Citation Nr: 21068016 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 15-41 208A DATE: November 8, 2021 ORDER Entitlement to an initial disability rating greater than 30 percent for anxiety disorder, not otherwise specified (NOS), is denied. Entitlement to a total disability rating based upon individual unemployability (TDIU) is denied. FINDINGS OF FACT 1. The preponderance of the evidence indicates that the symptoms and overall impairment caused by the Veteran's psychiatric disability approximates occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, but does not more nearly approximate occupational and social impairment with reduced reliability and productivity. 2. The Veteran's service-connected disabilities did not preclude substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for an initial disability rating greater than 30 percent for anxiety disorder NOS, have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.159, 3.321, 4.130, Diagnostic Code 9413. 2. The criteria for TDIU have not been met. 38 U.S.C. §§ 7104, 7105; 38 C.F.R. §§ 3.340, 3.341, 4.14, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 2001 to August 2004. These matters come before the Board of Veterans' Appeals (Board) on appeal from January 2013 and February 2014 rating decisions by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Board remanded these issues in February 2020 and March 2021 for further development. There has been substantial compliance with the March 2021 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). These matters are properly before the Board for adjudication. 1. An initial disability rating greater than 30 percent for anxiety disorder is denied. The Veteran contends an initial disability rating greater than 30 percent is warranted for his service-connected anxiety disorder. Disability evaluations (ratings) are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing the symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38 U.S.C. §§ 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10. In evaluating a disability, the Board considers the current examination reports in light of the whole recorded history to ensure that the current rating accurately reflects the severity of the condition. The Board has a duty to acknowledge and consider all regulations that are potentially applicable. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). The medical and industrial history is to be considered, and a full description of the effects of the disability upon ordinary activity is also required. 38 C.F.R. §§ 4.1, 4.2, 4.10. 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. See 38 C.F.R. § 4.7. Reasonable doubt regarding the degree of disability will be resolved in the veteran's favor. 38 C.F.R. § 4.3. At the time of an initial rating, separate ratings can be assigned for separate periods of time based on facts found, a practice known as staged ratings. Fenderson v. West, 12 Vet. App. 119, 126 (1999). Evaluations for various psychiatric disabilities are assigned pursuant to 38 C.F.R. § 4.130 under the General Rating Formula for Mental Disorders. The Veteran's anxiety disorder is currently assigned a 30 percent disability rating pursuant to Diagnostic Code 9413. Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behaviour, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events), is assigned a 30 percent rating. A 50 percent disability rating is assigned when a psychiatric disorder causes occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. A December 2012 VA examiner indicated that the Veteran's post-military occupational functioning was marked by inability to maintain employment primarily due to medical problems. The Veteran reported he lived with his mother and stepfather, and had regular contact with his biological father and some friends. He avoided situations that involve crowds because he experienced panic attacks in places such as large stores and hospitals. The examiner stated the Veteran's psychosocial functioning is marked by moderate impairment associated with social avoidance and decreased interest or participation in leisure activities. A battery of psychological tests revealed the Veteran suffered from moderately severe symptoms of depression (PHQ-9), severe symptoms of depression with symptoms of irritability, agitation, sleep disturbance, anxiety, with disrupted energy and concentration (Beck Depression Inventory-II), severe symptoms of anxiety (Beck Anxiety Inventory). The examiner indicated that the test results appeared consistent with the Veteran's clinical history, clinical interview, and clinical impression. The Veteran underwent a VA examination in January 2015. The examiner determined the Veteran's psychiatric disability caused occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although functioning satisfactorily, with normal routine behavior, self-care, and conversation. The Veteran reported he lives with his mother and has a daughter whom he sees approximately once a month. The Veteran maintained contact with some childhood friends and established a relationship with a woman which ended after one month. He reported spending his time watching television and sleeping. The examination report showed the Veteran suffered from depressed mood, anxiety, and chronic sleep impairment. The Veteran was oriented to all spheres. His speech was normal in rate and rhythm. His mood was mildly dysphoric with congruent affect. The Veteran's appearance and hygiene were adequate. He denied suicidal/homicidal ideation and his thought processes were linear with no evidence of a thought disorder. His attention and concentration appeared intact. The Veteran's intelligence was within the average range. The January 2015 examiner diagnosed unspecified depressive disorder, with anxious distress pursuant to the DSM-5. The Veteran reported continued symptoms of depression, anxiety, low moods, anhedonia, sleep disruption, and some weight gain. He reported problems with sleeping too much and procrastination in making appointments or doing what he needs to do. The examiner found it difficult determine how much of his impairment was actual or perceived. Despite limited contact with mental health providers, the examiner found treatment records showed impairment in the mild to moderate range. The Veteran was pleasant, cooperative, and did not present with significant levels of anxiety during the examination. The VA examiner noted the Veteran hadn't worked or attempted to work which made it difficult to determine any level of occupational impairment specific to mental health as opposed to what he perceives he can or cannot do. The examiner found the Veteran had adopted the disabled role and perceived he is unable to work or do much given the collective components of the physical pain and mental health issues. However, at the age of 32, in the absence of any severe pathology, and with his current treatment (e.g., Methadone), the examiner believed the Veteran may actually benefit from less idle time and more engagement in structured activities which would then likely improve his mental health experience. The Veteran, through counsel, submitted the March 2015 private medical report of C.V., RN, MS. C.V reviewed the Veteran's medical record and stated, in part, that the Veteran's document "non-exertional limitations" i.e., daily panic attacks, prevented him from performing any type of substantially gainful occupation in any exertional level. She indicated that the Veteran's primary restriction is his mental disorder, and a private sector employer would not accept such limitations. See Vocational Report at 4. The Veteran also submitted the private Disability Benefits Questionnaire of Dr. J.A. who stated the Veteran's psychiatric disability caused total occupational and social impairment. Dr. J.A. noted that the Veteran suffered from depressed mood, anxiety, suspiciousness, panic attacks that occur more than once a week, near continuous panic or depression affecting his ability function independently, appropriately, and effectively, disturbances of motivation and mood, difficulty in adapting to stressful circumstances (including work or a work-like setting), inability to establish and maintain effective relationships, suicidal ideation, and persistent delusions or hallucinations. Dr. J.A. supported his opinion with thoughtful analysis of the Veteran's medical record, a clinical interview, and review of the claims file. Dr. J.A. stated that the Veteran was depressed and psychotic following the abrupt onset of schizophreniform like disorder in January 2019. The Veteran also showed disordered thinking and this condition was marginally controlled by high levels of Seroquel. Dr. J.A. noted that the Veteran has been living with his mother for the past 12 years, is single, and has a 12-year-old daughter. He reported suicidal ideation since his back injury during active service but denied any attempts or current plans. A history of abrupt mania in January 2019 resulted in hallucinations, delusions, three or four days without sleep, angry thoughts, weight loss of 40 lbs., involuntary hospitalizations, paranoia, daily anxiety, phobic fears, yelling, cussing, hurtful thoughts, and had a history of violence towards others. Dr. J.A. noted that the Veteran had friends when he was younger but felt misunderstood after discharge. He continued to be paranoid, suspicious, and highly dependent upon his mother for support. Dr. J.A. stated that the Veteran's psychiatric disability alone renders him unemployable for the foreseeable future. A June 2021 VA examiner reviewed the Veteran's claims folder and submitted an addendum medical report. The examiner stated that the Veteran is able to drive, independent in activities of daily living (ADL), and has panic attacks which are more frequent when in public. The June 2021 examiner acknowledge Dr. J.A.'s report, however, the examiner stated that the Veteran's reported symptom severity is inconsistent with his reported functioning, mental status notes in VA treatment records, and VA examination reports. In addition to completing ADLs independently and driving when needed, the June 2021 VA examiner noted the Veteran has adequate receptive and expressive skills, and treatment providers found no evidence of difficulty comprehending or understanding questions, memory and attention difficulties, impaired judgment or insight. The Veteran was calm and cooperative with treatment providers and interacted with others in stores. He was also able to make plans independently of others. The VA examiner found that the discrepancy in the level of social and occupational functional impairment between the VA records, 2015 VA examinations, and independent medical evaluations is a result of the subjective information provided by Veteran during examinations. The June 2021 examiner highlighted that Dr. J.A. estimated that 60 percent of the Veteran's psychiatric symptoms were caused by a nonservice-connected bipolar disorder. Based on this information, the examiner opined the Veteran's service-connected psychiatric disability is moderate and results in social and occupational functional impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, though generally functioning satisfactorily with normal routine behavior. After review of the above, the Board finds an evaluation of 50 percent is not warranted. In this regard, the preponderance of the evidence weighs against a finding that the Veteran's service-connected psychiatric disability more nearly approximates occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. The evidence of record, including medical records, VA examination reports and lay statements show the Veteran's disability did not manifest in symptoms similar to or the equivalent those listed under the 50 percent criteria. Although the Veteran was involuntarily hospitalized on multiple occasions and exhibited psychosis, disordered thinking, and manic episodes, the evidence shows these symptoms were not caused by his service-connected disability. Specifically, VA treatment records show the Veteran exhibited normal speech, alertness, and was oriented with no evidence of psychomotor slowing, hallucinations, delusions, suicidal ideation, homicidal ideation, or thought process disorders from June 2012 to June 2017. Moreover, Dr. J.A. estimated that most of the Veteran's current symptoms were caused by his nonservice-connected bipolar disorder. The June 2021 VA examiner explained that the evidence of record, including statements made to medical providers indicate the severity of his service-connected disability is moderate. The Board has considered Dr. J.A. and C.V.'s private opinion and finds the June 2021 examiner's report and VA treatment records more probative. Although Dr. J.A. provided a thorough report detailing the Veteran's psychiatric disabilities, neither he nor C.V. discussed the glaring discrepancies between prior VA examination reports, VA treatment records, and their current findings. The June 2021 VA examiner provided an adequate and thorough rationale supporting her findings and attributed the discrepancies in the claims file to subjective information provided by Veteran. She also found that the Veteran's reported symptom severity was inconsistent with reported functioning found in treatment records and VA examination reports. As such, the Board finds that Dr. J.A.'s and C.V.'s reports are less probative. In making this determination, the Board has the authority to analyze the credibility and probative value of evidence when making factual findings. Madden v. Brown, 125 F. 3d 1477, 1481 (fed. Cir. 1997). The Board may also favor the opinion of one competent medical authority over another. See Owens v. Brown, 7 Vet. App. 429, 433 (1995); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Whether a physician provides a basis for his or her medical opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). While the Board may assess the credibility and weight given to medical evidence, the Board is not free to substitute its own judgment for such as a medical expert. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). An incomplete analysis will render a medical opinion inadequate. See Stefl v. Nicholson, 21 Vet. App. 120 (2007). Consideration is made to the Veteran's reports of experiencing suicidal thoughts. The Court has held that the presence of suicidal ideation in and of itself can support the assignment of a 70 percent rating. Bankhead v. Shulkin, 29 Vet. App. 10 (2017). However, unlike the appellant in Bankhead, who had an established history of suicidal ideation, the Veteran in the present case had not reported suicidal ideation to mental health providers throughout the course of psychological and psychiatric treatment the Veteran here consistently denied suicidal ideation to healthcare providers. Moreover, the Veteran's medical records reflects his adamant denial of suicidal ideation, intent, or plan. He repeatedly informed providers that he would never complete suicide. His reports to his medical providers and VA examiners, which were for purposes of diagnosis and treatment, are exceptionally trustworthy because the declarant has a strong motive to tell the truth in order to receive proper care. Rucker v. Brown, 10 Vet. App. 67, 73 (1997). Thus, the report of suicidal ideation is deemed not representative of the overall severity of his service-connected disability. Consideration has been given to the Veteran's assertions that a higher rating should be assigned. He is competent to report his current psychiatric symptoms as these observations come to him through his senses. Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, the question regarding the level of the Veteran's disability is considered to be complex in nature. Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Specifically, while the Veteran is competent to describe his symptoms, the Board accords his statements regarding the severity of such disorder less probative value as there is no evidence he has the training, knowledge, or experience to diagnose or assess mental disorders or to opine on such a complex medical question. Importantly, reports from the 2012, 2015, and 2021 VA examiners found the Veteran's service-connected disability more closely resembled 30 percent disability picture. Accordingly, the Board finds that the preponderance of the evidence is against the assignment of a 50 percent evaluation for his service-connected adjustment disorder with anxiety and mood disorder. In reaching this determination, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, because the preponderance of the evidence is against the claim, this doctrine is not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). 2. Entitlement to TDIU. A total rating for compensation may be assigned where the schedular rating is less than total when it is found that the disabled person is unable to secure or follow a substantially gainful occupation as a result of a single service-connected disability ratable at 60 percent or more or as a result of two or more disabilities, provided at least one disability is ratable at 40 percent or more, and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16 (a). It is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Rating boards are to refer to the Director of the Compensation Service for extra-schedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities but who fail to meet the percentage requirements. 38 C.F.R. § 4.16(b). In determining whether a veteran can secure, follow, and maintain a substantially gainful occupation, the Court in Ray v. Wilkie directed the Board to consider the following factors: (1) the Veteran's occupational history, education, skill, and training; (2) whether the Veteran has the physical ability (both exertional and non-exertional) to perform the type of activities required by the occupation at issue; and (3) whether the Veteran has the mental ability to perform the activities required by the occupation at issue. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340 (a). A Veteran's service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue must be addressed. Age may not be considered as a factor in evaluating service-connected disability; and unemployability, in service-connected claims, associated with advancing age or intercurrent disability, may not be used as a basis for a total disability rating. 38 C.F.R. § 4.19. The sole fact that a claimant is unemployed or has difficulty obtaining employment is not enough. A high rating in itself is a recognition that the impairment makes it difficult to obtain and keep employment. The question is whether the veteran is capable of performing the physical and mental acts required by employment, not whether the veteran can find employment. Van Hoose v. Brown, 4 Vet. App. 361 (1993). The applicable regulations place responsibility for the ultimate TDIU determination on the VA, not a medical examiner. Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013). TDIU is to be awarded based on the judgment of the rating agency. Floore v. Shinseki, 26 Vet. App. 376, 381 (2013). During the period on appeal, the Veteran was service-connected for the following disabilities: anxiety disorder (30 percent), degenerative disc disease of the lumbar spine (20 percent), right lower extremity radiculopathy (10 percent prior to March 30, 2012 and 20 percent thereafter), and lumbar area surgical scar (10 percent). The Veteran's total disability rating was 40 percent prior to March 30, 2012 and 60 percent thereafter. None of the exceptions in 38 C.F.R. § 4.16(a) (1)-(5) (disabilities of extremities, common etiology, single body system, incurred in action, or prisoner of war) are for application. Thus, the Veteran did not meet the schedular criteria in 38 C.F.R. § 4.16(a). However, it is the established policy of VA that all Veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. Thus, in any case where the veteran is unemployable by reason of service-connected disabilities but has failed to meet the percentage standards discussed above, rating boards will submit the case to the Director of Compensation, for extra-schedular consideration under 38 C.F.R. § 4.16(b). The Board cannot consider entitlement to TDIU under 38 C.F.R. § 4.16(b) in the first instance but must first remand the claim for referral to VA's Director of Compensation Service if such consideration is warranted. Bowling v. Principi, 15 Vet. App. 1, 10 (2001). Thus, the issue before the Board is whether a remand for referral for extraschedular consideration for TDIU is warranted. The initial extraschedular referral decision under § 4.16(b) should address whether there is sufficient evidence to substantiate a reasonable possibility that a veteran is unemployable by reason of his or her service-connected disabilities. Ray v. Wilkie, 31 Vet. App. 58, 66 (2019). For the following reasons, a preponderance of the evidence weighs against a remand for referral for extraschedular consideration of TDIU. Turning to the evidence of record, the Veteran completed one year of college. His work experience is limited to physical work including constructions, HVAC, butcher, and most lasted a few months or less. A 2012 VA examiner indicated that the service-connected lumbar disability prevented prolonged sitting and standing, ascending stairs, bending, twisting, turning, or lifting. A 2012 VA psychologist indicated that the Veteran's service-connected anxiety caused occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks although generally functioning satisfactorily, with normal routine behaviour, self-care, and conversation. A December 2014 examiner indicated the Veteran is unable to keep employment due to back pain, which is worsened with lifting, prolonged walking outside of his home, prolonged sitting, and standing longer than a few minutes. In January 2015, a VA examiner opined that the Veteran's anxiety caused occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks although generally functioning satisfactorily, with normal routine behaviour, self-care, and conversation. The examiner explained that the Veteran spends most of his time in bed, watching television, and reports continued back pain despite taking methadone. She explained it was difficult to determine any level of actual occupational impairment specific to his mental illness because the Veteran has not worked or even attempted to work. The examiner opined that the Veteran adopted the role of the "disabled role" and believes he is unable to work or do much given his physical and mental disabilities. She believed that the Veteran may benefit from engagement in structured activities which would improve his mental health. Ultimately, the examiner believed the Veteran's mental health disability would not preclude the Veteran from working. C.V. provided a private vocational assessment based on a records review and contact with the Veteran in March 2015. She opined that the Veteran's physical and mental disabilities precluded obtaining and maintaining substantially gainful employment. She stated the Veteran's exertional and non-exertional limitations included panic attacks that last anywhere from 10 minutes to five hours; constant positional changes from standing to sitting to walking to laying; lifting is limited to 5 lbs. or less; insomnia; fatigue; decreased motivation and concentration; and constant pain associated with back surgeries and right lower extremity radiculopathy. C.V. opined the Veteran did not have any transferable skills to light or sedentary employment, no specialized vocational skills or training, and is only qualified to perform entry-level unskilled jobs. However, she believed that the Veteran would not be a competitive candidate for employment in any occupation. Dr. J.A. stated that the Veteran's psychiatric disability caused total occupational and social impairment. Dr. J.A. indicated the Veteran is depressed and psychotic with symptoms of depressed mood, anxiety, suspiciousness, near continuous panic or depression affecting the ability function independently, appropriately, and effectively, disturbances of motivation and mood, difficulty in adapting to stressful circumstances, including work or a work-like setting, inability to establish and maintain effective relationships, suicidal ideation, and persistent delusions or hallucinations. Dr. J.A. stated that bipolar disorder causes mania, overactivity, delusions, hallucinations, and grandiosity. The Veteran's service-connected disability causes anxiety and depression linked to ongoing pain and reduced levels of activity. Dr. J.A. stated that the Veteran's psychiatric disability alone renders him unemployable for the foreseeable future. The June 2021 VA examiner medical report found the Veteran's service-connected disability caused moderate functional impairment and resulted in occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, though generally functioning satisfactorily with normal routine behavior. As noted above, the examiner explained that reports regarding the severity of the Veteran's symptoms were not consistent with marked impairment that is expected with total social and occupational functional impairment. She acknowledge that the Veteran's symptoms were severe; however, she also highlighted that the Veteran was calm and cooperative with healthcare providers and people he met in stores, made plans independently of others, carried out ADLs and drives when needed, had no difficulty comprehending or understanding questions, showed no difficulties in memory, attention, judgment, insight, or comprehension. The examiner also explained the discrepancy in the claims file was due to subjective information provided by the Veteran. The preponderance of the evidence, including SSA records, VA treatment records, private medical opinions, VA examination reports, and lay statements is against finding that the Veteran's service-connected disabilities have, at any time during the period on appeal, contributed to such severe impairment that they would preclude him from being able to secure or maintain gainful employment. Mental health examiners have indicated time and again that the Veteran's service-connected anxiety manifests in some loss of productivity; however, the preponderance of the evidence is against a finding that the unable to obtain and maintain sustainable employment solely due to his service-connected disabilities. Moreover, the preponderance of the evidence shows that the Veteran has nonservice-connected bipolar disorder which symptoms manifest as mania, overactivity, delusions, hallucinations and grandiosity. The Veteran's private medical examiner, Dr. J.A. stated that his service-connected psychiatric disability manifests as anxiety and depression. The 2015 VA examiner stated that the Veteran would benefit from engagement in structured activities instead of maintaining the "disabled role" and remaining inactive. In evaluating the Veteran's claim for a TDIU, the Board also recognizes that the Social Security Administration (SSA) has determined that the Veteran is not disabled pursuant to SSA rules and regulations. Although disability determinations made by SSA may be pertinent to claims for VA benefits, they are not controlling for VA determinations. Murincsak v. Derwinski, 2 Vet. App. 363, 370 (1992). In this case, an Administrative Law Judge found the Veteran is able to understand, remember, and carry out simple to detailed work tasks; sustain attention and effort for extended periods of two-hour segments on tasks requiring routine judgment; relate adequately in an object focused, less crowded work setting in which contact with co-workers and supervisors is casual and infrequent, without any requirement for extended conversation; and adapt to expected tasks demands as needed. The Board has considered Dr. J.A.'s medical report. However, as noted above, the Board gives little probative value to Dr. J.A.'s report because he failed to reconcile or explain stark contradictions between the Veteran's reports of severely debilitating symptoms with numerous mental status examinations which showed the Veteran's service-connected anxiety did not impact his judgment, concentration, memory, speech, ability to attend to ADLs and properly interact with others. The Board has considered C.V.'s private vocational assessment and disagrees with C.V.'s conclusion that the Veteran's service-connected disabilities preclude any type of employment. Based on the record, including the favorable evidence, the Veteran is capable of sedentary work. However, in a recent case of Withers v. Wilkie, the United States Court of Veterans Claims (Court) held that the precise meaning of sedentary work in any specific case should be based on the context clues of the VA examination or medical report cited as authority. The Court further declined to adopt a specific definition of the phrase sedentary employment for VA purposes when adjudicating entitlement to a TDIU, but instead held that the Board must provide a definition on a case-by-case basis. See Withers v. Wilkie, No 16-1543, 2018 U.S. App Vet. Claims Lexis 1054 (Aug. 10, 2018). Merriam-Webster online dictionary defines sedentary as "doing or requiring much sitting" (as it pertains to a job), and therefore, the Board adopts this definition in its analysis. See https://www.merriam-webster.com/dictionary/sedentary (last visited January 27, 2021). The Board finds sedentary employment to encompass a wide variety of administrative and clerical jobs, or other forms of employment that would not require the Veteran to spend a significant amount of time on his feet, standing or walking, and which would be performed in a seated position a large majority of the time with little interaction between himself and coworkers or supervisors. Thus, the Board determines that during the time period in question, and with consideration of his service-connected disabilities only, along with his education, training, and employment history at the time, that he is able to obtain or maintain various substantially gainful occupations which would have provided him with a living wage. For example, he would be able to work as a data entry clerk, which does not require a high level of computer skill set, does not require lifting, and affords minimal contact with coworkers and supervisors. Moreover, the Board notes that a schedular rating itself is recognition that a claimant's industrial capacity is impaired to some degree. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). 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 injury. 38 C.F.R. § 4.1; Van Hoose, supra. Although the Veteran's service-connected disabilities may have hindered some aspects of employment, a compensable schedular rating of less than 100 percent implies a degree of interference with employment that would not preclude a particular claimant from securing and following all substantially gainful employment. While the Board does not wish to minimize the nature and extent of the Veteran's overall disabilities, the evidence of record does not support his claim that his service-connected disabilities alone were sufficient to produce unemployability. Given the Veteran's work experience and the functional limitations solely caused by his service-connected disabilities based on the probative evidence of record, the Board finds he is able to work in a clerical environment that permits him to work in a seated position, take frequent breaks to stand and walk short distances, and which would be performed in a seated position a large majority of the time with lesser interaction between himself and coworkers or supervisors. Accordingly, a TDIU is not warranted. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mohammad Mahmoudi, 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.