Citation Nr: 21074907 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 09-22 947 DATE: December 16, 2021 ORDER A disability rating of 70 percent for post-traumatic stress disorder (PTSD), for the entire appeal period, is granted. A disability rating in excess of 10 percent prior to May 24, 2021, and in excess of 40 percent thereafter, for residuals of a compression fracture of thoracolumbar spine is denied. A total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is denied. FINDINGS OF FACT 1. During the entirety of the appeal, the Veteran's PTSD resulted in occupational and social impairment with deficiencies in most areas as a result of psychiatric symptomatology to include suicidal ideation, impaired impulse control (such as unprovoked irritability with periods of violence), and inability to establish and maintain effective relationships; however, the frequency, duration, and severity of such symptomatology have not produced more severe manifestations that more nearly approximate total occupational impairment. 2. Prior to May 24, 2021, there is no objective medical evidence showing that the Veteran's thoracolumbar spine condition manifested with forward flexion of the thoracolumbar spine of 30 degrees but not greater than 60 degrees; or, the 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; or forward flexion of 30 degrees or less or ankylosis of any sort. 3. There is no objective medical evidence from May 24, 2021 showing that the thoracolumbar spine condition more closely approximate neither favorable nor unfavorable ankylosis. 4. While the Veteran has two service-connected disabilities with a combined rating of at least 70 percent, there is insufficient evidence to show that he is unable to secure and follow substantially gainful occupation by reason of his service-connected disabilities. CONCLUSIONS OF LAW 1. The criteria for entitlement to a disability rating of 70 percent for PTSD, for the entire appeal period, have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.125, 4.126, 4.130, Diagnostic Code (DC) 9411. 2. The criteria for entitlement to a rating in excess of 10 percent prior to May 24, 2021, and a rating in excess of 40 percent thereafter for residuals of a compression fracture of thoracolumbar spine have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71a, DC 5235. 3. The criteria for entitlement to a TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.3, 4.15, 4.16, 4.18, 4.19, 4.25. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from November 2001 to September 2004. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in October 2008 by the Department of Veterans Affairs (VA) Regional Office in Pittsburgh, Pennsylvania. In September 2010, the Veteran testified at a Travel Board hearing. A transcript of that hearing is associated with the claims file. In March 2017, a letter was sent to the Veteran notifying him that the Veterans Law Judge who conducted the hearing no longer worked at the Board and informing him of his right to another hearing. The Veteran did not indicate that he desired another hearing. These issues were previously before the Board in March 2011, June 2017, and October 2020. In October 2020, the Board found that a November 2017 VA back examination did not comply with the June 2017 directives and the issue of increased rating was remanded for further development. In regard to the issue of increased rating for service-connected PTSD, the Board found that potentially relevant treatment records existed, and the issue was remanded to obtain any outstanding treatment records. Additionally, the Board found that a December 2017 TDIU application submitted by the Veteran did not contain a complete employment history, and the issue was remanded in order to afford the Veteran an opportunity to submit a new VA Form 21-8940 with the nature, hours, and income for any employment during the appeal period. A review of the record reflects substantial compliance with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In a June 2016 Decision Review Officer decision, the Veteran was granted an increased disability rating of 50 percent for his PTSD, effective February 10, 2014. Then, in a May 2021 rating decision, the Veteran was granted an increased disability rating of 40 percent for his thoracolumbar spine condition effective May 24, 2021. However, inasmuch as higher ratings are available for these disabilities throughout the appeal, and the Veteran is presumed to seek the maximum available benefit for a disability, his claims for higher ratings remain on appeal. See AB v. Brown, 6 Vet. App. 35, 38-39 (1993) (indicating it is presumed he is seeking the highest possible rating, unless he expressly indicates otherwise). Increased Ratings In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Disability evaluations are determined by the application of the facts presented to VA's Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). In any claim for an increased rating, "staged" ratings may be warranted where the factual findings show distinct time periods when the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119 (1999). If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for the higher evaluation; otherwise, the lower evaluation will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). In considering the appropriate disability rating, the Board has also considered the Veteran's statements that he is entitled to a higher rating. In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994). 1. Entitlement to a rating in excess of 30 percent prior to February 10, 2014, and a rating in excess of 50 percent thereafter for PTSD The Veteran asserts that a 70 percent rating is warranted for his PTSD. During this appeal period the Veteran's PTSD has been evaluated as 30 percent prior to February 10, 2014 and 50 percent thereafter, under 38 C.F.R. § 4.130, DC 9411. Under VA's General Rating Formula for Mental Disorders, a 30 percent rating requires occupational and social impairment with occasional decrease in work efficiency and intermittent periods of 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, mild memory loss (such as forgetting names, directions, recent events). 38 C.F.R. § 4.130, DC 9411. A 50 percent rating requires 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 requires 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); and inability to establish and maintain effective relationships. The maximum 100 percent rating requires total occupational and social impairment, due to such symptoms as: gross impairment in thought processes 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. The list of symptoms under the rating criteria are meant to be examples of symptoms that would warrant the rating, but are not meant to be exhaustive, and the Board need not find all or even some of the symptoms to award a specific rating. Mauerhan v. Principi, 16 Vet. App. 436, 442-43 (2002). Further, simply because the Veteran has some symptoms that are contemplated at a higher rating level does not mean the impact of his PTSD overall rises that level. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013). Instead, the Board must look to the frequency, severity, and duration of the impairment. In this case, a review of the medical treatment records reflect that the Veteran has had several VA PTSD examinations and treatment for PTSD. The Veteran was afforded a VA examination in September 2008. During the examination the Veteran reported an increased level of sadness, frequency in crying spells, increased periods of feeling hopelessness, experiencing mini panic attacks with shortness of breath, and heightened anxiety. During a September 2008 VA individual therapy session, the Veteran revealed he began trying his significant other's Adderall twice a day along with his prescribed medications. A November 2010 VA treatment note reflects that the Veteran reported recently considering suicide but did not have a plan or intent. In December 2013 he was hospitalized for 11 days with suicidal ideation. In February 2014, the Veteran was afforded a VA examination. The examiner determined that the Veteran's symptoms resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care, and conversation, which is generally evaluated at 30 percent. The examiner indicated that the Veteran had depressed mood; anxiety; suspiciousness; near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively; chronic sleep impairment; flattened affect; disturbances of motivation and mood; and suicidal ideation. Additionally, the examiner indicated the Veteran experienced irritable behavior and angry outbursts, hypervigilance, exaggerated startle response, and problems with concentration. The examiner note that the Veteran's PTSD symptoms are exacerbated by his continued illicit drug abuse. A September 2016 private treatment notes from a rehabilitation hospital reflects that the Veteran was found unconscious by his wife after overdosing on oxycodone and Klonopin in August 2016. In November 2017, the Veteran was afforded another VA examiner. The examiner determined that the Veteran's symptoms resulted in occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by medication, which is generally assigned a 10 percent disability rating. The examiner indicated that the Veteran's PTSD manifested with depressed mood, anxiety, chronic sleep impairment, flattened affect, and suicidal ideation. The Veteran reported past suicidal ideations and attempts. Additionally, the examiner indicated the Veteran experienced irritable behavior and angry outbursts, hypervigilance, exaggerated startle response, and problems with concentration. The examiner noted that his judgment and insight appeared below average. The Veteran was afforded another VA examination in May 2021. The examiner determined that the Veteran's symptoms resulted occupational and social impairment with reduced reliability and productivity, which is generally assigned a 50 percent. The examiner indicated that the Veteran's PTSD manifested with depressed mood; anxiety; panic attacks that occur weekly or less often; chronic sleep impairment; mild memory loss, such as forgetting names, directions, or recent events; flattened affect; disturbances of motivation and mood; inability to establish and maintain effective relationships; suicidal ideation; and neglect of personal appearance and hygiene. Additionally, the examiner indicated the Veteran experienced irritable behavior and angry outbursts, hypervigilance, exaggerated startle response, and problems with concentration. The examiner noted that the Veteran appeared dysthymic and cried as he expressed some of history. The Board finds that the totality of the evidence reflects symptoms warranting a 70 percent rating under the applicable criteria. The United States Court of Appeals for Veterans Claims (Court) has held that suicidal ideation generally rises to the level contemplated in a 70 percent rating. See Bankhead v. Shulkin, 29 Vet. App. 10, 20 (2017). The Court specified that VA must not require "more than thought or thoughts to establish the symptom of suicidal ideation," and may not require that the Veteran have been "hospitalized or treated on an inpatient basis" to establish suicidal ideation because that imposes a higher standard than the criteria in the DC for mental disorders. Id. at 20-21. Moreover, the Court cautioned VA not to conflate the risk of "suicidal ideation, which VA generally considers indicative of a 70 [percent] evaluation, and his risk of self-harm, the persistent danger of which VA generally considers indicative of a 100 [percent] evaluation." Id. at 21. As applied, the suicidal ideation documented during the entirety of the appeal period is more than sufficient to establish the suicidal ideation symptom consistent with a 70 percent rating in the General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130. The Board concludes that the Veteran's PTSD is manifested by symptomatology that nearly approximates the criteria for a 70 percent evaluation under DC 9411. However, the Board finds that the severity, duration, and frequency of the Veteran's symptoms have not produced a total occupational and social impairment warranting a 100 percent rating. There is no evidence of symptoms such as gross impairment in thought processes 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, or memory loss for names of close relatives, own occupation, or own name, which are the type of symptoms contemplated by a 100 percent rating under the General Rating Formula. The record also does not show that the Veteran has ever been hospitalized or institutionalized due his passive thoughts of suicidal ideation or his physical behavior. As there is no medical or lay evidence to show that the Veteran's symptoms inhibit his ability to independently function, a total rating is not warranted. The Board has also considered whether staged ratings under Fenderson, supra, are appropriate for the Veteran's service-connected PTSD; however, it finds that his symptomatology has been stable throughout the appeal period. Therefore, assigning staged ratings is not warranted. Further, neither the Veteran nor his representative have raised any other issues, nor have any other issues been reasonably raised by the record, with regard to the rating claim adjudicated herein. See Doucette v. Shulkin, 28 Vet. App. 366 (2017). Therefore, the Board finds that a 70 percent rating, but no higher, for PTSD is warranted. Insofar as the Board has denied a higher rating, the preponderance of the evidence is against such aspect of the Veteran's claim. Therefore, the benefit of the doubt doctrine is not applicable and such initial rating claim must otherwise be denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. To the extent described above, the claim is granted. 2. Entitlement to a rating in excess of 10 percent prior to May 24, 2021, and a rating in excess of 40 percent thereafter, for residuals of a compression fracture of thoracolumbar spine The Veteran assert that his disability picture more closely approximates ankylosis of the thoracolumbar spine and warrants a 50 percent disability rating. The Veteran's thoracolumbar condition is currently rated at 40 percent disabling under 38 C.F.R. § 4.71a, DC 5235. Prior to May 24, 2021, the Veteran's thoracolumbar condition was rated as 10 percent disabling. While portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, this diagnostic code was not changed. Under VA's General Rating Formula for Diseases and Injuries of the Spine (General Rating Formula), under which a 10 percent rating is assigned when forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, 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. 38 C.F.R. § 4.71a., DC 5235. A 20 percent rating is assigned for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or the 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. A 40 percent rating is assigned when forward flexion of the thoracolumbar spine of 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent rating is assigned for unfavorable ankylosis of the entire spine. The Board will briefly note here that ankylosis is "immobility and consolidation of a joint due to disease, injury, [or] surgical procedure." Lewis v. Derwinski, 3 Vet. App. 259 (1992) (citing Saunders' Encyclopedia and Dictionary Of Medicine, Nursing, and Allied Health at 68 (4th ed.1987)). In February 2014, the Veteran was afforded a VA back examination. A diagnosis of old thoracic fracture was noted. The Veteran reported having increased pain after repetitive lifting and doing housework. Initial range of motion and range of motion after repetitive use forward flexion measurements was 90 degrees. No guarding or muscle spasm, ankylosis, intervertebral disc syndrome (IVDS) or incapacitating episodes was noted. In November 2017, the Veteran was afforded another VA back examination. A diagnoses of healed thoracic fracture and traumatic degenerative disc disease of the thoracic spine were noted. The Veteran reported having mid thoracic pain flares, difficulty carrying, standing, or bending over for long period of time. Initial range of motion forward flexion measurement was 90 degrees. Evidence of pain with weight bearing was noted. No guarding or muscle spasm, ankylosis, IVDS or incapacitating episodes was noted. In May 2021, the Veteran was afforded another VA back examination. A diagnosis of thoracolumbar spine compression fracture was noted. The Veteran reported that he cannot bend over. He also reported that he has missed two months of his six months of employment due to his back. The Veteran reported that he has severe flare-ups daily lasting hours precipitated by bending over. The initial range of motion forward flexion measurement was 60 degrees. The examiner indicated that there was evidence of pain on weight-bearing, nonweight-bearing, active motion, passive motion, on rest/non-movement, resulting in functional loss. The examiner noted that the Veteran had difficulty walking, standing, and sitting for prolonged periods of time. Repetitive use range of motion forward flexion measurement was 40 degrees. Repeated use over time range of motion forward flexion measurement was 30 degrees. The examiner indicated that the Veteran experienced muscle spasm resulting in abnormal gait or abnormal spine contour. Additionally, the examiner indicated that the Veteran's condition interferes with sitting and standing, and causes disturbances of locomotion. No ankylosis, IVDS or incapacitating episodes was noted. The Veteran reported that he occasionally used a cane during flare-ups. Based on the findings of the VA examinations, the 10 and 40 percent ratings at different stages provide for the effects of limitation of motion, whether due to pain on movement or restricted movement due to the orthopedic injury itself. There is no evidence of record that supports a finding that prior to May 24, 2021 the Veteran's thoracolumbar spine condition manifested with forward flexion of the thoracolumbar spine of 30 degrees but not greater than 60 degrees; or, the 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; or forward flexion of 30 degrees or less or ankylosis of any sort. Additionally, there is no objective medical evidence from May 24, 2021 showing that the thoracolumbar spine condition more closely approximate neither favorable nor unfavorable ankylosis. In reaching its conclusions, the Board acknowledges the Veteran's belief that his disability is more severe than as reflected by the currently assigned ratings. While the Board recognizes that the Veteran is competent to describe his observable symptomatology, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Rather, the Board finds the medical evidence in which professionals with medical expertise examined the Veteran, acknowledged his reported symptoms, and described the manifestations of such disabilities in light of the rating criteria to be more persuasive than his reports regarding the severity of such condition. The Board has also considered whether additional staged ratings under Fenderson, supra, are appropriate for the Veteran's service-connected residuals of a compression fracture of thoracolumbar spine; however, the Board finds that his symptomatology has been stable throughout each period on appeal. Therefore, assigning additional staged ratings for such disability is not warranted. Further, neither the Veteran nor his representative have raised any other issues, nor have any other issues been reasonably raised by the record, with regard to the increased rating claims adjudicated herein. See Doucette, supra. In sum, the Board finds that an initial rating in excess of 10 percent prior to May 24, 2021 and in excess of 40 percent thereafter for the Veteran's residuals of a compression fracture of thoracolumbar spine is not warranted. In reaching such determination, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran's claims, that doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7; 1361 (Fed. Cir. 2001); Gilbert, supra. The claim is denied. 3. Entitlement to a TDIU due to service-connected disabilities The Veteran asserts that he is unable to obtain gainful employment due to his service-connected PTSD and back disability. Total disability is considered to exist when there is any impairment which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340 (a)(1). "Substantially gainful employment" is employment ordinarily followed by the nondisabled to earn a livelihood with earnings common to the particular occupation in the community where a Veteran resides. See Moore v. Derwinski, 1 Vet. App. 356, 358 (1991). Marginal employment is not substantially gainful employment. See C.F.R. § 4.16. A total disability rating for compensation purposes may be assigned on the basis of individual unemployability: that is, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. In such an instance, if there is only one service-connected disability, it must be rated at 60 percent or more; if there are two or more service-connected disabilities, at least one disability must be rated at 40 percent or more, and sufficient additional disability must bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). Individual unemployability must be determined without regard to any nonservice-connected disabilities or the Veteran's advancing age. 38 C.F.R. §§ 3.341(a), 4.19; Van Hoose v. Brown, 4 Vet. App. 361 (1993). The ultimate question is whether the claimant is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. See Van Hoose, 4 Vet. App. at 363. Thus, the sole fact that a claimant is unemployed or has difficulty obtaining employment is insufficient to establish entitlement to TDIU. The Veteran's service-connected disabilities are as follows: PTSD, rated as 70 percent disabling herein; thoracolumbar spine compression fracture, 40 percent; tinnitus, lower right extremity radiculopathy, and lower left extremity radiculopathy rated at 10 percent disabling each; and right shoulder shell fragment wound, right chest shell fragment wound, face shell fragment wound, bilateral hearing loss, right perforated tympanic membrane, residuals of traumatic brain injury, and migraine headaches, each rated as noncompensable. The Veteran's combined rating for compensation purposes is 90 percent and one of his disabilities is rated at the least at 40 percent. Therefore, the Veteran meets the schedular rating criteria for a TDIU. 38 U.S.C. § 4.16 (a). The remaining inquiry is whether he is unable to secure or follow a substantially gainful occupation due solely to service-connected disabilities. An April 2020 VA treatment contact note reflects that is employed full-time with no current employment issues. In response to the October 2020 remand directive, a new VA Form 21-8940 was sent to the Veteran in November 2020. To date, a completed form has not been submitted by the Veteran. A November 2020 VA treatment note reflects that the Veteran was working in meat production and enjoying his work. During the May 2021 VA PTSD examination, the Veteran reported being employed full-time since October 2020. During the May 2021 VA back examination, the Veteran described some of the tasks he was unable to do at his job, because of his back. He reported that he believes that his boss was not happy with him; however, he did not report that his hours had been reduced or that his job was in jeopardy. Conversely, the Veteran has reported that his job has reasonably accommodated his needs. The Veteran has not provided any evidence to showing how his PTSD and/or back condition affect his ability to maintain employment. Without evidence showing how the Veteran's service-connected disabilities affect his ability to secure or follow substantially gainful employment, the Board is unable to render a favorable finding. Therefore, a TDIU is not warranted by the record, as the evidence fails to show that the Veteran is unemployable. The claim is denied. JEREMY J. OLSEN Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Camille NeSmith, 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.