Citation Nr: 21001737 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 13-31 915 DATE: January 11, 2021 ORDER A rating in excess of 30 percent prior to August 17, 2013, and in excess of 60 percent thereafter for coronary artery disease (CAD) for substitution purposes is denied. A total disability based on individual unemployability due to service-connected disabilities (TDIU) for substitution purposes is denied. FINDINGS OF FACT 1. Prior to August 17, 2013, the Veteran’s CAD did not result in episodes of acute CHF, workload limited to greater than 3 but not greater than 5 METs, or left ventricle ejection fraction from 30 to 50 percent. 2. From August 17, 2013, the Veteran’s CAD did not result in CHF; workload of 3 METs or less; or left ventricle ejection fraction less than 30 percent. 3. The Veteran’s service-connected disabilities alone did not preclude him from obtaining and maintaining substantially gainful employment consistent with his level of education, prior work history and training. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 30 percent prior to August 17, 2013, and in excess of 60 percent thereafter for CAD for substitution purposes have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.10, 4.100, 4.104, Diagnostic Code (DC) 7005. 2. The criteria for a TDIU for substitution purposes have not been met 38 U.S.C. § 1155, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.158, 3.321, 3.340, 3.341, 4.15, 4.16, 4.19. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from December 1953 to December 1955 and from July 1959 to November 1966. He died in July 2019 and his surviving spouse has been substituted as the Appellant. These matters were last before the Board in September 2020 at which time they were remanded for readjudication. As a Supplemental Statement of the Case (SSOC) was issued in October 2020, substantial compliance with the remand requests has been achieved. See Stegall v. West, 11 Vet. App. 268 (1998). The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Increased Ratings Disability evaluations are determined by the application of the facts presented to VA’s Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991); Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Whether the issue is one of an initial rating or an increased rating, separate ratings can be assigned for separate periods of time based on the facts found, a practice known as “staged” ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and recurrence of his symptoms. Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge). Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Veteran was granted a 30 percent rating prior to August 27, 2013, and a 60 percent rating thereafter for his service-connected CAD under the criteria of 38 C.F.R. § 4.104, DC 7005, pertaining to atherosclerotic heart disease. Under DC 7005, a 30 percent evaluation is warranted when the disability results in a workload of greater than 5 metabolic equivalents (METs) but not greater than 7 METs results in dyspnea (shortness of breath), fatigue, angina (chest pain), dizziness, or syncope (fainting); or when there is evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or x-ray. A 60 percent evaluation is assigned when there is more than one episode of acute congestive heart failure in the past year; or when a workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope; or where there is left ventricular dysfunction with an ejection fraction of 30 percent to 50 percent. A 100 percent evaluation is warranted for chronic congestive heart failure; or when there is a workload of 3 METs or less which results in dyspnea, fatigue, angina, dizziness, or syncope; or when there is left ventricular dysfunction with an ejection fraction of less than 30 percent. 38 C.F.R. § 4.104, DC 7005. Most of the diagnostic codes used to evaluate diseases of the heart have nearly identical rating criteria. See 38 C.F.R. §§ 4.100, 4.104, DC 7000-7007, 7011, 7015-7020 (2017). When evaluating cardiovascular disorders under DC 7000-7007, 7011, and 7015-7020, it must be ascertained in all cases whether or not cardiac hypertrophy or dilatation (documented by electrocardiogram, echocardiogram, or x-ray) is present and whether or not there is a need for continuous medication. 38 C.F.R. § 4.100(a). METs testing is also required in all cases except: (1) when there is a medical contraindication; (2) when the left ventricular ejection fraction (LVEF) has been measured and is 50 percent or less; (3) when chronic congestive heart failure is present or there has been more than one episode of congestive heart failure within the past year; or (4) when a 100 percent evaluation can be assigned on another basis. 38 C.F.R. § 4.100(b). If LVEF testing is not of record, the cardiovascular disability must be based on the alternative criteria, unless the examiner states that the LVEF test is needed in a particular case because the available medical information does not sufficiently reflect the severity of the veteran’s cardiovascular disability. 38 C.F.R. § 4.100(c). One MET is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. When the level of METs at which dyspnea, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea, fatigue, angina, dizziness, or syncope may be used. See 38 C.F.R. § 4.104, Note (2). Turning to the evidence of record, in a February 2010 VA treatment record, the Veteran denied chest pain or tightness, palpitations, and shortness of breath (SOB). A private cardiac treatment record from March 2010 noted that the Veteran denied chest pain or palpitations. He described having an exertional dyspnea with minimal exertion that seemed to be worsening. There was no SOB at rest. The clinician stated that the Veteran could walk 100 yards but became short of breath. His heart had a regular rhythm without any murmurs. The most recent echocardiogram (from September 2009) was reviewed which showed preserved left ventricle function, mild aortic valve sclerosis without stenosis, and moderate diastolic dysfunction. The clinician stated that the Veteran’s CAD was clinically stable. He was unsure whether the chronic dyspnea had a pulmonary or cardiac etiology. The Veteran underwent a VA examination in April 2010. He was noted to be getting more symptomatic with SOB and chest pain. His current symptoms were anginal pain, mild to moderate, at least once a week. If the pain was mild and he rested, it went away. If it did not go away, he used nitroglycerin spray. He stated that he had to use the spray at least four times a month. He also had exertional dyspnea which was significant. He felt tired and fatigued all the time and had a history of dizziness. He fell about a year earlier but that was noted to probably be noncardiogenic and he had had no more syncopal attacks. The examiner stated that he was not in congestive heart failure (CHF). The Veteran reported that he could walk up to half a mile with great difficulty and after that he became very tired and fatigued and developed chest discomfort. He could slowly climb a flight of stairs. Left ventricular ejection fraction (LVEF) was not available but he had an estimated METs level between 5 and 7. In a July 2010 private treatment record, the Veteran reported chest pain lately, especially with exercise, and some SOB. He had decreased his levels of exercise to try to avoid those symptoms. He also noted some dizziness with activity. In an August 2010 private treatment record, LVEF was 65 percent. The Veteran was admitted to an emergency room for chest pain with no radiation or SOB. He was diagnosed with atypical chest pain, possible esophageal spasm, possible gastroenterological origin, or possible musculoskeletal etiology, and discharged. In a September 2010 private treatment record, LVEF was noted to be 60 percent and the clinician stated that there was no overt evidence of CHF. Another VA examination was conducted in February 2011. The Veteran reported occasional chest pain that resolved with rest. He was able to walk 1 to 2 miles without chest pain. He was able to manage his basic activities of daily living (ADLs) without help and did light duty chores such as sweeping, dishes, and cooking. His history was positive for angina, dizziness, syncope, fatigue, and dyspnea. Dyspnea onset with moderate exertion. He had no history of CHF. Upon examination, there was no evidence of CHF or pulmonary hypertension, heart sounds were present, and rhythm was regular. The examiner determined that stress testing was not indicated as METs were easily estimated at 5 to 7 based on the Veteran’s known disease, level of physical activity, and reported symptoms. In a March 2011 VA treatment record, the Veteran denied chest pain, tightness, and palpitations. A July 2011 private treatment record reflected that he walked 2 miles most days. The Veteran denied chest pain, tightness, and palpitations in a March 2013 VA treatment record. It was noted that he did not have an irregular heartbeat. The Veteran underwent another VA examination in August 2013. He described chest pain once in a while, noting that “it may last 2 seconds or may last twenty minutes. When it lasts a long time, I use nitro. Used nitro once last week, before that about a month ago.” He reported that he walked his dogs daily, about 2 miles over 30 minutes. He noted that he tried running but could not do it. He also stated that he had had a stress test about 3 months previously and was told not to worry about the results. The examiner indicated that the Veteran did not have CHF. There was no evidence of cardiac hypertrophy or dilatation upon precordial examination. The examiner stated that cardiac stress testing was medically contraindicated as METs were easily estimated based on the Veteran’s known disease, level of physical activity, and reported symptoms. The examiner estimated METs level at greater than 3 to 5. This level was consistent with activities such as light yard work (weeding), mowing lawn (power mower), and brisk walking (4 mph). Symptoms with such activity were dyspnea, fatigue, and angina. This was demonstrated by the Veteran’s ability to walk 2 miles over 30 minutes but inability to go faster or run due to SOB and intermittent chest pain. In September 2014, the Veteran’s LVEF was 59 percent. A private clinician stated that he was physically unable to exercise. In a February 2016 treatment record, the Veteran denied dizziness, lightheadedness, SOB, palpitations, and edema. He did report chest pain and that he was not exercising regularly. However, he walked his dogs around the block without complications. He denied SOB, chest pain, and dizziness in an April 2016 VA treatment record. His estimated LVEF was 45 to 50 percent in December 2016. The Veteran denied dizziness, lightheadedness, SOB, palpitations, and edema in March 2017. He endorsed chest pain once or twice. He noted that he walked every night without any chest pain. He denied SOB, chest pain, and dizziness in April 2017. A September 2017 private treatment record reflected no dizziness, lightheadedness, chest pain, SOB, palpitations, or edema. The Veteran reported that he walked 1 mile every day. Estimated LVEF was 55 to 60 percent in March 2018. Dizziness, lightheadedness, SOB, palpitations, and edema were denied but chronic chest pain and near syncope were endorsed. Another VA examination was conducted in December 2018. The Veteran reported a new symptom of chest pain on the left side that he had had for quite a while. He noted that he helped with chores around the home, including vacuuming and ironing. The examiner indicated that he did not have CHF. The Veteran’s heart rate, rhythm, and sounds were normal. The examiner noted that cardiac stress testing was medically contraindicated for the Veteran and METs were easily estimated based on his known disease, level of physical activity, and reported symptoms. An interview-based METs test resulted in greater than 3 to 5 METs, consistent with activities such as light yard work (weeding), mowing lawn (power mower) and brisk walking (4 mph). The METs level limitation was due solely to the heart condition. Estimated LVEF was noted to be 55 to 60 percent in March 2019 and 65 to 70 percent in April 2019. In a May 2019 treatment record, LVEF was 55 to 60 percent. The Veteran endorsed rare chest pain, SOB when walking, palpitations and lightheadedness on standing. He did not experience chest pain on exertion and had no arm pain or SOB when lying down. The Board notes at the outset that the VA examinations of record are an adequate basis upon which to determine the extent and severity of the Veteran’s service-connected CAD. Although cardiac stress testing was not conducted, as noted by the examiners, such testing was medically contraindicated for the Veteran. Further, METs were easily estimated based on his known disease, level of physical activity, and reported symptoms. Indeed, the examiners used the Veteran’s own reports of his daily activities and limitations to make their conclusions (i.e., walking his dogs daily, performing all ADLs independently, vacuuming and yardwork). His statements to examiners were consistent with his reports to his regular treating private and VA clinicians, as well. 1. A rating in excess of 30 percent prior to August 17, 2013, and in excess of 60 percent thereafter for CAD for accrued benefits purposes is denied. Based on the foregoing, the Board finds that a rating in excess of 30 percent prior to August 17, 2013, is not warranted. Prior to August 17, 2013, the Veteran had no episodes of acute CHF, METs were not limited to greater than 3 but not greater than 5, and LVEF was not from 30 to 50 percent, which would establish a 60 percent rating. As such, a rating in excess of 30 percent under DC 7005 is not merited. At the August 17, 2013, VA examination, workload was determined to be greater than 3 to 5 METs. As such, a 60 percent rating is warranted as of the date of the examination. This is the first clinical evidence of an increase in disability that is factually ascertainable. As such, a 60 percent rating is not warranted earlier than the date of the examination. From August 17, 2013, a rating in excess of 60 percent has not been established. There was no evidence of CHF; workload of 3 METs or less was not demonstrated; and LVEF was not less than 30 percent. As such, the criteria for a rating in excess of 60 percent under DC 7005 were not met. Accordingly, a rating in excess of 30 percent prior to August 17, 2013, and in excess of 60 percent thereafter for CAD is not warranted. TDIU A total disability rating for compensation purposes may be assigned where the schedular rating is less than total and where it is found that the disabled person is unable to secure or follow a substantially gainful occupation as a result of a 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 C.F.R. § 4.16(a). Consideration may be given to a veteran’s level of education, special training, and previous work experience in arriving at a conclusion, but not to his or her age or to the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 4.16, 4.19; see also Van Hoose v. Brown, 4 Vet. App. 361 (1993). To meet the requirement of “one 60 percent disability” or “one 40 percent disability,” the following will be considered as one disability: (1) disability of one or both lower extremities, including the bilateral factor, if applicable; (2) disabilities resulting from one common etiology; (3) disabilities affecting a single body system; (4) multiple injuries incurred in action; and (5) multiple disabilities incurred as a prisoner of war. Id. The Veteran submitted his claim for an increased rating for his service-connected CAD in March 2010. As such, the Appellant is seeking entitlement to TDIU from March 2010. The Veteran’s service-connected disabilities included CAD, rated 30 percent prior to August 27, 2013, and 60 percent thereafter; external and internal hemorrhoids rated 10%; and scar, pilonidal sinus and cyst surgery, and hypertension, at a noncompensable rate, for a combined evaluation of 40 percent prior to August 27, 2013, and 60 percent thereafter. Accordingly, the schedular threshold for TDIU was not met prior to August 27, 2013, but was met thereafter. If a claimant does not meet the threshold criteria, a TDIU may still be assigned but on a different basis. It is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 38 C.F.R. §4.16(b). The rating boards are required to submit all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards, to the Director, Compensation Service, for extraschedular consideration. Id. The Board does not have the authority to assign an extraschedular total disability rating for compensation purposes based on individual unemployability in the first instance. Bowling v. Principi, 15 Vet. App. 1 (2001). Rather, the Board’s sole inquiry is whether referral for extraschedular consideration is warranted in light of the evidence showing the veteran is unable to secure and follow a substantially gainful occupation by reason of service-connected disability. Therefore, the Board will consider whether referral for extraschedular consideration is warranted prior to August 27, 2013, and whether entitlement to a schedular TDIU is warranted from that date. Substantially gainful employment is defined as work which is more than marginal and which permits the individual to earn a living wage. Moore v. Derwinski, 1 Vet. App. 356 (1991). Marginal employment may also be held to exist, on a facts-found basis (including, but not limited to, employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. 38 C.F.R. § 4.16. The term “substantially gainful occupation” is not defined in the rating schedule. Rather, the Court of Appeals for Veterans Claims (Court) in Ray v. Wilkie, found the phrase has two components: an economic one and a noneconomic one. 31 Vet. App. 58 (2019). In assessing the Veteran’s ability to secure and follow a substantially gainful occupation, the Board is to consider the Veteran’s history, education, skill, and training as well as physical abilities and mental abilities required by the occupation at issue. Id. Such specific physical ability factors include lifting, bending, sitting, standing, walking, climbing, grasping, typing, reaching, auditory, and visual. Id. Specific mental ability factors include memory, concentration, ability to adapt to change, handle workplace stress, getting along with coworkers, and demonstrating reliability and productivity. Id. Concerning the economic component, the Veteran had a high school education and two years of college education. During his military service, he worked as a radio operation apprentice and a telegraphic-typewriter operator. He worked for more than 20 years as a corrections officer, maintaining custodial care, control, and supervision of inmates in a state correctional institution and supervising employees. His former employer indicated that his employment with the institution ended with regular state retirement. The Veteran reported that he later worked part-time as a clerk/animal trainer at a retail store until November 2006; the employer verified that he worked 20 hours per week on average. He stated that after his retirement, he enjoyed working part-time jobs for something to do. In several statements, he noted that he had applied for work with several businesses but that he had the impression that when he reported his heart condition to potential employers, they lost interest. He also felt they did not want to hire him because of his age. As such, from an economic perspective, the Veteran had the education, skills, work history, and vocational training to perform a variety of work, including corrections work, supervision of others, radio/telegraph/typewriter operation, animal training, and retail clerk duties. Concerning the noneconomic component, the Veteran underwent numerous VA examinations to determine the extent and severity of his service-connected disabilities. A February 2011 VA examiner determined that the Veteran’s CAD would not preclude light duty physical or sedentary employment as the condition was well controlled on oral agents, diet, and exercise. The effects on occupational activities were determined to be decreased concentration, decreased mobility, problems with lifting and carrying, lack of stamina, weakness or fatigue, decreased strength in the upper and lower extremities, and pain. The examiner also found that the Veteran’s hypertension would not preclude physical or sedentary employment, as it was well-controlled on oral agents, diet, and exercise. However, it would result in decreased mobility, problems with lifting and carrying, lack of stamina, and weakness or fatigue. The Veteran reported to the examiner that he was unable to do heavy lifting/carrying, climbing stairs/ladders, and prolonged walking/standing as a result of his hypertension and CAD disabilities. He was able to do ADLs. The Veteran reported to an August 2013 VA examiner that he had been looking lately for work but that he thought that employers did not want to hire him because of his age. “I am 78 but still feel like I could do the job.” He stated that he took care of all of the yardwork and housekeeping chores for himself and the Appellant. The examiner determined that the Veteran’s CAD would not preclude light duty or sedentary employment. He was living independently and performing all necessary ADLs, thereby demonstrating adequate physical capabilities for appropriate gainful employment. Additionally, he voiced his desire and perceived ability to work part-time but had not been able to find a suitable job. A December 2018 VA examiner found that the Veteran’s CAD did not impact his ability to work. An addendum opinion obtained in February 2019 noted that he had previously reported that he assisted in household chores, including vacuuming and ironing. As such, his CAD should not preclude sedentary employment. Review of the medical treatment records demonstrated the absence of objective evidence precluding gainful sedentary employment, if so desired. The examiner determined that physical employment should be limited to very light duties such as lifting no more than 5 to 10 pounds and walking short distances. The Veteran should be afforded work breaks as given/needed and opportunity to ask questions and request assistance if needed. Climbing ladders, repetitive bending and squatting, and pushing heavy objects should be avoided. Regarding the Veteran’s service-connected hemorrhoids, a February 2011 VA examiner concluded that the condition would not preclude light duty physical or sedentary employment as the condition was well controlled. The only impact was noted to be decreased concentration. The Veteran reported that his hemorrhoids flared-up at times with itching, burning pain, and some bleeding which was bothersome and embarrassing to him. Effects on chores, shopping, exercise, sports, recreation, and traveling were moderate and effects on feeding, bathing, dressing, toileting, and grooming were mild. In a February 2011 VA examination, the Veteran’s scars were determined to not result in any functional impairment in physical or sedentary employment as they were well-healed without any residuals. The Veteran also had several nonservice-connected disabilities including diabetes mellitus type II, hypercholesterolemia, gastroesophageal reflux disease, prostatic hypertrophy, osteoarthritis, and history of malignant melanoma. His age during the appeal period was 76 to 85 years old. 2. A TDIU for substitution purposes is denied. Based on the foregoing, the Board finds that entitlement to a TDIU, on both a schedular and extraschedular basis, is not warranted. The Board considered the physical ability factors noted in Ray, to include lifting, bending, sitting, standing, walking, climbing, grasping, typing, reaching, auditory, and visual. See Ray, supra. VA examiners did not find that the Veteran would be limited in being able to engage in sitting, grasping, typing, reaching, auditory, or visual abilities. He would however be limited in his ability to engage in lifting, bending, prolonged standing or walking, and climbing. Also, lack of stamina, weakness, and fatigue would impact functional ability. As such, he would have been unable to engage in his previous work as a corrections officer or animal trainer. He would, however, have likely been able to engage in supervisory duties, radio/telegraph/typewriter operations, and retail clerk duties, depending upon whether prolonged standing or stocking shelves were required. The Board also considered the mental ability factors noted in Ray, to include memory, concentration, ability to adapt to change, handle workplace stress, getting along with coworkers, and demonstrating reliability and productivity. See Ray, supra. Several examiners noted decreased concentration as a resulting impairment from the Veteran’s service-connected disabilities. As such, he could not have likely engaged in corrections work or animal training based on mental ability factors, due to safety concerns. In Withers v. Wilkie, the Court noted that VA has not explicitly defined the meaning of “sedentary employment.” Withers v. Wilkie, 30 Vet. App. 139 (2018). Until VA provides such a definition, “the meaning and relevance of the term will have to be discerned on a case-by-case basis from the medical and lay evidence presented and in light of each veteran’s education, training, and work history.” Id. at 149-150. In the Veteran’s case, his work history largely involved physically active work, including his extensive employment as a corrections officer. However, radio/telegraph/typewriter operation and some retail clerk positions would represent sedentary work, as they would generally involve prolonged sitting with little need for lifting, carrying, bending, or climbing. As such, the Veteran’s skills, training, and work history would not preclude such similar sedentary positions. Based on the foregoing, the Board finds no basis to refer the matter for extraschedular consideration as the evidence does not show that the Veteran’s service-connected disabilities prevented substantially gainful employment prior to August 27, 2013. In that regard, although the evidence suggests the Veteran did not maintain full-time employment, the preponderance of the evidence does not support that his difficulties were due to his service-connected disabilities alone. Indeed, VA examiners found that he would not be precluded from light duty physical or sedentary employment, defined for this Veteran’s purposes as not requiring lifting, carrying, bending, climbing, or prolonged walking or standing. The Veteran himself described going for daily walks with his dogs, completing ADLs independently, and engaging in physically-demanding household chores such as vacuuming and ironing. In light of the Veteran’s past work history, training, and skills and in light of the medical evidence in this case, the Board finds the Veteran was capable of substantially gainful work prior to August 27, 2013. Accordingly, the weight of the evidence does not support the conclusion that referral to the Director of Compensation Service for extraschedular consideration of entitlement to TDIU benefits is warranted. The Board also concludes that from August 27, 2013, the evidence does not demonstrate that the Veteran was unable to obtain or maintain substantially gainful employment due to service-connected disabilities alone. Again, although the Veteran would be precluded from engaging in some of his previous occupations (i.e., corrections officer) based on his inability to perform work requiring lifting, carrying, bending, climbing, and prolonged walking or standing, his service-connected disabilities were not shown to preclude all types of work for which he was qualified based on his education, skills, work history, and vocational training. Indeed, the Veteran stated to the August 2013 examiner that he had been seeking work and felt like he could perform the jobs but thought that he had not been hired due to his advanced age. As noted above, consideration may not be given to a veteran’s age or to the impairment caused by nonservice-connected disabilities when determining entitlement to TDIU. The Board notes that although the Veteran generally was seeking part-time jobs, that does not necessarily suggest he was unable to maintain full-time employment. He had retired after a long career both in the Navy and in corrections at an advanced age and noted that he sought such jobs “for something to do.” As such, it appeared that he did not desire full-time employment after his retirement. That is irrelevant as to whether or not he was able to maintain full-time employment. As outlined above, the Board has determined that based on his service-connected disabilities alone, the Veteran was not precluded from obtaining or maintaining substantially gainful employment consistent with his education, skills, work history, and vocational training. (Continued on the next page)   The Board does not doubt that the Veteran’s service-connected disabilities caused impairing symptomatology. This impairment of function is recognized by the ratings assigned to each of his service-connected disabilities. The evidence does not support that these disabilities precluded substantially gainful employment, specifically to include sedentary employment as outlined above. In light of the Veteran’s past work history, training, and skills and in light of the medical evidence in this case, the Board finds the Veteran was capable of substantially gainful work throughout the appeal period. Accordingly, entitlement to a TDIU is not warranted. Neither the Appellant nor her representative has raised any other issues, nor have any other issues been reasonably raised by the record. 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). Shereen M. Marcus Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Rachel E. Jensen, 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.