Citation Nr: 21005615 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 15-11 362 DATE: February 2, 2021 ORDER Service connection for an acquired psychiatric disorder other than specific phobia is denied. The reduction from 100 percent to 20 percent for a left shoulder disability, status post arthroscopic surgery, effective from February 1, 2016 was proper. A rating higher than 20 percent for a left shoulder disability from February 1, 2016 is denied. An initial rating higher than 40 percent for lumbar spine degenerative arthritis is denied. An initial rating higher than 40 percent for right lower extremity radiculopathy is denied. An initial rating higher than 10 percent for specific phobia is denied. An initial compensable rating for bilateral hearing loss is denied. An initial compensable rating for residuals of a cholecystectomy is denied. An initial compensable rating for cholecystectomy scars is denied. An initial compensable rating for right knee scars is denied. A total disability rating based on individual unemployability (TDIU) is denied. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has had an acquired psychiatric disability other than specific phobia at any time during or approximate to the pendency of the claim. 2. The Veteran’s left shoulder disability was examined in August 2014, he was notified of a proposed reduction in February 2015, and the reduction was implemented in November 2015 and effective February 2016. 3. From February 1, 2016, the Veteran’s left shoulder disability was not manifested by flexion or abduction of just 25 degrees from the side. 4. The Veteran’s lumbar spine degenerative arthritis is not manifested by unfavorable ankylosis. 5. The Veteran’s right lower extremity radiculopathy is manifested by no more than moderate severe incomplete paralysis. 6. The severity, frequency, and duration of the Veteran’s specific phobia symptoms did not more closely approximate occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. 7. The Veteran’s hearing has been manifested by acuity of no worse than Level I in the right ear and no worse than Level I in the left ear. 8. The Veteran’s cholecystectomy residuals are not symptomatic. 9. The Veteran has three cholecystectomy scars, each measuring 1 cm. by .2 cm., which are not painful or unstable. 10. The Veteran has four right knee scars, measuring 6 cm. by .4 cm., 5 cm by .2 cm., .5 cm. by .2 cm., and .5 cm. by .2cm., which are not painful or unstable. 11. The Veteran is in receipt of a 100 percent combined schedular rating, and does not have a single disability that has been shown to preclude gainful employment. CONCLUSIONS OF LAW 1. The criteria for service connection for an acquired psychiatric disorder other than specific phobia are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for a reduction from 100 percent to 20 percent for a left shoulder disability, status post arthroscopic surgery, effective from February 1, 2016 have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.105, 4.28. 3. The criteria for a rating higher than 20 percent for a left shoulder disability, status post arthroscopic surgery, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code (DC) 5201. 4. The criteria for a rating higher than 40 percent for lumbar spine degenerative arthritis have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, DC 5237. 5. The criteria for a disability rating higher than 40 percent for right lower extremity radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 6. The criteria for a disability rating in excess of 10 percent for specific phobia have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, DC 9403. 7. The criteria for an initial compensable rating for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, DC 6100. 8. The criteria for an initial compensable rating for residuals of a cholecystectomy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.114, DC 7318. 9. The criteria for an initial compensable rating for the Veteran’s cholecystectomy scars have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7802. 10. The criteria for an initial compensable rating for the Veteran’s right knee scars have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7805. 11. The criteria for a TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the U.S. Air Force and Air National Guard from May 1978 to May 1982 and from December 2009 to September 2013. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from March 2014, April 2014 and November 2015 rating decisions. It was previously remanded by the Board for additional development in August 2018 and February 2019. Service Connection 1. Acquired psychiatric disorder other than specific phobia Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). As noted below, the Veteran is presently service-connected for a specific phobia. The relevant question for this service connection claim is whether he has an additional psychiatric disorder. The Board concludes that the Veteran does not have any additional psychiatric diagnosis and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Veteran underwent VA examinations in April 2014 and October 2019. The April 2014 examiner only diagnosed the service-connected phobia. The October 2019 examiner stated that, notwithstanding the established phobia diagnosis, the Veteran had no current mental disorder. The remainder of the competent medical evidence does not otherwise show a diagnosed psychiatric disability outside of the specific phobia. While the Veteran believes he has an additional psychiatric diagnosis, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and knowledge regarding such disorders. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence, which shows no additional diagnosis to be present. Reduction 2. Left shoulder disability The Veteran was granted a 100 percent rating for his left shoulder disability under the provisions of 38 C.F.R. § 4.28. That regulation provides for pre-stabilization ratings. Pre-stabilization ratings are for assignment in the immediate post-discharge period. They will continue for a 12-month period following discharge from service. In each pre-stabilization rating an examination will be requested to be accomplished not earlier than 6 months nor more than 12 months following discharge. In those pre-stabilization ratings in which following examination reduction in evaluation is found to be warranted, the higher evaluation will be continued to the end of the 12th month following discharge or to the end of the period provided under 3.105(e) of this chapter, whichever is later. Here, the Veteran was assigned a 100 percent rating effective October 1, 2013, the day after his discharge from service. In August 2014, about 10 months after discharge, the Veteran underwent a VA examination for his left shoulder. This examination documented flexion of 40 degrees and abduction of 50 degrees, unchanged with repetitive testing. Notably, private records from that same month documented 72 degrees of flexion and 115 degrees of abduction. The Veteran is right-handed, and therefore his left shoulder represents the “minor” joint for rating purposes. The rating criteria for limitation of motion of the arm found in 38 C.F.R. § 4.71a, DC 5201 state that arm motion limited to midway between the side and shoulder level (approximately 45 degrees) warrants a 20 percent rating. Based on these findings, VA notified the Veteran in February 2015 that it proposed to reduce the evaluation for his left shoulder from 100 percent to 20 percent. Subsequently, in November 2015, VA implemented that reduction effective February 1, 2016. In sum, VA’s reduction of the rating for the Veteran’s left shoulder disability was consistent with the procedural requirements in 38 C.F.R. § 3.105(e) and 38 C.F.R. § 4.28. Increased Ratings Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran. 38 C.F.R. § 4.3. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, present level of disability is the primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). For musculoskeletal disabilities, VA must analyze the evidence of pain, weakened movement, excess fatigability, or incoordination and determine the level of associated functional loss in light of 38 C.F.R. § 4.40, which requires the VA to regard as “seriously disabled” any part of the musculoskeletal system that becomes painful on use. DeLuca v. Brown, 8 Vet. App. 202 (1995). However, pain that does not result in additional functional loss does not warrant a higher rating. See Mitchell v. Shinseki, 25 Vet. App. 32 (2011) (holding that pain alone does not constitute function loss but is just one fact to be considered when evaluating functional impairment). 3. Left shoulder disability from February 1, 2016 As discussed above, the Veteran’s left shoulder disability, status post arthroscopy, is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5201, for limitation of motion of the arm. Under Diagnostic Code 5201, limitation of motion of the minor extremity at shoulder level (90 degrees), or midway between the side and shoulder level (45 degrees), warrants a 20 percent rating. Limitation of motion of the arm to 25 degrees from side warrants a maximum 30 percent rating for the minor joint. 38 C.F.R. § 4.71a, Diagnostic Code 5201. Diagnostic Code 5201 “does not provide separate ratings for limitation of motion in the flexion and abduction planes, but rather is addressed generically to limitation of motion of the arm.” Yonek v. Shinseki, 722 F.3d 1355, 1358 (Fed. Cir. 2013). The Board finds that the preponderance of the evidence is against a rating in excess of 20 percent. Following the reduction from 100 percent to 20 percent effective February 1, 2016, the earliest evidence addressing range of motion is from April 2019 private treatment records which show flexion of 172 degrees and abduction of 115 degrees. A subsequent VA examination in October 2019 recorded flexion and abduction of 60 degrees. Notably, the Veteran reported experiencing flare-ups several times a day, and the examination itself was conducted during a flare-up. There was no additional limitation as a result of repetitive testing or repetitive use over time. None of these findings approach the 25 degrees of limitation necessary to warrant a higher 30 percent rating. The Board has considered whether any other Diagnostic Codes related to disabilities of the shoulder would provide for a higher disability rating. However, the evidence does not reflect that the symptoms would warrant a higher rating under a different Diagnostic Code. See 38 C.F.R. § 4.71a. Such ratings would require ankylosis of the shoulder or impairment of the humerus, neither of which has been shown by the competent medical evidence. 4. Lumbar spine degenerative arthritis The Veteran’s lumbar spine disability is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5237, which is part of the General Rating Formula for Diseases and Injuries of the Spine. Under that formula, a 40 percent rating is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. Unfavorable ankylosis is defined as “a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching.” Id. at Note 5. The Board finds that the preponderance of the evidence is against a rating in excess of 40 percent. VA examinations in November 2013 and October 2019 specifically noted that no ankylosis, let alone unfavorable ankylosis, were present. Additional private treatment records from November 2019 show restricted range of motion but do not describe any unfavorable ankylosis. Indeed, there is no competent evidence of any unfavorable ankylosis and no assertion from the Veteran that he experiences such symptoms. The General Rating Formula also provides that any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1. Indeed, the Veteran is already service-connected for right lower extremity radiculopathy which is discussed below. However, the evidence does not establish that any additional neurologic abnormalities are present and warrant separate ratings. The only evidence of an additional neurologic abnormality is private treatment records from September 2019 which reference bilateral sciatica. Paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8520. Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R. § 4.124a. The words “mild,” “moderate,” and “severe” as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. The term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at “Diseases of the Peripheral Nerves.” The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). The September 2019 private treatment records noted lower extremity strength of 4+/5. However, this is the only record of any left lower extremity neurologic disability. Indeed, the VA examination conducted just one month later in October 2019 specifically noted that no left lower extremity abnormality was present. The Board finds that the September 2019 record, alone, does not warrant a separate rating under DC 8520. 5. Right lower extremity radiculopathy The Veteran is currently assigned a 40 percent rating for his right leg radiculopathy under 38 C.F.R. § 4.124a, DC 8520. As discussed above, a higher 60 percent rating is assigned when the condition results in severe incomplete paralysis with marked muscular atrophy. No atrophy, let alone marked atrophy, has been shown during the appeal period. A November 2013 VA examination documented mild radiculopathy with symptoms of mild paresthesias. Strength was 5/5 and no atrophy was present. Sensation and reflexes were also normal. An October 2019 VA examination documented moderate symptoms and an overall assessment of moderately severe radiculopathy. Strength was still 5/5 and no atrophy was present. In addition, sensation was decreased but not absent, and reflexes were normal. The available private treatment records also do not show the presence of any atrophy in the right leg. Given that no atrophy has been shown and the Veteran’s other manifestations do not rise to a level of severe incomplete paralysis, a rating higher than 40 percent is not warranted. 6. Specific phobia The Veteran’s specific phobia is rated at 10 percent under 38 C.F.R. § 4.130, DC 9403, which is part of the General Formula for Mental Disorders (General Formula). Under that formula, the Board must conduct a “holistic analysis” that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). The issue in this appeal is whether the Veteran’s associated symptoms caused the level of impairment required for a disability rating of 30 percent or higher. A 10 percent rating is assigned when mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of occasional stress, or symptoms controlled by medication cause occupational and social impairment. A 30 percent rating is assigned when symptoms such as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, or recent events), cause 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 normal conversation). The Board concludes that the Veteran’s symptoms did not cause the level of impairment required for a disability rating of 30 percent or higher. The Veteran’s symptoms more closely approximated the symptoms associated with a 10 percent rating and resulted in a level of impairment that most closely approximated the level of impairment associated with a 10 percent rating. Private treatment records from November 2013 show that the Veteran only had anxiety or panic attacks when he attempted or talked about CPAP titration to treat his sleep apnea. Additional records show he used a mouthpiece to help treat his sleep apnea. An April 2014 VA examination noted that the Veteran experienced a phobic reaction and intense feelings of restriction when subjected to CPAP treatment or sleep study procedures. The examiner noted symptoms of anxiety and panic attacks, but these symptoms were not severe enough to interfere with functioning or require continuous medication. An October 2019 VA examination acknowledged the established phobia diagnosis but stated that no current mental disorder was present. The examiner acknowledged the Veteran’s report of not liking his hands and wrists restrained, as well as the record suggesting specific moments of anxiety and panic related to a sleep study and CPAP treatment. However, the diagnostic criteria of recurrent unexpected panic attacks, persistent worry or concern, or behavioral changes were not met, and the Veteran did not experience persistent anxiety causing distress. The Board finds the severity, frequency, and duration of the Veteran’s unlisted symptoms more closely approximate the symptoms contemplated by a 10 percent rating. See 38 C.F.R. § 4.126. Notably, panic attacks and anxiety are symptoms associated with the higher 30 percent rating. However, these symptoms were limited only to specific instances of undergoing a sleep study, the application of CPAP therapy (which he does not use), or the restraint of his hands and wrists. The evidence does not show that these circumstances occurred even annually during the appeal period. As a result, the frequency and duration of such symptoms, if they occur, is extremely short, and therefore not consistent with the overall level of impairment contemplated by the higher 30 percent rating. In making this determination, the Board notes that the Veteran reported difficulties associated with his ex-wife and their divorce, which occurred during service. However, these symptoms were not identified as being associated with his service-connected phobia. 7. Bilateral hearing loss Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz). 38 C.F.R. § 4.85, Diagnostic Code 6100. To evaluate the degree of disability from bilateral service-connected hearing loss, the schedule establishes 11 auditory hearing acuity levels designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. 38 C.F.R. § 4.85, Tables VI and VII. The Veteran underwent a VA examination in December 2013. Pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 15 15 15 25 18 LEFT 15 20 25 45 26 Speech audiometry revealed speech recognition ability of 100 percent in the right ear and 100 percent in the left ear. Utilizing Table VI, this corresponds to a hearing level of I in both ears. Under Table VII, this results in a 0 percent rating. An additional VA examination was conducted in October 2019. Pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 15 20 30 50 29 LEFT 20 25 40 60 36 Speech audiometry revealed speech recognition ability of 100 percent in the right ear and 96 percent in the left ear. Utilizing Table VI, this corresponds to a hearing level of I in both ears. Under Table VII, this results in a 0 percent rating. In sum, the objective evidence shows that a noncompensable rating for hearing loss is warranted. The Board expressly acknowledges its consideration of the lay evidence of record when adjudicating this claim, including assertions that he cannot hear some conversations or television and movie dialogue. The Veteran is competent to report these difficulties with his hearing. However, disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenmann v. Principi, 3 Vet. App. 345 (1992). The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran describes is contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Veteran’s main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned. See Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). Accordingly, the preponderance of the evidence is against the claim of entitlement to a compensable rating for hearing loss. 8. Cholecystectomy The Veteran is currently assigned a 0 percent rating under 38 C.F.R. § 4.114, DC 7318, for his cholecystectomy (gall bladder removal). Under this code, a 0 percent rating is assigned when the condition is not symptomatic. A 10 percent rating is assigned when there are mild symptoms. A 30 percent rating is assigned when there are severe symptoms. Regarding symptoms, the Board relies on DC 7314, which addresses cholecystitis and contemplates symptoms of gall bladder colic, dyspepsia and jaundice. In that regard, a higher 10 percent rating is not warranted. The Veteran underwent a VA examination in October 2019 which specifically found that no gall bladder colic, dyspepsia or jaundice was present, nor were there any other forms of abdominal pain. Indeed, a review of the available medical evidence from the appeal period does not show the presence of such symptoms at any time, and the Veteran himself has not alleged otherwise. As there is no indication that the Veteran’s gall bladder removal is symptomatic, a compensable rating is not warranted. 9. Cholecystectomy scars 10. Right knee scars Because these two issues are legally and factually similar, they will be discussed together. The Veteran’s cholecystectomy scars are rated under 38 C.F.R. § 4.118, DC 7802. His knee scars are rated under DC 7805. The Board notes that VA amended the criteria for rating skin disabilities effective from August 13, 2018. These new regulations apply to all applications for benefits received by VA or that are pending before the agency of original jurisdiction on or after August 13, 2018. Claims pending prior to the effective date will be considered under both old and new rating criteria, and whatever criteria is more favorable to the veteran will be applied. The Board may not apply a current regulation prior to its effective date, unless the regulation explicitly provides otherwise. Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). However, the Board is not precluded from applying prior versions of the applicable regulation to the period on or after the effective dates of the new regulation if the prior version was in effect during the pendency of the appeal. Prior to August 13, 2018, DC 7802, was for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that were superficial and nonlinear. Under these criteria, a scar with an area or areas of 144 square inches (929 sq. cm.) or greater warrants a 10 percent rating. 38 C.F.R. § 4.118. Note 1 to DC 7802 instructed that a superficial scar was one not associated with underlying soft tissue damage. Id. Since August 13, 2018, DC 7802 is for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are not associated with underlying soft tissue damage. 38 C.F.R. § 4.118. DC 7802 was otherwise unchanged by the August 13, 2018, amendments. DC 7805 is for other scars (including linear scars) and other effects of scars evaluated under Diagnostic Codes 7800, 7801, 7802, and 7804. It was not changed by the August 13, 2018, amendments. The Board finds that the preponderance of the evidence is against the assignment of a compensable rating for the Veteran’s cholecystectomy or right knee scars under DC 7802 or 7805. An October 2019 VA examination documented three cholecystectomy scars, each measuring 1 cm. by .2 cm., which were not painful or unstable. The Veteran also had four right knee scars, measuring 6 cm. by .4 cm., 5 cm by .2 cm., .5 cm. by .2 cm., and .5 cm. by .2 cm., which were also not painful or unstable. In other words, the Veteran’s scars do not affect an area of at least 929 sq. cm., are not painful or unstable, and do not affect the head, face or neck. Therefore, there is no basis upon which to assign a compensable rating. The Veteran has not asserted, and the medical records do not show, that any of his scars are manifested by any disabling effects. 11. TDIU A TDIU may be assigned where the schedular rating is less than total, when it is found that the disabled person is unable to secure or follow a substantially gainful occupation due a single service-connected disability ratable at 60 percent or more, or due to two or more disabilities, provided at least one disability is ratable at 40 percent or more, and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). The Veteran is in receipt of a 100 percent schedular rating for the entire appeal period. Nevertheless, consideration of a TDIU based on a single disability is still necessary. Bradley v. Peake, 22 Vet. App. 280 (2008) (holding that, while no additional disability compensation may be paid when a total schedular disability rating is already in effect, a separate award of a TDIU predicated on a single disability may form the basis for an award of special monthly compensation). The Veteran is presently service-connected for obstructive sleep apnea, lumbar spine degenerative arthritis, right lower extremity radiculopathy, a left shoulder disability, right knee ACL tear with removal of cartilage and limitation of motion, bilateral ankle degenerative arthritis, specific phobia, bilateral hearing loss, cholecystectomy, and various scars. Notably, neither the Veteran nor his previous attorney of record submitted a VA Form 21-8940, Application for Increased Compensation Based on Unemployability. A substantially complete VA Form 21-8940 gathers relevant and indispensable information regarding a claimant’s disabilities and employment and educational histories. It concludes with a series of sworn certification statements, and in endorsing it, a veteran attests to his employment status and signals understanding of the IU benefit’s incompatibility with substantially gainful work. During a VA examination in April 2014, the Veteran reported working at a gas station, in a grocery store, and for the Division of Forestry prior to service. He also worked as a subcontractor for new home builders. He stated that he attended some college, but never completed a formal course of study. During an October 2019 VA examination, he also referenced working as a baseball umpire during service but stated that his physical injuries prevented him from performing such work after service. Unfortunately, a TDIU cannot be granted because the evidence regarding the Veteran’s prior employment is incomplete. Specifically, it is not clear what type of subcontracting work he did, or in what capacity he served with the Division of Forestry. Without such information, the Board cannot assess whether the functional impact associated with his service-connected disabilities would preclude him from gainful employment because the nature of his past employment and skills are not known. In making this determination, the Board notes that the Veteran’s 100 percent combined schedular rating reflects total occupational impairment. What has not been shown is that the functional impairment from any single service-connected disability is sufficient to preclude him from gainful employment. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Shamil Patel, 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.