Citation Nr: 18159795 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 16-16 794 DATE: December 20, 2018 ORDER A total disability rating based on individual unemployability (TDIU) is granted. FINDINGS OF FACT 1. The Veteran is service-connected for prostate cancer, rated at 40 percent; peripheral neuropathy of the right lower extremity, rated at 20 percent; peripheral neuropathy of the left lower extremity, rated at 20 percent; tear of the left radioulnar and ulnocarpal ligaments, rated at 10 percent; disc space narrowing at C5-6, rated at 10 percent; tinnitus, rated at 10 percent; recurrent sinusitis and allergic rhinitis, rated at 10 percent; chronic acid reflux status post duodenitis, rated at 10 percent; status post non-Hodgkin’s lymphoma, rated at 10 percent; hypothyroidism, rated at 10 percent; macular degeneration, rated at 0 percent; bilateral hearing loss, rated at 0 percent; erectile dysfunction, rated at 0 percent; and residual scar status post prostatectomy, rated at 0 percent; for a combined service-connected disability rating of 80 percent. 2. Resolving reasonable doubt in favor of the Veteran, his service-connected disabilities, especially prostate cancer and non-Hodgkin’s lymphoma with the associated peripheral neuropathy, preclude him from securing or following a substantially gainful occupation. CONCLUSION OF LAW The criteria for a TDIU have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSION 1. TDIU On an April 2013 application for a TDIU, the Veteran indicated that his service-connected prostate cancer and non-Hodgkin’s lymphoma along with the problems created by treatment prevent him from securing or following any substantially gainful occupation. He reported that he last worked full-time and became too disabled to work in December 2012. He reported completing college with no other education or training. He reported missing 113 hours of work in the past six years. A TDIU may be assigned where the schedular rating is less than total, when it is found that the disabled person is unable to secure or follow a substantially gainful occupation as a result of a single service-connected disability ratable at 60 percent or more, or as a result of two or more disabilities, provided at least one disability is ratable at 40 percent or more, and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.340, 3.341, 4.16(a) (2018). The Veteran is service-connected for prostate cancer, rated at 40 percent; peripheral neuropathy of the right lower extremity, rated at 20 percent; peripheral neuropathy of the left lower extremity, rated at 20 percent; tear of the left radioulnar and ulnocarpal ligaments, rated at 10 percent; disc space narrowing at C5-6, rated at 10 percent; tinnitus, rated at 10 percent; recurrent sinusitis and allergic rhinitis, rated at 10 percent; chronic acid reflux status post duodenitis, rated at 10 percent; status post non-Hodgkin’s lymphoma, rated at 10 percent; hypothyroidism, rated at 10 percent; macular degeneration, rated at 0 percent; bilateral hearing loss, rated at 0 percent; erectile dysfunction, rated at 0 percent; and residual scar status post prostatectomy, rated at 0 percent; for a combined service-connected disability rating of 80 percent. A February 2013 VA prostate cancer examination report reflects the examiner’s note that the Veteran retired due to his cancer and peripheral neuropathy making him unable to have stamina to do more than 2 to 3 METs of activity without stopping to rest. An April 2013 letter from a private physician reflects that the Veteran was advised to reduce his work activity in May 2012 after his prostate cancer surgery and later advised to retire and remove himself from the workforce entirely. A September 2014 VA prostate cancer examination report reflects the examiner’s opinion that the Veteran’s disability does not prevent employment at either a sedentary or light physically-active occupation. However, the examiner noted the Veteran’s report that his incontinence prevented him from doing his job, that moving containers and pushing and pulling carts caused his incontinence to be more pronounced. The examiner also noted the Veteran’s report that since his prostate removal his energy level had significantly decreased to about 50 percent. A September 2014 VA non-Hodgkin’s lymphoma examination report reflects the examiner’s opinion that the Veteran’s disability prevents a physically-active occupation that requires being on his feet constantly or includes heavy lifting or carrying heavy object, but would not prevent sedentary work or light physical-activity job. However, the examiner noted the Veteran’s report that his neuropathy makes prolonged walking and standing more difficult, and running impossible. The examiner also noted the Veteran’s report that he is increasingly unsure of the position of his feet which is causing him to be unstable, disturbing his balance especially if he cannot see his feet. An April 2016 private medical record continues to show that the Veteran is unable to work and unemployable. Given the above, the Board finds that the evidence is in relative equipoise as to whether the Veteran’s prostate cancer and non-Hodgkin’s lymphoma prevent him from securing or following a substantially gainful occupation. A VA examiner in February 2013 prior to the Veteran’s retirement noted his decreased stamina and METs of 2 to 3, which the Board observes contemplates just standing and walking. A private physician initially advised the Veteran to reduce his work hours and later to not work at all due to his residuals of prostate cancer and non-Hodgkin’s lymphoma. While two VA examiners indicated that the Veteran’s disabilities would not prevent sedentary or light physically-active work, they also noted his reduced stamina and problems due to peripheral neuropathy of the lower extremities. Thus, resolving reasonable doubt in favor of the Veteran, the Board finds that his service-connected disabilities, especially prostate cancer and non-Hodgkin’s lymphoma with the associated peripheral neuropathy, preclude him from securing or following a substantially gainful occupation. 38 U.S.C. § 5107(b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Accordingly, the Board concludes that a TDIU is warranted. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. W. Kim, Counsel