Citation Nr: 21068274 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 16-52 133 DATE: November 9, 2021 ORDER Entitlement to a total disability rating due to individual unemployability (TDIU) as a result of service-connected disabilities is denied. FINDING OF FACT The Veteran has not been precluded from securing or following a substantially gainful occupation due to his service-connected disabilities. CONCLUSION OF LAW The criteria for a TDIU rating have not been met for any period on appeal. 38U.S.C. §§1155, 5107; 38C.F.R. §§3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from March 1964 to March 1966. In January 2021, the Board denied entitlement to a TDIU. The Veteran filed an appeal with the United States Court of Appeals for Veterans Claims (Court). Pursuant to an October 2021 Joint Motion for Partial Remand (JMPR) and Court Order, the portion of the decision which denied entitlement to a TDIU was vacated and remanded for action consistent with the JMPR. A TDIU rating may be granted upon a showing that the Veteran is unable to secure or follow a substantially gainful occupation due solely to impairment resulting from his service-connected disabilities. There are minimum disability rating percentages that must be shown for the service-connected disabilities, alone or in combination, to even qualify for consideration for a TDIU award under the schedular criteria. Indeed, if there is only one such disability, it must be rated at 60 percent or more; if instead there are two or more disabilities, at least one disability must be rated at 40 percent or more, with sufficient additional disability to bring the combined rating to 70 percent or more. In determining whether a veteran is unemployable for VA purposes, consideration may be given to the veteran's level of education, special training, and previous work experience, but not to age or any impairment caused by nonservice-connected disabilities. The central inquiry in determining whether a Veteran is entitled to a TDIU rating is whether service-connected disabilities alone are of sufficient severity to produce unemployability. The sole fact that a Veteran is unemployed or has difficulty obtaining employment is not enough; a high disability rating itself is recognition that the impairment makes it difficult to obtain or keep employment. The ultimate question, however, is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he can find employment. The ultimate question of whether a Veteran is capable of substantial gainful employment is not a medical one; rather, it is a determination for the adjudicator. The Veteran's service-connected disabilities include the following: prostate cancer (40% 10/01/2010), Non-Hodgkins lymphoma (30% 06/01/1993), anxiety disorder and other specified trauma related disorder (30% 12/12/2012), diabetes mellitus type II (20% 03/03/2003), hypothyroidism (10% 06/01/1993); and compression neuropathy of the bilateral upper extremities (separately rated 10% 05/20/2003). Based on the above, the Veteran's combined disability rating during the relevant temporal period from December 12, 2012 is 80 percent, and as such, the Veteran meets schedular percent requirements for a TDIU for the entire period on appeal. However, following a review of the evidence of record, and as discussed below, the Board finds that the preponderance of evidence weighs against the Veteran's claim of entitlement to a TDIU rating for the entire period on appeal. Within his February 2018 TDIU application, the Veteran documented that "all" of his service-connected disabilities prevented substantially gainful employment. He reported that his disabilities affected full-time employment on May 30, 2005, which was also the date he reported that he last worked full-time and the date he became too disabled to work. He noted that the most he ever earned in one year was $28,000, in 2005 while working in security for Emerson Electric. Regarding his employment history, he reported working in security for Emerson Electric full-time from February 1990 to May 2005 and that he lost approximately 100 days during that time due to illness. His highest reported gross earnings per month was $2,300. He also reported employment at Ryder as a school bus driver for approximately 10 to 15 hours per week from January 2002 to January 2005, during which time he lost approximately 15 days from illness and reported his highest gross earnings per month were $400. Notably, the Veteran stated that he did not leave his last job because of disability and that he did not expect to receive disability or Workers Compensation benefits. Finally, he reported an educational history including four years of high school, without any additional education or training. The Board has reviewed the evidence of record, to include the evidence of record for the one year prior to receipt of the Veteran's December 12, 2012 claim which gave rise to his TDIU claim on appeal. A February 2012 note on a prescription slip from Hematology Oncology Consultants reflects that the Veteran is unemployable due to fatigue/chronic incontinence. Noted was a history of lymphoma in 1991; prostate cancer in 2007; recurrent prostate in 2008; and memory loss. 02/28/2012 Medical Treatment Record-Non-Government Facility. The Board assigns limited probative weight to this note as the examiner did not cite to any medical evidence or objective findings in formulating this opinion, and it is not clear if the examiner had the benefit of review of the Veteran's medical records or if the conclusion was based on an examination of the Veteran. Such note also does not detail the functional limitations that results in him being unemployable. Moreover, as will be detailed below, the Veteran underwent C&P examinations a month later and such examinations did not reflect any residuals due to his lymphoma; no associated fatigue with any of his service-connected disabilities; with objective findings of voiding dysfunction due to his prostate cancer which caused embarrassment thus impacting his ability to work. The February 2012 statement, however, cannot provide the basis for a finding of employability as the "fatigue" is not supported by the medical record, and the examiner provided no rationale or discussion as to the impact of his disabilities on employment. Specifically, a March 2012 C&P Hematologic and Lymphatic Conditions examination reflects that he had Non-Hodgkin's lymphoma and he was in remission. There had been no history of recurrent and no residuals from the lymphoma or its treatments. The examiner specifically found no findings, signs, or symptoms due to lymphoma to include "easy fatigability." The examiner checked the 'No' box with regard to whether his lymphoma impacted his ability to work. 05/21/2012 C&P Exam at 5-9. A March 2012 C&P diabetes mellitus examination reflects that the Veteran had been prescribed an oral hypoglycemic agent but did not require the regulation of activities as part of medical management of his diabetes mellitus. He had not experienced episodes of ketoacidosis requiring hospitalization over the past 12 months and he was not experiencing any complications due to his diabetes mellitus. The examiner checked the 'No' box with regard to whether his diabetes mellitus impacted his ability to work. Id. at 9-12. A March 2012 C&P peripheral nerves examination reflects a diagnosis of bilateral carpal tunnel syndrome. The Veteran reported pain in his right thumb due to arthritis and numbness in his fingers without pain and tingling. He did not have any symptoms attributable to any peripheral nerve conditions and a sensory examination was normal. The right and left median nerve were normal. The examiner checked the 'No' box with regard to whether his peripheral nerve condition impacts his ability to work. Id. at 16-26. A March 2012 C&P prostate cancer examination reflects that his prostate cancer was in remission. Residuals of treatment included voiding dysfunction, which required the use of absorbent material which must be changed 2 to 4 times per day and daytime voiding interval between 1 and 2 hours and nighttime awakening to void 3 to 4 times. The examiner checked the 'Yes' box with regard to whether his prostate cancer impacts his ability to work, noting that the urinary incontinence is an embarrassment for the Veteran. Id. at 12-16. Thus, the March 2012 C&P examinations concerning the Veteran's service-connected Non-Hodgkins lymphoma, diabetes mellitus type II, and compression neuropathy of the bilateral upper extremities revealed no functional impact upon the Veteran's ability to work as a result of these disabilities; and, the March 2012 C&P examination concerning his prostate cancer reflects that he has voiding dysfunction that causes embarrassment for the Veteran, impacting his ability to work. Upon VA psychiatric examination in November 2013, a VA examiner commented that the Veteran's current mental health symptoms were moderate in severity and resulted in moderate functional impairment, although he did not endorse any history of mental health-related occupational concerns. The examiner specifically stated that the Veteran's anxiety disorder, with psychiatric symptoms including depressed mood, anxiety, suspiciousness, chronic sleep impairment, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships, resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. Regarding his occupational history, the examiner noted that the Veteran had previously retired from a 28-year career with Emerson Electric in 2005. Regarding his decision to retire, the Veteran stated that he was having "some problems at work" for several years with what he viewed as unfairness when others were promoted and he was not; however, the examiner again wrote that the Veteran reported no history of serious occupational concerns. VA treatment records from January 2014 document a review of the Veteran's various service-connected disabilities. At that time, the Veteran continued to use absorbent materials for urinary incontinence due to his prostate cancer. His diabetes mellitus type II was noted to be "uncontrolled." His hypothyroidism was within normal limits, and there were no complaints regarding his Non-Hodgkins lymphoma. Upon subsequent VA psychiatric examination in April 2015, a VA examiner concluded that the Veteran's psychiatric symptoms of anxiety and chronic sleep impairment resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The Veteran denied any employment since the prior November 2013 examination and reported minimal activities or interests outside of visiting the pool and spending time with his dogs and grandchildren. A September 2016 VA mental disorders examination documented that the Veteran continued to endorse several trauma-related symptoms which caused him significant distress and functional impairment. The VA examiner concluded that his psychiatric symptoms of anxiety, suspiciousness, chronic sleep impairment, and difficulty in establishing and maintaining effective work and social relationships resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care, and conversation. Regarding his occupational history, the Veteran stated that he had not worked outside of the home since his retirement. VA treatment records indicated that the Veteran continued to receive ongoing mental health care, although in June 2016, he elected to discontinue medication management services as he felt he was not in need of psychotropic medications. He had also participated in group psychotherapy services through the PTSD Clinic in the past and had completed a total of three time-limited groups, including Coping with Combat (a psychoeducational group regarding posttraumatic symptomology and coping), Depression & Combat PTSD (a group addressing ways of dealing with depressive and posttraumatic symptoms), and Sleep & Combat PTSD (a group with a goal of improving sleep quality/duration and reducing frequency and severity of trauma-related nightmares). The Veteran reported a desire to participate in further groups, but also noted that he found these groups to be emotionally difficult. Within a February 2017 Residual Functional Capacity Evaluation, Dr. Heather Henderson-Galligan, Ph.D., HSPP, concluded that the Veteran cannot sustain the stress from a competitive work environment or be expected to engage in gainful activity due to his anxiety disorder and other specified trauma disorder and stressor related disorder. She stated that his chronic sleep impairment would be a safety issue in the workplace and that his impaired short-term memory would affect his employment. She wrote the Veteran had difficulty maintaining and sustaining a steady mood and this inconsistent mood leads to problems in his social and work life. She documented the Veteran reported that he has not been able to have meaningful occupational or social relationships and believes that he could not let others into his life because of issues with trust. She documented the Veteran remarked that he felt nervous and worried and struggled with ongoing anxiety, which she wrote is a safety hazard on the job. She concluded that with poor interpersonal skills and workplace trust issues, the Veteran would have an increase in paranoia and would struggle with appropriate work interaction. She described the Veteran having physical signs of depression that interfered with daily work as these signs manifest as extreme fatigue, hypersomnia, appetite issues, weight fluctuation, and emotional outbursts. She wrote that employers note higher distractibility, absenteeism, and emotional turmoil as inappropriate in the workplace. It was her opinion that the Veteran suffered from unspecified anxiety disorder and other specified trauma and stressor related disorder that prevented him from maintaining substantially gainful employment. However, the Board finds that the conclusions made by Dr. Henderson-Galligan in the February 2017 report are of lessened probative value, as the conclusions contained therein are not supported by a rationale or reference to other evidence of record. They are also inconsistent with other evidence of record, including the multiple VA psychiatric examinations discussed above. For example, Dr. Henderson-Galligan checked the box that the Veteran's symptoms were indicative of an "inability to establish and maintain effective relationships." She also wrote the Veteran was "socially isolated and withdrawn." It is unclear from what facts she based these conclusions, when the Veteran has been married for more than 45 years to his wife and has consistently expressed having positive relationships with his wife, his two children, and their four grandchildren throughout the appeal period. Additionally, Dr. Henderson-Galligan documented the Veteran's remark that he could no longer enjoy the simplest of activities. However, throughout the appeal period, the Veteran has reported he "greatly enjoys" watching professional sports on television, and in 2018, he reported he and his son watch sports together. The evidence shows he has been swimming for exercise throughout the appeal period. In November 2013, the Veteran reported swimming was the "best medicine" for him, and in April 2015, he told the examiner that swimming was his "greatest joy" and reiterated that it was his "medicine." In September 2016, he reported he liked to swim and would try to go to the city pool three to four times a week. He also reported he liked watching football. At the time of the March 2018 examination, the Veteran reported he continued to go to the pool three to four times a week and but was precluded due to physical limitations due to nonservice-connected disabilities. VA treatment records throughout 2019 further document that the Veteran reported that he continued swimming multiple times a week and going to the gym. This evidence is not consistent with a finding that he cannot enjoy simple activities. Thus, while Dr. Henderson-Galligan stated that the Veteran's psychiatric symptoms included near-continuous panic or depression affecting the ability to function independently, appropriately, or effectively; difficulty in establishing and maintaining effective work and social relationships; difficulty adapting to stressful circumstances, including work or a worklike setting; and inability to establish and maintain effective relationships, the Board finds that the preponderance of the evidence is against this level of symptomatology for the reasons described above. Dr. Henderson-Galligan noted that the Veteran remained married and committed to his wife of many years, and, although he lacked other friendships, the Veteran reported that he continued to engage with others, including his VA doctor every three to four months, a therapist once a week, and had current attendance at VA group therapy. This is evidence against severe social impairment and is against the inability to establish and maintain effective relationships. Additionally, there is no credible evidence that the Veteran experienced near-continuous depression or panic attacks that prevented him from functioning independently, as the Veteran himself did not report this while seeking treatment or during the VA examinations during the appeal period. The Veteran's reported attendance of multiple forms of treatment are also weigh against this finding; moreover, he reported that he continued to walk his dog and swim without the assistance of others. As such, the February 2017 evaluation and private opinion by Dr. Henderson-Galligan does not weigh in favor of the Veteran's TDIU claim, as her description of the level of severity of the Veteran's psychiatric disorder is inconsistent with the other evidence of record, such as the multiple VA examinations of record which document the consistent findings from multiple VA examiners that the Veteran's psychiatric disability results in no worse than occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although he was generally functioning satisfactorily, with normal routine behavior, self-care, and conversation. This consistent conclusion by multiple VA examiners throughout the appeal period that the Veteran's psychiatric disorder was best summarized by the criteria described under the 30 percent disability rating is highly probative evidence against a finding that the Veteran's psychiatric disorder has precluded him from securing or following a substantially gainful occupation for any period on appeal. In a March 2017 private opinion from Dr. Homer Skaggs, MD, he concluded that the Veteran's service-connected impairments more likely than not have rendered him unable to maintain gainful work in any employment base for several years, and that based on the severity and frequency of his symptoms and limitations, he is not expected to make a substantial recovery to the point of being able to return to work in any facet. Similarly, an April 2017 private opinion by Dr. Stephanie G. Barnes found the Veteran has "a combination of physical and emotional conditions which interact in terms of severity level" and his major limitation was "mental and physical activity involved in sustaining work." She concluded that the Veteran is totally and permanently precluded from performing work at a substantial gainful level due to the severity of his service-connected prostate cancer, anxiety disorder NOS and other specified trauma and stress-related disorder, Non-Hodgkin's lymphoma, diabetes mellitus type II, hypothyroidism, compression neuropathy and bilateral upper extremities, and the record supports this finding as far back as the date of filing. The Board has also considered these private opinions in the context of the Veteran's TDIU claim; however, the Board concludes, based upon a review of the evidence discussed in detail above, that the March 2017 and April 2017 private opinions do not weigh in favor of a finding that the Veteran has been precluded from securing or following a substantially gainful occupation due to his service-connected disabilities for any period on appeal. Notably, while both the March 2017 and April 2017 private opinions attribute occupational and functional impairment to all of his service-connected impairments, such a finding is inconsistent with the additional objective evidence of record, including the March 2012 VA examinations, which do not document functional impairment related to the Veteran's non-psychiatric service-connected disabilities that would preclude substantially gainful employment, as well as the multiple VA psychiatric examinations discussed above which consistently found that the Veteran's psychiatric disorder resulted in no worse than occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care, and conversation. A March 2018 C&P Mental Disorders examination reflects the Veteran's report that he continues to reside with his wife and his marital relationship was positive. His spouse handles all household responsibilities and is very understanding. He reported a "pretty good" relationship with his children, and he occasionally watches sports with his son. He reported walking his dog less frequently (perhaps 1x/week) which the Veteran reported was due to arthritis in his right hip and his hands; not due to residuals of service-connected disabilities. He voiced worry about not being able to restrain his dog if a problem were to arise on their walk. He reported swimming about 3-4 days a week but reported he does not "swim as actively," indicating that he injured his shins in a car accident about 1 year prior and due to his arthritis. He discontinued managing the finances due to forgetfulness. He reported that he "retired" from Emerson Electric as he was fed up with his job position due to not getting promoted and feeling like he was not appreciated. He also stated that he wanted to enjoy his life. When asked about his ability to carry out his job duties prior to his retirement the Veteran stated that "I think I was very dependable and very good doing the job, with the exception of right there maybe, the last year I was there." The Veteran went on to state that towards the end of his employment he found himself feeling particularly tired and "nodding" off at his desk. He stated he was working as a supervisor and manager, and coworkers had on occasions caught him nodding off. The Veteran reported that his employers "looked out for" him, "especially right there at the end," and as a result he was never chastised or disciplined for this. The Veteran noted that a coworker encouraged him to retire as soon as he could, telling the Veteran that if he got into trouble, he could jeopardize his pension. The Veteran reportedly chose to go ahead and retire for fear of this happening. He also chose to retire because he felt he was not "representing" himself as well as he would have liked as a supervisor (due to the tiredness). He stated that when people began to discuss his lapses in energy, he wanted to leave the job. He also reported that he drove a school bus part time towards the end of his career at Emerson, but the job was stressful because the children would get into conflicts and he was worried about not being able to deal with it appropriately. He denied any further history of noteworthy occupational difficulties or trouble getting along with others at work. He "did a good job" at work overall. When asked what he feels render him unable to work at this time, he replied, "null and void" and when asked for clarification discussed his reluctance to use the computer and phone. He reported that he felt like he was "missing the boat" with regard to his use and understanding of technology. The examiner found that his PTSD was manifested by anxiety, chronic sleep impairment, and disturbances of motivation and mood. The examiner found that the Veteran's PTSD was manifested by occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The Board has also considered an article submitted by the Veteran from the Journal of Mental Health Policy and Economics in 2000 entitled, "The Civilian Labor Market Experiences of Vietnam-Era Veterans: The Influence of Psychiatric Disorders." The article and resulting study found that PTSD significantly lowered the likelihood of working and, for those veterans who were working, their hourly wages. The article addressed other psychological diseases, in particular anxiety disorders and major depression, which were found to have nearly as large an effect on employment rates as does PTSD. Notably, this article is of a generalized nature and does not apply to the particular facts of the Veteran's case; therefore, it does not establish that the Veteran's psychiatric disorder precluded substantially gainful employment. Moreover, the Board notes that the article admitted that "[p]sychiatric health may assume added importance in the labor supply decisions of veterans as opposed to the general population because of the availability of VA disability compensation." The Board has also considered the relevant lay evidence of record, including the Veteran's general statements asserting an inability to work, and a December 2016 statement from the Veteran's wife, which reported that she knew he would be unable to return to work due to his psychiatric symptoms. While the lay statements of record of probative evidence insofar as they report observable symptomatology, the Board finds that their lay statements do not weigh in favor of a TDIU rating. Moreover, while the Veteran himself has asserted within his February 2018 TDIU application that "all" of his service-connected disabilities have prevented substantially gainful employment, the most probative objective evidence of record does not weigh in favor of such a finding, for the reasons discussed above. Additionally, the Veteran's report to the March 2018 VA examiner that he retired out of concern for endangering his pension after coworkers caught him dozing off on several occasions does not support that he retired due to occupational impairment from his psychiatric disability. Moreover, the Veteran also denied a history of noteworthy occupational difficulties or trouble getting along with others at work and stated that he believed he was a good worker, which was the reason he was promoted throughout his career, and, when directly asked what led to his decision to file a claim for unemployability, the Veteran indicated that his attendance at PTSD groups, and apparently from the other people involved, reminded him of what he had gone through. Similarly, when asked what it is that he feels renders him unable to work, he discussed his reluctance to use and understand technology, including the computer and phone. This is at least some probative evidence that the Veteran has made the conscious choice not to work, which weighs against a finding that the Veteran's service-connected disabilities have precluded him from securing or following a substantially gainful occupation for the period on appeal. The case of Ray v. Wilkie, 31 Vet. App. 58 (2019), held that "substantially gainful employment," in the TDIU context, contains economic and noneconomic components; the economic component means "an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person," while the noneconomic component requires consideration of a veteran's ability to secure or follow that type of employment. The Court also provided guidance as to the meaning of a veteran's ability to "secure and follow" such employment, noting that attention must be given to: the veteran's occupational history, education, skill and training; whether the veteran has the physical ability to perform occupational activities; and whether the veteran has the mental ability to perform occupational activities. Here, after considering both economic and noneconomic components, the Board finds that the preponderance of the evidence is against finding that the Veteran's service-connected disabilities prevent him from obtaining and maintaining substantially gainful employment. Based upon a review of the record, including as discussed above, the Board concludes that while the evidence of record documents some impairment resulting from the Veteran's service-connected disabilities, including most notably functional impairment resulting from his psychiatric disorder and embarrassment related to his voiding dysfunction due to prostate cancer, the preponderance of the probative evidence of record, as discussed in detail above, is against a finding that the Veteran's service-connected disabilities have precluded him from securing or following a substantially gainful occupation for the entire period on appeal. There is no suggestion that these conditions require, or requires avoidance of, certain types of work, sedentary work, or has any other effect on employment or his earning capacity, meaning above and beyond what is contemplated by the ratings assigned for these service-connected disabilities. 38 C.F.R. §§ 4.1, 4.15. While the Veteran clearly has voiding dysfunction due to his residuals of prostate cancer, the subjective and objective evidence of record does not reflect that he was precluded from working at Emerson or as a bus driver due to his symptomatology and the need to change absorbent materials or the need to void. Again, the March 2012 examiner described his functional limitation as embarrassment. Likewise, while his PTSD symptomatology resulted in occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, this did not preclude him from working at Emerson or as a bus driver, and the evidence of record does not provide support for a finding that he is precluded from obtaining substantially gainful employment due to his PTSD symptomatology. As detailed above, the Veteran's admission to the March 2018 VA examiner that he had previously used a computer and telephone in his employment indicates that there are jobs that could be performed from home for which the Veteran is already qualified, such as a telemarketer, where the employee makes calls and reads a script, which type of job does not require a lot of experience and could be done with a high school education and military training. The Veteran has stated that he was a good and dependable worker in the past, which indicates that he would be able to perform this type of job from home, and the embarrassment related to his voiding dysfunction would not be an issue, since he would be in the privacy of his own home. This is evidence against a finding that the Veteran is precluded from all forms of substantially gainful employment. Again, the Veteran's stated reluctance to again utilize technology he had worked with in the past has not been shown to be related to service-connected disability. The disability ratings assigned for his service-connected disabilities acknowledges the disability affects or impairs (i.e., interferes with) employment. See 38 C.F.R. §§ 4.1, 4.15. Moreover, generally, the degrees of disabilities specified in the Rating Schedule are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. Id. In other words, the disability rating, itself, is recognition that industrial capabilities are impaired. See Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). Consequently, the record must reflect some factor that takes a particular case outside the norm for a claim for individual unemployability benefits to prevail. As the Court further explained in Van Hoose, the mere fact that a Veteran is unemployed or has difficulty obtaining employment is not enough. The question is whether he can perform the physical and mental acts required by employment, not whether he can find employment. As detailed, the record in this case clearly shows functional impairment due to his PTSD and residuals of prostate cancer, but such limitations do not reflect an inability to perform a substantially gainful job due to his service-connected disabilities. His medical examinations do not preclude sedentary or other types of less physically demanding work consistent with his level of education and prior occupational experience. The limitations shown on objective examination, to include PTSD symptoms and voiding, cannot service as basis or grounds for granting a TDIU. In sum, while the evidence discussed herein documents some functional impact upon the Veteran's ability to work based upon his service-connected disabilities, such functional impairment is contemplated by the 80 percent combined disability rating. For all the reasons described above, the Board concludes that the preponderance of evidence weighs against the Veteran's claim for entitlement to a TDIU rating for the entire period on appeal. As such, there is no reasonable doubt to be resolved, and the claim for a TDIU rating is denied. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.W. Kreindler, 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.