Citation Nr: 22018773 Decision Date: 03/30/22 Archive Date: 03/30/22 DOCKET NO. 20-02 534 DATE: March 30, 2022 ORDER For the entire increased rating period on appeal, from October 17, 2018 through October 29, 2020, an increased disability rating of 70 percent, but no higher, for service connected posttraumatic stress disorder, to include alcohol use disorder, (PTSD) is granted. From January 1, 2020 through October 29, 2020, a total disability rating for compensation purposes based on individual unemployability due to service connected disability (TDIU) is granted. FINDINGS OF FACT 1. During the increased rating period on appeal from October 17, 2018 through October 29, 2020, the severity, frequency, and duration of the symptoms of the service-connected PTSD more nearly approximated occupational and social impairment with deficiencies in most areas. 2. From January 1, 2020 through October 29, 2020, the Veteran was unable to maintain substantially gainful employment as a result of the service connected PTSD. CONCLUSIONS OF LAW 1. Resolving reasonable doubt in the Veteran's favor, from October 17, 2018 through October 29, 2020, the criteria for an increased disability rating of 70 percent, but no higher, for the service connected PTSD have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 3.326(a), 4.3, 4.7, 4.130, Diagnostic Code 9411. 2. Resolving reasonable doubt in the Veteran's favor, from January 1, 2020 through October 29, 2020, the criteria for a TDIU have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.340, 3.341, 4.15, 4.16, 4.18, 4.19, 4.25. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran, who is the appellant, had active service from March 1964 to August 1967. This matter came before the Board of Veterans' Appeals (Board) on appeal from multiple Department of Veterans Affairs (VA) Regional Office (RO) rating decisions. The Veteran's claim for an increased disability rating was received on October 17, 2018. During the course of this appeal, in a December 2020 rating decision, the Agency of Original Jurisdiction (AOJ) granted a total 100 percent disability rating for the service-connected PTSD from October 30, 2020. As such, the remaining question on appeal as to the PTSD rating issue is entitlement to an increased disability rating in excess of 50 percent for the rating period from October 17, 2018 through October 29, 2020. The Veteran testified at a December 2021 virtual Board hearing before the undersigned Veterans Law Judge. The hearing transcript has been associated with the record. The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107, 5126; 38 C.F.R. §§ 3.102, 3.159, 3.326(a). As the instant Board decision grants a TDIU for the rating period from January 1, 2020 through October 29, 2020, which, for the reasons discussed below, is a complete grant as to that issue, no further discussion of the duties to notify and assist is necessary as to the TDIU issue. As to the PTSD rating issue, concerning the duty to notify, the record reflects that the Veteran received adequate VCAA notice during the course of this appeal. Regarding the duty to assist, the record reflects that VA obtained all relevant documentation and obtained an adequate VA mental health examination. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). For these reasons, the Board finds that the duties to notify and assist the Veteran in this case have been fulfilled. Neither the Veteran nor the evidence has raised any specific contentions regarding the duties to notify or assist. 1. An Increased Disability Rating of 70 Percent for PTSD, for the Rating Period from October 17, 2018 through October 29, 2020, is Granted Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) found in 38 C.F.R. Part 4. 38 U.S.C. § 1155. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. Where there is a question as to which of two disability ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the rating of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a veteran's service-connected disabilities. 38 C.F.R. § 4.14. It is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes; however, the critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); Lyles v. Shulkin, 29 Vet. App. 107 (2017) (holding that 38 C.F.R. § 4.14 prohibits compensating a veteran twice for the same symptoms or functional impairment). When an unlisted condition is encountered it will be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. Conjectural analogies will be avoided, as will the use of analogous ratings for conditions of doubtful diagnosis, or for those not fully supported by clinical and laboratory findings. Nor will ratings assigned to organic diseases and injuries be assigned by analogy to conditions of functional origin. 38 C.F.R. § 4.20. Where an increase in an existing disability rating is at issue, the present level of disability is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). The relevant temporal focus for adjudicating an increased rating claim is on the evidence concerning the state of the disability from the time period one year before the claim was filed until VA makes a final decision on the claim. Hart v. Mansfield, 21 Vet. App. 505 (2007). Under Diagnostic Code 9411, a 50 percent rating will be assigned for a mental disability which is productive of occupational and social impairment with reduced reliability and productivity due to symptoms such as flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks occurring 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 or forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating will be assigned for occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood due to symptoms such 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); and an inability to establish and maintain effective relationships. A 100 percent rating will be assigned for total occupational and social impairment due to symptoms such as gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, a persistent danger of hurting herself or others, an intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene), disorientation to time or place, and memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130. The Secretary of VA, acting within the authority to adopt and apply a schedule of ratings, chose to create one general rating formula for mental disorders. 38 U.S.C. § 1155; see 38 U.S.C. § 501; 38 C.F.R. § 4.130. By establishing one general formula to be used in rating more than 30 psychiatric disorders, there can be no doubt that the Secretary of VA anticipated that any list of symptoms justifying a particular rating would in many situations be either under- or over inclusive. The Secretary's use of the phrase "such symptoms as," followed by a list of examples, provides guidance as to the severity of symptoms contemplated for each rating, in addition to permitting consideration of other symptoms, particular to each veteran and disorder, and the effect of those symptoms on the claimant's social and work situation. This construction is not inconsistent with Cohen v. Brown, 10 Vet. App. 128 (1997). See Mauerhan v. Principi, 16 Vet. App. 436, 442 (1992). The evidence considered in determining the level of impairment under 38 C.F.R. § 4.130 is not restricted to the symptoms provided in the diagnostic code. Instead, the rating specialist is to consider all symptoms of a claimant's condition that affect the level of occupational and social impairment, including, if applicable, those identified in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). See 38 C.F.R. § 4.126. If the evidence demonstrates that a claimant suffers symptoms or effects that cause occupational or social impairment equivalent to what would be caused by the symptoms listed in the diagnostic code, the appropriate, equivalent rating will be assigned. The schedular rating criteria rate by analogy psychiatric symptoms that are "like or similar to" those explicitly listed in the schedular rating criteria. Mauerhan, 16 Vet. App. at 443. The Federal Circuit has embraced the Mauerhan interpretation of the criteria for rating psychiatric disabilities. Sellers v. Principi, 372 F.3d 1318, 1326 (Fed. Cir. 2004). In Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (2013), the Federal Circuit held that VA "intended the General Rating Formula to provide a regulatory framework for placing veterans on a disability spectrum based upon their objectively observable symptoms." The Federal Circuit stated 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." It was further noted that "§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas." See also Bankhead v. Shulkin, 29 Vet. App. 10 (2017) (indicating that the Board should consider the severity, frequency, and duration of the signs and symptoms of a mental disorder when determining the appropriate rating). At the outset, the Board will address the rating period on appeal. As discussed in the introduction, VA received the Veteran's claim for an increased disability rating on October 17, 2018. Review of the record does not reflect that the Veteran first became entitled to an increased disability rating during the one-year lookback period from October 17, 2017 through October 17, 2018. 38 C.F.R. § 3.400. Also as discussed above, during the course of this appeal, in a December 2020 rating decision, the AOJ granted a total 100 percent disability rating for the service-connected PTSD from October 30, 2020. As such, the remaining question before the Board is entitlement to an increased disability rating in excess of 50 percent for the service-connected PTSD for the rating period from October 17, 2018 through October 29, 2020. Having reviewed the evidence of record, lay and medical, the Board finds that, from October 17, 2018 through October 29, 2020, the severity, frequency, and duration of the symptoms of the service-connected PTSD more nearly approximated occupational and social impairment with deficiencies in most areas to meet the criteria for a 70 percent disability rating. A VA mental health examination in November 2018 assessed that the PTSD symptoms manifested as difficulty adapting to stressful circumstances (including work or a worklike setting), which is contemplated by the 70 percent VA rating criteria. While the Veteran was still working at that time, it was noted that the Veteran's business had notably declined over the past two years due to worsening PTSD symptoms. The above finding is supported by the Veteran's testimony at the December 2021 virtual Board hearing. At that time, the Veteran credibly testified to having difficulty working with others due to the service-connected PTSD symptoms. The Veteran also testified about a confrontation he had with a loan officer when working on a loan closing for a client. VA received a lay statement from the Veteran's now ex-wife in October 2018. Per the lay statement, the Veteran, seemingly out of nowhere, would begin to "rage" at the wife and/or son. As the Veteran's anger would manifest with no warning, the wife and son would often walk on pins and needles around the Veteran to avoid another anger explosion. The Board finds such evidence consistent with a finding of impaired impulse control, to include unprovoked irritability with periods of violence, which is contemplated by the 70 percent VA mental health rating criteria. At the December 2021 virtual Board hearing, the Veteran credibly testified to having regular bouts of severe depression, which is consistent with a finding of near-continuous depression affecting the ability to function independently. Such regular and severe depression is contemplated by the 70 percent rating criteria. After a review of all the evidence, lay and medical, the Board finds that, from October 17, 2018 through October 29, 2020, the severity, frequency, and duration of the symptoms of the service-connected PTSD more nearly approximated occupational and social impairment with deficiencies in most areas, as required for a disability rating of 70 percent under Diagnostic Code 9411. The evidence supports that, during the increased rating period on appeal, the PTSD symptoms manifested as difficulty adapting to stressful circumstances, impaired impulse control, and near-continuous depression affecting the ability to function independently, which are specifically contemplated by the 70 percent rating criteria. For these reasons, and resolving all reasonable doubt in favor of the Veteran, the Board finds that the lay and medical evidence shows that an increased disability rating of 70 percent is warranted for the service connected PTSD for the increased rating period from October 17, 2018 through October 29, 2020. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7, 4.130, Diagnostic Code 9411. The Board has also considered whether a 100 percent total disability rating was warranted at any point during the increased rating period from October 17, 2018 through October 29, 2020. Having reviewed the evidence of record, lay and medical, the Board finds that, for the increased rating period on appeal from October 17, 2018 through October 29, 2020, the severity, frequency, and duration of the symptoms of the service connected PTSD did not manifest as total occupational and social impairment. Per a September 2020 VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability, the Veteran advanced both last working full time and becoming too disabled to work on December 31, 2019. As the evidence shows that the Veteran was substantially gainfully employed until December 31, 2019, the evidence does not show total occupational impairment prior to January 1, 2020. In this decision the Board finds that the Veteran was rendered unemployable due to service-connected PTSD from January 1, 2020; however, the evidence does not support that the Veteran had total social impairment during the rating period from October 17, 2018 through October 29, 2020. Per the now ex wife's October 2018 lay statement, at that time the Veteran had an ongoing relationship with his half-brother. It was noted that the Veteran would reach out to his children from an earlier relationship; however, the children would not respond to his efforts. At the time of the November 2018 VA mental health examination, the Veteran conveyed having a "great" relationship with his son from his most recent marriage. The Veteran also reported having a generally positive relationship with a daughter from a previous relationship. Per a subsequent May 2019 VA treatment record, the Veteran conveyed having a "good and positive" relationship with his son. At the December 2021 virtual Board hearing, the Veteran testified to being able to complete multiple telephone employment interviews and one in-person interview since ceasing work at the end of December 2020. Prior to January 1, 2020, the Veteran was substantially gainfully employed, and, during the entire increased rating period from October 17, 2018 through October 29, 2020, the Veteran was able to maintain a good relationship with his son and a few others and engage in multiple employment interviews, both by phone and in person. The evidence shows that during the increased rating period from October 17, 2018 through October 29, 2020, the Veteran's occupational and social impairment was not total, as required for a 100 percent disability rating under Diagnostic Code 9411. The record does not show symptoms commonly associated with the 100 percent rating criteria during the rating period from October 17, 2018 through October 29, 2020, or that any of the diagnosed symptoms during that time period were of such severity, frequency, and/or duration to be comparable to the symptoms contemplated by the 100 percent rating criteria, or that symptoms caused total social and occupational impairment for any period. For these reasons, the Board finds that a total 100 percent disability rating is not warranted at any point during the increased rating period from October 17, 2018 through October 29, 2020. 38 C.F.R. §§ 4.3, 4.7. Extraschedular Claim Not Raised The Board finds that neither the Veteran nor the record has raised a claim for extraschedular rating under 38 C.F.R. § 3.321(b) for any period for the increased rating issue on appeal. See Thun v. Peake, 22 Vet. App. 111 (2008); Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record); Yancy v. McDonald, 27 Vet. App. 484, 494 (2016), citing Dingess v. Nicholson, 19 Vet. App. 473, 499 (2006), aff'd, 226 Fed. Appx. 1004 (Fed. Cir. 2007) (holding that when 38 C.F.R. § 3.321(b)(1) is not "specifically sought by the claimant nor reasonably raised by the facts found by the Board, the Board is not required to discuss whether referral is warranted"). 2. A TDIU from January 1, 2020 through October 29, 2020 is Granted 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. 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. Total disability may or may not be permanent. 38 C.F.R. § 3.340(a)(1). 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). 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. The service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue will be addressed in both instances. 38 C.F.R. § 4.16(a),(b). 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. 38 C.F.R. § 4.16(a). For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. 38 C.F.R. § 4.16(a). If a veteran's disabilities do not meet the objective combined rating percentage criteria of 38 C.F.R. § 4.16(a), it then becomes necessary to consider whether the criteria for referral for extraschedular consideration are met under § 4.16(b) criteria. It is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Submission to the Director, Compensation and Pension Service, for extraschedular consideration is warranted in all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in § 4.16(a). 38 C.F.R. § 4.16(b). Individual unemployability must be determined without regard to any non service connected disabilities or a veteran's advancing age. 38 C.F.R. §§ 3.341(a), 4.19; Van Hoose v. Brown, 4 Vet. App. 361 (1993). The sole fact that a veteran is unemployed or has difficulty obtaining employment is not enough. A high rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether a veteran is capable of performing the physical and mental acts required by employment, not whether a veteran can find employment. Id. at 361. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in a veteran's favor. 38 C.F.R. § 4.3. In Faust v. West, 13 Vet. App. 342 (2000), the United States Court of Appeals for Veterans Claims (Court) defined "substantially gainful employment" as an occupation that provides an annual income that exceeds the poverty threshold for one person, irrespective of the number of hours or days that a veteran actually works and without regard to a veteran's earned annual income. In Hatlestad v. Derwinski, 5 Vet. App. 524, 529 (1993), the Court held that the central inquiry in determining whether a veteran is entitled to a TDIU is whether a veteran's service connected disabilities alone are of sufficient severity to produce unemployability. The determination as to whether a total disability is appropriate should not be based solely upon demonstrated difficulty in obtaining employment in one particular field, which could also potentially be due to external bases such as economic factors, but rather to all reasonably available sources of employment under the circumstances. See Ferraro v. Derwinski, 1 Vet. App. 326, 331-332 (1991). In evaluating a veteran's employability, consideration may be given to the level of education, special training, and previous work experience in arriving at a conclusion, but not to age or impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. Marginal employment is not considered substantially gainful employment and generally is deemed to exist when a veteran's earned income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist in certain cases when earned annual income exceeds the poverty threshold on a facts-found basis. Consideration shall be given in all claims to the nature of the employment and the reason for termination. 38 C.F.R. § 4.16(a). Marginal employment, odd-job employment, and employment at half the usual remuneration is not incompatible with a determination of unemployability if the restriction to securing or retaining better employment is due to disability. 38 C.F.R. § 4.17(a). The ultimate issue of whether a TDIU should be awarded is not a medical issue, but rather is a determination for the adjudicator. See Moore v. Nicholson, 21 Vet. App. 211, 218 (2007) (ultimate question of whether a veteran is capable of substantial gainful employment is not a medical one; that determination is for the adjudicator), rev'd on other grounds sub nom, Moore v. Shinseki, 555 F.3d 1369 (Fed. Cir. 2009). Although VA must give full consideration, per 38 C.F.R. § 4.15, to "the effect of combinations of disability," VA regulations place responsibility for the ultimate TDIU determination on VA, not a medical examiner's opinion. Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013); 38 C.F.R. § 4.16(a); see also Smith v. Shinseki, 647 F.3d 1380, 1385-86 (Fed. Cir. 2011) (VA is not required to obtain an industrial survey from a vocational expert before making a TDIU determination but may choose to do so in an appropriate case). At the outset, the Board will address the TDIU rating period on appeal. As discussed above, per a September 2020 VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability, the Veteran wrote that he last worked full time and becoming too disabled to work on December 31, 2019. As VA has granted a 100 percent (total) disability rating for the PTSD from October 30, 2020, and as Buie v. Shinseki, 24 Vet. App. 242 (2010) and Bradley v. Peake, 22 Vet. App. 280 (2008) do not apply to the instant matter (because the Veteran has not asserted being unemployable due to service connected tinnitus, bilateral hearing loss, or right lower extremity lacerations alone), the question of a TDIU from October 30, 2020 has been rendered moot; therefore, the question before the Board is entitlement to a TDIU for the rating period from January 1, 2020 through October 29, 2020. For the rating period from January 1, 2020 through October 29, 2020, the service connected disabilities met the combined disability rating eligibility criteria for a TDIU under 38 C.F.R. § 4.16(a). In the instant decision the Board grants an increased disability rating of 70 percent for the service-connected PTSD for the rating period from October 17, 2018 through October 29, 2020. As such, during the relevant TDIU period on appeal, from January 1, 2020 through October 29, 2020, the service-connected disabilities resulted in a combined disability rating of at least 70 percent, with at least one disability rated at 40 percent or more (PTSD rated as 70 percent disabling). Having reviewed the evidence of record, lay and medical, the Board finds that, from January 1, 2020 through October 29, 2020, the Veteran was unable to maintain substantially gainful employment as a result of the service connected PTSD. Per the September 2020 VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability, the Veteran last worked as a self employed commercial real estate advisor/managing director on December 31, 2019. At the time of the November 2018 VA mental health examination, it was noted that, while the Veteran was still working with two clients, the business had notably declined over the previous two years due to the Veteran's increasing PTSD symptoms. A subsequent May 2019 VA treatment record noted that the Veteran was still working but that business was slow. The Veteran received a VA mental health examination in December 2020. At that time, the Veteran conveyed retiring due to PTSD anger and anxiety symptoms. Per the Veteran, both his friends and clients informed him that he was no longer "a decent businessman." At the conclusion of the examination, the VA examiner opined that the PTSD symptoms would result in difficulties with maintaining sustained attention and concentration throughout an eight-hour workday schedule due to distractibility, anxiety, and irritability. Further, it was noted that the Veteran had moderate to severe difficulties working with others, and severe difficulties with listening to negative and constructive feedback from others due to poor anger management skills, poor coping skills, low self-concept/esteem, and some dichotomous and inflexible thinking about "how things should be done" when working in more collaborative team settings. At the December 2021 virtual Board hearing, the Veteran credibly testified that the PTSD symptoms prevented adequately working with clients and remembering details of conversations. As discussed above, the Veteran's PTSD symptoms resulted in an altercation with a loan officer in the past. Based upon a review of the evidence discussed above, the Board finds that, from January 1, 2020 through October 29, 2020, the Veteran was unable to maintain substantially gainful employment as a result of the service connected PTSD. Per the report from a VA examiner in December 2020, the Veteran's PTSD symptoms had resulted in difficulty concentrating for an entire eight-hour workday, difficulty working with others, and difficulty accepting negative and constructive feedback. Further, the Veteran has credibly testified that the PTSD symptoms resulted in difficulty working with clients and had even caused anger-induced altercations with others. For the above reasons, and resolving reasonable doubt in favor of the Veteran, the Board finds that the service-connected PTSD symptoms and impairments prevented the Veteran from maintaining substantially gainful employment for the period from January 1, 2020 through October 29, 2020; therefore, the Board finds that a TDIU is warranted for the rating period from January 1, 2020 (day following the Veteran's last day of substantially gainful employment) through October 29, 2020 (day prior to the grant of a 100 percent total disability rating for PTSD). 38 C.F.R. §§ 3.340, 3.341, 4.16. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Blowers, 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.