Citation Nr: 21076047 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 14-07 042A DATE: December 22, 2021 ORDER Entitlement to service connection for a right foot disability, to include as secondary to the service-connected lumbar spine disability is denied. Entitlement to service connection for a left foot disability, to include as secondary to the service-connected lumbar spine disability is denied. Entitlement to service connection for a right knee disability, to include as secondary to the service-connected lumbar spine disability is denied. Entitlement to service connection for a left knee disability, to include as secondary to the service-connected lumbar spine disability is denied. Entitlement to service connection for a right shoulder disability, to include as secondary to the service-connected lumbar spine disability is denied. Entitlement to service connection for a left shoulder disability, to include as secondary to the service-connected lumbar spine disability is denied. Entitlement to a total disability rating due to individual unemployability (TDIU) is granted. FINDINGS OF FACT 1. The Veteran's bilateral foot disabilities did not incur during active service, were not caused by active service, did not manifest to a compensable degree within one year of separation from active duty, and were not caused or aggravated by the service-connected lumbar spine disability. 2. The Veteran's bilateral knee disabilities did not incur during active service, were not caused by active service, did not manifest to a compensable degree within one year of separation from active duty, and were not caused or aggravated by the service-connected lumbar spine disability. 3. The Veteran's bilateral shoulder disabilities did not incur during active service, were not caused by active service, did not manifest to a compensable degree within one year of separation from active duty, and were not caused or aggravated by the service-connected lumbar spine disability. 4. The Veteran's service-connected disabilities preclude him from securing and maintaining substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for right and left foot disabilities have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.310. 2. The criteria for entitlement to service connection for right and knee disabilities have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.310. 3. The criteria for entitlement to service connection for right and left shoulder disabilities have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.310. 4. The criteria for entitlement to TDIU have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.15, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1972 to November 1975. The Veteran appeared at a hearing before the undersigned Veterans Law Judge in September 2016. The Board of Veterans' Appeals (Board) remanded the matters for further development in November 2017, May 2019, October 2020, and April 2021. The Board notes that neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Board notes that the Veteran was provided with a statement of the case in April 2017 which addressed entitlement to service-connection for fibromyalgia. The Veteran did not timely file a substantive appeal to bring the issue before the Board. Under Clemons, VA has a duty to construe claims for benefits broadly to include claims for each condition reasonably raised by the symptoms alleged. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). However, as the issue of fibromyalgia was not perfected, the issue is not to be considered in the instant appeal. In June 2021, the Veteran requested an examination with an experienced orthopedic back surgeon and a neurosurgeon. The duty to assist also includes providing a medical examination or obtaining a medical opinion when necessary to make a decision on a claim, as defined by law. See 38 C.F.R. § 3.159(c)(4). Here, the record contains examinations and addendum opinions in June 2011, August 2012, October 2012, April 2013, February 2019, June 2019, January 2021, February 2021, and May 2021. The Board acknowledges the Veteran's request for a new examination, but finds another examination is not warranted. Together, the examination reports and opinions were adequate because the examiners considered and addressed the Veteran's contentions, reviewed the claims file in conjunction with the examination, conducted thorough medical examinations of the Veteran, and provided sufficient supporting rationales for the opinions. Based on the foregoing, the Board finds the examination reports and addendums to be thorough, complete, and sufficient bases upon which to reach a decision on the Veteran's claims. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-05 (2008); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). As such, the duty to assist has been satisfied, and new examinations are not warranted. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military, naval or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in active service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires medical evidence or, in certain circumstances, lay evidence of the following: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). Alternately, service connection may be established under 38 C.F.R. § 3.303(b) by (a) evidence of (i) the existence of a chronic disease in service or during an applicable presumption period under 38 C.F.R. § 3.307 and (ii) present manifestations of the same chronic disease, or (b) when a chronic disease is not present during service, evidence of continuity of symptomatology. Certain chronic diseases, including degenerative arthritis, may be service connected if manifested to a degree of 10 percent disabling or more within one year after separation from service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. A disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. See 38 C.F.R. § 3.310(a). Furthermore, any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. See 38 C.F.R. § 3.310(b). 1. Entitlement to service connection for a bilateral foot disability The Veteran's entrance examination in March 1972 and the separation examination in September 1975 were negative for conditions or complaints for either the left or right feet. In June 2008 private treatment notes, the Veteran was diagnosed with osteoarthritis of the feet and toe joints. The Veteran was provided with a VA examination in June 2011. The Veteran did not report any musculoskeletal feet symptoms. Examination of the feet was normal. The Veteran was provided with a VA examination in August 2012. The Veteran was diagnosed with Morton's neuroma and metatarsalgia. The examiner also diagnosed the Veteran with foot pain in 1973. The Veteran reported landing on his feet during his February 1973 parachuting accident, and foot pain was immediate. Diagnostic testing did not find any abnormal findings of the feet. In October 2012, an addendum nexus opinion was provided, in which the examiner provided a negative opinion. In April 2013 VA treatment notes, the Veteran was diagnosed with post-traumatic osteoarthritis of the bilateral feet. The Veteran was provided with a VA examination and nexus opinion in June 2019. The examiner found no evidence of foot conditions during active duty in the service treatment records (STRs). There were no documented foot complaints until the early 2000s. The prior diagnosis for pes cavus was caused by other problems with the foot. Neither pes cavus nor pes planus were caused by any back conditions. The joint pain was more than likely related to degenerative joint disease related to aging. Accordingly, the Veteran's bilateral foot disabilities were less likely than not caused by active duty, and were not caused or aggravated by any lumbar spine disability. In January 2021, a VA examiner found the Veteran had been diagnosed with congenital type pes cavus, bilateral plantar fasciitis and minimal degenerative disc disease (DJD) of the first metatarsophalangeal joint. The examiner found the pes cavus was likely congenital and nor related to an injury. Plantar fasciitis is a common progression of pes cavus and not related to any in-service event. The Veteran's STRs did not show any evidence of a foot disorder. The DJD was most likely the result of the Veteran's age. None of the foot disorders were related in any way to the lumbar spine condition. Clarification was provided in February 2021. The examiner found the Veteran's diagnosed foot disorders had explained etiologies that were separate and unrelated to the Veteran's post traumatic arthritis of the lumbar spine; and there was no objective evidence to support aggravation of the foot disabilities by the lumbar spine. Accordingly, the Veteran's bilateral foot disabilities were less likely than not caused by active duty, and not caused or aggravated by the service-connected lumbar spine disability. In a May 2021 addendum opinion, the examiner noted that the STRs and examinations during active duty were silent for any foot complaints, diagnoses, or treatment, to include status post the parachute accident in 1973. The Veteran was first evaluated for foot pain in 2003, therefore intercurrent injury/disease could not be ruled out. There was no medical evidence presented to support the Veteran's foot diagnoses were related to active duty in any way. The Veteran's lay testimony established subjective chronicity of symptoms, but he is not qualified to ascribe symptoms to a diagnosis or determine an etiology. A condition of suggested severity would have required medical attention prior to the Veteran seeking medical care in 2003. Medical literature did not support lumbar spine problems causing or aggravating the diagnosed disorders. There was no medical evidence to support significant antalgic gait or severe muscle or nerve damage. The collective VA opinions show that the examiners reviewed the Veteran's entire record, and provided rationales to support the opinions. The record is negative for probative medical opinions indicating a positive nexus between the Veteran's foot disabilities and active service, or causation or aggravation by the service-connected lumbar spine disability. Certain chronic diseases will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki,708 F.3d 1331 (Fed. Cir. 2012). The Board concludes that, while the Veteran has arthritic findings in his feet, it was not chronic in service or had continued since service. The Board has every reason to believe the Veteran was offering a truthful account of his experiences to his clinicians in an attempt to receive appropriate medical care. However, arthritis did not manifest to a compensable degree within a presumptive period. There is no evidence in the record which shows diagnosed degenerative changes by November 1976, within a year of separation from active service. The earliest evidence of degenerative changes is located in June 2008 VA treatment records. This is nearly 32 years after separation from active service. The evidence supports finding that the Veteran's foot disorders were diagnosed over one year after separation, outside of the applicable presumptive period. While the Veteran is competent to report having experienced symptoms of foot pain since service, he does not possess the training or credentials necessary to provide a competent diagnosis in this case or to determine that these symptoms were manifestations of diagnosed disorders. The issues are medically complex, and require medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The Board gives more probative weight to competent medical evidence, which establishes that these symptoms are not related to the 1973 parachute accident or the service-connected back disorder. Accordingly, the preponderance of the evidence is against the claims, and the claims for service connection for bilateral foot disabilities must be denied. 38 U.S.C. § 5107(b). 2. Entitlement to service connection for bilateral knee disabilities The Veteran's entrance examination in March 1972 and the separation examination in September 1975 were negative for conditions or complaints for either the left or right knees. The Veteran was provided with a VA examination in August 2012. The Veteran was diagnosed with bilateral knee strain in 1973. The Veteran reported developing joint pain during regular drill exercises. In October 2012, an addendum nexus opinion was provided, in which the examiner provided a negative opinion. The Veteran was provided with a VA examination and nexus opinion in June 2019. The examiner found no evidence of knee conditions during active duty in the STRs. The Veteran reported knee pain in relation to fibromyalgia. The degenerative joint disease (DJD) in x-rays is age appropriate for the Veteran and a back condition will not cause arthritis in other joints. There was no evidence that the back condition aggravated the knees beyond its natural progression, as the back has been bothering the Veteran since 1970, and the Veteran only had mild DJD in his knees. Additionally, there was no supporting documentation to support the diagnosis of bilateral knee strain from the August 2012 VA examination. Accordingly, the Veteran's bilateral knee disabilities were less likely than not caused by active duty, and were not caused or aggravated by any the service-connected lumbar spine disability. A VA examination and opinion was provided in January 2021. The examiner provided a negative nexus opinion, finding the left knee DJD was not related to active duty or the back disorder. There was no evidence in the STRs showing knee problems or diagnosis for knee disorders, even when considering the parachute accident. The left knee DJD was commensurate with normal aging and not likely the result of any specific injury. There was no evidence of significant gait dysfunction documented which may indicate increased damage to the knee joint. Accordingly, the Veteran's left knee disorder was less likely than not caused by active duty, or caused or aggravated by any the service-connected back disorder. An additional addendum opinion was provided in May 2021. The examiner noted the STRs and examinations during active duty were silent for any knee complaints, diagnoses, or treatment to include status post the parachute accident in 1973. The Veteran was first evaluated for knee pain in several decades after active duty, therefore intercurrent injury/disease could not be ruled out. There was no medical evidence presented to support the Veteran's knee diagnoses were related to active duty in any way. The Veteran's lay testimony established subjective chronicity of symptoms, but he is not qualified to ascribe symptoms to a diagnosis or determine an etiology. A condition of suggested severity would have required medical attention decades prior to the Veteran seeking treatment. The most likely etiology of the osteoarthritis is age and obesity because it is a wear and tear disease. Medical literature did not support lumbar spine problems causing or aggravating the diagnosed disorders. There was no medical evidence to support significant antalgic gait or severe muscle or nerve damage. The Board is aware that the May 2021 VA examination opinion did not specifically mention bilateral knee strain diagnosed during the 2019 VA examination. The examiner, however, broadly spoke to the question of knee diagnoses and provided a detailed explanation of why such disorders were not etiologically related to service, and were not aggravated by a service-connected lumbar spine disability. The examiner clearly explained that the current knee symptoms arose many years after service and were not related to service. The examiner also clearly detailed how knee symptoms are not causally related to the lumbar spine in any manner. The Board finds that there is no reasonable likelihood that a remand for a further opinion would result in findings favorable to the Veteran, and will accordingly make its decision on the evidence presently of record, which is sufficient to address whether current knee disabilities were caused by service or caused or aggravated by the lumbar spine disability. The collective VA opinions show the examiners reviewed the Veteran's entire record, and provided rationales to support the opinions. The record is negative for probative medical opinions indicating a positive nexus between the Veteran's knee disorders and active service, as well as causation or aggravation by the service-connected back disorder. The Board concludes that, while the Veteran has arthritic findings, they were not chronic in service or had continued since service. The Board has every reason to believe the Veteran was offering a truthful account of his experiences to his clinicians in an attempt to receive appropriate medical care. However, arthritis did not manifest to a compensable degree within a presumptive period. There is no evidence in the record which shows diagnosed degenerative changes by November 1976, within a year of separation from active service. The earliest evidence of degenerative changes was from January 2019. This is nearly 43 years after separation from active service. The evidence supports finding that the Veteran's knee disorders were diagnosed over one year after his separation from active service, outside of the applicable presumptive period. While the Veteran is competent to report having experienced symptoms of knee pain since service, he does not possess the training or credentials necessary to provide a competent diagnosis in this case or to determine that these symptoms were manifestations of diagnosed disorders. The issues are medically complex, and require medical knowledge. Jandreau, 492 F.3d at 1377. The Board gives more probative weight to the competent medical evidence, which establishes that these symptoms are not related to the 1973 parachute accident or the service-connected back disorder. Accordingly, the preponderance of the evidence is against the claims, and the claims for service connection for bilateral knee disabilities must be denied. 38 U.S.C. § 5107(b). 3. Entitlement to service connection for bilateral shoulder disabilities The Veteran's entrance examination in March 1972 and the separation examination in September 1975 were negative for conditions or complaints for either the left or right shoulders. August 1989 private chiropractic records show that the Veteran complained of right shoulder pain. The Veteran complained of shoulder pain history but had normal range of motion without pain or tenderness in June 2008 private treatment notes. The Veteran complained of bilateral shoulder pain in October 2009 private treatment notes. In June 2011 VA treatment notes, the Veteran complained of chronic shoulder pain. The Veteran was provided with a VA examination in August 2012. The Veteran was diagnosed with bilateral shoulder strain in 1973. The Veteran reported developing joint pain during regular drill exercises. No diagnostic testing was conducted on the shoulders. In October 2012, an addendum nexus opinion was provided, in which the examiner provided a negative opinion. The Veteran provided an April 2013 shoulder and arm condition disability benefit questionnaire (DBQ). The Veteran was diagnosed with bilateral shoulder impingement. Imaging studies showed arthritis of the right shoulder. In February 2013 VA treatment records, the Veteran was diagnosed with right shoulder degenerative arthritis. In April 2013 VA treatment notes, the Veteran was diagnosed with post-traumatic osteoarthritis of the bilateral shoulders. The Veteran was provided with a VA examination and nexus opinion in June 2019. The examiner found no evidence of shoulder conditions during active duty in the STRs. The Veteran did not report shoulder pain until almost 40 years after separation from active duty. The mild arthritis, impingement syndrome, and tendinitis in both shoulders is age-appropriate for the Veteran. Additionally, there was no supporting documentation to support the diagnosis of bilateral shoulder strain from the August 2012 VA examination. The Veteran's lumbar spine would have no effect on his arms. They are far apart on the body and back conditions won't cause any conditions in the shoulders and it would not aggravate any shoulder conditions because of anatomic distance. Accordingly, the Veteran's bilateral shoulder disabilities were less likely than not caused by active duty; nor caused or aggravated by any the service-connected lumbar spine disability. A VA examination and opinion was provided in January 2021. The examiner provided a negative nexus opinion, finding the Veteran's STRs did not show any evidence of a shoulder disorder. Medical records after the 1973 parachute accident only showed back pain. There is no evidence in the STRs showing an onset of the shoulder disorder during active duty. There was no objective evidence of past trauma accelerating the course of the degenerative changes, which were age appropriate. The impingement of both shoulders are common shoulder disorders that were not caused by any specific injury nor related to the Veteran's back disorder in any way. Accordingly, the Veteran's bilateral shoulder disorders were less likely than not caused by active duty, and not caused or aggravated by any the service-connected back disorder. An additional addendum opinion was provided in May 2021. The examiner noted that the STRs and examinations during active duty were silent for any shoulder complaints, diagnoses, or treatment to include status post the parachute accident in 1973. The Veteran was first evaluated for shoulder pain in several decades after active duty, and therefore intercurrent injury/disease could not be ruled out. There was no medical evidence presented to support the Veteran's shoulder diagnoses were related to active duty in any way. The Veteran's lay testimony established subjective chronicity of symptoms, but he is not qualified to ascribe symptoms to a diagnosis or determine an etiology. A condition of suggested severity would have required medical attention decades prior to the Veteran seeking treatment. The most likely etiology of the osteoarthritis is age and obesity because it is a wear and tear disease. Medical literature did not support lumbar spine problems causing or aggravating the diagnosed disorders. There was no medical evidence to support significant antalgic gait or severe muscle or nerve damage. The Board is aware that the May 2021 VA examination opinion did not specifically mention prior diagnoses including bursitis and impingement syndrome. The examiner, however, broadly spoke to the question of a shoulder diagnosis and provided a detailed explanation of why such disorder was not etiologically related to service, and was not aggravated by a service-connected lumbar spine disability. The examiner clearly explained that the current shoulder symptoms arose many years after service and were not related to service. The examiner also clearly detailed how shoulder symptoms are not causally related to the lumbar spine in any manner. The Board finds that there is no reasonable likelihood that a remand for a further opinion would result in findings favorable to the Veteran, and will accordingly make its decision on the evidence presently of record, which is sufficient to address whether a current shoulder disability was caused by service or caused or aggravated by the lumbar spine disability. The collective VA opinions show the examiners reviewed the Veteran's entire record, and provided rationales to support the opinions. The record is negative for probative medical opinions indicating a positive nexus between the Veteran's shoulder disorders and active service, or causation or aggravation by the service-connected back disorder. The Board concludes that, while the Veteran has arthritic findings in his shoulders, it was not chronic in service or had continued since service. The Board has every reason to believe the Veteran was offering a truthful account of his experiences to his clinicians in an attempt to receive appropriate medical care. However, arthritis did not manifest to a compensable degree within a presumptive period. There is no evidence in the record which shows diagnosed degenerative changes by November 1976, within a year of separation from active service. The earliest evidence of degenerative changes was in February 2013 VA treatment records. This is nearly 37 years after separation from active service. The evidence supports finding that the Veteran's shoulders disabilities were diagnosed over one year after his separation from active service, outside of the applicable presumptive period. While the Veteran is competent to report having experienced symptoms of shoulder pain since service, he does not possess the training or credentials necessary to provide a competent diagnosis in this case or to determine that these symptoms were manifestations of diagnosed disorders. The issues are medically complex, and require medical knowledge. Jandreau, 492 F.3d at 1377. The Board gives more probative weight to competent medical evidence, which establishes that these symptoms are not related to the 1973 parachute accident or the service-connected back disorder. Accordingly, the preponderance of the evidence is against the claims, and the claims for service connection for bilateral shoulder disabilities must be denied. 38 U.S.C. § 5107(b). 4. Entitlement to TDIU TDIU is warranted where the evidence shows that the Veteran is precluded from obtaining or maintaining substantially gainful employment consistent with his education and occupational experience, because of service-connected disability. 38 C.F.R. §§ 3.340, 3.341, 4.16. A total disability rating may be assigned where the schedular rating is less than total and when the Veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disability, provided, however, that if there is only one such disability, it must be rated 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 rating to 70 percent or more. 38 C.F.R. § 4.16(a). Marginal employment shall not be considered substantially gainful employment. 38 C.F.R. § 4.16(a). In making its determination, VA considers such factors as the extent of the service-connected disabilities, and employment and educational background. 38 C.F.R. §§ 3.321(b), 3.340, 3.341, 4.16(b), 4.19. The determination must be made without regard to any nonservice-connected disabilities or the veteran's advancing age. 38 C.F.R. § 3.341(a). See also Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). The fact that a veteran may be unemployed or has difficulty obtaining employment is not determinative. The ultimate question is whether the veteran, because of service-connected disability, is incapable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose, 4 Vet. App. at 363. In this case, the Veteran has met the schedular criteria for entitlement to TDIU throughout the entire period on appeal. The Board must now determine whether his service-connected disabilities prevent him from securing or following a substantially gainful occupation. In making that determination, the Board considers such factors as the extent of the service-connected disabilities, and employment and educational background. The Veteran submitted TDIU applications in June 2011 and June 2016, in which he asserted he had not worked full time since June 2010. The Veteran's back disability and lower extremity radiculopathy impacted his ability to work. The Veteran completed four years of high school and two years of college education. He worked as computer programmer for the U.S. Navy in a civilian capacity from June 1988 to June 2010. His work experience included program analyst, information technology, and accounting. In June 2011, the Veteran reported that he had to retire at the age of 56 because of elevated joint pain, body pain, depression, and panic attacks. He could not sit or stand for long periods of time and found it difficult to concentrate on his work as a programmer and analyst. In June 2011, the Veteran provided a letter from his pervious supervisor of 4 years before he retired in 2010. In October 2007, medical documentation provided from the Veteran's physician showed the Veteran's low back disorder, low back pain, limitation of motion in his back required an ergonomic chair as an accommodation for work. The Veteran was also provided with a raised desktop for his workspace. The Veteran was accommodated with flexibility in use of his accumulated sick leave for doctors' appointments and late arrival requests due to joint pain in the morning. The Veteran also was provided with a parking space in close proximity to building access. In the March 2016 and September 2016 VA back examination, the examiner found the back disorder would limit standing, sitting, walking, lifting, carrying, bending, and twisting. Heavy physical jobs would not be feasible. The Veteran's work history reflected extensive work experience in office-type environments. The evidence of record shows that his service-connected orthopedic and neurological disorders alone, would greatly limit his ability to perform office-based, sedentary forms of employment. The inability to sit and stand for long periods of time would greatly limit the Veteran's ability to perform even the most basic computer task since he is a program analyst. The Veteran's work history does not show he has the ability to work in labor-intensive career fields, and his back disorder and lower extremity radiculopathy would prohibit him from such forms of work. Based upon the above evidence, the Board finds that the Veteran's physical limitations due to service-connected disabilities would preclude him, if not from all employment, at least from securing and following substantially gainful employment. The Veteran's previous employer tried to accommodate the Veteran, and he still had to retire due to his physical limitations. It is difficult under these circumstances to envision the Veteran performing more than marginal employment, given the enumerated limitations. As such, the criteria for TDIU have been met, and the claim is granted in full. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. N. Quarles, 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.