Citation Nr: 21031681 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 12-31 250A DATE: May 24, 2021 ORDER For the initial rating period prior to January 13, 2017, a 70 percent rating, but no higher, for posttraumatic stress disorder (PTSD) is granted. For the initial rating period prior to January 13, 2017, a total disability rating based on individual unemployability (TDIU) as due to the service-connected PTSD disability is granted. For the appeal period prior to January 13, 2017, special monthly compensation (SMC) pursuant to 38 U.S.C. § 1114 (s) is granted. FINDINGS OF FACT 1. For the appeal period prior to January 13, 2017, the Veteran's PTSD disability more nearly approximated occupational and social impairment, with deficiencies in most areas, but has not resulted in total social impairment. 2. For the appeal period prior to January 13, 2017, the evidence is at least in equipoise as to whether the Veteran's service-connected PTSD disability has prevented him from obtaining or maintaining a substantially gainful occupation. 3. The Veteran is already in receipt of SMC for the appeal period beginning January 13, 2017. 4. For the rating period prior to January 13, 2017, the Veteran's TDIU, due to the service connected PTSD disability, is a service-connected disability rated as total, and his other service-connected disabilities combine to a 60 percent rating. CONCLUSIONS OF LAW 1. For the entire initial rating period prior to January 13, 2017, the criteria for a 70 percent rating, but no higher, for PTSD are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9411 2. Prior to January 13, 2017, the criteria for a TDIU due solely to the service-connected PTSD disability, are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. 3. Prior to January 13, 2017, the criteria for SMC at the housebound rate are met. 38 U.S.C. §§ 1114 (s), 5103, 5107; 38 C.F.R. §§ 3.102, 3.350. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1965 to December 1969. The Veteran is a recipient of the Vietnam Service Medal and Vietnam Campaign Medal for his service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from rating decisions issued in November 2010 and September 2012 by a Department of Veterans Affairs (VA) Regional Office. In an October 2018 decision, the Board awarded the Veteran a rating of 50 percent, prior to January 13, 2017 for his service-connected PTSD, and an earlier effective date for the award of a TDIU. In a November 2018 rating decision, the Agency of Original Jurisdiction (AOJ) awarded an effective date of May 2, 2007, the last date of employment, for TDIU. Thereafter, the Veteran appealed the decision to the Court of Appeals for Veterans Claims (Court). In January 2019, the Court granted the Veteran's and the Secretary of VA's (parties') Joint Motion for Remand (JMR), which vacated and remanded the Board's October 2018 decision. In January 2020 and September 2020, the Board remanded the claims for additional development and they now return for further appellate review. PTSD Rating Prior to January 13, 2017 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. 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 in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant's favor. 38 C.F.R. § 4.3. When there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. Separate ratings can be assigned for separate periods based on the facts found a practice known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The Veteran's PTSD is evaluated as 50 percent disabling as of November 29, 2007, the date of service connection, and 70 percent disabling as of January 13, 2017, pursuant to the criteria of DC 9411, which provides that such disability is evaluated pursuant to the General Rating Formula for Mental Disorders at 38 C.F.R. § 4.130. Under DC 9411, a 50 percent rating is warranted when there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairments of short-and long-term memory; impaired judgment; impaired abstract thinking; disturbance of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. Id. A 70 percent evaluation is warranted when there is occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; 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); inability to establish and maintain effective relationships. Id. A 100 percent evaluation 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. Id. The United States Court of Appeals for the Federal Circuit has held that 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, 11617 (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 11718; 38 C.F.R. § 4.130, DC 9411. 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). In Bankhead v. Shulkin, 29 Vet. App. 10 (2017), the Court held that the language of the General Rating Formula "indicates that the presence of suicidal ideation alone may cause occupational and social impairment with deficiencies in most areas." The Board notes that the revised DSM-5, which, among other things, eliminates Global Assessment of Functioning (GAF) scores, applies to appeals certified to the Board after August 4, 2014, as is the case here. See 79 Fed. Reg. 45, 093 (August 4, 2014). Consequently, the Board will not consider the previously assigned GAF scores in determining the outcome of this case. See Golden v. Shulkin, 29 Vet. App. 221 (2018). As an initial matter, the Board notes that the parties to the JMR found that the October 2018 decision failed to address relevant evidence of record indicating that the Veteran reported auditory hallucinations and suicidal ideations. Additionally, the Board did not adequately discuss why a May 2012 VA examiner's opinion outweighed the lay statement by the Veteran's daughter and the opinion of the Veteran's social worker. Finally, the parties agreed that the Board erred when it failed to ensure VA obtained outstanding VA treatment records from October 2009 to October 2010, which has now been associated with the claims file. Such evidence will be discussed herein. Turning to the evidence of record, VA treatment records reveal that the Veteran began bi-weekly therapy sessions with a social worker in September 2007. Such sessions were later reduced to monthly sessions, but continued for the duration of the appeal period. At the initial consultation, in September 2007, the Veteran reported a history of depression, lack of anger control, and sleep disturbances. The mental status examination at the time was normal, with the exception of a sad mood as he reflects on past stressors. Throughout the appeal period, the Veteran reported symptoms of depressed mood, anxiety, difficulty being around large crowds, difficulty sleeping, difficulty coping with the loss of family members, and feelings of regret, during his individual sessions. The Veteran also consistently reported close relationships with his wife, children, and mother. Moreover, mental status examinations during these sessions were all normal, and the Veteran denied current suicidal intentions. VA treatment records also indicate that the Veteran began participating in group therapy in February 2009. While therapy reports note that the Veteran engaged in conversations and was attentive during the sessions; he also reported increased sleep disturbances due to group participation later that same month. The Veteran underwent a PTSD screening in November 2007. At the time, he reported symptoms of depression, hypervigilance, anxiety, social isolation, anger and irritability, intrusive thoughts, and sleep impairment. The examiner reported no occupational impairment as the Veteran recently retired after working 36 years as a coal miner. However, she did report some social impairment as he reported that he is uncomfortable around large crowds. A May 2008 letter from the Veteran's first VA social worker, stated that he was diagnosed with PTSD and endorsed symptoms of daily intrusive thoughts (with and without triggers), which produced feelings of depression and anger; insomnia, characterized by frequent disruptions of sleep throughout the night; depressed, and often tearful mood; decreased concentration; avoidance behaviors; anhedonia; feelings of guilt from past events; and angry, irritable outbursts. The social worker, who had been providing bi-weekly treatment, opined that these symptoms cause significant functioning impairment, both socially and with family. Moreover, she opined that, due to the severity of the symptoms, he was unable to maintain stable employment and is considered unemployable. In a May 2008 letter, a VA physician noted that the Veteran had diagnoses of PTSD and depression and, at the time, was not emotionally stable to handle the stress of a court trial. This letter was written in regard to an ongoing class action lawsuit against the Veteran's former employer, which the Veteran had no interest in participating. In this regard, VA treatment records during this time indicated that the Veteran was required to sit for depositions that lasted for up to 8 hours, which he described as "uncomfortable." In a July 2008 VA treatment record, the Veteran reported difficulty sleeping, "life-like" dreams and mild hallucinations of voices of Vietnamese children. In this regard, he reported that he recently ran out of his medication and attributed such symptoms as side effects to the discontinuation of his medication. Furthermore, he reported that he feels too dependent on the medication and wants to discontinue them. The mental health examination report notes that the Veteran denied suicidal ideations and auditory commands. Overall, the social worker reported that the Veteran was stable, from a depressive standpoint, and did not appear to be in acute distress at the time. Thereafter, in September 2008, the Veteran reported intentions to physically harm persons who damaged his pool by throwing rocks in it. In November 2008, he described a break-in at his neighbor's house where a drug addict attempted to rape the neighbor. The Veteran felt enraged and admitted that kept a firearm in close proximity for the remainder of the night and would have pistol-whipped or shot the drug addict. In an August 2009 VA treatment record, the Veteran indicated that he had four consecutive days with insomnia and heightened anxiety after attending a family reunion trip with his wife. During the trip, he reported that he was not involved with any activities because he was overwhelmed and unfamiliar with the area and culture of the people. Rather, he stayed in the hotel, away from the noise and the crowd. Thereafter, in September 2009, he reported that he feared he would have gotten physical with a misbehaving grandson, had he not been taking his medication. Later that same month, he reported gunshots outside his home which reminded him of being under attack in Vietnam. In July 2009, a statement by the Veteran's mother was associated with the claims file. She wrote that the Veteran has difficulty trusting others, which makes it difficult to form and maintain relationships. In an April 2011 statement, the Veteran's daughter wrote that he has issues being around crowds and tends to dissociate himself from everyone during these times. Specifically, she wrote that he was overwhelmed during her college graduation and had to excuse himself from the event. This has caused problems for the family as the Veteran cannot spend important memories with his children and grandchildren, and often alienates himself. In May 2012, the Veteran was afforded a VA examination. After an examination and full review of the claims file, the examiner opined that the Veteran's symptomatology resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. The Veteran reported that he lived with his wife, with whom he had been married for two decades at that time. He also reported to have good relationships with his children and his mother, with whom he visits regularly. However, he also stated that he did not really socialize with many people. The Veteran enjoys spending time outside, working in his garden, watching sports, hunting, and fishing. While he denied a history of drug or alcohol problems, he also reported that he consumes about a half a pint every day. However, he reported that such does not cause problems. Finally, he reported that he retired in 2007 after working as a coal miner for over three decades, due to his service-connected neuropathy disabilities. The VA examination report notes symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, and mild memory loss. Results of the mental status examination were normal, with the exception of dysphonic and tearful mood and sleep impairment. The Veteran denied panic attacks, suicidal ideations, auditory or visual hallucinations. Finally, while the Veteran reported that he was noticing memory problems, testing was normal, except for delayed recall. In March 2013, the Veteran reported that he had been talking to himself more often that in the past. Additionally, he acknowledged that he had been hearing voices in his head; however, he denied command voices and losing blocks of time. The Veteran denied suicidal intentions and visual hallucinations. In an April 2013 treatment record, the Veteran further described hearing mumbled voices and that sometimes he can hear what they are saying, and on occasion will talk back to them. In regard to suicidal ideations raised by the parties in the JMR, in October 2015, the Veteran reported that he does have suicidal plans, but denied a plan. At the time, he reported feeling and falling asleep. Additionally, as noted by the parties in the JMR in June 2016, the Veteran denied suicidal intent; however, he admitted that there are days where he thought of suicide as an option. Finally, in December 2016, the Veteran admitted that he has days when the pain is so bad that he wants to shoot himself. However, he reassured the medical provider at the time that he was not having those thoughts the day of the therapy session. VA treatment records prior to January 2017 continue to note symptoms of depressed mood, insomnia, mood swings, irritability, anxiety, flashbacks and nightmares, decreased appetite, and occasional suicidal thoughts, without plan or intent. The Veteran submitted a Disability Benefits Questionnaire in January 2017, which is the basis for his 70 percent rating. The examination report again notes that the Veteran has been married for over two decades, previously worked as a coal miner and the medication he is taking, includes Bupropion and Trazadone. The Veteran endorsed symptoms of depressed mood, anxiety, suspiciousness, panic attacks more than once weekly, chronic sleep impairment, mild memory loss, impairment of short- and long-term memory loss, circumstantial, circumlocutory or stereotyped speech, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, and an inability to establish and maintain effective relationships. Based on the evidence of record, the Board finds that the Veteran's PTSD symptoms have remained relatively consistent throughout the rating period on appeal. Further, the Board finds that the evidence of record is at least in equipoise as to whether the Veteran's PTSD disability more nearly approximates the 70 percent rating criteria for the rating period prior to January 13, 2017. The Veteran has been found to have difficulty in establishing and maintaining effective relationships, and has reported feelings of being overwhelmed with large crowds and large family functions. The Veteran's daughter indicated that the Veteran disassociated himself and often missed important family moments. The May 2008 letter by the VA social worker indicates that his symptomatology significantly impairs family and social functioning. The Veteran has also endorsed irritability and difficulties controlling his anger. The Board also notes that the Veteran reported thoughts of suicide in October 2015, June 2016, and December 2016. The Board finds that some of these symptoms are specifically included in the 70 percent rating criteria under DC 9411 and more nearly approximate occupational and social impairment, with deficiencies in most areas. Accordingly, and resolving reasonable doubt in his favor, a 70 percent rating for PTSD is warranted for the rating period prior to January 13, 2017. Nonetheless, for the rating period prior to January 13, 2017, PTSD symptomatology does not more nearly approximate the criteria for a 100 percent rating. The Veteran's PTSD symptoms do not more nearly approximate total social impairment and do not contemplate the symptomology considered under the 100 percent rating criteria. Specifically, the records show that the Veteran was married throughout the entirety of the appeal period, he maintained relationships with his adult children, and he often visited with his mom. The Board also acknowledges the May 2008 social worker's assertion that the Veteran's PTSD symptomatology renders him unemployable. However, the Board notes that the treatment reports during such sessions does not indicate that the Veteran retired from his 36-year long career as a coal miner due to his symptomatology. Moreover, the Veteran did not assert that he was unable to find or maintain employment throughout the appeal period as a result of his PTSD. Accordingly, the Board accords little probative weight to the social worker's opinion regarding occupational impact. In reaching this conclusion regarding the degree of occupational and social impairment, the Board has considered all the Veteran's psychiatric symptoms and impairment, whether or not the symptom is specifically listed in the rating criteria, considering such symptoms as like or similar to the symptoms in the rating criteria. With this in mind, the evidence shows that the Veteran's overall PTSD picture is already adequately contemplated by the 70 percent rating granted herein. The Veteran does suffer from depressed mood, anxiety, suspiciousness, panic attacks more than once weekly, chronic sleep impairment, mild memory loss, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, and an inability to establish and maintain effective relationships, but these symptoms are specifically contemplated in the 30, 50, and 70 percent rating criteria. The same is true with the rare suicidal thoughts, difficulty in adapting to stressful circumstances, and inability to establish and maintain effective relationships, which are symptoms specifically contemplated under the 70 percent PTSD rating. For these reasons, the evidence does not demonstrate total social impairment and does not more nearly approximate the symptoms contemplate under the 100 percent rating criteria. Accordingly, a 70 percent rating for PTSD, but no higher, is warranted for the period prior to January 13, 2017. TDIU prior to January 13, 2017 As an initial matter, the Board notes that the Veteran is currently in receipt of a TDIU, effective date of May 2, 2007, based upon the collective impact of the Veteran's service-connected disabilities. However, beginning January 13, 2017, the RO granted SMC based on a finding that the Veteran's TDIU was based solely on his PTSD disability, and he had additional service-connected disabilities rated as 60 percent or more. See November 2018 Rating Decision Codesheet. In August 2019, the Court granted the parties JMR finding that the Board did not adequately address whether entitlement to a TDIU prior to January 13, 2017, could be established solely upon the impact of the Veteran's PTSD. A veteran may be awarded a TDIU upon a showing that he is unable to secure or follow a substantially gainful occupation due solely to impairment resulting from his service-connected disabilities. 38 U.S.C. § 1155 ; 38 C.F.R. §§ 3.340, 3.341, 4.16. A total rating 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, if there is only one such disability, this disability shall be ratable at 60 percent or more, or if there are two or more disabilities, there shall be at least one ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). Consideration may be given to a veteran's level of education, special training, and previous work experience in arriving at a conclusion, but not to his age or the impairment caused by any non service-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. The test of individual unemployability is whether a veteran, as a result of his or her service-connected disabilities alone, is unable to secure or follow any form of substantially gainful occupation which is consistent with his education and occupational experience. 38 C.F.R. §§ 3.321, 3.340, 3.341, 4.16. Pursuant to the Board's decision herein, the Veteran is now service-connected for PTSD, evaluated as 70 percent disabling as of November 11, 2007. Therefore, the Veteran meets the schedular criteria for a TDIU based solely on his service-connected PTSD for the entire appeal period. In his October 2009 Application for Increased Compensation Based on Unemployability (VA Form 21-8940), the Veteran indicated that he last worked full time as a coal miner in May 2007, which is when he became too disabled to work. In regard to his education, the Veteran reported that he completed two years of college and had completed training in carpentry and business. In regard to the Veteran's PTSD, in the May 2008 letter, the VA social worker, C.G., reported that the Veteran's PTSD rendered him unemployable due to his symptomatology. However, the Board also notes that, at a November 2007 PTSD screening, a different VA social worker noted that the Veteran's PTSD did not result in occupational impairment, as the Veteran was gainfully employed for approximately 36 years as a coal miner. At the May 2012 VA examination, the examiner opined that the Veteran's PTSD symptomatology resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. Pursuant to the September 2020 remand, a VA psychiatric examination was obtained in February 2021. At that time, the examiner indicated that the veteran's intrusive thoughts and flashbacks impaired his attention and ability to focus. His irritability would interfere with social interactions with co-workers or supervisors. His diminished concentration would impair ability to initiate and complete repetitive tasks. A symptom of PTSD is sleep disturbance, which impairs ability to maintain a normal schedule and be on time due to the resulting fatigue. In a January 2017 VA psychiatric examination, the examiner noted that the Veteran's PTSD resulted in significant issues with anger, recurrent thoughts and dreams and social isolated. His ability to control his emotions, maintain effective concentration and interact with others significantly impaired his functional abilities. The Board finds that the evidence is at least in equipoise as to whether the Veteran's service-connected PTSD disability has prevented him from maintaining a substantially gainful occupation for the appeal period prior to January 13, 2017. Therefore, in consideration of the evidence discussed above, in addition to the Veteran's work history and educational level, and resolving reasonable doubt in his favor, entitlement to a TDIU based solely on the Veteran's PTSD disability is warranted for the rating period prior to January 13, 2017. The Board finds that any claim of entitlement to a TDIU is moot for the period beginning from January 13, 2017. In this regard, the Veteran has already been granted TDIU based on his PTSD disability and has been granted an award SMC based on additional service-connected disabilities independently ratable at 60 percent or more. See November 2018 Rating Decision Codesheet. As the Veteran has already been awarded SMC and therefore would have no need to establish a TDIU rating in order to qualify for SMC under 38 U.S.C. § 1114 (s). Therefore, the TDIU claim is moot for the appeal period from January 13, 2017 SMC prior to January 13, 2017 The Court has held that VA has a "well-established" duty to maximize a claimant's benefits. See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011); AB v. Brown, 6 Vet. App. 35, 38 (1993); see also Bradley v. Peake, 22 Vet. App. 280 (2008). This duty to maximize benefits requires VA to assess all of a claimant's disabilities to determine whether any combination of disabilities establishes entitlement SMC under 38 U.S.C. § 1114. See Bradley, 22 Vet. App. 280, 294 (2008) (finding that SMC "benefits are to be accorded when a Veteran becomes eligible without need for a separate claim"). SMC is payable where the Veteran has a single service connected disability rated as 100 percent and (1) has additional service connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems, or (2) is permanently housebound by reason of service-connected disability or disabilities. 38 U.S.C. § 1114 (s); 38 C.F.R. § 3.350 (i). Subsection 1114 (s) requires that a disabled Veteran whose disability level is determined by the ratings schedule must have at least one disability that is rated at 100 percent in order to qualify for the special monthly compensation provided by that statute. Under the law, subsection 1114 (s) benefits are not available to a Veteran whose 100 percent disability rating is based on multiple disabilities, none of which is rated at 100 percent disabling. The Court has held that although a TDIU may satisfy the "rated as total" element of section 1114 (s), a TDIU based on multiple underlying disabilities cannot satisfy the section 1114 (s) requirement of "a service-connected disability" because that requirement must be met by a single disability. The Court declared, however, if a Veteran were awarded a TDIU based on multiple underlying disabilities and then later receives a schedular disability rating for a single, separate disability that would, by itself, create the basis for an award of a TDIU, that the order of the awards was not relevant to the inquiry as to whether any of the disabilities alone would render the Veteran unemployable and thus entitled to a TDIU rating based on that condition alone. Buie v. Shinseki, 24 Vet. App. 242, 250 (2010). In this case, the Board notes that as a result of this decision, a TDIU due to service connected PTSD has been granted for the rating period prior to January 13, 2017. Thus, for SMC purposes, this disability satisfied the requirement of a "service-connected disability rated as total." See Buie v. Shinseki, 24 Vet. App. 242, 251 (2011); see also Bradley v. Peake, 22 Vet. App. 280, 293 (2008). Because the Veteran has a single service-connected disability rated as total (i.e., his TDIU is due solely to his service-connected PTSD disability), and has additional service-connected disabilities that are independently rated as at least 60 percent disabling, the criteria for SMC at the housebound rate have been met for the rating period prior to January 13, 2017. Thus, in light of the Court's decisions in Bradley and in Buie, entitlement to SMC at the housebound rate under 38 U.S.C. § 1114 (s) is granted for the rating period prior to January 13, 2017. Romina A. Casadei Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Waite 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.