Citation Nr: 25005076 Decision Date: 04/15/25 Archive Date: 04/15/25 DOCKET NO. 18-50 925 DATE: April 15, 2025 ORDER A 50 percent rating for PTSD, but no higher, is granted for the period prior to May 5, 2017, subject to the laws and regulations governing payment of monetary benefits. A 70 percent rating for PTSD, but no higher, is granted from May 5, 2017, subject to the laws and regulations governing payment of monetary benefits. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is granted, subject to the laws and regulations governing payment of monetary benefits. FINDINGS OF FACT 1. The evidence is persuasively weighted towards finding that the Veteran's PTSD symptoms resulted in occupational and social impairment with reduced reliability and productivity prior to May 5, 2017, but not deficiencies in most areas of functioning and/or total social impairment. 2. The evidence is in an approximate balance as to whether the Veteran's PTSD caused deficiencies in most areas of functioning from May 5, 2017, but not total social impairment. 3. 3. The evidence demonstrates that the Veteran's service-connected disabilities render him unable to secure and follow a substantially gainful occupation. CONCLUSIONS OF LAW 1. The criteria for a 50 percent rating for PTSD, but no higher, are met prior to May 5, 2017. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, DC 9411. 2. The criteria for a 70 percent rating, but no higher, for PTSD are met from May 5, 2017. 38 U.S.C. § 1155; 38 C.F.R. § 4.130, DC 9411. 3. The criteria for entitlement to a TDIU have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.15, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active-duty service in the United States Marine Corps from January 2001 to January 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from October 2014 and April 2015 rating decisions. The Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ) in August 2022. A transcript of that hearing has been associated with the claims file. The Veteran was alerted in a January 2025 correspondence that the VLJ who presided over the August 2022 hearing has a conflict of interest and is not available to review this appeal. The Veteran was offered the opportunity for an additional Board hearing but waived that right in a February 2025 correspondence. The Board remanded these claims in October 2022 Board decision for further development. The benefits sought on appeal were not granted in full in a November 2023 Board decision. The Veteran appealed these denials ot the U.S. Court of Appeals for Veterans Claims (Court) in a July 2024 Joint Motion for Partial Remand (JMPR). The Court vacated the denials and remanded these claims to the Board for further adjudication. The Board has considered the terms of the JMPR in this readjudication. The Board notes that the AOJ requested the Veteran submit any relevant private treatment records or submit information with which VA can assist the Veteran in obtaining private treatment records. Required notice and information were provided in the claim form which the Veteran signed, certifying to the fact that such notice was received and further than they have included or identified relevant evidence. VA requested records for which the Veteran submitted a proper release and/or adequately identified. The duty to assist is not a one-way street. If a Veteran desires help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). Thus, the Board finds that VA has satisfied the duty to assist. No further notice or assistance to the Veteran is required to fulfill VA's duty to assist in development. Smith v. Gober, 14 Vet. App. 227 (2000); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Increased ratings for PTSD Disability ratings are assigned in accordance with VA's Schedule for Rating Disabilities and are intended to represent the average impairment of earning capacity resulting from a disability. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. When a question arises as to which of two ratings shall be applied under a DC, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for the higher rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. During the period on appeal, the Veteran's service-connected PTSD is rated under DC 9411. Psychiatric disorders such as PTSD are rated under the General Rating Formula for Mental Disorders, which provides that a 100 percent rating is warranted for total occupational and social impairment, due to such symptoms as, for example: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. A 70 percent rating is warranted for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as, for example: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. A 50 percent rating is warranted for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. The symptoms listed in VA's general rating formula for mental disorders are not an exhaustive list, but rather serve as examples of the type and degree of symptoms, or their effects, that would justify a rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). The Board is precluded from differentiating between symptoms attributable to service-connected and nonservice-connected mental health disorders absent clinical evidence clearly showing such distinction. Mittleider v. West, 11 Vet. App. 181, 182 (1998). When evaluating a mental disorder, the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission must be considered. 38 C.F.R. § 4.126(a). The evaluation must be 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 time of examination. Further, a rating cannot be assigned solely based on social impairment. 38 C.F.R. § 4.126(b). Separate ratings may be assigned for separate periods of time based on facts found, a practice known as "staged ratings." Fenderson v. West, 12 Vet. App, 119 (1999). Factual Background A February 2014 VA psychiatry progress note documents irritability, difficulty with concentration, nightmares and insomnia. In a December 2014 statement, the Veteran endorsed having decreased motivation in social gathering or attending public events with feelings of paranoia, anxiety, rapid heart rate, and heavy breathing. An April 2015 VA general social work note documents symptoms of worsening nightmares, difficulty sleeping due to headaches, use of alcohol as a coping tool, difficulty controlling anger, and social isolation to control anger. A VA treatment record from March 2014 reported, as it related to auditory hallucinations, the Veteran heard "sounds during the day[,]" and, as noted visual hallucinations, that the Veteran sees things in his "peripheral vision" that he "can't really explain." In June 2015, he stated he "often hear[d] voices and no one's there [and] often [saw] things that are not there or do not belong." In June 2018, he reported that"[h]e has heard voices in the past for about 7-8 years" on an almost daily basis but had not heard them in the past year. A March 2015 VA PTSD examination notes occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily. The Veteran's ability to understand and follow instructions was considered not to be impaired. His ability to retain instructions as well as sustain concentration to perform simple tasks was considered to be not impaired. His ability to sustain concentration to task persistence and pace was considered moderately impaired. His ability to respond appropriately to coworkers and supervisors or the public in general was considered to be mild impaired in addition to his ability to respond appropriately to changes at work. The Veteran was diagnosed with chronic alcohol use disorder that impacts his psychosocial functioning. The examiner felt that this condition was not related to his PTSD but likely exacerbated his PTSD symptoms. The Veteran reported having a good relationship with his wife who he lives with. He has uncles and friends in Mexico that he visits annually. The examiner noted that the Veteran was in college in the year prior and obtained his bachelor's degree. For VA rating purposes, symptoms noted to actively apply to the Veteran's PTSD diagnosis were anxiety, suspiciousness, panic attacks that occur weekly or less often and chronic sleep impairment. He reported intrusive nightmares about warfare and anger that he can mostly control although he snaps at times. In a June 2015 statement, the Veteran stated that he lives in constant depression. He stated that he has flattened affect and some passive suicidal ideation. He has panic attacks and nightmares and endorsed being unable to form social relationships. He has trouble focusing, hypervigilance, and stated that he must drink every day to deal with depression, pain and sleep deprivation. He has difficulty with completing tasks that are mentally challenging. He reported being totally socially isolated. A May 2017 VA PTSD examination notes a diagnosis of PTSD assessed as causing occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The Veteran reported being married but being "emotionally disengaged" to his wife. He denied spending time with friends or leaving his house for social activities. He reported having about 6 hours of sleep per night, he reports that his sleep is irregular as he sleeps these 6 hours in 2 to 3 hour intervals, reported having trauma based nightmares (does have aggressive behavior when he is sleeping), themes in his sleep are based around death, reports that he has intrusive memories of trauma when he is driving, feeling of derealization at times when he is driving, feeling "completely" disconnected from others, he reported difficulty in concentration, increased irritability with lowered frustration tolerance (noted that he experiences this when people "upset him"), he noted that when he becomes angry he does experience "zoning out/blacking out," reported that specific loud sounds will cause an exaggerated startle response, reported a decrease in his hypervigilant behavior. He denied any suicidal ideation but noted that he is apathetic about death. Symptoms noted for VA rating purposes that actively apply to the Veteran's diagnoses were anxiety, suspiciousness, panic attacks that occur weekly or less often, chronic sleep impairment, mild memory loss, such as forgetting names, directions or recent events, flattened affect, difficulty in establishing and maintaining effect work and social relationships, difficulty in adapting to stressful circumstances, including work or a work like setting. The Veteran presented to the exam dressed appropriately, he was well groomed, and was cooperative. His behaviors included frequent hand gestures, sitting on the edge of his seat, and appearing at times sleepy/tired, as well as appearing to be in pain. He had limited eye contact, at times had slowed speech, and displayed anxious mood with a flattened affect. He displayed tangential but coherent thought processes, normal thought content, and normal perceptions. He displayed moderately impaired attention and concentration. His delayed recall appeared to be impairment but his memory appeared to be intact otherwise. A June 2018 VA nursing note documents an encounter with the Veteran when he walked in with a report of a worsening of PTSD symptoms. He has nightmares, anxiety, and avoidance. He stated that his mood is depressed, anxious, and he is irritable most of the time. He denied suicidal and homicidal ideation. He denied hallucinations and delusions. He noted a past history of "hearing voices" almost daily but these symptoms had not occurred in the past year. In the October 2018 notice of disagreement (NOD), the Veteran reported symptoms of irritability, anxiety, social estrangement from others including family members and traumatic nightmares. He stated that "he could kill people who deserve to be killed no problem." He stated that he would often do jobs with "high death defying odds" and that "life would be better without him." During the August 2022 Board hearing, the Veteran reported having angry outbursts and irritability that negatively impact his occupational functioning. He reported difficulty respecting authority. He stated that he was trying "trying to find ways to endanger himself." A November 2022 statement from the Veteran communicates symptoms of flattened affect, traumatic memories being triggered by noise or confrontation, becoming easily irritated, forgetting to do simple things or tasks, frequent panic attacks which limit his driving and getting out of his house, difficulty sleeping and night terrors. An August 2022 VA mental health note indicates that the Veteran was future oriented and his activities of daily living are intact. The Veteran denied suicidal ideation, homicidal ideation, auditory hallucinations or visual hallucinations. He did not display or endorse symptoms of psychosis, mania, or hypomania. A March 2023 VA PTSD examination assessed the Veteran as having PTSD and major depressive disorder. His psychiatric disorders were assessed as causing occupational and social impairment with reduced reliability and productivity. The examiner indicated that the symptoms attributable to each diagnosis could not be differentiated. The Veteran reported irritability, hypervigilance, problems with concentration, and difficulties falling and staying asleep. He reported depressed mood and loss of interest in activities most of the day nearly every day, feelings of guilt, insomnia, fatigue, and loss of concentration. He denied suicidal and homicidal ideation. He denied ever having panic attacks or frequent angry outbursts since 2022. Symptoms noted for VA rating purposes that actively apply to the Veteran's diagnoses were depressed mood, near-continuous panic or depression affecting the ability to function independently, appropriately and effectively suspiciousness, chronic sleep impairment, disturbances of motivation and mood, difficulty in establishing and maintaining effect work and social relationships, difficulty in adapting to stressful circumstances, including work or a work-like setting, and impaired impulse control, such as unprovoked irritability with periods of violence. The Veteran presented with hostile affect. In a September 2023 statement, the Veteran endorsed near continuous depression, flattened affect, constant fatigue and a nonexistent social life due to lack of focus and concentration. He stated that his PTSD is an obsessive ritual which requires him to stay at home. He stated his belief that all infantrymen who have fired their weapons in combat should be rated at 100 percent for PTSD. Analysis The Veteran's increased rating claim was received on December 12, 2014. A 30 percent rating is assigned from December 12, 2014, to May 4, 2017. A 50 percent rating is assigned from May 5, 2017, to August 16, 2022, and a 70 percent rating is assigned thereafter. Period on appeal prior to May 5, 2017 The below analysis also considers that an increased rating may be awarded up to one year prior to receipt of the claim if the evidence shows an increase in disability was factually ascertainable during that period (also known as the "look back" period). See 38 U.S.C. § 5110(b); 38 C.F.R. § 3.400 (o)(2); Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010). In this case, there is no medical evidence documenting a factually ascertainable increase in PTSD symptoms during this one year look back period. The Board has determined that a 50 percent rating is warranted for PTSD for the period on appeal prior to May 5, 2017. 38 C.F.R. § 4.130, DC 9411. The Board finds probative the Veteran's June 2015 statement that during that period he experienced "constant depression." He endorsed symptoms of flattened affect, passive thoughts of self-harm, panic attacks, nightmares and being unable to form social relationships. He stated that he has trouble focusing, is hypervigilant, must drink every day to deal with depression, pain and sleep deprivation. He also indicated that he is completely socially isolated. Moreover, a VA treatment record from March 2014 notes that the Veteran experiences auditory hallucinations, the Veteran heard "sounds during the day[,]" and, as noted visual hallucinations, that the Veteran sees things in his "peripheral vision" that he "can't really explain." In June 2015, he stated he "often hear[d] voices and no one's there [and] often [saw] things that are not there or do not belong." The evidence during this period therefore reasonably shows that the Veteran experienced impaired judgment and abstract thinking during this period. He also described symptoms of disturbances of motivation and mood and difficulty in establishing and maintaining effective work and social relationships due to his social isolation. These are symptoms that specifically contemplated under the rating criteria as being emblematic of a psychiatric disorder that warrants a higher 50 percent rating. The Board also considered granting a still higher 70 percent rating for PTSD. However, the evidence during this period, as a whole, refutes that the Veteran's PTSD has been consistently characterized by the following symptoms which are contemplated under the rating criteria as being suggestive of a higher 70 percent rating: suicidal ideation, obsessional rituals which interfere with routine activities, speech intermittently illogical, obscure, or irrelevant, near-continuous panic or depression affecting the ability to function independently, appropriately and effectively, impaired impulse control (such as unprovoked irritability with periods of violence), spatial disorientation and neglect of personal appearance and hygiene. The Board acknowledges that the Veteran PTSD symptoms have been noted to cause difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances including work or a worklike setting. He has also consistently reported the inability to establish and maintain effective social relationships. There are symptoms specifically contemplated under the criteria for a higher 70 percent. As discussed above, however, the evidence as a whole indicated satisfactory functioning with respect to family relations, judgment, thinking, or mood, with acknowledged intermittent exacerbations of symptoms affecting his thinking and mood at times. The evidence during this period indicates that the Veteran was able to maintain his marriage and full-time employment which is probative in determining that his PTSD did not cause deficiencies in most areas of his functioning. Finally, the Veteran was not observed to have psychotic symptoms; thought processes were logical and goal-directed; and behavior and conversation were noted to be appropriate. His passive thoughts of self-harm noted in the June 2015 appear to have been transitory and fleeting based on consistent denials of suicidal ideation during the numerous mental health treatment visits of record during this period. Thus, the evidence of record shows that a 50 percent rating for PTSD is warranted for the period on appeal prior to May 5, 2017. However, the evidence of record persuasively weighs against a rating in excess of 50 percent during this period and, to that extent, the appeal is denied, and the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). Period on appeal from May 5, 2017 Affording all reasonable doubt to the Veteran, the Board finds that the Veteran's PTSD caused a degree of impairment contemplated by the criteria for a 70 percent rating from the date of the May 5, 2017 VA examination. In that respect, the evidence documents that the Veteran experienced deficiencies in most areas of functioning during this period. The evidence indicates during this period he maintained his marriage but reported being "emotionally disengaged" from his wife. At the time of the May 2017 VA PTSD examination, he indicated that he does not leave his house to spend time with friends or engage in any social activities. In addition, a June 2018 VA nursing note documents an encounter with the Veteran when he walked in with a report of a worsening of PTSD symptoms. He reported nightmares, anxiety, and avoidance. He stated that his mood is depressed, anxious, and he is irritable most of the time. He denied suicidal and homicidal ideation. He denied hallucinations and delusions. He noted a past history of "hearing voices" almost daily but these symptoms had not occurred in the past year. In the October 2018 notice of disagreement (NOD), the Veteran also reported symptoms of irritability, anxiety, social estrangement from others including family members and traumatic nightmares. He stated that "he could kill people who deserve to be killed no problem." He stated that he would often do jobs with "high death defying odds" and that "life would be better without him." Thus, the Veteran PTSD symptoms have been noted to cause difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances including work or a worklike setting. He has also consistently reported the inability to establish and maintain effective social relationships. There are symptoms specifically contemplated under the criteria for a higher 70 percent rating The evidence is therefore in an approximate balance as to whether the Veteran's PTSD caused deficiencies in family relations, judgment, thinking, or mood. The criteria for a 70 percent therefore are met from May 5, 2017 onwards and a higher rating is granted to that extent. Finally, the Board has considered whether the criteria for a maximum 100 percent rating have been met but has determined that the Veteran's symptoms have not caused total occupational and social impairment. During the March 2023 VA examination, the interviewing psychologist did not indicate that the Veteran's PTSD was characterized by the following symptoms contemplated under the rating criteria as typifying a psychiatric disorder which causes total occupational and social impairment: 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. Rather, the examiner determined that the Veteran's overall level of impairment was occupational and social impairment with reduced reliability and productivity, which coincides with a 50 percent rating. Further, the Veteran's symptoms noted throughout the appeal period such as impaired impulse control (such as unprovoked irritability with periods of violence), difficulty in adapting to stressful circumstances (including work or a worklike setting), and the inability to establish and maintain effective relationships, are specifically contemplated under the rating criteria for a 70 percent rating. In other words, his psychiatric symptoms are of such severity, duration, type, and frequency as those more typically associated with a 70 percent rating. It is also notable that the Veteran has consistently reported that he has maintained his marriage and was able to maintain full-time employment up until 2022. While the Veteran has reported having bouts of passive suicidal ideation and past auditory and visual hallucinations, the evidence does not document that he has ever been assessed as being a persistent danger of self-harm. In addition, he has never been observed to be psychotically impaired. He has never been found to be incompetent to manage his own finances or perform activities of daily living. He has also consistently denied having any hallucinations for long stretches of time throughout the appeal period. Sympathetic consideration has been given to the Veteran's contention that all combat infantrymen should receive a 100 percent rating for PTSD based on their traumatic experiences. See September 2023 statement. It is emphasized again however that disability ratings are assigned based on all the evidence of record that bears on occupational and social impairment. The Veteran is not competent to assess the degree of impairment cause by his PTSD. More probative weight is placed on the assessments of the psychologists who have interviewed the Veteran and have not found him to be totally occupationally and socially impaired. Here, the evidence as a whole then does not support finding that the Veteran's PTSD has caused total occupational and total social impairment. The VA examinations and mental health treatment records do not document observable behavioral abnormalities with respect to presentation, thought processes, mood, or communication that are consistent with an individual that is totally occupationally and socially impaired. While the Veteran's PTSD certainly causes a significant degree of occupational and social impairment, this is contemplated by the assigned 70 percent rating. To the extent that the Veteran has argued that a higher rating for his PTSD than what the Board has currently assigned herein is warranted, these assertions are outweighed by the assessments and evaluations performed by the qualified medical professionals that have interviewed the Veteran and reviewed his claims file. See Jones v. Brown, 7 Vet. App. 134, 137-138 (1994). Moreover, while the Veteran has communicated that he is totally socially impaired/isolated as a result of his PTSD, a higher 100 percent rating cannot be assigned solely based on social impairment. 38 C.F.R. § 4.126(b). As discussed, the Veteran must have retained at least a moderate level of occupational functioning until at least 2022 when he ceased working full-time. Thus, the evidence of record persuasively weighs against granting a rating in excess of 70 percent for PTSD from May 5, 2017 onwards. As the evidence of record persuasively weighs against a rating in excess of 70 percent during this period, the appeal is denied to that extent and the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 1. Entitlement to a TDIU Legal Criteria Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that, if there is only one such disability, the disability shall be ratable at 60 percent or more, and that, if there are two or more service-connected disabilities, at least one must be rated at 40 percent or more and the combined rating must be 70 percent or more. 38 C.F.R. § 4.16(a). Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, "entitlement to TDIU is based on an individual's particular circumstance." Rice v. Shinseki, 22 Vet. App. 447, 452 (2009). Therefore, in adjudicating a TDIU claim, VA must consider the individual veteran's education, training, and work history. Hatlestad v. Derwinski, 1 Vet. App. 164, 168 (1991). Factual Background & Analysis This decision has granted a 50 percent rating for PTSD prior to May 5, 2017, the Veteran's combined disability rating therefore meets the minimum requirements for consideration of a schedular TDIU throughout the period on appeal. C.F.R. § 4.16(a). At his August 2022 Board hearing, the Veteran reported that he is unable to work because of his service-connected disabilities. A VA examination was conducted in March 2023, wherein is noted that the veteran has occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. In addition, symptoms noted were depressed mood, suspiciousness, near-continuous panic or depression affecting the ability to function independently, appropriately and effectively, chronic sleep impairment, flattened affect, speech intermittently illogical, obscure, or irrelevant, impaired judgement, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, including work or a work like setting, impaired impulse control, such as unprovoked irritability with periods of violence, and neglect of personal appearance and hygiene. An April 2023 VA examination notes that the Veteran's service-connected lumbar spine disability also impairs his ability to perform occupational tasks. The Veteran stated that he left his previous occupation working for the government due to "back complaints." He stated that "I cannot do occupation[al] or household tasks. If any I will perform some tasks in small steps. 1 task can take weeks, months or years." Pain was noted to cause functional loss in all ranges of motion. The Veteran reported limited range of motion causes functional loss in bending, lifting, and turning side to side, making it painful and difficult to bend, push, pull, lift, carry heavy objects, as well as to sit, stand, or walk for prolonged periods. The Veteran also service-connected for radiculopathy in his bilateral lower extremities which causes neurological pain and symptoms associated with his lumbar spine disability. After consideration of the above, the Board determines that the evidence is persuasively weighted towards finding that the combined effects of the Veteran's service-connected disabilities render him unable to obtain and maintain a substantially gainful occupation. The claim for a TDIU is being granted due to the combined effect of multiple service-connected disabilities. See Buie v. Shinseki, 24 Vet. App. 242, 251 (2011); see also Bradley v. Peake, 22 Vet. App. 280, 293 (2008). See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The Board will defer to the RO as to the assignment of the effective date for the TDIU. Urban v. Principi, 18 Vet. App. 143, 145 (2004). Scott W. Dale Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mckone, Kyle 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.