Citation Nr: 18143817 Decision Date: 10/23/18 Archive Date: 10/22/18 DOCKET NO. 12-28 170 DATE: October 23, 2018 ORDER Entitlement to a compensable rating for service-connected erectile dysfunction is denied. Entitlement to a rating in excess of 40 percent for service-connected voiding dysfunction residual of prostate cancer, status-post radical prostatectomy is denied. Entitlement to a compensable rating for a service-connected scar, status-post radical prostatectomy is denied. Entitlement to a rating in excess of 30 percent prior to April 18, 2015 and in excess of 50 percent thereafter for service-connected posttraumatic stress disorder (PTSD) is denied. Entitlement to a total disability rating based on individual unemployability due to service connected disabilities (TDIU) prior to February 19, 2014 is denied. FINDINGS OF FACT 1. Throughout the appeal period, the Veteran’s erectile dysfunction was manifested by difficulty in achieving erections, but without any deformity. 2. Throughout the appeal period, the Veteran’s urinary residuals of a radical prostatectomy were manifested by no more than nighttime voiding at least 5 times a night. 3. The Veteran has one 15-centimeter surgical scar on his lower abdomen that is not painful or unstable, and does not result in any disabling effects. 4. Prior to April 18, 2015, the Veteran’s PTSD was manifested by no more than occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. 5. From April 18, 2015, the Veteran’s PTSD was manifested by no more than occupational and social impairment with reduced reliability and productivity. 6. The Veteran’s service connected disabilities did not meet the schedular criteria for a TDIU prior to February 19, 2014, and they did not render him unable to obtain or maintain substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for an initial compensable rating for erectile dysfunction have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.20, 4.31, 4.115b, Diagnostic Code 7522. 2. The criteria for an initial disability rating in excess of 40 percent for a voiding dysfunction residual of a radical prostatectomy are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.115a, 4.115b, Diagnostic Code 7528. 3. The criteria for an initial compensable rating for a service-connected scar, status-post radical prostatectomy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.118, Diagnostic Codes 7800-05. 4. Prior to April 18, 2015, the criteria for a disability rating in excess of 30 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.130, Diagnostic Code 9411. 5. From April 18, 2015, the criteria for a disability rating in excess of 50 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.130, Diagnostic Code 9411. 6. The criteria for a TDIU prior to February 19, 2014 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1966 to January 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions dated in September 2012 and October 2012 by a Department of Veterans Affairs (VA) Regional Office (RO). Although the Veteran initially requested a hearing before the Board of Veterans Appeals and later requested a hearing before a RO decision review officer, he withdrew his hearing request in an April 2018 statement. This case was previously before the Board in May 2017 when it was remanded for additional development. The Board finds that there has been substantial compliance with the remand directives. See Stegall v West, 11 Vet. App. 268, 271 (1998). Increased Ratings A disability rating is determined by the application of VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Board will consider whether 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, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 1. Entitlement to a compensable rating for service-connected erectile dysfunction The Veteran’s service-connected erectile dysfunction is rated by analogy to penis deformity, with loss of erectile power. 38 C.F.R. §§ 4.20, 4.115(b), Diagnostic Code 7522. The Board can identify no more appropriate diagnostic code and the Veteran has not identified one. See Butts v. Brown, 5 Vet. App. 532, 538 (1993). Diagnostic Code 7522 provides a single 20 percent rating where the evidence shows deformity of the penis with loss of erectile power. 38 C.F.R. § 4.115(b), Diagnostic Code 7522. When the requirements for a compensable rating of a diagnostic code are not shown, a 0 percent rating is assigned. 38 C.F.R. § 4.31. The Board observes that recent VA treatment records, as well as a May 2010 VA genitourinary examination report and September 2012 prostate cancer examination report, indicate that the Veteran has erectile dysfunction. The Board observes, however, that none of the evidence of record shows that the Veteran has a penile deformity. Although there is evidence of the Veteran reporting an inability to achieve and/or maintain erections, there is essentially no evidence of any testicular or penile deformities. Specifically, at his May 2010 VA examination, no penile deformity was noted on physical examination. Absent evidence of penile deformity, even though there is erectile dysfunction, a compensable rating is not warranted under Diagnostic Code 7522. As the requirements for a compensable rating under Diagnostic Code 7522 are not met, a noncompensable (0 percent) rating is proper pursuant to 38 C.F.R. § 4.31. The Board also finds that staged ratings are not indicated in the present case, as the Veteran’s erectile dysfunction has been 0 percent disabling throughout the appeal period. As the preponderance of the evidence is against a compensable rating for erectile dysfunction, the benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). 2. Entitlement to a rating in excess of 40 percent for service-connected voiding dysfunction residual of prostate cancer, status-post radical prostatectomy The Veteran’s voiding dysfunction residual of prostate cancer, status-post radical prostatectomy is rated 40 percent disabling. Under 38 C.F.R. § 4.115b, Diagnostic Code 7528, for malignant neoplasms of the genitourinary system, a 100 percent rating is assigned for active malignancy. After six months following the cessation of surgical, X-ray, antineoplastic chemotherapy, or other therapeutic procedure, if there has been no local reoccurrence or metastasis, the disability is to be rated on residuals, as voiding dysfunction or renal dysfunction, whichever is predominant. Id. At the outset, the Board notes that the Veteran underwent a radical prostatectomy in June 2008. Active malignancy has not been demonstrated at any time during the appeal period. He filed the current claim for service connection in April 2010, over six months after the last treatment for prostate cancer. As such, a 100 percent disability rating is not warranted under Diagnostic Code 7528. The Board also notes that erectile dysfunction, another residual of prostate cancer, is separately rated as noted above. As such, that issue will not be considered herein. Furthermore, the Veteran does not appear to demonstrate any renal dysfunction, as noted in various examination reports. The Veteran is not claiming that he has renal dysfunction at any point during this appeal. Rather, to the extent that he has reported any symptoms, he reports a predominance of urinary/voiding dysfunction. Accordingly, his residuals will be evaluated under the pertinent criteria for voiding dysfunction. Voiding dysfunction is rated under the three subcategories of urine leakage, urinary frequency, and obstructed voiding. Regarding voiding dysfunction, a 40 percent disability rating is warranted when the dysfunction requires wearing absorbent materials which must be changed 2 to 4 times per day. See 38 C.F.R. § 4.115a. A 60 percent disability rating is warranted when the dysfunction requires the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day. Id. As for urinary frequency, a maximum 40 percent disability rating is warranted with daytime voiding intervals of less than an hour, or awakening to void 5 or more times per night. Id. Obstructive voiding warrants a maximum 30 percent disability rating for urinary retention requiring intermittent or continuous catheterization. Id. The ratings for urinary frequency and obstructed voiding do not surpass the 40 percent disability rating currently assigned. As such, consideration will be given to whether the Veteran’s radical prostatectomy urinary residuals warrant an increased rating under the diagnostic criteria for voiding dysfunction. During a September 2012 VA prostate cancer examination, the Veteran reported voiding dysfunction that resulted in urine leakage. However, the Veteran denied use of absorbent material or an appliance. He also reported increased urinary frequency, with a daytime voiding interval between 2 and 3 hours and nighttime awakening to void 5 or more times. During a January 2014 VA examination, the Veteran noted increased urinary frequency, mostly during the night. He denied use of diapers or other absorbent materials. He again noted daytime voiding interval between 2 and 3 hours and nighttime awakening to void 5 or more times. Throughout the VA treatment records, there is no indication that the Veteran used any absorbent material or an appliance for urinary leakage. Based on the above, the evidence shows the Veteran’s urinary residuals are manifested by a voiding frequency of 5 or more times a night. As the preponderance of the evidence is thus against a disability rating in excess of 40 percent for the Veteran’s service-connected voiding dysfunction, the benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 49. 3. Entitlement to a compensable rating for a service-connected scar, status post radical prostatectomy The Veteran contends that a compensable rating is warranted for his service-connected abdominal scar, status-post radical prostatectomy. The Veteran’s scar is rated under 38 C.F.R. § 4.118, Diagnostic Code 7805, which contemplates other effects of scars not contemplated under the other Diagnostic Codes for rating scars, or Diagnostic Codes 7800, 7801, 7202 and 7804, and instructs to rate such effects under an appropriate diagnostic code. Diagnostic Code 7800 pertains to scars or disfigurement to the head, face, or neck and, therefore, is not applicable in the instant appeal. Diagnostic Code 7801 relates to deep and non-linear scars, which is also not shown in this case. Under Diagnostic Code 7802, scars not of the head, face, or neck, that are superficial and nonlinear in an area or areas of 144 square inches (929 sq. cm.) or greater warrant a 10 percent evaluation. A superficial scar is one not associated with underlying soft tissue damage. Diagnostic Code 7804 provides a 10 percent rating for 1 or 2 scars that are unstable or painful. A 20 percent rating is warranted for 3 to 4 scars that are unstable or painful and a 30 percent disability rating assigned for 5 or more scars that are unstable or painful. Note (1) to provides that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Note (2) provides that if one or more scars are both unstable and painful, add 10 percent to the evaluation that is based on the total number of unstable or painful scars. 38 C.F.R. § 4.118. During a September 2012 VA examination, the Veteran was noted to have a scar that was not painful or unstable, and did not have an area of greater than 39 square centimeters. During a January 2014 VA examination, the Veteran was noted to have a scar on his lower abdomen resulting from a radical prostatectomy. The Veteran indicated that the scar was not painful and the examiner found that it was not unstable. There were no scars on the trunk or extremities related to burns. The scar was non-linear, superficial, and measured 15 centimeters by 1 centimeter. He noted it had a brownish color but was not depressed or keloidal. The examiner indicated the scar was not tender or disfiguring. There were no other pertinent physical findings related to the Veteran’s scar and no functional impact was noted. The Board has reviewed the Veteran’s VA treatment records and notes that there is no treatment related to this scar. Based on the above, the Board finds that a compensable disability rating for the Veteran’s service-connected scar, status-post radical prostatectomy, is not warranted. Absent evidence showing that the scar has an area greater than 144 square inches or that the scar is unstable or painful, there exists no basis for a compensable rating. Additionally, there is no evidence that the Veteran’s scar results in any disabling effects to warrant a compensable rating under another appropriate diagnostic code in accordance with Diagnostic Code 7805. As the preponderance of the evidence is against a compensable disability rating for the Veteran’s service-connected scar, the benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 49. 4. Entitlement to a rating in excess of 30 percent prior to April 18, 2015 and in excess of 50 percent thereafter for service-connected posttraumatic stress disorder (PTSD) Prior to April 18, 2015, the Veteran’s PTSD was rated 30 percent disabling. Thereafter, his PTSD rating was increased to 50 percent. PTSD is rated under the General Rating formula for Mental Disorders. See 38 C.F.R. § 4.130, Diagnostic Code 9411. Under these criteria, a 30 percent rating is warranted for 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 conversation normal) due to such symptoms as: depressed mood; anxiety; suspiciousness; panic attacks (weekly or less often); chronic sleep impairment; and mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is warranted for occupational and social impairment with reduced reliability and productivity due to particular 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; impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is warranted where there is occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, 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 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 work-like setting); inability to establish and maintain effective relationships. A 100 percent rating is warranted where there is 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. In addition, when evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran’s capacity for adjustment during periods of remission. 38 C.F.R. § 4.126(a). The rating agency shall 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. Id. However, when evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation on the basis of social impairment. 38 C.F.R. § 4.126(b). The Board notes that with regard to the use of the phrase “such as” in 38 C.F.R. § 4.130 (General Rating Formula for Mental Disorders), ratings are assigned according to the manifestations of particular symptoms. However, the use of the phrase “such as” in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve only as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Accordingly, the evidence considered in determining the level of impairment under § 4.130 is not restricted to the symptoms provided in the Diagnostic Code. Instead, VA must consider all symptoms of a claimant’s condition that affect the level of occupational and social impairment, including, if applicable, those identified in the Diagnostic and Statistical Manual of Mental Disorders. VA has implemented DSM-5 for claims certified to the Board beginning August 4, 2014, such as in the instant appeal. See 79 Fed. Reg. 45, 093, 45,094 (Aug. 4, 2014). Hence, this appeal is governed by DSM-5. During a June 2011 VA examination, the Veteran reported trouble sleeping, ruminations, depressed mood, avoidance behavior and stated that he was socially withdrawn. The onset of these symptoms was when he returned from Vietnam. The Veteran indicated that he was married once and divorced and had 3 children. He lived alone but described his family relationship and social relationships as “good.” For leisure, the Veteran would go to the movies, attend church, and participate in church activities. He also stated that he would take care of his sister. The Veteran reported a history of violence, getting physically aggressive with his nephew 4 years prior. On observation, the Veteran was clean with spontaneous speech, a constricted affect, and an anxious mood. He was cooperative during the examination and the examiner noted the Veteran demonstrated psychomotor retardation. His attention was intact and he was oriented in all spheres. The Veteran’s thought process was circumstantial, his thought content unremarkable, and there was no evidence of delusions. The Veteran understood the outcome of his behavior and that he had a problem. The Veteran denied hallucinations and did not have inappropriate or obsessive/ritualistic behavior. He also denied panic attacks and homicidal or suicidal thoughts. His impulse control was noted to be fair and he was deemed able to maintain minimum personal hygiene. His memory was normal. The Veteran’s PTSD symptoms consisted of recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. He exercised avoidance behaviors and had markedly diminished interest or participation in significant activities. He also had difficulty falling or staying asleep and an exaggerated startle response. Ultimately, the examiner found the Veteran’s symptomatology to be mild. During an October 2011 VA examination, the examiner summarized the Veteran’s symptomatology 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 that he had been living alone for the previous 15 years. He described his family relationship as “good” at present but indicated it was very difficult in the past. The Veteran stated that he was active in his church activities and continued to take care of his sister. He indicated that he had not been followed for psychiatric treatment. He reported difficulty falling and staying asleep, occasional exaggerated startle response, isolation, and occasional nightmares. The Veteran also noted disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and an inability to establish and maintain effective relationships. During a January 2014 VA examination, the examiner found that the Veteran’s PTSD symptoms were not severe enough either to interfere with occupational and social functioning or to require continuous medication. The Veteran reported that he was still retired and living by himself at the time of the examination. The Veteran was described as coherent, logical, and relevant without a significant decrease in functionality since his previous examination. The Veteran was not taking any medication for his PTSD and was last treated in September 2012. The Veteran submitted a private psychiatric evaluation dated in April 2015. At that time, the Veteran reported flashbacks, nightmares, and anger outbursts. The Veteran noted sleep disturbances that left him drowsy during the day. He would spend his days working in between catnaps. The Veteran said he would fall asleep in meetings and was not able to perform as expected in his duties. The examiner described the Veteran as easily distracted, changing subjects and attending to family phone calls and other activities not pertinent to the evaluation. He was described as well-nourished, well developed, and had adequate hygiene. He was oriented in all spheres and his memory was preserved at all levels. His affect was flat and his mood was inexpressive. His thought process was logic, coherent, and relevant. There was no evidence of delusions or hallucinations. His insight appeared impaired and he had difficulty understanding his anger outbursts. His judgment was also impaired as he had poor emotional control. The Veteran’s treatment records reflect that he first sought VA mental health treatment in April 2015. At that time, the Veteran reported nightmares, sleep disturbances, and irritability. He further endorsed severe depressive and anxiety symptoms, death wishes, and insomnia. The Veteran was described as exhibiting adequate hygiene, being cooperative, and using readily spontaneous, yet slow, speech. He was alert and attentive, oriented in all spheres, his memory was adequate, and his mood was described as “good” with a euthymic affect. His thought process was coherent, organized, and goal directed, though at times he was tangential. His judgement was inadequate. The Veteran denied suicidal or homicidal ideation, plan, or intent. During a June 2015 Social Work Behavioral Health Psychosocial Assessment, the Veteran reported that he lived alone but had several friends and was a member of a church, which he considers a supportive network. He noted irritability and some interpersonal relationship problems due to angry outbursts. He was described as exhibiting adequate hygiene and had appropriate eye contact. The Veteran was alert, oriented in all spheres, his thought process was logical, coherent, and relevant, and his speech was fluid. His judgment and insight appeared to be normal and there were no perceptual disturbances or disruptive behaviors observed. The Veteran denied suicidal and homicidal ideations and hallucinations. In March 2016, the Veteran was described as exhibiting adequate hygiene, he was cooperative with good eye contact, and he was oriented in person, place, and time. He denied suicidal and homicidal ideation or plan. His thought process was coherent, relevant, logical, and organized. His memory was intact and his judgment and insight were good. Based on the above, the Board finds that the currently assigned 30 percent disability rating prior to April 18, 2015 and 50 percent rating thereafter are appropriate. Prior to April 18, 2015, the Veteran’s symptoms are not shown to more nearly approximate occupational and social impairment with reduced reliability and productivity. Indeed, the Veteran reported being active in his church and even taking care of his sister. Although he reported hypervigilance, sleep impairment, and previous instances of violence, there is no evidence showing a disruption of memory or impaired judgment during this time. Additionally, the Veteran reported a “good” family relationship. Compellingly, the Board notes that the VA examiners during this period found the Veteran’s PTSD symptomatology to be mild and, at most, to cause occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. This level of symptomatology corresponds to no more than the 30 percent rating currently assigned prior to April 18, 2015. From April 18, 2015, when considering the Veteran’s total disability picture, his PTSD symptoms do not more nearly approximate occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. Despite some evidence of impaired judgment, the Veteran was routinely observed to have coherent and logical thought processes and as oriented in all spheres. He maintained his church relationships and endorsed some friendships, even describing them as a supportive network. There is no evidence that the Veteran experienced near-continuous panic or depression or even that he had panic attacks. No suicidal ideation has been reported. The Board is aware that the presence or absence of specific symptoms, which correspond to a particular rating, is not dispositive. 38 C.F.R. § 4.130; Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). However, as noted above, the evidence does not show that the Veteran’s symptomatology is more severe than considered by the 30 percent disability rating assigned prior to April 18, 2015 and 50 percent disability rating assigned thereafter. As such, the preponderance of the evidence is against the claims for a disability rating in excess of 30 percent for PTSD prior to April 18, 2015, and in excess of 50 percent thereafter. 38 U.S.C. § 5107(b). The benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 49. 5. Entitlement to a total disability rating based on individual unemployability due to service connected disabilities (TDIU) prior to February 19, 2014 In a March 2017 rating decision, the RO granted entitlement to a TDIU effective from February 19, 2014. The Veteran contends that his service-connected disabilities precluded him from securing or maintaining substantially gainful employment prior to that time. VA will grant a TDIU when the evidence shows that a Veteran is precluded, by reason of service-connected disabilities, from obtaining and maintaining any form of gainful employment consistent with his education and occupational experience. See 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. TDIU benefits are granted only when it is established that the service-connected disabilities are so severe, standing alone, as to prevent the retaining of gainful employment. If there is only one such disability, it must be rated at least 60 percent disabling to qualify for TDIU benefits; if there are two or more such 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). In determining whether an appellant is entitled to a total disability rating based upon individual unemployability, neither the appellant’s nonservice-connected disabilities nor advancing age may be considered. 38 C.F.R. §§ 3.341(a), 4.19. Factors to be considered are the Veteran’s education, employment history, and vocational attainment. See Ferraro v. Derwinski, 1 Vet. App. 326, 332 (1991). Here, prior to February 19, 2014, the Veteran was service connected for PTSD, rated 30 percent disabling; voiding dysfunction, rated 40 percent disabling; erectile dysfunction, rated noncompensably; and status-post radical prostatectomy scar, rated noncompensably. His combined rating was 60 percent. Accordingly, prior to February 19, 2014, the Veteran did not meet the schedular requirements for a TDIU as set forth in 38 C.F.R. § 4.16(a). It is VA policy, however, to grant TDIU in all cases where a Veteran is unable to work due to service-connected disability. Rating boards are required to submit to the Director of Compensation Service (Director), for extraschedular consideration, all cases of Veterans who are unemployable by reason of service-connected disability(ies), but who fail to meet the percentage standards set forth in 38 C.F.R. § 4.16(a). 38 C.F.R. § 4.16(b). Where a claimant does not meet the schedular requirements of 38 C.F.R. § 4.16(a), the Board has no authority to assign a total disability evaluation based on individual unemployability under 38 C.F.R. § 4.1(b). The Board may, however, refer the claim to the Director for extraschedular consideration. The governing norm for the Board in making the determination is whether there is a plausible basis for concluding that the Veteran is unable to secure and follow a gainful occupation. Bowling v. Principi, 15 Vet. App. 1 (2001). Based on a review of the record, the Board finds that the Veteran’s service-connected disabilities did not render him unable to secure and maintain substantially gainful employment prior to February 19, 2014. On the Veteran’s September 2012 Application for Increased Compensation Based on Unemployability, the Veteran reported that he was an electrical engineer from 1970 to 1997, when he reportedly stopped working by reason of his service-connected disabilities. He noted that he received retirement from his employer. The Veteran indicated that he completed 4 years of college. During a May 2010 VA genitourinary examination, the Veteran indicated that he obtained a Master’s degree in Engineer Management and worked as an electrical engineer until 1997, when he retired as eligible by age or duration of work. His erectile dysfunction did not have any effects on his usual daily activities. During a June 2011 VA PTSD examination, the Veteran’s PTSD was noted to cause a “mild impairment”. During a September 2012 VA prostate cancer examination, the Veteran’s status-post prostate cancer was not found to impact his ability to work. During a January 2014 VA examination, neither the Veteran’s voiding dysfunction nor his scar were found to impact his ability to work. The Board acknowledges the Veteran’s statements that he had problems with his service-connected conditions. The record reflects that although the Veteran has not worked since January 1997, he has given a conflicting statement regarding his motivation to stop work. During VA examinations, the Veteran reported retiring by eligibility of age or duration of work. The only time the Veteran reported being too disabled to work was on his application for TDIU. Additionally, despite VA mental health examinations demonstrating that his PTSD has some impact on his ability to work, there is no showing of total unemployability based solely on his service-connected disabilities during this time. Thus, the Board finds that the competent and probative evidence does not show that the Veteran’s service-connected disabilities prevented him from gainful employment prior to February 19, 2014. As the preponderance of the evidence is against a finding that the Veteran’s service-connected disabilities rendered him unemployable prior to February 19, 2014, the Board finds it unnecessary to refer this claim to the Director for extraschedular consideration. The benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 49. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Lindsey Connor