A disability rating in excess of 50 percent for post-traumatic stress disorder (PTSD) is denied.

Citation Nr: 26001399 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 16-35 801A DATE: January 30, 2026 ORDER A disability rating in excess of 50 percent for post-traumatic stress disorder (PTSD) is denied. As of July 18, 2014, but no earlier, a total disability rating based on individual unemployability due to service-connected disabilities (TDIU), on an extra-schedular basis, is granted. FINDINGS OF FACT 1. During the entire period on appeal, the severity, frequency, and duration of the Veteran's PTSD symptoms did not more closely approximate occupational and social impairment with deficiencies in most areas. 2. As of July 18, 2014, but no earlier, the Veteran's service-connected disabilities rendered him unable to secure and follow a substantially gainful occupation consistent with his education and work history. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 50 percent for PTSD have not been met. 38 U.S.C. §§ 1110, 1134, 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. 2. As of July 18, 2014, but no earlier, the criteria for a TDIU have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from April 1988 to March 1995. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), herein referred to as the Agency of Original Jurisdiction (AOJ). As relevant, the Board denied the issue of an increased rating for the Veteran's PTSD and remanded the issue of entitlement to a TDIU in a January 2024 decision. Thereafter, the Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court). In a July 2025 Joint Motion for Partial Remand (JMPR), the Court vacated the January 2024 decision and remanded the above issues for action consistent with the findings in the JMPR. The Board notes that in a March 2025 rating decision, the AOJ awarded a TDIU effective March 18, 2020. However, as the Veteran's claim for a TDIU is part and parcel of the increased rating claim for PTSD, entitlement to a TDIU prior to such date remains on appeal. Rice v. Shinseki, 22 Vet. App. 447 (2009). 1. Entitlement to a rating in excess of 50 percent for PTSD. Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant's favor. 38 C.F.R. § 4.3. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. Separate ratings can be assigned for separate periods based on the facts found - a practice known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The appeal period before the Board stems from the Veteran's September 16, 2014, increased rating claims, plus the one-year look-back period. Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010). For the entire appeal period, the Veteran's PTSD is currently assigned a 50 percent disability pursuant to DC 9411, which is rated pursuant to the General Rating Formula for Mental Disorders (General Rating Formula). 38 C.F.R. § 4.85, DC 9411. Under the General Rating Formula, 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. 38 C.F.R. § 4.130. A 70 percent rating is warranted for occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, or mood, due to such symptoms as: suicidal ideation; obsessional rituals, which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such an 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 inability to establish and maintain effective relationships. Id. A schedular maximum 100 percent disability rating contemplates total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Id. As the United States Court of Appeals for the Federal Circuit explained, evaluation under 38 C.F.R. § 4.130 is "symptom-driven," meaning that "symptomatology should be the fact-finder's primary focus when deciding entitlement to a given disability rating" under that regulation. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 11617 (Fed.Cir.2013). The symptoms listed are not exhaustive, but rather "serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating." Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In the context of determining whether a higher disability evaluation is warranted, the analysis requires considering "not only the presence of certain symptoms [,] but also that those symptoms have caused occupational and social impairment in most of the referenced areas" - i.e., "the regulation...requires an ultimate factual conclusion as to the Veteran's level of impairment in 'most areas.'" Vazquez-Claudio, 713 F.3d at 117-18; 38 C.F.R. § 4.130, DC 9411. Further, when evaluating a mental disorder, the Board must consider the "frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission," and must also "assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination." 38 C.F.R. § 4.126(a). In Bankhead v. Shulkin, 29 Vet. App. 10 (2017), the Court held that the language of the General Rating Formula "indicates that the presence of suicidal ideation alone...may cause occupational and social impairment with deficiencies in most areas." However, as recognized by the Court, VA must engage in a holistic analysis in assessing the severity, frequency, and duration of the signs and symptoms of a veteran's service-connected psychiatric disability, and their resulting social and occupational impairment. As noted in the January 2024 Board decision, the Veteran contends that his PTSD is more severe than the current rating. In his May 2018 Form 9, the Veteran argued that the AOJ ignored the significant treatment records describing the severity of Veteran's condition. In the January 2024 decision, the Board relied on multiple statements of record, VA examinations, and treatment records. Specifically, in an August 2013 statement, the Veteran's spouse of 34 years reported that the Veteran struggled with mood swings, angry outbursts, and paranoia for many years. She also reported that his symptoms gradually increased as the Veteran started experiencing nightmares and becoming more reclusive. She reported that the Veteran would avoid making plans with friends and "shut them out." The Veteran's spouse stated that the Veteran had no friends and did not want to be around people. She reported that she felt like she was constantly "walking on eggshells" and that she was "afraid to talk to him" because he was sometimes verbally abusive. She also stated that although his job was "low stress," she did not anticipate him being able to work much longer as he was not able to hold any other jobs for which he is qualified. In a January 2015 VA examination, the Veteran's occupational and social impairment was described by the examiner as "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 examiner reported that the Veteran experienced excessive worry, feeling on edge, irritability, difficulty staying asleep, nightmares which were decreasing in frequency significantly, avoiding social interactions, loneliness, feelings of worthlessness, difficulty concentrating, and mild memory issues. During the January 2015 VA examination, the Veteran reported that his symptoms started in 1994 and have been chronic since. In 1995, the Veteran was admitted to the ER for chest pains and was hospitalized for three days; it was determined his chest pains were caused by anxiety. The Veteran reported no suicide attempts or gestures. The Veteran also reported that he felt like he drank excessively; he usually drank four or five rum and cokes in one sitting every day because he liked it, and it made him sleepy. The examiner noted a diagnosis of mild alcohol use disorder, in addition to the Veteran's PTSD diagnosis. The examiner opined that the Veteran's alcohol use started well before the PTSD stressor and worsened decades after his stressor and onset of PTSD; therefore, the two diagnoses were not related, and the PTSD symptoms were not attributable to the psychological effects of the alcohol. The Veteran also reported several symptoms such as anxiety, suspiciousness, chronic sleep impairment, mild memory loss, flattened affect, impaired abstract thinking, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances, including work or a work like setting. The examiner opined that the Veteran's symptoms negatively impacted his work performance, but did not preclude the Veteran's ability to work in any capacity. In a March 2015 letter, the Veteran reported that his bilateral hearing disability forced him "to be reclusive and avoid social settings and dealings with others altogether." The Veteran also stated that his hearing loss caused his PTSD symptoms to worsen, and that he has difficulty following simple instructions and managing his personal affairs and finances. He also stated that he neglected his personal appearance and hygiene which required constant family monitoring, and he was in a constant state of anxiety and paranoia. The Veteran stated that he displayed frequent episodes of unprovoked irritability with near violence, and his speech and conversation is more often than not illogical or irrelevant. The Veteran also stated that he experienced "frequent episodes of spatial orientation [sic.]" in which he forgets where he is and what he is doing. In an April 2016 psychiatry note, the clinician noted that the Veteran was dressed appropriately with normal speech, appropriate tone, good eye contact, coherent cognitive functioning, good judgment, appropriate mood, and intact problem solving. However, the Veteran reported intermittent and situational anxiety, decreased sexual functioning, and difficulty relating to others. The Veteran reported that he had a support system through his family, although he admitted he tended to be reclusive, partly due to PTSD and partly due to hearing loss. He described his recreational activities to include "anything outside," and he stated that he enjoyed home repair, woodworking, and yard work. The Veteran stated that he had been married one time for 36 years. He reported an excellent relationship with his wife and stated he had one son, aged 27. Both the Veteran and his wife were retired and had recently moved to be closer to their son. The Veteran admitted to intrusive thoughts on a daily basis, but he stated he had learned to deal with them through long-term therapy. During the appointment, the Veteran indicated that he was well acquainted with mindfulness, and that he had attended eight weeks of mindfulness training while at the VA in Virginia. The Veteran stated he did not remember nightmares or bad dreams. In a February 2019 psychiatry note, the Veteran reported that he was "doing okay." The Veteran reported that there had been no consistent increase in the Veteran's PTSD triggers, he experienced intermittent, situational anxiety, and he felt comfortable with the current medication intervention. In an October 2019 psychiatry note, the Veteran reported that he felt like he was doing well with the current medication. He reported that he took the trazodone intermittently and that it was very helpful. The Veteran did not report any increase in symptoms. In an October 2023 VA examination, the Veteran's occupational and social impairment was described by the examiner as "occupational and social impairment with reduced reliability and productivity." The Veteran reported several symptoms such as depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, disturbances of motivation and mood, irritable behavior and angry outbursts, hypervigilance, exaggerated startle response, sleep disturbance, diminished interest or participation in significant activities, feelings of detachment or estrangement from others, and difficulty in adapting to stressful circumstances, including work or a work like setting. The examiner observed that the Veteran arrived on time and was casually dressed and groomed. The Veteran's speech was clear and volume was normal; he was alert, cooperative and oriented to person, time, place and situation. The Veteran's thought processes were logical, coherent and goal-directed, his affect was normal, and his mood was congruent. The Veteran denied current suicidal ideations, and there was no evidence of delusions. The Veteran denied auditory/visual hallucinations. The Veteran's attention and concentration were normal, and his short-term and long-term memory appeared normal. The examiner observed that the Veteran's insight and judgment were good. In discussing the Veteran's PTSD diagnostic criteria, the October 2023 VA examiner reported that the Veteran had recurrent, involuntary, and intrusive distressing memories of the traumatic event, recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event, intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event, and marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event. The Veteran also experienced persistent avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event as well as external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event. The examiner opined that the Veteran's PTSD symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Based on the foregoing evidence, the Board determined that during the entire appeal period, the Veteran's PTSD symptoms more nearly approximated the initial 50 percent rating. 38 C.F.R. § 4.130, DC 9410. In making such determination, the Board relied on the January 2015 and October 2023 VA examination reports describing the Veteran's psychological symptoms, finding such to be the most probative evidence of record because the examiners thoroughly reviewed the Veteran's medical history, listened to the Veteran's lay statements, and provided detailed rationales. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The examinations also showed that the Veteran has struggled with symptoms that have impacted him daily, causing him to have nightmares and to avoid people and certain situations. Although the Veteran's PTSD symptoms were present, his speech was clear and volume was normal; he was alert, cooperative and oriented to person, time, place and situation in both VA examinations. These two examinations were thorough and detailed. Both paint a complete picture of the Veteran's psychological symptoms, which more nearly approximated the currently assigned initial 50 percent rating. 38 C.F.R. § 4.130, DC 9411. Additionally, the Board discussed the March 2015 statement, in which the Veteran wrote that his severe hearing disability, not his PTSD symptoms, forced him to "be reclusive and avoid social settings and dealings with others altogether." The Veteran also reported in his medical records and in VA examinations that he has a good relationship with his wife and son. The record indicates that the Veteran's ongoing treatment for PTSD through therapy has been relatively successful in managing the condition. The medical records and his wife's lay statements show that although the Veteran struggled with symptoms such as anxiety and mood disturbances, the frequency and severity of these symptoms did not prevent him from maintaining his close familial relationships or engaging in hobbies. Although the Veteran reported his speech and conversation is "more often than not illogical or irrelevant" and that he experienced "frequent episodes of spatial orientation," there is nothing in the many years of medical records and examinations to corroborate these statements. See March 2015 Veteran's letter. At no time in his medical records did any of his clinicians report that the Veteran's occupational and social impairment rose to a level consistent with a rating in excess of 50 percent. The Veteran's medical records are void of any reports that the Veteran lacked spatial orientation, that the Veteran suffered from illogical, obscure, or irrelevant speech, near-continuous panic or depression affecting the ability to function independently, appropriately and effectively, or suicidal ideations or obsessional rituals. 38 C.F.R. § 4.130, DC 9411. Finally, it was noted that a 50 percent rating contemplates symptoms similar to the ones described in the Veteran's March 2015 letter such as "difficulty in understanding complex commands," "impaired judgment," and "circumstantial, circumlocutory, or stereotyped speech." Id. The Veteran's above-described symptoms and level of occupational and social functionality is therefore inconsistent with a rating higher than 50 percent. Although the Veteran had deficiencies in some areas, he did not have deficiencies in most areas during the period on appeal. Id. Therefore, the Board determined that the symptoms reported and discussed in the examinations, medical records, and lay statements were consistent with the types of symptoms listed in the general rating formula for mental disorders under the 50 percent rating. Thus, it was found that the Veteran's PTSD does not warrant a rating higher than 50 percent. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Here, the Board notes that since the issuance of the January 2024 decision, VA treatment records associated with the file are silent for any treatment for the Veteran's PTSD. Moreover, in the July 2025 JMPR, the parties determined that the Board failed to address an August 2014 Social Security Administration (SSA) Disability Determination in denying the Veteran's increased rating claim. Specifically, the determination found that the Veteran was totally disabled, in part, due to anxiety related disorders. Here, the Board notes that the Disability Determination notes rheumatoid arthritis and other inflammatory polyarthropathies as the primary diagnosis contributing to the Veteran's disability and anxiety related disorders as secondary. Moreover, the SSA records indicate that the Veteran reported that his disabilities, to include ulcerative colitis, arthritis, hearing loss, PTSD, hypertension bone spurs, plantar fasciitis, and hyperglycemia all contribute to his inability to work. Here, the Board acknowledges that SSA determined that the Veteran's PTSD contributed to his disability determination. However, occupational impairment is contemplated in the 50 percent rating for PTSD. Moreover, SSA did not find that the Veteran was primarily or solely disabled as a result of his PTSD. Finally, while the SSA decision is probative evidence in regard to his increased rating claim and has been considered herein, it is not dispositive or binding on the VA. Collier v. Derwinski, 1 Vet. App. 413, 417 (1991) (indicating the SSA's favorable determination, while probative evidence to be considered in the claim with VA, is not dispositive or altogether binding on VA since the agencies have different disability determination requirements). Based on the foregoing evidence, to include the August 2014 SSA Disability Determination, the Board finds that an increased rating for the Veteran's PTSD is not warranted. In reaching such determination, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the weight of the probative evidence is against the Veteran's claim, the benefit of the doubt doctrine is not appliable, and his increased rating claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 2. Entitlement to a TDIU prior to March 18, 2020. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a veteran 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, such disability shall be ratable as 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. 38 C.F.R. § 4.16(a). With respect to the award of a TDIU on extra-schedular basis, in Witkowski v. Collins, 2025 U.S. App. Vet. Claims LEXIS 1423 (October 21, 2025), the Court overruled Bowling v. Principi, 15 Vet. App. 1, 10 (2001), wherein it was determined that the Board cannot grant a TDIU on an extra-schedular basis under 38 C.F.R. § 4.16(b) without first remanding the matter for referral to the Director. Thus, the Board may award a TDIU on an extra-schedular basis in the first instance. "Substantially gainful employment" is considered "work that involves doing significant productive physical or mental duties and is done for pay or profit" even if the work "is done on a part-time basis or if a claimant is paid less, or is given less responsibility than when the same claimant worked before." In other words, a "substantially gainful occupation" is "one that provides annual income that exceeds the poverty threshold for one person, irrespective of the number of hours or days that the veteran actually works and without regard to the veteran's earned annual income" prior to when he was last employed. See Faust v. West, 13 Vet. App. 342, 356 (2000) (citing analogous SSA regulations). Marginal employment generally shall be deemed to exist when a veteran's earned annual 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. 38 C.F.R. § 4.16(a). Marginal employment may also be held to exist, on a facts-found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination. Id. The Court indicated that factors to consider in determining whether marginal employment exists may include the "magnitude of the veteran's job responsibilities and the degree of accommodation necessary for successful, full-time work." Cantrell v. Shulkin, 28 Vet. App. 382, 396 (2017). Additionally, in Judge Lance's concurring opinion, it was noted that where a veteran's disabilities do not result in lost income or where legally required accommodations permit a veteran to maintain gainful employment, an award of TDIU does not serve its intended purpose. Id. at 396. Most recently, the Court defined "employment in a protected environment" to unambiguously mean "a lower-income position that, due to the veteran's service-connected disability or disabilities, is shielded in some respect from competition in the employment market." LaBruzza v. McDonough, 37 Vet. App. 111, 123-24 (2024). Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, "entitlement to a TDIU is based on an individual's particular circumstances." Rice v. Shinseki, 22 Vet. App. 447, 452 (2009). Therefore, when adjudicating a TDIU claim, VA must consider the individual veteran's education, training, and work history. Hatlestad v. Derwinski, 1 Vet. App. 164 (1991) (level of education is a factor in deciding employability); Friscia v. Brown, 7 Vet. App. 294 (1994) (considering Veteran's experience as a pilot, his training in business administration and computer programming, and his history of obtaining and losing 19 jobs in the previous 18 years); Beaty v. Brown, 6 Vet. App. 532 (1994) (considering Veteran's 8th grade education and sole occupation as a farmer); Moore v. Derwinski, 1 Vet. App. 356 (1991) (considering Veteran's master's degree in education and his part-time work as a tutor). Age may not be considered as a factor when evaluating unemployability or intercurrent disability, and it may not be used as a basis for a total disability rating. 38 C.F.R. § 4.19. There must be a determination that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age or a non-service-connected disability. 38 C.F.R. §§ 3.340, 3.341, 4.16. The sole fact that a claimant 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. The ultimate question, however, is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). In Ray v. Wilkie, 31 Vet. App. 58 (2019), the Court defined the term "unable to secure and follow a substantially gainful occupation" in § 4.16(b) to include two components: one economic and one noneconomic. The economic component means an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person. The non-economic component includes consideration of the veteran's history, education, skill, and training; whether the veteran has the physical ability to perform the type of activities required by the occupation at issue; and whether the veteran has the mental ability to perform the activities required by the occupation at issue. The Veteran's claim for a TDIU had been raised in connection with his September 16, 2014, claim for increased ratings for his service-connected disabilities pursuant to Rice, supra. As relevant, he is service-connected for PTSD, evaluated as 50 percent disabling; bilateral hearing loss, evaluated as 20 percent disabling; and tinnitus evaluated as 10 percent disabling; such disabilities result in a combined disability rating of 60 percent prior to March 18, 2020. As noted above, the Veteran was awarded entitlement to a TDIU effective March 18, 2020, the date he met the schedular threshold for a TDIU. Nevertheless, as his TDIU is part and parcel of his claim for an increased rating for PTSD, the issue of entitlement to a TDIU prior to such date remains on appeal. See Rice, supra. Here, the Board also notes that, in January 2024, the Veteran's claim was remanded for referral to the Director of Compensation for consideration of a TDIU on an extra-schedular basis, finding that the evidence suggested that the Veteran's service-connected PTSD and bilateral hearing loss rendered him unable to obtain or maintain substantially gainful employment. In November 2024, the Director issued a decision finding that the Veteran's service-connected disabilities did not prevent employment on an extraschedular basis. Nevertheless, while the Board has jurisdiction to review such determination, the Board may now award a TDIU on an extra-schedular basis in the first instance. See Witkowski, supra. In his September 2014 Application for Increased Compensation Based on Unemployability (VA Form 21-8940), the Veteran indicated that he became too disabled to work, and last worked full time, on July 17, 2014. At that time, he was employed as a warehouseman beginning in July 2007 until July 2014. A review of SSA records indicates that his employment history also includes work as a truck driver from November 2005 to June 2007 and as a state trooper from October 1995 to October 2005. The Veteran further indicated that he completed 4 years of college and completed the Florida Highway Patrol Training Academy in April 1996. Specifically, the Board notes that the Veteran's January 2015 VA PTSD examination states that he had never been fired from a job, but he had to retire from the police force, and later his warehouse job, due to his disabilities. In a March 2015 correspondence, the Veteran stated that he had not been able to work since July 2014 due to his PTSD and bilateral hearing loss symptoms. He reported that he has been denied the use of his service dog (hearing dog) at work, and although special accommodations were made for him, the accommodations were not successful and proved to be humiliating to him. He stated that he "demonstrated substandard work performance and experienced frequent absences due to his symptoms, frequent medical treatments and follow-up appointments." The Veteran stated that his wife was retiring to relocate the couple closer to their son so that he can assist the Veteran with life activities and to "watch out" for him. In an April 2016 psychology note, the Veteran reported that after discharge, he worked as a highway patrol officer for ten years, but his "PTSD and hearing loss got the best of [him], so [he] had to leave." He stated that he then worked for a school district as a warehouseman for eight years and again had to leave due to an increase in his symptoms. He filed for disability and considered himself fully retired. The clinician reported that during the Veteran's psychology appointment, the Veteran was having trouble hearing and frequently asked the clinician to repeat questions, even though the Veteran was wearing hearing aids. Finally, with respect to his bilateral hearing loss, a June 2017 VA examiner determined that the Veteran's disability impacted his ability to work. In this regard, the Veteran reported that he had difficulty hearing and communication was a challenge, at best. He had become reclusive and paranoid and he felt it made his PTSD worse. Finally, the Veteran indicated that he retired on disability, largely due to his bilateral hearing loss. Thus, after resolving all doubt in favor of the Veteran, the Board finds that, as of July 18, 2014, the date after he last worked full-time, his service-connected disabilities, in combination, rendered him unable to secure or follow a substantially gainful occupation with his education and prior work history. Specifically, the Veteran had substantial employment in law enforcement, as a truck driver, and in a warehouse, but consistently reported that he was no longer able to work due to his disabilities. Additionally, as discussed above, SSA determined that the Veteran's anxiety related disorders contributed to his inability to work. Furthermore, as a result of his bilateral hearing loss, the Veteran had considerable difficulty in engaging in conversations and hearing the phone. Therefore, the Board finds that a TDIU as of July 18, 2014, is warranted. The Board acknowledges the Veteran's report that accommodations were provided for him at work prior to July 2014. Here, the Board notes that, in an April 2013 statement, the Veteran's spouse indicated that he worked a low stress job and was unable to hold any other jobs he is qualified for. However, at an April 2014 VA PTSD examination, he indicated that he worked as a warehouse person and performed his work well. Additionally, at a February 2014 VA Hearing Loss examination, the Veteran reported that, due to his hearing, he often missed the phone ringing and has difficulty speaking on the phone. Consequently, he no longer engaged in group activities as it was difficult to engage in conversations. However, the Board finds that such does not meet the criteria of a protected environment, which the Court held unambiguously means "a lower-income position that, due to the veteran's service-connected disability or disabilities, is shielded in some respect from competition in the employment market." LaBruzza v. McDonough, 37 Vet. App. 111, 123-24 (2024). Therefore, resolving all doubt in the Veteran's favor, the Board finds that a TDIU, on an extra-schedular basis, is warranted as of July 18, 2014. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. W. Daknis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Waite, Jennifer 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.