Citation Nr: 18154630 Decision Date: 11/30/18 Archive Date: 11/30/18 DOCKET NO. 09-03 647A DATE: November 30, 2018 ORDER Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is granted. Entitlement to service connection for the Veteran’s cause of death is granted. FINDINGS OF FACT 1. In February 2007, at the time the Veteran became unemployed, he was rated at 40 percent for a lumbar spine disability, 30 percent for right knee degenerative joint disease (DJD), i.e., arthritis, and 30 percent for left knee DJD, for a combined rating of 70 percent. From August 1, 2011 the Veteran was rated at 20 percent for left knee DJD and 20 percent for right knee DJD, for a total combined rating of 40 percent. 38 C.F.R. § 4.25; see May 2011 rating decision. 2. The Veteran stated that he worked as an electronic inspector from November 1978 to February 2007. The record includes lay statements, as well as private and VA physician reports, reflecting that he became unemployed in February 2007 as an electronic inspector, and that his job started requiring him to stand and carry 40 pounds. February 2007 private treatment records show his physician did not believe that he could progress to the job tasks he had been asked to perform because of his knee disability. As of May 2007, the Veteran had limitations functionally and reported to be limited to a scooter for long distances and a walker for short distances. In addition, VA examinations dated February 2008, September 2009, and October 2011, describe functional limitations such as the Veteran being unable to stand, unable to balance, and unable to walk more than a few yards, with constant pain and weakened movement in both knees. 3. In June 2017 an advisory opinion was requested from the Chief Benefits Director or Director, Compensation and Pension Service, for extra-schedular consideration of TDIU. An opinion was received in March 2018. 4. The Board finds the Veteran was rendered unable to obtain and maintain substantially gainful employment as a result of his service-connected disabilities throughout the period on appeal. 5. The Veteran died in December 2011. His death certificate lists the immediate cause of death as cardiac arrest due to or as a consequence of cardiomyopathy, non-insulin-dependent diabetes mellitus, and dyslipidemia. 6. At the time of his death, the Veteran was service connected for DJD of the knees, so bilaterally, i.e., for both. 7. In July 2016, VA obtained a medical opinion regarding the Veteran’s cause of death. The examiner concluded that the Veteran’s service-connected knee condition is at least as likely as not to have contributed substantially to his cause of death. The examiner opined that severe degenerative changes of both knees would make physical activity painful, likely worsening the Veteran’s obesity and depression. The examiner stated it was reasonable that the Veteran’s cause of death, including heart disease, lipid abnormalities, and diabetes would be worsened by obesity and inactivity. 8. Another VA opinion was obtained in August 2016. That examiner concluded that the Veteran’s bilateral knee condition was neither the principal cause of death nor contributed substantially or materially to the Veteran’s cause of death. The examiner opined that the Veteran’s obesity worsened his knee condition, rather than his knee condition worsening his obesity. But resolving all reasonable doubt in the Veteran’s favor, the Board finds that service connection for the Veteran’s cause of death is warranted. CONCLUSIONS OF LAW 1. The criteria for a TDIU on a schedular and extra-schedular basis have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.3, 4.15, 4.16; see also Thun v. Peake, 22 Vet. App. 111 (2008) 2. The criteria for service connection for the Veteran’s cause of death also have been met. 38 U.S.C. §§ 1110, 1112, 1131, 1310, 5107 (2012); 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.311, 3.312 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1974 to February 1978. He died in December 2011; the Appellant is his surviving spouse. In March 2015, the Appellant requested a Board hearing. A hearing was scheduled in October 2015. The Appellant did not appear for the scheduled hearing, however, and the request consequently is considered withdrawn. But this ultimately is of no significance since the claims are being granted, regardless. (Continued on the next page)   The Board remanded this appeal in December 2015 for further development. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. D’Allaird, Associate Counsel