Entitlement to an initial rating of 10 percent, but not higher, for orthostatic hypotension, is granted.

Board reasoning

The Board found that the orthostatic hypotension symptoms most closely approximate a 10 percent rating under DC 6204, noting the veteran’s history of mild, occasional dizziness and lightheadedness with no episodes of fainting, which aligns with the 10% criterion rather than the 30% for vertigo or staggering. For TDIU, the Board concluded the medical evidence showed the veteran became unable to secure or follow substantially gainful employment as of December 1, 2021, due to a combination of mental health and bilateral knee disabilities, with Ray and related caselaw addressing economic and non-economic components of employability. The Board also relied on prior decisions and medical records to support a finding of unemployability dating from December 1, 2021, resolving all reasonable doubt in the veteran’s favor.