Citation Nr: 21014409 Decision Date: 03/12/21 Archive Date: 03/12/21 DOCKET NO. 15-30 547 DATE: March 12, 2021 ORDER Entitlement to a rating of 70 percent, but no more, for posttraumatic stress disorder (PTSD) (previously diagnosed as major depressive disorder) with bipolar disorder from October 12, 2011, to October 15, 2019, is granted. Entitlement to a rating in excess of 70 percent for PTSD with bipolar disorder from October 16, 2019, is denied. Entitlement to a total disability rating based upon individual unemployability (TDIU) due to service-connected disabilities from October 12, 2011 is granted. FINDINGS OF FACT 1. From October 12, 2011 to October 15, 2019, the Veteran’s major depressive disorder with bipolar disorder was productive of deficiencies in most areas. 2. From October 16, 2019, the Veteran’s major depressive disorder with bipolar disorder was not productive of total social and occupational impairment. 3. The Veteran’s service-connected disabilities from October 12, 2011 precluded him from obtaining and maintaining substantially gainful employment consistent with his level of education, prior work history and training. CONCLUSIONS OF LAW 1. The criteria for entitlement to a rating of 70 percent, but no more, for major depressive disorder with bipolar disorder, from October 12, 2011 to October 15, 2019, are met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.125, 4.130, Diagnostic Code 9434. 2. The criteria for entitlement to a rating in excess of 70 percent for PTSD with bipolar disorder, from October 16, 2019, are not met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.125, 4.130, Diagnostic Code 9411. 3. The criteria for entitlement to a total disability rating based on individual unemployability (TDIU) are met. 38 U.S.C. §§ 1155; 38 C.F.R. §§ 3.102, 3.159, 3.340, 3.341, 4.15, 4.16, 4.18, 4.19. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from January 2003 to October 2011. This appeal comes before the Board of Veterans’ Appeals (Board) from an October 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) which granted an initial rating of 30 percent for service-connected major depression disorder with bipolar disorder. The Veteran filed a February 2013 supplemental claim for PTSD. In a January 2014 rating decision and statement of case, the RO increased the Veteran’s rating to 50 percent for PTSD, effective February 14, 2013, but did not discuss the earlier period of appeal. The Board remanded the appeal in October 2018 for additional development including a new VA examination. The RO issued a July 2020 rating decision increasing the rating to 70 percent for PTSD effective October 16, 2019 and a July 2020 supplemental statement of case continuing the Veteran’s prior ratings of 30 and 50 percent for PTSD, respectively. The case was then returned to the Board for adjudication. Increased Rating Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. See 38 U.S.C. § 1155; 38 C.F.R. Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted considering the entire recorded history, and each disability must be considered from the viewpoint of the Veteran working or seeking work. 38 C.F.R. § 4.2. If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In all increased rating claims, staged ratings must be considered for the entire period on appeal. A staged rating is appropriate when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings under the applicable diagnostic code(s). Hart v. Mansfield, 21 Vet. App. 505, 509 (2007), Fenderson v. West, 12 Vet. App. 119 (1999). 1. Entitlement to increased ratings for major depressive disorder with bipolar disorder (claimed as PTSD), from October 12, 2011, to February 14, 2013 and from February 15, 2013, to October 15, 2019. 2. Entitlement to a rating in excess of 70 percent for posttraumatic stress disorder (PTSD) with bipolar disorder from October 16, 2019 Under the General Formula for Mental Disorders (General Formula), the Board must conduct a “holistic analysis” that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The 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. See Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-117 (Fed. Cir. 2013). The symptoms listed 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 the context of determining whether a higher disability evaluation is warranted, the analysis requires considering “not only the presence of certain symptoms, but also that those symptoms have caused occupational and social impairment in most of the referenced areas” - i.e., “the regulation...requires an ultimate factual conclusion as to the Veteran’s level of impairment in most areas.” Vazquez-Claudio, 713 F.3d at 117-118; 38 C.F.R. § 4.130. Further, when evaluating a mental disorder, the Board must consider the “frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran’s capacity for adjustment during periods of remission,” and must also “assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner’s assessment of the level of disability at the moment of the examination.” 38 C.F.R. § 4.126(a). The Veteran’s service-connected PTSD with bipolar disorder has been evaluated pursuant to 38 C.F.R. § 4.130, Diagnostic Code (DC) 9434 and 9411 throughout the appeal period. Under DC 9434 and 9411, a 30 percent rating is assigned where 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, and mild memory loss (such as forgetting names, directions, recent events). 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 understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment, impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is warranted where there is occupational and social impairment with deficiencies in most areas, including work, school, family relationships, judgment, thinking or mood, due to such symptoms as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting 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 inability to establish and maintain effective relationships. The highest rating of 100 percent is warranted where there is total occupational and social impairment due to such symptoms as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. a) October 12, 2011 to February 14, 2013 The Veteran contends in his October 2013 notice of disagreement that a higher rating is warranted for his major depressive disorder with bipolar disorder (claimed as PTSD). The RO assigned a 30 percent disability rating for this period. The Veteran’s service treatment records (STRs) indicate a history of depression, PTSD and bipolar disorder. See September 2011 STRs. While stationed in Germany, the Veteran had multiple physical arguments with his superiors. He was hospitalized from August 27, 2010 to September 28, 2010 for suicidal tendencies and statements that he wanted to “throw himself in front of the train”. The attending physician stated that the Veteran was unable to distance himself credibly from suicidal tendencies. Id. As a result of his symptoms, he received an early discharge from service. During a September 2011 routine medical appointment, the Veteran denied suicidal thoughts or attempts but stated that he felt numb, guarded, and was having nightmares. See August 2012 Medical Treatment Records. He reported daily symptoms of depression, hopelessness, sleep issues, difficulty with concentration, and restlessness. He stated that his symptoms were making it very difficult to work or take care of things at home. Id. In January 2012, he reported depression, high anxiety, irritability, anger and that he was only sleeping 2-3 hours a night. He denied suicidal ideation but indicated that he sometimes felt like hurting other people. Id. In March 2012, the Veteran stated that he was a student and currently unemployed. He reported depression, fatigue, slow thinking, numbness and sensitivity to noise. Id. During a January 2012 VA examination the Veteran reported nightmares, mood swings, irritability, hostility, and difficulty controlling his anger. The Veteran had been unemployed since discharge from the military in 2011. The Veteran’s symptoms included depressed mood, anxiety, memory loss, problems with concentration, panic attacks, severe agitation, loss of sleep, indecisiveness and issues with anger. He struggled with work and social relationships, felt detached from others and did not have any close relationships. The examiner noted that the Veteran’s STRs indicated he had been hospitalized at least twice for homicidal and suicidal ideation. The Veteran was quick to makes threats to those around him. The VA examiner opined that the Veteran had occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress or symptoms controlled by medication. Id. The Veteran did attend Northwood University and was awarded his bachelor’s in business administration (BBA) in December 2013 with a 3.6 GPA. See December 2016 Academic Transcripts. The Board finds that during the period of appeal from October 12, 2011 to February 14, 2013, the Veteran’s reported symptoms, supported by the record, are commensurate with a 70 percent rating. The Veteran reported symptoms of depression, loss of sleep, memory issues, nightmares, anxiety and problems with concentration. He was hospitalized at least twice for homicidal and suicidal ideation while in service, would get into physical arguments with superiors and received an early discharge due to the symptoms of his mental disorder. While the Veteran states he is currently a student, he has been unemployed since his discharge from service, has no close personal relationships and states at times he feels like hurting other people. The Board finds the evidence of record supports that the Veteran’s PTSD symptoms occurred with the frequency, duration and severity to cause occupational and social impairment with deficiencies in most areas, including work, school, family relationships, judgment, thinking and mood. However, the Board also finds that the preponderance of the evidence is against total occupational and social impairment. A rating of 70 percent, but no more, for major depressive disorder with bipolar disorder is warranted. 38 C.F.R. § 4.130. Therefore, the Board finds that affording the Veteran the benefit of the doubt, his major depressive disorder with bipolar disorder, claimed as PTSD, is entitled to a rating of 70 percent. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Accordingly, a rating of 70 percent, but no higher, for major depressive disorder with bipolar disorder is granted. b) February 15, 2013 to October 15, 2019 On February 2013, and during the pendency of this appeal, the Veteran filed a supplemental claim for PTSD. The Veteran stated that that while in service he was exposed to both indirect and direct fire and on multiple occasions saw servicemembers killed. See February 2013 Statement in Support. The RO assigned a 50 percent disability rating for this period. In a February 2013 buddy statement, D.D. stated that he was deployed with the Veteran in Iraq and noticed that he started to show social dysfunction. He stated that the Veteran would only sleep 2-3 hours a night and would have nightmares and often slept clutching his weapon. The Veteran also repeatedly got into physical altercations with other servicemembers. Id. During an October 2013 VA examination, the Veteran stated that while deployed he watched a truck explode which killed several people. He reported nightmares, avoidance behaviors, irritability, hypervigilance, and trouble sleeping. He stated that he had a manic episode one week prior where he didn’t sleep for 4 days straight, spent $1,000 on random things he didn’t need, and he had “flights of thoughts”. He reported that he had been unemployed since 2011, that he had no friends or social relationships and that he just read books. Id. The Veteran’s symptoms included anxiety, suspiciousness, loss of sleep, memory loss, forgetting names, disturbance of mood, impulsiveness and difficulty maintaining social relationships. He denied current suicidal ideation. The VA examiner opined that the Veteran had occupational and social impairment with reduced reliability and productivity due to his symptoms. Id. The Veteran’s medical treatment records note instances of violence, anger and aggression. During a May 2015 medical appointment, the Veteran stated that his aggression was increasing and that after his car was towed, he threatened the clerk by stating he would put a “bullet in her head”. See August 2015 Medical Treatment Records. He repeatedly discusses losing his temper quickly, wanting to beat people up or kill them, and stated that he was let go from a brief employment after getting angry at the manger. Id. In a July 2015 buddy statement, D.B. stated that he was stationed with the Veteran and was currently still friends with him. D.B. stated that the Veteran has delusions of “bloodletting”, that he shows inappropriate behaviors, has no other relationships and is not civil to others. He further stated that the Veteran had lost two jobs in the private sector due to violent episodes and in his opinion the only reason the Veteran was able to obtain his college degree was because he did it on base and at night. Id. D.B. stated that at times he needs to restrain the Veteran from becoming violent with civilians when he is visiting. Id. An October 2015 VA examiner stated that they were unable to provide a diagnosis of the Veteran’s current mental health disorder because he was overreporting symptoms during testing. The Veteran reported during the examination that he had punched someone in 2014 and knocked out their teeth. Id. In a December 2015 response to Veteran’s application for the Vocational Rehabilitation Program (VRE) the counselor stated that the Veteran was unable to engage in employment duties that have stress, deal with difficult people, require memory and word recall, or that have crowded environments. Further, the counselor indicated that the Veteran’s mental disability significantly impairs his ability to gain or retain suitable employment and that he was at an employment disadvantage compared to other similarly circumstanced Veterans. Id. While in the VRE program, the Veteran was awarded his master’s degree in management at Embry-Riddle in 2016 with a 3.5 GPA. In January 2017, the Veteran requested his treating physician provide him a letter for work regarding his fitness for employment after he became aggressive and threatened to “blow stuff up” and was subsequently placed on administrative leave. See July 2019 Medical Treatment Records. In June 2017 the Veteran was terminated from his federal employment during the probationary period due to his failure to demonstrate fitness for his position. See January 2017 Military Personnel Record. The notice of termination indicated the Veteran failed to demonstrate proficiency in his employment after continuous training. Id. The Veteran was temporarily employed in by Walmart in 2017 for 42 days and stated he quit because he “didn’t like their style”. In March 2018 he was hired as a project engineer at Arsenal and maintained the position for at least 60 days. In November 2018 he completed his VRE program and was declared rehabilitated. See November 2018 VRE Correspondence. The Veteran stated he was terminated from his job as a project engineer in March 2019 because “it went bad”. See July 2019 Medical Treatment Records. The Veteran stated it was hard to keep a job because of his anger, depression, insomnia and fighting with his supervisors. Id. He stated that he had nightmares, startled easily, and felt numb, hostile, and irritated. His counselor opined that his prognosis was poor to fair and he may not benefit from additional therapy. Id. The Board finds that during the period of appeal from February 15, 2013 to October 15, 2019, the Veteran’s reported symptoms, supported by the record, are commensurate with a 70 percent rating. The Veteran reported symptoms of depression, loss of sleep, memory issues, nightmares, anxiety, problems with concentration, anger, irritability and impulsiveness. There were multiple instances where he reacted in a threatening and violent manner towards others including while at work. In his buddy statement, D.B. reported the Veteran often acts inappropriately and at times needs to be physically restrained from harming others and had lost two jobs due to violent episodes. While the Veteran has a master’s degree in science management, he has been unable to obtain and maintain employment since his discharge from service. The Board finds the evidence of record supports that the Veteran’s PTSD symptoms occurred with the frequency, duration and severity to cause occupational and social impairment with deficiencies in most areas, including work, school, family relationships, judgment, thinking and mood. However, the Board also finds that the preponderance of the evidence is against total occupational and social impairment. A rating of 70 percent, but no more, for PTSD is warranted. 38 C.F.R. § 4.130. Therefore, the Board finds that affording the Veteran the benefit of the doubt, his PTSD with bipolar disorder is entitled to a rating of 70 percent. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Accordingly, a rating of 70 percent, but no higher, for PTSD with bipolar disorder is granted. c) From October 16, 2019 The Veteran has consistently asserted that he is entitled to a higher rating for his PTSD with bipolar disorder due to the severity of his symptoms. During an October 2019 VA examination the Veteran stated that his social situation was “not good” as he has difficulty making friends and dislikes hanging out with other people socially. See December 2019 VA Examination. He only mentioned one friend in his social network and reported that his relationship with his family was very strained. The Veteran was unemployed after having been terminated from another employment in 2018. The examiner confirmed the Veteran’s diagnoses of PTSD and bipolar disorder and diagnosed the Veteran with other specified Personality Disorder, Cluster B personality traits. The examiner opined that the Veteran’s other specified Personality Disorder was less likely than not cause by his military service, however he was unable to differentiate which of the Veteran’s symptoms could be attributed to each of his mental disorders without speculation. Id. The Veteran’s symptoms included depressed mood, anxiety, suspiciousness, panic attacks, chronic sleep impairment, mild memory loss, flattened affect, impaired judgment, disturbance of mood, impulsiveness, difficulty maintaining work and social relationships and periods of violence. He denied current suicidal ideation. The VA examiner opined that the Veteran had occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment thinking and mood. Id. The Board finds that during the period of appeal from October 16, 2019, the Veteran did not report, and the record did not reflect, any symptoms commensurate with a 100 percent rating. The Veteran reported symptoms of panic attacks, depression, anxiety, disturbances of motivation and mood, irritable behavior, sleep impairment and difficulty maintaining work and social relationships. However, despite his reported difficulty with work and social relationships due to symptoms of his mental disorders, the Veteran is not totally impaired due to persistent hallucinations or delusions, persistent danger to himself or to others, or unable to perform the necessary activities of daily living. See December 2019 VA examination. Thus, the Board finds that his symptoms did not occur with the frequency, duration and severity to warrant a higher rating. While the Board acknowledges the Veteran’s PTSD caused social and occupational impairment, the record reflects his symptoms are wholly contemplated by his 70 percent rating. A rating in excess of 70 percent for PTSD with bipolar disorder is not warranted. 38 C.F.R. § 4.130. For the foregoing reasons, the preponderance of the evidence is against the claim for a rating in excess of 70 percent from October 16, 2019 for PTSD with bipolar disorder. The benefit of the doubt doctrine is therefore not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. 3. Entitlement to a total disability rating based upon individual unemployability (TDIU) due to service-connected disabilities is remanded. The Veteran contends that his symptoms caused by his PTSD and bipolar disorder contribute to his inability to secure and follow substantially gainful employment. Although the Veteran has been employed at various times during the period of appeal, the record indicates he has had multiple periods of unemployment in addition to difficulty maintaining employment. The Board finds that the issue of entitlement to a total disability rating based on individual unemployability (TDIU) has been reasonably raised by the record consistent with Rice v. Shinseki, 22 Vet. App. 447 (2009). Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities (Rating Schedule), which is based on the average impairment of earning capacity. 38 U.S.C. § 1155 (2012). Total disability is considered to exist when there is any impairment 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). Total disability may or may not be permanent. Id. Total ratings are authorized for any disability or combination of disabilities for which the Rating Schedule prescribes a 100 percent evaluation. 38 C.F.R. § 3.340(a)(2). A TDIU may be assigned when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). If there is only one such disability, it must be rated at 60 percent or more; if there are two or more disabilities, at least one disability must be rated at 40 percent or more, with sufficient additional disability to bring the combined rating to 70 percent or more. Id. Entitlement to a total rating must be based solely on the impact of the Veteran’s service-connected disabilities on his ability to keep and maintain substantially gainful employment. See 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). For VA purposes, the term “unemployability” is synonymous with an inability to secure and follow a substantially gainful occupation. VAOPGPREC 75-91; 57 Fed. Reg. 2317 (1992). The term “unable to secure and follow a substantially gainful occupation” in § 4.16(b) has 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. Ray v. Wilkie, 31 Vet. App. 58, 72-73 (2019). In a claim for TDIU, the ultimate question of whether a Veteran is capable of substantially gainful employment is not a medical one; that determination is for the adjudicator. See 38 C.F.R. § 4.16(a); see also Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013) (noting that “applicable regulations place responsibility for the ultimate TDIU determination on the adjudicator, not a medical examiner”). When reasonable doubt arises as to the degree of disability, such doubt will be resolved in the Veteran’s favor. 38 C.F.R. § 4.3. The Veteran is currently service connected for major depression with bipolar disorder, claimed as PTSD, rated at 70 percent, effective October 12, 2011. 38 C.F.R. §§ 4.25, 4.26. As such, the Veteran had one disability rated at 60 percent or more from October 12, 2011. 38 C.F.R. § 4.16(a). Therefore, for the period of appeal, the Veteran meet the schedular TDIU requirements. Id. As indicated earlier herein, the Veteran has had multiple periods of unemployment since his medical discharge from the Army in October 2011 and has had difficulty obtaining and maintaining employment due to his service-connected PTSD. The Veteran’s PTSD symptoms include, but are not limited to, depression, hopelessness, sleep issues, difficulty with concentration, restlessness, irritability, hostility, and difficulty controlling his anger and feelings that he wants to hurt other people. Due to his PTSD symptoms, the Veteran has been unable to obtain and maintain substantially gainful employment. He was discharged from the military in October 2011 due to his PTSD symptoms. During a January 2012 VA examination the Veteran stated he had been unemployed since discharge from the military in 2011. He attended Northwood University and was awarded his bachelor’s degree in business administration (BBA) in December 2013 with a 3.6 GPA. See December 2016 Academic Transcripts. During an October 2013 VA examination, the Veteran stated that he had been unemployed since 2011, that he had no friends or social relationships and that he just read books. During a May 2015 medical appointment, he discussed losing his temper quickly, wanting to beat people up or kill them, and stated that he was let go from a brief employment after getting angry at the manger. See August 2015 Medical Treatment Records. In a July 2015 buddy statement, D.B. stated that in his opinion the only reason the Veteran was able to obtain his college degree was because he did it on base and at night. Id. D.B. stated that at times he needs to restrain the Veteran from becoming violent with civilians when he is visiting. Id. In a December 2015 response to Veteran’s application for the Vocational Rehabilitation Program (VRE) the counselor stated that the Veteran was unable to engage in employment duties that have stress, deal with difficult people, require memory and word recall, or that have crowded environments. Further, the counselor indicated that the Veteran’s mental disability significantly impairs his ability to gain or retain suitable employment and that he was at an employment disadvantage compared to other similarly circumstanced Veterans. Id. While in the VRE program, the Veteran was awarded his master’s degree in management at Embry-Riddle in 2016 with a 3.5 GPA. He was hired by the federal government as a budget analyst in July 2016. However, in January 2017, the Veteran requested his treating physician provide him a letter for work regarding his fitness for employment after he became aggressive and threatened to “blow stuff up” and was subsequently placed on administrative leave. See July 2019 Medical Treatment Records. He was terminated in June 2017 during the probationary period due to his failure to demonstrate fitness for his position. See January 2017 Military Personnel Record. The notice of termination indicated the Veteran failed to demonstrate proficiency in his employment after continuous training. Id. The Veteran was temporarily employed in by Walmart in 2017 for 42 days and stated he quit because he “didn’t like their style”. See July 2019 Medical Treatment Records. In March 2018 he was hired as a project engineer at Arsenal and maintained the position for at least 60 days. In November 2018 he completed his VRE program and was declared rehabilitated. See November 2018 VRE Correspondence. The Veteran stated he was terminated from his job as a project engineer in March 2019 because “it went bad”. See July 2019 Medical Treatment Records. The Veteran stated it was hard to keep a job because of his anger, depression, insomnia and fighting with his supervisors. Id. The Board is satisfied that the current evidence of record indicates the Veteran is prevented from securing and maintaining substantially gainful employment. While the record indicates the Veteran has a bachelor and master’s degree, and although he has obtained employment periodically over the course of the appeal period, his symptoms caused by his PTSD prohibit him from obtaining and maintaining substantially gainful employment. The Board has considered the possibility of a staged TDIU to account for the periods of the Veteran’s employment during the appeal period. However, each period ended due to the Veteran’s PTSD symptoms as discussed above. The Board is mindful that a veteran’s TDIU rating may not be reduced on the basis of having obtained substantially gainful employment unless the Veteran maintains the occupation for a period of 12 consecutive months. 38 C.F.R. § 3.343(c)(2). That did not occur here. Accordingly, the Board concludes staging downward to account for the Veteran’s limited periods of employment is not warranted. Despite the Veteran’s completion of the VRE program, his education level and periodic employment, the Veteran has not been capable of actual, substantially gainful employability at any period during the appeal. Therefore, the Board finds there is an equal balance of evidence establishing he was unable to obtain or maintain substantially gainful employment as a result of his service-connected disabilities. 38 C.F.R. § 4.16(a). Accordingly, after resolving all doubt in favor of the Veteran, the Board concludes that entitlement to a schedular TDIU rating due to service-connected disabilities from October 12, 2011 is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. J. B. FREEMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Aubee, Associate 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.