Citation Nr: 20021933 Decision Date: 03/30/20 Archive Date: 03/30/20 DOCKET NO. 14-19 888A DATE: March 30, 2020 ORDER A rating in excess of 40 percent for lumbosacral strain is denied. The assignment of a separate rating for right lower extremity radiculopathy of the sciatic nerve, evaluated as 20 percent disabling as of April 4, 2019, is proper; the appeal is denied. The assignment of a separate rating for left lower extremity radiculopathy of the sciatic nerve, evaluated as 20 percent disabling as of April 4, 2019, is proper; the appeal is denied. As of October 21, 2010, but no earlier, a separate noncompensable rating, but no higher, for a scar of the lumbar spine is granted, subject to the laws and regulations governing the payment of monetary awards. As of April 4, 2019, a total disability rating based on individual unemployability due to service-connected disability (TDIU) is granted, subject to the laws and regulations governing the payment of monetary awards. REMANDED Entitlement to a TDIU prior to April 4, 2019, is remanded. FINDING OF FACT 1. For the entire appeal period, the Veteran’s degenerative joint disease of the lumbar spine does not result in unfavorable ankyloses of the entire thoracolumbar spine or the entire spine, intervertebral disc syndrome (IVDS) with incapacitating episodes, or associated objective neurologic abnormalities other than right and left lower extremity radiculopathy as of April 4, 2019. 2. As of April 4, 2019, but no earlier, the Veteran’s right lower extremity radiculopathy resulted in no more than moderate incomplete paralysis of the sciatic nerve. 3. As of April 4, 2019, but no earlier, the Veteran’s left lower extremity radiculopathy resulted in no more than moderate incomplete paralysis of the sciatic nerve. 4. As of October 21, 2010, the Veteran’s scar of the lumbar spine has not been shown to be unstable, painful, nonlinear, or deep, or of a size warranting a compensable rating, and does not result in disabling effects. 5. As of April 4, 2019, the Veteran’s service-connected disabilities rendered him unable to secure or follow a substantially gainful occupation consistent with his education and work history. CONCLUSION OF LAW 1. The criteria for a rating in excess of 40 percent for degenerative joint disease of the lumbar spine have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code (DC) 5237. 2. The assignment of a separate rating for right lower extremity radiculopathy of the sciatic nerve, evaluated as 20 percent disabling as of April 4, 2019, was proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, DC 8520. 3. The assignment of a separate rating for left lower extremity radiculopathy of the sciatic nerve, evaluated as 20 percent disabling as of April 4, 2019, was proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, DC 8520. 4. As of October 21, 2010, but no earlier, the criteria for the assignment of a separate noncompensable rating, but no higher, for a scar of the lumbar spine have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.118, DC 7802 5. As of April 4, 2019, 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 FINDING AND CONCLUSION The Veteran served on active duty from October 1975 to December 1978. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in July 2011 by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In March 2018, the Board remanded the Veteran’s claim for an increased rating for his back disability and entitlement to a TDIU for additional development. While on remand, an August 2019 rating decision awarded separate 20 percent ratings for right and left lower extremity radiculopathy affecting the sciatic nerves associated with the Veteran’s back disability and a noncompensable rating for a scar of the lumbar spine, effective April 4, 2019. While the Veteran did not enter a notice of disagreement with regard to the propriety of the assigned effective dates or ratings for such awards, the Board notes that such issues are part and parcel of his claim for entitlement to an increased rating for his back disability. See 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine, Note (1). Thus, the Board has assumed jurisdiction over such matters, and the case now returns for further appellate review. 1. Entitlement to a rating in excess of 40 percent for lumbosacral strain. Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant’s favor. 38 C.F.R. § 4.3. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. Separate ratings can be assigned for separate periods based on the facts found—a practice known as “staged” ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. Functional loss may be due to the absence or deformity of structures or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior in undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. § 4.40. In Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011), the United States Court of Appeals for Veterans Claims (Court) held that, although pain may cause a functional loss, “pain itself does not rise to the level of functional loss as contemplated by VA regulations applicable to the musculoskeletal system.” Rather, pain may result in functional loss, but only if it limits the ability “to perform the normal working movements of the body with normal excursion, strength, speed, coordination, or endurance.” Id., quoting 38 C.F.R. § 4.40. With respect to joints, in particular, the factors of disability reside in reductions of normal excursion of movements in different planes. Inquiry will be directed to more or less than normal movement, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity or atrophy of disuse. 38 C.F.R. § 4.45; DeLuca v. Brown, 8 Vet. App. 202 (1995). The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, even in the absence of arthritis. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). In this regard, 38 C.F.R. § 4.59 requires that “[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.” Correia v. McDonald, 28 Vet. App. 158 (2016). Further, 38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the DC under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). The appeal period before the Board begins on October 21, 2010, the date VA received the Veteran’s claim for an increased rating for his back disability, plus the one-year look-back period. See Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010). In this regard, such disability has been rated as 40 percent disabling for the entire appeal period pursuant to DC 5237, which provides that lumbosacral strain is evaluated under the General Rating Formula for Disease and Injuries of the Spine (General Rating Formula). Ratings under the General Rating Formula for Diseases and Injuries of the Spine are made with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease. A 40 percent rating is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. Finally, a 100 percent rating is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a. Note (1): Any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, should be separately evaluated under an appropriate diagnostic code. Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner’s assessment that the range of motion is normal for that individual will be accepted. Note (4): Round each range of motion measurement to the nearest five degrees. Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability. Id. IVDS may be evaluated under either the General Rating Formula or under the IVDS Rating Formula, whichever method results in the higher evaluation when all disabilities are combined. See 38 C.F.R. § 4.25 (combined ratings table). The IVDS Rating Formula provides that a 40 percent evaluation is warranted when there are incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months. A 60 percent evaluation is warranted when there are incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. Note (1) provides that an incapacitating episode is a period of acute signs and symptoms due to IVDS that requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a. Upon review of the entirety of the evidence, the Board finds that, as such fails to show that the Veteran’s back disability results in ankylosis of any part of his spine or IVDS with incapacitating episodes, a rating in excess of 40 percent under the General Rating Formula or the IVDS Rating Formula at any point pertinent to the appeal. In this regard, the Veteran’s spine was not assessed as ankylosed, either in a favorable or unfavorable position, during his June 2011 or April 2019 VA examinations; nor has the Veteran, or any medical professional, indicated that his spine is ankylosed. Moreover, his medical records consistently show that, while he experiences constant, rather than flare-ups of, pain in his back, he is capable of range of motion, albeit limited, in his spine, and such VA examinations show that, while his range of motion is further reduced following repetitive use testing and repeated use over time, he is still capable of range of motion in the thoracolumbar spine. Consequently, as ankylosis is not present, a rating in excess of 40 percent under the General Rating Formula is not warranted. Moreover, the Veteran has not reported, and his medical records do not reflect, that he has experienced IVDS with incapacitating episodes. Furthermore, no incapacitating episodes were noted at the June 2011 examination, and the April 2019 VA examiner specifically found that IVDS was not present. Therefore, the Board finds that a rating in excess of 40 percent under the IVDS Rating Formula is not warranted. Pursuant to Note (1) of the General Rating Formula, the Board has also considered whether separate ratings are warranted for associated objective neurologic abnormalities. In this regard, the Veteran is currently in receipt of separate ratings for right and left lower extremity radiculopathy of the sciatic nerve, each evaluated as 20 percent disabling as of April 4, 2019, the propriety of which will be addressed below. However, the Veteran does not have any additional objective neurologic abnormalities associated with his back disability, further separate ratings are not warranted. In this regard, while he has reported experiencing erectile dysfunction, the April 2019 VA examiner opined that such was less likely than not related to his back disability; rather, it was noted that he experienced such following surgery for prostate cancer, and also had hypertension and diabetes mellitus. Furthermore, the June 2011 VA examiner attributed his erectile dysfunction to long-term smoking. Moreover, the evidence does not show, and the Veteran does not contend, that his back disability results in bladder or bowel incontinence. Further, both the June 2011 and April 2019 VA examiners found that such neurological disorders were not present. Consequently, separate ratings for objective neurologic abnormalities other than radiculopathy of the bilateral lower extremities is not warranted. 2. Propriety of the assignment of a separate rating for right lower extremity radiculopathy of the sciatic nerve, evaluated as 20 percent disabling as of April 4, 2019. 3. Propriety of the assignment of a separate rating for left lower extremity radiculopathy of the sciatic nerve, evaluated as 20 percent disabling as of April 4, 2019. As noted above, the Veteran was awarded separate 20 percent ratings for right and left lower extremity radiculopathy of the sciatic nerve, as of April 4, 2019, the date of the VA examination reflecting the presence of such manifestations. Such disability is evaluated pursuant to DC 8520, which provides for a 20 percent rating for moderate incomplete paralysis of the sciatic nerve; a 40 percent rating for moderately severe incomplete paralysis of the sciatic nerve; and a 60 percent rating for severe incomplete paralysis of the sciatic nerve with marked muscular atrophy. Further, an 80 percent rating is warranted where there is complete paralysis of the sciatic nerve where the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost. 38 C.F.R. § 4.124a. The words “moderate” and “severe” are not defined in 38 C.F.R. §§ 4.120-4.124a. In applying the schedular criteria for rating peripheral nerve disabilities, the term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type pictured for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. Id. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. In this regard, for the appeal period prior to April 4, 2019, the Veteran’s medical records and June 2011 VA examination report are negative for objective evidence of radiculopathy. The Board observes that Social Security Administration (SSA) records dated in May 1997 reflect a report of a history of back pain with radiation of pain into the right lower extremity, with motor and sensory deficits in the right lower extremity. However, the Veteran subsequently underwent a L5-S1 laminectomy and discectomy on the right due to a herniated disc and severe degenerative disease. While he continued to complain of radiating pain, a 2003 EMG/NCV test of the right leg showed no evidence of radiculopathy. Furthermore, there is no evidence of objective neurologic abnormalities of right or lower extremity radiculopathy during the appeal period stemming from the Veteran’s October 2010 claim. Specifically, at the June 2011 VA examination, the Veteran had normal motor strength in the bilateral lower extremities, normal reflexes in the right leg (absent on the left leg due to an unrelated below the knee amputation), and no sensory deficits. Further, the examiner found that there was no abnormality identified in the anatomic spinal nerve distribution in either leg. Finally, he noted that a 2009 MRI of the lumbar spine was negative for significant central canal stenosis. The Board further observes that April 2016 and July 2016 VA treatment records reflect a notation of chronic back pain with right lumbar radiculopathy; however, such findings were not clinically correlated and, while a November 2015 X-ray showed moderate to severe degenerative disc disease with facet arthropathy, disc space narrowing, and marginal osteophyte formation with sclerotic changes at L5-S1, no nerve impingement was shown. Furthermore, the Veteran’s complaints of radiating pain, to include as reported at his June 2017 Board hearing, are contemplated in the currently assigned 40 percent rating under the General Rating Formula. Rather, the first indication of objective neurologic abnormalities of bilateral lower extremity radiculopathy was noted on VA examination on April 4, 2019, and, thus, such has been established as the effective date of the separately assigned ratings for such disabilities. At the April 2019 VA examination, the examiner found that the Veteran’s back disability results in moderate incomplete paralysis of the sciatic nerve bilaterally. In support of such determination, he noted that the Veteran had moderate intermittent pain and moderate paresthesias and/or dysesthesias; however, he denied constant pain and numbness. Furthermore, the Veteran had normal muscle strength at 5/5, reflexes, and sensory testing throughout the bilateral lower extremities (to the extent possible in light of the Veteran’s unrelated below the knee amputation of the left leg). Consequently, as the Veteran’s bilateral lower extremity radiculopathy results in no more than subjective symptoms, with normal objective testing, the Board finds that such results in no more than moderate incomplete paralysis of the sciatic nerve. Therefore, ratings in excess of 20 percent for such disabilities is not warranted. Consequently, the Board finds that the assignment of separate ratings for right and left lower extremity radiculopathy of the sciatic nerve, evaluated as 20 percent disabling as of April 4, 2019, was proper. 4. Propriety of the assignment of a separate rating for scar of the lumbar spine associated with lumbosacral strain, evaluated as noncompensable as of April 4, 2019. As noted above, the Veteran was awarded a separate noncompensable rating for a scar of the lumbar spine, as of April 4, 2019, the date of the VA examination reflecting the presence of such manifestation. Such disability is evaluated pursuant to DC 7802, which pertains to burn scars or scars due to other causes not of the head, face, or neck that are superficial and nonlinear, and provides for a 10 percent rating when the scar(s) cover an area or areas of 144 square inches (929 sq. cm) or greater. No other rating is provided by this DC. Note (1) states that a superficial scar is one not associated with underlying soft tissue damage. 38 C.F.R. § 4.118. As an initial matter, the Board observes that, while an effective date of April 4, 2019, was assigned, the evidence demonstrates that the Veteran’s scar of the lumbar spine has been present prior to the appeal period. Specifically, as noted previously, the Veteran underwent surgery on his lumbar spine in the 1990’s and a September 2002 VA examination noted a well-healed scar in the lumbosacral area measuring 6 centimeters. Consequently, the Board finds that an effective date of October 21, 2010, the date of receipt of the Veteran’s claim for an increased rating for his back disability, is warranted. In this regard, as such manifestation was factually ascertainable more than one year prior to the receipt of such claim, the proper effective date is the date of claim. 38 U.S.C. § 5110(b)(2); 38 C.F.R. § 3.400(o); Harper v. Brown, 10 Vet. App. 125 (1997). As to the propriety of the noncompensable rating assigned for the Veteran’s scar of the lumbar spine, the Board notes that the April 2019 VA examination found that such measured at 5.5 by 0.2 centimeters, and is not painful or unstable. Further, there is no indication that such is nonlinear, deep, or results in any disabling effects. Consequently, a compensable rating is not warranted under DC 7802, or any other potentially applicable DC, to include DC 7801, 7804, or 7805. Therefore, the Board finds that a separate noncompensable rating, but no higher, is warranted as of October 21, 2010, but no earlier. Other Considerations In reaching the foregoing determinations, the Board recognizes the Veteran’s sincerely held belief that his back disability and associated bilateral lower extremity radiculopathy and scar symptomatology is more severe than as reflected by the currently assigned ratings, and notes he is competent to describe his symptoms and their effects on his daily life. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465, 469 (1994); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). However, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). The Board finds the medical evidence in which professionals with medical expertise examined the Veteran, completed necessary testing, acknowledged his reported symptoms, and described the manifestations of such disabilities in light of the rating criteria to be more persuasive than his own reports regarding the severity of such conditions. The Board has also considered whether additional staged ratings under Hart, supra, are appropriate for the Veteran’s service-connected back disability and associated bilateral lower extremity radiculopathy and scar; however, the Board finds that such symptomatology has been stable throughout each period on appeal. Therefore, assigning additional staged ratings is not warranted. Further, neither the Veteran nor his representative have raised any other issues, nor have any other issues been reasonably raised by the record, in connection with the increased rating claim adjudicated herein. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). In sum, the Board has resolved all doubt in the Veteran’s favor, which has resulted in an earlier effective date for the award of a separate rating for scar of the lumbar spine. However, insofar as the Board has denied higher or separate ratings herein for his service-connected back disability and associated bilateral lower extremity radiculopathy and scar, the preponderance of the evidence is against such aspects of the Veteran’s claim. Therefore, the benefit of the doubt doctrine is not applicable to those aspects of the appeal and his increased rating claim must otherwise be denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 5. Entitlement to a TDIU as of April 4, 2019. The Veteran contends that his service-connected lumbosacral strain and associated bilateral lower extremity radiculopathy render him unable to secure or follow a substantially gainful occupation. Specifically, he reports that such service-connected disabilities prevent him from maintaining full-time employment consistent with his past work as a truck driver due to pain and limited range of motion. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a veteran 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, such disability shall be ratable as 60 percent or more, and if there are two or more 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). Rating boards should submit to the Director of Compensation Service for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities but who fail to meet the percentage standards set forth in 38 C.F.R. § 4.16 (a). See 38 C.F.R. § 4.16(b). From October 21, 2010, the date of the Veteran’s increased rating claim, to April 4, 2019, he is service-connected for lumbosacral strain, evaluated as 40 percent disabling, and a scar of the lumbar spine, evaluated as noncompensably disabling. As of April 4, 2019, he is also service-connected for right and left lower extremity radiculopathy affecting the sciatic nerve, each evaluated as 20 percent disabling. As such disabilities all stem from a common etiology, i.e., the Veteran’s back disability, they are considered as one for TDIU purposes. Consequently, his combined disability rating is 40 percent prior to April 4, 2019, and 60 percent thereafter. Therefore, he meets the schedular threshold for consideration of a TDIU as of April 4, 2019. However, prior to such date, he does not and, thus, as will be discussed below, a TDIU is only available on an extra-schedular basis. In his March 2011 Veteran’s Application for Increased Compensation Based on Unemployability (VA Form 21-8940), the Veteran reported that he became too disabled to work as of 1996, the date he last worked full-time. In this regard, he reported that he completed high school and one year of trade school for auto mechanics, and he had previously worked as a car detailer, a dish washer, and a truck driver. He reported that his last full-time employment was as a truck driver, which reportedly ended due to limitations from his back disability in 1996. VA treatment records from November 1982 document his inability to perform work-study duties when he could not do the lifting, bending, or stooping required to perform his job. Furthermore, SSA determined that the Veteran was rendered disabled as a result of his lumbar spine impairment as of December 1995. In reaching such determination, SSA noted that the Veteran’s physician, Dr. R.R. indicated in April 1997 that the Veteran was only able to work three hours in a normal work due to chronic and incapacitating back pain, and found that the Veteran’s back disability rendered him unable to perform his past relevant work. At the June 2011 VA examination, the Veteran reported that he was not working due to back pain. While he could not quantify how far or how long he can walk, he indicated that he experienced back pain after standing for 10 minutes. The examiner ultimately concluded that a combination of the Veteran’s nonservice-connected disorders and his service-connected back disability would interfere with his ability to perform manual labor, but such did not interfere with his ability to obtain and maintain sedentary employment. Similarly, at the April 2019 VA examination, the examiner noted that the Veteran’s service-connected back disability and associated bilateral lower extremity radiculopathy impacted his ability to bend his back and lift objects and, therefore, he could not perform manual work. Based on such assessments of the functional impact that the Veteran’s back disability and associated bilateral lower extremity radiculopathy, the Board finds that such renders him unable to perform physical or manual labor. While the VA examiners found that such did not interfere with his ability to obtain and maintain sedentary employment, the Veteran does not have the education or work history that would allow him to be successful in such a role. Specifically, as noted previously, he has a high school degree and one year of trade school, and has worked as a car detailer, a dish washer, and a truck driver, which all require physical or manual labor. Furthermore, at the June 2017 Board hearing, the Veteran described his inability to perform work that required him to sit for very long, and indicated that he had no knowledge or training regarding computers and administrative work. Consequently, the Board finds that, as of April 4, 2019, the date the Veteran meets the schedular threshold for a TDIU, his back disability and associated bilateral lower extremity radiculopathy renders him unable to secure or follow a substantially gainful occupation consistent with his education and work history and, therefore, a TDIU is warranted. However, as the Veteran does not meet the schedular criteria for a TDIU prior to April 4, 2019, the Board herein remands such matter for referral to the Director of Compensation Service for extra-schedular consideration pursuant to 38 C.F.R. § 4.16(b). REASONS FOR REMAND 6. Entitlement to a TDIU prior to April 4, 2019. As noted above, as the evidence suggest that the Veteran is unable to secure or follow a substantially gainful occupation consistent with his education and work history due to his service-connected back disability for the appeal period prior to April 4, 2019, the claim should be submitted to the Director of Compensation Service for consideration of whether a TDIU is warranted on an extra-schedular basis pursuant to 38 C.F.R. § 4.16(b). The matter is REMANDED for the following action: Refer the case to the Director of Compensation Service for extra-schedular consideration of a TDIU prior to April 4, 2019, pursuant to 38 C.F.R. § 4.16(b). A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.B. English, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.