Citation Nr: 21007556 Decision Date: 02/10/21 Archive Date: 02/10/21 DOCKET NO. 12-33 527A DATE: February 10, 2021 ORDER An initial rating in excess of 10 percent for ischemic heart disease prior to March 21, 2011 is denied. An initial 30 percent rating, but no higher, for ischemic heart disease from March 21, 2011 to June 7, 2013 is granted. An initial rating in excess of 60 percent for ischemic heart disease from June 8, 2013 is denied. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) prior to June 8, 2013 is denied. FINDINGS OF FACT 1. Prior to March 21, 2011, the Veteran’s ischemic heart disease did not result in a workload greater than 5 METs but not greater than 7 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope; or evidence of cardiac hypertrophy or dilatation. 2. From March 21, 2011 to June 7, 2013, the Veteran’s ischemic heart disease manifested by evidence of cardiac hypertrophy and dilatation and a workload of 7 METs resulting in symptoms of dyspnea and angina; however, it did not result in more than one episode of acute congestive heart failure in the past year; a workload of greater than 3 METs but not greater than 5 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope; or left ventricular dysfunction with an ejection fraction of 30 to 50 percent. 3. Since June 8, 2013, the Veteran’s ischemic heart disease has not resulted in chronic congestive heart failure; a workload of 3 METs or less resulting in dyspnea, fatigue, angina, dizziness, or syncope; or left ventricular dysfunction with an ejection fraction of less than 30 percent. 4. Prior to June 8, 2013, the Veteran does not meet the criteria for a schedular TDIU and his service-connected disabilities are not shown to have rendered him incapable of substantially gainful employment during this period. CONCLUSIONS OF LAW 1. Prior to March 21, 2011, the criteria for an initial rating in excess of 10 percent for ischemic heart disease have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.321, 4.1, 4.3, 4.7, 4.100, 4.104, Diagnostic Code 7005. 2. From March 21, 2011 to June 7, 2013, the criteria for an initial 30 percent rating, but no higher, for ischemic heart disease have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.321, 4.1, 4.3, 4.7, 4.100, 4.104, Diagnostic Code 7005. 3. Since June 8, 2013, the criteria for an initial rating in excess of 60 percent for ischemic heart disease have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.321, 4.1, 4.3, 4.7, 4.100, 4.104, Diagnostic Code 7005. 4. The criteria for entitlement to a TDIU for the period prior to June 8, 2013 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.1, 4.15, 4.16, 4.19. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from December 1965 to September 1967. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a March 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board previously remanded these matters in October 2017 and October 2020 for additional development. As the actions specified in the prior remand have been substantially completed, the case has been properly returned to the Board for appellate consideration. See D’Aries v. Peake, 22 Vet. App. 97, 105 (2008); Stegall v. West, 11 Vet. App. 268 (1998). Duties to Notify and Assist With respect to the Veteran’s claims herein, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A; 38 C.F.R. § 3.159. Neither the Veteran nor his representative have advanced any procedural arguments in relation to VA’s duties to notify and assist; therefore, the Board will proceed with appellate review. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015). Increased Rating Disability ratings are determined by application of the criteria set forth in VA’s Schedule for Rating Disabilities, which is based on average impairment of earning capacity. 38 U.S.C. § 1155; see generally 38 C.F.R. § Part 4. When a question arises as to which of two ratings applies under a particular diagnostic code, the higher rating is assigned if the disability more closely approximates the criteria for the higher rating. Otherwise, the lower rating applies. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the veteran. 38 C.F.R. § 4.3. The veteran’s entire history is to be considered when making disability evaluations. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where, as here, the question for consideration is the propriety of the initial rating assigned, evaluation of the medical evidence since the effective date of the grant of service connection and consideration of the appropriateness of the assignment of different ratings for distinct periods of time, based on the facts found, is required. See Fenderson v. West, 12 Vet. App. 119, 126 (1999); Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. Gilbert, 1 Vet. App. at 53. 1. Entitlement to an initial rating in excess of 10 percent for ischemic heart disease prior to February 9, 2013, in excess of 30 percent prior to June 8, 2013, and in excess of 60 percent thereafter The Veteran is currently in receipt of (i) an initial 10 percent rating from August 31, 2010 to February 8, 2013; (ii) an initial 30 percent rating from February 9, 2013 to June 7, 2013; and (iii) an initial 60 percent rating since June 8, 2013, for service-connected ischemic heart disease. The Veteran generally contends that he is entitled to a higher rating because his ischemic heart disease and its associated symptoms are more severe than contemplated by the currently-assigned ratings. When evaluating disabilities of the cardiovascular system under Diagnostic Codes 7000-7007, 7011, and 7015-7020, it must be ascertained in all cases whether or not cardiac hypertrophy or dilatation (documented by electrocardiogram, echocardiogram, or x-ray) is present and whether or not there is a need for continuous medication. 38 C.F.R. § 4.100(a). METs testing is also required in all cases except: (1) when there is a medical contraindication; (2) when the left ventricular ejection fraction (LVEF) has been measured and is 50 percent or less; (3) when chronic congestive heart failure is present or there has been more than one episode of congestive heart failure within the past year; (4) when a 100 percent evaluation can be assigned on another basis. 38 C.F.R. § 4.100(b). If LVEF testing is not of record, the cardiovascular disability must be based on the alternative criteria unless the examiner states that the LVEF test is needed in a particular case because the available medical information does not sufficiently reflect the severity of the cardiovascular disability. 38 C.F.R. § 4.100(c). For rating diseases of the heart, one MET (metabolic equivalent) is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. When the level of METs at which dyspnea, fatigue, angina, dizziness, or syncope develops is required for rating, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea, fatigue, angina, dizziness, or syncope may be used. 38 C.F.R. § 4.104, Note (2). The Veteran’s ischemic heart disease is rated pursuant to 38 C.F.R. § 4.104, Diagnostic Code 7005 for arteriosclerotic heart disease (coronary artery disease). Under Diagnostic Code 7005, a 10 percent rating is assigned when a workload greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope; or continuous medication required. A 30 percent rating is assigned when a workload greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope; or evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or x-ray. A 60 percent rating is assigned for more than one episode of acute congestive heart failure in the past year; or a workload of greater than 3 METs but not greater than 5 METs which results in dyspnea, fatigue, angina, dizziness, or syncope; or left ventricular dysfunction with an ejection fraction of 30 to 50 percent. A 100 percent rating is assigned for chronic congestive heart failure; or a workload of 3 METs or less which results in dyspnea, fatigue, angina, dizziness, or syncope; or left ventricular dysfunction with an ejection fraction of less than 30 percent. 38 C.F.R. § 4.104. Turning to the relevant evidence of record, the Veteran submitted an ischemic heart disease disability benefits questionnaire (DBQ) completed by his private cardiologist in September 2010. The doctor noted that the Veteran has a diagnosis of coronary artery disease, with a history of myocardial infarction and percutaneous coronary intervention, which requires treatment with continuous medications. The doctor further noted that the Veteran last underwent an exercise stress test in October 2009 which showed that he can perform a workload between 7 to 10 METs resulting in symptoms of dyspnea and fatigue. A concurrent echocardiogram showed left ventricular ejection fraction of 65 percent. There was no evidence of congestive heart failure, cardiac hypertrophy, or dilation. In a November 2010 statement, the Veteran reported that, due to his heart condition, he is no longer able to shovel snow or go ice fishing or hunting. He stated that with these activities, he experiences shortness of breath, headaches, occasional dizziness, and weakness. A March 21, 2011 echocardiogram showed the Veteran’s left atrial chamber to be dilated; left ventricular hypertrophy was identified; and ejection fraction was estimated to be greater than 55 percent. A November 2011 exercise stress test indicated that the Veteran can perform a workload of 10.1 METs with shortness of breath and fatigue. Left ventricular systolic function was normal with a calculated ejection fraction of 57 percent. The Veteran underwent an exercise stress test in February 2013 after being admitted to the hospital for chest pain and heartburn. It was found that he could perform a maximum workload of 7 METs with symptoms of dyspnea and angina. A nuclear stress test revealed left ventricular ejection fraction of 67 percent. In May 2013, the Veteran reported to a VA nurse that he has had worsening shortness of breath for two months which is sometimes accompanied by sharp chest pain and sweating. The Veteran underwent a VA examination in June 2013. The VA examiner noted that the Veteran’s cardiac condition requires treatment with continuous medications. The examiner referred to the Veteran’s last stress test, performed in February 2013, to find that the Veteran can perform a workload of 7 METs. His last echocardiogram, also in February 2013, showed left ventricular ejection fraction of 67 percent. The examiner found that there was no evidence of congestive heart failure, cardiac hypertrophy, or dilatation. The examiner noted that the Veteran’s cardiac conditions caused functional limitations due to shortness of breath and fatigue. In this regard, the Veteran reported that he is unable to shovel snow, mow his lawn, climb a ladder, or walk for a prolonged period of time without shortness of breath and lightheadedness. In August 2013, the same VA examiner noted in an addendum opinion that the Veteran’s subjective complaints related to his limited functional capacity suggest a MET ability of 3 to 4. The examiner opined that the discrepancy between his clinical finding of a workload of less than 4 METs and the exercise stress test which suggested a workload of 7 METs may be explained by the Veteran exerting himself on the stress test beyond the point at which he would normally stop to rest in his everyday life. A November 2013 echocardiogram revealed the Veteran’s left atrial chamber to be dilated; left ventricular hypertrophy was identified; and ejection fraction was estimated to be greater than 55 percent. In April 2014, the Veteran reported to his VA physician experiencing significant dyspnea on exertion. He has trouble performing chores around the house and can only walk up a half-flight of stairs or one block before needing to stop. He stated that he can no longer shovel snow because it is too difficult. A September 2014 echocardiogram showed normal left ventricular wall thickness and ejection fraction of 60 percent. In April 2016, the Veteran’s private physician noted that the Veteran has symptoms suggestive of typical chest pain, but no discomfort suggestive of angina. The Veteran also reported shortness of breath and dyspnea on exertion. A May 2016 echocardiogram revealed left ventricular ejection fraction of 55 percent with mild hypertrophy. After reporting worsening chest pain, the Veteran underwent a nuclear stress test in April 2018. He was found to have left ventricular ejection fraction of 56 percent. On testing, the Veteran was noted to experience dyspnea with stress which was resolved with rest. Mild left ventricular hypertrophy was indicated. The Veteran underwent a VA examination in January 2019. The VA examiner noted that the Veteran’s cardiac condition requires treatment with continuous medications. He does not have congestive heart failure. The examiner noted that evidence of cardiac hypertrophy was found on an April 2018 echocardiogram; there is no evidence of cardiac dilatation. The examiner also noted that the Veteran had ejection fraction of 56 percent on his last echocardiogram. Based on an interview of the Veteran, the examiner estimated that the Veteran can perform a workload of greater than 5 but not greater than 7 METs resulting in dyspnea and angina. The examiner stated that the Veteran’s METs level limitation is due solely to his cardiac condition. First, after careful review of the foregoing evidence of record, the Board finds that an initial rating in excess of 10 percent for ischemic heart disease prior to March 21, 2011 is not warranted. In this regard, the medical evidence does not show that the Veteran’s ischemic heart disease resulted in a workload greater than 5 METs but not greater than 7 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope at any time prior to March 21, 2011. Moreover, there is no evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or x-ray during this time. As the evidence does not show that the Veteran’s ischemic heart disease more closely approximated the criteria for a 30 percent rating at any time prior to March 21, 2011, an initial rating in excess of 10 percent is not warranted. Next, the Board finds that an initial 30 percent rating, but no higher, for ischemic heart disease from March 21, 2011 to June 7, 2013 is warranted. The probative medical evidence of record indicates that the Veteran underwent an echocardiogram on March 21, 2011 which showed the Veteran to have both cardiac hypertrophy and dilatation. These findings were also present on subsequent echocardiograms. Moreover, in February 2013, an exercise stress test revealed that the Veteran could perform a maximum workload of 7 METs resulting in dyspnea and angina. In light of the above, the Board finds that the criteria for a 30 percent rating have been met since March 21, 2011, and a 30 percent rating is granted as of that date until June 8, 2013, when the Veteran is in receipt of a 60 percent rating. The Board has considered whether the Veteran is entitled to an even higher, 60 percent rating during this period; however, there is no medical evidence to indicate that the Veteran ischemic heart disease resulted in more than one episode of acute congestive heart failure in the past year; a workload of greater than 3 METs but not greater than 5 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope; or left ventricular dysfunction with an ejection fraction of 30 to 50 percent, at any time prior to June 8, 2013. As such, a rating higher than 30 percent is not warranted from March 21, 2011 to June 8, 2013. Finally, the Board finds that an initial rating in excess of 60 percent for ischemic heart disease since June 8, 2013 is not warranted. In this regard, the evidence of record does not show that the Veteran’s cardiac condition results in chronic congestive heart failure; a workload of 3 METs or less resulting in dyspnea, fatigue, angina, dizziness, or syncope; or left ventricular dysfunction with an ejection fraction of less than 30 percent. First, the Veteran has never been found by his VA examiners or treating physicians to have congestive heart failure. Moreover, his left ventricular ejection fraction has never been less than 55 percent on echocardiogram. With regard to METs level during the relevant period, the Board acknowledges that the June 2013 VA examiner noted (in an August 2013 addendum) that the Veteran’s subjective complaints of experiencing dyspnea and fatigue when performing activities such as shoveling snow and mowing the lawn corresponds to a MET ability of “3 to 4.” However, at an exercise stress test just six months prior, the Veteran was able to perform a maximum workload of 7 METs. In January 2019, based on an interview with the Veteran, a different VA examiner determined that the Veteran can perform a workload of greater than 5 but not greater than 7 METs. As such, the Board finds that the preponderance of the evidence indicates that the Veteran is able to perform a workload of greater than 3 METs and, thus, his ischemic heart disease more closely approximates the criteria for the currently-assigned 60 percent rating. As the evidence does not show that the Veteran’s ischemic heart disease more closely approximates the criteria for a 100 percent rating at any time since June 8, 2013, an initial rating in excess of 60 percent is not warranted. In reaching the above conclusions, the Board acknowledges that the Veteran believes his ischemic heart disease and its associated symptoms to be more severe than contemplated by his currently-assigned disability ratings. The Board notes that the Veteran is competent to report on factual matters of which he has first-hand knowledge, such as experiencing an increased level of cardiac symptoms. Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Layno v. Brown, 6 Vet. App. 465, 469-71 (1994). However, he is not competent to report that his cardiac condition is of sufficient severity to warrant higher ratings under the rating schedule, as such an opinion requires specialized medical expertise which falls outside the realm of the common knowledge of a layperson. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board must rely on the medical evidence of record to assign the appropriate disability ratings in this case and, therefore, accords the objective medical findings greater weight than the Veteran’s subjective complaints of increased symptomatology. In summary, for the reasons set forth, the Board finds that (i) an initial rating in excess of 10 percent for ischemic heart disease prior to March 21, 2011 is denied; (ii) an initial 30 percent rating, but no higher, for ischemic heart disease from March 21, 2011 to June 7, 2013 is granted; and (iii) an initial rating in excess of 60 percent for ischemic heart disease from June 8, 2013 is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53. 2. Entitlement to a TDIU prior to June 8, 2013 The Veteran seeks entitlement to a TDIU prior to June 8, 2013; he is already in receipt of a TDIU since June 8, 2013. The Veteran generally contends that his service-connected ischemic heart disease prevented him from securing and following substantially gainful employment prior to June 8, 2013. It is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 4.16. Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. §§ 3.340(a)(1), 4.15. If the total rating is based on a disability or combination of disabilities for which the Rating Schedule provides an evaluation of less than 100 percent, it must be determined that the service-connected disabilities are sufficient to produce unemployability. 38 C.F.R. § 3.341(a). A total disability rating may be assigned where the schedular rating is less than total when the disabled person is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that, if there is only one such disability, this disability shall be ratable at 60 percent or more, or 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 combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). Prior to June 8, 2013, the Veteran is in receipt of service connection for ischemic heart disease (rated 10 percent disabling from August 31, 2010 and 30 percent disabling from March 21, 2011) and erectile dysfunction (rated noncompensable from May 10, 2011). As such, the Veteran does not meet the minimum percentage requirements under 38 C.F.R. § 4.16(a) for entitlement to a schedular TDIU prior to June 8, 2013. Where the schedular percentage requirements are not met, entitlement to a TDIU on an extraschedular basis may be considered when the veteran is unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities; consideration is given to the veteran’s background including his employment and educational history. 38 C.F.R. § 4.16(b). The Board does not have the authority to assign an extraschedular total disability rating for compensation purposes based on individual unemployability in the first instance. Bowling v. Principi, 15 Vet. App. 1 (2001). Therefore, such cases are referred to the Director of Compensation Service for extraschedular consideration. Referring a case for extraschedular consideration requires that the record reflect some factor which places the case in a different category than other veterans with an equal rating of disability. See Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). The pertinent question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. This is so because a disability rating in itself is recognition that the impairment makes it difficult to obtain or keep employment. Id. The Board has considered whether the Veteran’s disability picture prior to June 8, 2013 warrants referral for extraschedular consideration. However, the Board finds that a remand for referral of the Veteran’s claim for consideration of a TDIU prior to June 8, 2013 is not warranted. Review of the record reveals that the Veteran retired from General Motors in 1996. In a May 2011 statement, the Veteran stated that he “worked in an automobile assembly line for 30 years because I had no training for other work and it allowed me to maintain a distance from others in light of my PTSD symptoms. My heart condition would not allow me to work [in] any field for which I am trained and able to work considering my PTSD.” The Board notes that the Veteran is not service-connected for any psychiatric disability. In a December 2012 statement, the Veteran further stated that “during the last eight years of my employment [with GM], I was given a maintenance job that involved light duties and no heavy lifting… I would have liked to have stayed in my job, but could not in light of my heart condition… If I walk any distance, or up an incline, I become short of breath and lightheaded. On any exertion I suffer sharp shooting pains around my heart.” As an initial matter, the Board notes that the Veteran has not alleged, and the record does not indicate, that his service-connected erectile dysfunction impacts his ability to secure and follow substantially gainful employment. In fact, an April 2011 VA examiner determined that the condition has no significant effects on occupational or usual daily activities. As such, the following analysis only discusses whether the Veteran’s service-connected ischemic heart disease alone impacted his employability. The Board has reviewed the Veteran’s voluminous private and VA medical records, which contain years of cardiac testing, imaging, and analysis following the Veteran’s August 2004 myocardial infarction and subsequent angioplasty and stent placement. Between August 31, 2010 (the date he became service-connected for ischemic heart disease) and June 8, 2013, there is no competent medical evidence of record to indicate that the Veteran’s service-connected ischemic heart disease precluded him from obtaining or maintaining gainful employment. In this regard, on a September 2010 ischemic heart disease DBQ, the Veteran’s private cardiologist estimated that the Veteran could perform a workload between 7 to 10 METs resulting in symptoms of dyspnea and fatigue. The Board notes that this METs level is consistent with activities such as climbing stairs quickly, moderate bicycling, sawing wood, and jogging. A November 2011 exercise stress test indicated that the Veteran could perform a workload of 10.1 METs with shortness of breath and fatigue and left ventricular systolic function was normal. Finally, at a February 2013 exercise stress test, the Veteran was found capable of performing a maximum workload of 7 METs with symptoms of dyspnea and angina, which is consistent with activities such as golfing, mowing the lawn, and doing heavy yard work. A nuclear stress test revealed a normal left ventricular ejection fraction of 67 percent. In light of the above, there is no indication from the medical evidence of record that, prior to June 8, 2013, the Veteran would not have been able to perform light physical tasks, much like the maintenance job he described doing in the later years of his employment with General Motors. See Veteran’s December 2012 Statement. Moreover, the Board finds it significant that none of the Veteran’s treating physicians ever recommended that he restrict his activities or avoid strenuous physical activities at any time due to his ischemic heart disease, nor did they suggest that he should not pursue employment due to his disability. As such, the Board does not find compelling evidence that the Veteran’s ischemic heart disease caused such an exceptional or unusual disability picture so as to place him in a different category than other veterans with an equal rating of disability at any time prior to June 8, 2013. Therefore, the Board does not find that the Veteran’s claim should be referred to the Director of Compensation Service for consideration of entitlement to a TDIU on an extraschedular basis under the provisions of 38 C.F.R. § 4.16(b). Although the Veteran sincerely believes that his cardiac disability precluded him from securing or following a substantially gainful occupation prior to June 8, 2013, the Board notes that, as a lay person, lacking in medical training and expertise, the Veteran cannot provide a competent opinion on a matter as complex as whether he can secure or follow a substantially gainful occupation as a result of service-connected disability. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (2009). Any probative value of the Veteran’s own conclusions is far outweighed by that of the competent medical evidence that indicates his service-connected disability was not productive of impairment that would rise to the level of unemployability prior to June 8, 2013. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Finally, the Board emphasizes that the rating schedule is intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. To the extent his service-connected disability affected the Veteran’s employment, the assigned schedular ratings for the disability compensated the Veteran for such impairment. (Continued on next page) Accordingly, because the preponderance of the evidence indicates that the Veteran was not unemployable by reason of service-connected disabilities prior to June 8, 2013, referral of this case to the Director of the Compensation Service for extraschedular consideration under 38 C.F.R. § 4.16(b) is not warranted. The Veteran’s claim for entitlement to a TDIU prior to June 8, 2013 is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Melissa Barbee, 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.