Citation Nr: 20054064 Decision Date: 08/14/20 Archive Date: 08/14/20 DOCKET NO. 13-32 340 DATE: August 14, 2020 ORDER Entitlement to a rating in excess of 10 percent prior to January 4, 2020, and in excess of 20 percent thereafter for chronic lumbar strain (back condition) is denied. REMANDED Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. FINDINGS OF FACT 1. Prior to January 4, 2020, the Veteran’s back condition was not manifested by forward flexion of the thoracolumbar spine limited to 60 degrees or less; a combined range of motion of the thoracolumbar spine limited to 120 degrees or less; muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis; or ankylosis of the spine. 2. From January 4, 2020, the Veteran’s back condition has not been manifested by forward flexion of the thoracolumbar spine limited to 30 degrees or less or by ankylosis of the spine. 3. The Veteran’s back condition was not manifested by intervertebral disc syndrome (IVDS) resulting in incapacitating episodes. CONCLUSION OF LAW The criteria for a rating in excess of 10 percent prior to January 4, 2020, and in excess of 20 percent thereafter for back condition have not been met. 38 U.S.C. §§ 1155, 5107 (b) (2012); 38 C.F.R. §§ 3.102, 3.159, 3.400, 4.3, 4.7, 4.14, 4.21, 4.71a, Diagnostic Code 5237 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from September 1998 to September 2001. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2011 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia. The Veteran testified at a Central Office hearing before the undersigned Veterans Law Judge in May 2014. A transcript of the hearing is of record. The Board remanded this matter in May 2015 and December 2019. The Board finds there has been substantial compliance with its December 2019 remand directives. See D’Aries v. Peake, 22 Vet. App. 97, 105 (2008); see also Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (holding that there was no Stegall (Stegall v. West, 11 Vet. App. 268 (1998)) violation when the examiner made the ultimate determination required by the Board’s remand.) The issue of entitlement to TDIU is raised by the Veteran’s contentions. Rice v. Shinseki, 22 Vet. App. 447 (2009). Entitlement to a rating in excess of 10 percent prior to January 4, 2020, and in excess of 20 percent thereafter for chronic lumbar strain (back condition) Disability ratings are determined by the application of VA’s Schedule for Rating Disabilities (Schedule), which is based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Pertinent regulations do not require that all cases show all findings specified by the Schedule, but that findings sufficient to identify the disease and the resulting disability and, above all, coordination of the rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21; see also Mauerhan v. Principi, 16 Vet. App. 436 (2002). When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required 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,” in all claims for increased ratings. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505, 519 (2007). The Veteran contends that he is entitled to a rating in excess of 10 percent prior to January 4, 2020, and in excess of 20 percent thereafter for his back condition. The Veteran’s degenerative disc disease of the lumbar spine is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5237. Diagnostic Code 5237 pertains to lumbosacral strain. Diagnostic Code 5237 directs that the disability be rated under the General Rating Formula for Diseases and Injuries of the Spine (General Formula). As relevant in this case, under the General Formula, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour, or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. 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. A 100 percent rating is warranted for unfavorable ankylosis of the entire spine. Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1. Ankylosis is defined as “immobility and consolidation of a joint due to disease, injury, or surgical procedure.” Dorland’s Illustrated Medical Dictionary, 94 (32nd ed. 2012). Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Id. at Note 5. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (“[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran’s disability, after which a rating is determined based on the § 4.71a criteria.”). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). Prior to January 4, 2020 In a December 2010 VA examination, the Veteran reported pain flare ups with prolonged standing, walking, or other physical activities. This occurred almost on a daily basis as his job as a security guard required him to stand for prolonged periods of time. The pain was usually gone by the next day and did not require medication. He denied other symptoms associated with his low back such as muscle spasms, stiffness, weakness, or any radicular symptoms. The Veteran reported flare ups as moderate with activity. Precipitating factors were activities such as prolonged standing or walking. Alleviating factors were rest and massage. The Veteran had to decrease physical activities during flare ups. There were no incapacitating episodes of spine disease. The Veteran was able to walk 1 to 3 miles. Upon examination, gait was normal. There was no gibbus, kyphosis, lumbar lordosis, lumbar flattening, reverse lordosis, list, scoliosis, or ankylosis. There was no spasm, atrophy, guarding, pain with motion, tenderness, or weakness. Range of motion was flexion to 90 degrees, extension to 30 degrees, left lateral flexion to 30 degrees, left lateral rotation to 30 degrees, right lateral flexion to 30 degrees, and right lateral rotation to 30 degrees. There was no evidence of pain on active range of motion. There was no objective evidence of pain following repetitive motion or additional limitation after 3 repetitions of range of motion. In a September 2012 VA treatment record, the Veteran’s gait was steady. There was tenderness across the lower back with no swelling or deformity. There was some paralumbar muscle tightness. The Veteran complained of chronic lower back pain. In a December 2013 VA treatment record, the Veteran was evaluated for lower back pain. He said the pain and discomfort had extended to the upper/mid-back. He described tremendous pain when taking care of his children, and washing dishes, clothes, and changing diapers. In a March 2014 examination conducted by a VA treating physician, the Veteran reported flare ups that caused soreness and tightness in mid-lumbar area of back. Range of motion was forward flexion to 15 degrees with objective evidence of painful motion to 15 degrees, extension to 20 degrees with objective evidence of painful motion to 20 degrees, right lateral flexion to 20 degrees with objective evidence of painful motion to 20 degrees, left lateral flexion to 20 degrees with objective evidence of painful motion to 20 degrees, right lateral rotation to 20 degrees with objective evidence of painful motion to 20 degrees, and left lateral rotation to 15 degrees with objective evidence of painful motion to 15 degrees. Repetitive use testing and functional loss sections were not completed. The examiner noted tenderness along the lower thoracic area and lumbar area. Parathoracic muscles were tight. The Veteran had guarding or muscle spasm that did not result in abnormal gait or spinal contour. There was no muscle atrophy. There was no radiculopathy or any other neurologic abnormalities. There was no IVDS. It was noted that the Veteran used a back brace to help support lower back and for pain control. The examiner noted that pain limited how much he could walk and how long he could stand or sit. Stiffness limited work and he could not get in tight places or reach. At the May 2014 Board hearing, the Veteran testified that he had pain at each range of motion during the December 2010 VA examination. The Veteran reported “stiffness, like swelling, some like irritation throughout the day.” The Veteran said he had constant pain rated as a 10 daily. The Veteran said that the only time he was not in pain was when he was asleep. He took Tramadol and Naproxen for the pain. Daily activities caused stiffness and more pain in the lower spine. He said if he moved fast he would get a sharp pain. He said he tried to limit walking as much as possible. He also had to lift objects a certain way. He said he had physical therapy. The Veteran said he was not employed. He was last employed April 2013 as a dental assistant. The Veteran said he was trained for dental assistant and hygienist work in the military. In a May 2015 VA treatment record, it was noted that the Veteran’s back had left paraspinal muscle tightness/spasm. There was good range of motion and negative leg raise. In a June 2015 VA treatment record, the Veteran complained of back pain and requested his medication be renewed. He said he was having lower back pain and legs were still going numb after sitting for a while. In an October 2015 VA examination, the Veteran said since his last VA examination he continued to have chronic low back pain without neurologic findings. He complained of numbness in the back of his legs with prolonged sitting. He had negative x-ray and MRI of the lumbar spine. Etiology was unclear, and the Veteran said that he had numbness in back thigh with prolonged sitting on commode. This went away after moving around. The Veteran continued to have daily back pain, stiffness, and muscle spasm. He was treated with TENS, Naproxen, and Mentho cream. He had constant 8 out of 10 low back pain (on fire) from bottom of spine up to his neck. His back was aggravated after standing for more than 30 minutes, walking more than 2 blocks, stairs, bending, and twisting. The Veteran did not report flare ups or functional loss. Range of motion was forward flexion to 70 degrees, extension to 25 degrees, right lateral flexion to 25 degrees, left lateral flexion to 25 degrees, right lateral rotation to 20 degrees, and left lateral rotation to 20 degrees. Range of motion itself did not contribute to functional loss. Pain was noted on exam at all ranges of motion on rest/non-movement. There was no evidence of pain with weight bearing. There was evidence of localized tenderness or pain on palpation in the low back. The Veteran was able to perform repetitive use testing with at least 3 repetitions without additional loss of function or range of motion. The Veteran was examined immediately after repetitive use and the examiner determined that pain, weakness, fatigability or incoordination did not significantly limit functional ability with repeated use over a period of time. There was localized tenderness that did not result in abnormal gait or abnormal spinal contour. There was no guarding, muscle spasm, or muscle atrophy. There was no radiculopathy, ankylosis, or other neurologic abnormalities. There was no IVDS and the Veteran did not use assistive devices. The examiner noted that the Veteran’s back condition did impact his ability to work. The examiner said the Veteran was in school for aviation work. He had trouble with prolonged sitting. In the past he was a dental assistant and had trouble leaning forward; he was no longer doing this job. He did full time child-care and said it was painful to pick up over 50 pounds. He had to squat to do housework; he did not bend over. In an October 2017 private treatment letter, it was noted that the Veteran suffered from severe osteoarthritis and chronic back pain. As such, the Veteran may benefit from a tub that he could fit his whole body in for warm soaks. In a November 2017 VA treatment record, it was noted that pain was mostly in his mid-back, and radiated from mid-back to tailbone constantly. The pani was described as achy, sore, shooting, and throbbing. Pain was worse randomly with movements, but the Veteran was unable to tell the physician specific movements. The Veteran reported that at times he got severe sharp pain “out of nowhere.” He wore a velcro back brace for support throughout the day. It was determined that there was minimal degenerative changes without significant spinal canal or neural foraminal stenosis. In a November 2018 VA treatment record, the Veteran’s back was positive for right lumbar paravertebral muscle spasm/ttp. There was limited range of motion. From January 4, 2020 In a January 2020 VA examination, the Veteran reported worsened back spasms, constant tightness, and sharp pain. The Veteran did not report flare ups. The Veteran described functional loss as pain with prolonged sitting/standing, bending, and household chores. Range of motion was forward flexion to 60 degrees, extension to 20 degrees, right lateral flexion to 25 degrees, left lateral flexion to 25 degrees, right lateral rotation to 25 degrees, and left lateral rotation to 25 degrees. Range of motion itself contributed to functional loss described with bending and squatting. Pain was noted at all ranges of motion and caused functional loss. There was evidence of pain with weight bearing. There was no objective evidence of localized tenderness or pain on palpation. The Veteran was able to perform repetitive use testing with at least 3 repetitions without additional loss of function or range of motion. The Veteran was not examined immediately after repetitive use over time and the examiner determined that the examination was neither medically consistent or inconsistent with the Veteran’s statements describing functional loss with repetitive use over time. Pain significantly limited functional ability with repeated use over a period of time. Range of motion was described as forward flexion to 55 degrees, extension to 15 degrees, right lateral flexion to 20 degrees, left lateral flexion to 20 degrees, right lateral rotation to 20 degrees, and left lateral rotation to 20 degrees. The examination was not conducted during a flare up and the examiner determined that the examination was neither medically consistent or inconsistent with the Veteran’s statements describing functional loss during flare up. Pain, weakness, fatigability or incoordination did not significantly limit functional ability with flare ups. There was no guarding or muscle spasm. There was interference with sitting and standing; prolonged sitting and standing caused pain. There was no muscle atrophy. There was no radiculopathy, ankylosis, or other neurologic abnormalities. There was no IVDS. No assistive devices were noted. The examiner determined that the Veteran’s back condition impacted his ability to work. Self-employed was noted with 0 to 1 week of work time lost in the past 12 months. Prolonged sitting and standing caused pain due to chronic lumbar strain. In a January 2020 x-ray, it was noted that the Veteran had normal lumbar spine radiographs. Additional post service treatment records a silent for any evidence showing a rating was warranted in excess of 10 percent prior to January 4, 2020, or in excess of 20 percent thereafter for the Veteran’s back condition. Overall, the Board finds that the preponderance of the evidence is against a rating in excess of 10 percent for a back condition prior to January 4, 2020, and in excess of 20 percent thereafter. The Board finds that prior to January 4, 2020, the Veteran’s back condition had forward flexion to, at worse, 70 degrees. The Board notes the March 2014 VA examination that finds forward flexion to only 15 degrees. However, the Board also notes that this examination was incomplete and is at odds with all other evidence which is of record. Therefore, the Board finds this examination’s findings inadequate. At no point prior to January 4, 2020, was the Veteran’s back condition credibly shown to have forward flexion limited to 60 degrees or less. Additionally, there was no muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour to warrant a higher 20 percent disability rating. The Board acknowledges the Veteran’s lay reports of symptoms and that there was sharp pain and increased stiffness. However, even considering the Veteran’s lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements that would not result in limitation of motion more nearly approximating forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees or the combined range of motion of the thoracolumbar spine not greater than 120 degrees. The Veteran’s medical treatment records do not show such limitations during that period. Accordingly, the Board concludes that the criteria for an initial rating in excess of 10 percent was not warranted prior to January 4, 2020. Moreover, from January 4, 2020, the Board finds that the preponderance of the evidence is against a rating in excess of 20 percent for the Veteran’s back condition. The Board finds that from January 4, 2020, the Veteran’s back condition had forward flexion to, at worse, 60 degrees. At no point from January 4, 2020, was the Veteran’s back condition shown to have forward flexion to 30 degrees or less. Additionally, there was no evidence of any ankylosis to warrant a higher 40 percent disability rating. The Board acknowledges the Veteran’s lay reports of symptoms and that there was sharp pain and increased stiffness. However, even considering the Veteran’s lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements that would not result in limitation of motion more nearly approximating forward flexion of the thoracolumbar spine less than 30 degrees. The Veteran’s medical treatment records do not show such limitations during that period. Accordingly, the Board concludes that the criteria for an initial rating in excess of 20 percent was not warranted from January 4, 2020. The Board has also considered whether higher initial ratings may be assigned under the Formula for Rating IVDS Based on Incapacitating Episodes. For purposes of the Formula for Rating IVDS Based on Incapacitating Episodes, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. In this case, there is no evidence of IVDS, and the Veteran has not stated he has IVD or that there are periods where he must rest due to his lumbar spine symptoms. Therefore, a higher rating due to IVDS is not warranted. For the foregoing reasons, the preponderance of the evidence is against the Veteran’s claim for entitlement to ratings in excess of 10 percent prior to January 4, 2020, and in excess of 20 percent thereafter for a back condition. In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Yancy v. McDonald, 27 Vet. App. 484, 495 (2016); Doucette v. Shulkin, 38 Vet. App. 366, 369-70 (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). REASONS FOR REMAND Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. The Veteran contends that he is entitled to TDIU because of his service-connected disabilities. 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). Here, the Veteran is currently service-connected for adjustment disorder with depressed mood, rated as 70 percent disabling; chronic lumbar strain, rated as 20 percent disabling; gastroesophageal reflux disease (GERD), rated as 10 percent disabling; residuals of scrotal injury, rated as 10 percent disabling; erectile dysfunction associated with residuals of scrotal injury, rated as noncompensable; and tinea cruris with genital warts, rated as noncompensable. Her combined disability rating is 80 percent. Therefore, the Veteran meets the preliminary schedular requirement for a TDIU. Nonetheless, the inquiry does not end there. The question in a TDIU claim is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. A high disability rating in itself is recognition that the impairment makes it difficult to obtain or keep employment. See Van Hoose v. Brown, 4 Vet. App. 361 (1993). There must be a determination that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age or a nonservice-connected disability. 38 C.F.R. §§ 3.340, 3.341, 4.16. In the December 2010 back VA examination, the Veteran reported that he worked part-time as a security guard. There was no time lost from work during the past 12 months. The examiner determined that there was no effect on usual occupation. In a December 2010 genitourinary VA examination, the examiner determined that the Veteran’s testicle condition did not have any significant effects on general occupation. In an August 2012 VA treatment record, it was noted that the Veteran worked as a cab driver. In an October 2012 VA treatment record, the Veteran reported he was unemployed and almost 3 months behind in rent. In a December 2013 esophageal VA examination, the Veteran’s GERD diagnosis was noted. The examiner determined that the Veteran’s esophageal condition did not impact his ability to work. In a December 2013 skin diseases VA examination, the examiner noted diagnoses of tinea cruris and genital warts. The examiner determined that the Veteran’s skin condition did not impact his ability to work. In a December 2013 mental disorders VA examination, the examiner determined that the Veteran had 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. In a March 2014 back VA examination, the Veteran reported flare ups that caused soreness and tightness in mid-lumbar area of back. The examiner noted that pain limited how much he could walk and how long he could stand or sit. Stiffness limited work and he could not get in tight places or reach. In a March 2014 male reproductive organ conditions VA examination, the examiner determined that the Veteran’s reproductive condition did not impact his ability to work. At the May 2014 Board hearing, the Veteran testified that he was not employed. He was last employed April 2013 as a dental assistant. The Veteran said he was trained for dental assistant and hygienist work in the military. In a July 2015 reproductive system conditions VA examination, the Veteran said he was currently a student. He said he was a dental technician/assistant in service. He emphasized that he could not work as a dental assistant as standing for long periods of time in limited space caused him left scrotal pain. Based on the Veteran’s report, the examiner stated that his scrotal injury did impact his ability to work. The Veteran said that left testicle sensitivity disabled him from sitting with legs compressed while he assisted dentist as a dental hygienist/assistant. In an October 2015 back VA examination, the Veteran said since his last VA examination he continued to have chronic low back pain without neurologic findings. He complained of numbness in the back of his legs with prolonged sitting. He had negative x-ray and MRI of the lumbar spine. His back was aggravated after standing for more than 30 minutes, walking more than 2 blocks, stairs, bending, and twisting. The examiner noted that the Veteran’s back condition did impact his ability to work. The examiner said the Veteran was in school for aviation work. He had trouble with prolonged sitting. In the past he was a dental assistant and had trouble leaning forward; he was no longer doing this job. He did full time child-care and said it was painful to pick up over 50 pounds. He had to squat to do housework; he did not bend over. In a January 2018 esophageal conditions VA examination, the examiner opined that the Veteran’s esophageal condition did not impact his ability to work. The examiner stated that the Veteran had GERD that resulted in intermittent epigastric pain and discomfort. The onset of the symptoms related to GERD were able to be controlled by the Veteran’s eating habits and food choices. There was no physical limitations or disability pertaining to GERD condition. Furthermore, there was no conventional regular prescribed medication therapy for this condition which suggested a mild severity level for this condition. For those reasons, the examiner determined that the Veteran was not deemed to be functionally impaired to perform any kind of employment. In a January 2018 mental disorders VA examination, the examiner determined that the Veteran had occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. The examiner stated that the Veteran was functionally impaired. In a January 2018 skin VA examination, the examiner determined that the Veteran’s skin condition did not impact his ability to work. The examiner stated that the Veteran was not functionally impaired as it related to his tinea cruris with genital warts and could perform both physical and sedentary employment. The examiner said that the Veteran’s condition was intermittent in nature, and managed well with topical application of steroid creams. There was no active rash on exam. There was no functional impairment in relation to completing occupational tasks both physical and sedentary due to the Veteran’s tinea cruris condition. Genital warts were not visible on examination. The Veteran was not functionally impaired as it related to the Veteran’s skin condition. In a January 2020 VA opinion, the examiner opined that the Veteran was able to perform medium work in a normal 8 hour day, with consideration of the Veteran’s service-connected conditions. Medium work was described as exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. Physical demand requirements were in excess of those for light work. In a January 2020 back VA examination, the Veteran reported worsened back spasms, constant tightness, and sharp pain. The examiner determined that the Veteran’s back condition impacted his ability to work. Self-employed was noted with 0 to 1 week of work time lost in the past 12 months. Prolonged sitting and standing caused pain due to chronic lumbar strain. However, the Board finds that there is not enough information to complete its analysis because a Veteran’s Application for Increased Compensation for Unemployability (VA Form 21-8940) has not been found in the record. In March 2018, the RO requested that the Veteran complete and submit a Veteran’s Application for Increased Compensation for Unemployability (VA Form 21-8940), but the record shows no evidence that it was ever received. The Board notes that there were additional internal emails looking for the VA Form 21-8940; however, there is no indication that the Veteran was given another opportunity to submit this form. In June 2018, the RO denied the Veteran’s claim for TDIU and listed the missing VA Form 21-8940 as a rationale for why the RO could not find that the Veteran was unable to secure or follow a substantially related gainful occupation. This evidence of record is insufficient to grant a TDIU at this time because more information is needed regarding the Veteran’s employment status, work history, and education. As a result, the Board finds that a remand is necessary so the Veteran can submit (VA Form 21-8940), a Veteran’s Application for Increased Compensation for Unemployability to further the development of the Veteran’s claim. The matters are REMANDED for the following actions: 1. Provide the Veteran with another opportunity to submit (VA Form 21-8940), Veteran’s Application for Increased Compensation for Unemployability. Request that the Veteran provide specific dates of employment and income information for each employer. The RO should ensure that the Veteran receives the request to complete the VA Form 21-8940. 2. Thereafter, readjudicate the claim on appeal. If the benefit sought remains denied, issue the Veteran and his representative a supplemental statement of the case and provide a reasonable opportunity to respond before returning the matter to the Board for further appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Saudiee Brown, 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.