Citation Nr: 21001761 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 16-05 083 DATE: January 11, 2021 ORDER A total disability rating based on individual unemployability due to service-connected disabilities (hereinafter, TDIU) is denied. FINDING OF FACT The Veteran’s service-connected disabilities do not render him unable to secure or follow a substantially gainful occupation consistent with his education and work history. CONCLUSION OF LAW The criteria for a TDIU have not been met. 38 U.S.C. § 5107; 38 C.F.R. § 3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the U.S. Army from September 1977 to June 1978. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). This appeal was last before the Board in March 2019, at which time the Board found remand was necessary for the Agency of Original Jurisdiction to implement the Board’s award of service connection for hypertropia and readjudicate the TDIU claim in light of any possible increase in the combined disability rating. The matter now returns for further appellate review. Entitlement to a TDIU. 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). 38 C.F.R. § 4.16(b). Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, “entitlement to a TDIU is based on an individual’s particular circumstances.” Rice v. Shinseki, 22 Vet. App. 447, 452 (2009). Therefore, when adjudicating a TDIU claim, VA must take into account the individual veteran’s education, training, and work history. Hatlestad v. Derwinski, 1 Vet. App. 164 (1991) (level of education is a factor in deciding employability); Friscia v. Brown, 7 Vet. App. 294 (1994) (considering Veteran’s experience as a pilot, his training in business administration and computer programming, and his history of obtaining and losing 19 jobs in the previous 18 years); Beaty v. Brown, 6 Vet. App. 532 (1994) (considering Veteran’s 8th grade education and sole occupation as a farmer); Moore v. Derwinski, 1 Vet. App. 356 (1991) (considering Veteran’s master’s degree in education and his part-time work as a tutor). Age may not be considered as a factor when evaluating unemployability or intercurrent disability, and it may not be used as a basis for a total disability rating. 38 C.F.R. § 4.19. There must be a determination that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age or a non-service-connected disability. 38 C.F.R. §§ 3.340, 3.341, 4.16. The sole fact that a claimant is unemployed or has difficulty obtaining employment is not enough. A high rating in itself is recognition that the impairment makes it difficult to obtain or keep employment. The ultimate question, however, is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). Recently, in Ray v. Wilkie, 31 Vet. App. 58 (2019), the United States Court of Appeals for Veterans Claims (Court) held that the initial extra-schedular referral decision under § 4.16(b) should address whether there is “sufficient evidence to substantiate a reasonable possibility that a veteran is unemployable by reason of his or her service-connected disabilities”. Moreover, the Court defined the term “unable to secure and follow a substantially gainful occupation” in § 4.16(b) to include two components: one economic and one noneconomic. The economic component means an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person. The non-economic component includes consideration of the veteran’s history, education, skill, and training; whether the veteran has the physical ability to perform the type of activities required by the occupation at issue; and whether the veteran has the mental ability to perform the activities required by the occupation at issue. Here, VA received the Veteran’s initial TDIU claim on June 7, 2012. Service connection has been established for anxiety disorder, hypertension, hypertropia and left varicocele. The Veteran’s left varicocele has a noncompensable (0 percent) evaluation, effective June 27, 1978. The Veteran’s hypertropia has a noncompensable evaluation, effective August 10, 2011. The Veteran’s hypertension has a 10 percent evaluation, effective June 7, 2012; and his anxiety disorder has a 50 percent evaluation, effective June 7, 2012. Thus, for the period prior to June 7, 2012, the Veteran’s combined disability evaluation was 0 percent; and for the period now on appeal beginning June 7, 2012, the Veteran has a combined disability rating of 60 percent. Notably, the Veteran does not have a single service-connected disability rated at 60 percent or more. Further, although the Veteran has a single disability ratable at 40 percent or more (anxiety disorder), he does not have a combined disability evaluation of 70 percent or more. Thus, the Veteran does not meet the schedular threshold for consideration of a TDIU at any time during the pendency of the appeal. 38 C.F.R. § 4.16(a). Nonetheless, if it is shown that the Veteran is rendered unemployable by reason of his service-connected disabilities, the Board may refer the case to the Director of Compensation Service for extra-schedular consideration pursuant to 38 C.F.R. § 4.16(b). Here, however, the Board finds the preponderance of the evidence is against a finding that the Veteran’s service-connected disabilities precluded him from participating in substantially gainful employment consistent with his education and work history during the period on appeal. As such, the Veteran is not entitled to a TDIU, and referral for extra-schedular consideration is not warranted. In his July 2012 VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability (TDIU Application), the Veteran reported that his disability affected his full-time employment on June 16, 2011, and he last worked full time in June 2011. He stated that this was the date he became too disabled to work. The most he had ever earned in a year was $60,000.00 in 2010 when he was working as a planner for a pharmaceutical company. He worked 40 hours a week in this position from May 1988 to June 2011. His highest gross earnings per month in that position were $5,000.00. He stated that he left this last job because of his disability. He reported that he had tried to obtain employment since he became too disabled to work, but he did not mention any specific potential employers. The Veteran reported that he had completed college but did not have any other education or training before or since he became too disabled to work. In an August 2012 VA Form 21-4192, Request for Employment Information, the Veteran’s employer at the pharmaceutical company reported that the Veteran worked at the company as a planner from May 24, 1988, to June 16, 2011. The Veteran earned $56,823.60 in the 12 months preceding the last date of employment. The reason for the Veteran’s termination of employment was a reduction in force. Specifically, the Veteran’s employer at the pharmaceutical company stated in an August 2012 letter that, due to a reorganization, the Veteran’s position was impacted on June 16, 2011. It was his last day working for the company. Conversely, in a September 2019 statement, the Veteran reported that he was dismissed from his position at the pharmaceutical company on June 16, 2011. As a result of the dismissal, he was forced to file for bankruptcy since he could not fulfill his economic responsibilities. In an April 2012 psychiatric evaluation, the examiner stated that, after 23 years in the same company, the Veteran was fired. He went bankrupt and lost his house and savings. In a February 2013 Psychiatry Consult, the Veteran reported that he had a bachelor’s degree in chemistry and a license. He was not working at the time, but he used to work in industrial engineering (“in folding cartons”). In a May 2013 Social Work Note, the Veteran stated that he retired from work as a chemist due to health issues. However, the Board notes several of these statements are inconsistent with the other evidence of record, including evidence from the Veteran’s former employer as described above. In weighing credibility, the VA may consider inconsistent statements and consistency with other evidence of record. Caluza v. Brown, 7 Vet. App. 498 (1995). With respect to his education and work history, a June 2013 Psychology Note shows the Veteran reported that he had a bachelor’s degree in chemistry and that he had worked all his life in factories in the production development area. In a January 2016 Social Work Initial Evaluation Note, the Veteran reported that he had worked at different pharmaceutical companies. He was able to take good care of himself and complete his activities of daily living and household chores. He reported poor use of leisure time and interest in vocational rehabilitation. In a February 2016 Vocational Rehabilitation Consult, the Veteran stated that he was tired of looking for a job, and he could not find one. He decided to attend school. He set a goal of registering for vocational training by May 2016 and starting training by August 2016. However, in a June 2016 Vocational Rehabilitation Note, the Veteran stated that he decided not to attend college, and he wished to be discharged from the vocational rehabilitation program. He stated that he was no longer interested in vocational training. In a January 2012 buddy statement, the Veteran’s wife reported that the Veteran’s physical and mental condition had deteriorated since he lost his job in June 2011. She stated that, because the Veteran is unemployed, he felt uneasy and depressive. Everything bothers him and he barely sleeps. In another January 2012 buddy statement, a friend of the Veteran reported that the Veteran had been sad and depressed. In a February 2012 Disability Determination Program document, the Veteran reported that his last job was in July 2011 as a production planner, similar to a manufacturing supervisor. He held that job for 23 years until he got laid off. The Veteran reportedly had been looking for a job without any success. The Veteran believed that he could not return to work due to his mental condition. He had difficulty concentrating and finishing different tasks. At a November 2012 VA examination, the Veteran was diagnosed with anxiety disorder, not otherwise specified (NOS), as well as alcohol dependence. The VA examiner found that the Veteran’s anxiety disorder resulted in occupational and social impairment with reduced reliability and productivity. The Veteran reported that he had a bachelor’s degree in chemistry, used to work as a chemist, and had worked in a pharmaceutical corporation for 23 years until he was fired due to job duty elimination in June 2011. The Veteran exhibited symptoms of depressed mood, chronic sleep impairment, mild memory loss (such as forgetting names, directions, or recent events), disturbances in motivation and mood. The Veteran was capable of managing his financial affairs. In a December 2012 VA medical opinion, the VA examiner stated that the Veteran’s mood instability could limit his capacity to interact effectively and on a sustained basis with other individuals. Social function at work environments that involved interaction with public, responding appropriately to persons in authority, or cooperative behaviors involving coworkers could be limited. In an August 2011 Social Security Administration (SSA) Function Report, the Veteran stated he had difficulty following instructions, remembering, concentrating, and getting along with others. However, he reported that he had never been fired or suspended from a job due to problems getting along with people. In an August 2011 Psychiatric Medical Report, the Veteran reported that he felt useless because he was not able to perform any type of work. He reported forgetting things and having things confuse him. He reported being afraid of people and stated that they saw him as deformed, as if he were a monster or alien. He reported that he sequestered himself in his house and did not want to go out. The examiner stated that the Veteran did not tolerate people; he rejected contact and communication with other people, became irritated, and lost control. The examiner observed that the Veteran appeared groomed but disheveled. He had poor eye contact and was suspicious. His thought processes were sometimes illogical and irrelevant; and he had attention difficulties, mental blocking, and circumstantial thought. The Veteran had difficulty retaining information and following instructions. He had poor judgment, loss of impulse control, and loss of ability to make decisions by himself. The Veteran also reported hearing voices. The examiner diagnosed the Veteran with schizoaffective disorder and major depression. In an April 2012 psychiatric evaluation, the Veteran reported that he had been very irritable and verbally aggressive. He had little tolerance for stressful situations. He also became very anxious, irritable, and angry. He had lost interest in life and motivation in things he used to do. He found it difficult to concentrate well. He sometimes had crying episodes. The Veteran also reported that he was often isolated. He hid from others and did not participate in community activities. He did not want to be seen. His relationship with his neighbors was distant. The Veteran also needed help for his personal hygiene; he sometimes did not want to wash up. He reported that he slept a few hours and got up to look out the window. The examiner observed that the Veteran looked slow, tense, and older than his age. The Veteran was cooperative, not spontaneous, and dependent on his wife. His hair was short and poorly cared for, and he had a sloppy beard. His facial expression exhibited sadness, anxiety, and concern. His mood was depressive and sad. His thoughts were logical, coherent, and relevant. He did not express self-destructive or aggressive ideas, but he sometimes had such ideas. His judgment was erratic and sometimes impulsive. He was oriented to person, place, and time. The examiner stated that there was no history of using or abusing drugs, controlled substances, or alcohol. The examiner diagnosed the Veteran with major depressive disorder single severe episode with anxiety. In a May 2012 letter, Dr. N.A.O stated that the Veteran presented with episodes of excessive anxiety and worry, restlessness, easy fatigue, muscle tension, and difficulty concentrating. He also had episodes of irritability, which interfered with his daily living. The examiner reported that the Veteran became very anxious and nervous and had frequent mood changes. He also presented with episodes of decreased interest and pleasure in most of his usual activities. He had fatigue or low energy nearly every day, as well as memory problems. The Veteran also reported episodes where he felt sad and isolated himself. He had frequent episodes with a worthless sensation. He had depressed mood with alteration in his sleep and eating patterns. In an April 2013 Report for Disability Insurance Purposes, the examiner found that the Veteran had symptoms of irritability, sleep problems, nightmares, and anxiety. The examiner diagnosed the Veteran with anxiety disorder, NOS, as well as schizoaffective disorder by history. When asked whether the Veteran was capable of doing all of his work, the examiner checked the box that said no, but she offered no other rationale or explanation. When asked whether the Veteran was capable of doing any other work, the examiner checked the box that said no, but she again offered no other rationale or explanation. She also did not articulate or differentiate how much of this was a result of the service-connected anxiety disorder and how much was a result of the non-service-connected schizoaffective disorder. Ultimately, the examiner found that the Veteran’s mental impairment resulted in moderate limitation. In a February 2013 VA Psychiatry Admission Evaluation Note, the Veteran reported that, after losing his job in 2011, he fell into bankruptcy and lost his house, and his depressive symptoms worsened. He also reported multiple episodes of anxiety and irritability, but he denied suicidal or homicidal ideas or hallucinations. The examiner observed that the Veteran was alert, oriented, cooperative, and well-groomed. His mood was okay, and his affect was blunted. His speech was clear and productive, and his insight and judgment were good. The examiner found that the Veteran had anxiety disorder, NOS, and a past history of schizoaffective disorder. In a Psychiatry Consult from a couple weeks later, the Veteran endorsed an irritable mood for many years. He explained that he becomes irritable because he wants things to be done the way he likes, but he understood that this will not always happen. He reported problems falling and staying asleep; and he stated his sleep was fragmented, but he was able to go back to sleep once he awoke. He suffered nightmares once or twice a week. He had good appetite, concentration, motivation, and energy levels. He stated that he suffered anxiety but could not state why. He said his anxiety improved with Clonazepam. At a May 2013 Psychiatry Consult, the Veteran reported that he felt very anxious and overwhelmed. He had a passive death wish, but he denied suicidal or homicidal ideation. He stated that he heard voices calling him. He felt paranoid at times, like someone wanted to hurt him. In a June 2013 Psychology Note, the Veteran stated that, since retiring, his emotional symptoms had become worse. He reported that he could not sleep very well, and he woke up sweating. He also stated that he forgot things and that concentration was difficult. He reported that he constantly felt on edge, and he thought someone was following him. In a January 2016 Social Work Initial Evaluation Note, the Veteran reported a history of alcohol use since his adolescence, as well as a history of cannabis and nicotine use that was in remission. The examiner also noted his history of schizoaffective disorder and generalized anxiety disorder. The examiner observed that the Veteran was cooperative, alert, oriented, attentive, coherent, relevant, logical, and providing accurate responses. He was adequately dressed and groomed, and he exhibited good judgment and insight. In a March 2016 Addiction Psychiatry Therapist Note, the Veteran reported that he had continued in abstinence of alcohol for the past 3 months. He stated that he felt in the best control of his life. He reported good self-esteem. He reported no anxiety or depressed mood and no urges or cravings for alcohol. He reported that he felt stable emotionally, and he had been taking all of his medication properly. In a July 2019 Nursing Note, the Veteran reported a relapse in alcohol use three weeks ago. In a Psychiatry Note from the same day, the Veteran reported that he is doing fine without depressed mood. He reported mild anxiety symptoms, especially in the morning. He also reported increasing alcohol intake since early June. He was currently consuming 24 beers from Friday to Sunday; he also admitted to consuming alcohol during the rest of the week. He stated that his anxiety is sometimes relieved when drinking beer early in the morning. He also reported difficulty with sleep; he was sleeping three to four hours a night. The Veteran denied irritability or aggressive behavior. He adamantly, emphatically, and firmly denied any current death wishes, suicidal ideas, or plans to kill himself. He denied hearing voices or seeing things not noted by others. In a Psychiatry Note from a couple weeks later, the Veteran reported abstinence from alcohol, though he had cravings. He reported that he was doing fine with no depressed mood or anxiety symptoms with current medications. He reported improvements in anxiety and insomnia. In an August 2019 Mental Health Administrative Note, the Veteran reported sporadic use of alcohol, such as four or five beers on weekends. He reported that he was suffering anxiety. In a November 2019 Psychiatry Note, the Veteran reported he was feeling anxious and not sleeping well. In the assessment, the examiner stated that the Veteran had a history of alcohol use disorder, and the Veteran reported depressive and anxiety symptomatology, including insomnia, which the examiner stated was most likely due to poor compliance with pharmacotherapy and a stressor of a recent surgery. The Veteran reported sobriety since one or two months ago. In a December 2019 Psychiatry Note, the Veteran reported feeling anxious sometimes sad and not sleeping well. He admitted to an alcohol relapse one or two weeks ago. In a March 2020 Psychiatry Telephone Encounter Note, the Veteran reported improvement of anxiety and sleep since he was taking his medications daily. He also reported a decrease of alcohol use. In an August 2020 Psychiatry Telephone Encounter Note, the Veteran reported that he was doing fine with no depressed mood or anxiety symptoms with current medications and decreased alcohol use. He also reported improvements in sleep, though he was still sleeping five hours a night. He denied problems with learning and memory. The Veteran was completely independent in non-instrumental and instrumental activities of daily living. He denied feeling anxiety, restlessness, difficulty concentrating, irritability, and muscle tension. At an October 2012 VA examination, the VA examiner found that the Veteran’s hypertension did not impact his ability to work. At a December 2012 VA examination, the Veteran was reported to take continuous medication for hypertension. However, the VA examiner again found that the Veteran’s hypertension did not impact his ability to work. The VA examiner stated that the Veteran’s hypertension did not preclude him from obtaining or maintaining gainful employment. The Veteran was able to perform all of his daily living activities without problem up to the date of the examination, and there were no functional limitations due to the Veteran’s hypertension. At a November 2012 VA examination for the Veteran’s eye condition, the Veteran was diagnosed with strabismus, left exotropia, and incipient senile cataracts. The Veteran stated that his main problem was not double vision but having objects “move” to the side; this resulted in trouble driving. The VA examiner found that the Veteran had diplopia (double vision) and exotropia, as well as possible suppression scotoma, which avoided double vision in the primary position. The VA examiner determined that the Veteran’s eye condition impacted his ability to work in that he reported difficulty while driving. The Veteran stated that he had double vision only occasionally, and he stated that this was mostly for reading. A diplopia test revealed double vision inferiorly and laterally with the central 10 degrees not affected. In a December 2012 VA medical opinion, the examiner stated that the Veteran’s main complaint of jumping images was most probably due to changing from looking with the right eye to looking with the left eye. This jumping image affected him mostly while driving, which would be, for the most part, the extent of functional impairment. The VA examiner stated that the Veteran should not work as a chauffeur or heavy vehicle driver. At an April 2020 VA examination, the VA examiner diagnosed the Veteran with alternating exotropia, mild bilateral nuclear sclerosis, and bilateral stationary peripheral pterygium. The VA examiner observed that the Veteran’s reduction in visual acuity was due to refractive error and nuclear sclerosis in both eyes. The VA examiner found that the Veteran’s eye condition impacted his ability to work due to long standing exotropia. Upon correction of muscle deviation, image jumping could occur. The examiner stated that the Veteran would have difficulty working as a chauffeur. In a January 2012 VA examination, the Veteran was diagnosed with varicocele. The Veteran reported that he had suffered chronic, recurrent pain at the left hemiscrotum, and he had a fullness palpitated adjacently to the testicle. He reported pain three or four times a week of mild to moderate intensity lasting several minutes to hours. He continued to perform his regular activities. He just refrained from doing activities that may increase the pain such as carrying, running, or having sex. Alleviating factors included lying in bed to rest, wearing tight underwear, and medication such as over-the-counter ibuprofen. The VA examiner observed that the Veteran’s left epididymis was abnormal and tender to palpation. The VA examiner found that the Veteran’s varicocele condition did not impact his ability to work. In an August 2012 VA addendum medical opinion, the VA examiner stated that, based solely on the Veteran’s left varicocele, he was able to obtain and maintain a financially gainful occupation because he had no functional disabilities due to this condition. At a December 2012 VA examination, the Veteran was diagnosed with a left varicocele. He referred to almost constant pain and discomfort in the scrotum. He continuously used ibuprofen for the condition. However, the VA examiner found that the Veteran’s left varicocele condition did not impact his ability to work. The VA examiner stated that the Veteran’s left varicocele condition did not preclude him from obtaining or maintaining gainful employment. The Veteran was able to perform all of his daily activities without problems up to the date of the examination, and there were no functional limitations due to the Veteran’s left varicocele. In an October 2012 VA examination, the Veteran reported that he had daily constant moderate to severe pain and swelling on the left upper testicle that was exacerbated by climbing a flight of stairs and walking more than 100 yards. The pain was not relieved by ibuprofen, which he took two or three times a day. However, the VA examiner found that the condition did not impact his ability to work. The Board has reviewed the balance of the Veteran’s other medical treatment records from the period on appeal. The findings in the other medical treatment records are substantially similar to those noted in the VA examinations and treatment records described above. The Board notes that the Veteran has some musculoskeletal disabilities that impact his mobility, but none of these are currently service-connected. As mentioned earlier, the Board cannot consider non-service-connected disabilities in a TDIU claim. Based on the evidence as described above, the Board finds that, although the Veteran’s service-connected disabilities may have negatively impacted his employability during the period on appeal, they did not preclude him from securing and maintaining a substantially gainful occupation. Notably, the question of employability is ultimately a legal one, not a medical one. The Board acknowledges that the Veteran has experienced symptoms related to his service-connected anxiety disorder, to include irritability, depressed mood, chronic sleep impairment, mild memory loss, and disturbances in motivation and mood; and his examiners observed that he may be limited in sustained interactions with other individuals. However, he has consistently maintained good relationships with family and friends. Additionally, the Veteran has a bachelor’s degree in chemistry. The Board also notes that the main reason he was let go from his job at the pharmaceutical company was because of a reorganization and reduction in the work force at the company. In this respect, the Board finds the Veteran’s inconsistent reports of his work history detract from the credibility to be afforded his lay statements regarding the impact of his service-connected disabilities on his employability. Caluza v. Brown, 7 Vet. App. 498, 506 (1995) (VA adjudicators may properly consider internal inconsistency, facial plausibility, and consistency with other evidence submitted on behalf of the Veteran in weighing evidence); Cartwright v. Derwinski, 2 Vet. App. 24, 25 (1991) (a pecuniary interest may affect the credibility of a claimant’s testimony). The Board acknowledges that an aforementioned August 2011 Psychiatric Medical Report states that the Veteran rejected contact and communication with other people, and his thought processes were sometimes illogical and irrelevant with circumstantial thought. It also noted that Veteran had difficulty retaining information and following instructions. However, the August 2011 Psychiatric Medical Report was from prior to the period on appeal, and the preponderance of the evidence from the period on appeal does not demonstrate that the Veteran’s psychiatric symptoms from his service-connected anxiety disorder would prevent him from securing or maintaining gainful employment. Additionally, the examiner in the August 2011 Psychiatric Medical Report did not specify which symptoms were from the Veteran’s service-connected anxiety disorder and which symptoms were from his non-service-connected schizoaffective disorder. Further, even if the Veteran preferred to be isolated and/or had concentration or memory problems because of his anxiety disorder, the Board finds such would not preclude him from participating in occupations that did not require frequent social interaction or extensive memorization. He could still perform work that allowed him to work largely alone and commit concepts to writing. The evidence also does not show that his other service-connected disabilities of hypertension, hypertropia, and/or left varicocele prevented him from participating in occupations that allowed accommodations for such. In the instant case, the Veteran’s educational and work background is not so limited as to have precluded occupations of the nature described above during the period on appeal. Thus, the Board finds that the Veteran’s service-connected disabilities do not preclude him from performing the physical and mental acts necessary to secure and maintain a substantially gainful occupation consistent with his educational and occupational background. In reaching such determination, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to a TDIU, that doctrine is not applicable in the instant appeal. Therefore, a TDIU, or referral for extra-schedular consideration of a TDIU, is not warranted. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). M. M. Celli Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs 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.