Citation Nr: 21004642 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 14-37 103 DATE: January 27, 2021 ORDER Prior to November 5, 2015, a compensable rating for bilateral hearing loss is denied. A rating higher than 30 percent for bilateral hearing loss is denied. From October 29, 2009, but no earlier, an initial 40 percent rating for chronic spondylolisthesis L5-S1 with degenerative joint disease (DJD) and degenerative disc disease (DDD), is granted, subject to controlling regulations governing the payment of monetary awards. An initial rating higher than 40 percent for chronic spondylolisthesis L5-S1 with DJD and DDD is denied. From February 27, 2006 to June 30, 2014, a total disability based on individual unemployability (TDIU) is denied.   FINDINGS OF FACT 1. Prior to November 5, 2015, the Veteran’s bilateral hearing loss was manifested by hearing acuity of no worse than Level VIII in the right ear and no worse than Level I in the left ear. 2. From November 5, 2015, the Veteran’s bilateral hearing has been manifested by hearing acuity of no worse than Level VI in the right ear and no worse than Level VI in the left ear. 3. From October 29, 2009, but no earlier, the Veteran’s low back disability manifested by severe painful motion with forward flexion approximating 30 degrees or less. 4. The Veteran’s low back disability is not manifested by ankylosis or intervertebral disc syndrome (IVDS) requiring bedrest of at least 6 weeks within any 12 months during the appeal period. 5. From February 27, 2006 to June 30, 2014, the Veteran’s service-connected disabilities did not preclude him from securing or following a substantially gainful occupation. CONCLUSIONS OF LAW 1. The criteria for a compensable rating for bilateral hearing loss, prior to November 5, 2015, are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code (DC) 6100. 2. The criteria for a rating higher than 30 percent for bilateral hearing loss are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.85, 4.86, DC 6100. 3. The criteria for a 40 percent rating for chronic spondylolisthesis L5-S1 with DJD and DDD, from October 29, 2009, but no earlier, are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.71a, DC 5242. 4. The criteria for a rating higher than 40 percent for chronic spondylolisthesis L5- S1 with DJD and DDD are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.71a, DC 5242. 5. The criteria for a TDIU, from February 27, 2006 to June 30, 2014, are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1966 to November 1969. The case is on appeal from June 2011 and March 2012 rating decisions. The Board notes that the March 2012 rating decision was a readjudication of the initial rating assigned in the June 2011 rating decision for a low back disability, as the Veteran’s July 2011 submission is reasonably construed as a notice of disagreement (NOD) with the 10 percent rating assigned, from February 27, 2006, the date of claim. See also September 2011 VA Form 21-4138 Statement in Support of Claim; November 2019 Board decision. Further, additional relevant evidence was submitted within one year of the June 2011 rating decision. See February 2012 VA treatment records (lumbar spine arthritic changes worse since prior examination); Beraud v. McDonald, 766 F.3d 1402, 1407 (2014). By rating decision in September 2015, the back rating was increased to 40 percent, from October 24, 2013. See AB v. Brown, 6 Vet. App. 35, 38 (1993) (where increase does not satisfy the appeal in full, the issue remains on appeal). Following the issuance of the September 2015 statement of the case (SOC), the Veteran timely appealed. See February 2016 VA Form 21-4138 Statement in Support of Claim; February 2016 VA substantive appeal; November 2020 VA Form 8; see also Percy v. Shinseki, 23 Vet. App. 38 (2009) In May 2018, the Veteran testified at a Board hearing. In a January 2019 decision, the Board denied claims for compensation under 38 U.S.C. § 1151 for infection after nasal surgery and an effective date for the grant of service connection for a back disability prior to February 27, 2006. The issues of service connection for a psychiatric disorder and sciatica of the lower extremities, as well as higher ratings for a back disability and bilateral hearing loss, including a TDIU, were remanded for additional development. The issues of service connection for diabetes and coronary artery disease (CAD) were stayed pending the January 1, 2020 effective date of the Blue Water Navy Vietnam Veterans Act of 2019. In a January 2020 decision, the Board granted service connection for diabetes and CAD. By rating decision in May 2020, a 100 percent rating was assigned for ischemic heart disease and special monthly compensation (SMC) based on the housebound criteria being met was granted, effective June 30, 2014. Thus, the claim for a TDIU from that date is rendered moot. However, the issue of a TDIU prior to June 30, 2014, remains on appeal. By rating decision in August 2020, service connection for radiculopathy of the right and left lower extremity, a psychiatric disorder, and a surgical scar of the back was granted. This represents a full grant of the benefits sought with respect to those issues. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions 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). Legal Criteria Ratings are based on a schedule of reductions in earning capacity from specific injuries or combination of injuries. The ratings shall be based, as far as practicable, upon the average impairments of earning capacity resulting from such injuries in civil occupations. 38 U.S.C. § 1155. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz). 38 C.F.R. § 4.85, DC 6100. To evaluate the degree of disability from bilateral service-connected hearing loss, the schedule establishes 11 auditory hearing acuity levels designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. 38 C.F.R. § 4.85, Tables VI and VII. An exceptional pattern of hearing impairment occurs when the pure tone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more. 38 C.F.R. § 4.86(a). In that situation, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. Further, when the average pure tone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral, and that numeral will then be elevated to the next higher numeral. 38 C.F.R. § 4.86(b). Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent rating is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. Unfavorable ankylosis is defined as “a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching.” Id. at Note 5. Additionally, fixation of a spinal segment in neutral position (zero degrees) is “always” considered favorable ankylosis. Id. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (“[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran’s disability, after which a rating is determined based on the § 4.71a criteria.”). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). Regulations require that where there is a question as to which of two evaluations is to be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Analysis 1. A compensable rating for bilateral hearing loss prior to November 5, 2015; an in excess of 30 percent thereafter. The RO assigned staged ratings for the Veteran’s bilateral hearing loss, that is, separate ratings for distinct periods during the rating period on appeal. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). The Veteran maintains that his hearing impairment is worse than reflected in the staged ratings currently assigned, and particularly with respect to speech recognition. See November 2012 VA Form 21-4138 Statement in Support of Claim. A May 2011 private examination report reflects the speech recognition score and pure tone thresholds, in decibels, were as follows: May 24, 2011 HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 40 45 75 80 54 88 LEFT 30 25 65 70 44 94 Applying the results to Table VI, the findings yield a numeric designation of Level II in the right ear and Level I in the left ear. Entering the resulting bilateral numeric designation of Level II for the right ear and Level I for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a noncompensable (zero percent) rating under DC 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown. An October 2013 VA examination report, see November 2013 report, reflects the Veteran’s Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: October 18, 2013 HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 50 55 80 80 66 52 LEFT 30 35 65 75 51 96 Applying the results to Table VI, the findings yield a numeric designation of Level VIII in the right ear and Level I in the left ear. Entering the resulting bilateral numeric designation of Level VIII for the right ear and Level I for the left ear to 38 C.F.R. § 4.85, Table VII, equates to noncompensable rating under DC 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown. Based on the above, the criteria for a compensable rating for bilateral hearing loss were not met for the earlier period. The RO increased the rating to 30 percent based on audiological evaluation on November 5, 2015 reflecting average pure tone thresholds, in decibels, of 68 in the right ear and 59 in the left ear, with speech recognition scores of 72 and 64 percent, respectively. See February 2016 CAPRI documents. Applying the results to Table VI, the findings yield a numeric designation of Level VI in both the right and left ear. Entering the resulting bilateral numeric designation of Level VI hearing in each ear to 38 C.F.R. § 4.85, Table VII, equates to a 30 percent rating under DC`6100. Although an exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown, it was noted that the Veteran’s hearing loss was expected to result in significant communication problems, especially in noisy listening environments and in the absence of visual cues. See Martinak v. Nicholson, 21 Vet. App. 447 (2007). Subsequent evaluations do not support a rating higher than the 30 percent currently assigned. In that respect, a June 2016 VA examination report shows the Veteran’s Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: June 16, 2016 HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 50 70 70 80 67.5 72 LEFT 35 60 65 75 58.75 64 Applying the results to Table VI, the findings yield a numeric designation of Level VI in the right ear and Level VI in the left ear. Entering the resulting bilateral numeric designation of Level VI for the right ear and Level VI for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a 30 percent disability rating under Diagnostic Code 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown. Pursuant to the Board’s November 2019 remand, the Veteran was afforded another VA examination in December 2019. The report reflects the Veteran’s Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: December 27, 2019 HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 65 70 80 85 75 80 LEFT 55 65 65 80 66.25 74 Applying the results to Table VI, the findings yield a numeric designation of Level V in the right ear and Level VI in the left ear. Entering the resulting bilateral numeric designation of Level V for the right ear and Level VI for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a 20 percent rating under DC 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was shown in both ears. Applying the results to Table VIA yields Level VI in the right ear and level V in the left ear. Entering the resulting bilateral numeric designation of Level VI for the right ear and Level VI for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a 30 percent rating under DC 6100. Here, Table VIA yields the higher 30 percent rating currently assigned. Based on the evidence above, the Veteran’s bilateral hearing loss did not meet the criteria for a compensable rating prior to November 5, 2015. The earliest date that an increase in the Veteran’s bilateral hearing loss is factually ascertainable is November 5, 2015. See Swain v. McDonald, 27 Vet. App. 219, 224 (2015). In addition, the Veteran’s hearing loss does not meet the criteria for a rating higher than 30 percent. The Board expressly acknowledges its consideration of the lay evidence of record, including the Veteran’s difficulty hearing in group discussions, hearing instructions and/or reacting to potential safety hazards within a work environment. See September 2013 VA 21-4138 Statement in Support of Claim. The Veteran is competent to report difficulty with his hearing and VA treatment records in August 2017 reflect hearing aids were issued; however, disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenmann v. Principi, 3 Vet. App. 345 (1992). 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 ratings assigned. See Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). The preponderance of the evidence is against the claims; the benefit of the doubt doctrine is not applicable; and a compensable rating for bilateral hearing loss prior to November 5, 2015, and a rating higher than 30 percent thereafter are therefore not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. 2. A rating higher than 10 percent for chronic spondylolisthesis L5-S1 with DJD and DDD prior to October 24, 2013; and in excess of 40 percent thereafter. The Veteran seeks higher ratings for his back disorder. The RO assigned the 40 percent rating based on the date of the October 24, 2013 VA examination. Thus, it is not materially in dispute that the Veteran’s back disability meets the 40 percent criteria since at least that date. See, e.g., Murphy v. Shinseki, 26 Vet. App. 510, (2014). An effective date for an increased rating should not be assigned mechanically based on the date of an examination. Rather, all of the facts should be examined to determine the date that the increase in disability first manifested. Accordingly, the effective date for an increased rating-as well as for an initial rating or for staged ratings-is predicated on when the increase in the level of disability can be ascertained. Swain, 27 Vet. App. at 224. In this case, the evidence shows that the 40 percent disability level first arose earlier than the date of the October 2013 VA examination. Specifically, on October 29, 2009, a flare up of chronic back pain was noted, and x-ray examination of the lumbar spine was noted to show worsening spondylolisthesis at L5-S1. See March 2010 VA treatment records. In addition, and although flexion was to 65 degrees on examination in May 2011, in consideration of the additional functional impairment noted during flare ups occurring approximately twice a month, see Sharp v. Shulkin, 29 Vet. App. 26 (2017), as well as worsening arthritic changes in the lumbar spine noted on imaging in October 2011, see February 2012 CAPRI documents, the Board finds that an increase in the back disability to the 40 percent level was factually ascertainable on October 29, 2009, particularly when resolving doubt in the Veteran’s favor. Prior to October 29, 2009, the evidence does not show an increase in the severity of the Veteran’s back disability. In that respectVA treatment records in October 2005 noting SSA disability for severe dyspnea reflect that the Veteran’s low back pain was stable, and that he felt well since a stent placement in 2004. See April 2007 VA treatment records. In addition, VA treatment records in both April 2007 and April 2009 reflect that the Veteran’s back symptoms were stable and allowed for routine activities. Although use of pain medication was noted, a pain score of “0” was reported. See April 2007 records. The Board notes that although the Veteran’s continued use of medication is not explicitly considered by the rating criteria, the pain that necessitates such medication is sufficiently addressed by the rating criteria. Moreover, no palpable spinal or para-spinous muscle tenderness or costovertebral angle tenderness was reported. Straight leg raise testing was negative bilaterally, deep tendon reflexes were normal, and motor power was 5/5, intact, and without deficit. Although the April 2007 records note complaints of worsening back pain, degenerative changes were noted to be moderate on imaging in both April 2001 and April 2007. See February 2006 & April 2011 VA treatment records, respectively. The April 2007 report of x-ray examination specifically states that the impression was similar to prior x-ray examination. See also February 2012 VA treatment records. The Board notes that although a December 2006 private opinion states that the Veteran’s back disability would make physical labor difficult, the record reflects the Veteran’s history of administrative/sedentary work. See November 2012 VA 21-8940, April 2009 VA treatment records. Regardless, the opinion does not establish an increase in the back disability. In addition, and although pain was noted to be chronic, there is no indication of flare ups. See Sharp, 29 Vet. App. at 26. The Board notes that the 10 percent rating assigned prior to October 24, 2013 contemplates the Veteran’s functional impairment due to the back disability. Additionally, bilateral pars defects and incontinence were noted to be unrelated to the Veteran’s spondylolisthesis. See February 2006, February 2012 VA treatment records. Further, in April 2009, the Veteran reported that his back pain was stable and no changes in back symptoms were noted. In addition, and although not bound by a determination of the Social Security Administration (SSA), see Collier v. Derwinski, 1 Vet. App. 413, 417 (1991), the Board notes that SSA records reflect disability due to not only the Veteran’s service connected back disorder, but also a psychiatric disorder, heart disease, and diminished lung capacity. See October 2009 SSA records. Further, and although the Board is granting the 40 percent rating for the earlier period, the next higher ratings require ankylosis, which is not shown. See January 2020 VA examination report. When the maximum schedular evaluation based on limitation of motion is assigned, and a higher rating requires ankylosis, the provisions contained in 38 C.F.R. §§ 4.40 and 4.45, pertaining to functional loss, are not for application. Johnston v. Brown, 10 Vet. App. 80, 84-85 (1997). The record specifically reflects no ankylosis. Additionally, the Board determines there is no increased rating warranted due to IVDS under DC 5243. In this regard, the January 2020 VA examiner specifically reported no IVDS and the record does not show physician prescribed bedrest. In sum, the evidence is in favor of a 40 percent rating for the Veteran’s spondylolisthesis L5-S1 with DJD and DDD from October 29, 2009. This is particularly so when resolving reasonable doubt in the Veteran’s favor. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. As reasonable doubt was already applied in granting the 40 percent rating from October 29, 2009, an even earlier date for the 40 percent rating is clearly not warranted. The preponderance of the evidence is against a rating higher than 40 percent; the benefit of the doubt doctrine is not applicable; and a rating higher than 40 percent for spondylolisthesis L5-S1 with DJD and DDD is therefore not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. 3. A TDIU prior to June 30, 2014. As noted above, from June 30, 2014, the Veteran is in receipt of a 100 percent and SMC based on the housebound criteria being met. As such, the issue is whether a TDIU is warranted prior to June 30, 2014. Legal Criteria 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). In determining whether a veteran can secure and follow a substantially gainful occupation, attention must be given to: • The veteran’s history, education, skill, and training; • Whether the veteran has the physical ability (both exertional and nonexertional) to perform the type of activities (e.g., sedentary, light, medium, heavy, or very heavy) required by the occupation at issue. Factors that may be relevant include, but are not limited to, the veteran’s limitations, if any, concerning lifting, bending, sitting, standing, walking, climbing, grasping, typing, and reaching, as well as auditory and visual limitations; and • Whether the veteran has the mental ability to perform the activities required by the occupation at issue. Factors that may be relevant include, but are not limited to, the veteran’s limitations, if any, concerning memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity. Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). Analysis During the rating period on appeal prior to June 30, 2014, even with the increase to 40 percent for the lumbar spine above, the does Veteran not meet the schedular percentage standards for consideration of a TDIU because his combined rating is 60 percent or less, and not 70 percent or more, prior to June 30, 2014. 38 C.F.R. § 4.16(a). Accordingly, the Veteran does not meet the schedular criteria for consideration for the assignment of a TDIU. 38 C.F.R. § 4.16(a). However, TDIU on an extraschedular basis is still for consideration under 38 C.F.R. § 4.16(b). In addition, the evidence does not demonstrate that the Veteran was unable to secure and follow substantially gainful employment prior to June 30, 2014 as a result of his then service-connected disabilities and their severity prior to that time. As noted above, SSA records reflect disability due to not only the Veteran’s service-connected back and psychiatric disorders, but also heart disease and diminished lung capacity. See October 2009 SSA records. The Board notes that a lung condition is not service connected and service connection for heart disease was not established prior to June 30, 2014. In addition, and although the SSA determination reflects disability since March 2000, the Board is not bound by a determination of the SSA. See Collier, 1 Vet. App. at 417. Moreover, VA treatment records in October 2005 noting disability due to severe dyspnea reflect that the Veteran’s low back pain was stable, and that he felt well since a stent placement in 2004. See April 2007 VA treatment records. Further, a noncompensable rating was assigned for the service-connected psychiatric disorder prior to December 11, 2013, and increased to 10 percent thereafter based on occupational and social impairment due to only mild or transient symptoms which decreased work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by medication. See December 2011 VA mental disorders examination. Furthermore, and although VA treatment records in November 2009 note communication problems due to service-connected bilateral hearing loss, a noncompensable rating was assigned. See February 2012, March 2011 VA treatment records. In addition, VA treatment records in September 2010 reflect that nonservice-connected headache pain was the cause of the Veteran’s functional impairment and sleep difficulty. Moreover, a May 2011 examination report reflects the Veteran’s lengthy work history and the VA physician specifically concluded that the back disorder did not render the Veteran unemployable. Further, in September 2013, the Veteran noted that he was able to lift 10-20 pounds and maintain his daily activities without assistance. The record reflects the Veteran’s service-connected disabilities caused impairment in regard to employment prior to June 30, 2014; however, he was not unable to secure or follow a substantially gainful occupation as a result of such disabilities. Although he had some limitations in terms of standing/walking for extended periods of time and/or interacting with others, his service-connected disabilities did not prevent him from performing sedentary work. For purposes of this decision, the Board uses the term “sedentary” to have the common meaning of a non-physical job, primarily involving sitting and usually performed in an indoor, office-type environment. See Withers v. Wilkie, 30 Vet. App. 139, 147-48 (2018). The Board is sympathetic to the Veteran’s assertions regarding the impact his disabilities. However, those problems are compensated by the schedular ratings for such disabilities. Van Hoose v. Brown, 4 Vet. App. 361 (1993). Moreover, while these disabilities caused some economic impairment, his assigned disability ratings contemplated his level of occupational impairment. A TDIU claim is not purely a medical question. Here, the Board has considered both the relevant medical evidence as well as the non-medical evidence such as work history and lay statements. Therefore, because the evidence of record shows neither a combined disability rating meeting the criteria of 38 C.F.R. § 4.16(a) nor functional impairment caused by the Veteran’s service-connected disabilities resulting in an inability to secure and maintain a substantially gainful occupation during the appeal period from February 27, 2006 to June 30, 2014, referral for extraschedular consideration is not warranted. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Accordingly, a TDIU prior to June 30, 2014, is not warranted. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Taylor 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.