Citation Nr: 21070698 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 10-49 506 DATE: November 24, 2021 ORDER Entitlement to an initial rating in excess of 10 percent for left tibial stress fracture (left tibial disability) is denied. Entitlement to an initial rating in excess of 10 percent for right tibial stress fracture (right tibial disability) is denied. Entitlement to a total disability rating based on individual unemployability (TDIU) prior to June 2, 2018 is denied. FINDINGS OF FACT 1. The Veteran's left tibial disability is manifested by reports of pain, swelling, and weakness, as well as functional loss due to difficulty standing for long periods and pain during flare-ups; moderate knee or ankle disability has not been shown. 2. The Veteran's right tibial disability is manifested by reports of pain, swelling, and weakness, as well as functional loss due to difficulty standing for long periods and pain during flare-ups; moderate knee or ankle disability has not been shown. 3. The Veteran's service-connected disabilities have not precluded her from securing or maintaining substantially gainful employment prior to June 2, 2018. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for left tibial disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.7, 4.71a, Diagnostic Codes (DC) 5262. 2. The criteria for a rating in excess of 10 percent for right tibial disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.7, 4.71a, DC 5262. 3. The criteria for a TDIU prior to June 2, 2018 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16, 4.19. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had a period of active duty for training (ACDUTRA) in the U.S. Army from June 2006 to February 2007. She also had additional unverified U.S. Army Reserve service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2008 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claims on appeal in September 2015, November 2019 and February 2021 for additional development. The Board's remand directives have been substantially completed. See Stegall v. West, 11 Vet. App. 268 (1998). The claim for a TDIU has been raised by the record and the Board now has jurisdiction over the issue. See Rice v. Shinseki, 22 Vet. App. 447, 453 (2009). In an April 2021 rating decision, the RO awarded entitlement to a TDIU effective June 2, 2018. However, as such did not constitute a full grant of the benefit sought on appeal, the issue of entitlement to a TDIU as set forth above remains in appellate status. AB v. Brown, 6 Vet. App. 35 (1993). Increased Rating Ratings are based on a schedule of reductions in earning capacity from specific injuries or combination of injuries. The ratings shall be based, as far as practicable, upon the average impairments of earning capacity resulting from such injuries in civil occupations. 38 U.S.C. § 1155. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 3.102, 4.3. When evaluating joint disabilities rated on the basis of limitation of motion, VA must consider granting a higher rating in cases in which functional loss due to pain, weakness, excess fatigability, or incoordination is demonstrated, and those factors are not contemplated in the relevant rating criteria. See 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202 (1995). "Although pain may cause a functional loss, pain itself does not constitute functional loss." Mitchell v. Shinseki, 25 Vet. App. 32, 37 (2011) (emphasis in original). Painful motion is deemed to be limitation of motion and warrants the minimum compensable rating for the joint, even if there is no actual limitation of motion. 38 C.F.R. § 4.59; Lichtenfels v. Derwinski; 1 Vet. App. 484, 488 (1991). The provisions of 38 C.F.R. § 4.59 relating to painful motion are not limited to arthritis and must be considered when raised by the claimant or when reasonably raised by the record. Burton v. Shinseki, 25 Vet. App. 1 (2011). The Board must also consider whether VA examiners have elicited information concerning the "severity, frequency, duration, or functional loss manifestations" of such flare-ups. Sharp v. Shulkin, 29 Vet. App. 26 (2017). The United States Court of Appeals for Veterans Claims (Court) also has issued the opinion of Correia v. McDonald, 28 Vet. App. 158 (2016), which clarifies additional requirements that VA examiners should address when assessing musculoskeletal disabilities, holding specifically, that the joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. During the pendency of the appeal, the rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. § 4.71a were amended effective February 7, 2021. 85 Fed. Reg. 76453 (Nov. 30, 2020) (to be codified as 38 C.F.R. § 4.71a). Prior to February 7, 2021, the Board will consider the old version of the diagnostic code only; however, for the period beginning February 7, 2021, the Board will consider both the old and amended version of the diagnostic code and rate based on whichever is most favorable to the Veteran. 1. Entitlement to an initial rating in excess of 10 percent for left tibial disability 2. Entitlement to an initial rating in excess of 10 percent for right tibial disability The Veteran is currently evaluated at 10 percent for each of her left and right tibial disability using 38 C.F.R. § 4.71a, DC 5262, impairment of the tibia and fibula. Under the criteria in effect prior to February 7, 2021, under DC 5262, pertaining to impairment of the tibia and fibula, a 10 percent disability rating is assigned for malunion with slight knee or ankle disability, and a 20 percent disability rating is warranted for malunion with moderate knee or ankle disability. A 40 percent disability rating is appropriate where there is nonunion of the tibia and fibula with loose motion requiring a brace. 38 C.F.R. § 4.71a, DC 5262. Descriptive words such as "slight," "moderate", and "marked" as used in the various DCs are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all of the evidence for "equitable and just decisions." 38 C.F.R. § 4.6. Under the revised criteria, DC 5262 now provides a 30 percent evaluation for shin splints requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, both lower extremities; a 20 percent rating is warranted for shin splints requiring treatment for no less than 12 consecutive months, and unresponsive to surgery and either shoe orthotics or other conservative treatment, one lower extremity, a 10 percent rating is warranted for shin splints requiring treatment for no less than 12 consecutive months, and unresponsive to either shoe orthotics or other conservative treatment, one or both lower extremities; and a noncompensable rating is warranted for shin splints that have treatment less than 12 consecutive months, one or both lower extremities. Turning to the evidence of record, the Veteran initially underwent a VA examination for her left and right tibial disability in July 2009. The VA examiner diagnosed the Veteran with status-post bilateral tibial stress fractures with residual tendonitis of bilateral lower legs with pain and swelling. Bilateral knee range of motion was within normal limits with no evidence of pain. Bilateral ankle pain was noted with moderate tenderness over achilles tendon, affecting the motion of the joint. No flare-ups were reported. Radiographic studies of tibia and fibula showed no fracture or dislocation. Soft tissues were unremarkable. In July 2011, the Veteran underwent a VA examination for her bones. A diagnosis of right and left tibial stress fractures in bilateral lower legs was confirmed. The examiner noted that her disability impacts her occupational activities due to decreased mobility and problems with lifting and carrying. Mild to moderate impairment was noted. The Veteran underwent another VA examination for her left and right tibial disability in February 2013. At that time, the Veteran reported experiencing flare-ups. She reported that colder weather, prolonged standing and walking increase aching in lower legs. The examiner diagnosed the Veteran with bilateral shin splits with residual Tarsal Tunnel syndrome and reflex sympathetic dystrophy. On examination, bilateral knee flexion was to 130 degrees. No limitation of extension was noted. The repetitive use testing resulted in the same range of motion measurements bilaterally. Pain on movement was noted bilaterally. Muscle strength test results were within normal limits. No instability or dislocation was noted. No surgical history or use of assistive devices was noted. The examiner noted that the Veteran's left and right tibial disability impacts her ability to work due to increased pain in lower legs with strenuous activity and prolonged standing and walking. Pursuant to September 2015 Board's remand directives, the Veteran underwent a VA examination for her left and right tibial disability in December 2017. At that time, the Veteran reported experiencing bilateral lower extremity swelling, sharp pain, and decreased sensation. She reported experiencing flare-ups with prolonged walking, standing, and cold weather. On examination, the initial range of motion measurements were within normal limits bilaterally. The examiner was unable to say without speculation whether pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time, because the Veteran was not examined after repetitive use. Likewise, the examiner was unable to estimate functional loss during flare-ups as the Veteran was not examined during a flare-up. Muscle strength test results were within normal limits. No ankylosis or muscle atrophy was noted. There was no evidence of pain with weight-bearing or crepitus. The examiner noted no history of recurrent subluxation, lateral instability, or recurrent effusion. Regular use of compression stockings to decrease extremity swelling was noted. The examiner noted that the Veteran's bilateral tibial disability impacts her ability to work due to her inability to stand or walk for prolonged periods of time. Pursuant to November 2019 Board's remand directives, the Veteran underwent another VA examination for her left and right tibial disability in January 2020. At that time, the Veteran reported numbness and constant burning pain with pins and needles from toes to knees bilaterally. The Veteran also reported experiencing daily flare-ups that impacts her ability to do housework. On examination, the initial range of motion measurements were within normal limits bilaterally, with pain noted on flexion and extension in the medial tibia. There was no evidence of pain with weight-bearing or crepitus. There was objective evidence of localized tenderness or pain on palpation in the medial tibia shaft, rated at 7 out of 10 in severity. No additional functional loss bilaterally was noted after repetitive use testing. The examiner noted that pain, weakness, fatigability or incoordination do not significantly limit functional ability with repeated use over a period of time or during flare-ups. No additional factors contributing to disability were noted. Muscle strength test results were within normal limits. No muscle atrophy or ankylosis were noted. There was no history of recurrent subluxation, lateral instability or recurrent effusion. The examiner noted that the Veteran's condition does not affect range of motion of her ankle. There was no objective evidence of pain on passive range of motion testing or on nonweight-bearing. No surgical history or use of assistive devices was noted. The examiner noted that the Veteran's bilateral tibial disability impacts her ability to perform physical labor jobs that require a lot of walking or standing. The Board is cognizant that all the examinations during the appeal period may not include all necessary findings as required by Correia and Sharp. See, supra. However, the examinations together accurately and sympathetically reveal the Veteran's functional limitations. Specifically, the examiner in December 2017 was unable to say without speculation whether pain, weakness, fatigability or incoordination significantly limit functional ability with repeated use over a period of time, because the Veteran was not examined after repetitive use. However, the Board subsequently remanded for another VA examination. In response, the examiner in January 2020 found no additional functional loss bilaterally after repetitive use testing, and noted that pain, weakness, fatigability or incoordination do not significantly limit functional ability with repeated use over a period of time or during flare-ups. See also February 2013 VA examination report. The VA examination reports provide an adequate disability picture for evaluative purposes. Further review of the record shows that the Veteran receives VA treatment and from private treatment providers for pain associated with her bilateral tibial disability. However, there is no indication from the treatment notes of record that the Veteran's condition is worse than as noted above. In light of the foregoing, the Board finds that a rating greater than 10 percent for the Veteran's left and right tibial disability is not warranted. At no time during the period on appeal did the Veteran's limitation of flexion or extension meet the criteria for a compensable rating. Furthermore, the Veteran is already currently rated for at least the minimum compensable rating for painful motion under 38 C.F.R. § 4.59. The Board notes that a review of the Veteran's treatment records, and VA examination reports indicates that her symptoms are neurological in nature. The Veteran's is currently in receipt of a separate rating for tibial nerve complex pain syndrome under DC 8524. The Board acknowledges the Veteran's lay reports of symptoms including pain, swelling, and decreased sensation. Indeed, the February 2013 VA examiner noted functional loss with strenuous activity and prolonged standing and walking. However, no marked loss of range of motion due to pain was shown during the appeal period. Radiographic studies of tibia and fibula also showed no fracture or dislocation, and soft tissues were unremarkable. As such, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation would not result in symptoms more nearly approximating malunion of the tibia or fibula with moderate knee or ankle disability. 38 C.F.R. § 4.71a, DC 5262. The Board has also considered the provisions of 38 C.F.R. § 4.40 and § 4.45 and finds that the evidence of record fails to demonstrate functional loss due to pain warranting a higher rating. Moreover, as noted, the Veteran's competent and credible report of pain symptoms are already contemplated in the assigned 10 percent ratings. In considering other applicable DCs, in order to warrant ratings in excess of 10 percent, the evidence must demonstrate, or approximate knee flexion limited to 30 degrees, extension to 15 degrees, instability or subluxation, or ankylosis of the knee, none of which has been shown. 38 C.F.R. §§ 4,7, 4.71a, DCs 5257, 5260, 5261. Nor does the evidence show that a higher rating is warranted under the revised criteria since February 7, 2021. The Board also acknowledges contentions of the Veteran's representative, arguing that a higher rating for the Veteran's bilateral knee disability is warranted. See August 2021 Appellant's Post-Remand Brief. Nonetheless, the evidence during the entire period on appeal reflects that the Veteran's symptoms have at no point more nearly approximated the criteria for assigment of a rating in excess of 10 percent. In sum, the Board finds that the preponderance of the evidence is against the Veteran's claims for ratings in excess of 10 percent for left and right tibial disability. In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 3. Entitlement to a TDIU prior to June 2, 2018 For the reasons that follow, the Board finds that entitlement to a TDIU is not warranted. Total disability ratings for compensation may be assigned when a veteran is unable to secure and follow a substantially gainful occupation. See 38 U.S.C. § 1155; 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." See Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993); also see Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993) (the ultimate question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he can find employment). Additionally, entitlement to a TDIU is based on an individual's particular circumstances. 38 C.F.R. § 4.16; Ray v. Wilkie, 31 Vet. App. 58, 72 (2019). Thus, in adjudicating a TDIU claim, VA must consider the individual veteran's education, training, and work history, but not his or her age or the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. The phrase "unable to secure and follow a substantially gainful occupation" in 4.16 has both an economic and a noneconomic component. Ray, supra. The economic component means an occupation earning more than marginal income outside of a protected environment. Id. The noneconomic component concerns whether the Veteran is able to "secure or follow" gainful employment. Id. In determining whether a Veteran can secure and follow a substantially gainful occupation, in addition to the Veteran's history, education, skill, and training, the Board should consider whether he or she "has the physical ability (both exertional and nonexertional) to perform the type of activities (e.g., sedentary, light, medium, heavy, or very heavy) required" to work in a substantially gainful occupation, and "whether the Veteran has the mental ability to perform the activities required" to work in a substantially gainful occupation. Id. For purposes of a TDIU, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census. Marginal employment may also be held to exist, on a facts-found basis including, but not limited to, employment in a protected environment such as a family business or sheltered workshop-when earned annual income exceeds the poverty threshold. 38 C.F.R. § 4.16(a). Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a Veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that if there is only one such disability, this disability shall be ratable at 60 percent or more; if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). For the purpose of one 60 percent disability or one 40 percent disability, disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable; disabilities resulting from common etiology or a single accident; disabilities affecting a single body system, e.g., orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric; and multiple injuries incurred in action, will be considered as one disability. Id. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). In pertinent part, before June 2, 2018, the Veteran was service connected for: (1) left lower extremity popliteal (tibial) nerve complex regional pain syndrome, rated at 10 percent disabling from May 18, 2010 and 30 percent from September 13, 2010; (2) right lower extremity popliteal (tibial) nerve complex regional pain syndrome, rated at 10 percent disabling from May 18, 2010 and 30 percent from September 13, 2010; (3) thoracolumbar spine degenerative disc disease (DJD), rated at 20 percent from February 15, 2007 and 10 percent from July 9, 2012; (4) left lower extremity crural (femoral) peripheral neuropathy, rated at 10 percent from May 18, 2010; (5) right lower extremity crural (femoral) peripheral neuropathy, rated at 10 percent from May 18, 2010; (6) right inferior pubic ramus stress fracture, rated at 10 percent from February 15, 2007; (7) right tibial stress fracture, rated at 10 percent from February 15, 2007; (8) left tibial stress fracture, rated at 10 percent from February 15, 2007. The Veteran's combined evaluation was 40 percent from February 15, 2007, 70 percent from May 18, 2010, and 80 percent from September 13, 2010. As such, the schedular percentage criteria for a TDIU are met from May 18, 2010. As a preliminary matter, the Board observes that the Veteran has been employed full-time from June 15, 2014 to June 2, 2018. See VA 21-8940; SSA records. Additionally, the record shows that the Veteran worked full-time and earned income in excess of the poverty level. There is also no evidence of record showing that her employment was the equivalent of sheltered or marginal employment, or a protected environment. As such, entitlement to a TDIU as of June 15, 2014 is not warranted. Given the Veteran's employment history, the Board will now discuss whether entitlement to a TDIU prior to June 15, 2014 is warranted. Turning to the evidence of record, the Veteran's military occupational specialty (MOS) was a medical specialist (combat medic in training). See military personnel records. Since separation from service and prior to June 15, 2014, the Veteran primarily was a full-time college student, studying psychology. See VA treatment records. She graduated with bachelor's degree in May 2012. See March 2013 VA treatment record. Based on the foregoing, the Board finds that prior to June 15, 2014, the Veteran had the proficiency to work in an office-like setting, performing administrative or clerical work. As to the Veteran's contentions, she asserts that she was unable to work due to her pain and complications from injuries in the Army. See VA 21-8940. The Veteran underwent a VA examination for her bilateral lower extremity regional pain syndrome in July 2010. The examiner noted that her disability impacts her usual daily activities. Specifically, the examiner noted mild to severe impact on daily strenuous physical activities. No effect on low impact physical activities was noted. The examiner underwent a VA examination for her back disability in July 2012. At that time, the examiner noted that the Veteran's disability impacts her ability to work due to her limited capacity to lift, bend, push, and pull. The examiner added that the Veteran cannot tolerate weight bearing on heels. The Veteran underwent a VA examination for her bilateral lower extremity crural (femoral) peripheral neuropathy in March 2012. Upon examination, the examiner concluded that the Veteran's disability impacts her ability to work due to pain. The examiner added that she is moderately to severely impacted for all work requiring walking, standing and lifting. As to the Veteran's right inferior pubic ramus stress fracture, she initially underwent a VA examination in July 2010. The examiner noted mild to moderate impact of her disability on daily strenuous physical activities due to pain. No effect on low impact physical activities was noted. She underwent another VA examination in July 2011. The examiner noted that her right inferior pubic ramus stress fracture impacts her occupational activities due to decreased mobility and problems with lifting and carrying. In September 2011, the Veteran underwent another VA examination for her right inferior pubic ramus stress fracture. The examiner noted that the Veteran is a college student studying psychology. The examiner concluded that her disability impacts her ability to work because her physical activity is limited by pelvic pain with heavy lifting, pushing, or prolonged carrying of objects 10 pounds or greater. The examiner added that her sitting is limited to an hour. In January 2013, the Veteran underwent yet another VA examination for her right inferior pubic ramus stress fracture. At that time, the examiner noted that the Veteran was currently unemployed. However, the examiner concluded that there would be a mild impact on the sedentary employment due to pain with prolonged sitting. As to physical employment, the examiner noted that there would be mild to moderate impact due to pain with prolonged standing, walking and repetitive heavy lifting. In July 2011, the Veteran underwent a VA examination for her bones. A diagnosis of right and left tibial stress fractures in bilateral lower legs was noted. The examiner noted that her disability impacts her occupational activities due to decreased mobility and problems with lifting and carrying. In February 2013, the Veteran underwent a VA examination for her left and right tibial disability. The examiner noted that the Veteran's left and right tibial disability impacts her ability to work due to increased pain in lower legs with strenuous activity and prolonged standing and walking. The evidence of record shows that the Veteran worked in daycare, department store and a gas station, part-time while attending college full-time during the timeframe on appeal. See VA December 2009 VA examination. The records also show that the Veteran graduated with bachelor's degree in May 2012, majoring in psychology. See VA treatment records. At the February 2013 VA examination for her lower extremities, the Veteran reported that after finishing school she worked part-time at a gas station and had to miss too much work due to leg pain. Based on a review of all the evidence of record, the Board finds that the Veteran's service-connected disabilities have not precluded her from being able to secure and maintain substantially gainful employment prior to June 15, 2014. While it is clear that prior to June 15, 2014 the Veteran was not able to function in a role requiring any physical labor, she has a bachelor's degree and the records do not show that her service-connected disabilities prevented her from working in an office setting, where physical exertion is minimal. The evidence of record shows that prior to June 15, 2014, the Veteran was able to sit for periods of time as long as she was given frequent breaks, approximately every hour, to stretch and/or change positions. The Veteran would have also been able to alternate between sitting and standing with a stand-up desk in an office-like setting. Thus, the Board finds that any accommodations afforded by a prospective employer that would allow the Veteran frequent breaks or ergonomic work environment would have been reasonable, not extraordinary. See Cantrell v. Shulkin, 28 Vet. App. 382, 396 (2017) (Lance, J., concurring) ("Where a claimant's employer is required by law to provide reasonable accommodations pursuant to the ADA and those accommodations allow the claimant to engage in a substantially gainful occupation, a TDIU award would, in effect, constitute a second paycheck on the back of the taxpayer."). Accordingly, prior to June 15, 2014, the Veteran's service-connected disabilities would not have impacted her ability to perform administrative or clerical tasks. It is also noted that the Veteran's mental capacity was full and service connection for psychiatric impairment is not in effect. Further, the Board notes that medical professionals have not found the Veteran to be precluded from obtaining and/or maintaining employment due to her service-connected disabilities prior to June 15, 2014. Indeed, the VA examiners noted a mild impact on the sedentary employment due to pain with prolonged sitting and the Veteran's inability to work a physical labor-type of job. Nonetheless, prior to June 15, 2014, the VA examiners did not find that the Veteran was precluded from obtaining and/or maintaining any employment due to her service-connected disabilities. The Board acknowledges the Veteran's statements that she would not have been able to perform social work due to physical nature of the job. See VA treatment records. However, for the purposes of a TDIU, the term "substantially gainful" does not necessarily mean that the Veteran has the job for which they were trained. When analyzing whether a TDIU is warranted, the Board considers whether the Veteran has the potential to earn more than marginal income and her employment history, education, skill, and training. See Ray, supra. As noted, prior to June 15, 2014, the Veteran had the proficiency to work in an office-like setting, performing administrative or clerical work. Such an occupation would have likely provided more than marginal income. Thus, even though prior to June 15, 2014 the Veteran was not able to perform social work, the Board finds that her service-connected disabilities did not preclude her from obtaining any substantially gainful employment. The Board is also mindful of the SSA determination. However, given the different standards utilized by VA and SSA, the Board is not bound by the SSA determination. See Collier v. Derwinski, 1 Vet. App. 413, 417 (1991). In sum, while the Veteran experienced symptoms related to her service-connected disabilities prior to June 15, 2014, the evidence does not show that the Veteran was unemployable due to these service-connected disabilities. The preponderance of the evidence is against the claim for a TDIU. As such, the benefit of the doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Thus, entitlement to a TDIU is not warranted. C. CRAWFORD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Kuzniar, 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.