Citation Nr: 23020522 Decision Date: 04/04/23 Archive Date: 04/04/23 DOCKET NO. 19-09 858 DATE: April 4, 2023 ORDER A compensable evaluation for bilateral hearing loss prior to April 5, 2019, is denied. A 30 percent evaluation for bilateral hearing loss is granted beginning April 5, 2019. An evaluation in excess of 30 percent for bilateral hearing loss beginning April 5, 2019, is denied. An evaluation in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied. Entitlement to a total disability rating based on individual unemployability (TDIU) prior to January 27, 2020, is granted. Entitlement to special monthly compensation based on statutory housebound status is granted effective April 7, 2021. FINDINGS OF FACT 1. Prior to March 2, 2021, the Veteran's bilateral hearing loss has been manifested by hearing acuity of no worse than Level I in the right ear and no worse than Level III in the left ear. 2. In his April 5, 2019 VA Form 9, the Veteran stated his hearing became worse. 3. Beginning March 2, 2021, the Veteran's bilateral hearing loss has been manifested by hearing acuity of no worse than Level VI in the right ear and no worse than Level VI in the left ear. 4. Posttraumatic stress disorder did not manifest as total occupational and social impairment. 5. Prior to January 27, 2020, the Veteran was unable to secure or follow a substantially gainful occupation due to his service-connected disabilities. 6. Beginning April 7, 2021, the Veteran has one disability rated as 100 percent disabling and other disabilities independently ratable as 60 percent disabling. CONCLUSIONS OF LAW 1. The criteria for a compensable evaluation for bilateral hearing loss prior to April 5, 2019, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 2. A 30 percent evaluation for bilateral hearing loss is granted, beginning April 5, 2019. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 3. The criteria for an evaluation in excess of 30 percent for bilateral hearing loss beginning April 5, 2019, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 4. The criteria for an evaluation in excess of 70 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. 5. The criteria for entitlement to a TDIU prior to January 27, 2020, have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.15, 4.16. 6. The criteria for entitlement to special monthly compensation based on statutory housebound status have been met. 38 U.S.C. § 1114 (s); 38 C.F.R. § 3.350(i). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1968 to April 1973. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Board remanded this matter for further evidentiary development. The requested development was completed, and the case has now been returned to the Board for further appellate action. VA's Duties to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA), in part, describes VA's duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5100, 5102, 5103, 5103A; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a). The VCAA applies to the instant claim. VA is required to notify the claimant and his or her representative of any information, and any medical or lay evidence, not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide. 38 U.S.C. § 5103(a); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). The duty to notify in this case was satisfied by a form entitled "Notice to Veteran of Evidence Necessary to Substantiate a Claim for Veterans Disability Compensation and Related Compensation Benefits." The Veteran certified receipt of such notice in his June 2014 claim submitted under the Fully Developed Claim program. The claim was last adjudicated in April 2021. 38 U.S.C. §§ 5102, 5103, 5103A (2012); 38 C.F.R. § 3.159 (2016); Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015). The VCAA also requires VA to make reasonable efforts to help a claimant obtain evidence necessary to substantiate his claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c), (d). This "duty to assist" contemplates that VA will help a claimant obtain records relevant to his claim, whether or not the records are in Federal custody, and that VA will provide a medical examination or obtain an opinion when necessary to make a decision on the claim. 38 C.F.R. § 3.159(c)(4). In that regard, the Veteran's service treatment records, VA treatment records, private treatment records, and lay statements have been associated with the record. As discussed in the respective sections below, VA afforded the Veteran examinations relating to the severity of his disabilities. The VA examiners obtained a history and considered the Veteran's reported symptoms and statements. The examiner described the disabilities in sufficient detail to enable a fully informed rating. Therefore, the Board finds that the Veteran has been provided adequate medical examinations in conjunction with each claim. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Pursuant to the August 2019 Board remand, VA attempted to obtain private treatment records. The Veteran indicated that he only received VA treatment except for a bone scan. Also pursuant to the Board remand, the March 2021 VA audiology examination was conducted, upon which the increased evaluation of 30 percent was awarded. Accordingly, there was substantial compliance with the remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). As there is no indication that any failure on the part of VA to provide additional notice or assistance reasonably affects the outcome of this case, the Board finds that any such failure is harmless. See Mayfield v. Nicholson, 19 Vet. App. 103 (2005), rev'd on other grounds, Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir. 2006). 1. A compensable evaluation for bilateral hearing loss prior to March 2, 2021. 2. An evaluation in excess of 30 percent for bilateral hearing loss beginning March 2, 2021. The Veteran disagreed with the initial noncompensable rating assigned to for his bilateral hearing loss disability. In an April 2021 rating decision, a 30 percent rating was awarded beginning March 2, 2021. A rating decision issued subsequent to a notice of disagreement which grants less than the maximum available rating does not "abrogate the pending appeal." AB v. Brown, 6 Vet. App. 35, 38 (1993). Thus, the rating beginning March 2, 2021, remains in appellate status. The assigned evaluation for hearing loss is determined by mechanically applying the rating criteria to certified test results. See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). Under the applicable criteria, ratings for hearing loss are determined in accordance with the findings obtained on audiometric examinations. Evaluations of hearing impairment range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of controlled speech discrimination tests (Maryland CNC), together with the average hearing threshold level as measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 Hertz. The rating criteria establish eleven auditory acuity levels designated from I to XI. As set forth in the regulations, Tables VI, VIa, and VII are used to calculate the rating to be assigned. See 38 C.F.R. § 4.85, Diagnostic Code 6100. Table VIa establishes a Roman numeral designation based only on the pure tone threshold average. 38 C.F.R. § 4.85(c). However, Table VIa will only be used when the examiner certifies that use of the speech discrimination test is not appropriate because of language difficulties, inconsistent speech discrimination scores, etc., or when indicated under the provisions of 38 C.F.R. § 4.85(c). Additionally, the regulations allow for evaluating exceptional patterns of hearing impairment. When the pure tone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, Table VI or Table VIa is to be used, whichever results in the higher numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86(a). When the pure tone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, Table VI or Table VIa is to be used, whichever results in the higher numeral. Thereafter, that numeral will be elevated to the next higher numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86(b). In this case, on the authorized audiological evaluation in September 2014, pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg. RIGHT 35 40 60 65 50 LEFT 30 35 80 90 61 Speech audiometry using the Maryland CNC word list revealed speech recognition ability of 92 percent in the right ear and of 90 percent in the left ear. The results do not present an exceptional pattern of hearing impairment. The Veteran reported functional loss trouble hearing on the telephone, when viewing television, and in conversation. Martinak v. Nicholson, 21 Vet. App. 447, 455-56 (2007). Applying the results to Table VI yields a finding of Level I hearing loss in the right ear and a finding Level III hearing loss in the left ear. Where hearing loss is at Level I in one ear and a Level III in the other, a noncompensable rating is assigned under Table VII in 38 C.F.R. § 4.85. In the April 5, 2019 Form 9 substantive appeal. The Veteran stated that his hearing has "gone south." In March 2021, the Veteran was afforded another VA examination for his hearing loss. At that examination, pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg. RIGHT 40 40 65 70 54 LEFT 30 50 85 100 66 Speech audiometry using the Maryland CNC word list revealed speech recognition ability of 62 percent in the right ear and of 72 percent in the left ear. The results do not present an exceptional pattern of hearing impairment. The Veteran reported functional loss as hearing a buzzing when wearing hearing aids, difficulty hearing spoken works, and difficulty hearing understanding and localizing sound. In the workplace, the Veteran stated he had to be careful all the time and watch everything that was around him. Martinak, 21 Vet. App. at 455-56. Applying the results to Table VI yields a finding of Level VI hearing loss in the right ear and a finding Level VI hearing loss in the left ear. Where hearing loss is at Level VI in each ear, a 30 percent rating is assigned under Table VII in 38 C.F.R. § 4.85. A review of the treatment records showed no audiogram evidence other than a reference to the audiogram in the September 2014 VA examination. The RO chose the date of the March 2, 2021 VA examination as the effective date of the 30 percent rating. For initial rating claims and increased rating claims, "the effective date can be no earlier than the date it was factually ascertainable" that a veteran's disability was diagnosed or worsened. Swain v. McDonald, 27 Vet. App. 219, 224 n. 4 (2015). The effective date should not be "assigned mechanically" as of the date of an examination. Id. at 224. There must be a factual basis for choosing an earlier date. The Veteran reported in the April 5, 2019 substantive appeal that his hearing has "gone south." This indicates the Veteran reported a worsening. April 5, 2019 is the appropriate effective date for the 30 percent rating, as the Veteran is competent to state his hearing became worse and there is no evidence of record to show that the statement is not credible. Based on a review of the evidence, the Board finds that a compensable evaluation is not warranted prior to April 5, 2019, and that an evaluation in excess of 30 percent beginning April 5, 2019, is not warranted. A mechanical application of the rating criteria shows the Veteran's hearing loss disability did not meet the criteria for a higher rating. In reaching this conclusion, the Board has determined that the VA medical examinations are highly probative evidence. The Veteran's lay statements as to his symptoms are not competent evidence of hearing loss as it conforms to VA rating criteria. Therefore, the persuasive weight of the competent and credible evidence is against an increased evaluation. While the Veteran has reported various functional impairments with respect to his hearing and sincerely believes his hearing loss is worse than the assigned criteria, the law and regulations do not allow for a higher evaluation. In fact, all the Veteran's hearing loss symptoms and described hearing impairments are contemplated by the schedular rating criteria. The Veteran's hearing loss disability has manifested in difficulty hearing speech when commincating face-to-face, over the telephone, and when watching television. As determined by the United States Court of Appeals for Veterans Claims, the schedular rating criteria specifically provide for ratings based on all levels of hearing loss in various contexts, as measured by both audiometric testing and speech recognition testing. Doucette v. Shulkin, 28 Vet. App. 366 (2017). Thus, the Veteran's functional impairments as he has reported them have been taken into consideration. 3. An evaluation in excess of 70 percent for posttraumatic stress disorder. The Veteran asserts he should have a 100 percent evaluation for his service-connected posttraumatic stress disorder (PTSD). The Veteran's PTSD is rated under Diagnostic Code 9411. Diagnostic Code 9411 is evaluated under the General Formula for Mental Disorders (General Formula). Under the General Formula, the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). The issue in this appeal is whether the Veteran's associated symptoms caused the level of impairment required for a disability rating of 100 percent. The Board concludes that the Veteran's occupational and social impairment does not more nearly approximate that of both total occupational and total social impairment. Under the General Formula a 30 percent rating is assigned when symptoms such as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, or recent events), cause occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and normal conversation). A 50 percent rating is assigned when symptoms such 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; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity. A 70 percent rating is assigned when 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 worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. A 100 percent rating is assigned for 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. The Board finds that a 100 percent rating is not warranted because the Veteran does not have total social impairment. "Total" is defined as "whole, not divided; full; complete," and "utter, absolute." Black's Law Dictionary, 1498 (7th ed. 1999). The Veteran's PTSD impacts his ability to work. However, he does not have total social impairment. Both total occupational and total social impairment are required for the 100 percent rating. In this case, a September 2014 VA examination showed the Veteran had been married for 47 years with two grown children. He reported working as a logger in the family business for more than 40 years. He reported that anger pervades his marriage despite the humor with which he and his wife discussed their life together. He complained of his father and brother being poorly motivated and his having to steer the company and deal with their resistance including the laziness of his brother. He reports anxiety, anger, difficulty in relationships, depression, insomnia, startle, hypervigilance, nightmares, and intrusive thoughts. This examination report is persuasive evidence against total social impairment. While the Veteran reported difficulty with relationships, his 47 years marriage and steering a company is inconsistent with utter and absolute social impairment. A February 2015 private psychological evaluation report is of record. The report noted that the Veteran was interviewed in the company of his wife. The report noted that an excellent marital relationship was described, although difficulties emerged after the Veteran broke his back. As a result, he has been at home. The report noted that if the Veteran becomes angry, he will get up and storm out. It will be quiet a day or two, then it is over. The report noted that the Veteran has "fine" relationships with his two daughters. This report also is evidence against total social impairment. The Veteran's ability to maintain an interview, as well as the reported positive aspects of his relationships with his wife and daughters is inconsistent with utter, complete, and absolute social impairment. The Veteran's wife submitted a September 2019 statement in which she reported that the Veteran came home from Vietnam a changed man; the he is hard to get along with because he can't control his temper and he is getting worse; he doesn't do well in crowds so they have to stay home most of the time; he flies off the handle very easily; he doesn't sleep well at night because he has flashbacks; he had to stop working in 2013 because he couldn't get along with the men and the day to day pressure; and he stays to himself most of the time now. This statement reflects difficulties with social functioning. However, these difficulties are contemplated by the 70 percent rating the Veteran is assigned. A March 2020 VA PTSD examination was conducted. The examination report showed the Veteran was married for 53 years. The quality of the marriage was reported as fair. He reported they had a major disagreement in the past few weeks. The Veteran has never been previously married. The Veteran denied verbal and physical abuse to his wife. He described his current social relationships as "a few." As these reports show, the Veteran has successful social functioning, given he has a long term marriage and relationships with his daughters, although limited and impaired. He does not have total social impairment. The Board finds that the Veteran's reports of his social impairment in his statement and his reports during examinations are more credible and probative of the Veteran's social functioning than any report of symptoms associated with the 100 percent rating. In short, the Veteran's symptoms do not more nearly approximate the level of impairment required for a 100 percent rating. Accordingly, a higher evaluation must be denied. 4. Entitlement to a TDIU prior to January 27, 2020. In a May 2020 rating decision, the Veteran was awarded a TDIU based on his PTSD effective January 27, 2020. Once entitlement to a TDIU is put in issue as part of a claim for a higher initial rating or increased rating and the RO grants a TDIU that does not span the entire period on appeal, the issue of entitlement to a TDIU for an earlier period is still on appeal. Harper v. Wilkie, 30 Vet. App. 356 (2018). Accordingly, the Board reviews whether a TDIU is warranted prior to January 27, 2020. In his January 2020 application for a TDIU, the Veteran stated that he had to retire due to his PTSD. The stress of managing a business and the pressures were so great that he could hardly handle them. Therefore, due to the stress of everyday life handling his business, he had to retire. In an April 2020 statement in support of his claim, the Veteran reported that he lost nearly a year of work in 2013 due to depression and that he sold his logging business in 2014. In a September 2019 statement, the Veteran's wife said he stopped working because he couldn't get along with the men and the day-to-day pressure. A TDIU may be assigned, where the schedular rating is less than total, where a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). To qualify for schedular consideration of a TDIU, if there is only one such disability, this disability shall be ratable at 60 percent or more, and, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. Id. The phrase "unable to secure and follow a substantially gainful occupation" contains both economic and noneconomic components. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). The economic component refers to 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. Id. The noneconomic component requires a determination as to a veteran's ability to secure and follow such employment. Id. Attention should be given to the veteran's history, education, skills, and training; whether the veteran has the physical ability (both exertional and non exertional) to perform the types of activities required by the occupation at issue (e.g., lifting, bending, sitting, standing, walking, climbing, as well as auditory and visual limitations); and whether the veteran has the mental ability to perform the activities required by the occupation at issue (e.g., memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity). Id. An award of TDIU is an individualized determination, specific to a veteran's particular circumstances, e.g., their history, education, skills, and training. See Todd v. McDonald, 27 Vet. App. 79, 85 (2014). It does not require a showing of 100 percent unemployability. Roberson v. Principi, 251 F.3d 1378, 1385 (Fed. Cir. 2001). The ultimate question is whether the veteran is capable of performing the physical and mental acts required by employment, not whether they can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). The type employment is any substantial employment, not necessarily the type of employment in which the Veteran had been previously engaged. The record in this case shows that the Veteran has the following disabilities that are service connected: PITSD rated 70 percent effective June 2013; bilateral hearing loss rated noncompensable prior to March 2021 and rated 30 percent beginning March 2021; lumbar spine arthritis rated 10 percent effective June 2013; tinnitus rated 10 percent effective June 2013; left and right lower extremity radiculopathy of both the femoral and sciatic nerves rated 10 percent for each extremity and nerve effective April 2021; and lumbar spine scars rated noncompensably effective April 2021. Based on the forgoing, the Veteran has one disability rated 60 percent or more and at least one disability rated at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. Accordingly, the Board may consider the claim for a TDIU on a schedular basis. 38 C.F.R. § 4.16(a). When giving the benefit of the doubt to the Veteran, the Board finds that a TDIU is warranted prior to January 27, 2020. The September 2014 VA PTSD examination reported that the Veteran has a GED and has retired from the logging business after 47 years. After retirement he fell and broke his back. The February 2015 private treatment evaluation reports that the Veteran has troubles with impulse control as evidenced by his irritability and angry outbursts were quite evidence and likely to substantially negatively impact his employability. The March 2020 VA PTSD examination showed that the Veteran began to notice symptoms when his father retired in 1998. He bought the business from his brother, because they did not get along, and he eventually couldn't manage it. This was very stressful. He reports he became very angry, and would lose his temper, yell, and break things. He was hard to get along with. He reports then he broke his back in 2014 and this stopped his ability to work. The Veteran appears to have appreciable physical and administrative skills. He has physical skills and experience in the logging business. He has administrative or management skills in that he managed the family's logging business for a number of years, buying out his brother after this father retired. The Board acknowledges, however, that the Veteran's physical abilities became limited in 2014 due to the lumbar spine disability, after he fell and broke his back. The VA spine examination noted the Veteran cannot sit, stand or walk for long periods of time without increased pain. This Board notes that this limitation does not appear to preclude employment that is mostly performed in a seated position with reasonable periods of walking around, or reasonable breaks to stretch his spine. The Veteran's ability to secure and follow a substantially gainful occupation is impacted by the mental effects of PTSD. In that regard, he displayed troubles with impulse control as evidenced by his irritability and angry outbursts were quite evidence and likely to substantially negatively impact his employability, according to the private psychological evaluator. The issue is whether this trouble with impulse control was severe enough to render the Veteran unable to secure or follow a substantially gainful occupation. The Veteran's statements indicate that it was the stress of managing a business that caused him to retire. Because entitlement to a TDIU is not necessarily tied to the inability to work in the Veteran's own occupation, the Board contemplates whether an occupation where the Veteran is not managing a business would ease this irritability and anger to the point where he is able to work reliably. To answer that question, the Board turns to the March 2020 VA PTSD examination. This examination was conducted after about 6 years of not working and presumably having reduced stress. In that regard, A May 2020 VA opinion regarding employability stated that the Veteran's symptoms of sleep disturbance including nightmares, leave him unrested at times, irritable and having concentration problems. This along with social avoidance of others, anxiety, negative beliefs about the world and others, negative emotions; would affect veteran's mood and motivation and ability to be productive and maintain gainful employment. This is similar to the previous examination report that the Veteran's employment would be impacted in a serious way. It is unclear whether it would render the Veteran unemployable. Nonetheless, giving the Veteran the benefit of the doubt, the Board finds that a TDIU is warranted. 5. Entitlement to special monthly compensation based on statutory housebound status. Entitlement to special monthly compensation based on statutory housebound status will be granted when a veteran has a single service-connected disability rated as 100 percent and 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. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350 (i). A TDIU based on a single disability satisfies the "rated as total" element of section 1114(s). Buie v. Shinseki, 24 Vet. App. 242 (2011). The May 2020 rating decision awarding a TDIU beginning January 27, 2020, states that it was based on the Veteran's PTSD. The TDIU award, therefore, is based on a single disability (PTSD). The Veteran's other disabilities do not combine to form 60 percent until April 7, 2021. Therefore, the Veteran qualifies for SMC based on statutory housebound status effective April 7, 2021. Bradley v. Peake, 22 Vet. App. 280 (2008). D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Rocktashel, 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.