10-27 645, 10-27 645

Veteran served 1970–1977; appeal from VA RO decision; Board remanded for development and held hearings and exams (transcript March 2011; exams Apr 2008, May 2014, Sept 2014 addendum).
Service-connected disability: schizophrenia (Diagnostic Code 9204) rated 50% during the pendency of the claim.
Veteran alleges worsening symptoms (depression, panic, memory/concentration issues) and inability to maintain employment; also applied for TDIU.
Medical evidence: VA treatment notes, SSA examinations, and multiple VA mental health exams showing fluctuating depressive symptoms, generally flat affect, mild–moderate concentration issues, GAF scores mostly 50–55 (one SSA 45), and periods of schizophrenia in remission on medication.
Functional evidence: Veteran served as full‑time caregiver for partner (ceased competitive work in 2006 when employer closed), performed ADLs, household management, driving, shopping, and testified she could work if not caring for partner.
Procedural posture: Board denied increase above 50% and denied TDIU; found schedular criteria and record did not show deficiencies in most areas or total occupational/social impairment; no extraschedular referral warranted.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether schizophrenia warrants >50% rating	Schizophrenia and related depression produce occupational/social impairment exceeding 50% (marked concentration/memory loss, panic, inability to work)	Record shows symptoms consistent with 50%—remission of psychosis, mostly moderate symptoms, ability to perform ADLs and caretaking	Denied — evidence does not show deficiencies in most areas required for 70% rating
Whether TDIU is warranted	Veteran cannot secure/maintain substantially gainful employment because of service‑connected schizophrenia	Veteran stopped work to care for partner; exams show ability to do simple/structured work and functioning sufficient for gainful employment; does not meet schedular criteria	Denied — veteran does not meet schedular TDIU thresholds and extraschedular referral not warranted

Stegall v. West, 11 Vet. App. 268 (Board remand duty to comply with development directives)
Gonzales v. West, 218 F.3d 1378 (agency need not discuss every piece of evidence)
Mauerhan v. Principi, 16 Vet. App. 436 (symptoms listed in rating schedule are illustrative, not exhaustive)
Thun v. Peake, 22 Vet. App. 111 (standards for extraschedular consideration)
Bryant v. Shinseki, 23 Vet. App. 488 (duties when conducting hearings: explain issues and suggest evidence)
Hatlestad v. Brown, 5 Vet. App. 524 (central inquiry for unemployability is whether service‑connected disabilities alone produce unemployability)
Floyd v. Brown, 9 Vet. App. 88 (Board may consider referral for extraschedular ratings and remand to RO)
Anderson v. Shinseki, 22 Vet. App. 423 (Board review of Director decisions/referral process)
Mayfield v. Nicholson, 444 F.3d 1328 (notice and duty-to-assist principles)