Citation Nr: 21003641 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 15-12 089A DATE: January 22, 2021 ORDER Entitlement to a rating for a bilateral hearing loss disability in excess of 40 percent from January 9, 2015 to February 20, 2015, to a compensable rating from February 20, 2015 to January 15, 2019, and to a rating in excess of 10 percent thereafter is denied. Entitlement to a total disability rating due to unemployability (TDIU) for the period after June 15, 2016 is granted. REMANDED Entitlement to a TDIU for the period from April 2, 2013 to June 15, 2016 is remanded. FINDINGS OF FACT 1. During the period from January 9, 2015 to February 20, 2015, the Veteran’s bilateral hearing loss disability was manifested by a Level VII hearing loss in both ears. 2. During the period from February 20, 2015 to January 15, 2019 the Veteran’s bilateral hearing loss disability was manifested by a Level I hearing loss in the right ear and a Level II hearing loss in the left ear. 3. During the period after January 15, 2019, the Veteran’s bilateral hearing loss disability has been manifested by a Level IV hearing loss in the right ear and a Level V hearing loss in the left ear. 4. The Veteran’s service-connected disabilities prevented him from securing and following substantial gainful occupation during the period after June 15, 2016. CONCLUSIONS OF LAW 1. The criteria for a rating for a bilateral hearing loss disability in excess of 40 percent from January 9, 2015 to February 20, 2015, to a compensable rating from February 20, 2015 to January 15, 2019, and to a rating in excess of 10 percent thereafter have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code (DC) 6100 (2019). 2. The criteria for entitlement to TDIU for the period after June 15, 2016 are met. 38 U.S.C. § 1155, 5103, 5107 (2012); 38 C.F.R. §§ 3.340, 3.341, 4.16 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1973 to September 1977, with additional periods of National Guard service. This matter came before the Board of Veterans Appeals (Board) on appeal from February 2014 and February 2015 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran’s Law Judge during a September 2017 hearing. The transcript of the hearing is of record. A June 2018 Board decision dismissed the issue of an increased rating for lower extremity radiculopathy and remanded the remaining issues on appeal for further development. 1. Entitlement to a rating for a bilateral hearing loss disability in excess of 40 percent from January 9, 2015 to February 20, 2015, to a compensable rating from February 20, 2015 to January 15, 2019, and to a rating in excess of 10 percent thereafter The Veteran contends that he is entitled to a higher rating for his bilateral hearing loss disability. The Veteran has been assigned a staged rating and is currently rated as 40 percent disabling for the period from January 9, 2015 to February 20, 2015, as noncompensable for the period from February 20, 2015 to January 15, 2019, and as 10 percent disabling thereafter. The Board concludes that the criteria for higher ratings have not been met. Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities. Individual disabilities are assigned separate diagnostic codes. See U.S.C. §1155; 38 C.F.R. § 4.1. When there is a question as to which of two evaluations applies, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for the rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In evaluating a disability’s severity, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary importance. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). That said, higher evaluations may be assigned for separate periods based on the facts found during the appeal period. See Fenderson v. West, 12 Vet. App. 119, 126 (1999). This practice is known as staged ratings. Id. Evaluations for defective hearing are based upon organic impairment of hearing acuity as measured by the results of controlled speech discrimination tests, along with the average hearing threshold level as measured by puretone audiometric tests in the frequencies of 1000, 2000, 3000, and 4000 Hertz. 38 C.F.R. § 4.85, Tables VI, VII. To evaluate the degree of disability for service-connected bilateral hearing loss, the rating schedule establishes eleven auditory acuity levels, designated from level I for essentially normal acuity, through level XI for profound deafness. Table VI is used to determine the Roman numeric designation, based on test results consisting of puretone thresholds and Maryland CNC test speech discrimination scores. The numeric designations are then applied to Table VII to determine the appropriate rating for hearing impairment. Id. Where there is an exceptional pattern of hearing impairment, a rating based on puretone thresholds alone may be assigned (Table VIA). This alternative method for rating hearing loss disability may be applied if the puretone thresholds at 1000, 2000, 3000, and 4000 Hertz are all at 55 decibels or higher, or if the puretone threshold at 1000 Hertz is 30 or less and at 2000 Hertz is 70 or more. 38 C.F.R. § 4.86. Each ear is to be evaluated separately under this part of the regulations. Ratings for hearing impairment are derived by a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are rendered. Lendenmann v. Principi, 3 Vet. App. 345 (1992). The Veteran submitted a January 2015 private audiological examination finding that puretone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 RIGHT 35 40 60 75 LEFT 30 35 70 70 The average puretone threshold was 52.5 decibels in the right ear and 51.25 decibels in the left ear. Speech audiometry speech recognition ability of 60 percent in the right ear and 50 percent in the left ear. A December 2018 report later confirmed that the private provider used Maryland CNC testing. At the February 2015 VA audiological examination for compensation purposes, puretone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 RIGHT 30 25 50 70 LEFT 30 35 60 70 The average puretone threshold was 44 decibels in the right ear and 49 decibels in the left ear. Speech audiometry conducted with the Maryland CNC test revealed speech recognition ability of 96 percent in the right ear and 92 percent in the left ear. The Veteran was diagnosed with bilateral sensorineural hearing loss. The examiner noted the Veteran’s reports that he often had to ask others to repeat themselves. A March 2015 VA audiological consult found bilateral mild to severe sensorineural hearing loss and the provider recommended hearing aids. The Veteran reported ear pressure, problems hearing in background noise, and difficulty using the phone and hearing the television without turning up the volume. The March 2015 VA audiogram showed that puretone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 RIGHT 35 40 60 70 LEFT 25 45 65 70 The average puretone threshold was 51.25 decibels in the right ear and 51.25 decibels in the left ear. Speech audiometry was conducted with NU-6 test, not the Maryland CNC test, and the examination results are therefore not adequate for rating purposes. In a September 2020 email, the VA provider explained that the NU-6 results could not be translated to Maryland CNC results as the materials and presentation were different. The provider also confirmed that he did not perform the Maryland CNC test in his clinical practice. June 2015 VA treatment records noted that the Veteran reported problems hearing and understanding speech. At the January 2019 VA audiological examination for compensation purposes, puretone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 RIGHT 40 50 60 65 LEFT 30 40 60 70 The average puretone threshold was 54 decibels in the right ear and 50 decibels in the left ear. Speech audiometry conducted with the Maryland CNC test revealed speech recognition ability of 76 percent in the right ear and 68 percent in the left ear. The Veteran was diagnosed with bilateral sensorineural hearing loss. The examiner noted the Veteran’s reports that he had problems hearing in background noise and from a distance, and that he could not understand women and his grandchildren without hearing aids. At the outset, the Board finds that the VA and private examinations are adequate for appellate review. There is no evidence that the examiners were not competent or credible, and as the reports are based on the Veteran’s statements, in-person examinations and the examiners’ observations, the Board finds them entitled to significant probative weight with respect to the severity of the Veteran’s bilateral hearing loss disability at the time of the examinations. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302–05 (2008). Period from January 9, 2015 to February 20, 2015 Again, the Veteran’s bilateral hearing loss disability is rated as 40 percent disabling for the period from January 9, 2015 to February 20, 2015. The Board finds that an increased rating is not warranted as the evidence indicates that during the period the Veteran’s hearing loss disability was manifested by a Level VII hearing acuity in both ears. Applying the medical evidence from the period from January 9, 2015 to February 20, 2015 to the rating criteria, specifically the January 2015 private examination, the Veteran is assigned a Level VII designation in both ears under Table VI. These categories correspond with a 40 percent disability rating under Table VII. 3 8 C.F.R. § 4.85, Diagnostic Code 6100. The Veteran’s hearing loss did not meet the criteria for an exceptional pattern of hearing loss in either ear. 38 C.F.R. § 4.86 (a)(b). Accordingly, the Board will not use Table VIA in its analysis. The Veteran is competent to report his difficulty hearing. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 310 (2007); and 38 C.F.R. § 3.159 (a)(2) (2017). Nevertheless, as a layperson, without the appropriate medical training and expertise, his statements are not competent evidence to provide a probative opinion on a medical matter, especially the severity of his bilateral hearing loss disability in terms of the applicable rating criteria. Rather, this necessarily requires appropriate medical findings regarding the extent and nature of his bilateral hearing loss, including audiometric testing for puretone thresholds. While the January 2015 private examination is silent for a description of functional loss, the February 2015 VA examination noted the Veteran’s reports of difficulty understanding others. 38 C.F.R. § 4.10; Martinak v. Nicholson, 21 Vet. App. 447 (2007). The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran described is contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Veteran’s main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned. See Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). As indicated above, rating a hearing loss disability involves the mechanical application of rating criteria to the results of specified audiometric studies. The probative medical evidence does not show the Veteran’s hearing loss has ever reached a disability rating in excess of 40 percent disabling during the period. Considering the results of the January 2015 private examination, entitlement to a rating in excess of 40 percent for a bilateral hearing loss disability must be denied. Period from February 20, 2015 to January 15, 2019 Again, the Veteran’s bilateral hearing loss disability is rated as noncompensable for the period from February 20, 2015 to January 15, 2019. The Board finds that an increased rating is not warranted as the competent evidence indicates that during the period the Veteran’s hearing loss disability was manifested by a Level I hearing acuity in the right ear and Level II hearing acuity in the left ear. The Veteran submitted an October 2015 statement reporting that at his February 2015 VA examination the examiner did not put him in a soundproof testing booth and took 30 minutes rather than an hour, and therefore the examination was not sufficient for rating purposes. The Board acknowledges the Veteran’s reports that he was not in a soundproof booth at the February 2015 VA examination and the examination only took 30 minutes, however the criteria for the evaluation of hearing impairment do not specify either the length of the examination or that the speech discrimination test take place in a soundproof booth. The regulations require hearing examinations to be conducted by a state-licensed audiologist and include a controlled speech discrimination test using the Maryland CNC word list but are silent for a requirement regarding time or using a soundproof booth. The Board therefore cannot find that the examination was inadequate for rating purposes on those grounds. The Board also notes the Veteran’s contention that the speech discrimination scores of 60 percent in the right ear and 50 percent in the left ear at the January 2015 private examination was more accurate than the February 2015 VA examination scores of 96 percent in the right ear and 92 percent in the left ear. However, the Board finds that the record taken as a whole does not support this contention. As noted above, there is no indication that the February 2015 VA examiner was not competent, and the report indicates that puretone threshold testing and speech discrimination testing were performed in accordance with regulatory requirements. Moreover, the February 2015 VA examination results are consistent with the subsequent evidence of record, which does not contain speech discrimination results of the severity shown in the January 2015 private examination. Significantly, the speech discrimination scores from the subsequent January 2019 VA examination were 76 percent in the right ear and 68 percent in the left ear, which the Board notes shows a markedly less severe level of hearing impairment than found at the January 2015 examination. However, the record does not contain any indication, and the Veteran does not contend, that his hearing loss disability improved during the period on appeal. In a January 2015 statement, the Veteran contended that his hearing had worsened, and he required hearing aids, which the record shows were fitted and adjusted in March 2015. VA treatment records through April 2020 are silent for a subsequent adjustment. The Board therefore finds that the results of the February 2015 VA examination are more consistent with the subsequent evidence of record than the January 2015 private examination and, accordingly, assigns the February 2015 VA examination greater probative weight regarding the severity of the Veteran’s bilateral hearing loss during the period. Applying the results of the February 2015 VA examination to the rating criteria, the Veteran is assigned a Level I designation in the right ear and a Level II designation in the left ear under Table VI. These categories correspond with a noncompensable rating under Table VII. 3 8 C.F.R. § 4.85, Diagnostic Code 6100. The Veteran’s hearing loss did not meet the criteria for an exceptional pattern of hearing loss in either ear. 38 C.F.R. § 4.86 (a)(b). Accordingly, the Board will not use Table VIA in its analysis. The February 2020 VA examination noted that a functional impairment of difficulty understanding others and March 2015 VA treatment records noted problems hearing in background noise, and difficulty using the phone and hearing the television without turning up the volume. 38 C.F.R. § 4.10; Martinak v. Nicholson, 21 Vet. App. 447 (2007). The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran describes, is contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Veteran’s main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned. See Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). As indicated above, rating a hearing loss disability involves the mechanical application of rating criteria to the results of specified audiometric studies. The probative medical evidence does not show the Veteran’s hearing loss ever reached a disability rating in excess of 0 percent disabling during the period. Considering the results of the February 2015 VA examination and its consistency with the subsequent evidence of record, entitlement to a compensable rating for bilateral hearing loss disability must be denied. Period after January 15, 2019 Again, the Veteran’s bilateral hearing loss disability is rated as 10 percent disabling for the period after January 15, 2019. The Board finds that an increased rating is not warranted as the evidence indicates that during the period the Veteran’s hearing loss disability was manifested by a Level IV hearing acuity in the right ear and Level V hearing acuity in the left ear. Applying the foregoing medical evidence from the period to the rating criteria, the Veteran’s right ear is assigned a Level IV designation and the left ear is assigned a Level V designation under Table VI. These categories correspond with a 10 percent disability rating under Table VII. 3 8 C.F.R. § 4.85, Diagnostic Code 6100. The Veteran’s hearing loss did not meet the criteria for an exceptional pattern of hearing loss in either ear. 38 C.F.R. § 4.86 (a)(b). Accordingly, the Board will not use Table VIA in its analysis. The January 2019 VA examiner noted that the Veteran reported the functional impairment of problems hearing in background nose and from a distance as well as problems understanding women and his grandchildren. 38 C.F.R. § 4.10; Martinak v. Nicholson, 21 Vet. App. 447 (2007). The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran describes, is contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Veteran’s main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned. See Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). As indicated above, rating a hearing loss disability involves the mechanical application of rating criteria to the results of specified audiometric studies. The probative medical evidence does not show the Veteran’s hearing loss has ever reached a disability rating in excess of 10 percent disabling during the period. Considering the results of the VA examination, entitlement to a compensable rating for bilateral hearing loss disability must be denied. 2. Entitlement to a total disability rating due to unemployability (TDIU) for the period after June 15, 2016 The Veteran contends that he is unable to work due to his service-connected disabilities. For the reasons outlined below, the Board finds that the Veteran meets the schedular threshold for entitlement to TDIU and that his service-connected disabilities render him unable to secure and maintain substantially gainful employment during the period after June 15, 2016. A TDIU is therefore warranted. TDIU may be assigned where the schedular rating is less than total when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation due to service-connected disabilities. 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 U.S.C. § 1155; 38 C.F.R. § 4.16(a). The Veteran filed his application for TDIU on April 2, 2013. During the period from April 2013 to the present, he was service connected for his lumbar spine disability, left and right lower extremity radiculopathy, tinnitus and a bilateral hearing loss disability. Beginning June 15, 2016, the Veteran had a single disability rated at 40 percent. His combined rating during the period after June 15, 2016 was 80 percent. The schedular threshold is therefore met for the period after June 15, 2016. Entitlement to TDIU for the period from April 2, 2013 to June 15, 2016, when the schedular threshold was not met, will be addressed in the remand portion below. The Board will therefore consider whether the Veteran’s service-connected disabilities render him unable to secure and maintain substantially gainful employment for the period after June 15, 2016. This involves consideration of two components: an economic component involving an occupation outside of a protected environment earning more than marginal income, and a non-economic component involving the Veteran’s ability to secure and follow such employment. See Ray v. Wilkie, 31 Vet. App. 58 (2019). VA may consider the Veteran’s level of education, special training, and previous work experience in making this determination, but may not consider age or the impairment caused by non-service-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19; see also Ferraro v. Derwinski, 1 Vet. App. (1991). Medical evidence describing the effect of each disability on the Veteran’s occupational functioning is crucial to permit the Board to arrive at an assessment of employability. 38 C.F.R. § 4.1. However, the determination of whether service-connected disabilities are of sufficient severity to produce unemployability is ultimately the Board’s to make. See Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013) (citing 38 C.F.R. § 4.16 (a) as support for the conclusion that the applicable statutory and regulatory provisions “place responsibility for the ultimate TDIU determination on the VA, not a medical examiner”). Therefore, the Board will review the medical evidence in the context of the other evidence of record prior to reaching a conclusion regarding employability. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b). The Veteran submitted an April 2013 VA 21-8940, in which he reported he last worked full time in October 2000. He reported past employment as communications equipment operator. He also reported that he completed high school. A July 2002 Social Security Administration (SSA) decision found severe impairment due to the Veteran’s back disability and radiculopathy. The decision found that the Veteran had a residual functional capacity for less than a full range of sedentary work and was incapable of performing past light to medium exertional level work. The decision also noted that the Veteran had a high school education and an unskilled work background and that his skills were not transferable to work within his residual functional capacity level. A May 2003 VA orthopedic examination evaluated the Veteran’s back disability. The examiner found that that the Veteran could sit for 30 minutes, stand for 20 minutes, walk about a mile and could lift 15 pounds. A December 2011 VA back examination noted that the Veteran retired in 2000 due to back problems. The examiner found that the back disability caused functional loss, including interference with sitting, standing and or weight-bearing. A February 2014 VA nerve examination diagnosed moderate incomplete paralysis of the left lower extremity and found moderate paresthesias and numbness in the left lower extremity. The examiner noted the use of the cane but found that the Veteran’s nerve disability did not affect his ability to work. March 2015 VA treatment records noted bilateral hearing loss and problems hearing in background noise and hearing the phone and television. A June 2016 VA back examination found that the Veteran was unable to sit, stand or walk for prolonged periods of time due to his back disability. The examiner found that the Veteran would need to refrain from employment requiring prolonged standing, frequent walking, climbing stairs or ladders and that he would need frequent breaks from prolonged sitting. The examiner also found moderate bilateral lower extremity radiculopathy, noting symptoms of moderate constant pain and severe numbness in the bilateral lower extremities. At the outset, the Board finds that the VA examinations are adequate for appellate review. There is no evidence that the examiners were not competent or credible, and as the reports are based on the Veteran’s statements, in-person examinations and the examiners’ observations, the Board finds they are entitled to significant probative weight. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302–05 (2008). At the September 2017 Board hearing, the Veteran reported that his back and radiculopathy made him unable to work, specifically stating that he needed to lay down once an hour during the day to ease his back. He also reported that he uses a cane and has balance problems. He also reported that he had problems sleeping due to pain and got up 2 to 3 times per night to sit in a lounge chair. He noted that his last job was as a mail clerk, and that this work required lifting 50 to 60 pound bags of mail The Board notes that the Veteran is competent to report lay-observable symptoms such as pain as well as his former job requirements and accords his statements significant probative weight. Moreover, the undersigned has had the opportunity to observe the Veteran and finds him to be credible. See Dalton v. Nicholson, 21 Vet. App. 23, 38 (2007); Caluza v. Brown, 7 Vet. App. 498, 511 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996). The Board finds that the Veteran was precluded from all non-marginal employment during the period after June 15, 2016 due to his service-connected disabilities. The competent evidence indicates that the Veteran’s back disability prevents long standing, walking and sitting in addition to limitations on lifting. Due to these impairments, the Board finds that he is precluded from both physical and sedentary employment. In so finding, the Board notes that sedentary employment is the common meaning in society of non-physical, white collar, office-type work. Significantly, the June 2016 VA examiner found that the Veteran was unable to sit for long periods due to his back disability, consistent with the SSA finding that the Veteran had residual functional capacity for less than a full range of sedentary work. This is also consistent with the May 2003 VA examiner’s finding that he could only sit for 30 minutes, suggesting that the Veteran’s level of functional impairment has persisted throughout the period on appeal. In addition, the Veteran’s difficulty hearing in background noise and difficulty using the telephone due to his bilateral hearing loss disability would further prevent him from performing routine office-type work. The Board also notes the Veteran’s high school education and unskilled work history, which the July 2002 SSA evaluation indicated did not provide the Veteran with transferrable skills. The Board therefore finds that the Veteran’s limitations, particularly his inability to sit for long periods, render him unable to obtain and maintain substantially gainful employment, especially when combined with limitations associated with his bilateral lower extremity radiculopathy and bilateral hearing loss disabilities. The Board notes that the Veteran’s work history involves work as a mail clerk and required lifting 50 to 60 pounds. The Veteran is therefore precluded from his past work as the record indicates that he is unable to lift more than 15 pounds. The preponderance of the evidence therefore indicates that the Veteran’s service-connected disabilities render him unable to secure and maintain substantial gainful employment. TDIU is therefore warranted under 38 C.F.R. § 4.16(a). REASONS FOR REMAND 1. Entitlement to a total disability rating due to unemployability (TDIU) for the period from April 2, 2013 to June 15, 2016 is remanded. When a veteran is unable to secure and follow a substantially gainful occupation due to service-connected disabilities, but fails to meet the percentage requirements for TDIU set forth in 38 C.F.R. § 4.16 (a), the case may be referred to appropriate VA officials for extraschedular consideration of the assignment of a TDIU rating. 38 C.F.R. § 4.16 (b). The Board does not have the authority to assign an extraschedular total disability rating based on individual unemployability in the first instance. Bowling v Principi, 15 Vet. App. 1 (2001). As noted above, the Veteran has a combined rating of 40 percent for the period from November 15, 2012 to February 15, 2013, other than a 70 percent rating assigned for the period from January 9, 2015 to February 20, 2015. He has already been found unemployable due to his service-connected back disability, along with his bilateral lower extremity radiculopathy and hearing loss disabilities. Accordingly, the Board finds that the criteria for referral of the claim for extraschedular consideration of a TDIU rating have been met. The matters are REMANDED for the following action: 1. Refer the case to the Director, Compensation Service, for an extraschedular determination as to whether the Veteran was entitled a total disability rating based on individual unemployability due to service-connected disability during the period from April 2, 2013 to June 15, 2016 in accordance with the provisions of 38 C.F.R. § 4.16 (b). The rating board should include a full statement as to the Veteran’s service-connected disability, employment history, educational and vocational attainment and all other factors having a bearing on the issue. 2. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Arnold, 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.