Citation Nr: 21007677 Decision Date: 02/10/21 Archive Date: 02/10/21 DOCKET NO. 191205-47603 DATE: February 10, 2021 ORDER Entitlement to a total disability rating based upon individual unemployability (TDIU) due to service-connected posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT The Veteran’s service-connected PTSD renders him unable to secure and maintain substantially gainful employment. CONCLUSION OF LAW The criteria for entitlement to a TDIU have been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.16. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1966 to December 1969, to include service in the Republic of Vietnam. He was awarded the Combat Action Ribbon, among other decorations. By way of background, this appeal stems from a November 2019 rating decision in which a Department of Veterans Affairs (VA) regional office granted service connection for PTSD and assigned a 70 percent disability rating. The Veteran appealed the rating assigned to the Board of Veterans’ Appeals (Board). The Board denied the claim in a December 2019 decision, which the Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In an August 2020 Joint Motion for Remand (JMR), the parties agreed that the Board should have addressed entitlement to a TDIU as part of the Veteran’s increased rating claim. See Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009). In August 2020, the Court granted the JMR, vacating the Board’s decision only to the extent that it failed to address entitlement to a TDIU. Accordingly, the Board must now consider this issue. VA will grant a total rating for compensation purposes based on unemployability when the evidence shows a veteran is precluded from obtaining or maintaining any gainful employment consistent with his education and occupational experience, by reason of his service-connected disabilities. 38 C.F.R. §§ 3.340, 3.341, 4.16. In reaching such a determination, the central inquiry is “whether the Veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). In arriving at a conclusion, consideration may be given to the veteran’s level of education, special training, and previous work experience, but not to his age or the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. If there is only one service-connected disability, it must be rated at least 60 percent disabling to qualify for TDIU benefits; if there are two or more such 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). The Veteran meets the threshold schedular disability percentage requirement for TDIU consideration as a result of his service-connected PTSD, coronary artery disease, prostate cancer with urinary tract infections, and tinnitus. 38 C.F.R. § 4.16(a). The Veteran asserts that his service-connected PTSD alone renders him unemployable. Military personnel records reflect the Veteran’s military occupation specialty/rating was that of a medical assistant. The Veteran reported completing college with a degree in accounting. He reported that he last worked in 2016. The record reflects that the Veteran worked as an accountant for various businesses for many years, but began taking on more short-term jobs as time passed. Ultimately, he reported working from 2006 to 2016 as a self-employed florist, and that since retirement he works with flowers as a hobby. The Veteran underwent evaluation for PTSD by a Licensed Clinical Social Worker, M.P., in May 2019. M.P. opined that the Veteran’s PTSD resulted in occupational and social impairment with deficiencies in most areas. The Veteran’s PTSD manifested in isolating, irritability, social withdrawal, hypervigilance, and problems with attachment to others. The Veteran experienced a markedly diminished interest in significant activities as well as irritability and outbursts of anger. He had difficulty concentrating and was suspicious of others. Additionally, M.P. noted that the Veteran’s PTSD caused difficulty in establishing and maintaining effective work relationship, difficulty adapting to stressful circumstances, impaired impulse control, and neglect of personal appearance and hygiene. The Veteran reported that he had anxiety in social situations and disliked being in situations where he did not have the option to leave. The Veteran presented for a VA examination to assess the current severity of his service-connected PTSD in September 2019, at which time he was interviewed by the examiner who also reviewed the pertinent medical history and performed an examination. The Veteran reported feeling depressed and anxious and suffering from chronic sleep impairment. The examiner reported that the Veteran’s short-and long-term memory were impaired and that he may forget to complete tasks. The Veteran’s speech was intermittently illogical, obscure, or irrelevant, and he provided answers to the examiner that did not relate to the questions asked. The examiner suggested that the Veteran would have difficulty in understanding complex commands, as well as difficulty in establishing and maintaining effective work relationships. The examiner opined that the Veteran’s thought process was not clear, and that his impulse control was impaired. When asked to describe the functional impact the Veteran’s disability has on his ability to work the examiner reported that the Veteran’s PTSD manifested in occupational impairment with reduced reliability and productivity. Taken as a whole, the Veteran’s symptoms suggest he was unable to obtain and maintain employment due to his service-connected PTSD. Given the Veteran’s education and work history, symptoms reported by the Veteran, and the level of functional impairment as reported by the VA examiner and the Veteran’s treatment providers, the Board finds that the level of impairment caused by PTSD would preclude employment. In that regard, while the Veteran does have a high level of education that, taken alone, would likely allow him to maintain sedentary employment, the evidence demonstrates that he suffers from memory impairment, impulse control, and an unclear thought process that would prevent him from carrying out the type of work he previously did as an accountant and when he was self-employed. The Veteran was not able to clearly answer the VA examiner’s questions, and the evidence suggests that he would be unable to follow directions and would have difficulty remembering to complete tasks. Based on all the evidence, the Board finds that the evidence is in favor of a finding that the Veteran is unable to secure and follow a substantially gainful occupation by reason of his service-connected PTSD. Thus, a TDIU is warranted and the claim is granted. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. D. Bruce, 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.