Citation Nr: 18146429 Decision Date: 10/31/18 Archive Date: 10/31/18 DOCKET NO. 14-15 863A DATE: October 31, 2018 ORDER The issues of issues of entitlement increased ratings for: rotator cuff tendonitis, right shoulder, evaluated as 20 percent disabling, rotator cuff tendonitis, left shoulder, evaluated as 20 percent disabling, residuals, status post decompression of cubital tunnel syndrome, right elbow, evaluated as 10 percent disabling, and residuals, status post decompression of cubital tunnel syndrome, left elbow, evaluated as 10 percent disabling, are dismissed. Prior to August 22, 2012, a rating in excess of 10 percent for service-connected PTSD is denied. As of August 22, 2012, a rating in excess of 70 percent for service-connected PTSD is denied. An initial evaluation in excess of 30 percent for service-connected migraine and tension headaches is denied. A total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is denied. FINDINGS OF FACT 1. During his hearing, held in October 2017, prior to the promulgation of a decision in the appeal, the Veteran indicated that he desired to withdraw the issues of entitlement to increased ratings for: rotator cuff tendonitis, right shoulder, evaluated as 20 percent disabling, rotator cuff tendonitis, left shoulder, evaluated as 20 percent disabling, residuals, status post decompression of cubital tunnel syndrome, right elbow, evaluated as 10 percent disabling, and residuals, status post decompression of cubital tunnel syndrome, left elbow, evaluated as 10 percent disabling. 2. Prior to August 22, 2012, the Veteran’s service-connected PTSD is not shown to have not resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, or worse. 3. As of August 22, 2012, the Veteran’s service-connected PTSD is shown to have been productive of symptoms that include anger, irritability, nightmares, flashbacks, and sleep disturbance, but his psychiatric symptomatology did not cause total occupational and total social impairment. 4. The Veteran’s service-connected migraine and tension headaches are not shown to be productive of severe economic inadaptability. 5. The Veteran’s service-connected disabilities are not shown to render him unable to secure and follow a substantially gainful occupation. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the appeals of the issues of entitlement to increased ratings for: rotator cuff tendonitis, right shoulder, evaluated as 20 percent disabling, rotator cuff tendonitis, left shoulder, evaluated as 20 percent disabling, residuals, status post decompression of cubital tunnel syndrome, right elbow, evaluated as 10 percent disabling, and residuals, status post decompression of cubital tunnel syndrome, left elbow, evaluated as 10 percent disabling, by the appellant have been met. 38 U.S.C. § 7105 (b)(2), (d)(5); 38 C.F.R. § 20.204. 2. Prior to August 22, 2012, the criteria for a rating in excess of 10 percent for service-connected PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.7, 4.130, Diagnostic Code 9411. 3. As of August 22, 2012, the criteria for a rating in excess of 70 percent for service-connected PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.7, 4.130, Diagnostic Code 9411. 4. The criteria for an initial evaluation in excess of 30 percent for service-connected migraine and tension headaches have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.124a, Diagnostic Code 8100. 5. The criteria for TDIU are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. § 3.102, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 2004 to November 2005. For all claims, the Board first notes that although additional evidence has been received that has not been reviewed by the agency of original jurisdiction (RO), waivers of RO review are of record. See 38 C.F.R. § 20.1304. Accordingly, a remand for RO review is not required. 1. Increased rating: bilateral shoulder, and bilateral elbow. The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the Veteran or by his or her authorized representative. 38 C.F.R. § 20.204. A review of the claims folder shows that the Veteran initiated an appeal on the issues of entitlement increased ratings for: rotator cuff tendonitis, right shoulder, evaluated as 20 percent disabling, rotator cuff tendonitis, left shoulder, evaluated as 20 percent disabling, residuals, status post decompression of cubital tunnel syndrome, right elbow, evaluated as 10 percent disabling, and residuals, status post decompression of cubital tunnel syndrome, left elbow, evaluated as 10 percent disabling. The Veteran has since indicated that he desires to withdraw his appeal as to these issues. Specifically, during his hearing, held in October 2017, it was stated that the Veteran desired to withdraw these issues. This testimony indicates that the Veteran understood the consequences of withdrawing his claim. Acree v. O’Rourke, 891 F.3d 1009 (Fed. Cir. 2018). As there remain no allegations of errors of fact or law for appellate consideration, the Board does not have jurisdiction to review the appeal on the issues listed above. They are dismissed. 2. Increased Ratings, Headaches and PTSD. PTSD. With regard to the history of the disability in issue, the Veteran is shown to have served in Iraq. His awards include the Combat Action Badge. In an April 2009 VA PTSD examination, he was diagnosed with chronic, mild PTSD. Thereafter, he received outpatient treatment, with medications that included Bupropion and Trazodone. See 38 C.F.R. § 4.1. In August 2009, the RO granted service connection for PTSD, evaluated as 10 percent disabling. There was no appeal, and the RO’s decision became final. See 38 U.S.C. § 7105(c). On August 22, 2012, the Veteran filed a claim for an increased rating. In May 2013, the RO granted the claim, to the extent that it evaluated the Veteran’s PTSD as 70 percent disabling, with an effective date of August 22, 2012. The Veteran has appealed. The Veteran’s PTSD is evaluated under 38 C.F.R. § 4.130, Diagnostic Code (DC) 9411, under the general rating formula for mental disorders, which became effective prior to the Veteran’s claim for service connection. A 10 percent rating is assigned when a veteran’s PTSD causes occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or when symptoms are controlled by continuous medication. A 30 percent rating is assigned when a veteran’s PTSD causes 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, or mild memory loss (such as forgetting names, directions, recent events). A 70 percent rating is assigned when a veteran’s PTSD causes 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 ideations; obsessional rituals that 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 assigned when a veteran’s PTSD causes 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. The symptoms listed at 38 C.F.R. § 4.130 are not an exclusive or exhaustive list of symptomatology which may be considered for a higher rating claim. Mauerhan v. Principi, 16 Vet. App. 436 (2002). As this appeal was certified to the Board in November 2016, subsequent to the effective date for this change, DSM-5 is applicable to this claim. See 70 Fed. Reg. 45,093-94 (Aug. 4, 2014). In such cases, it is improper to discuss global assessment of functioning scores. Golden v. Shulkin, 29 Vet. App. 221 (2018). When determining the appropriate disability evaluation to assign, the Board’s primary consideration is the Veteran’s symptoms, but it must also make findings as to how those symptoms impact the Veteran’s occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). Because the use of the term “such as” in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Mauerhan, 16 Vet. App. at 442. Nevertheless, as all ratings in the general rating formula are also associated with objectively observable symptomatology and the plain language of the regulation makes it clear that the Veteran’s impairment must be “due to” those symptoms, a veteran may only qualify for a given disability by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d at 118. At his hearing, held in October 2017, the Veteran testified that he has symptoms that include depression, anxiety, anger, and social disconnect. He reported having suicidal thoughts five to six times in the previous year, a “short fuse,” anxiety attacks often four to five times per day, poor attention and concentration, and poor memory (forgetting dates, times and people), and that he avoids crowds. He stated that his claim for Social Security Administration (SSA) disability benefits had been denied, and was on appeal. Prior to August 22, 2012. The Veteran’s increased rating claim was filed on August 22, 2012. Therefore, the relevant evidence of record for the time period in issue consists of evidence dated up to one year prior to receipt of his claim, i.e., as of August 22, 2011. See 38 C.F.R. § 3.400 (o)(2). A statement from A.P., MS, LPC, shows that she states that she worked with the Veteran beginning in 2011, and that he has “exacerbated” PTSD symptoms, depression, and suicidal thoughts. She states that the Veteran’s PTSD impacted his ability to trust, and to form lasting intimate relationships. She states that PTSD symptoms do not go away, and that they must be managed with treatment. A report from G.H., LSCW, dated in July 2012, notes that he began treating the Veteran in December 2011, for PTSD with secondary depression. His PTSD was characterized as moderate to severe. A July 2012 evaluation notes mild to moderate limitations in 13 areas of functioning, to include three findings of “no evidence of limitation,” five findings of mild limitations, and five findings of moderate limitations. The Veteran was expected to be absent from work due to his symptoms less than once a month, but required continued therapy to remain employed. Reports from the Vet Center show treatment between December 2011 and June 2012. They note complaints of inter-family problems, and indicate that he was attending school. He was noted to have PTSD and anger. The Board finds that a rating in excess of 10 percent is not warranted for the Veteran’s PTSD prior to August 22, 2012. While there are some findings of moderate limitation, there are also findings of no limitations, and mild limitations. It was noted that the Veteran was expected to be absent from work due to his symptoms less than once a month. There are no findings show impairment in such areas as speech, thought content, or thought processes, nor is there evidence of audio or visual hallucinations, or a psychosis. It appears that the Veteran was in school during this time. Given the foregoing, the Board finds that overall, it is not factually ascertainable that the Veteran’s psychiatric symptoms were of such severity as to approximate, or more nearly approximate, the criteria for a 30 percent rating under DC 9411 prior to August 22, 2012. See 38 C.F.R. § 4.7; Vazquez-Claudio. As of August 22, 2012. The medical evidence is summarized as follows: A VA PTSD DBQ, dated in February 2013, shows that the Veteran’s symptoms were noted to include depressed mood, anxiety, suspiciousness chronic sleep impairment, impaired judgment, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, including work or a worklike setting, an inability to establish and maintain effective relationships, and suicidal ideation. He reported that he had to quit his job related to symptoms of PTSD while driving and that he was struggling as a full-time student. The diagnoses were PTSD, major depressive disorder, and alcohol dependence. A VA TBI examination report, dated in April 2013, shows that the Veteran reported that a 2010 neuropsychological evaluation showed that he had no significant cognitive deficits due to a TBI. He reported that he was one year away from obtaining a bachelor’s degree, with a double major in Chinese and math. On evaluation, there were no complaints of impairment of memory, attention, concentration, or executive functions. Judgment was normal. Social interaction was routinely appropriate. There were no neurobehavioral effects. There were subjective symptoms that did not interfere with work. He was able to communicate and comprehend spoken and written language. Reports from A.P., a counselor, dated in 2014, note PTSD with suicidal ideation, and periodic binge drinking. The Veteran complained that he felt overwhelmed. He reported that he started school in 2011, and that he has attended school for three years without a break. He reported that he was working in a bar five nights a week, with notations that he had been working part-time in a restaurant, and that he was actively involved in a restaurant business. A VA PTSD DBQ, dated in January 2016, shows the following: The Veteran complained of moderate to severe PTSD symptoms, with nightmares and intrusive thoughts, and feeling distant and mistrustful of others. He also reported sleep disruption, hypervigilance, and irritability. It was noted that he did not report suicidal or homicidal ideation. The diagnosis was PTSD. He was noted to have occupational and social impairment with deficiencies in most areas. He reported that he had last worked in 2006, and that he quit his job due to difficulty coping with his boss yelling at him. He was divorced in 1998, and last dated three years’ ago. He reported that he had completed three years of college in math, and that he was an “A” and “B” student. On examination, he was oriented to person, place, time, and purpose. Thoughts were logical and goal-directed. There were no signs of major psychopathology such as hallucinations or delusions. Attention and memory were intact. A report from VA vocational rehabilitation service, dated in January 2016, states that the Veteran’s program was discontinued “because you reported you are no longer interested in services.” A report from the Social Security Administration shows that the Veteran filed a claim for disability benefits based on PTSD, shoulder disability, TBI, poor hearing, and obesity. In January 2017, the SSA determined that the Veteran’s conditions were not severe enough to keep him from working, and that he was still able to perform some types of work. A VA PTSD DBQ, dated in February 2018, shows the following: The Veteran’s symptoms were noted to include concentration problems, sleep disturbance, low motivation, lack of interest in activities, dysphoric mood, avoiding socializing, and hypervigilance. His symptoms were noted to be productive of occupational and social impairment with reduced reliability and productivity. The Veteran reported that he had not worked since 2007 due to his symptoms. He denied suffering from recent suicidal, homicidal, or psychotic ideation. He was noted to have depressed mood, anxiety, suspiciousness, chronic sleep impairment, and disturbances of motivation and mood. The diagnoses were PTSD, and persistent depressive disorder. Overall, VA progress notes show ongoing treatment for psychiatric symptoms, with medications that included Sertraline, Bupropion and Trazodone. He tended to deny suicidal or homicidal ideation, with some exceptions, and screens for suicide tended to be negative. In April 2015, the Veteran reported recent suicidal ideation, however, the report notes that his suicidal ideation had resolved to baseline, and without plan or intent. He was noted to have fluent and non-pressured speech, with no latency. Cognition was grossly intact. Judgment was intact and insight was adequate. He was alert and oriented times four, with no audio or visual hallucinations, and no delusions. There was fleeting suicidal ideation at baseline, but no homicidal ideation. He was approved for intake and three sessions of PTSD treatment. The Board finds that the criteria for a rating in excess of 70 percent have not been met. The findings in such areas as the Veteran’s memory, judgment, insight, thought processes, speech, orientation, and hygiene, and the lack of evidence of such symptoms as delusions, or hallucinations, do not warrant the conclusion that the criteria for a rating in excess of 70 percent have been met. Although the Veteran has reported being unemployed since about 2007, he was a full-time student between about 2011 and 2014, and there are notations dated in 2014 that he was working part-time in the restaurant business. There is insufficient evidence of 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, disorientation to time or place, memory loss of names of close relatives, own occupation, or own name; nor are there other psychiatric symptoms of a “similar severity, frequency, and duration” as those required for a 100 percent evaluation under the General Rating Formula. Vazquez-Claudio. Given the foregoing, the Board finds that the Veteran’s symptoms are not of such severity to approximate, or more nearly approximate, the criteria for a rating of 100 percent under DC 9411. Id.; see also 38 C.F.R. § 4.7. Headaches. During his October 2017 Board hearing, the Veteran testified to the following: He gets migraines between two and five times a month, and he has been to the emergency room for treatment. He most recently went to the emergency room about six to seven months before. He sits or lays down in bed with the lights blacked out to treat his symptoms. He also has nausea and vomiting. He feels that his headaches impact his ability to work, and he indicated that this was due to missed work. At his most recent job, he had missed one or two days a month of work due to his symptoms. In May 2013, the RO granted service connection for migraine and tension headaches, evaluated as 30 percent disabling, with an effective date of January 25, 2013. The Veteran’s migraine and tension headaches have been evaluated under 38 C.F.R. § 4.124a, Diagnostic Code (DC) 8100. Under DC 8100, where migraine headaches occur with characteristic prostrating attacks occurring on an average of once a month over the last several months, a 30 percent disability rating is appropriate. Id. Migraine headaches with very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability warrant a maximum schedular 50 percent disability rating. Id. The rating criteria do not define “severe economic inadaptability,” however, nothing in Diagnostic Code 8100 requires the Veteran to be completely unable to work in order to qualify for a 50 percent rating. See Pierce v. Principi, 18 Vet. App. 440 (2004). The Secretary has conceded that the term “productive of economic adaptability” could be read as either “producing” or “capable of producing.” Id. at 445. A VA headache examination report, dated in April 2013, notes that the Veteran has been diagnosed with migraine, including migraine variants, and tension headache. He reported that since 2010 he has had daily headaches, with severe nausea and vomiting. He reported seeking emergency room care about once a month. He currently reported having migraines about twice a month, lasting four to six hours, which tended to resolve with sleep. The examiner indicated that the Veteran has characteristic prostrating attacks of migraine headache pain more frequently than once a month, but not very frequent prostrating and prolonged attacks of migraine headache pain. The examiner found that the Veteran did not have prostrating attacks of non-migraine headache pain. The Veteran’s ability to work was impacted to the extent that he gets headaches that might cause him to leave school or work once or twice a month, however, he was still able to do well in school despite his headaches. The examiner found that the impact on the Veteran’s employability was minimal, but could require some minimal accomodation. A VA headache BDQ, dated in January 2016, shows that the Veteran complained of migraine headaches four or five times a month, with an average duration of two to three days. He also reported having vomiting, an inability to tolerate light, and dizziness. He reported having tension headaches almost every day, typically lasting all day, treated with Tylenol. The examiner indicated the following: The Veteran has characteristic prostrating attacks of migraine or non-migraine headache pain, with less frequent attacks over the last several months. The examiner found that the Veteran did not have very prostrating and prolonged attacks of migraines or non-migraine pain productive of severe economic inadaptability. The Veteran’s ability to work was impacted to the extent that his headaches “make it difficult to concentrate to do anything.” The medical documentation of headache for the preceding 12 months was minimal, and the responses noted were based solely on the Veteran’s statements at examination, and not otherwise documented. A VA headache DBQ, dated in June 2018, shows the following: The Veteran stated that his condition was unchanged since his examination in 2016. He complained of persistent headaches since 2006. He has nausea and vomiting. The examiner indicated that the Veteran typically had head pain lasting more than two days, and that he has characteristic prostrating attacks of migraine or non-migraine pain once a month, but not very prostrating and prolonged attacks of migraine or non-migraine pain productive of severe economic inadaptability. The diagnoses noted migraine, including migraine variants, and tension headache. The Veteran’s ability to work was impacted to the extent that increased absenteeism was anticipated with headache flairs. Overall, VA progress notes show multiple treatments for headaches, with notations of emergent treatment. An October 2014 report notes a complaint of daily headaches. As discussed supra, there is evidence that his headaches are frequent, and that at times they are prostrating. However, the evidence is insufficient to show that the Veteran’s headaches are “very frequent, completely prostrating and prolonged,” or that they are productive of severe economic inadaptability. Malone. There is no objective evidence to show time lost from school or work due to headaches. The Veteran has testified that at his most recent job, he had missed one or two days a month of work due to his symptoms. The January 2016 and June 2018 VA examiners specifically concluded that the Veteran’s headaches were not productive of severe economic inadaptability. In summary, there is insufficient objective medical or other evidence to show that the Veteran’s headaches are of such frequency and severity to meet the criteria for an initial evaluation in excess of 30 percent under DC 8100. Accordingly, the preponderance of the evidence is against an initial evaluation in excess of 30 percent, and the claim must be denied. 3. TDIU. In May 2016, the RO denied the Veteran’s claim for a TDIU. During his hearing, held in October 2017, the Veteran asserted that he is unemployable due to his PTSD and/or headaches. 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. 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). If the schedular rating is less than 100 percent, the issue of unemployability must be determined without regard to the advancing age of the veteran. 38 C.F.R. §§ 3.341 (a), 4.19. Factors to be considered are the veteran’s education, employment history and vocational attainment. Ferraro v. Derwinski, 1 Vet. App. 326, 332 (1991). Being unable to maintain substantially gainful employment is not the same as being 100 percent disabled. “While the term ‘substantially gainful occupation’ may not set a clear numerical standard for determining TDIU, it does indicate an amount less than 100 percent.” Roberson v. Principi, 251 F.3d 1378 (Fed Cir. 2001). In determining entitlement to a TDIU, the central inquiry is whether the Veteran’s service-connected disabilities alone are of sufficient severity to cause unemployability, without regard to advancing age or disabilities for which service connection has not been established. See Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993); 38 C.F.R. §§ 3.341 (a), 4.16(a). Service connection is currently in effect for PTSD, evaluated as 70 percent disabling, migraine and tension headaches, evaluated as 30 percent disabling, rotator cuff tendonitis, right shoulder, evaluated as 20 percent disabling, rotator cuff tendonitis, left shoulder, evaluated as 20 percent disabling, tinnitus, evaluated as 10 percent disabling, residuals, status post decompression of cubital tunnel syndrome, right elbow, evaluated as 10 percent disabling, and residuals, status post decompression of cubital tunnel syndrome, left elbow, evaluated as 10 percent disabling, and hearing loss, evaluated as noncompensable. The Veteran’s combined rating is 90 percent. The evidence discussed supra is incorporate herein. In addition, a January 2016 VA peripheral nerves DBQ shows that the examiner noted that the Veteran’s ability to work was impacted to the extent that he states it makes it difficult to do work as a mechanic. A January 2016 shoulder and arm DBQ shows that the examiner stated that the Veteran’s ability to work was impacted to the extent that he claimed that it made it difficult to do work as a mechanic, especially overhead. The Veteran meets the minimum schedular requirements for TDIU, see 38 C.F.R. § 4.16 (a). However, the Board finds that the evidence does not demonstrate that the Veteran is presently unable to obtain or maintain substantially gainful employment as a result of service-connected disabilities. The Veteran is shown to have significant impairment due to psychiatric, headache, and neurological symptoms in his upper extremities. However, generally, the degrees of disability specified in the rating schedule are considered adequate to compensate for considerable loss of working time from exacerbations or any illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. A disability rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether the veteran is capable of performing the physical and mental acts required by employment, not whether he can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). In this case, although the Veteran has reported being unemployed since about 2007, but he was a full-time student between about 2011 and 2014, and there are notations that he worked part-time in the restaurant business in 2014. Although not dispositive of the claim, the SSA has also determined that he was not disabled. There is no competent opinion of record to show that his service-connected disabilities render him unemployable. Therefore, the Board finds that the Veteran does not meet the requirements for a TDIU. 4. Conclusion. The Board has considered the Veteran’s statements that he is entitled to an increased rating/an increased initial evaluation, and a TDIU. The Board is required to assess the credibility and probative weight of all relevant evidence. McClain v. Nicholson, 21 Vet. App. 319, 325 (2007). In doing so, the Board may consider factors such as facial plausibility, bias, self-interest, and consistency with other evidence of record. Jandreau v. Nicholson, 492 F.3d 1372, 1376 (Fed. Cir. 2007). The Board may consider the absence of contemporaneous medical evidence when determining the credibility of lay statements, but may not determine that lay evidence lacks credibility solely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Personal interest may affect the credibility of the evidence, but the Board may not disregard testimony simply because a claimant stands to gain monetary benefits. Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991). However, disability ratings are made by the application of a schedule of ratings which is based on average impairment of earning capacity as determined by the clinical evidence of record. Therefore, the Board finds that the medical findings, which directly address the criteria under which the disabilities are evaluated, are more probative than the Veteran’s assessment of the severity of his disabilities. The examinations also took into account the Veteran’s competent (subjective) statements with regard to the severity of his disabilities. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T.S.E., Counsel