Citation Nr: 21065789 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 11-04 574 DATE: October 27, 2021 ORDER Entitlement to an initial rating in excess of 10 percent for status post shot gun injury of the left foot (left foot disability) for the period on appeal prior to July 21, 2009 is denied. Entitlement to a disability rating in excess of 30 percent for the left foot disability for the periods on appeal from July 21, 2009 to November 13, 2009 and from July 1, 2010 is denied. Entitlement to a total disability rating based on individual unemployability (TDIU), to include on an extraschedular basis, is denied. FINDINGS OF FACT 1. Prior to July 21, 2009, the Veteran's left foot disability was not manifested by symptoms that more nearly approximate a moderately severe disability. 2. For period from July 21, 2009 to November 13, 2009 and from July 1, 2010, the Veteran's left foot disability has been assigned the maximum 30 percent rating for a unilateral foot disability under the schedular criteria; the Veteran's disability does not involve a level of impairment comparable to amputation with prosthesis. 3. The Veteran's service-connected disabilities did not meet the schedular criteria for a TDIU rating, and the preponderance of the evidence of record is against a finding that her service-connected disabilities were of such nature and severity as to preclude her from securing and following a substantially gainful occupation. CONCLUSIONS OF LAW 1. The criteria for entitlement an initial rating in excess of 10 percent for a left foot disability for the period on appeal prior to July 21, 2009 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 3.321, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code (DC) 5284. 2. The criteria for entitlement to a disability rating in excess of 30 percent for a left foot disability for the periods on appeal from July 21, 2009 to November 13, 2009 and from July 1, 2010 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 3.321, 4.40, 4.45, 4.59, 4.71a, DC 5167, 5284. 3. The criteria for a TDIU, to include on an extraschedular basis, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.16, 4.19. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1982 to March 1982. This matter comes before the Board of Veterans' Appeals (Board) on appeal from August 2009, December 2009 and March 2012 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO. The Veteran's claims for increased disability ratings for her left foot disability were previously denied by the Board in a June 2018 decision. The Veteran appealed to the Court of Appeals for Veterans Claims (CAVC). In January 2020, CAVC issued a decision vacating the June 2018 Board decision and remanding for further action. This matter was subsequently remanded by the Board in May 2021. In consideration of the appeal, the Board is satisfied there was substantial compliance with the remand directives and will proceed with review. See Stegall v. West, 11 Vet. App. 268 (1998). Increased Rating Disability evaluations are determined by application of criteria set forth in the VA's Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § Part 4. When a question arises as to which of two ratings apply under a particular diagnostic code, the higher rating is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. In general, when an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). However, when the current appeal arises from the initially assigned rating, consideration must be given as to whether staged ratings should be assigned to reflect entitlement to a higher rating at any point during the pendency of the claim. Fenderson v. West, 12 Vet. App. 119 (1999). Moreover, staged ratings are appropriate in any increased rating claim in which distinct time periods with different ratable symptoms can be identified. Hart v. Mansfield, 21 Vet. App. 505 (2007). The Board has considered the entire record, including the Veteran's treatment records. These show complaints and treatment but will not be referenced in detail. The Federal Circuit has held that the Board must review the entire record but does not have to discuss each piece of evidence. Gonzales v. West, 218 F.3d 1378 (Fed. Cir. 2000). Therefore, the Board will discuss the evidence pertinent to the rating criteria and the current disability. The Veteran is currently rated under DC 5284. Under DC 5284, moderate residuals of a foot injury warrant a 10 percent evaluation; moderately severe residuals warrant a 20 percent evaluation; and severe residuals warrant a 30 percent evaluation. 38 C.F.R. § 4.71a, DC 5284. The words "slight," "moderate," and "severe," as used in the various codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all the evidence, to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6. The use of terminology such as "severe" by VA examiners and others, although an element of evidence to be considered by the Board, is not dispositive of an issue. The Board notes that the Veteran was assigned a 100 percent disability rating for her left foot disability for the period from November 13, 2009 to July 1, 2010. 1. Entitlement to initial rating in excess of 10 percent for a left foot disability for the period on appeal prior to July 21, 2009 The Veteran's left foot disability is initially rated as 10 percent disabled, prior to July 21, 2009. A March 2002 private treatment record noted the Veteran had pain on manipulation of her left foot and she could not do a toe-raise. The Veteran had an examination for her left foot disability in April 2004. The Veteran reported frequent swelling and pain in her left foot. She stated that at rest, she had pain, stiffness and swelling and while standing or walking, she had pain, weakness and stiffness. Functional impairment was noted to be difficulty walking, and occasionally the foot locks and she becomes unstable on her feet. The condition resulted in four times lost from work per year. Examination of the feet did not reveal any signs of abnormal weight bearing, and she did not require an assistive device for ambulation. The Board finds the current 10 percent rating, prior to July 21, 2009, is appropriate. As noted, to warrant a higher 20 percent rating, the Veteran's left foot disability must be moderately severe. Here, the evidence indicates the Veteran had pain, stiffness and swelling at rest, pain on manipulation of the foot, difficulty walking, and pain, weakness and stiffness while standing or walking. However, examination did not reveal any abnormal weight bearing and although she had an altered gait, she did not require an assistive device for ambulation or any type of support for her shoes. Furthermore, while the April 2004 examiner noted pain and stiffness while standing, walking, or resting, there is no indication that the Veteran's pain was constant. Notably, when discussing the Veteran's low back condition, the examiner specifically stated that the "pain occurs constantly". However, the April 2004 examiner notably did not describe the Veteran's left foot pain as "constant". Additionally, while the Veteran reported that her foot occasionally locks and becomes unstable, there is no evidence that Veteran's left foot locking and instability occurred frequently enough to warrant a higher disability rating. The Veteran is competent to report certain obvious symptoms of disability, but not to identify a specific level of disability. Barr v. Nicholson, 21 Vet. App. 303 (2007); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994). Competent evidence concerning the nature and extent of the Veteran's service-connected disability has been provided by the medical professionals who have examined her. The overall medical findings adequately address the criteria under which this disability is evaluated. The Board accords the objective medical findings greater weight than subjective complaints of increased symptomatology. Cartwright v. Derwinski, 2 Vet. App. 24, 25 (1991). In reaching this conclusion, the Board has considered any additional functional limitation due to factors such as pain, weakness, incoordination, or fatigability. See 38 C.F.R. §§ 4.40 and 4.45; Deluca v. Brown. In considering additional limitation of function, the Board acknowledges the Veteran's complaints of pain on use. The Board notes that the Veteran is competent to give evidence about what she experiences; for example, she is competent to discuss current pain and other experienced symptoms. See, e.g., Layno v. Brown, 6 Vet. App. 465 (1994). These complaints are well documented in the lay statements submitted and were considered in the assignment of the 10 percent rating for this period. However, even considering the Veteran's pain and limitation of function, there is no persuasive evidence that the Veteran's disability warrants a rating higher than 10 percent, prior to July 21, 2009. The Board recognizes the limitations that the Veteran has as a result of her service-connected left foot. However, these limitations, including the Veteran's pain and interference with standing and walking, have been considered in the 10 percent rating assigned, prior to July 21, 2009. 2. Entitlement to a disability rating in excess of 30 percent for a left foot disability for the periods on appeal from July 21, 2009 to November 13, 2009 and from July 1, 2010 For the periods on appeal from July 21, 2009 to November 13, 2009 and from July 1, 2010, the Veteran's left foot disability is rated at 30 percent under DC 5284. Under DC 5284, a 30 percent rating is provided when the injury is severe, and a 40 percent rating is provided when there is actual loss of use of the foot. See 38 C.F.R. § 4.71a, DC 5167. The term "loss of use" of a hand or foot is defined at 38 C.F.R. § 3.350(a)(2) as that condition where "no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance. The determination will be made on the basis of the actual remaining function, whether the acts of grasping, manipulation, etc., in the case of the hand, or of balance, propulsion, etc., in the case of a foot, could be accomplished equally well by an amputation stump with prosthesis." See also 38 C.F.R. § 4.63. Examples under 38 C.F.R. § 3.350(a)(2) that constitute loss of use of a foot include extremely unfavorable ankylosis of the knee, complete ankylosis of two major joints of an extremity, shortening of the lower extremity of three and a half inches or more, and complete paralysis of the external popliteal (common peroneal) nerve and consequent foot-drop, accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of that nerve. See also 38 C.F.R. § 4.63. In Tucker v. West, 11 Vet. App. 369, 373 (1999), the Court held that the relevant inquiry concerning loss of use is not whether amputation is warranted, but whether the claimant has had effective function remaining other than that which would be equally well served by an amputation with use of a suitable prosthetic appliance. The Court also held that, in accordance with 38 C.F.R. § 4.40, the Board is required to consider the impact of pain in making its decision and to articulate how pain on use was factored into its decision. The Veteran had an examination for her left foot disability in July 2009. The Veteran reported constant, burning, aching, and sharp pain, which was exacerbated by physical activity and walking. At rest, standing or walking, she reported pain, weakness, stiffness and swelling. The Veteran reported an inability to walk or stand for more than 15 minutes, secondary to pain. Examination of the feet revealed abnormal weight bearing with an unusual shoe pattern. There were no callosities, or breakdown. She required a cane for ambulation because of pain. The left foot had painful motion, but there was no edema, disturbed circulation, weakness, atrophy of the musculature tenderness, heat, redness or instability. The examiner noted that the Veteran's pain was relieved by Neurontin and Darvocet. The Veteran reported that her pain results in her not being able to function. The Veteran did not require a brace, crutches, corrective shoes, a wheelchair, a prosthesis, or a walker. A September 2009 VA treatment note indicates the Veteran sought treatment for her left foot. She reported chronic left foot pain. She indicated that she used a walker because even with a cane her gait was not good. She reported taking both Neurontin and Darvocet/Vicodin, at least four times a day to ease the pain. She was measured for, trained on and issued a rolling walker with a seat. An October 2009 treatment note indicated the Veteran had significant and severe pain in her left foot. In November 2009, it was noted the Veteran's symptoms were not responding to conservative treatment and she underwent a triple arthrodesis of the left foot. She continued to experience pain, and an April 2010 treatment note indicated she had delayed healing of the TN and CC joints after her November 2009 surgery, which necessitated an additional surgery in May 2010 to remove hardware placed during the November 2009 surgery. The Veteran had another examination for her left foot disability in May 2012. The Veteran reported constant use of a walker for mobilization. The examiner indicated that the Veteran's left foot disability did not result in functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis. An April 2013 VA treatment note reported the Veteran had a total of four reconstructive surgeries on her left foot, but continued to experience chronic pain, swelling, and weakness of the left foot. A June 2013 VA physical therapy note reported that the Veteran stated her pain was a 10/10 and she was unable to participate with range of motion and muscle testing because of pain. It was noted that the Veteran came in using her rollator walker, ambulated in a slow, cautious manner and was wearing her off loader boot on the left foot. She was issued a TENS unit for pain management. A June 2015 VA treatment note indicated the Veteran wore orthotic shoes and she continued to take pain medication regularly. It was noted she was on long-term opioid therapy for her left foot pain, with a goal to be able to continue to walk one block using her rolling walker. The Veteran had another examination for her left foot disability in September 2016. The Veteran described experiencing "fairly constant" excruciating left foot pain with weight bearing and non-weight bearing. The Veteran indicated that she is unable to put weight on her left foot and that she does not wear a shoe on her left foot due to pain, opting to go barefoot or with a padded heel protector boot. The examiner described the Veteran's left foot pain as severe. The examiner noted that the Veteran's foot condition chronically compromises weight bearing. The examiner noted that the Veteran experienced pain on movement, pain on weight-bearing, pain on non-weight-bearing, disturbance of locomotion, and interference with standing. The Veteran reported the constant use of crutches. The examiner indicated that the Veteran's left foot disability did not result in functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis. The Veteran had another examination for her left foot disability in December 2017. The Veteran reported experiencing flare-ups of her left foot disability, noting increased pain and swelling with overuse. The Veteran reported functional loss of the foot. The Veteran specifically reported experiencing daily pain and that her "legs give out". She stated that some mornings she cannot even stand on her feet. The examiner noted that the Veteran experienced less movement than normal, weakened movement, pain on movement, swelling, deformity, atrophy of disuse, instability of station, disturbance of locomotion, interference with sitting, interference with standing, and lack of endurance. The Veteran reported the constant use of crutches. The examiner indicated that the Veteran's left foot disability did not result in functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis. Additionally, the examiner noted that the Veteran's left foot disability impacted her ability to work. Specifically, the examiner stated that the Veteran uses crutches daily for ambulation, is unable to bear weight on the left foot, and if she manipulates the left foot, she experiences swelling and increased pain. The examiner indicated that the Veteran could perform light physical and sedentary activities, but the Veteran cannot perform general activities without restrictions, nor can she perform light duties. In this case, the weight of the evidence demonstrates that, for the periods on appeal, the Veteran maintained some function of her left foot, in that she retained the ability to ambulate using an assistive device, principally a walker or crutches. Furthermore, the Board notes that the May 2012, September 2016, and December 2017 examiners all concluded that the Veteran's left foot disability did not result in functional impairment of an extremity such that no effective function remains other than that which would be equally well served by an amputation with prosthesis. Overall, the medical evidence does not support a finding that, for the periods on appeal, the Veteran's ambulation would be equally well served by an amputation and prosthesis. The Board acknowledges the Veteran's assertion that she has lost the use of her left foot and has considered her reported symptomatology. While the Veteran is competent to report symptomatology, including that she has pain and weakness in her left foot and that she has difficulty walking, the determination of whether "loss of use" exists is a legal determination. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Here, the Veteran's lay reports are outweighed by the medical evidence of record, which fails to demonstrate that she is unable to ambulate with her left foot. The Board recognizes that the rating criteria for assessing the severity of musculoskeletal disabilities do not specifically contemplate the use of medication to ameliorate symptoms and that the Veteran has reported the use of pain relievers to treat her symptoms. See Jones v. Shinseki, 26 Vet. App. 56, 63 (2012), ("[a]bsent a clear statement [in the diagnostic code] setting out whether or how the Board should address the effects of medication...the Board may not deny entitlement to a higher disability rating on the basis of relief provided by medication.") However, the Board finds that, even when considering the symptoms the Veteran may experience when not aided by the ameliorative effect of medication, higher ratings are not warranted as there is no probative evidence indicating that, absent medication, the Veteran would experience loss of use of the foot. In this regard, while the Veteran is competent to provide evidence regarding her symptomatology, she is not competent to provide an opinion regarding the severity of her symptomatology in accordance with the rating criteria. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). The Board finds the medical evidence in which professionals with medical expertise examined the Veteran, acknowledged her reported symptoms, and described the manifestations of such disabilities in light of the rating criteria to be more persuasive than her own reports regarding the severity of such conditions. Accordingly, a disability rating in excess or 30 percent for a left foot disability for the periods on appeal from July 21, 2009 to November 13, 2009 and from July 1, 2010 is not warranted. 3. Entitlement to a TDIU, to include on an extraschedular basis Total disability rating may be assigned where the schedular rating is less than total when the disabled person 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, this disability shall be ratable at 60 percent or more, or 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. See 38 C.F.R. § 4.16(a). During the pendency of this appeal, the Veteran is service connected for status post shot gun injury of the left foot, rated as 10 percent from September 4, 2003, 30 percent from July 21, 2009, 100 percent from November 13, 2009, and 30 percent from July 1, 2010; left foot scar rated as 20 percent from November 13, 2009; left lower extremity hypesthesia rated as 10 percent from September 20, 2017; and linear left foot scar rated as noncompensable from November 13, 2009. Excluding the temporary 100 percent rating period, the Veteran had a combined disability rating of at most 50 percent from September 20, 2017. Consequently, the Veteran does not meet the schedular rating for a TDIU. Even when a Veteran does not meet the percentage standards for schedular TDIU, he or she may be considered for TDIU on an extraschedular basis pursuant to 38 C.F.R. § 4.16(b). Put differently, the Board may consider whether referral to the Director of Compensation Service (Director) for extraschedular consideration is warranted. In the September 2019 Board decision, the issue of entitlement to a TDIU, on an extraschedular basis, was referred to the Director. VA will grant a total rating for compensation purposes based on unemployability when the evidence shows a veteran is precluded from obtaining or maintaining any gainful employment consistent with his or her education and occupational experience, by reason of his or her service-connected disabilities. 38 C.F.R. §§ 3.340, 3.341, 4.16. In reaching such a determination, the central inquiry is "whether the Veteran's service-connected disabilities alone are of sufficient severity to produce unemployability." Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). In arriving at a conclusion, consideration may be given to the veteran's level of education, special training, and previous work experience, but not to his or her age or the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. The United States Court of Appeals for Veterans Claims (Court) has held that the term "unable to secure and follow a substantially gainful occupation" in 38 C.F.R. § 4.16 has two components. First, there is an economic component which essentially contemplates 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. Second, there is a non-economic component dealing with the individual veteran's ability to "follow and secure" employment. For the second component, attention must be given to: (a) the veteran's history, education, skill and training, (b) the veteran's physical ability (both exertional and non-exertional) to perform the type of activities (e.g., sedentary, light, medium, heavy or very heavy) required by the occupation at issue, with relevant factors such as lifting, bending, sitting, standing, walking, climbing, grasping, typing, reaching, auditory and visual, and (c) whether the Veteran has the mental ability to perform the type of activities required by the occupation at issue, with relevant factors such as memory, concentration, and 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 (2019). The Court also held in Ray that the Board's determination to refer a case for extraschedular consideration under § 4.16(b) is a factual finding that does not bind the Board or require the Board to award an extraschedular rating; however, if the Board denies entitlement to a TDIU after referral, the Board "must provide adequate reasons or basis for deviating from its earlier referral decision." Ray v. Wilkie, at 62; see also Wages v. McDonald, 27 Vet. App. 233 (2015) (explaining that the Director does not have nonreviewable discretion and the Board has the jurisdictional authority to review the Director's extraschedular decisions). The Veteran competed a VA form 21-8940 in September 2009. The Veteran reported that she became too disabled to work in June 2005. The Veteran stated that she previously worked at a power store from November 1974 to June 2005. The Veteran reported attending college for two years. She stated that she was forced to retire from her place of employment due to her left foot condition. The Veteran reported that she was receiving social security benefits. In a November 2009 VA form 21-4192, the Veteran's former employer confirmed that the Veteran previously worked in shipping and receiving until June 2006. The Veteran left her previous employer due to back, left foot, and left knee pain. The Veteran had an examination in April 2004. The examiner noted that the Veteran's left foot disability resulted in four times lost work per year. The Veteran had another examination for her left foot disability in July 2009. The Veteran stated that she cannot keep up with her normal work requirements because she reports being forced to retire due to increased pain and discomfort in the ankle. The examiner noted that the Veteran had limited ability to stand and walk. In an October 2009 statement, the Veteran stated that it is almost impossible for her to walk with her back, left hip, left knee, and left foot hurting. She further stated that she is in constant pain and that the pain medications she takes make her sleepy resulting in her being unable to function. In private treatment records from April 2010, the Veteran's physician, Dr. P.G., stated that the Veteran has been unable to work since her surgery on November 13, 2009. In a March 2010 statement, the Veteran stated that she cannot walk without pain and the assistance of crutches. She further stated that she was forced to retire due to her foot and back problems. In a private treatment record from January 2011, the Veteran's physician, Dr. H.P. stated that the Veteran is "permanently disabled due to severe medical problems." In a January 2011 statement, Dr. P.G. stated that the Veteran "has been rendered totally unemployable because of her left foot." Additionally, Dr. P.G. stated that the Veteran has reached the maximum medical improvement to include corrective surgery attempts. In a January 2012 statement, the Veteran stated that she is unable to work due to her pain medication. She stated that her medication causes blurred vision and impairs her thinking and reactions. The Veteran had another examination for her left foot disability in May 2012. The examiner indicated that the Veteran's left foot disability affected her ability to work. The examiner stated that the Veteran has pain with prolonged standing and walking due to the development of traumatic arthritis. The Veteran had another examination for her left foot disability in September 2016. The examiner indicated that the Veteran's left foot disability impacted her ability to work. The examiner specifically stated that the Veteran is unable to bear weight on her left foot and requires the use of crutches. The examiner further noted that this makes it difficult for her to do prolonged standing or walking, going up and down stairs, and she should not be climbing any ladders. The Veteran had another examination for her service-connected left foot disability in December 2017. The examiner opined that the Veteran's service-connected left foot disability resulted in functional loss. Specifically, the examiner stated that the Veteran uses crutches daily for ambulation, is unable to bear weight on the left foot, and if she manipulates the left foot, she experiences swelling and increased pain. The examiner indicated that the Veteran could perform light physical and sedentary activities, but the Veteran cannot perform general activities without restrictions, nor can she perform light duties. The Veteran had a peripheral nerves examination in January 2018. The examiner indicated that the Veteran's peripheral nerve condition impacted her ability to work. Specifically, the examiner stated that the Veteran has persistent severe pain in the left foot and leg that prevents normal ambulation. As addressed above, the Veteran did not meet the schedular rating for TDIU. As such, entitlement for a TDIU based on an extraschedular consideration was implicated, and in June 2018, the Board remanded the claim finding the Veteran provided some evidence sufficient to warrant referral to the Director, for extraschedular consideration of a TDIU. In a June 2020 determination, the Director considered the Veteran's record and stated that the cumulative evidence shows the Veteran is unemployable as a result of multiple service connected and non-service-connected conditions. The Director further noted that after excluding the non-service-connected conditions, the record is negative for evidence of symptoms consistent with occupational and social impairment with reduced reliability and productivity related to the service-connected left foot conditions. The Director stated that although the Veteran experiences significant impairment resulting from her left foot in terms of ambulation and physical limitations, "the Veteran has physical capacity to maintain sedentary employment". After a thorough review of the record, the Board finds that the preponderance of the evidence shows that the functional limitations imposed by the Veteran's service-connected disabilities do not render her unable to secure and maintain substantially gainful employment. As such, TDIU is not warranted on an extraschedular basis. Although the Veteran has significant mobility issues due to her service-connected disabilities, the probative medical evidence of record indicates she is still likely able to secure and maintain substantially gainful employment. Specifically, while it was consistently noted that the Veteran has severe mobility issues due to her left foot disability, the probative evidence of record does not indicate that she is precluded from working in positions that require less physical exertion, where no prolonged standing or walking is required as a result of her service-connected disabilities. The Board notes that the December 2017 examiner indicated that the Veteran "can perform light physical and sedentary activities". Additionally, while the private opinions from Dr. P.G. and Dr. H.P. found that the Veteran was "permanently disabled" and "totally unemployable", the Board does not afford the opinions significant probative weight because Dr. P.G. and Dr. H.P. did not provide an adequate rationale for their opinions. Ultimately, the preponderance of the evidence of record is against a finding that her service-connected disabilities were of such nature and severity as to preclude her from securing and following a substantially gainful occupation. Furthermore, the Board recognizes that the Veteran has been in receipt of Social Security Administration (SSA) disability benefits. However, SSA determinations, while probative, are not binding on the Board, as they involve the application of different legal standards. See Collier v. Derwinski, 1 Vet. App. 413 (1991). Notably, a SSA decision that determined the Veteran was disabled, considered non-service-connected disabilities, specifically status post lumbar laminectomies with fusion and degenerative joint disease of the cervical, thoracic and lumbar spine, as well as the Veteran's age, which are factors that VA cannot consider. Accordingly, the Board agrees with the determination of the Director, that an extraschedular TDIU pursuant to 38 C.F.R. § 4.16(b) is not warranted in this case. While there is evidence that the Veteran has limited mobility due to her service-connected left foot disability, the preponderance of the evidence is against the claim. The record has not demonstrated that the Veteran's service-connected disabilities are so severe that they preclude an ability to secure and follow gainful employment when considering her education, training, and occupational experience. Therefore, the claim is denied. Bethany L. Buck Veterans Law Judge Board of Veterans' Appeals Attorney for the Board David M. Sebstead, 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.