Citation Nr: 21014681 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 14-15 949A DATE: March 15, 2021 ORDER An initial disability rating higher than 50 percent for posttraumatic stress disorder (PTSD) with alcohol abuse disorder is denied. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is denied. FINDINGS OF FACT 1. For the entire initial rating period on appeal, the Veteran’s service-connected PTSD with alcohol abuse disorder has been manifested by symptomatology more nearly approximating occupational and social impairment with reduced reliability and productivity due to symptoms of anger, irritability, mild memory loss, hypervigilance, difficulty concentrating, disturbances of motivation and mood, and difficulty in adapting to stressful circumstances, including work or a worklike setting; deficiencies in most areas is not shown. 2. From May 2009 to August 2016, the Veteran did not meet the schedular requirements for a TDIU, and his service-connected disabilities did not preclude him from obtaining and retaining substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for an initial disability rating higher than 50 percent for posttraumatic stress disorder (PTSD) with alcohol abuse disorder have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107, 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.3, 4.7, 4.125, 4.126(a), 4.130, Diagnostic Code 9411. 2. The criteria for entitlement to a TDIU due to service-connected disabilities have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board remanded the matters twice—in July 2019 and October 2020. The Board finds that the remand directives have been substantially complied with and therefore will proceed with the appeal. Stegall v. West, 11 Vet. App. 268. The Board remanded the matters in order to obtain information regarding the impact the Veteran’s alcohol abuse disorder may have had on his PTSD. In a February 2021 rating decision, the RO recharacterized the PTSD to claim to include alcohol abuse disorder. This recharacterization is reflected in the title page. Increased Disability Rating Psychiatric disabilities, such as PTSD, is evaluated under the General Rating Formula for Mental Disorders (pertinent portions listed below). See 38 C.F.R. § 4.130, Diagnostic Code 9411. Under the General Rating Formula for Mental Disorders, a 100 percent disability rating requires 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; or memory loss for names of close relatives, own occupation, or own name. Id. A 70 percent disability rating requires 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); or inability to establish and maintain effective relationships. Id. A 50 percent disability rating requires occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. Id. 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 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. Further, the United States Court of Appeals for the Federal Circuit has acknowledged the “symptom-driven nature” of the General Rating Formula and that “a veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration.” Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116 (Fed. Cir. 2013). The Federal Circuit has explained that “symptomatology should be the fact-finder’s primary focus when deciding entitlement to a given disability rating.” Id. at 117. The Veteran’s PTSD with alcohol abuse disorder is rated as 50 percent disabling, effective May 7, 2009. As this rating includes the entire time period on appeal the question before the Board is whether a rating higher than 50 percent is warranted at any time during the appeal period. The Veteran submitted a private psychological evaluation dated just prior to the start of the appeal period. However, the Board will consider this evaluation as it assists to provide a total picture of the severity of the Veteran’s PTSD. During the appeal period, he underwent three VA examinations and one private examination related to his PTSD with alcohol abuse disorder. The pertinent information from the examinations will be summarized below. An April 2009 private psychological evaluation was performed. The Veteran is the oldest of three children. A comparatively stable childhood family environment was described. He reported excellent relationships with both parents, and good sibling relationships. He graduated from high school then enrolled in college and completed his bachelor’s degree in History and Political Science. He was first employed at the age of eleven, delivering newspapers. He was then employed by a fence company. During summer terms in his college years he was employed by the National Bureau of Standard as a Lab Technician Assistant. After graduating college, he worked at the U.S. Postal Service, sorting mail, and he also worked at a gas station. For almost three years he became employed by the National Archives and Records Center in Washington D.C. for two months. He then returned to the National Bureau of Standards for which he oversaw the Tour Program and the Exhibits Program. After that he worked for the Energy Research and Development Administration which ultimately merged with four other agencies to become the U.S. Department of Energy. He spent 24 years there, in the Office of Public Affairs. He retired in late December 2000. He described a history of difficulties with supervisors in his work environments. He acknowledged a history of arguing but denied any physical altercations. He married in 1971. He described the marriage as “okay, we tolerate each other, really.” Occasional arguing was noted, but he denied any physical altercations. He has four children and three grandchildren. Two of his children reside across the street from him and the other two live with him and his wife. He began drinking alcohol during college, with the heaviest usage occurring during service. A history of substance abuse, primarily involving his excessive use of alcohol was reported. He ceased drinking for approximately five years but recently resumed drinking, consuming about “a couple of beers a week.” He denied a significant history of drug use. Symptoms of PTSD were listed as persistent re-experiencing, persistent avoidance or numbing, and persistent arousal. He described experiencing occasional intrusive thoughts with flashbacks, as well as recurrent nightmares. A pattern of markedly diminished interest and participation in significant activities such as athletics and drag racing relative to his behavior prior to military service was described. He demonstrated marked problems with insomnia as evidenced by his difficulties with sleep onset and terminal waking. He endorsed irritability and angry verbal outbursts. He described concentration problems. He described hypervigilance in the form of his preference for sitting “where [he] can see everything that’s going on” in public settings. He described being in a “pretty good” mood most of the day, nearly every day. He endorsed psychomotor retardation. He reported experiences of fatigue and loss of energy. He further reported cognitive difficulties, including the diminished ability to think and indecisiveness “on occasion.” He denied suicidal ideation. Upon mental status examination, the Veteran was easily engaged in the evaluation. He was pleasant and cooperative throughout the interview. His impulse control appeared to fall within normal limits. Speech was normal in manner and content. Form of thought and thought content were within normal limits. He denied suicidality, homicidal thoughts, and perceptual abnormalities. He described his mood as “good.” Affect was normal, stable, and appropriate. He was he was oriented to all three spheres: person, time, and place. His attention capacities, memory for recent events, and memory for recent past events were within normal limits. His remote memory was intact. His intelligence and fund of information was above the average range. Judgment, insight, concentration abilities, and immediate memory abilities fell below normal limits. The examiner strongly recommended that he seek out individual and group therapy. The examiner strongly recommended psychiatric symptom management. His prognosis was extremely guarded. During the September 2009 VA examination, the Veteran reported nightmares and trouble sleeping. He was triggered by sounds such as car backfiring, hunters shooting in the woods, and helicopters. He reported avoidance of crowds, such as ball games. His avoidance of crowds has led him to stop several hobbies such as racing cars or going to sporting events. He avoided combat-related material on television. He reported some detachment from emotions. Drinking helped him sleep. He drank two, six packs per week in order to help him sleep. He was often uptight and irritable. He used to smash things, but now takes a walk outside and has learned some better ways to deal with his anger. Longest period of employment was 25 years at the Department of Energy. He was not close to anyone at work and this likely affected his ability to move up higher in the hierarchy and advance his career. He has been married for 36 years and described his relationship as good. He described his relationship with his kids as fair. He had a few friends from church, and goes to church once per week. He performed carpentry work, metal work, and works on cars. Upon mental status examination, the Veteran was oriented to person, place, and time. His behavior was appropriate. His rate and flow of speech were normal. He could maintain personal hygiene and basic activities of daily living. Depression and sleep impairment were noted. There was no indication of impairment of thought process or communication, delusions, hallucinations, memory loss or impairment, panic attacks, impaired pulse control, or presence of obsessive or ritualistic behavior which interfered with routine activities. The same private psychologist who performed the April 2009 private psychological evaluation did another evaluation in March 2010. The Veteran had not pursed counseling or psychiatric services due to his perception that he was uncertain whether “it’s going to do any good.” He still reported problems sleeping but estimated that he got about six hours of sleep per night. He described “occasional” troubles with verbal outbursts. He endorsed continued hypervigilance and exaggerated startle responses. Immediate memory abilities now were within normal limits. Prognosis was somewhat guarded. The Board acknowledges the letter authored by a private examiner dated April 2010. A review of the letter does not show that it is substantive regarding the increased rating claim before the Board. It was more substantive regarding a service connection claim for psychiatric disorder. During the December 2014 VA examination, the Veteran reported still being married to the same woman and still retired from Department of Energy as of 2000. He remained active and did not have enough time to do everything. His four grown children were doing okay. His six grandchildren, ranging from ages five to 20, were doing well. He worked around his house in Maryland and his house in Florida. Between the two houses, the cars, and the kids he was busy. In Maryland, he keeps busy with his house and the kids’ houses, and in Florida, he stays busy by going out in a boat and working in the yard and on the house. They travel back and forth to Florida seasonally. He had a few friends and occasionally has dinner with them. Most of his interactions were with his wife, children, and grandchildren. He described a fairly good quality of life. He reported not undergoing any mental health treatment, specifically stating he has never had treatment. He stated that he probably drinks a little more than he should, stating that he has 12 to 18 beers a week. He had not encountered any health or other problems when drinking. The examiner concluded that the Veteran’s consumption was consistent with the last exam and helps him sleep. He retired back in 2000, in a planful way, and had not worked since. Upon mental status examination, the Veteran was oriented to all spheres; his attitude was pleasant, polite, cooperative; his speech fluent and coherent; his affect appropriate; his mood was congruent; his thought flow logical and goal directed; and his attention was good. He was casually dressed and adequately groomed. His mood showed some anxiety. He did not endorse hallucinations, delusions, or suicidal or homicidal ideations. The symptoms for VA rating purposes included anxiety, suspiciousness, chronic sleep impairment, disturbances of motivation and mood, and difficulty in adapting to stressful circumstances, including work or a worklike setting. The examiner concluded that the Veteran’s level of impairment resulted in occupational and social impairment with 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. A September 2016 private consultation report notes the Veteran’s reports that he quit drinking before his June 2016 prostate cancer diagnosis. An October 2016 private medical record reflects that he has not had alcohol since his prostate cancer diagnosis. A July 2020 VA PTSD examination was conducted via approved video telehealth. The Veteran continued to report a good close relationship with his children and wife. He has been married for over 40 years. He gets together with his family regularly. Two of his adult children still reside with him and his wife. He worked for the Department of Energy until he retired in 2000 as a GS-13—after taking the retirement buyout he was offered. He denied any significant work-related issues to include write ups. Towards the end of his career, his promotion to GS-14 never went through despite his supervisor putting him in for a promotion. He was not currently in any mental health treatment at the Martinsburg, VA. He had never been on medications or prescribed medications. He reported he had not consumed alcohol since 2016. He denied alcohol cravings. He stopped all alcohol use in 2016 when diagnosed with prostate cancer. The symptoms for VA rating purposes included depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss such as forgetting names, directions or recent events, disturbances of motivation and mood, and difficulty in adapting to stressful circumstances, including work or a worklike setting. He was capable of managing his financial affairs. Under the remarks section in the report the VA examiner stated that the Veteran previously met criteria for alcohol use disorder, moderate but was never service connected for this. The examiner found that since 2016, the Veteran no longer meets DSM-5 criteria once he stopped all alcohol consumption. He denied any cravings for alcohol, and admitted he had little difficulty stopping his consumption of alcohol. During this examination, he endorsed anxiety, depressed mood, irritability, sleep disturbance, hypervigilance, difficulty with mild memory issues, and an exaggerated startle response when surprised by loud unexpected noises. At times, his intrusive thoughts of his stressors would interrupt his ability to remember where he put his keys or something new his wife has told him to do. He reported difficulty trusting others and often being suspicious of new people. He preferred to interact with close family and friends. He never sought mental health treatment for his PTSD symptoms. The examiner concluded that the Veteran’s level of impairment resulted in occupational and social impairment with 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. The VA examiner also provided opinions in conformity with the remand directives. He opined that the alcohol abuse disorder is not a symptom of or related to the Veteran’s PTSD. The rationale provided is that the Veteran no longer consumes alcohol, ceasing completely in 2016. The examiner stated that this account was further confirmed by his treating physician for prostate cancer. A note dated September 13, 2016 illustrates he discontinued all alcohol use. The examiner also opined that the Veteran has difficulty attending to, or is easily distracted from, the task at hand. The examiner stated that the Veteran also has intrusive thoughts which interfere with the ability to stay focused on the tasks at hand. Under the remarks section of the report the examiner stated that the Veteran has been retired from since 2000. He reported a normal progression in government employment and retired as a GS-13, after a buyout in 2000. He has not attempted to find work since that time and considers himself fully retired. “The checklist of impairment is based on his current PTSD symptoms.” In January 2021, a VA examiner opined that the Veteran’s alcohol disorder is secondary to his service-connected PTSD that was diagnosed in 2009. The examiner also found that the Veteran’s symptoms and levels of impairment did not change significantly due to the alcohol use, but rather were included in the impairment levels of the previous exams. The preponderance of the evidence does not support a rating higher than 50 percent at any time during the period on appeal. The Board recognizes that there are two VA medical opinions of record regarding the Veteran’s alcohol abuse disorder and his PTSD. The July 2020 VA examiner opined that the alcohol abuse disorder is not a symptom of or related to the Veteran’s PTSD. However, the rationale was solely based on the Veteran’s cessation of alcohol in 2016. The January 2021 VA examiner opined that not only is the Veteran’s alcohol disorder a result of PTSD, but that these symptoms were included in the impairment levels of the previous exams. The Board finds the January 2021 VA opinion to be of high probative value. Additionally, a review of the file supports the VA examiner’s conclusion that symptoms of the Veteran’s alcohol abuse disorder have been included when assessing the level of severity of the Veteran’s PTSD. The most probative evidence of record illustrates that the severity of the Veteran’s PTSD with alcohol abuse disorder warrants a 50 percent rating, and no higher. The Veteran’s PTSD with alcohol abuse disorder was not manifested by symptomatology more nearly approximating occupational and social impairment with deficiencies in most areas 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. In fact, the December 2014 and July 2020 VA examiners both concluded that the Veteran’s level of impairment resulted in occupational and social impairment with 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, consistent with a 30 percent disability rating. Throughout the appeal period the Veteran’s PTSD with alcohol abuse disorder has manifested in anxiety, depressed mood, irritability, sleep disturbance, hypervigilance, difficulty with mild memory issues, startle response, avoidance of crowds. anxiety, and suspiciousness—all contemplated by the currently assigned 50 percent rating. At no time during the appeal period did the Veteran’s PTSD with alcohol abuse disorder result in symptoms consistent with a 70 percent rating, such 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, or effectively or impaired impulse control. The Veteran has been in a stable, committed marriage with his wife of over 40 years. He has four adult children and six grandchildren. He is close with his family and prefers spending time with them. He has his bachelor’s degree in History and Political Science. He had a successful government career with the Department of Energy and retired with a buyout in 2000 as a GS-13. He owns property in Maryland and Florida and keeps busy with housework and working on cars. There is no doubt that his PTSD with alcohol abuse disorder impacts his daily activities. However, the 50 percent disability rating contemplates for this impact. Therefore, the Board finds that the Veteran’s PTSD with alcohol abuse disorder more nearly approximates the criteria for a rating of 50 percent and no higher. In arriving at this conclusion, the Board has carefully considered the lay assertions of the Veteran, as well as the argument presented in the February 2021 Brief. The Board understands his belief that his symptoms warrant a disability rating higher than 50 percent. However, the Board considered both the lay and medical evidence in reaching this conclusion. Even considering the Veteran’s reports, the most probative evidence shows occupational and social impairment as evidenced by his 50 percent rating, but it does not show that he has occupational and social impairment with deficiencies in most areas. The Board finds that the Veteran’s deficiencies must be “due to” symptoms listed for that rating level, “or others of similar severity, frequency, and duration.” Vasquez-Claudio, 713 F.3d at 117. The symptoms noted during the VA examinations during the appeal period are of similar nature, severity, frequency, and duration of those noted under the criteria for a 50 percent rating. As the preponderance of the evidence is against the claim for a disability rating higher than 50 percent at any time during the appeal period, the benefit of the doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. TDIU Total disability will be considered to exist where there is present any impairment of mind and body that is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that the Veteran meets the schedular requirements. If there is only one service-connected disability, this disability should be rated at 60 percent or more; if there are two or more disabilities, at least one should be rated at 40 percent or more with sufficient additional service-connected disability to bring the combination to 70 percent or more. 38 C.F.R. § 4.16(a). To meet the requirement of “one 60 percent disability” or “one 40 percent disability,” the following will be considered as one disability: (1) disability of one or both lower extremities, including the bilateral factor, if applicable; (2) disabilities resulting from one common etiology; (3) disabilities affecting a single body system; (4) multiple injuries incurred in action; and (5) multiple disabilities incurred as a prisoner of war. Id. Substantially gainful employment is defined as work which is more than marginal, and which permits the individual to earn a living wage. Moore v. Derwinski, 1 Vet. App. 356 (1991). Where these percentage requirements are not met, entitlement to benefits on an extraschedular basis may be considered when the Veteran is unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities, and consideration is given to the Veteran’s background including his or her employment and educational history. 38 C.F.R. § 4.16(b). The Board does not have the authority to assign an extraschedular total disability rating for compensation purposes based on individual unemployability in the first instance. Bowling v. Principi, 15 Vet. App. 1 (2001). In a recent decision, the United States Court of Appeals for Veterans Claims (Court) provided guidance in defining “unable to secure and follow a substantially gainful occupation.” The Court found that 38 C.F.R. § 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 following: 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). In determining whether unemployability exists, consideration may be given to the Veteran’s level of education, special training, and previous work experience, but it may not be given to his or her age or to any impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. The appeal period commences May 7, 2009. Prior to August 3, 2016, the Veteran was service connected for hearing loss at 0 percent, PTSD with alcohol abuse disorder at 50 percent, and prostate cancer at 0 percent. His combined rating prior to August 3, 2016 was 50 percent. The schedular threshold requirement for establishing entitlement to TDIU has not been met. The Veteran did have at least one disability ratable at 40 percent or more, but there are no additional service-connected disabilities to bring the combined rating to 70 percent or more. As such, 38 C.F.R. § 4.16(a) is not for application. Although the Veteran’s service-connected disabilities did not meet the threshold percentage requirement to establish eligibility for TDIU pursuant to 38 C.F.R. § 4.16(a), the Board must still determine whether his service-connected disabilities preclude him from engaging in substantially gainful employment on an extra-schedular basis. See 38 C.F.R. § 4.16(b). Nevertheless, rating boards should submit to the Director, Compensation Service, for extraschedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities but who fail to meet the percentage standards set forth in 38 C.F.R. § 4.16(a). Consideration of an extraschedular rating under the provisions of 38 C.F.R. § 4.16(b) is not warranted. As discussed more fully below, the most probative evidence in this case fails to show that the Veteran’s service-connected disabilities alone rendered him unable to secure and follow substantially gainful employment, prior to August 3, 2016. Referral for consideration of a total rating based on unemployability due to service-connected disabilities is not warranted. As will be described below the question for the Board is whether a TDIU is warranted prior to August 3, 2016 only. As of August 3, 2016, the Veteran’s prostate cancer has been rated as 100 percent disabling and he has been in receipt of special monthly compensation (SMC). As such the claim of entitlement to a total disability based on individual unemployability, as of August 3, 2016, has been rendered moot by the award of a 100 percent schedular evaluation and by the award of SMC “s.” See Bradley v. Peake, 22 Vet. App. 280 (2008). Accordingly, the Board will assess whether TDIU is warranted at any time between May 2009 and August 2, 2016. As referenced in the July 2019 Board remand, the Court agreed with the Veteran and found that the issue of TDIU had been raised. The matter was remanded for additional development in July 2019 and October 2020. In December 2019 and in in October 2020 VA sent the Veteran a letter requesting that he complete the VA Form 21-8940 for his TDIU claim. To date this form has not been submitted. form. The Board reminds the Veteran and his representative that the duty to assist is not a “one-way street.” Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). August 2016 and October 2016 VA treatment records show that he remains active, mowing the grass and working on his cars. A December 2017 VA examination shows that with proper hearing and or adaptive devices he would have no work restrictions related to his hearing loss or tinnitus. As stated above, the Veteran retired in 2000. As clearly noted in the July 2020 examination, he elected to retire and made no contentions that his lack of employment had to do with his PTSD with alcohol abuse disorder or any other service-connected disability. He clearly reported that he has not attempted to find work since 2000 and considers himself fully retired. He was busy working on his home in Maryland and his home in Florida. The Veteran has not provided any probative evidence that his service-connected disabilities interfered with his ability to obtain or maintain gainful employment. In fact, the Veteran has not made any specific contentions related to how he feels his service-connected disabilities impacted his ability to work or whether he feels his service-connected disabilities warrant a TDIU. The Veteran, without regard to advancing age and nonservice-connected disabilities, can perform the physical and mental actions required for substantial employment during the applicable appeal period. He is college educated and had a successful career at the Department of Energy for 25 years. As reported during the December 2014 VA examination, he retired back in 2000 in a planful way and has not worked since. His PTSD with alcohol abuse disorder may have impacted his ability to perform job related tasks, but he remained consistently employed full time, and during the July 2020 VA examination, he denied any significant work-related issues. He reported a normal progression in government employment and retirement as a GS-13 after a buyout in 2000. He even stated that his supervisor put him in for a promotion to GS-14. Although the Veteran may sincerely believe his service-connected PTSD with alcohol abuse disorder, prostate cancer, or other service-connected disabilities rendered him unemployable prior to August 3, 2016, the most probative evidence of record does not show that he was unable to sustain employment based on his service-connected PTSD with alcohol abuse disorder or other service-connected disabilities. Indeed, the Veteran was employed full time since leaving the military and was able to maintain the same employment for 25 years, despite reporting a history of difficulties with supervisors in his work environments. The Board does not doubt that the Veteran’s service-connected disabilities had some impact on his employability. However, the 50 percent schedular evaluation for his service-connected PTSD with alcohol abuse disorder and 50 percent combined evaluation in effect prior to August 3, 2016, recognizes significant industrial impairment resulting from his disorders. For the reasons and bases set forth above, the preponderance of the evidence is against finding that prior to August 3, 2016 the Veteran’s service-connected disabilities are of such severity to preclude his participation in any form of substantially gainful employment, and referral for extraschedular consideration is not warranted. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Talamantes, 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.