Citation Nr: 21009053 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 14-11 046 DATE: February 18, 2021 ORDER An initial disability rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied. For the period prior to February 1, 2018, a total disability rating based on individual unemployability as (TDIU) is denied. FINDINGS OF FACT 1. Throughout the period on appeal, the Veteran’s PTSD was not characterized by total occupational and social impairment. 2. Prior to February 1, 2018, the Veteran’s service-connected PTSD has not been shown to render him incapable of securing or maintaining substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for an initial rating in excess of 70 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.7, 4.130, Diagnostic Code (DC) 9411 (2019). 2. For the period on appeal prior to February 1, 2018, the criteria for establishing a TDIU have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.16, 4.18, 4.19 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran, who is the appellant in this case, served on active duty from August 1990 to December 2010. This matter comes before the Board of Veterans’ Appeals (Board) from a February 2012 rating decision by a Veterans Affairs (VA) Regional Office (RO). The Board notes that this appeal arises from a pre-discharge claim for VA disability benefits. In a February 2017 rating decision, during the pendency of the present appeal, the RO awarded an increased rating of 50 percent for PTSD for the entire period on appeal. Nonetheless, because less than the maximum available benefit for a schedular rating was awarded, the claim remains before the Board. See Fenderson v. West, 12 Vet. App. 119, 126 (1999); AB v. Brown, 6 Vet. App. 35 (1993). In January 2018, the Board remanded this appeal for additional development. In a June 2019 rating decision, the RO awarded an increased rating of 70 percent for PTSD for the entire period on appeal. The RO also awarded a TDIU, effective February 1, 2018. Nonetheless, because less than the maximum available benefit for a schedular rating was awarded and the TDIU was not awarded for the entire period, the claims remain before the Board. See Fenderson v. West, 12 Vet. App. 119, 126 (1999); AB v. Brown, 6 Vet. App. 35 (1993). In November 2019, the Board remanded this appeal for additional development. The Board notes that in its November 2019 decision, the issues on appeal were styled as “entitlement to an initial disability rating in excess of 50 percent for PTSD prior to January 1, 2011, and in excess of 70 percent thereafter” and “entitlement to an earlier effective date prior to February 1, 2018 for the grant of a TDIU.” However, this characterization of the issues on appeal was incorrect. Specifically, the Board notes that effective date for the award of service connection for PTSD is the day after the Veteran left active service, and entitlement to service connection cannot be earlier than the day after the Veteran has left active service. 38 C.F.R. § 3.400. Thus, the issue of entitlement to an increased rating for PTSD has been recharacterized as reflected herein. Additionally, the issue of entitlement to a TDIU has been recharacterized to reflect that the Board has jurisdiction over the issue as part of the claim for an increased rating for PTSD. See Harper v. Wilkie, 30 Vet. App. 356 (2018)(holding that once entitlement to a TDIU is put in issue as part of a claim for a higher initial rating/increased rating and the RO grants a TDIU that does not span the entire period on appeal, the issue of entitlement to a TDIU for an earlier period is still on appeal). The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016). Increased Ratings Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The Veteran's entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Staged ratings are appropriate for any initial rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119, 126 (1999). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran. 38 C.F.R. § 4.3. Where a veteran is diagnosed with multiple disabilities of the same body part/system, and it is unclear from the record which symptoms are attributable to each distinct disability, the Board is precluded from differentiating between the symptomatology and the disabilities. See Mittleider v. West, 11 Vet. App. 181, 182 (1998) (per curiam). In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994). When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether a veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). A veteran is competent to report symptoms because this requires only personal knowledge, not medical expertise, as it comes to her through her senses. See Layno, 6 Vet. App. 465, 469. Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303 (2007). Lay evidence may establish a diagnosis of a simple medical condition, a contemporaneous medical diagnosis, or symptoms that later support a diagnosis by a medical professional. Jandreau, 492 F.3d 1372, 1377. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 1. Entitlement to an initial disability rating in excess of 70 percent for PTSD. The Veteran is in receipt of a 70 percent initial disability rating for PTSD under 38 C.F.R. § 4.130, DC 9411. He seeks a higher rating. The Veteran's PTSD is rated under the general rating formula for rating mental disorders pursuant to 38 C.F.R. § 4.130, DC 9411. Under such formula, a 70 percent rating is warranted when the psychiatric disorder results in occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, 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 an 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 inability to establish and maintain effective relationships. A total schedular rating of 100 percent is warranted when the disorder results in total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of mental and personal hygiene); disorientation to time or place; and memory loss for names of close relatives, own occupation, or own name. In applying the above criteria, the Board notes that, when it is not possible to separate the effects of the service-connected disability from a nonservice-connected disability, such signs and symptoms shall be attributed to the service-connected disability. See 38 C.F.R. § 3.102; Mittleider v. West, 11 Vet. App. 181 (1998), citing Mitchem v. Brown, 9 Vet. App. 136, 140 (1996). Effective August 4, 2014, VA amended the portion of the Rating Schedule dealing with mental disorders and its adjudication regulations that define the term "psychosis" to remove outdated references to the DSM-IV and replace them with references to the updated Fifth Edition (DSM-5). See 79 Fed. Reg. 149, 45094. The provisions of the interim final rule apply to all applications for benefits that are received by VA or that were pending before the Agency of Original Jurisdiction on or after August 4, 2014. Id. VA adopted as final, without change, the interim final rule and clarified that the provisions of this interim final rule do not apply to claims that have been certified for appeal to the Board or are pending before the Board as of August 4, 2014. See 80 Fed. Reg. 53, 14308 (March 19, 2015). Here, the RO certified the Veteran's appeal to the Board after August 4, 2014; therefore, the PTSD claim is governed by DSM 5 and the GAF scores are not relevant for consideration. See Golden v. Shulkin, 29 Vet. App. 221, 225-26 (2018) (holding that the Board errs when it uses GAF scores to assign a psychiatric rating in cases where DSM-5 applies). When evaluating mental health disorders, the factors listed in the Rating Schedule are simply examples of the type and degree of symptoms, or their effects, that would justify a particular rating; the analysis should not be limited solely to whether a veteran exhibited the symptoms listed in the Rating Schedule. Rather, the determination should be based on all of a veteran's symptoms affecting his level of occupational and social impairment. See Mauerhan v. Principi, 16 Vet. App. 436, 442-43 (2002). The lists of symptoms under the Rating Schedule are meant to be examples of symptoms that would warrant the disability evaluation but are not meant to be exhaustive. Id. On review, the Board finds that the Veteran's PTSD symptoms have most nearly approximated occupational and social impairment with deficiencies in most areas for the entire period on appeal. The evidence reflects that the Veteran has experienced symptoms of suicidal ideation and continuous panic or depression affecting ability to function independently, appropriately, and effectively during the pendency of the present appeal. See May 2012 private treatment record (noting inpatient hospitalization related to anxiety and depression with suicidal and homicidal ideations, without plan); January 2014 statement from treating psychologist (noting recent suicidal ideation on a weekly basis); September 2019 VA treatment record (indicating that his isolative behavior and difficulties going places with his family have been disabling); February 2020 VA treatment record (noting profound sadness and feeling empty for three days last week, such that he stayed in bed for most of the time and ate very little). In addition, the evidence reflects that the Veteran has consistently experienced symptoms of impaired impulse control, such as unprovoked irritability with periods of violence, and difficulty in adapting to stressful circumstances (including work or a worklike setting). See June 2016 VA examination report; October 2017 VA treatment record (noting continued irritability and anger outbursts at work); November 2019 VA treatment record (reporting being intolerant of little stressors). Furthermore, the April 2019 VA examination reported indicated that the Veteran’s PTSD symptoms manifested in neglect of personal appearance and hygiene. Finally, the evidence reflects that the Veteran has experienced symptoms of depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, flattened affect, mild memory loss, circumstantial, circumlocutory or stereotyped speech, disturbances of motivation and mood, hypervigilance, and difficulty in establishing and maintaining effective work and social relationships. See December 2010, June 2016, and April 2019 VA examination reports. For these reasons, the Board finds that the Veteran's MDD symptoms have more nearly approximated occupational and social impairment with deficiencies in most areas throughout the rating period on appeal, warranting a 70 percent rating. However, a rating higher than 70 percent is not warranted because the evidence does not reflect that the Veteran’s PTSD has caused total occupational and social impairment. There is no evidence of disorientation to time or place, persistent delusions or hallucinations, persistent danger of hurting self or others, grossly inappropriate behavior, gross impairment in thought processes or communication, intermittent inability to perform activities of daily living, or memory loss for close relatives, own occupation, or own name. While the record reflects that the Veteran has experienced symptoms of homicidal ideations and hallucinations, it does not appear that such symptoms were persistent, as is required for a 100 percent rating. See November 2010 VA examination report (no delusions or hallucinations, and no suicidal or homicidal ideations); May 2012 private treatment record (noting inpatient hospitalization related to anxiety and depression with suicidal and homicidal ideations, without plan, as well as auditory and visual hallucinations, all of which resolved after initiation of medication); December 2015 VA treatment record (“No thoughts of harming himself or anyone else”); June 2016 VA examination report (no delusions or hallucinations, and no suicidal or homicidal ideations); October 2017 VA treatment record (indicating Veteran vehemently denies thoughts of self-harm or harm to others and seeing or hearing things not perceived by others); April 2019 VA examination report (Veteran denied having suicidal ideations or homicidal ideations, and also denied having delusions and audio/visual hallucinations). To the contrary, the Board notes that the record does not indicate that the Veteran has had any hallucinations since May 2012. The Board notes further that a higher rating of 100 percent based on total occupational and social impairment generally requires symptoms severe enough to severely distort the individual's perception of reality, which is not shown by the record. For these reasons, total occupational and social impairment is not demonstrated by the record, and a 100 percent rating for the Veteran's PTSD is not warranted. Finally, neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 69-70 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). 2. Entitlement to TDIU for the period prior to February 1, 2018. It is the established policy of VA that all veterans who are unable to secure and maintain substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 4.16. A finding of total disability is appropriate “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(a)(1), 4.15. Controlling laws provide that a TDIU may be assigned when a veteran has one service-connected disability rated at 60 percent or more, or two or more service-connected disabilities where at least one disability is rated at 40 percent or more and the combined rating is at least 70 percent. 38 C.F.R. § 4.16(a). The record must also show that the service-connected disabilities alone result in such impairment of mind or body that the average person would be precluded from securing or maintaining a substantially gainful occupation. Id. The Veteran in this case has met the schedular percentage requirements for a TDIU under 38 C.F.R. § 4.16(a) since January 1, 2011. As of that date, he was in receipt of service connection for PTSD (rated 70 percent disabling, effective January 1, 2011); a right shoulder disability (rated 20 percent disabling, effective January 1, 2011) a low back disability (rated 20 percent disabling, effective January 1, 2011); a left shoulder disability (rated 10 percent disabling, from January 1, 2011 to January 15, 2018, and 20 percent thereafter); a cervical spine disability (rated 10 percent disabling from January 1, 2011 to January 15, 2018, and 20 percent thereafter); a right ankle strain (rated 10 percent, effective January 1, 2011); tinnitus (rated 10 percent, effective January 1, 2011); right and left wrist disabilities (each rated 10 percent disabling, effective January 1, 2011); right and left hip disabilities (each rated 10 percent, effective January 1, 2011); right and left knee disabilities (each rated 10 percent disabling, effective January 1, 2011); erectile dysfunction (rated zero percent disabling, effective June 18, 2014); and bilateral pes planus, bilateral hearing loss, an umbilical hernia repair scar, bilateral tinea pedis, and tension headaches (each rated zero percent disabling, effective January 1, 2011). The Board notes that the Veteran has been in receipt of a combined 100 percent rating for the entire period on appeal. Although no additional disability compensation may be paid when a total schedular disability rating is already in effect, a separate award of TDIU predicated on a single disability may form the basis for an award of special monthly compensation. Bradley v. Peake, 22 Vet. App. 280 (2008) (there could be a situation where a Veteran has a schedular total rating for a particular service-connected disability, and could establish a TDIU rating for another service-connected disability in order to qualify for SMC under 38 U.S.C. § 1114(s) by having an additional disability of 60 percent or more). Therefore, for the period prior to February 1, 2018, the Board will consider whether the Veteran is entitled to a TDIU based on a single disability, solely for the purpose of determining whether the Veteran is entitled to benefits under 38 U.S.C. § 1114(s). As the Veteran’s PTSD has the highest disability rating of any of his service-connected disability and the record indicates that it is the disability that causes the most significant occupational impairment, the Board has limited its analysis to whether the Veteran is entitled to a TDIU based solely on his PTSD, for the purposes of entitlement to benefits under 38 U.S.C. § 1114(s). SMC is payable at the housebound rate where the claimant has a single service-connected disability rated as totally disabling and one or more distinct service-connected disabilities, which are independently ratable at 60 percent or more and involve different anatomical segments or bodily systems. 38 U.S.C. § 1114(s)(1); 38 C.F.R. § 3.350(i). The remaining question is whether these service-connected disabilities preclude the Veteran from securing and following a substantially gainful occupation. See 38 C.F.R. § 4.16(a). The fact that a veteran is unemployed or has difficulty finding employment does not alone warrant assignment of a TDIU, as a high rating itself establishes that his disability makes it difficult for him to obtain and maintain employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). Rather, the evidence must show that he is incapable “of performing the physical and mental acts required” to be employed. Id. at 363. Thus, the central question is whether a veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability, and not whether a veteran could find employment. Id. Consideration may be given to a veteran’s education, training, and special work experience, but not to his age or to impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19 (2019). In Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013), the Federal Circuit held that, when a veteran is claiming TDIU based upon the combined effects of multiple service-connected disabilities, VA’s duty to assist “does not require obtaining a single medical opinion regarding the combined impact of all service-connected disabilities.” See also Smith v. Shinseki, 647 F.3d 1380, 1385-86 (Fed. Cir. 2011) (VA is not required to obtain an industrial survey from a vocational expert before making a TDIU determination but may choose to do so in an appropriate case). Although VA must give full consideration, per 38 C.F.R. § 4.15, to “the effect of combinations of disability,” VA regulations place responsibility for the ultimate TDIU determination on VA adjudicators, not a medical examiner’s opinion. Geib, 733 F.3d at 1354; see also 38 C.F.R. § 4.16(a). The ultimate issue of whether TDIU should be awarded is not a medical issue, but rather is a determination for the VA adjudicator. See Moore v. Nicholson, 21 Vet. App. 211, 218 (2007) (ultimate question of whether a veteran is capable of substantial gainful employment is not a medical one; that determination is for the adjudicator), rev’d on other grounds sub nom, Moore v. Shinseki, 555 F.3d 1369 (Fed. Cir. 2009). Substantially gainful employment” is defined as an occupation that provides an annual income that exceeds the poverty threshold for one person, irrespective of the number of hours or days that a veteran actually works and without regard to a veteran’s earned annual income. See Faust v. West, 13 Vet. App. 342 (2000). There is no regulatory definition of “substantially gainful employment.” 38 C.F.R. § 4.16(a) provides guidance in that it states: “Marginal employment shall not be considered gainful employment.” It also says definitively that marginal employment exists 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. 38 C.F.R. § 4.16(a). Even if the income exceeds the poverty threshold, marginal employment may still exist on a facts-found basis. One example given is employment in a protected environment like a family business or a sheltered workshop. 38 C.F.R. § 4.16(a). VA must consider the nature of employment. Id. Notably, in Ray v. Wilkie, the Court of Appeals for Veterans Claims defined the term "unable to secure and follow a substantially gainful occupation" in § 4.16(b) to have two components: one economic and one noneconomic. The economic component means an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person. The non-economic component includes consideration of: the veteran's history, education, skill, and training; whether the veteran has the physical ability to perform the type of activities required by the occupation at issue; and whether the veteran has the mental ability to perform the activities required by the occupation at issue. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). Here, the Veteran’s DD-214 indicates that he served on active duty for approximately 20 years. During that time, he had several different military occupational specialties, including reproduction equipment specialist, administrative clerk, combat lithographer, drill instructor, and combat visual information chief. The evidence reflects that the Veteran was employed as a corrections officer from October 2011 to May 2012. See March 2017 statement. The Veteran reported trying to work after leaving his corrections officer position but feeling limited by his PTSD. Id. In July 2012 medical records, the Veteran is recorded as saying he was unemployed after leaving his corrections officer position. In 2012, the Census Bureau’s poverty threshold for one person under 65 was $11,945. Tax documents indicate that the Veteran was employed by West at Home, LLC, earning $4,631.06 in 2012. His work as a corrections officer provided the Veteran with an additional annual income of $13,779.88. In 2013, the Census Bureau’s poverty threshold for one person under the age of 65 was $12,119. Tax documents indicate the Veteran continued working for West at Home, LLC, earning $12,392.33 in 2013. In 2014, the Census Bureau’s poverty threshold for one person under the age of 65 was $12,31. The Veteran was employed by West at Home, LLC, earning $893.93. Medical documentation by Dr. J.L.J. reports that the Veteran stopped working in January 2014, and June 2014 medical records reported that the Veteran was unemployed. February 2014 VA medical records indicate that the Veteran was taking an online class. In 2015, the Census Bureau’s poverty threshold for one person under the age of 65 was $12,331. Tax documents indicate the Veteran began working for a bank, earning $1,227.63 in 2015. In September 2015 VA medical records, the Veteran reported being in a master’s program. In December 2015 VA medical records, the Veteran stated he was working two days a week at a bank. In 2016, the Census Bureau’s poverty threshold for one person under the age of 65 was $12,486. Tax documents reflect that the Veteran continued working for a bank, earning $16,644.12. He was also employed by a local school district, earning $2,565. In 2017, the Census Bureau’s poverty threshold for one person under the age of 65 was $12,752. The Veteran earned $23,170.58 from his employment at the bank, as well as $1462.50 from another employer. In 2018, the Census Bureau’s poverty threshold for one person under the age of 65 was $13,064. The Veteran reported that he quit working at the bank in January 2018 because he was getting angry with coworkers. He earned $3,495.19 from the bank in 2018, and reported no other employment. In the April 2018 VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability, the Veteran stated that his disability affected full-time employment as of January 31, 2018. He listed the same date as both the date he last worked full-time and the date he became too disabled to work. As shown above, the Veteran was employed intermittently during the period from 2012 to 2018. Some of that employment, however, was marginal. In 2014, 2015, and 2018, the Veteran’s earned annual income did not exceed the amount established by the Census Bureau as the poverty threshold for one person for those years and his employment during those years is considered to be marginal for TDIU purposes. For the years 2012, 2013, 2016, and 2017, the Veteran was employed with jobs providing compensation above the poverty threshold; thus, his employment during those years was not marginal in nature. There is no question that the Veteran’s PTSD symptoms interfered with his employment throughout the appeal period. His PTSD was rated as 70 percent disabling throughout this period, and such rating is based on an approximation of earning capacity impairment. 38 C.F.R. § 4.1. Moreover, the criteria for rating mental health disabilities explicitly contemplates occupational impairment at every compensable level. See 38 C.F.R. § 4.130, DC 9411. While the Veteran was employed during some of the appeal period, and some periods of employment were marginal, unemployment is not the same as unemployability. The fact that the Veteran was able to obtain and maintain employment at various points during the period on appeal, particularly the extended period that he worked at the bank (from 2015 to 2018), supports a finding that he was not incapable of obtaining and maintaining substantially gainful employment during this period. There is no evidence that the bank job was in a protected environment, and this long-term period of employment is not accompanied by any contemporaneous evidence of improvement in his PTSD symptoms. As to the period prior to his beginning employment at the bank in 2015, the Board finds that it is less likely than not that the Veteran was unemployable because he was subsequently employed for an extended period without any other evidence of improvement in his PTSD symptoms. For these reasons, the Board finds that the Veteran’s service-connected PTSD did not render him unable to obtain and maintain substantially gainful employment for the period prior to February 1, 2018. Therefore, the criteria for a single service-connected disability rated as totally disabling for 38 U.S.C. § 1114(s) purposes have not been met. In so finding, the Board emphasizes that a disability rating in itself is recognition that the ability to work is impaired. 38 C.F.R. § 4.1. The Board is grateful for the Veteran's honorable service. However, given the record before it, the Board finds that, for the period prior to February 1, 2018, the evidence in this case does not meet the criteria for a TDIU or reach the level of equipoise regarding entitlement to TDIU. See 38 U.S.C. § 5107(a) (“[A] claimant has the responsibility to present and support a claim for benefits ....”); Fagan v. Shinseki, 573 F.3d 1282, 1286 (Fed. Cir. 2009). As the preponderance of the evidence is against the claim, the benefit of the doubt rule is inapplicable. 38 U.S.C. § 5107; C.F.R. § 3.102. Megan R. Thomas Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Lee Feldman, Attorney Advisor 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.