Citation Nr: 21073965 Decision Date: 12/13/21 Archive Date: 12/13/21 DOCKET NO. 16-15 784 DATE: December 13, 2021 ORDER 1. Entitlement to an initial increased rating in excess of 30 percent for posttraumatic stress disorder (PTSD) prior to February 22, 2021, and in excess of 70 percent thereafter is denied. 2. Entitlement to an initial increased rating in excess of 10 percent for peripheral neuropathy of the left upper extremity is denied. 3. Entitlement to an initial increased rating in excess of 10 percent for peripheral neuropathy of the right upper extremity is denied. 4. Entitlement to a total disability rating for compensation based on individual unemployability due to service-connected disabilities (TDIU). FINDINGS OF FACT 1. Prior to February 22, 2021, the Veteran's PTSD was not manifested by occupational and social impairment with reduced reliability and productivity. 2. From February 22, 2021, the Veteran's PTSD has not been manifested by total occupational and social impairment. 3. The Veteran's peripheral neuropathy of the left upper extremity has not been manifested as moderate constant pain, severe intermittent pain, moderate paresthesias and/or dysesthesias, or moderate numbness of the left upper extremity without muscle atrophy. 4. The Veteran's peripheral neuropathy of the right upper extremity has not been manifested as moderate constant pain, severe intermittent pain, moderate paresthesias and/or dysesthesias, or moderate numbness of the right upper extremity without muscle atrophy. 5. Prior to February 22, 2021, the Veteran was not precluded from securing or following a substantially gainful occupation due to his service-connected disabilities. 6. From February 22, 2021, the Veteran is in receipt of a combined 100 percent rating for his service-connected disabilities. CONCLUSIONS OF LAW 1. The criteria for an initial disability rating in excess of 30 percent for PTSD prior to February 22, 2021, and in excess of 70 percent thereafter have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.126, 4.130, Diagnostic Code (DC) 9411. 2. The criteria for an initial disability rating in excess of 10 percent for peripheral neuropathy of the left upper extremity have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.14.14, 4.123, 4.124a, Diagnostic Code 8616. 3. The criteria for an initial disability rating in excess of 10 percent for peripheral neuropathy of the right upper extremity have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.14.14, 4.123, 4.124a, Diagnostic Code 8616. 4. The criteria for entitlement to a TDIU have not been met prior to February 22, 2021. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the United States Army from October 1967 to July 1970. The Board of Veterans' Appeals (Board) remanded the Veteran's claims in June 2021 so the Agency of Original Jurisdiction could readjudicate the claims and issue a Supplemental Statement of the Case. The Board finds there has been substantial compliance with the Board's directives. The Board will now consider the claims on the merits. In a February 2021 rating decision, the Regional Office found there was a clear and unmistakable error in the effective date for the 70 percent disability rating for the Veteran's service-connected PTSD and established the effective date of February 22, 2021. Increased Rating Disability evaluations are determined by evaluating the extent to which a Veteran's service-connected disability adversely affects the Veteran's ability to function under the ordinary conditions of daily life, including employment, by comparing the Veteran's symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 C.F.R. Part 4. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. 1. Entitlement to an initial increased rating in excess of 30 percent for PTSD prior to February 22, 2021, and in excess of 70 percent thereafter The Veteran contends that his PTSD disability rating should be higher than the current 30 percent disability rating, which was in effect until February 2021. In his March 2016 VA Form 9, Appeal to the Board, the Veteran stated that he has problems understanding complex commands, memory problems, problems with using his judgment, and maintaining work and social relationships. He also stated that he has not worked since 2010 due to his service-connected disabilities. A 30 percent rating is assigned for PTSD manifested by occupational and social impairment with an occasional decrease in work efficiency and intermittent periods of an inability to perform occupational tasks (although generally functioning satisfactorily with routine behavior, self-care, and conversation normal) due to such symptoms as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, and mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is assigned for PTSD manifested by occupational and social impairment with reduced reliability and productivity due to such symptoms as flattened affect, circumstantial, circumlocutory, or stereotyped speech, panic attacks more than once a week, difficulty in understanding complex commands, impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks), impaired judgment, impaired abstract thinking, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. A 70 percent rating is assigned for PTSD manifested by occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking or mood due to such symptoms as suicidal ideation, obsessional rituals which interfere with routine activities, speech intermittently illogical, obscure, or irrelevant, near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively, impaired impulse control (such as unprovoked irritability with periods of violence), spatial disorientation, neglect of personal appearance and hygiene, difficulty in adapting to stressful circumstances (including work or a work-like setting), or an inability to establish and maintain effective relationships. A 100 percent rating is assigned for PTSD manifested by total occupational and social impairment due to such symptoms as gross impairment in thought process or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene), disorientation to time or place, and memory loss for names of close relatives, own occupation, or own name. A. Prior to February 22, 2021 The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of an initial increased rating in excess of 30 percent for PTSD prior to February 22, 2021. The reasons follow. In the August 2013 VA examination report, when asked which of the following best summarized the Veteran's level of occupational and social impairment, the psychologist checked occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily with normal routine behavior, self-care, and conversation, which is the criteria that falls under the 30 percent rating. While the adjudicator makes the determination of what evaluation is warranted for the service-connected PTSD, the examiner's conclusion that the Veteran's psychiatric disorder was summarized best by the criteria described under the 30 percent evaluation is evidence against a finding that the Veteran's psychiatric disorder caused occupational and social impairment with reduced reliability and productivity to warrant a 50 percent rating. During the August 2013 VA examination, the Veteran stated that it was hard for him to get along with people because he is too outspoken. He said that he can learn new procedures, but he has a hard time handling work stress. He also reported that he was never fired from his employment, but that he would get mad and quit. However, he told the examiner he talks to his mother and his five children. Additionally, he reported having a few friends. Furthermore, in February 2015, the Veteran reported that he has two small children that he liked to go to the park with them and spend time with, but his physical pain would in the way. The fact he has consistent and positive relationships with his family members weighs against a finding of difficulty in establishing and maintaining effective social relationships and does not support a finding of this level of social impairment. At the August 2013 VA examination, the Veteran reported his PTSD symptoms included depressed mood, anxiety, and chronic sleep impairment. He also reported that he has irritability and that he is on guard all the time. He stated that he hates to be in a place where he cannot see an exit. The Board finds this as evidence of the Veteran's depressed mood, anxiety, chronic sleep impairment, and suspiciousness, which are symptoms contemplated by the 30 percent disability rating. In his March 2016 VA Form 9, the Veteran stated that he has problems understanding complex commands and memory problems. However, the Veteran reported at the August 2013 VA examination that he taught himself how to play the guitar, saxophone, drums, and piano. The Board finds that the ability to teach himself multiple music instruments is evidence against a finding that he has difficulty in understanding complex commands or impairment of short or long-term memory; and further evidence against PTSD symptoms causing a level of occupational impairment that results in reduced reliability and productivity. Furthermore, VA treatment records show that medical professionals consistently documented that the Veteran has appropriate speech, has been well oriented, and has demonstrated normal judgment, thinking and mood. See February 2015 Community Based Primary Care note; October 30, 2020 CBOC Telephone Note; February 2021 Community Based Primary Care note. Such findings and symptoms weigh against a finding of circumstantial, circumlocutory, or stereotyped speech, difficulty in understanding complex commands, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, which are some of the symptoms that would demonstrate that the Veteran's disability picture warranted a 50 percent rating for this part of the appeal period. As the Veteran's PTSD symptoms do not rise to the level of impairment contemplated by the 50 percent rating, it follows that his service-connected PTSD symptoms also do not meet the more severe rating criteria for an increased 70 or 100 percent disability rating. Significantly, he has not shown the required severity of occupational and social impairment necessary for an increased 50, 70, or 100 percent disability rating during the rating period, and his symptoms, as a whole, are not of similar severity, frequency, and duration as those particular symptoms associated with a 50, 70, or 100 percent disability rating prior to February 22, 2021. In sum, the preponderance of the evidence is against a disability rating in excess of 30 percent for PTSD prior to February 22, 2021. As the preponderance of the evidence is against the claim for a higher rating, the benefit of the doubt doctrine is not for application, and the Veteran's claim for an increased rating for this part of the appeal period is denied. See 38 U.S.C. § 5107(b). B. From February 22, 2021 The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of an initial rating in excess of 70 percent for PTSD from February 22, 2021. The reasons follow. The preponderance of the evidence is against a finding that the Veteran's PTSD results in total occupational and social impairment, to warrant a 100 percent rating. Although the Veteran lives alone and states that he keeps to himself, the Veteran stated during the February 2021 VA examination that he talks to his children at times. The Board finds this is affirmative evidence against a finding of total social impairment. In order for the 100 percent disability to be warranted, there must be both total social and total occupational impairment, and the Veteran does not have such level of social impairment. Additionally, during this part of the appeal period, the Veteran has been shown to have appropriate dress, speech, thought processes, judgment and insight, without delusion, suicidal thoughts, or homicidal ideation. Accordingly, the preponderance of the evidence is against a finding that the Veteran's PTSD is manifested by symptoms that resemble gross impairment in thought process or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene), disorientation to time or place, and memory loss for names of close relatives, own occupation, or own name, or symptoms of similar severity, which are symptoms that demonstrate the criteria for a 100 percent rating. In sum, the preponderance of the evidence is against a disability rating in excess of 70 percent for PTSD from February 22, 2021 because the Veteran's disability picture is not indicative of total social and total occupational impairment. As the preponderance of the evidence is against the claim for a higher rating, the benefit of the doubt doctrine is not for application, and the Veteran's claim for an increased rating for this part of the appeal period is denied. See 38 U.S.C. § 5107(b). 2. - 3. Entitlement to an initial increased ratings in excess of 10 percent for peripheral neuropathy of the left and right upper extremities The Veteran contends that his right and left upper extremity peripheral neuropathy should be higher than the current 10 percent disability rating. In his March 2016 VA Form 9, the Veteran stated that he experienced moderate nerve damage in both of the upper extremities. The Veteran is right handed and thus his right upper extremity is his major arm and the left upper extremity is the minor arm. The Veteran's upper extremity peripheral neuropathy is rated under Diagnostic Code (DC) 8616 as 10 percent disabling. Under DC 8616, incomplete paralysis of the major and minor ulnar nerve warrants a 10 percent rating when it is mild in degree. A 20 percent rating is warranted for incomplete paralysis of the minor ulnar nerve which is moderate in degree. A 30 percent rating is warranted for incomplete paralysis of the major ulnar nerve which is moderate in degree; and incomplete paralysis of the minor ulnar nerve which is severe in degree. A 40 percent rating is warranted for incomplete paralysis of the major ulnar nerve which is severe in degree. 38 C.F.R. § 4.124a, DC 8616. When the involvement is only sensory, the rating should be for the mild, or at most, the moderate degree. In rating peripheral nerve disability, neuritis, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete paralysis. The maximum rating to be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate incomplete paralysis, or with sciatic nerve involvement, for moderately severe incomplete paralysis. 38 C.F.R. § 4.123. The words "slight," "moderate," and "severe" as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6. The Veteran underwent a VA medical examination in August 2013. The examiner confirmed a diagnosis of diabetic peripheral neuropathy. The Veteran told the examiner that the neuropathy had a slow onset. He stated he experienced symptoms upon standing for long periods, where his feet and achilles tendon would be tight. The longer he sits, the more symptoms he experienced in the morning. Upon physical examination, the examiner documented there was no constant pain or intermittent pain in the upper extremities, but there was mild paresthesias and/or dysesthesias in the upper extremities, and mild numbness in his right upper extremity. Muscle Strength was normal in his upper extremities with elbow flexion, elbow extension, wrist flexion, wrist extension, grip, and pinch. His deep tendon reflexes were normal in his upper extremities, except for decreased light touch testing results in his right and left hands/fingers. Position sense, vibration, and cold sensation were all normal in the upper extremities. There was no muscle atrophy and no trophic changes. The examiner noted that the Veteran had mild incomplete paralysis of the had ulnar nerve, bilaterally, as well as moderately severe incomplete paralysis of the sciatic nerve. All other nerves were normal. There were no other pertinent findings. The examiner opined that the Veteran's peripheral neuropathy affected his ability to work, as he would have difficulty walking on uneven surfaces, standing for extended periods, or running. The Veteran was afforded another VA medical examination in April 2016. Upon examination, there was no constant or intermittent pain, paresthesias and/or dysesthesias, or numbness in his upper extremities. Muscle Strength was normal in his upper extremities with elbow flexion, elbow extension, wrist flexion, wrist extension, grip, and pinch. Deep tendon reflexes, light touch testing, and sensations were found to be normal in his upper extremities. Position sense, vibration, and cold sensation were all normal in the upper extremities. The examiner determined that the Veteran did not have upper extremity diabetic peripheral neuropathy. There were no other pertinent findings. The examiner opined that the Veteran's peripheral neuropathy affected his ability to work, as he would have difficulty walking and walked with a cane. The Veteran's VA treatment records show regular treatment for peripheral neuropathy for which the Veteran took Gabapentin and Duloxetine. Furthermore, an October 2020 and February 2021 VA medical treatment record shows that the examiners found the Veteran had no apparent motor deficits. Based on the evidence of record, the Board concludes that initial ratings in excess of 10 percent are not warranted for the Veteran's service-connected diabetic neuropathy in the upper extremities. The clinical findings documented by medical professionals shows that the Veteran experiences no more than mild incomplete paralysis of any pertinent nerve in an upper extremity. The preponderance of the evidence is against a finding that he has experienced a severity of symptomatology that more nearly approximates moderate incomplete paralysis. The Board has also considered the Veteran's statements regarding his peripheral neuropathy of the upper extremities. The Veteran's statements are competent evidence as to the symptoms of his peripheral neuropathy of the upper extremities as this comes to him through his senses. Moreover, his statements are credible to the extent that they are consistent with the medical evidence of the record. However, his statements are not competent evidence as to a specific level of disability according to the appropriate diagnostic codes. See Robinson v. Shinseki, 557 F.3d 1355 (2009). Evidence concerning the nature and extent of the Veteran's peripheral neuropathy of the upper extremities has been provided by the medical personnel who have examined him at various times during the current appeal and who have rendered pertinent opinions in conjunction with the physical evaluations. The medical findings as provided in the examination reports directly address the criteria under which this type of disability is evaluated. The Board, therefore, finds the medical findings to be of a greater probative value as to the current severity of the Veteran's peripheral neuropathy of the upper extremities than his statements. Given such, the Board finds that initial ratings in excess of 10 percent are not warranted. Thus, for all the foregoing reasons, the Board finds that ratings in excess of 10 percent for peripheral neuropathy of the upper extremities are not warranted,. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claims, that doctrine is not applicable. See 38 U.S.C. § 5107(b). TDIU 4. Entitlement to a TDIU rating A. Prior to February 22, 2021 A TDIU rating may be granted upon a showing that the veteran is unable to secure or follow a substantially gainful occupation due solely to impairment resulting from his or her service-connected disabilities. See 38 C.F.R. § 4.16(a). There are minimum disability rating percentages that must be shown for the service-connected disabilities, alone or in combination, to even qualify for consideration for a TDIU award under § 4.16(a). Indeed, if there is only one such disability, it must be rated at 60 percent or more; if instead there are two or more disabilities, at least one disability must be rated at 40 percent or more, with sufficient additional disability to bring the combined rating to 70 percent or more. Id. In determining whether a veteran is unemployable for VA purposes, consideration may be given to the veteran's level of education, special training, and previous work experience, but not to age or any impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. A veteran need not show 100 percent unemployability in order to be entitled to a TDIU. Roberson v. Principi, 251 F.3d 1378, 1385 (Fed. Cir. 2001). The U.S. Court of Appeals for Veterans Claims (Court) has held that the central inquiry in determining whether a veteran is entitled to a TDIU is whether service-connected disabilities alone are of sufficient severity to produce unemployability. Hatlestad v. Brown, 5 Vet. App. 524 (1993). The test of individual unemployability is whether a veteran, as a result of his or her service-connected disabilities alone, is unable to secure or follow any form of substantially gainful occupation which is consistent with his or her educational and occupational experience. 38 C.F.R. § 3.340, 3.341, 4.16. The Board also notes that the ultimate question of whether a veteran is capable of substantial gainful employment is not a medical one; rather, that determination is for the adjudicator. 38 C.F.R. § 4.16(a); Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013). The sole fact that a veteran is unemployed or has difficulty obtaining employment is not enough. A high rating itself is recognition that the impairment makes it difficult to obtain or keep employment. The ultimate question, however, is whether the veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). Prior to February 22, 2021, the Veteran was service connected for sciatic nerve peripheral neuropathy of the right lower extremity at a rate of 40 percent; sciatic nerve peripheral neuropathy of the left lower extremity at a rate of 40 percent; PTSD at a rate of 30 percent; diabetes mellitus type II at a rate of 20 percent; femoral nerve peripheral neuropathy of the left lower extremity at a rate of 20 percent; femoral nerve peripheral neuropathy of the right lower extremity at a rate of 20 percent; peripheral neuropathy of the left upper extremity at a rate of 10 percent; and peripheral neuropathy of the right upper extremity at a rate of 10 percent. The combined rating for compensation is 90 percent. Because the Veteran is in receipt of a combined rating of 90 percent for the entirety of the period on appeal, he meets the schedular requirements for TDIU. However, as noted above, the central inquiry in determining entitlement to TDIU is whether the service-connected disabilities alone are of sufficient severity to produce unemployability. Hatlestad v. Brown, 5 Vet. App. 524 (1993). The Board finds that the preponderance of the evidence is against a finding that the Veteran was unable to secure or follow substantially gainful employment based on his service-connected disabilities alone at any point during the period on appeal. The reasons follow. In determining whether a veteran can secure and follow a substantially gainful occupation, the Court in Ray v. Wilkie directed the Board to consider the following factors: (1) the veteran's history, education, skill, and training; (2) whether the veteran has the physical ability (both exertional and non-exertional) to perform the type of activities required by the occupation at issue; and (3) whether the veteran has the mental ability to perform the activities required by the occupation at issue. Ray, 31 Vet. App. 58, 73 (2019). In determining whether unemployability exists, consideration may be given to the Veteran's level of education, special training, and previous work experience, but not to his age or to any impairment caused by nonservice-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. The Veteran has not filed a formal application for TDIU, although he was requested in a July 2021 to complete the form. While the application is not necessary, it is extremely helpful in having relevant facts to assist VA with its determination. For example, the application has an area where the Veteran lists his/her education and past work history. Instead, the Board has reviewed other records to determine the Veteran's educational level and past work history. After reviewing the record, the Board noted the following regarding the Veteran's education, training, skills, and work history. The evidence within the record shows that the Veteran reported that he quit high school in the tenth grade, and he received his GED while in the military. He also stated that he finished a year of college studying business. As for his work history, during his August 2013 VA examination, the Veteran told the examiner that he had different jobs over the years. He reported that he usually worked construction jobs and he had a railroad job for four years doing track maintenance. He stated that he does occasional house paining when he can find one. During his February 2021 VA examination, however, the Veteran reported that he worked from 1970 to 1996 with the railroad. He stated he then moved in 1996 and began painting houses. He stated that he retired in 2013 due to medical issues with his back and legs. The Board notes that the Veteran is not service connected for a disability related to his back. On the June 2012 VA Form 21-526, Veteran's Application for Compensation or Pension, the Veteran reported that his only work involves odd jobs painting, and he has limited income. He reported that his physical limitations limited how much he worked. The Board finds the discrepancy of the Veteran's employment history weighs against the Veteran's credibility, specifically his reports of his employment history. For instance, at his August 2013 VA examination, the Veteran reported that he worked at the railroad for four years. Then at the February 2021 VA examination, the Veteran reported that he worked at the railroad for 26 years. Overall, the Veteran's work history and his education record demonstrate a capacity for learning, training, and adaptability that would not be hindered by his service-connected disabilities and supports a finding that the Veteran can secure and follow substantially gainful employment. These attributes would facilitate the Veteran's transition to a separate line of work that the Veteran is capable of performing. As to the Veteran's mental ability to perform substantially gainful employment, the Board acknowledges that the Veteran experiences a range of psychiatric symptoms, as discussed above; however, the record generally does not show these symptoms cause significant functional limitations that would preclude substantially gainful employment. Findings on mental status examination generally indicate the Veteran to be fully alert and oriented with intact cognitive functioning, linear and goal-directed thought processes, adequate insight, judgment, and impulse control, and cooperative and appropriate behavior. Treatment records describe the Veteran as cooperative. At the August 2013 VA examination, the Veteran was described as pleasant, cooperative, polite, with good communication. At the February 2021 VA examination, the examiner described the Veteran's concentration as good, he was oriented times four and alert. Fund of information was good and he had good insight and good judgment. Accordingly, the Veteran's psychiatric symptoms can be reasonably accommodated by restricting the Veteran from jobs involving executive decision-making and managerial or supervisory duties. As such limitations would not preclude the Veteran from all forms of substantially gainful employment, the weight of the evidence shows that the Veteran is mentally capable of performing substantially gainful employment. As to the Veteran's physical ability to perform substantially gainful employment, the Veteran experiences recurrent pain symptoms in his lower extremities and fatigue. However, treatment records predominantly reflect the Veteran's to have full strength (in all areas, except his right ankle dorsiflexion and plantar flexion), intact sensation, and no muscle atrophy. Furthermore, the Veteran has demonstrated independence in his activities of daily living and the ability to ambulate independently. While the Veteran indicated he needed assistance with bathing and dressing, he also indicated that he was able to self-propel over typical terrain for a reasonable period and feeds himself from a prepared tray in an October 2020 assessment for a home health aide. The Department of Labor's Dictionary of Occupational Titles (DOT) defines sedentary work as exerting up to 10 pounds of force occasionally (i.e., up to one third of the time), and/or a negligible amount of force frequently (i.e., from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. According to DOT's definition, sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. The Board finds no prejudice to the Veteran in considering this definition for purposes of deciding the Veteran's claim. The longitudinal record indicates that the Veteran is capable of sedentary work with a sit/stand option and the use of a cane for ambulation. Accordingly, the weight of the evidence shows that the Veteran is physically capable of performing substantially gainful employment. The Board finds that the service-connected PTSD, peripheral neuropathy of the four extremities, and diabetes mellitus type II do not prevent the Veteran from securing or following substantially gainful employment. Based on the above assessment of the Veteran's physical and mental abilities with consideration of his education, training, skills, and work history, the Board finds that the Veteran is capable of work that would result in income at the level of substantially gainful employment. For example, the Veteran would be capable of performing jobs that involve data entry. With data entry, the Veteran is primarily responsible for entering data into a system. These jobs can usually be done from home without significant training or experience. These occupations require very little exertional effort. Based on the Veteran's education history, his one year of college experience, and intact cognitive functioning, the Veteran has, or is capable of quickly gaining, the basic computer skills needed for such a position. Alternatively, there are jobs that can be performed at home, such as a telemarketer, where the employee makes calls and reads a script, which does not require extensive training or experience, and would require minimal exertional activity. Similarly, a customer service agent interacts with customers to handle complaints, process orders, and answer questions. These positions can often be performed from home, while seated. The Veteran also would be capable of performing certain cashier positions, or work as a library, theater, or museum attendant, positions that would not exceed the demands of sedentary work and would involve only simple and repetitive tasks. These examples are not exhaustive but are merely illustrative of potential occupations that the Veteran could perform. This is evidence against a finding that the Veteran is precluded from all forms of substantially gainful employment due to his service-connected disabilities during the relevant period. For all these reasons, the Board finds the preponderance of the evidence is against a finding that the Veteran is precluded from securing or following all forms of substantially gainful occupation due to his service-connected disabilities prior to February 22, 2021. As the probative evidence of record weighs against the Veteran's claim, there is no reasonable doubt to be resolved, and the claim of entitlement to a TDIU rating is denied. B. From February 22, 2021 The Veteran's claim of entitlement to a TDIU has been rendered moot by the award of a combined 100 percent schedular evaluation from February 22, 2021. A 100 percent schedular rating is a higher benefit than a TDIU. Thus, when a 100 percent rating has been granted, a TDIU claim is often moot, as consideration of a TDIU involves a situation where the schedular rating is less than total. 38 C.F.R. § 4.16. As of February 22, 2021, the Veteran's combined rating is total. In Bradley v. Peake, the Court reiterated that the Secretary of VA is required to maximize benefits. Here, the Veteran's 100 percent schedular rating is based upon a combination of service-connected disabilities and the Veteran does not have a single disability rated at 100 percent, and the Board does not find that the Veteran is precluded from substantially gainful employment due to PTSD alone, nor has the Veteran made that allegation (the Veteran alleges the inability to work due to physical disabilities). In light of the foregoing, the Board finds the preponderance of the evidence is against a claim for a TDIU from February 22, 2021. As such, the benefit of the doubt doctrine is inapplicable, and the claim is denied. See 38 U.S.C. § 5107(b). A. P. SIMPSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Griffin, 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.