Citation Nr: 21006624 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 13-32 364 DATE: February 4, 2021 ORDER The claim of entitlement to service connection for lumbar spine disability, to include degenerative disc disease (DDD) dismissed. The claim of entitlement to a disability rating higher than 10 percent for traumatic arthritis of the left hip based on limitation of extension is denied. The claim of entitlement to an initial disability rating higher than 20 percent for traumatic arthritis of the left hip based on impairment of the thigh is denied. The claim of entitlement to an initial compensable rating from January 30, 2012, through May 7, 2019, and a rating higher than 20 percent from May 8, 2019, for traumatic arthritis of the left hip based on limitation of flexion is denied. The claim of entitlement to a disability rating higher than 20 percent from January 30, 2012, through October 10, 2016, and a rating higher than 30 percent from October 11, 2016, for acromioclavicular (AC) arthrosis and supra infraspinatus tendinosis of the left shoulder, status post recurrent left shoulder subluxation is denied. The claim of entitlement to an initial disability rating higher than 20 percent for recurrent dislocation of the left shoulder is denied. The claim of entitlement to a total disability rating based on individual unemployability (TDIU) prior to January 30, 2012, to include on an extra-schedular basis pursuant to 38C.F.R. §4.16(b), is denied. FINDINGS OF FACT 1. In a September 2020 rating decision, service connection for a lumbar spine disability was granted, resulting in a full grant of the benefit sought on appeal. 2. For the entire period on appeal, the Veteran’s left hip limitation of extension is rated as 10 percent disabling, which is the maximum schedular rating permitted for limitation of extension of the hip. 3. For the entire period on appeal, the Veteran’s left thigh impairment is rated as 20 percent disabling, which is the maximum schedular rating permitted for impairment of the thigh. 4. From January 30, 2012, through May 7, 2019, the Veteran’s left hip limitation of flexion was, at worst, limited to 50 degrees. From May 8, 2019, the Veteran’s left hip limitation of flexion was, at worst, limited to 35 degrees. 5. From January 30, 2012, through October 10, 2016, the Veteran’s AC arthrosis and supra infraspinatus tendinosis did not manifest as flexion or abduction limited to 25 degrees of the minor extremity. From October 11, 2016, the Veteran has been in receipt of the maximum schedular rating permitted for left shoulder AC arthrosis and supra infraspinatus tendinosis. 6. The Veteran’s recurrent dislocation of the left shoulder did not manifest as fibrous union of the humerus, nonunion of the humerus (false flail joint), or loss of head of the humerus (flail shoulder). 7. The Veteran’s service-connected disabilities did not preclude gainful employment consistent with his education and occupational experience prior to January 30, 2012. CONCLUSIONS OF LAW 1. The criteria for dismissal of entitlement to service connection for a lumbar spine disability have been met. 38 U.S.C. § 7105. 2. The criteria for a rating in excess of 10 percent for traumatic arthritis of the left hip based on limitation of extension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5010-5251. 3. The criteria for a rating in excess of 20 percent for traumatic arthritis of the left hip based on impairment of the thigh have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5010-5253. 4. The criteria for an initial compensable rating from January 30, 2012, through May 7, 2019, and a rating higher than 20 percent from May 8, 2019, for traumatic arthritis of the left hip based on limitation of flexion have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5010-5252. 5. The criteria for a rating in excess of 20 percent from January 30, 2012, through October 10, 2016, and a rating higher than 30 percent from October 11, 2016, for AC arthrosis and supra infraspinatus tendinosis of the left shoulder, status post recurrent left shoulder subluxation have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5010-5201. 6. The criteria for a rating in excess of 20 percent for recurrent dislocation of the left shoulder have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5202. 7. The criteria for the grant of TDIU prior to January 30, 2012, have not been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. § 3.158, 3.340, 3.341, 4.15, 4.16, 4.19. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1972 to May 1974. These matters come before the Board of Veterans’ Appeals (Board) on appeal from April 2012, August 2016, and October 2019 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2017, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is associated with the claims file. The claims were previously remanded by the Board in March 2020. There was substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998); Dyment v. West, 13 Vet. App. 141, 146-47 (1999). Dismissed Claim 1. Entitlement to service connection for lumbar spine disability, to include DDD The claim of entitlement to service connection for a lumbar spine disability was initially denied in an August 2010 rating decision. The issue was properly appealed to the Board and remanded in February 2018 and March 2020 for additional evidentiary development. Subsequently, in September 2020, the RO granted entitlement to service connection for this disability. This is a full grant of benefits sought on appeal, and there is no case or controversy for the Board to adjudicate. Consequently, the claim is dismissed. 38 U.S.C. § 7105. Increased Rating Disability evaluations are determined by applying the criteria set forth in the Schedule for Rating Disabilities to the Veteran’s current symptomatology. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower evaluation will be assigned. 38 C.F.R. § 4.7. The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as “staged ratings,” whether it is an initial rating case or not. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505, 519 (2007). When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (“[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran’s disability, after which a rating is determined based on the § 4.71a criteria.”). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing “for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint.” In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination. 2. Entitlement to a disability rating higher than 10 percent for traumatic arthritis of the left hip based on limitation of extension On January 30, 2012, the Veteran filed a claim of entitlement to increased ratings for his left hip disabilities. Currently, the Veteran’s left hip limitation of extension is rated as 10 percent disabling under Diagnostic Code 5010-5251 from July 9, 2009. A hyphenated diagnostic code is used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the rating assigned. The additional diagnostic code is shown after the hyphen. Diagnostic Code 5010 addresses traumatic arthritis, and instructs that the condition be rated according to Diagnostic Code 5003. Diagnostic Code 5003 addresses degenerative arthritis, and states that the condition should be rated on the basis of limitation of motion under the appropriate diagnostic codes. Therefore, the Veteran’s left hip limitation of extension is rated under Diagnostic Code 5251 which addresses limitation of extension. Normal ranges of motion of the hip include hip extension and flexion from 0 degrees to 125 degrees, and hip abduction from 0 degrees to 45 degrees. 38 C.F.R. § 4.7, Plate II. Under Diagnostic Code 5251, a maximum 10 percent rating is warranted for extension of the thigh limited to 5 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5251. As the Veteran has been in receipt of the highest schedular rating for limitation of extension of the thigh for the entire period on appeal, there is no basis to award a higher rating. 38 C.F.R. § 4.71a, Diagnostic Code 5251. Therefore, the appeal must be denied. 3. Entitlement to an initial disability rating higher than 20 percent for traumatic arthritis of the left hip based on impairment of the thigh The Veteran seeks a rating in excess of 20 percent for traumatic arthritis of the left hip based on impairment of the thigh for the entire period on appeal. The disability is rated under Diagnostic Code 5010-5253. Under Diagnostic Code 5253, a maximum 20 percent rating is warranted for limitation of abduction, motion lost beyond 10 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5253. As the Veteran is in receipt of the highest schedular rating for impairment of the thigh, there is no basis to award a higher rating, and the claim must be denied. 38 C.F.R. § 4.71a, Diagnostic Code 5253 4. Entitlement to an initial compensable rating from January 30, 2012, through May 7, 2019, and a rating higher than 20 percent from May 8, 2019, for traumatic arthritis of the left hip based on limitation of flexion The Veteran claims he is entitled to an initial compensable rating from January 30, 2012, through May 7, 2019, and a rating in excess of 20 percent from May 8, 2019, for traumatic arthritis of the left hip based on limitation of flexion. This disability is rated under Diagnostic Code 5010-5252. A 10 percent disability rating is warranted where flexion of the thigh is limited to 45 degrees under Diagnostic Code 5252. A 20 percent disability rating is assigned where flexion is limited to 30 degrees; a 30 percent disability rating is assigned where flexion is limited to 20 degrees; and a 40 percent disability rating is assigned where flexion is limited to 10 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5252. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 C.F.R. § 4.31. Additionally, 38 C.F.R. § 4.59 allows for consideration of functional loss due to painful motion to be rated to at least the minimum compensable rating for a particular joint. January 30, 2012 – May 7, 2019 At the March 2017 Board hearing, the Veteran reported that his hip disabilities prevent him from sitting for more than 20 minutes at a time. He also reported that he has to sleep in a recliner, and that standing and walking beyond 30 minutes requires rest in the recliner for at least two hours. The Veteran was afforded VA examinations in March 2012, July 2016, and October 2016. He reported that his left hip pain increases when walking and rising from a seated position, but that the pain subsides within minutes. The Veteran also stated he experienced flare-ups that consist of pain that causes his leg to give way. At worst, the Veteran was able to demonstrate left hip flexion to 50 degrees during range of motion testing at the July 2016 examination. The VA examiner stated that the Veteran’s examination was being conducted during a flare-up. A review of VA treatment notes show the Veteran complained of left hip pain in November 2013. The VA physician noted that the Veteran had excellent, painless range of motion of his left hip. The Veteran again complained of left hip pain in April 2014, and requested steroid hip injections. However, while the record shows the Veteran received such injections for his back and shoulder, it does not appear this treatment was administered with regard to his left hip. Based on the evidence discussed above, we find that prior to May 8, 2019, the Veteran’s left hip limitation of flexion did not warrant a compensable rating. Even during flare-ups, he was able to demonstrate left hip flexion to 50 degrees. A compensable rating would require flexion limited to 45 degrees or less. Further, the Board acknowledges that the Veteran was unable to perform range of motion testing in October 2016 due to pain. However, a separate rating may not be assigned for arthritis with painful or limited motion, including with respect to limitation of motion in separate planes under 38 C.F.R. § 4.59, as § 4.59 only allows for one compensable rating for the affected joint. Prior to May 8, 2019, the Veteran was in receipt of compensable ratings for limitation of motion under Diagnostic Codes 5251 and 5253, as his left hip traumatic arthritis manifested as pain associated with a thigh impairment and limited extension. Accordingly, a compensable rating from January 30, 2012, through May 7, 2019, for left hip limitation of flexion must be denied. May 8, 2019 - Present The Veteran seeks a rating in excess of 20 percent for left hip limitation of flexion from May 8, 2019. In May 2019, the Veteran attended a VA examination, during which he reported experiencing chronic left hip pain and stiffness with flare-ups that cause additional burning pain. Range of motion testing results showed the Veteran had left hip flexion to 35 degrees. Though the examination was not conducted during a flare-up, the VA examiner estimated that left hip flexion would be reduced to 25 degrees. Additionally, there was objective evidence of pain when the left hip was used in both weight bearing and non-weight bearing. The Veteran’s most recent VA examination occurred in August 2020. The Veteran stated his left hip pain had worsened. However, during range of motion testing, the Veteran was noted to have left hip flexion to 90 degrees, demonstrating a significant improvement compared to results in previous examinations. Although the examination was not conducted during a flare-up, the VA examiner determined that the Veteran would still have left hip flexion to 90 degrees during flare-ups. There was objective evidence of left hip pain when used in weight-bearing and non-weight-bearing. The Board finds the Veteran is not entitled to a rating in excess of 20 percent for left hip limitation of flexion from May 8, 2019. At worst, the Veteran demonstrated left hip flexion to 35 degrees. As flexion limited to 35 degrees falls between the 10 percent rating for 45 degrees of flexion, and the 20 percent rating for 30 degrees of flexion, the Veteran was awarded the higher 20 percent rating. A review of additional medical records fails to show the Veteran’s left hip flexion was limited to such a degree that would support an award of a higher disability rating. Accordingly, an increased rating for left hip flexion from May 8, 2019, is denied. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. The Board has also considered the other Diagnostic Codes pertaining to the hip and thigh throughout the entire period on appeal. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); see also Lyles v. Shulkin, 29 Vet. App. 107 (2017) (holding that 38 C.F.R. § 4.14 prohibits paying compensation twice for the same symptoms or functional impairment). However, at no point during the period on appeal was the Veteran found to have left hip ankylosis, flail joint, or femur impairment. 38 C.F.R. § 4.71a, Diagnostic Codes 5250, 5254, 5255. 5. Entitlement to a disability rating higher than 20 percent from January 30, 2012, through May 7, 2019, and a rating higher than 30 percent from May 8, 2019, for AC arthrosis and supra infraspinatus tendinosis of the left shoulder, status post recurrent left shoulder subluxation On January 30, 2012, the Veteran filed a claim seeking an increased rating for his service-connected left shoulder AC arthrosis and supra infraspinatus tendinosis. This disability is rated as 20 percent disabling from January 30, 2012, and 30 percent disabling from May 8, 2019, under 38 C.F.R. § 4.71a, Diagnostic Code 5010-5201 for limitation of motion of the arm. 38 C.F.R. § 4.71, Plate I, defines normal ranges of motion of the shoulder. Normal ranges of motion of the shoulder are flexion (forward elevation) from 0 degrees to 180 degrees, abduction from 0 degrees to 180 degrees, external rotation from 0 degrees to 90 degrees, and internal rotation from 0 degrees to 90 degrees. Under Diagnostic Code 5201, limitation of motion of the arm at shoulder level warrants a 20 percent rating for both the major and minor extremity. Limitation of motion of the arm midway between side and shoulder (interpreted by the Board as flexion and/or abduction limited to 45 degrees) warrants a 20 percent rating for the minor extremity and a 30 percent rating for the major extremity. Limitation of motion of the arm to 25 degrees from side warrants a maximum 30 percent rating for the minor joint and a maximum 40 percent rating for the major joint. 38 C.F.R. § 4.71a, Diagnostic Code 5201. The Board notes that the medical record establishes that the Veteran’s left upper extremity is his minor extremity. 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). However, the Board January 30, 2012 – October 10, 2016 The Board finds that the preponderance of the evidence is against a finding that the Veteran’s left shoulder AC arthrosis and supra infraspinatus tendinosis resulted in flexion or abduction of the left shoulder limited to 25 degrees from the side to warrant a 30 percent rating from January 30, 2012, through October 10, 2016. VA treatment notes from October 2013 show the Veteran reported that his left shoulder arthralgia remained unchanged, and he declined additional intervention at the time. In July 2015, the Veteran began receiving corticosteroid injections in the left shoulder. The severity of the Veteran’s left shoulder disability was assessed during VA examinations in March 2012 and October 2015. He described having left shoulder flare-ups when attempting to raise his left arm to shoulder level, lying on the left side, performing twisting actions, and lifting more than five pounds. His March 2012 range of motion test results were left shoulder flexion to 135 degrees, and abduction to 85 degrees. At the October 2015 VA examination, which was conducted during a flare-up, the Veteran demonstrated left shoulder flexion to 80 degrees, and abduction to 70 degrees. Based on a review of the medical records, and the Veteran’s recorded range of motion measurements, the Board finds the Veteran is not entitled to a rating in excess of 20 percent from January 30, 2012, through October 10, 2016. His left shoulder disability did not limit motion of the arm to 25 degrees from side to warrant a 30 percent rating. The Board concludes that the Veteran is not entitled to a rating in excess of 20 percent for left shoulder AC arthrosis and supra infraspinatus tendinosis from January 30, 2012, through October 10, 2016. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. October 11, 2016 – Present The Board finds the Veteran is entitled to a 30 percent rating, and no higher, for left shoulder AC arthrosis and supra infraspinatus tendinosis since October 11, 2016. As noted above, under 38 C.F.R. § 4.71a, Diagnostic Code 5201, limitation of motion of the arm midway between side and shoulder (interpreted by the Board as flexion and/or abduction limited to 45 degrees) warrants a 20 percent rating for the minor extremity, and limitation of motion of the arm to 25 degrees from side warrants a maximum 30 percent rating for the minor extremity. During range of motion testing at a VA examination on October 11, 2016, the Veteran demonstrated left shoulder flexion to 60 degrees and abduction to 30 degrees. Based on the left shoulder abduction range of motion measurement, and by affording the Veteran the benefit of the doubt, the Board finds the Veteran is entitled to a 30 percent rating from October 11, 2016, for left shoulder AC arthrosis and supra infraspinatus tendinosis. His limited motion of the left shoulder more closely approximates the criteria under the 30 percent rating. As previously noted, the evidence of record shows that the Veteran’s left upper extremity is his minor extremity. As the Veteran is in receipt of the highest schedular rating for limitation of motion of the arm of the minor extremity since October 11, 2016, there is no basis to award a higher rating. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s appeal for a rating in excess of 30 percent for left shoulder AC arthrosis and supra infraspinatus tendinosis since October 11, 2016. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 6. Entitlement to an initial disability rating higher than 20 percent for recurrent dislocation of the left shoulder is denied. The Veteran seeks an increased rating for his left shoulder recurrent dislocation. Service connection was established on October 8, 2015, and is rated as 20 percent disabling under Diagnostic Code 5202. A rating in excess of 20 percent for the minor extremity under Diagnostic Code 5202 requires evidence of the following: fibrous union of the humerus warrants a 40 percent rating; nonunion of the humerus (false flail joint) warrants a 50 percent rating; and loss of head of the humerus (flail shoulder) warrants a maximum 70 percent rating. 38 C.F.R. § 4.71a, Diagnostic Code 5202. The Board finds that the preponderance of the evidence is against a rating in excess of 20 percent for left shoulder recurrent dislocation. The Veteran attended VA examinations in October 2015, October 2016, May 2019, and August 2020. Each VA examiner determined the Veteran did not have fibrous union of the humerus, false flail joint, or flail shoulder. A review of treatment notes also fails to show the Veteran was noted to have any of these conditions. Therefore, the Veteran is not entitled to a higher rating for left shoulder recurrent dislocation. The Board has considered whether any other Diagnostic Codes related to disabilities of the shoulder would provide for a higher disability rating. However, the Board notes that the evidence of record fails to reflect that the Veteran’s shoulder disabilities are manifested by ankylosis, or clavicle or scapula impairment, thereby rendering the related Diagnostic Codes of 5200 and 5203 inapplicable. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s appeal for a rating in excess of 20 percent for left shoulder recurrent dislocation. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. TDIU Total disability ratings for compensation may be assigned where the schedular rating is less than 100 percent, when the disabled person is unable to secure or follow a substantially gainful occupation as a result of one or more service-connected disabilities without regard to advancing age or nonservice-connected disability. 38 C.F.R. §§ 3.340, 3.341(a), 4.16(a), 4.19; Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993) (holding that the central inquiry is whether the Veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability). The claimant’s service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue must be considered. 38 C.F.R. § 4.16 (b). Certain percentage requirements must be satisfied to qualify for schedular consideration of entitlement to TDIU. Specifically, if unemployability is the result of only one service-connected disability, this disability must be ratable at 60 percent or more. 38 C.F.R. § 4.16 (a). If it is the result of two or more service-connected disabilities, at least one must be ratable at 40 percent or more, with the others sufficient to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16 (a). Disabilities of one or both upper extremities, or one or both lower extremities, including the bilateral factor, disabilities resulting from a common etiology or a single accident, and disabilities affecting a single body system such as orthopedic disabilities, will be considered as one disability for TDIU purposes. 38 C.F.R. § 4.16 (a). If the schedular requirements for TDIU are not satisfied, but the veteran is still found unemployable due to service-connected disabilities, the case will be submitted to the Director of the Compensation Service (Director) for extra-schedular consideration. 38 C.F.R. § 4.16 (b). Except as otherwise provided, the effective date of an evaluation and award of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is the later. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. 7. The claim of entitlement to TDIU prior to January 30, 2012, to include on an extra-schedular basis pursuant to 38C.F.R. §4.16(b) The Veteran seeks an earlier effective date for the grant of TDIU. In a September 2020 rating decision, an earlier effective date of January 30, 2012, for TDIU was granted. That date coincides with the date of the Veteran’s claim for increased ratings for his hip and shoulder disabilities and a service connection claim for a back disability. That date is also the earliest date that the percentage requirements for schedular entitlement to TDIU have been met. See 38 C.F.R. § 4.16 (a). For the following reasons, the Board finds the Veteran was not unemployable for TDIU purposes prior to January 30, 2012, and therefore referral for extraschedular consideration of entitlement to TDIU is not warranted. See 38 C.F.R. § 4.16 (b). Prior to January 30, 2012, the percentage requirements for schedular entitlement to TDIU were not met. More specifically, prior to that date, service connection was in effect for left shoulder arthrosis and tendinosis rated as 10 percent disabling from November 30, 2010, and 20 percent disabling from July 8, 2011; and left hip arthritis with limited extension rated as 10 percent disabling from July 9, 2009. Service connection for other disabilities was awarded on January 30, 2012, July 20, 2015, and May 8, 2019. Prior to January 30, 2012, the Veteran’s combined disability rating was 10 percent from July 9, 2009, 20 percent from November 30, 2010, and 30 percent from July 8, 2011. Because the Veteran did not have a single service-connected disability rated at 60 percent or higher, or a service-connected disability rated at 40 percent or higher, with a combined rating of 70 percent or higher, the percentage requirements for schedular entitlement to TDIU were not satisfied prior to January 30, 2012. See 38 C.F.R. § 4.16 (a). The Veteran reported in a 2016 TDIU application that he has been unable to work since 2009 due to his back, hip, and shoulder disabilities. He previously worked as a truck driver, and reported that he did not complete high school and did not have any other education or training specialty. A VA examination report from August 2009 shows the Veteran reported that he was unable to continue working as a truck driver due to his poor eyesight. The medical examiner stated that he was unable to define any disabilities that would interfere with the Veteran’s ability to perform his usual employment. The Board notes that the Veteran has never been in receipt of service connection for an eye disability. Subsequently, at a VA examination in February 2011, the Veteran contradicted his prior report and stated that he stopped working not due to his eyesight, but due to his left shoulder restrictions. The Board finds that the Veteran is competent to state that he is unable to work, as this is a firsthand event. However, his statement during the February 2011 VA examination has limited credibility given that it contradicts his prior statement regarding his inability to work. In weighing credibility, VA may consider bias, self-interest, and desire for monetary gain. See generally Caluza v. Brown, 7 Vet. App. 498 (1995). The Veteran has not submitted any medical evidence to support his assertion that his service-connected disabilities prevented him from substantially gainful employment prior to January 30, 2012. Further, while his left shoulder was service-connected effective November 30, 2010, it was rated as only 10 percent disabling from that date, and 20 percent disabling from July 8, 2011. It was not until March 2012 that a VA medical examiner opined that the severity of the Veteran’s left shoulder disability prevented him from working. As previously noted, the established effective date for TDIU is January 30, 2012, which predates the March 2012 opinion. Additionally, the Board finds that the facts are not sufficient to warrant referral to the Director of Compensation Service for consideration of an extraschedular TDIU prior to January 30, 2012. The evidence fails to substantiate that the Veteran’s service-connected disabilities were of such a severity or frequency that they prevent the Veteran from securing or following substantially gainful employment, consistent with his occupational history and educational attainment. Rather, the evidence establishes that the Veteran discontinued working due to a non-service-connected disability. In light of the above analysis, extraschedular referral is not warranted and entitlement to a TDIU is denied. Accordingly, the claim of an effective date prior to January 30, 2012, for entitlement to TDIU, to include on an extraschedular basis, must be denied. Because the preponderance of the evidence is against a finding of unemployability prior to January 30, 2012, the benefit-of-the-doubt rule does not apply. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Miller, 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.