Citation Nr: 21072293 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 14-21 124 DATE: December 2, 2021 ORDER An initial 20 percent rating for left lower extremity, sciatic nerve, from June 26, 2012 to October 4, 2018, is granted. An initial rating higher than 20 percent for left lower extremity, sciatic nerve, from October 5, 2018 to the present, is denied. An initial rating higher than 10 percent for right lower extremity, sciatic nerve, from June 26, 2012 to October 4, 2018, is denied. An initial rating higher than 20 percent for right lower extremity, sciatic nerve, from October 5, 2018 to the present, is denied. An initial rating higher than 20 percent for left lower extremity, femoral nerve, is denied. An initial rating higher than 20 percent for right lower extremity, femoral nerve, is denied. A rating higher than 10 percent for a thoracolumbar strain with thoracic arthritis, prior to July 2, 2013, to include extraschedular consideration, is denied. A rating higher than 20 percent for a thoracolumbar strain with thoracic arthritis, from July 2, 2013 to the present, to include extraschedular consideration, is denied. A total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is denied. FINDINGS OF FACT 1. From June 26, 2012 to October 4, 2018, symptoms of the Veteran's left lower extremity, sciatic nerve, manifested as moderate incomplete paralysis. 2. From October 5, 2018 to the present, symptoms of the Veteran's left lower extremity, sciatic nerve, manifested as, at worst, moderate incomplete paralysis. 3. From June 26, 2012 to October 4, 2018, symptoms of the Veteran's right lower extremity, sciatic nerve, manifested as, at worst, mild incomplete paralysis. 4. From October 5, 2018 to the present, symptoms of the Veteran's right lower extremity, sciatic nerve, manifested as, at worst, moderate incomplete paralysis. 5. The Veteran's bilateral lower extremity, femoral nerve, has manifested by, at worst, moderate incomplete paralysis. 6. Prior to July 2, 2013, the Veteran's low back disability has not manifested by forward flexion of the thoracolumbar spine greater than 30 degrees, but not greater than 60 degrees; combined range of motion of the thoracolumbar spine not greater than 120 degrees; or muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. 7. From July 2, 2013 to the present, the Veteran's low back disability has not manifested by ankylosis, limitation of flexion to 30 degrees or less, or incapacitating episodes requiring physician-ordered bed rest having a total duration of at least 4 weeks during a 12-month period. 8. The evidence does not demonstrate that the Veteran's service-connected disabilities rendered him unable to secure and follow a substantially gainful occupation. CONCLUSIONS OF LAW 1. From June 26, 2012 to October 4, 2018, the criteria for an initial 20 percent rating for left lower extremity, sciatic nerve, from have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.7, 4.10, 4.123, 4.124, 4.124a, Diagnostic Code (DC) 8520. 2. From October 5, 2018 to the present, the criteria for an initial rating higher than 20 percent for left lower extremity, sciatic nerve, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.7, 4.10, 4.123, 4.124, 4.124a, DC 8520. 3. From June 26, 2012 to October 4, 2018, the criteria for an initial rating higher than 10 percent for right lower extremity, sciatic nerve, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.7, 4.10, 4.123, 4.124, 4.124a, DC 8520. 4. From October 5, 2018 to the present, the criteria for an initial rating higher than 20 percent for right lower extremity, sciatic nerve, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.7, 4.10, 4.123, 4.124, 4.124a, DC 8520. 5. The criteria for initial ratings higher than 20 percent for bilateral lower extremity, femoral nerve, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.7, 4.10, 4.123, 4.124, 4.124a, DC 8526. 6. Prior to July 2, 2013, the criteria for a rating higher than 10 percent for a thoracolumbar strain with thoracic arthritis have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, DC 5242. 7. From July 2, 2013 to the present, the criteria for a rating higher than 20 percent for a thoracolumbar strain with thoracic arthritis have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, DC 5242. 8. The criteria for entitlement to a TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.314, 3.321, 3.340, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from September 1982 to August 1986. This matter was previously before the Board of Veterans' Appeals (Board) in May 2021 when the issues were remanded for further development. Further development having been completed; the matter is once again before the Board. After a review of the evidence, the Board has determined the following: An initial 20 percent rating for left lower extremity, sciatic nerve, from June 26, 2012 to October 4, 2018, will be granted because the evidence shows moderate incomplete paralysis of the extremity. A rating higher than 20 percent for left lower extremity, sciatic nerve, from October 5, 2018 to the present, will be denied because, at worst, the evidence shows moderate incomplete paralysis of the extremity. Ratings higher than 10 percent, from June 26, 2012 to October 4, 2018, and higher than 20 percent, from October 5, 2018 to the present, for right lower extremity, sciatic nerve, will denied because, at worst, the evidence shows mild and moderate incomplete paralysis of the extremity during the respective periods. Ratings higher than 20 percent for bilateral lower extremity, femoral nerve, will be denied because, at worst, the evidence shows moderate incomplete paralysis. Ratings higher than 10 percent for a thoracolumbar strain, to include extraschedular consideration, prior to July 2, 2013, and higher than 20 percent, from July 2, 2013 to the present, will be denied because the evidence does not show that higher ratings are warranted for either period. A TDIU will be denied because the evidence does not show that the Veteran's service-connected disabilities rendered him unable to secure and follow a substantially gainful occupation. Increased Ratings Disability evaluations are determined by the application of a schedule of ratings which is based, as far as can practically be determined, on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Each service-connected disability is rated on the basis of specific criteria identified by DCs. 38 C.F.R. § 4.27. When rating the Veteran's service-connected disability, the entire medical history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). A claimant may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505 (2007). Regulations require that where there is a question as to which of two evaluations is to 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 rating disabilities of the musculoskeletal system, 38 C.F.R. § 4.40 allows for consideration of functional loss due to pain and weakness causing additional disability beyond that reflected on range of motion measurements. DeLuca v. Brown, 8 Vet. App. 202 (1995). Further, 38 C.F.R. § 4.45 provides that consideration also be given to decreased movement, weakened movement, excess fatigability, incoordination, and pain on movement, swelling, and deformity or atrophy of disuse. Painful motion is considered limited motion at the point that pain sets in. See VAOPGCPREC 9-98. With any form of arthritis, painful motion is an important factor of disability, the facial expression, wincing, etc., on pressure or manipulation, should be carefully noted and definitely related to affected joints. Muscle spasm will greatly assist the identification. Sciatic neuritis is not uncommonly caused by arthritis of the spine. The intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. Crepitation either in the soft tissues such as the tendons or ligaments, or crepitation within the joint structures should be noted carefully as points of contact which are diseased. Flexion elicits such manifestations. The joints involved should be tested for pain on both active and passive motion, in weight-bearing and non-weight-bearing and, if possible, with the range of the opposite undamaged joint. 38 C.F.R. § 4.59. Additionally, painful motion is an important factor of disability, and joints that are actually painful, unstable, or malaligned, due to healed injury, should be entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. Where a claimant has a full range of motion with pain, or a noncompensable limitation of motion that is accompanied by pain, a 10 percent rating may be appropriate. See Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). Painful motion should be considered to determine whether a higher rating is warranted on such basis, whether or not arthritis is present. See Burton, 25 Vet. App. at 5. After the evidence has been assembled, it is the Board's responsibility to evaluate the entire record. 38 U.S.C. § 7104(a). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. A VA claimant need only demonstrate that there is an approximate balance of positive and negative evidence in order to prevail. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert at 54. 1. An initial 20 percent rating for left lower extremity, sciatic nerve, from June 26, 2012 to October 4, 2018, is granted. 2. An initial rating higher than 20 percent for left lower extremity, sciatic nerve, from October 5, 2018 to the present, is denied. 3. An initial rating higher than 10 percent for right lower extremity, sciatic nerve, from June 26, 2012 to October 4, 2018, is denied. 4. An initial rating higher than 20 percent for right lower extremity, sciatic nerve, from October 5, 2018 to the present, is denied. The Veteran's bilateral lower extremity, sciatic nerve, has been rated as 10 percent disabling, from June 26, 2012 to October 4, 2018, and as 20 percent disabling, from October 5, 2018 to the present, under DC 8520. For the following reasons, an initial 20 percent rating for left lower extremity, sciatic nerve, from June 26, 2012 to October 4, 2018, is granted; a rating higher than 20 percent for left lower extremity, sciatic nerve, from October 5, 2018 to the present, is denied; and ratings higher than 10 percent, from June 26, 2012 to October 4, 2018, and higher than 20 percent, from October 5, 2018 to the present, for right lower extremity, sciatic nerve, are denied. DC 8520 provides ratings for paralysis of the sciatic nerve. DC 8520 provides a 10 percent rating for mild incomplete paralysis; a 20 percent rating for moderate incomplete paralysis; and a 40 percent rating for moderately severe incomplete paralysis. A 60 percent rating is warranted for severe incomplete paralysis with marked muscular atrophy. An 80 percent rating is warranted for complete paralysis. See 38 C.F.R. § 4.124a, DC 8520. The terms "mild," "moderate," and "severe" are not defined in the rating schedule. Rather than applying a mechanical formula, the Board must evaluate all the evidence to arrive at a just and equitable decision. Additionally, the use of such terminology by VA examiners and others, although an element to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. Disability ratings for neurological conditions are ordinarily assigned based on impairment of motor, sensory, or mental function. See 38 C.F.R. § 4.124a. In evaluating peripheral nerve injuries, VA considers the site and character of the injury, the relative impairment in motor function, trophic (external) changes, or senses. VA gives special consideration to complete or partial loss of use of one or more extremities and disturbances of gait. The August 2012 VA back examination shows that the Veteran experienced mild intermittent pain to the right lower extremity and moderate intermittent pain to the left, no paresthesias or dysesthesias to the right lower extremity and moderate paresthesias to the left, no numbness to the right lower extremity and moderate numbness to the left. Right lower extremity sciatic nerve radiculopathy was mild in severity and moderate in the left. Muscle strength was normal bilaterally with no evidence of atrophy. Reflexes and sensation to light touch were normal. The use of assistive devices was denied. The examiner noted that the symptoms of radiculopathy are subjective only. The July 2013 VA back examination shows that the Veteran experienced no constant or intermittent pain to the right lower extremity and no constant pain, but moderate intermittent pain to the left, no paresthesias or dysesthesias to the right lower extremity and mild paresthesias to the left, and no numbness bilaterally. No radiculopathy of the right lower extremity was indicated. However, left lower extremity sciatic nerve radiculopathy was mild in severity. Muscle strength was normal bilaterally with no evidence of atrophy. Reflexes and sensation to light touch were normal. The use of assistive devices was denied. The July 2013 VA peripheral neuropathy examination shows that the Veteran does not have a peripheral nerve condition or peripheral neuropathy and does not have any symptoms attributable to any peripheral nerve condition. No trophic changes were noted, and gait was normal. The results of all nerve tests were normal. The examiner noted that the Veteran has mild left leg sciatica with a normal sensory and motor examination. An April 2016 VA electrodiagnostic study shows normal results with no evidence of left lumbosacral radiculopathy, left peroneal neuropathy at the fibular head, or large fiber neuropathy. The September 2017 VA back examination shows that the Veteran experienced mild intermittent pain to the right lower extremity and moderate intermittent pain to the left, no paresthesias or dysesthesias to the right lower extremity, moderate paresthesias to the left, and no numbness bilaterally. The right lower extremity sciatic nerve was mild in severity and moderate in the left. Muscle strength was normal bilaterally with no evidence of atrophy. Reflexes and sensation to light touch were normal. The use of assistive devices was denied. A May 2018 VA electrodiagnostic study shows normal results with no evidence of bilateral lumbosacral radiculopathy or large fiber neuropathy. The October 2018 VA back examination shows that the Veteran experienced no constant or intermittent pain to the right lower extremity, mild constant, and intermittent pain to the left lower extremity, no paresthesias and/or dysesthesias bilaterally, no numbness to the right lower extremity, and mild numbness to the left. Radicular pain with constant numbness and tingling to the bilateral lower extremity was noted. The right lower extremity sciatic nerve was not affected, and the left lower extremity sciatic nerve radiculopathy was mild in severity. Muscle strength was four out of five on all areas tested bilaterally, without evidence of atrophy. Reflexes and sensation to light touch were normal. The use of assistive devices was denied. The October 2018 VA peripheral neuropathy examination shows that the Veteran experienced no constant pain to the right lower extremity but had moderate intermittent pain to the extremity. He experienced moderate constant and intermittent pain to the left lower extremity. No paresthesias or dysesthesias was noted bilaterally. Mild numbness was noted to the right lower extremity and moderate numbness was noted to the left. Muscle strength was normal bilaterally, but for decreased strength measured as four out of five on bilateral knee extension, with no evidence of atrophy. Reflexes were hyperactive without clonus at the bilateral knee and ankle. Sensation to light touch was normal. No trophic changes were noted, and gait was normal. The Veteran's bilateral sciatic nerve was noted as normal. The use of assistive devices was denied. The July 2021 VA peripheral neuropathy examination shows that the Veteran experienced no constant pain to the bilateral lower extremity, mild intermittent pain to the right lower extremity and moderate to the left, mild paresthesias or dysesthesias to the right lower extremity and moderate to the left, and mild numbness to the right lower extremity and moderate to the left. Muscle strength was normal bilaterally, with no evidence of atrophy. Reflexes and sensation to light touch were normal. No trophic changes were noted, and gait was normal. The examiner noted mild incomplete paralysis of the sciatic nerve bilaterally. The use of assistive devices was denied. In terms of functional impact, the Veteran reported that his sciatic pain and numbness causes him to fall three to four times per month. The July 2021 VA back examination shows that the Veteran experienced no constant pain to the bilateral lower extremity but had mild intermittent pain to the right lower extremity and moderate intermittent pain to the left, mild paresthesias and/or dysesthesias to the right lower extremity and moderate paresthesias and/or dysesthesias to the left, mild numbness to the right lower extremity and moderate to the left. The examiner noted radicular pain with involvement of the bilateral lower extremity sciatic nerve root. Muscle strength was five out of five on all areas tested bilaterally, without evidence of atrophy. Reflexes and sensation to light touch were normal. The use of assistive devices was denied. For the period from June 26, 2102 to October 4, 2018, a higher, 20 percent rating, is warranted for the Veteran's left lower extremity, sciatic nerve, because the evidence demonstrates moderate incomplete paralysis of the extremity. See 38 C.F.R. § 4.124a, DC 8520. However, for the period from October 5, 2018 to the present, the preponderance of the evidence is against a rating higher than 20 percent because the Veteran has not had moderately severe incomplete paralysis, severe incomplete paralysis with marked muscular atrophy, or complete paralysis of the extremity. Id. For the period from June 26, 2102 to October 4, 2018, the preponderance of the evidence is against a higher, 20 percent rating, for the Veteran's right lower extremity, sciatic nerve, because the Veteran has not had moderate incomplete paralysis, moderately severe incomplete paralysis, severe incomplete paralysis with marked muscular atrophy, or complete paralysis of the extremity. Id. From October 5, 2018 to the present, the preponderance of the evidence is against a rating higher than 20 percent because the Veteran has not had moderately severe incomplete paralysis, severe incomplete paralysis with marked muscular atrophy, or complete paralysis of the extremity. Id. In conclusion, for the period from June 26, 2102 to October 4, 2018, a higher, 20 percent rating, is warranted for the Veteran's left lower extremity, sciatic nerve, and the claim is granted to that extent. However, the preponderance of the evidence is against ratings higher than 20 percent for left lower extremity, sciatic nerve, from October 5, 2018 to the present, higher than 10 percent for right lower extremity, sciatic nerve, from June 26, 2012 to October 4, 2018, and higher than 20 percent for right lower extremity, sciatic nerve, from October 5, 2018 to the present, and to this extent, the claims are denied. To the extent that the claims have been denied, the benefit-of-the-doubt doctrine is inapplicable. 38 C.F.R. § 4.3. 5. An initial rating higher than 20 percent for left lower extremity, femoral nerve, is denied. 6. An initial rating higher than 20 percent for right lower extremity, femoral nerve, is denied. The Veteran's bilateral lower extremity, femoral nerve, has been rated as 20 percent disabling, from October 5, 2018 to the present, under DC 8526. For the following reasons, higher ratings are not warranted, and the claims are denied. DC 8526 provides ratings for paralysis of the femoral nerve. DC 8526 provides a 10 percent rating for mild incomplete paralysis; a 20 percent rating for moderate incomplete paralysis; and a 30 percent rating for severe incomplete paralysis. A 60 percent rating is warranted for complete paralysis of quadriceps extensor muscles. See 38 C.F.R. § 4.124a, DC 8526. As noted above, the terms "mild," "moderate," and "severe" are not defined in the rating schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to arrive at a just and equitable decision. Additionally, the use of such terminology by VA examiners and others, although an element to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. The August 2012 VA back examination shows that the Veteran experienced radiculopathy with involvement of the sciatic nerve roots. Involvement of the femoral nerve roots was not indicated. The July 2013 VA back examination shows that the Veteran experienced left lower extremity radiculopathy with involvement of the sciatic nerve root. Involvement of the femoral nerve root was not indicated. As noted above, the July 2013 VA peripheral neuropathy examination shows that the Veteran does not have a peripheral nerve condition or peripheral neuropathy and does not have any symptoms attributable to any peripheral nerve condition. No trophic changes were noted, and gait was normal. The results of all nerve tests were normal. As noted above, the April 2016 VA electrodiagnostic study shows normal results with no evidence of left lumbosacral radiculopathy, left peroneal neuropathy at the fibular head, or large fiber neuropathy. The September 2017 VA back examination shows that the Veteran experienced radiculopathy with involvement of the sciatic nerve roots. Involvement of the femoral nerve roots was not indicated. As noted above, the May 2018 VA electrodiagnostic study shows normal results with no evidence of bilateral lumbosacral radiculopathy or large fiber neuropathy. The October 2018 VA back examination shows that the Veteran experienced no constant or intermittent pain to the right lower extremity, mild constant, and intermittent pain to the left, no paresthesias and/or dysesthesias bilaterally, no numbness to the right lower extremity, and mild numbness to the left. Radicular pain with constant numbness and tingling to the bilateral lower extremity was noted. Involvement of the bilateral femoral nerve roots was indicated, with the right lower extremity femoral nerve not affected and the left was mild in severity. Muscle strength was four out of five on all areas tested bilaterally, without evidence of atrophy. Reflexes and sensation to light touch were normal. The use of assistive devices was denied. The October 2018 VA peripheral neuropathy examination shows that the Veteran experienced no constant pain to the right lower extremity but had moderate intermittent pain to the extremity. He experienced moderate constant and intermittent pain to the left lower extremity. No paresthesias or dysesthesias was noted bilaterally. Mild numbness was noted to the right lower extremity and moderate numbness was noted to the left. Muscle strength was normal bilaterally, but for decreased strength measured as four out of five on bilateral knee extension, with no evidence of atrophy. Reflexes were hyperactive without clonus at the bilateral knee and ankle. Sensation to light touch was normal. No trophic changes were noted, and gait was normal. The Veteran's bilateral femoral nerve was noted as normal. The use of assistive devices was denied. The July 2021 VA peripheral neuropathy examination shows that the Veteran experienced no constant pain to the bilateral lower extremity, mild intermittent pain to the right lower extremity and moderate to the left, mild paresthesias or dysesthesias to the right lower extremity and moderate to the left, and mild numbness to the right lower extremity and moderate to the left. Muscle strength was normal bilaterally, with no evidence of atrophy. Reflexes and sensation to light touch were normal. No trophic changes were noted, and gait was normal. The examiner noted mild incomplete paralysis of the right femoral nerve and moderate incomplete paralysis of the left. The use of assistive devices was denied. The July 2021 VA back examination shows that the Veteran experienced no constant pain to the bilateral lower extremity but had mild intermittent pain to the right lower extremity and moderate intermittent pain to the left, mild paresthesias and/or dysesthesias to the right lower extremity and moderate paresthesias and/or dysesthesias to the left, mild numbness to the right lower extremity and moderate to the left. The examiner noted radicular pain with involvement of the bilateral lower extremity femoral nerve root. Muscle strength was five out of five on all areas tested bilaterally, without evidence of atrophy. Reflexes and sensation to light touch were normal. The use of assistive devices was denied. As noted above, prior to October 5, 2018, the evidence does not show bilateral lower extremity peripheral neuropathy with involvement of the femoral nerve root. From October 5, 2018 to the present, the preponderance of the evidence is against a rating higher than 20 percent because the Veteran has not had severe incomplete paralysis or complete paralysis of quadriceps extensor muscles of the right or left lower extremity. See 38 C.F.R. § 4.124a, DC 8526. In conclusion, the preponderance of the evidence is against ratings higher than 20 percent, from October 5, 2018 to the present, for the Veteran's bilateral lower extremity, femoral nerve. As such, the benefit-of-the-doubt doctrine is inapplicable. 38 C.F.R. § 4.3. For these reasons, the claims are denied. 7. A rating higher than 10 percent for a thoracolumbar strain with thoracic arthritis, prior to July 2, 2013, to include extraschedular consideration, is denied. 8. A rating higher than 20 percent for a thoracolumbar strain with thoracic arthritis, from July 2, 2013 to the present, to include extraschedular consideration, is denied. The Veteran contends that his service-connected lumbar spine disability, currently evaluated at 10 percent disabling, prior to July 2, 2013, and at 20 percent, from July 2, 2013 to the present, warrants higher ratings. For the following reasons, higher ratings are not warranted at any time during the period on appeal, and the claim is denied. Disabilities of the spine are rated under the General Rating Formula for Diseases and Injuries of the Spine (DCs 5235 to 5243) (General Rating Formula), or under the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes (DC 5243) (IVDS Rating Formula), whichever method results in the higher rating when all disabilities are combined under 38 C.F.R. § 4.25(2017). 38 C.F.R. § 4.71a. Ratings under the General Rating Formula are made with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease. Under the General Rating Formula, a 10 percent disability rating is assigned for forward flexion of the thoracolumbar spine greater than 60 degrees, but not greater than 85 degrees; forward flexion of the cervical spine greater than 30 degrees, but not greater than 40 degrees; combined range of motion of the thoracolumbar spine greater than 120 degrees, but not greater than 235 degrees; muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. Id. A 20 percent disability rating is assigned for forward flexion of the thoracolumbar spine greater than 30 degrees, but not greater than 60 degrees; forward flexion of the cervical spine greater than 15 degrees, but not greater than 30 degrees; combined range of motion of the thoracolumbar spine not greater than 120 degrees; or muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. Id. A 40 percent disability rating is assigned for forward flexion of the thoracolumbar spine at 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. A 50 percent disability rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent disability rating is assigned for unfavorable ankylosis of the entire spine. Id. Note 2: (See also Plate V) For VA compensation purposes, normal forward flexion of the thoracolumbar spine is zero to 90 degrees; extension is zero to 30 degrees; left and right lateral flexion are zero to 30 degrees; and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of the spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. Id. Under DC 5243 (Intervertebral Disc Syndrome), a 10 percent disability rating is assigned with incapacitating episodes having a total duration of at least 1 weeks but less than 2 weeks during the past 12 months; a 20 percent disability rating is assigned with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months; a 40 percent disability rating is assigned with incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months; and a maximum 60 percent disability rating is assigned with incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. Id. During the August 2012 VA back examination, the Veteran reported flare-ups which cause increased, constant pain, in the mid and lower back, with a frequency of every few days, cause occasional numbness, tingling, and weakness, which limit his range of motion (ROM). Initial ROM measurements were recorded as the following: forward flexion to 75 degrees, with pain at 0 degrees; extension to 25 degrees, with pain at 0 degrees; right lateral flexion to 20 degrees, with pain at 0 degrees; left lateral flexion to 10 degrees, with pain at 0 degrees; right lateral rotation to 30 degrees or greater, with pain at 0 degrees; and left lateral rotation to 20 degrees, with pain at 0 degrees. Results of ROM after repetitive-use mirrored those of the initial testing. However, the Veteran had functional loss/impairment in the form of less movement than normal, weakened movement, excess fatigability, and pain on movement. The Veteran also had localized tenderness or pain to palpation for joints and/or soft tissue of the thoracolumbar spine, which manifested in the over the lumbar spine. Guarding or muscle spasm was denied. Muscle strength was normal without evidence of atrophy. Reflexes and sensation to light touch were normal. Results of the straight leg raising test were normal. The use of assistive devices was denied. In terms of functional impact, the examiner noted that the Veteran has chronic pain in the upper and lower back with decreased ROM and has difficulty carrying and lifting heavy objects. During the July 2013 VA back examination, the Veteran reported daily pain, described as seven out of ten in severity. He reported flare-ups, occurring four to five times monthly, with an average duration of two to twelve hours. He reported that when flare-ups occur, he cannot do anything. He reported that he can stand for a few minutes and can lift about 30 pounds. He reported that he is unable to ascend or descend a ladder. He reported that he can sit for 30 minutes, with frequent changes in position, and that he can walk about four to five minutes. Initial ROM measurements were recorded as the following: forward flexion to 70 degrees, with pain at 50 degrees; extension to 20 degrees, with pain at 20 degrees; right and left lateral flexion to 25 degrees, with pain at 25 degrees; right and left lateral rotation to 30 degrees or greater, with pain at 30 degrees or greater. Results of ROM after repetitive-use mirrored those of the initial testing, but for forward flexion, which was recorded as limited to 50 degrees. The Veteran had functional loss/impairment in the form of less movement than normal, excess fatigability, incoordination, interference with sitting, standing and/or weight-bearing, and pain on movement. Localized tenderness or pain to palpation and guarding or muscle spasm were denied. Muscle strength was normal without evidence of atrophy. Reflexes and sensation to light touch were normal. Results of the straight leg raising test were negative for the right leg and positive for the left leg. In terms of functional impact, the examiner noted that the Veteran has chronic pain in the mid and lower back that impacts his ability to work. The examiner noted that, due to diminished concentration and errors made, the Veteran was terminated from his warehouse job in March 2013. The use of assistive devices was denied. A June 2015 VA treatment record shows that the Veteran presented with severe low back pain and spasms. Sharp radiating pain to the thighs was reported. No bladder or bowel issues were indicated. Another June 2015 VA treatment record shows that the Veteran presented three days prior to the emergency department with an acute exacerbation of lower back pain when he was unable to move. An October 2015 VA emergency department note shows that the Veteran was evaluated for pain with a severity of nine out of ten. The record shows that the Veteran had back stiffness at discharge and was able to ambulate with the help of his son and spouse. A November 2015 VA treatment record shows that the Veteran reported back pain of up to nine out of ten in severity. No bladder or bowel symptoms were reported. An April 2016 VA electrodiagnostic study shows normal results with no evidence of left lumbosacral radiculopathy, left peroneal neuropathy at the fibular head, or large fiber neuropathy. A June 2016 VA treatment record shows that the Veteran reported that his back pain has worsened over the past few weeks. A July 2016 VA treatment record shows that the Veteran reported a flare-up of his lower back and requested an increase in his prescription for Oxycodone. During the September 2017 VA back examination, the Veteran reported that pushing, pulling, and lifting worsens his back pain. He also reported that his pain worsens when sitting or standing for more than 20 minutes without moving. He reported that driving causes his pain to worsen. Initial ROM measurements were recorded as the following: forward flexion to 80 degrees, extension to 25 degrees, right and left lateral flexion to 30 degrees, and right and left lateral rotation to 30 degrees. Pain was noted on forward flexion and bilateral flexion, without functional loss. Observed repetitive use testing was conducted, without any additional loss of function or ROM. Repeated use over time testing was not conducted. The examiner noted that pain, weakness, fatigability, or incoordination does not significantly limit functional ability with repeated use over a period of time. Guarding or muscle spasm was denied. No additional contributing factors of the disability were noted. Muscle strength was normal without evidence of atrophy. Reflexes and sensation to light touch were normal. Results of the straight leg raising test were negative. Ankylosis was denied. The examiner noted that the Veteran has IVDS, but without episodes requiring bedrest. The use of assistive devices was denied. In terms of functional impact, the examiner noted that the Veteran will need accommodations at work such that he can sit and get up to stretch intermittently. The Veteran cannot perform jobs that involve repetitive bending, reaching, or twisting from side to side. He cannot lift for than 20 pounds and climbing stairs must be limited. The examiner noted that passive ROM testing could not be performed in a safe and reasonable manner. The examiner noted that there is no objective evidence of pain when in a non-weightbearing position. A December 2017 VA emergency department note shows that the Veteran presented with acute back spasm, radiating to his left lower extremity. He reported a recent soft fall due to spasm and that he was able to catch himself. The spasms were described as a very uncomfortable, palpable, paraspinal lumbar spasm that is very tender over the lower lumbar area. Weak dorsiflexion was noted to the left lower extremity. The Veteran was administered Toradol and Flexeril. His symptoms were noted as much improved before he was discharged. An April 2018 VA emergency department noted shows that the Veteran presented with a flare-up of chronic back pain. He reported that steroid shots have helped his condition in the past. He reported pain to the left lower extremity. Now bowel or bladder symptoms were noted. A May 2018 VA electrodiagnostic study shows normal results with no evidence of bilateral lumbosacral radiculopathy or large fiber neuropathy. A May 2018 VA neurosurgery consultation report shows pain at the midline lumbosacral junction with radiation in every direction, most consistent in the left lower extremity from thigh to knee. Numbness and tingling were noted in the bilateral buttocks to leg. Pain, at worst, was reported as nine out of ten, and, at best, four out of ten. No bowel or bladder changes were noted. The examiner noted five out of five myotomes of the bilateral lower extremities, except as limited by pain. The straight leg raising test was negative bilaterally, sitting and supine. Low back ROM was noted as guarded, but only mildly limited by pain in all planes. The Veteran's gait was wide and antalgic, and he was unable to toe, or heel walk due to back pain. Calf raises were limited by back pain, but he was able to complete five bilaterally. He had full ROM at the bilateral hip without pain at the end of range bilaterally. Reflexes of the bilateral knee and ankle were hyperactive without clonus. A September 2018 VA emergency department note shows that the Veteran presented with chest pain and arm numbness. He also reported that he has been stressed and has had head, neck, and back pain with shortness of breath. He arrived in a wheelchair. During the October 2018 VA back examination, the Veteran reported flare-ups that cause his pain to increase from eight out of ten to ten out of ten. When this occurs, he reported that he is unable to walk without help, and he visits the emergency room. He reported that his last emergency room visit was in the summer of 2018. He reported that the typical frequency of his flare-ups is daily, and that every three months they cause him to visit the emergency room. The typical severity of a flare-up was reported as eight to ten out of ten, with a typical duration of three to seven days. Functional loss/impairment was described as worsening pain, traveling into the bilateral lower extremities, inability to sit for extended periods, inability to sleep, difficulty with bending, inability to walk or function, and increased spasms, which cause his knees to buckle, resulting in increased risk of falling. Initial ROM measurements were recorded as the following: forward flexion to 45 degrees, extension to 15 degrees, right lateral flexion to 20 degrees, left lateral flexion to 15 degrees, and bilateral rotation to 25 degrees. Pain was noted on rest/non-movement. The examiner noted that when the Veteran performs lumbar flexion, he is in acute and severe pain and must slowly return to the upright position, and that the Veteran expressed pain with grimacing and guarded motion. There was objective evidence of localized tenderness or pain on palpation in the lower thoracic and lumbar spine, with a severity of six out of ten. The examiner also noted evidence of pain with weight bearing. The Veteran was unable to perform repetitive use testing for fear of pain. The Veteran was not examined immediately after repetitive use over time or during a flare-up. The examiner was unable to describe any additional limitation of ROM without resorting to mere speculation. The Veteran had guarding or muscle spasm not resulting in abnormal gait or spinal contour. Muscle strength was recorded as four out of five on all areas tested. Muscle atrophy was denied. Reflexes and sensation to light touch were normal. Results of the straight leg raising test were positive. Ankylosis was denied. The examiner noted that the Veteran has IVDS, but without episodes requiring bedrest. The use of assistive devices was denied. In terms of functional impact, the examiner noted that the Veteran has missed up to one week of work time in the last 12 months. The examiner noted that back pain, spasm, and decreased strength and ROM limit the Veteran's ability to lift crates, boxes, and stand for extended periods of time. The Veteran reported that he is the only person at the warehouse, and he cannot miss work. He reported that he needs the income and cannot afford to lose his job. The Veteran reported that, even with flare-ups, he uses medication, goes to work, and takes it easy. He reported that he has looked for less physically demanding work but has been unable to find such employment. An April 2019 VA MRI without contrast revealed the following: current mild to moderate foraminal narrowing at L3/L4, and mild at L4/SI. The examiner noted that these results differ from a previous description of moderate to severe foraminal narrowing at L3/L4, and L5/SI. The MRI was revealed current mild left lateral recess narrowing with L5 nerve encroachment at L4/S1. An October 2020 VA MRI without contrast revealed a posterior disc bulge at L4/SI with small annular tear appearing, like the prior examination. The L4/SI area was noted as unchanged compared to the earlier study. At L3/L4, L2/L3, L1/L2, and T12/LI there was no evidence of disc bulge and neural foraminal was noted a patent. The examiner noted that the conus terminates normally at mid-LI. During the January 2021 VA back addendum examination, the examiner noted that the Veteran was not examined immediately after repetitive use over time. However, pain was noted to significantly limit functional ability with repeated use over a period of time. The examiner described the additional limitation of ROM as the following: forward flexion to 40 degrees, extension to 10 degrees, right lateral flexion to 15 degrees, left lateral flexion to 10 degrees, and bilateral rotation to 20 degrees. The examination was not conducted during a flare-up. However, pain was noted to significantly limit functional ability with flare-ups. The examiner described the additional limitation of ROM as the following: forward flexion to 35 degrees, extension to 5 degrees, right lateral flexion to 10 degrees, left lateral flexion to 5 degrees, and bilateral rotation to 15 degrees. During the July 2021 VA back examination, the Veteran did not report flare-ups. However, he reported functional loss/impairment, described as pain with bending, lifting, standing, sitting, and walking for extended periods of time. He reported daily back pain, with intermittent sciatic pain. He reported that sciatic pain causes numbness and pain, which causes him to fall. Initial ROM measurements were recorded as the following: forward flexion to 55 degrees, extension to 20 degrees, right lateral flexion to 25 degrees, left lateral flexion to 15 degrees, right lateral rotation to 25 degrees, and left lateral rotation to 15 degrees. ROM itself was noted not to cause a functional loss. However, pain was noted on all movements. Passive ROM testing was not conducted to prevent further injury. Pain was noted to cause functional loss on active motion. No evidence of crepitus or localized tenderness or pain on palpation was noted. Observed repetitive use testing revealed no additional loss of function or ROM. The Veteran was not examined immediately after repeated use over time. However, the examiner noted that pain significantly limits functional ability with repeated use over time. Estimated ROM on repeated use over time was described as follows: forward flexion to 45 degrees, extension to 15 degrees, right lateral flexion to 20 degrees, left lateral flexion to 10 degrees, right lateral rotation to 20 degrees, and left lateral rotation to 10 degrees. The Veteran was not examined during a flare-up, and the examiner noted that the procured evidence does not suggest that the Veteran's functional ability is significantly limited with flare-ups. Instead, the Veteran specifically denied flare-ups. Muscle spasm and guarding were also specifically denied. No additional contributing factors were noted. Muscle strength was normal, five out of five, on all areas tested. Muscle atrophy was denied. Reflexes and sensation to light touch were normal. Results of the straight leg raising test were negative. Ankylosis was denied. The examiner noted that the Veteran does not have IVDS. The use of assistive devices was denied. In terms of functional impact, the examiner noted that the Veteran has pain with bending, lifting, standing, sitting, and walking for extended periods. Prior to July 2, 2013, the symptomatology and functional impairment of the spine disability has not approximated the criteria for a higher, 20 percent rating, that is, forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, a combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis; or, incapacitating episodes having a total duration of at least two weeks but less than four weeks during a 12-month period. 38 C.F.R. § 4.71a, DCs 5242, 5243. Prior to July 2, 2013, as discussed above, the weight of the evidence shows that the thoracolumbar spine disability has not manifested as muscle spasms or guarding resulting in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis during the relevant rating period. The lumbosacral spine disorder also has not manifested as a limitation of motion contemplated by a higher 20 percent rating, as the thoracolumbar spine evidenced forward flexion to 75 degrees; extension to 25 degrees; right lateral flexion to 20 degrees; left lateral flexion to 10 degrees; right lateral rotation to 30 degrees or greater; and left lateral rotation to 20 degrees; for a combined range of motion of 180 degrees. Prior to July 2, 2013, the Veteran's current 10 percent rating contemplates additional painful motion. See 38 C.F.R. § 4.71a. For these reasons, the preponderance of the evidence weighs against a finding that the thoracolumbar spine disability more closely approximates the next higher, 20 percent rating, under the General Rating Formula, prior to July 2, 2013. See 38 C.F.R. §§ 4.3, 4.7, 4.40, 4.45, 4.59; DeLuca, at 206-07. Prior to July 2, 2013, a higher, 20 percent rating, is not warranted under the IVDS Rating Formula, as the weight the of the evidence does not show that the Veteran's had IVDS during the period. 38 C.F.R. §§ 4.3, 4.7, 4.71a, IVDS Formula. Therefore, prior to July 2, 2013, a 20 percent rating is not warranted for the Veteran's service-connected lumbar spine disability, and the claim is denied. During the period from July 2, 2013 to the present, the symptoms and functional impairment of the thoracolumbar spine disability has not approximated forward flexion of the thoracolumbar spine 30 degrees or less; favorable ankylosis of the entire thoracolumbar spine; or incapacitating episodes having a total duration of at least four weeks but less than six weeks during any 12-month period, as required for a higher, 40 percent rating. 38 C.F.R. § 4.71a, DCs 5242, 5243. From July 2, 2013 to the present, the evidence shows that, even when considering the potential for additional functional loss during episodes of flare ups and severe pain as a basis for a higher rating, given evidence of forward flexion no less than 35 degrees and motion to no less than 10 degrees in all other directions, forward flexion 30 degrees or less and favorable ankylosis of the entire thoracolumbar spine is not evidenced. For these reasons, the preponderance of the evidence weighs against a finding that the thoracolumbar spine disability more closely approximates the next higher, 40 percent rating, under the General Rating Formula at any time during the rating period from July 2, 2013 to the present. See 38 C.F.R. §§ 4.3, 4.7, 4.40, 4.45, 4.59; DeLuca, at 206-07. From July 2, 2013 to the present, a higher, 40 percent rating, is not warranted under the IVDS Rating Formula, as the weight the of the evidence does not show that the Veteran's IVDS caused incapacitating episodes having a total duration of at least four weeks but less than six weeks during any 12-month period. 38 C.F.R. §§ 4.3, 4.7, 4.71a, IVDS Formula. Therefore, for the period from July 2, 2013 to the present, a higher, 40 percent rating, is not warranted for the Veteran's service-connected lumbar spine disability, and the claim is denied. In a November 2020 Memorandum, the Director of C&P Service considered the issue of entitlement to an extra-scheduler rating for the Veteran's thoracolumbar strain in accordance with 38 C.F.R. § 3.321(b). The Director noted that extra-scheduler evaluations are assigned in cases where an exceptional or unusual picture is presented with such related factors as marked interference with employment or frequent periods of hospitalization that renders application of the regular rating scheduler standards impracticable. The Director of Compensation and Pension found that the record, when considering the totality of the evidence, does not support criteria for entitlement to an extra-scheduler evaluation for the thoracolumbar strain. The Director of C&P also found that the evidence does not provide an exceptional picture that renders the application of scheduler standards impractical. Therefore, it was determined that entitlement to an extra-scheduler evaluation was not warranted. Because the appropriate first line authority has adjudicated entitlement to an extra-scheduler rating, the Board may now consider the issue. The threshold question is whether the rating criteria adequately contemplate the Veteran's disability. For the reasons set forth below, the Board ultimately finds that an extra-scheduler rating is not warranted for the Veteran's service-connected thoracolumbar strain. As explained previously, in discussing whether an extraschedular rating is warranted there must be a finding whether that the disability picture is not adequately contemplated by the rating schedule. Throughout the period on appeal, the evidence shows that the Veteran's disability picture was adequately, and appropriately, contemplated by the applicable scheduler rating criteria. See Thun v. Peake, 22 Vet. App. 111, 115 (2008). As discussed above, the Veteran's spine disability, currently evaluated at 10 percent disabling, prior to July 2, 2013, and at 20 percent, from July 2, 2013 to the present, is rated under DC 5242. The first Thun element is not satisfied here. The Veteran's thoracolumbar strain is manifested by pain and limitation of motion. These signs and symptoms and their resulting impairment are specifically contemplated by the rating schedule as part of the rating schedule. See 38 C.F.R. § 4.71a, DC 5242. The Board has thoroughly considered the Veteran's contentions. However, the Board concludes that the schedular rating criteria reasonably describes the Veteran's disability picture. The evidence demonstrates that the Veteran's disability has resulted in pain and limitation of motion. However, he has been able to maintain his employment throughout the entire period on appeal. In short, the Board finds there is nothing exceptional or unusual about the Veteran's thoracolumbar strain because the rating criteria describe his disability level and symptomology. The Board has considered the Veteran's general contentions however an extraschedular rating is not warranted. Because the scheduler criteria adequately contemplated the Veteran's level of disability and symptomatology of his thoracolumbar strain; the threshold for an extra-scheduler rating were not met and the second step of the inquiry need not be addressed. See also, Urban v. Shulkin, No. 15-3744 (Vet. App. Sep. 18, 2017). As such, ratings higher than 10 percent, prior to July 2, 2013, and higher than 20 percent, from July 2, 2013 to the present, on an extra-scheduler basis is not warranted 9. A TDIU is denied. The Veteran contends that a TDIU is warranted due to his service-connected disabilities. The Veteran meets the schedular criteria for a TDIU from June 26, 2012. As such, the following analysis will focus on the period from June 26, 2012 to the present. For the following reasons, a TDIU is not warranted, and the claim is denied. Schedular TDIU may be assigned when the disabled person is determined to be unable to secure or follow a substantially gainful occupation as a result of service-connected disability or disabilities, provided that, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. See 38 C.F.R. § 4.16(a). Disabilities resulting from common etiology or a single accident are considered one disability for the purpose of meeting the percentage thresholds for TDIU. Id. When determining whether the Veteran is unable to secure or follow a substantially gainful occupation due to his service-connected disability, consideration may be given to the Veteran's level of education, special training, and previous work experience, but it may not be given to his age or to any impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. From June 26, 2012, the Veteran's service-connected major depressive disorder was evaluated as 50 percent disabling, his thoracolumbar stain was evaluated as 10 percent disabling, his left lower extremity sciatic nerve was evaluated as 20 percent disabling, his right lower extremity sciatic nerve was evaluated as 10 percent disabling, his tinnitus was evaluated as 10 percent disabling, and his synovitis and bilateral hearing loss were evaluated as noncompensable. From June 26, 2012, the Veteran's combined rating was 70 percent. Under 38 C.F.R. § 4.16(a), the Veteran meets the schedular requirement for a TDIU, from June 26, 2012. Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340(a). A veteran's service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue must be addressed. Age may not be considered as a factor in evaluating service-connected disability; and unemployability, in service-connected claims, associated with advancing age or intercurrent disability, may not be used as a basis for a total disability rating. 38 C.F.R. § 4.19. As previously noted herein, the Veteran has met the scheduler threshold criteria for the award of a TDIU, from June 26, 2012. The August 2012 VA back examination shows that the Veteran has chronic pain in the upper and lower back with decreased ROM and has difficulty carrying and lifting heavy objects. In a February 2013 statement, the Veteran reported that he was employed and reported constant back pain. In a subsequent February 2013 statement, the Veteran reported that he was currently maintaining gainful employment, but with difficulty and extreme pain. An April 2016 letter from the Veteran's manager stated his belief that the Veteran did not have the strength left to continue his position for much longer, that the Veteran's ability to handle the workload has tremendously decreased due to his back issues, and that the Veteran had missed numerous days of work due to hospital and clinic visits. A March 2020 VA mental health note shows that the Veteran was working as a warehouse manager that sells construction tools, and that he has worked in the warehouse industry since his separation from military service. A June 2020 VA medical record shows that the Veteran reported working in the construction industry. A February 2021 VA physical medicine note shows that the Veteran requested telemedicine visits due to his work schedule. For the period from June 26, 2012, the evidence does not demonstrate that the Veteran's service-connected disabilities rendered him unable to secure and follow a substantially gainful occupation. Although the evidence of record shows that the Veteran has had occupational difficulty, the evidence also shows that he has been able to maintain his employment during the period on appeal. From June 26, 2012, there is no indication that the Veteran's service-connected disabilities caused him to be unable to secure or follow substantially gainful employment. The VA examinations and treatment records consistently show that the Veteran's service-connected back disability and disabilities of the bilateral lower extremity have caused him to miss up to one week of work time per year. Additionally, the evidence does not show that his service-connected major depressive disorder has prevented him from maintaining employment during the period. Thus, for the period from June 26, 2012, the evidence does not demonstrate that the Veteran's service-connected disabilities rendered him unable to secure and follow a substantially gainful occupation. (CONTINUED ON THE NEXT PAGE) Therefore, as the Veteran is found to have been capable of substantially gainful employment, from June 26, 2012, entitlement to a TDIU cannot be granted for the period, and the claim is denied. Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Timothy T. Emmart The Board's action is binding only in this case. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.