Citation Nr: 21071119 Decision Date: 11/29/21 Archive Date: 11/29/21 DOCKET NO. 20-10 658 DATE: November 29, 2021 ORDER Entitlement to a rating higher than 20 percent for a right shoulder disability is denied. Entitlement to a rating higher than 10 percent for a right ankle disability is denied. Entitlement to a rating higher than 10 percent for patellofemoral pain syndrome with arthritis of the right knee (excluding a period of temporary 100 percent rating) is denied. Entitlement to a compensable initial rating for limitation of flexion of the right knee is denied. Entitlement to a rating higher than 10 percent for limitation of extension of the right knee is denied. Entitlement to a compensable initial rating for shin splint of the right knee is denied. Entitlement to an initial rating higher than 10 percent for painful vertical scar of the right knee is denied. Entitlement to a compensable rating for scars of the right knee is denied. FINDINGS OF FACT 1. The Veteran's right shoulder disability is not manifested by limitation of motion of the arm to at least midway between the side and shoulder level. 2. The Veteran's right ankle disability is not manifested by marked limitation of motion. 3. The Veteran's right knee patellofemoral pain syndrome with osteoarthritis is manifested by no more than mild instability and subluxations. 4. The Veteran's right knee disability does not result in flexion limited to 45 degrees. 5. The Veteran's right knee disability does not result in extension limited to 15 degrees. 6. The Veteran's right shin splint has not manifested with a slight right knee or right ankle disability, and has not required treatment for no less than 12 consecutive months. 7. The Veteran does not have three or four scars of the right knee that are unstable or painful. 8. The evidence of record is against finding that the Veteran's scars of the right knee covers an area of 144 square inches (929 sq. cm.) or greater; is associated with underlying soft tissue; or causes any other disabling effect such as limitation of function of the affected body part. CONCLUSIONS OF LAW 1. The criteria for a rating higher than 20 percent for a right shoulder disability have not been met. 38 U.S.C. § 5107; 38C.F.R. §4.71a, Diagnostic Code 5201. 2. The criteria for a rating higher than 10 percent for a right ankle disability have not been met. 38 U.S.C. § 5107; 38C.F.R. §4.71a, Diagnostic Code 5271. 3. The criteria for a rating higher than 10 percent for patellofemoral pain syndrome with osteoarthritis of the right knee (excluding a period of temporary 100 percent rating) have not been met. 38 U.S.C. § 5107; 38C.F.R. §4.71a, Diagnostic Code 5271. 4. The criteria for a rating higher than 10 percent for limitation of extension of the right knee have not been met. 38 U.S.C. § 5107; 38 C.F.R. § 4.71a, Diagnostic Code 5261. 5. The criteria for a compensable initial rating for limitation of flexion of the right knee have not been met. 38 U.S.C. § 5107; 38 C.F.R. § 4.71a, Diagnostic Code 5260. 6. The criteria for a compensable initial rating for shin splint of the right knee have not been met. 38 U.S.C. § 5107; 38 C.F.R. § 4.71a, Diagnostic Code 5262. 7. The criteria for painful vertical scar of the right knee have not been met. 38 U.S.C. § 5017; 38 C.F.R. § 4.118, Diagnostic Code 7804. 8. The criteria for scars of the right knee have not been met. 38 U.S.C. § 5017; 38 C.F.R. § 4.118, Diagnostic Code 7802. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service with the United States Air Force from November 2004 to September 2014, to include service in the Persian Gulf. These issues come before the Board of Veterans' Appeals (Board) on appeal of an October 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In December 2020, the Veteran provided testimony at a Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is of record. In July 2021, the Board remanded the claims for further development. While the case was in remand status, in a September 2021 rating decision, the RO granted service connection for right knee limitation of flexion and right knee shin splint, with noncompensable ratings assigned for each disability and granted service connection for painful scar of the right knee, with a 10 percent rating assigned. While the actions were phrased as one for service connection, the ratings are part and parcel of the Veteran's claims for an increased rating for his right knee disability and for scars of the right knee. Thus, the Board has taken jurisdiction over these issues and have included them on appeal. Furthermore, the Board notes that the remand directives have been substantially complied with (current VA examinations have been conducted) and therefore will proceed with a decision. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The rating schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries. 38 U.S.C. § 1155; 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 for that rating. 38 C.F.R. § 4.7. Further, 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). The Court clarified that although pain may be a cause or manifestation of functional loss, limitation of motion due to pain is not necessarily rated at the same level as functional loss where motion is impeded. See Mitchell v. Shinseki, 25 Vet. App. 32 (2011). Instead, the Mitchell Court explained that pursuant to 38 C.F.R. §§ 4.40 and 4.45, the possible manifestations of functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance (38 C.F.R. § 4.40), as well as less or more movement than is normal, weakened movement, excess fatigability, and pain on movement (as well as swelling, deformity, and atrophy) that affects stability, standing, and weight-bearing (38 C.F.R. § 4.45). 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. 230 (Nov. 30, 2020). These amendments revised select diagnostic codes" to ensure that this portion of the rating schedule uses current medical terminology and provides detailed and updated criteria for the evaluation of musculoskeletal disabilities." Id. 1. Right Shoulder The Veteran seeks a rating higher than 20 percent for his service-connected right shoulder disability under Diagnostic Code 5201 which pertains to limitation of motion of the arm. Shoulder disabilities are rated under Codes 5200 to 5203. 38 C.F.R. § § 4.71a. As noted previously, as of February 7, 2021, the musculoskeletal rating criteria were revised and the version more favorable to the Veteran applied; however, application of the amended regulations do not warrant a higher rating. The evidence of record demonstrates that the Veteran is right hand dominant. Therefore, his right shoulder is considered his dominant extremity. Under Diagnostic Code 5201, for limitation of motion of the major shoulder and arm, a 20 percent rating is assigned for limitation of motion of the arm to shoulder level; a 30 percent rating is assigned for limitation of motion to midway between the side and shoulder level; and a 40 percent rating is assigned for limitation of motion to 25 degrees from the side. 38 C.F.R. § 4.71a. Under the revised criteria, Diagnostic Code 5201 contains the same rating criteria as the former version but clarifies that limitation of motion of the arm includes flexion and/or abduction, and that limitation of motion to shoulder level is limitation of flexion and/or abduction to 90 degrees, while limitation midway between side and shoulder level is flexion and/or abduction limited to 45 degrees. Normal range of motion of the shoulder is set forth in 38 C.F.R. § § 4.71, Plate I. Normal forward elevation, or flexion, is from 0 to 180 degrees. Normal shoulder abduction is also from 0 to 180 degrees. Normal external rotation and internal rotation are from 0 to 90 degrees. 38 C.F.R. § § 4.71, Plate I. On VA examination in August 2018, the Veteran reported pain in the right shoulder when lifting about shoulder height, when walking long distances and discomfort at night. He denied flare-ups of the right shoulder. Right shoulder flexion was to 95 degrees. Abduction was to 80 degrees. Internal rotation was to 65 degrees and external rotation was to 80 degrees. Pain was noted on examination and with repetitive testing, but it did not result in or cause functional loss or loss of range of motion. Muscle strength testing was normal. There was no ankylosis of the right shoulder. There was no instability, dislocation or labral pathology. There was no loss of head (flail shoulder), nonunion (false flail shoulder) or fibrous union of the humerus. There was no malunion of the humerus with moderate or marked deformity. There was no instability, dislocation or labral pathology. There was no loss of head (flail shoulder), nonunion (false flail shoulder) or fibrous union of the humerus. There was no malunion of the humerus with moderate or marked deformity. There was no clavicle, scapula, acromioclavicular (AC) joint and sternoclavicular joint condition. On VA examination in September 2021, the Veteran reported difficulty with tasks that required using the right shoulder and arm to push, lift, reach, grab, hold or manipulate objects. Right shoulder flexion was to 60 degrees. Abduction was to 65 degrees. Internal and external rotation were to 40 degrees each. Following repeated use, right shoulder flexion was to 50 degrees. Abduction was to 50 degrees. Internal and external rotation were to 30 degrees, each. There was no muscle atrophy. There was no ankylosis of the right shoulder. Muscle strength testing was normal. There was no ankylosis of the right shoulder. There was no instability, dislocation or labral pathology. There was no loss of head (flail shoulder), nonunion (false flail shoulder) or fibrous union of the humerus. There was no malunion of the humerus with moderate or marked deformity. Based on the above, the Board finds that entitlement to a rating in excess of 20 percent is not warranted for the right shoulder. As noted above, a 30 percent rating for the Veteran's right (major) shoulder requires motion limited to no more than midway between the side and shoulder level (45 degrees). As the VA examination reports show that the Veteran's right shoulder limitation of motion is not limited to no more than halfway between the side and shoulder level (45 degrees), entitlement to a rating in excess of 20 percent for the Veteran's right shoulder, is not warranted. Moreover, there is no evidence of fibrous union of the humerus that would warrant a higher rating under Diagnostic Code 5202. A rating higher than 20 percent for the right shoulder disability is not warranted based on functional loss due to pain, weakness, premature or excess fatigability, and incoordination causing additional disability beyond that reflected in range of motion measurements. 38 C.F.R. §§ 4.40, 4.45. The record on appeal does not support evaluating the Veteran's right shoulder disability under alternate diagnostic codes. The VA examinations did not identify ankylosis in the right shoulder; therefore, Diagnostic Code 5200 is not applicable. Diagnostic Code 2203 is not applicable because the record does not document dislocation, nonunion, or malunion of the clavicle and scapula. Thus, a rating higher than 20 percent for the right shoulder disability is not warranted. 2. Right Ankle The Veteran seeks a rating higher than 10 percent for his service-connected right ankle disability under Diagnostic Code 5271 which pertains to limitation of motion of the ankle. Again, 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. 230 (Nov. 30, 2020). Diagnostic Code 5271, limitation of motion ankle, was purportedly amended but the rating did not change substantially. Under Diagnostic Code 5271, a 10 percent rating is awarded for moderate symptoms (less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion.) A 20 percent rating is awarded for marked symptoms (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion). As an initial matter, the evidence does not show ankylosis, malunion of the os calcis or astragalus, or astragalectomy so Diagnostic Codes 5270, 5272, 5273, and 5274 are not for application. On VA examination in August 2018, the Veteran complained of pain in the right ankle with prolonged walking, running and anything that required pushing off his foot/ankle. He denied any flareups of the ankle. Dorsiflexion of the ankle was to 10 degrees and plantar flexion was to 45 degrees. There was no evidence of pain with weight bearing. The Veteran was able to perform repetitive use testing with at least three repetitions with additional loss of function or range of motion. Muscle strength testing was normal. There was no ankylosis of the right ankle. There were no additional contributing factors of disability. Examination further showed normal stability and strength. On VA examination in September 2021, the Veteran reported that he continued to experience right ankle pain and weakness. No functional loss or impairment was noted. There was no history of instability of the right ankle. Plantar flexion was to 30 degrees. Dorsiflexion was to 10 degrees. Following repeated use, there was no additional loss of function or range of motion. The examiner estimated that with during flare-ups, plantar flexion would be to 20 degrees and dorsiflexion would be to 5 degrees. There was no muscle atrophy. There was no ankylosis of the ankle. Stability testing was normal. As noted above, to receive a higher disability rating there would need to be a showing of marked limited ankle motion symptoms (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion). Such is not disclosed in the evidence of record. At worst, the September 2021 VA examiner estimated that during flare-ups, the Veteran's right ankle dorsiflexion would be 5 degrees and plantar flexion would be to 20 degrees. The Board finds that the limitation of motion and pain requiring limitation in walking endurance is best assessed as moderate, indicative of a 10 percent disability rating. Accordingly, the appeal for a rating higher than 10 percent for the right ankle disability must be denied. 3. Right Knee Patellofemoral Syndrome, Limitation of Extension, Limitation of Flexion, and Shin Splint The Veteran seeks increased ratings for his service-connected right knee disabilities. He is currently in receipt of a 10 percent rating for patellofemoral knee syndrome with arthritis under Diagnostic Code 5257 (excluding a period of temporary 100 percent rating); a noncompensable rating for limitation of flexion of the right knee under Diagnostic Code 5260; a 10 percent rating for limitation of extension of the right knee under Diagnostic Code 5261; and a noncompensable rating for right knee shin splint (secondary to his service-connected right knee disability), under Diagnostic Code 5262. While portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, the amendments did not change the criteria under Diagnostic Codes 5256, 5258, 5259, 5260, or 5261. Under the criteria in effect prior to February 7, 2021, Diagnostic Code 5257 provides a 10 percent rating for slight recurrent subluxation or lateral instability. A 20 percent rating is warranted for moderate recurrent subluxation or lateral instability. A 30 percent rating is warranted for severe recurrent subluxation or lateral instability. 38 C.F.R. § 4.71a, Diagnostic Code 5257 (2020). Under the revised criteria, Diagnostic Code 5257 for recurrent subluxation and instability now provides a 30 percent rating for unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device (e.g., cane(s), crutch(es), walker) and bracing for ambulation or a sprain incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribes a brace and/or assistive device (e.g., cane(s), crutch(es), walker) for ambulation. A 20 percent rating is warranted for unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation. A 10 percent rating is warranted for sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation. For patellar instability under the revised Diagnostic Code 5257, a 30 percent rating is warranted for a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker. A 20 percent rating is warranted for a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for one of the following: A brace, cane, or walker. A 10 percent rating is warranted for a diagnosed condition involving the patellofemoral complex with recurrent instability (with or without history of surgical repair) that does not require a prescription from a medical provider for a brace, cane, or walker. Under 38 C.F.R. § 4.71a, Diagnostic Code 5260, if flexion of the knee is limited to 45 degrees a 10 percent rating is in order. If flexion of the knee is limited to 30 degrees a 20 percent rating is in order. If flexion of the knee is limited to 15 degrees a 30 percent rating is in order. Under 38 C.F.R. § 4.71a, Diagnostic Code 5261, if extension of the knee is limited to 10 degrees a 10 percent rating is in order. If extension of the knee is limited to 15 degrees a 20 percent rating is in order. If extension of the knee is limited to 20 degrees a 30 percent rating is in order. Under the criteria in effect prior to February 7, 2021, under Diagnostic Code 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 30 percent rating is warranted for marked 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, Diagnostic Code 5262. Under the revised criteria, Diagnostic Code 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. For rating purposes, normal range of motion in a knee joint is from 0 to 140 degrees of flexion. 38 C.F.R. § 4.71, Plate II. On VA examination in August 2018, the Veteran reported pain with any activity that involves running and stiffness with prolonged sitting. Flexion of the knee was to 90 degrees. There was no limitation of extension. There was no additional limitation in range of motion of the right knee following repetitive use testing. Joint stability testing was normal. There was no ankylosis. There was slight anterior instability of the knee. The Veteran did not have recurrent patellar dislocation, shin splints, stress fractures, chronic exertional compartment syndrome or any other tibial or fibular impairment. There was no meniscus condition. The Veteran did not use any assistive devices. On VA examination in September 2021, the Veteran reported increased pain, swelling and stiffness of the right knee and periodic buckling. It was noted that the Veteran had a history of instability or recurrent subluxation of the knee without frequent effusion. Flexion was to 70 degrees. There was no limitation of extension. Passive range of motion was the same as active range of motion. There was evidence of pain on all ranges of motion. There was pain on palpation inferior and lateral to the patella and anterior shin. There was no additional limitation in range of motion of the right knee following repetitive use testing. With repeated use, the examiner estimated that the Veteran's flexion would be 70 degrees with no limitation of extension. With flare-ups, estimated flexion would be 60 degrees with no limitation of extension. There was no muscle atrophy. There was no ankylosis of the knee. There was recurrent subluxation or persistent instability of the knee, however, there was no prescription by a medical provider for ambulation. There was no recurrent patellar instability. The Veteran did not use any assistive devices. The Veteran had shin splints that required treatment for less than 12 consecutive months. The Board finds that the preponderance of the evidence is against a rating higher than 10 percent for right knee chondromalacia patella with arthritis under the old version of Diagnostic Code 5257. Specifically, the August 2018 examination report shows instability of the right knee to be no more than mild. Moreover, on examination in September 2021, the Veteran reported that his knee would buckle sometimes. Overall, the lay and medical evidence suggest the presence of symptoms more nearly approximating no more than mild severity. The Board also notes that the Veteran does not qualify for a higher rating under the new version of Diagnostic Code 5257. For recurrent subluxation or instability, a 20 or 30 percent rating requires a sprain, an unrepaired, or a failed repair of complete ligament tear, of which there is no evidence. For patellar instability, a 20 or 30 percent rating under the new criteria requires surgical repair, of which there is no evidence. The criteria for a rating higher than 10 percent under new Diagnostic Code 5257, whether based on recurrent subluxation or instability, or patellar instability, have not been met. The Veteran is in receipt of a noncompensable rating for limited flexion of the right knee under Diagnostic Code 5260. For the Veteran to be entitled to a compensable rating, flexion must be limited to 45 degrees. In this case, however, the evidence shows flexion in the right knee is limited to no less than 60 degrees, at worst. The Veteran is also in receipt of a 10 percent rating for limited extension of the right knee under Diagnostic Code 5261. Extension has consistently been normal, so a higher rating for limitation of extension of the right knee is not warranted. The Veteran is in receipt of a noncompensable rating for shin splint of the right knee under Diagnostic Code 5262 (impairment of the tibia and fibula). The Board finds that a compensable rating is not warranted under Diagnostic Code 5262 under the old or revised rating criteria. The Veteran does not have nonunion (failure of fractured bone to unite) or, for that matter, malunion, of the tibia and fibula. Such has not been identified or demonstrated on any VA examination. Moreover, there is no evidence that the shin splint requires any treatment. Throughout the period on appeal, the VA examiners found that the Veteran experienced pain, weakness, fatigue, and lack of endurance bilaterally, but these factors were considered by the examiners when reporting the range of motion of each knee. Thus, a higher rating is not warranted for the right knee under the factors set forth in DeLuca. The Board also notes that the preponderance of the evidence does not reflect that the Veteran's right knee disability is manifest by ankylosis, dislocation of semilunar cartilage, symptomatic removal of the semilunar cartilage, or genu recurvatum. Therefore, Diagnostic Code 5256, 5258, 5259 and 5263 are not for application in this case. Accordingly, higher ratings for the Veteran's right knee disabilities are not warranted. 4. Entitlement to an initial rating higher than 10 percent for painful scar of the right knee The Veteran's right knee scars have been rated as noncompensable under Diagnostic Code 7802, with one painful scar rated as 10 percent disabling under Diagnostic Code 7804. These are residual scars from the Veteran's surgeries associated with his service-connected right knee patellofemoral knee syndrome with osteoarthritis. Under Diagnostic Code 7802, a 10 percent rating is assigned for scars that are superficial and nonlinear and cover an area or areas of 144 square inches (929 square centimeters) or greater. Under Diagnostic Code 7804, one or two scars that are unstable or painful warrant a 10 percent rating. Three or four scars that are unstable or painful warrant a 20 percent rating. Five or more scars that are unstable or painful warrant a 30 percent rating. 38 C.F.R. § 4.118. Note 1 to Diagnostic Code 7804 instructs that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Id. On VA scars examination in August 2018, the examiner noted that three scars on the right lower extremity were identified: a right knee distal vertical scar, measured as 3.0 x 0.7 cm; lateral right knee scar, measured as 0.5 x 0.1 c, and medial right knee scar, measured as 0.3 x 0.1 cm. The scars were superficial and non-linear. The approximate total area of the scars was 2.18 cm2. There was no underlying tissue damage. The scars did not result in limitation of function. There were no other findings, or complications associated with the scars. On VA scars examination in March 2020, the Veteran reported that he had a second ACL repair of the right knee and that the scar was painful when kneeling. The Veteran was noted to have one painful scar on his right lower extremity. The scar was not manifested by frequent loss of covering of skin. The scar was 7.5 x 0.7 cm. The scar was tender to palpation. The scar did not result in limitation of function. There were no other pertinent physical findings related to the scar. On VA scars examination in September 2021, the examiner noted that there were three scars. There was a scar on the right patella, which measured 7.5 x 1 cm. A scar on the right lower medial knee measured 2.5 cm by 0.5 cm. A scar on the right upper medial knee measured 1 cm x 0.25 cm. There was pain and tenderness on palpation of a right patella scar. None of the scars were unstable, with frequent loss of covering of skin over the scar. None of the scars had underlying tissue damage. Given the above, Veteran has one painful vertical scar on his right knee. The evidence show that he has more than one painful or unstable scar. Absent evidence showing three or four painful or unstable scars, a rating higher than 10 percent is not warranted under Diagnostic Code 7804. Moreover, the evidence shows that the Veteran's right knee scars do not cover areas of 144 square inches (929 sq. cm.), a compensable rating is not warranted rating is not warranted under Diagnostic Code 7802 for scars due to other causes that are not associated with underlying soft tissue damage. Accordingly, an initial rating higher than 10 percent for painful vertical scar of the right knee and a compensable rating for right knee scars is denied. (Continued on next page) As a final note, the Board acknowledges that the Veteran is in receipt of a fairly high combined disability rating. However, neither he nor his attorney has contended that the disabilities presently before the Board have precluded his ability to secure or follow a substantially gainful occupation. The Veteran's most recent VA examination for his psychiatric disorder reflects that he has held a number of jobs, but that he was currently working at the time of the examination. Under these circumstances, the Board does not find that the issue of entitlement to a TDIU has been contended by the Veteran or raised by the record. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Henriquez, 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.