarding suicidal ideation, the record contains inconsistent information. The Veteran reported vague suicidal thoughts on VA examination and reported thoughts of being better off dead on a depression screen. VA outpatient records, however, generally show that he repeatedly denied suicidal ideation, plan or intent. Resolving reasonable doubt in his favor, the Board finds that the Veteran’s overall disability picture, to include the reports of suicidal thoughts, more nearly approximates occupational and social impairment with deficiencies in most areas. See 38 C.F.R. § 4.3; Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017) (“... the language of the regulation indicates that the presence of suicidal ideation alone, that is, a [V]eteran’s thoughts of his or her own death or thoughts of engaging in suicide-related behavior, may cause occupational and social impairment with deficiencies in most areas.”) Accordingly, an initial 70 percent rating is granted. A rating greater than 70 percent, however, is not warranted at any time during the appeal period. That is, the disability picture does not reflect total occupational and social impairment. As discussed, the Veteran was able to work part-time for a portion of the appeal period and there is clearly evidence of social relationships, including with his wife and boss. Further, the Veteran is not shown to have gross impairment in thought processes or communication, and he does not exhibit psychotic behavior. Evidence of record does not show a persistent danger of hurting self or others and while he reports staying in bed for extended periods, an intermittent inability to perform the activities of daily living due to psychiatric symptoms is not shown. The Veteran is repeatedly described as oriented and there is no indication of memory loss for names or occupation. The Board concludes that he was not totally socially impaired at any time during the appeal period to warrant a 100 percent rating. Entitlement to an initial rating greater than 20 percent for lumbosacral strain with IVDS In February 2019, VA granted entitlement to service connection for lumbosacral strain with IVDS and assigned a 20 percent rating from October 13, 2017. The Veteran disagreed with the rating and perfected this appeal. He generally contends that the assigned rating does not adequately reflect the severity of his disability. The Veteran’s lumbar spine disorder is currently rated under 38 C.F.R. § 4.71a, Diagnostic Code 5243, for IVDS. Diagnostic Code 5243 provides that IVDS is to be rated either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating IVDS Based on Incapacitating Episodes, whichever method results in the higher rating when all disabilities are combined under 38 C.F.R. § 4.25. The Formula for Rating IVDS Based on Incapacitating Episodes provides that a 10 percent rating is warranted for IVDS with incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months. A 20 percent rating is warranted for IVDS with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months. A 40 percent rating is warranted for IVDS with incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months. A 60 percent rating is warranted for IVDS with incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. 38 C.F.R. § 4.71a, Formula for Rating IVDS Based on Incapacitating Episodes. Note 1 to Diagnostic Code 5243 provides that, for purposes of ratings under Diagnostic Code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. Id. at Note 1. Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent rating is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. On VA examination in December 2018, the Veteran reported lower back pain and limited range of motion. Flare-ups were described as repeated back pain every 5-6 months and he reported that slight movement can cause 30 days of bed confinement with pain usually in the lower back. On physical examination, range of motion of the thoracolumbar spine was forward flexion 0 to 60 degrees; extension 0 to 30 degrees; right and left lateral flexion 0 to 30 degrees; and right and left lateral rotation 0 to 30 degrees. Limited forward flexion impairs completion of the activities of daily living. There was pain noted in forward flexion and evidence of pain with weightbearing. There was also localized tenderness or pain on palpation at L4-S1. The Veteran was able to perform repetitive use testing with no additional loss of function or range of motion. The examiner stated that pain, weakness, fatigability or incoordination did not significantly limit functional ability with repeated use over time or with flare-ups. There was guarding but it did not result in abnormal gait or abnormal spinal contour. The examiner noted that there was less movement than normal, disturbance of locomotion, and interference with sitting and standing. There was no ankylosis of the spine. The examiner indicated that the Veteran had IVDS and there had been episodes of physician prescribed bed rest. This was based on medical history as described by the Veteran (spasms of the back lasting up to a week, requiring bed rest) and was not supported by documentation. The examiner further stated that the reported episodes over the past 12 months had a total duration of less than one week. In a September 2020 statement, the Veteran reported that he has difficulty bending and cannot tie his shoes. He gets sore if he crouches and he is in pain after climbing two flights of stairs. The Veteran was interviewed by a private vocational consultant in October 2020. He reported he was unable to sit for prolonged periods and must change positions frequently. He had difficulties with prolonged standing and walking. The preponderance of the evidence is against finding that a rating in excess of 20 percent is warranted based on incapacitating episodes. While the December 2018 examiner indicated that the Veteran had IVDS and was prescribed bed rest by a physician, this was for a total duration of less than one week. There is no documentation that he had incapacitating episodes as defined by regulation having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months. The preponderance of the evidence is also against a rating in excess of 20 percent under the General Rating Criteria. That is, evidence of record shows thoracolumbar flexion from 0 to 60 degrees. There is no indication of flexion to 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine. The Veteran’s complaints of pain are acknowledged, but the record does not contain findings or other adequate pathology sufficient to support a higher rating based on functional impairment due to pain on motion or other factors. In making this determination, the Board observes that lumbar spine x-rays taken in December 2018 were reported as normal. The doctrine of reasonable doubt is not for application and the claim is denied. 38 C.F.R. § 4.3. Entitlement to initial ratings greater than 10 percent for right and left lower extremity lumbar radiculopathy In February 2019, VA granted entitlement to service connection for lumbar radiculopathy of the right and left lower extremities. Each extremity was assigned a 10 percent rating effective October 13, 2017. The Veteran disagreed with the ratings and perfected this appeal. He generally contends that the assigned ratings do not adequately reflect the severity of his disabilities. The lumbar radiculopathies are evaluated as impairment of the sciatic nerve. Paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8520. (Neuritis and neuralgia of that group are evaluated under Diagnostic Codes 8620 and 8720.). Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R § 4.124a. The words “mild,” “moderate,” and “severe” as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. The term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at “Diseases of the Peripheral Nerves.” The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). On VA examination in December 2018, strength in the lower extremities was reported as 5/5 on the right and left. There was no muscle atrophy. Deep tendon reflexes were normal at the knee and ankle on both sides. Sensory examination was normal and straight leg raising was negative on the right and left. The Veteran, however, reported moderate constant pain, moderate intermittent pain, moderate paresthesias and/or dysesthesias; and moderate numbness in both lower extremities. The examiner indicated that there was involvement of the sciatic nerve on both the right and the left and the severity was described as moderate. There were no other neurologic abnormalities noted. While no objective abnormalities were noted, the Veteran is competent to describe his symptoms and the examiner indicated that the severity of the radiculopathies was moderate. Resolving reasonable doubt in the Veteran’s favor, initial 20 percent ratings are warranted. 38 C.F.R. § 4.3. Ratings in excess of 20 percent, however, are not warranted. As indicated, the Veteran’s reflexes and sensation were reported as normal, strength was 5/5, and there was no muscle atrophy. The disability picture does not more nearly approximate moderately severe incomplete paralysis of the sciatic nerve. Entitlement to an initial rating greater than 10 percent for contact dermatitis with PFB In February 2019, VA granted entitlement to service connection for contact dermatitis with PFB (claimed as skin condition with rash on arms, hands, face and neck) and assigned a 10 percent rating effective October 13, 2017. The Veteran disagreed with the rating and perfected this appeal. He generally contends that the assigned rating does not adequately reflect the severity of his disability. The Veteran’s skin disorder is evaluated under Diagnostic Code 7806 as dermatitis. VA amended the criteria for rating skin disabilities effective from August 13, 2018. These new regulations apply to all applications for benefits received by VA or that are pending before the agency of original jurisdiction on or after August 13, 2018. Claims pending prior to the effective date will be considered under both old and new rating criteria, and whatever criteria is more favorable to the veteran will be applied. The Board may not apply a current regulation prior to its effective date, unless the regulation explicitly provides otherwise. Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). However, the Board is not precluded from applying prior versions of the applicable regulation to the period on or after the effective dates of the new regulation if the prior version was in effect during the pendency of the appeal. Prior to August 13, 2018, under Diagnostic Code 7806, a noncompensable rating is assigned for less than 5 percent of the entire body or less than 5 percent of exposed areas affected, and; no more than topical therapy required during the past 12 months. A 10 percent rating is assigned for at least 5 percent, but less than 20 percent, of the entire body, or at least 5 percent, but less than 20 percent, of exposed areas affected, or; intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period. A 30 percent rating is assigned for 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly during the past 12-month period. A 60 percent rating is assigned for more than 40 percent of the entire body or more than 40 percent of exposed areas affected, or; constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12- month period. Or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DC’s 7801, 7802, 7803, 7804, or 7805), depending on the predominant disability. 38 C.F.R. § 4.118, Diagnostic Code 7806. For claims filed prior to August 13, 2018, the Court held that a systematic therapy is one that that affects the entire body in its treatment of the condition at issue, and that the Board must determine (1) whether a topical treatment affects the body as a whole in treating a veteran’s skin condition; and (2) whether the given treatment is “like” a corticosteroid or other immunosuppressive drug.” Burton v. Wilkie, 30 Vet. App. 286 (2018). Only the second question need be addressed if the treatment is clearly systemic. Id. Effective August 13, 2018, VA regulations explicitly state that systemic therapy is treatment that is administered through any route other than the skin, and topical therapy is treatment that is administered through the skin. 38 C.F.R. § 4.118(a). Additionally, effective August 13, 2018, a new General Rating Formula for the Skin applies to Diagnostic Codes 7806, 7809, 7813 to 7816, 7820 to 7822, and 7824. See 38 C.F.R. § 4.118. Under this formula, a noncompensable rating is assigned for no more than topical therapy required over the past 12-month period and at least one of the following: characteristic lesions involving less than 5 percent of the entire body affected; or characteristic lesions involving less than 5 percent of exposed areas affected. A 10 percent rating is assigned for at least one of the following: characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or at least 5 percent, but less than 20 percent, of exposed areas affected; or intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12-month period. A 30 percent rating is assigned at least one of the following: characteristic lesions involving more than 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period. A 60 percent rating is assigned for at least one of the following: characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required over the past 12-month period. Or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DC’s 7801, 7802, 7803, 7804, or 7805), depending on the predominant disability. 38 C.F.R. § 4.118, General Rating for the Skin for DCs 7806, 7809, 7813-7816, 7820-7822, and 7824. VA records dated in September 2017 show the Veteran was seen for atopic dermatitis and prescribed Benadryl, Triamcinolone, and hydrocortisone cream. Review of the VA medication list indicates that diphenhydramine HCL (Benadryl) is an oral medication. On VA examination in December 2018, the Veteran reported rashes on his arms, hands, face and neck with symptoms beginning during service and getting worse. He stated that he had to get a waiver signed from the Department of Motor Vehicles to allow for tinting of his car windows due to rashes and bleeding from sun exposure. He developed a permanent red spot on the rear of his neck. Exposure to the sun causes rashes and irritation on the head, face, neck, arms, and hands. Repeat exposure causes the areas to blister and break. The condition is treated with constant/near constant use of topical antihistamines (Cortizone 10) and other topical medications (Neosporin, Triamcinolone, and Benadryl). Physical examination revealed dermatitis covering less than 5 percent of exposed areas and 5 to 20 percent of total body area. Infections of the skin not listed elsewhere involved less than 5 percent of exposed areas and total body area. The examiner stated there was PFB to the beard area. There was dermatitis to the bilateral upper and lower extremities, not present on examination but the claimant reported it erupts with flares of anxiety and is mildly itchy and painful. The skin condition did not cause any scarring or disfigurement of the head, face or neck. VA records dated in May 2019 indicate the Veteran had a pruritic papular rash to the bilateral ankles present only to the elastic woven fabric in his socks. Assessment was contact dermatitis and he was advised to change footwear/socks. A June 2019 record indicates the Veteran was seen for a follow up on rash. He stated that although he thought the rash was healed, it came back. It itches and has a burning sensation. He also reported that he was given a steroid (Medrol Dosepak). Physical examination showed a scaly rash on the arms, legs, and face. In August 2019, the Veteran underwent a VA dermatology consult. Physical examination showed scattered folliculocentric papules on the chin and upper neck. Mild generalized skin xerosis, more pronounced on the lower extremities and dry pinpoint sandpaper like papules on the upper extremities. Assessment was eczema craquele/asteatotic eczema. The Veteran was given hydrophilic cream (Eucerin) to use daily. For flares and itching, he was prescribed Triamcinolone .1% cream to use 3 times a day as needed. He was also diagnosed with PFB and prescribed benzoyl peroxide 10% gel and clindamycin solution both for daily use. In a September 2020 statement, the Veteran reported his dermatitis is triggered by even a short amount of time in the sun. He gets dry skin, lesions, and raised bumps that can bleed, itch and burn. He either wears long sleeves or sports sleeves all the time. On review there is no evidence of scarring and the predominant disability appears to be dermatitis. The Board finds that the preponderance of the evidence is against the assignment of a rating in excess of 10 percent under the pre-August 13, 2018 regulations because the Veteran’s skin disorder does not more nearly approximate 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; require systemic therapy such as corticosteroids or other immunosuppressive drugs for a total duration of six weeks or more, but not constantly during the past 12-month period. The Board acknowledges the near constant use of topical medications as described on VA examination, to include steroid cream, but does not find that they affect the body as a whole so as to be considered systemic. To the extent the Veteran took oral diphenhydramine and subsequently hydroxyzine for itching, these are antihistamines and are not like a corticosteroid or other immunosuppressive drug. The Board acknowledges that an oral steroid was reportedly prescribed for the Veteran’s rash. Review of the VA medication list indicates that methylprednisolone (Medrol Dosepak) was prescribed in May 2019 for a period of 6 days with no refill. The Board also finds that the preponderance of the evidence is against the assignment of a rating in excess of 10 percent under the August 13, 2018 regulations because the Veteran’s skin disorder does not more nearly approximate characteristic lesions involving more than 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period. Again, the Board acknowledges the use of an oral steroid, but it was not prescribed for a period of 6 weeks or more. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 4.3. The claim is denied. Entitlement to an initial rating greater than 10 percent for migraine headaches In February 2019, VA granted entitlement to service connection for migraine headaches as a residual of TBI and assigned a 10 percent rating from October 13, 2017. The Veteran disagreed with the rating and perfected this appeal. He generally contends that the assigned rating does not adequately reflect the severity of his disability. Migraine headaches are rated pursuant to 38 C.F.R. § 4.124a, Diagnostic Code 8100. Under this provision, a noncompensable rating is warranted for migraines with less frequent attacks. A 10 percent rating is warranted for migraines with characteristic prostrating attacks averaging one in 2 months over the last several months. A 30 percent rating is warranted for migraines with characteristic prostrating attacks occurring on an average once a month over the last several months. A 50 percent rating is warranted for migraines with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. The phrase “characteristic prostrating attacks” is used in the criteria corresponding to 10 percent and 30 percent ratings under Diagnostic Code 8100 to describe the nature and severity of migraines, but it is not defined in the regulation. Pursuant to Dorland’s Illustrated Medical Dictionary 1531 (32d ed. 2012), prostration is defined as “extreme exhaustion or powerlessness.” Thus, the phrase “characteristic prostrating attacks” is understood to describe migraine attacks that typically produce extreme exhaustion or powerlessness. On VA examination in December 2018, the Veteran reported continued headaches and he takes Tylenol extra strength daily. He described his headaches as pulsating or throbbing head pain with nausea and sensitivity to light and sound. The typical location of the pain was in the back of his head. He stated that severe migraines can last more than a week and the examiner noted that he was unable to perform activities of daily living during these times. The examiner indicated that the Veteran experienced characteristic prostrating attacks once in 2 months. The headaches were not productive of severe economic inadaptability. In September 2020, the Veteran reported that he gets migraines every 3 to 6 months. They happen randomly and start out as a normal headache but get worse with dizziness, blurred vision and nausea. They only go away with time, so he treats them by lying down and trying to sleep. The Veteran was interviewed by a private vocational consultant in October 2020. He explained that when he had a migraine, he would miss work 2 or 3 days at a time, and this occurred several times per month. VA treatment records note sporadic complaints of headaches but do not show any specific treatment for migraines. The Veteran is competent to report his headaches symptoms and perceived level of impairment. Layno v. Brown, 6 Vet. App. 465, 470 (1994). Based on the VA examination, he experiences prostrating headaches averaging one in 2 months and by his own recent statement, he experiences prostrating headaches every 3 to 6 months. The Board acknowledges the statement in the private employability evaluation of having migraines several times a month but notes this is inconsistent with his own declaration and is therefore not found to be credible as to frequency. On review, evidence of record does not show migraines with characteristic prostrating attacks occurring on average once a month and the criteria for a 30 percent rating are not met. The preponderance of the evidence is against the claim and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 4.3. The claim is denied. Entitlement to TDIU In his November 2018 notice of disagreement, the Veteran indicated he was seeking the highest possible rating for multiple disabilities to include TDIU. Accordingly, the Board accepts the issue as part of the current appeal. Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009) (When evidence of unemployability is submitted during an appeal from an assigned disability rating, a claim for entitlement to a TDIU will be considered “part and parcel” of the claim for benefits for the underlying disability.) Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities: provided that, if there is only one such disability, such disability shall be ratable as 60 percent or more and if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). Marginal employment shall not be considered substantially gainful employment. For purposes of this section, marginal employment generally shall be deemed to exist when a veteran’s earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination. Id. The Veteran is service connected for the following disorders effective October 13, 2017: major depression with anxious distress and TBI (increased herein to an initial 70 percent rating); lumbosacral strain with IVDS (20 percent); contact dermatitis with PFB (10 percent); migraine headaches (10 percent); right lower extremity lumbar radiculopathy (increased herein to an initial 20 percent rating); and left lower extremity lumbar radiculopathy (increased herein to an initial 20 percent rating). Considering the grants herein, the combined rating is calculated as 90 percent from October 13, 2017. See 38 C.F.R. §§ 4.25, 4.26. The Veteran meets the schedular requirements for TDIU for the entirety of the appeal period. In considering entitlement to individual unemployability, the pertinent inquiry is whether service-connected disabilities individually or in combination are of sufficient severity to produce unemployability - not whether a veteran is unemployable solely due to his service-connected disabilities. Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993); Pratt v. Derwinski, 3 Vet. App. 269, 272 (1992). On his VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability, the Veteran indicated that he last worked full time in March 2017 and then worked part-time until March 2019. He reported a high school diploma and some training at community college. He also submitted an earnings record from the Social Security Administration showing earnings of approximately $17,000 in 2017 and approximately $2,000 in both 2018 and 2019. In a September 2020 statement, the Veteran reported that he worked full time at his last job from 2010 to 2017. At that time, he started having dizzy spells, fatigue, and memory and irritability problems. He was also getting physically slower and needed help. He brought up his concerns with his boss and since the boss liked him, he was allowed to work half days and to work when he could. In June 2018, his doctor advised him to stop working yet he stayed on the payroll until he officially quit in March 2019. In support of his claim, the Veteran submitted an employability evaluation completed in November 2020 by a private vocational consultant. The consultant reviewed the Veteran’s claims folder and conducted a phone interview. She noted that he obtained a degree in furniture upholstery from community college but had never been employed in that capacity. He also possessed basic computer skills. She discussed the Veteran’s medical and occupational history in detail and set forth an occupational analysis focusing on the Veteran’s prior civilian employment as a parts clerk, driver, day laborer, and in printing. It was her vocational opinion that the Veteran’s service-connected disabilities, as listed above, have at least as likely as not precluded him from securing and following substantially gainful employment in any capacity, including unskilled sedentary employment, from at least January 2018 to the present. She further stated that the Veteran last earned wages above the federal poverty level in 2017 and it was her vocational opinion that his wages from 2018 and 2019 were merely marginal and did not represent substantially gainful employment. The private vocational opinion, which indicates the Veteran’s service-connected disabilities were of such severity to preclude substantially gainful employment from January 2018 is considered probative. On the Board’s review, the record does not contain probative evidence to the contrary. Thus, entitlement to TDIU is granted effective January 1, 2018. In making this determination, the Board acknowledges the part-time employment in 2018 and 2019 but information of record indicates this was no more than marginal. The Board acknowledges the attorney’s argument that the Veteran has not worked in a substantially gainful capacity since March 2017 and that TDIU is warranted effective as of that date. First, the Veteran is not service connected for any disabilities prior to October 13, 2017 and thus, the benefit cannot be prior to that date. Second, the Veteran’s income for 2017 was noted to exceed the poverty threshold. The Board has considered the Veteran’s reports that he was able to continue part-time employment because his boss liked him, but he has not specifically argued that this was sheltered employment. Further, their own expert opinion indicates entitlement as of January 2018 with no suggestion that the employment in 2017 was anything other than substantially gainful. Considering the foregoing, entitlement to TDIU for the period from October 13, 2017 to December 31, 2017 is denied. Effective Dates The assignment of effective dates for compensation is governed by 38 U.S.C. § 5110 and 38 C.F.R. § 3.400. Unless specifically provided otherwise, the effective date of an award based on an original claim “shall be fixed in accordance with the facts found but shall not be earlier than the date of receipt of application therefore.” 38 U.S.C. § 5110(a). More specifically, the effective date for an award of disability compensation for service connection is the day following separation from active service or the date entitlement arose, if the claim was received within one year after separation from service; otherwise, it is the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110(b)(1); 38 C.F.R. § 3.400(b)(2)(i). A specific claim in the form prescribed by the Secretary must be filed 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). Effective March 24, 2015, the law no longer allows for informal claims, but the pertinent regulation allows a claimant to submit an intent to file a claim, and VA may recognize the receipt date of the intent to file a claim as the date of claim so long as VA receives the successfully completed claim form within a year. 38 C.F.R. § 3.155(b) (“Upon receipt of the intent to file a claim, VA will furnish the claimant with the appropriate application form prescribed by the Secretary. If VA receives a complete application form... [for the] benefit sought within 1 year of receipt of the intent VA will consider the complete claim filed as of the date the intent to file a claim was received.”). If submitted in writing, the intent to file must be submitted on a standardized form. Id. at 38 C.F.R. § 3.155(b)(1)(ii) (mandating that the claim must be “[w]ritten on an intent to file a claim form. The submission to an agency of original jurisdiction of a signed and dated intent to file a claim, on the form prescribed by the Secretary for that purpose, will be accepted an intent to file a claim.”). If not on a standardized Intent to File form, then any communication “is considered a request for an application form for benefits” and has no impact on effective dates, which is governed based upon when the formal claim is received. Id. at § 3.155. VA will not recognize more than one intent to file concurrently for the same benefit (e.g., compensation, pension). If an intent to file has not been followed by a complete claim, a subsequent intent to file regarding the same benefit received within 1 year of the prior intent to file will have no effect. If, however, VA receives an intent to file followed by a complete claim and later another intent to file for the same benefit is submitted within 1 year of the previous intent to file, VA will recognize the subsequent intent to file to establish an effective date for any award granted for the next complete claim, provided it is received within 1 year of the subsequent intent to file. 38 C.F.R. § 3.155(b)(6). Entitlement to effective dates for service connection prior to October 13, 2017 In February 2019, VA granted service connection for major depression with anxious distress and TBI from October 13, 2018. VA also granted service connection for a lumbar spine disorder, contact dermatitis with PFB, right and left lower extremity lumbar radiculopathy, and migraines all effective from October 13, 2017. The Veteran disagreed with the decision. In January 2020, VA granted an earlier effective date for major depression to October 13, 2017. A statement of the case was furnished on all effective date issues and the Veteran subsequently perfected this appeal. Review of the claims folder shows that an intent to file was received on October 13, 2017. On October 10, 2018, within the one-year period, the Veteran submitted a VA Form 21-526, Application for Disability Compensation and Related Compensation Benefits, wherein he claimed service connection for a psychiatric disorder, lumbar spine disorder, skin disorder, and headaches. (Continued on the next page)   The effective date was assigned based upon the intent to file received on October 13, 2017 and this is appropriate. The record does not contain any earlier intent to file followed by a formal claim; and there is no indication that a formal or informal claim was filed for these benefits prior to March 24, 2015. There is simply no basis for assigning an effective date prior to October 13, 2017. The preponderance of the evidence is against the claims and the doctrine of reasonable doubt is not for application. 38 C.F.R. § 3.102. The claims are denied. LAURA E. COLLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Carsten, 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.