Citation Nr: 21009969 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 11-16 188 DATE: February 23, 2021 ORDER 1. For the period from June 30, 2010 to March 1, 2012, a rating in excess of 10 percent for the lumbar spine disability is denied. 2. For the period from March 1, 2012 to September 8, 2020, a rating in excess of 20 percent for a lumbar spine disability is denied. 3. For the period from September 8, 2020 forward, a rating in excess of 40 percent for a lumbar spine disability is denied. 4. For the period from June 30, 2010 to March 7, 2017, a rating in excess of 30 percent for an acquired psychiatric disorder is denied. 5. For the period from March 7, 2017 to September 28, 2020, a rating in excess of 50 percent for an acquired psychiatric disorder is denied. 6. For the period from June 30, 2010 forward, a compensable rating for neuropathy of the left side (post-operative lateral femoral cutaneous neuropathy) is denied. 7. Service connection for a dental disorder for VA compensation purposes is denied. 8. For the period from December 12, 2013 to September 28, 2020, a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is denied. 9. For the period from September 28, 2020 forward, a TDIU is moot. FINDINGS OF FACT 1. For the period from June 30, 2010 to March 1, 2012, the lumbar spine disability was not manifested by forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. 2. For the period from March 1, 2012 to September 8, 2020, the lumbar spine disability was not been manifested by ankylosis or limitation of flexion of the thoracolumbar spine to 30 degrees or less. 3. For the period from September 8, 2020 forward, the lumbar disability has not been manifested by ankylosis of the thoracolumbar spine. 4. For the period from June 30, 2010 to March 7, 2017, the acquired psychiatric disorder most nearly approximated occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. 5. For the period from March 7, 2017 to September 28, 2020, the acquired psychiatric disorder most nearly approximated occupational and social impairment with reduced reliability and productivity. 6. For the period from June 30, 2010 forward, the peripheral neuropathy of the left side (post-operative lateral femoral cutaneous neuropathy) has not been manifested by severe to complete paralysis of the external cutaneous nerve of the thigh. 7. The Veteran does not have a current dental disability subject to VA compensation. 8. For the period from December 12, 2013 to September 28, 2020, the Veteran was not unable to secure or maintain a substantially gainful occupation solely due impairment caused by service-connected disabilities. 9. For the period from September 28, 2020 forward, the Veteran is in receipt of a 100 percent (“total”) schedular disability rating for an acquired psychiatric disorder. CONCLUSIONS OF LAW 1. For the period from June 30, 2010 to March 1, 2012, the criteria for a rating in excess of 10 percent for the lumbar spine disability have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.10, 4.20, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5235. 2. For the period from March 1, 2012 to September 8, 2020, the criteria for a rating in excess of 20 percent for the lumbar spine disability have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.10, 4.20, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5235. 3. For the period from September 8, 2020 forward, the criteria for a rating in excess of 40 percent for the lumbar spine disability have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.10, 4.20, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5235. 4. For the period from June 30, 2010 to March 7, 2017, the criteria for a rating in excess of 30 percent for an acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 3.326(a), 4.3, 4.7, 4.130, Diagnostic Code 9435. 5. For the period from March 7, 2017 to September 28, 2020, the criteria for a rating in excess of 50 percent for an acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 3.326(a), 4.3, 4.7, 4.130, Diagnostic Code 9435. 6. For the period from June 30, 2010 forward, the criteria for a compensable rating for neuropathy of the left side have not been met. 38 U.S.C. § 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.321, 4.3, 4.7, 4.124a, Diagnostic Code 8529. 7. The criteria for service connection for a dental disorder for VA compensation purposes have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310, 3.381, 4.150. 8. For the period from December 12, 2013 to September 28, 2020, the criteria for a TDIU have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.340, 3.341, 4.3, 4.15, 4.16, 4.18, 4.19, 4.25. 9. For the period from September 28, 2020 forward, a question of a TDIU is rendered moot by a total combined schedular disability rating. 38 U.S.C. § 7104; 38 C.F.R. § 4.16(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 2004 to May 2008. Although the Veteran had previously requested a Board of Veterans’ Appeals (Board) hearing, the Veteran submitted a written statement in August 2014 indicating that he wished to withdraw his request for a Board hearing. In May 2014 and April 2020, the Board remanded the claims currently on appeal for further development. Development has been completed, and the case is again before the Board. Disability Rating Legal Authority Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) found in 38 C.F.R. Part 4. 38 U.S.C. § 1155. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. Where there is a question as to which of two disability ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability, such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Separate ratings may be assigned for separate periods of time based on the facts found, a practice known as “staged” ratings. 38 C.F.R. § 4.2; Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). If an increase in disability occurred within one-year prior to the claim for increase, the increase is effective as of the date the increase was factually ascertainable. See 38 U.S.C. § 5110(b)(2); 38 C.F.R. § 3.400(o)(2); Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010) (holding “that an increase in a veteran’s service-connected disability must have occurred during the one year prior to the date of the veteran’s claim in order to receive the benefit of an earlier effective date”). In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the rating of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a veteran’s service-connected disabilities. 38 C.F.R. § 4.14. It is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes; however, the critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); Lyles v. Shulkin, 29 Vet. App. 107 (2017) (holding that 38 C.F.R. § 4.14 prohibits compensating a veteran twice for the same symptoms or functional impairment). When an unlisted condition is encountered, it will be permissible to rate it under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. Conjectural analogies will be avoided, as will the use of analogous ratings for conditions of doubtful diagnosis, or for those not fully supported by clinical and laboratory findings. Nor will ratings assigned to organic diseases and injuries be assigned by analogy to conditions of functional origin. 38 C.F.R. § 4.20. 1. Rating a Lumbar Spine Disability for the Period from June 30, 2010 to March 1, 2012 For the rating period on appeal from June 30, 2010 to March 1, 2012, a 10 percent disability rating was in effect for the lumbar spine disability under the General Rating Formula. See 38 C.F.R. § 4.71a, Diagnostic Code 5235. The Veteran contends that a higher disability rating for the lumbar spine disability is warranted. See June 2010 Statement by the Veteran’s Representative. Disabilities of the spine are rated under the General Rating Formula for Diseases and Injuries of the Spine for Diagnostic Codes 5235 to 5243, unless 5243 is rated under the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes (IVDS Rating Formula). Ratings under the General Rating Formula are made with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease. The General Rating Formula provides a 10 percent disability rating for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range-of-motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is provided for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range-of-motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent disability rating is provided for forward flexion of the thoracolumbar spine 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine. A 50 percent disability rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent disability rating is assigned for unfavorable ankylosis of the entire spine. Note (1) to the rating formula specifies that any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, should be separately rated under an appropriate diagnostic code. Note (2) (See also Plate V) provides that, for VA compensation purposes, normal forward flexion of the lumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range-of-motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range-of-motion of the lumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range-of-motion. Note (3) provides that, in exceptional cases, an examiner may state, that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range-of-motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range-of-motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner’s assessment that the range-of-motion is normal for that individual will be accepted. Note (4) instructs to round each range-of-motion measurement to the nearest five degrees. Note (5) provides that, for VA compensation purposes, unfavorable ankylosis is a condition in which the entire lumbar 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. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. After a review of all the evidence, lay and medical, the Board finds that for the entire rating period on appeal from June 30, 2010 to March 1, 2012 the criteria for a higher disability rating in excess of 10 percent for the lumbar spine disability had not been met or more nearly approximated. An August 2010 VA examination shows flexion to 65 degrees, extension to 20 degrees, left lateral flexion to 15 degrees, left lateral rotation to 35 degrees, right lateral flexion to 25 degrees, right lateral rotation to 35 degrees, and a combined range of motion of 195 degrees, with pain noted on examination that does not cause functional loss after three repetitions of range of motion. The Veteran reported pain, stiffness, and decreased range of motion in the thoracolumbar spine. The Veteran did not report any periods of incapacity in the past year due to the lumbar spine disability. The VA examiner noted negative findings for muscle spasms, localized tenderness, or guarding severe enough to result in an abnormal gait or abnormal spinal contour. The Veteran reported severe flare-ups of the lumbar spine four times per week that last for hours, which are relieved by rest, a transcutaneous electrical nerve stimulation (TENs) unit, and pain medication, and that the flare-ups decrease the ability to walk, stand, or sit. The Board has considered whether there is additional functional loss due to pain or due to weakness, fatigability, incoordination, or pain on movement of a joint under 38 C.F.R. §§ 4.40, 4.45, and 4.59. See also DeLuca v. Brown, 8 Vet. App. 202 (1995). However, even after considering these factors, evidence including the VA examination report indicates at worst, forward flexion to 65 degrees, a combined range of motion of 195 degrees, and no muscle spasms, localized tenderness, or guarding severe enough to result in an abnormal gait or abnormal spinal contour. For this reason, a higher rating is not warranted. The Board finds that the preponderance of the evidence is against the appeal for a rating in excess of 10 percent for the lumbar spine disability for the entire rating period on appeal from June 30, 2010 to March 1, 2012, as the lumbar spine disability was not manifested by forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.3, 4.7, 4.71a, DC 5235. 2. Rating a Lumbar Spine Disability for the Period from March 1, 2012 to September 8, 2020 For the rating period on appeal from March 1, 2012 to September 8, 2020, a 20 percent disability rating was in effect for the lumbar spine disability under the General Rating Formula. See 38 C.F.R. § 4.71a, Diagnostic Code 5235. The Veteran contends that a higher disability rating for the lumbar spine disability is warranted. See June 2010 Statement by the Veteran’s Representative. After a review of all the evidence, lay and medical, the Board finds that for the entire period on appeal from March 1, 2012 to September 8, 2020, the service-connected back disability has not been manifested by ankylosis or limitation of flexion to 30 degrees or less. Specifically, findings from the March 2012 VA examination are consistent with a 20 percent rating under the General Rating Formula for Diseases and Injuries of the Spine for the symptoms and level of impairment actually demonstrated by the back disability. Diagnostic Code 5235 warrants a 20 percent rating for forward flexion greater than 30 degrees, but not greater than 60 degrees, or a combined range of motion of the thoracolumbar spine not greater than 120 degrees, or muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour. A March 2012 VA examination shows flexion to 50 degrees with pain, extension to 25 degrees with pain, left lateral flexion to 20 degrees with pain, left lateral rotation to 30 degrees with pain, right lateral flexion to 25 degrees with pain, right lateral rotation to 30 degrees with pain, and a combined range of motion of 180 degrees, with functional loss and additional limitation of the range of motion after repetitive use due to pain on movement, and interference with sitting, standing, or weight bearing. The VA examiner noted negative findings for muscle spasms, localized tenderness, or guarding severe enough to result in an abnormal gait or abnormal spinal contour. The Veteran reported severe low back pain with decreased motion and increased pain with prolonged sitting or standing. The Veteran reported flare-ups consisting of a decreased ability to sit, stand, or walk with flare-up pain; including difficulty walking up steps in his home with his laundry due to low back pain. A higher disability rating of 40 percent or higher for the back disability would only be warranted for forward flexion more closely approximating 30 degrees or less, favorable or unfavorable ankylosis of the entire thoracolumbar spine, none of which is present here. See March 2012 VA examination report. Even with considerations of additional functional loss due to pain or due to weakness, fatigability, incoordination, or pain on movement of a joint (see 38 C.F.R. §§ 4.40, 4.45, 4.59), the evidence shows indicates, at worst, forward flexion to 50 degrees with pain, which does not warrant a higher rating based on limitation of motion. For these reasons, the Board finds that the preponderance of the evidence is against the assignment of a rating in excess of 20 percent for the lumbar spine disability for the rating period on appeal from March 1, 2012 to September 8, 2020 forward. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7, 4.71a. 3. Rating a Lumbar Spine Disability for the Period from September 8, 2020 Forward The Veteran is in receipt of a 40 percent disability rating for the service-connected lumbar spine disability under the General Rating Formula for the period from September 8, 2020 forward. See 38 C.F.R. § 4.71a, Diagnostic Code 5235. The Veteran generally appeals for a higher rating for the lumbar spine disability. See June 2010 Statement by the Veteran’s Representative. After a review of all the evidence of record, the Board finds that the lay and medical evidence demonstrates that, for the entire rating period from September 8, 2020 forward, the lumbar spine disability has more nearly approximated forward flexion of the thoracolumbar spine of 30 degrees or less (required for the currently assigned 40 percent rating); and has not more nearly approximated unfavorable ankylosis of the entire thoracolumbar spine (required for a higher 50 percent rating). Even with full consideration to limitations of motion and function due to any of the diagnoses and orthopedic limiting factors (see 38 C.F.R. §§ 4.40, 4.45, and 4.59), the evidence does not show ankylosis of the entire thoracolumbar spine required for a higher 50 percent disability rating. See also DeLuca. The Board finds that a rating in excess of 40 percent for the lumbar spine disability is not warranted for the rating period from September 8, 2020 forward. The evidence of record demonstrates that the lumbar spine disability has not manifested in unfavorable ankylosis of the entire thoracolumbar spine (criteria required for a 50 percent rating). The September 2020 VA examination report does not show ankylosis in the thoracolumbar spine. For these reasons, the Board finds that the preponderance of the evidence is against the assignment of a rating in excess of 40 percent for the lumbar spine disability for the rating period on appeal from September 8, 2020 forward. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7, 4.71a. 4. Rating an Acquired Psychiatric Disorder for the Period from June 30, 2010 to March 7, 2017 The Veteran’s psychiatric disorder is rated under 38 C.F.R. § 4.130, Diagnostic Code 9435 (unspecified depressive disorder). Pertinent in this case, the General Rating Formula provides that a 30 percent rating is assigned for occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 38 C.F.R. § 4.130. A 50 percent rating will be assigned for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130. A 70 percent rating will be assigned for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); and inability to establish and maintain effective relationships. Bowling v. Principi, 15 Vet. App. 1, 11-14 (2001). A 100 percent schedular rating contemplates total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130. The use of the term “such as” in the General Rating Formula for Mental Disorders in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating. See Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). It is not required to find the presence of all, most, or even some, of the enumerated symptoms recited for particular ratings. Id. The use of the phrase “such symptoms as,” followed by a list of examples, provides guidance as to the severity of the symptoms contemplated for each rating, in addition to permitting consideration of other symptoms particular to each veteran and disorder, and the effect of those symptoms on his/her social and work situation. In Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (2013), the Federal Circuit held that VA “intended the General Rating Formula to provide a regulatory framework for placing veterans on a disability spectrum based upon their objectively observable symptoms.” The Federal Circuit stated that “a veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration.” It was further noted that “§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas.” Id.; Bankhead v. Shulkin, 29 Vet. App. 10 (2017) (indicating that the Board should consider the severity, frequency, and duration of the signs and symptoms of a mental disorder when determining the appropriate rating). The Veteran asserts that for the period from June 30, 2010 to March 7, 2017, the psychiatric disorder has been manifested by more severe symptoms and impairment than those contemplated by the 30 percent disability rating. See June 2010 letter from the Veteran’s representative. After a review of all the evidence, lay and medical, the Board finds that, for the period from June 30, 2010 to March 7, 2017, the weight of lay and medical evidence demonstrates that a disability rating in excess of 30 percent for the service-connected psychiatric disorder is not warranted, as the psychiatric disorder has been manifested by occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, which is consistent with a 30 percent rating. At a September 2010 VA examination, the Veteran reported good relationships with childhood friends with whom he socializes at least weekly and attending social events at church. The Veteran was not employed at the time but reported that he had recently started classes for a computer network security certification. The Veteran reported that it has no deleterious effect on close relationships but does occasionally interfere with interacting with persons with whom he is not close. The Veteran reports good response to medication in this area and stated that he is hopeful that some adjustment to his medication regimen will further improve his mood swings, impulsiveness, and irritability.” The Veteran also reported sleep impairment and was evaluated as having a depressed mood, both of which are specifically contemplated by the currently assigned 30 percent rating for a mood disorder. The VA examiner in September 2010 assessed that mental disorder signs and symptoms did not result in deficiencies in the areas of judgment, thinking, family relations, work, mood, or school, and did not result in reduced reliability and productivity. The VA examiner assessed that the mental disorder resulted in an occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. The VA examiner explained that “frequent expression of the Veteran’s irritable mood has the potential to compromise interpersonal relationships within a work environment. July 2011 VA treatment records show that the Veteran was placed on a 72-hour psychiatric hold after being brought to the emergency room by his mother who feared he would make a suicide attempt. The Veteran denied suicidal ideation and was discharged on the fourth day after being admitted. September 2011 VA treatment records show that the Veteran came to the emergency room of his own accord, where he was prescribed psychiatric medication and consistently denied suicidal ideation. A mental inquest warrant was also filed by the Veteran’s mother in September 2011, after which the Veteran received a psychiatric evaluation and denied suicidal ideation. A February 2012 private psychiatric assessment states that the Veteran experienced a moderate level of restriction of activities of daily living, a moderate level of difficulty maintaining social functioning, a moderate level of difficulty in maintaining concentration, persistence, or pace due to a mental disorder, and that the Veteran has a medically documented history of a mental disorder of at least two year’s duration that has caused more than a minimal limitation of ability to do any basic work activity. A March 2012 mental health outpatient note shows that the Veteran denied suicidal ideation and was making fair progress toward achieving his treatment plan. A December 2013 VA mental health outpatient treatment note shows that the Veteran reported that the mood symptoms had remained mostly stable with his current medication regimen and denied suicidal ideation. A June 2015 private examination submitted as part of an application for Social Security Disability benefits states that the Veteran was “cognitively capable of understanding, remembering, and carrying out simple to moderately complex instructions” and “would not seem to have difficulty adjusting to simple changes in a work routine. He can communicate effectively with others verbally.” The private examiner also wrote that “whether [the Veteran] is able to persist [at] task and work quickly is deferred to physicians, as [the Veteran] does report significant physical problems. [The Veteran] would appear to have significant difficulty consistently interacting appropriately with coworkers, supervisors, or the public. He seems to have distortions in his perceptions, at times seems paranoid, and experiences chronic irritability… [the Veteran] appears to have significant difficulty tolerating stress and interacting in an appropriate fashion consistently with others due to his mood disturbance.” The Board finds that, to the extent that the service-connected psychiatric disorder has been manifested by disturbances in motivation and mood, and difficulty in establishing and maintaining effective work and social relationships, the disability more nearly approximates occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, consistent with a 30 percent rating. This is because the Veteran reported that his mood symptoms had remained mostly stable with medication at a March 2012 mental health treatment visit and reported good relationships with childhood friends with whom he socializes at least weekly at the September 2010 VA examination. In Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (2013), the Federal Circuit held that VA “intended the General Rating Formula to provide a regulatory framework for placing veterans on a disability spectrum based upon their objectively observable symptoms.” The Federal Circuit stated that “a veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration.” It was further noted that “§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas.” Id.; Bankhead v. Shulkin, 29 Vet. App. 10 (2017) (indicating that the Board should consider the severity, frequency, and duration of the signs and symptoms of a mental disorder when determining the appropriate rating). For these reasons, the totality of the evidence demonstrates that for the period from June 30, 2010 to March 7, 2017, the Veteran experienced symptoms of occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. As the Veteran’s psychiatric symptoms and degrees of social and occupational impairment are most nearly contemplated by the 30 percent rating criteria, the appeal for higher rating for this period is denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7, 4.130. 5. Rating an Acquired Psychiatric Disorder for the Period from March 7, 2017 to September 28, 2020 Throughout the course of the appeal, the Veteran has contended generally that the psychiatric disorder has been manifested by more severe symptoms and impairment than those contemplated by the 50 percent disability rating, which was assigned for the period from March 7, 2017 to September 28, 2020. After a review of all the evidence, lay and medical, the Board finds that, for the entire rating period on appeal, the weight of the competent and probative lay and medical evidence demonstrates that a disability rating in excess of 50 percent for the service-connected psychiatric disorder is not warranted as the psychiatric disorder has been manifested by occupational and social impairment with reduced reliability and productivity, which is consistent with a 50 percent rating. The evidence of record does not support findings of a degree of occupational and social impairment or symptoms to more nearly approximate a higher 70 percent rating for this period. A March 2017 VA examiner wrote that the Veteran experienced occupational and social impairment with reduced reliability and productivity, and experienced symptoms including a depressed mood, suspiciousness, difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances, including work or a worklike setting. The Veteran denied suicidal ideation since his hospitalization in 2008. A March 2017 VA examiner wrote that “in relationship to usual occupational and daily activities, the Veteran’s ability to understand and follow instructions is considered mildly impaired. Ability to retain instructions as well as sustain concentration to perform simple tasks is considered mildly impaired. Ability to sustain concentration to task persistence and pace is considered moderately impaired. Ability to respond appropriately to coworkers, supervisors, or the general public is considered moderately impaired. Ability to respond appropriately to changes in the work setting is considered moderately impaired.” The VA examiner wrote that “due to the complex interaction between job and individual, it is impossible to state whether employment is precluded or not, as such absolute statements would require speculation about multiple complex events and interactions including totally unpredictable random events. It is clear that the Veteran would have difficulty in any job setting that does not address his above difficulties in sustaining task performance and responding appropriately to change and others. Success would be much more likely in a job with stable demands and little interaction with others.” A November 2020 private psychologist opined that the Veteran experienced social and occupational impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. The Board finds the March 2017 VA examination more probative, as March 2017 VA examiner conducted an in-person examination of the Veteran, while the November 2020 private psychologist rendered an opinion based only upon review of the Veteran’s medical records. For these reasons, the totality of the evidence demonstrates that during the period on appeal, the Veteran experienced occupational and social impairment with reduced reliability and productivity, as contemplated by the 50 percent rating; therefore, the appeal for higher rating for this period must be denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7, 4.130. 6. Rating Neuropathy of the Left Side from June 30, 2010 Forward The neuropathy of the left side (post-operative lateral femoral cutaneous neuropathy) is rated as noncompensable (0 percent) under Diagnostic Code 8529 (DC 8529). DC 8529 concerns impairment of the external cutaneous nerve of the thigh. A noncompensable rating is warranted for mild or moderate paralysis of the external cutaneous nerve of the thigh and a maximum 10 percent rating is warranted for severe to complete paralysis. 38 C.F.R. § 4.124a, DC 8529. An August 2010 VA examination shows a diagnosis of postoperative lateral femoral cutaneous neuropathy. A sensory examination of the left side shows normal vibration sensation, normal position sense, normal pain or pinprick sensation, normal light touch sensation, and no dysthesias. An October 2010 VA examination shows that the Veteran reported a moderate to severe level of discomfort in the left hip, which had been progressively worsening, and tingling and numbness which was stable. The Veteran reported that he had lost his balance, especially on wet surfaces, and that he experienced a pins and needles sensation intermittently. The VA examiner documented that the numbness from the neuropathy on the left side limited the Veteran’s ability to sit for prolonged periods and caused difficulty climbing stairs, according to the report of symptoms. A March 2012 VA examination shows severe intermittent pain in the right and left lower extremity as a symptom of radiculopathy. The Veteran reported that he experienced intermittent but daily bilateral leg pain that he described as “sharp” which occurred in his posterior leg/buttock area extending to his lateral thigh and down the anterior legs to the level of his calves. The Veteran denied having any numbness or tingling sensation in either lower extremity. At the March 2012 VA examination, all nerves were evaluated to be normal and without paralysis, but an electromyography study showed abnormal results in the right and left lower extremities. A July 2012 VA examination shows severe intermittent pain in the left lower extremity. A September 2020 VA examiner wrote that the Veteran did not have either a peripheral nerve condition or peripheral neuropathy, and “has no symptoms or clinical findings to suggest he has residual lateral femoral cutaneous nerve neuropathy. This conclusion is reached because of lack of symptoms and lack of clinical findings. In addition, the EMG report dated 3-14-2017 specifically stated ‘There is no electrodiagnostic evidence of a left or right lateral femoral cutaneous neuropathy nor left ulnar neuropathy.’” Thus, after review of all the evidence, lay and medical, the Board finds that the evidence of record does not show that the Veteran experiences severe or complete paralysis of the left side. The Board notes that intermittent pain, noted on the March 2012 and July 2012 VA examinations does not constitute severe or complete paralysis of the left side. The Board finds that the tingling, numbness, and pins-and-needles sensation reported by the Veteran more closely approximates mild or moderate paralysis of the left side, rather than severe or complete paralysis of the left side. The Board has carefully considered the Veteran’s contention that the neuropathy of the left side more closely approximates the criteria for a compensable rating under DC 8529. While the Veteran is competent to report symptoms, he is not competent to identify a specific level of disability of his disorder according to the appropriate rating criteria. Such competent evidence has been provided by the VA examiner who examined him and rendered a pertinent opinion in conjunction with the examination. The medical findings directly address the criteria under which this disability is evaluated. Moreover, as the VA examiner has the requisite medical expertise to render a medical opinion regarding the degree of impairment caused by the disability and had sufficient facts and data on which to base the conclusion, the Board affords the medical opinion great probative value. The VA examination is more probative than the Veteran’s subjective evidence of complaints of increased symptomatology. Accordingly, entitlement to a compensable disability rating for neuropathy of the left side is denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7, 4.124. 7. Service Connection for a Dental Condition to Include a Chipped Tooth The Veteran contends that service connection for a dental disorder is warranted. Specifically, the Veteran contends that he chipped a tooth when he fell down a cliff while walking during active duty in Japan. See November 2010 VA examination. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Generally, service connection for a disability requires evidence of: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. Compensation is only available for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. Compensation is available for loss of teeth only if such is due to loss of substance of body of maxilla or mandible due to trauma or disease such as osteomyelitis, but not periodontal disease. Otherwise, a veteran may be entitled to service connection for dental conditions including treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease, for the sole purpose of receiving VA outpatient dental services and treatment, if certain criteria are met. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 17.161. After reviewing all the evidence, both lay and medical, the Board finds that the weight of the evidence is against a finding that the Veteran has a dental disability subject to compensation, as discussed below. See 38 C.F.R. § 4.150, 17.161. That is, there is no diagnosis of record, nor has the Veteran submitted evidence of a diagnosis of loss of whole or part of the mandible, nonunion or malunion of the mandible, loss of whole or part of the ramus, loss of whole or part of the maxilla, nonunion or malunion of the maxilla, loss of the condyloid or coronoid process, or loss of any part of the hard palate, for which service-connected compensation could be granted. See 38 C.F.R. § 4.150. Regarding the lack of a current disability, the Veteran asserted at the November 2010 VA examination that the chipped tooth was asymptomatic following the fall in Japan and that the tooth has been asymptomatic ever since. The November 2010 VA examiner documented that there was no loss of bone of the maxilla, no malunion or nonunion of the maxilla, no loss of bone of the mandible, no nonunion of the mandible, malunion of the mandible, no loss of bone of the hard palate, no evidence of osteoradionecrosis or osteomyelitis, no speech difficulty, and no tooth loss due to loss of substance of body of maxilla or mandible (other than loss due to periodontal disease). The service treatment records do not document a chipped tooth or any dental injury during service. Rather, the Veteran denied “severe tooth or gum trouble” on a September 2007 Report of Medical History. The evidence of record does not show that any claimed tooth or gum disability is due to the loss of substance of the body of maxilla, mandible, or hard palate during service through trauma or disease such as osteomyelitis. While the record indicates that the Veteran currently has a chipped tooth, the Board notes that a chipped tooth alone does not constitute a disability for VA compensation purposes under 38 C.F.R. § 4.150. Moreover, the post-service treatment records also reflect no symptoms, diagnosis, or treatment for any current dental condition. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. §§ 1110, 1131; See also Degmetich v. Brown, 104 F. 3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the veteran currently has a compensable dental or oral disability for which benefits are being claimed. Because the evidence does not establish that the Veteran has a current compensable dental condition during the pendency of the appeal, the Board finds that the Veteran is not entitled to service connection for a compensable dental disorder under 38 C.F.R. § 4.150. As the Veteran has not been diagnosed with a dental disability for which service connection may be granted, the claim for service connection for a dental disorder for compensation purposes is denied. TDIU Legal Authority Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities (Rating Schedule), which is based on the average impairment of earning capacity. 38 U.S.C. § 1155. Total disability is considered to exist when there is any impairment which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. Total disability may or may not be permanent. 38 C.F.R. § 3.340(a)(1). Total ratings are authorized for any disability or combination of disabilities for which the Rating Schedule prescribes a 100 percent evaluation. 38 C.F.R. § 3.340(a)(2). TDIU may be assigned when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. The service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue will be addressed in both instances. 38 C.F.R. § 4.16(a), (b). If there is only one such disability, it must be rated at 60 percent or more; if there are two or more disabilities, at least one disability must be rated at 40 percent or more, with sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one disability: (1) disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. 38 C.F.R. § 4.16(a). If a veteran’s disabilities do not meet the objective combined rating percentage criteria of 38 C.F.R. § 4.16 (a), it then becomes necessary to consider whether the criteria for referral for extraschedular consideration are met under § 4.16(b) criteria. 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. Submission to the Director, Compensation and Pension Service, for extraschedular consideration is warranted in all cases of veterans who are unemployable by reason of service-connected disabilities, but who fail to meet the percentage standards set forth in § 4.16(a). 38 C.F.R. § 4.16(b). Individual unemployability must be determined without regard to any non-service-connected disabilities or a veteran’s advancing age. 38 C.F.R. §§ 3.341(a), 4.19; Van Hoose v. Brown, 4 Vet. App. 361 (1993). The sole fact that a veteran is unemployed or has difficulty obtaining employment is not enough. A high rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether a veteran is capable of performing the physical and mental acts required by employment, not whether a veteran can find employment. Id. at 361. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in a veteran’s favor. 38 C.F.R. § 4.3. In Faust v. West, 13 Vet. App. 342 (2000), the United States Court of Appeals for Veterans Claims (Court) defined “substantially gainful employment” as an occupation that provides an annual income that exceeds the poverty threshold for one person, irrespective of the number of hours or days that a veteran actually works and without regard to a veteran’s earned annual income. In Hatlestad v. Derwinski, 5 Vet. App. 524, 529 (1993), the Court held that the central inquiry in determining whether a veteran is entitled to a TDIU is whether a veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability. The determination as to whether a total disability rating is appropriate should not be based solely upon demonstrated difficulty in obtaining employment in one particular field, which could also potentially be due to external bases such as economic factors, but rather to all reasonably available sources of employment under the circumstances. See Ferraro v. Derwinski, 1 Vet. App. 326, 331-332 (1991). In evaluating a veteran’s employability, consideration may be given to the level of education, special training, and previous work experience in arriving at a conclusion, but not to age or impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. Marginal employment is not considered substantially gainful employment and generally is deemed to exist when a veteran’s earned income does not exceed the amount established by the U.S. Department of Commerce, Bureau of the Census, as the poverty threshold for one person. Marginal employment may also be held to exist in certain cases when earned annual income exceeds the poverty threshold on a facts-found basis. Consideration shall be given in all claims to the nature of the employment and the reason for termination. 38 C.F.R. § 4.16(a). Marginal employment, odd-job employment, and employment at half the usual remuneration is not incompatible with a determination of unemployability if the restriction to securing or retaining better employment is due to disability. 38 C.F.R. § 4.17 (a). The ultimate issue of whether a TDIU should be awarded is not a medical issue, but rather is a determination for the adjudicator. See Moore v. Nicholson, 21 Vet. App. 211, 218 (2007) (ultimate question of whether a veteran is capable of substantial gainful employment is not a medical one; that determination is for the adjudicator), rev’d on other grounds sub nom, Moore v. Shinseki, 555 F.3d 1369 (Fed. Cir. 2009). Although VA must give full consideration, per 38 C.F.R. § 4.15, to “the effect of combinations of disability,” VA regulations place responsibility for the ultimate TDIU determination on VA, not a medical examiner’s opinion. Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013); 38 C.F.R. § 4.16 (a); see also Smith v. Shinseki, 647 F.3d 1380, 1385-86 (Fed. Cir. 2011) (VA is not required to obtain an industrial survey from a vocational expert before making a TDIU determination but may choose to do so in an appropriate case). 8. TDIU for the Period from December 12, 2013 to September 28, 2020 The Veteran asserts that a TDIU is warranted due to the cumulative effect of the service-connected disabilities, which he asserts render him unable to maintain substantially gainful employment. See May 2020 Statement by the Veteran. For the TDIU period on appeal, the service-connected disabilities are a mood disorder; rated as 10 percent disabling from May 31, 2008 to June 30, 2010, as 30 percent disabling from June 30, 2010 to March 7, 2017, and as 50 percent disabling from March 7, 2017 to September 28, 2020; a lumbar spine disability rated as 10 percent disabling from May 31, 2008 to March 1, 2012 and as 20 percent disabling from March 1, 2012, and as 40 percent disabling from September 8, 2020 forward; a surgical scar on the lower back, rated as noncompensable, and post-operative lateral femoral cutaneous neuropathy of the left side, rated as noncompensable; for a combined overall rating of 20 percent from May 31, 2008, a 40 percent combined overall rating from June 30, 2010, and a 60 percent combined overall rating from March 7, 2017 through September 28, 2020. Because the Veteran did not have one service-connected disability rated at least 60 percent during the period on appeal, or one service-connected disability rated at least 40 percent with a minimum combined rating of at least 70 percent for all service-connected disabilities until September 8, 2020, the service-connected disabilities do not satisfy the threshold rating percentage requirements for consideration of TDIU (38 C.F.R. § 4.16(a)) for the period from December 12, 2013 through September 8, 2020. For the period from September 8, 2020 through September 28, 2020, the service-connected lumbar spine disability was rated as 40 percent disabling, and the overall combined rating was 70 percent, satisfying the threshold for the schedular requirement for consideration of TDIU. 38 C.F.R. § 4.16(a) Having considered all the evidence of record, lay and medical, the Board finds that referral under 38 C.F.R. § 4.16(b) to the Director of Compensation and Pension for extraschedular consideration is not warranted for the period from December 12, 2013 through September 8, 2020. While the evidence of record reflects that the service-connected disabilities caused some functional limitations and impairment, the Board finds that the service-connected disabilities did not render the Veteran unable to secure and maintain substantially gainful employment. Further, the Board finds that for the period from September 8, 2020 through September 28, 2020, the preponderance of the evidence is against a finding of TDIU. During the period on appeal, the service-connected mood disorder and lumbar spine disability manifested as occupational and social impairment with reduced reliability and productivity, and the inability to lift anything weighing more than 25 pounds, perform repetitive bending or repetitive lifting irrespective of weight, and inability to work in a stooped posture, respectively. Regarding the Veteran’s employment and educational history, a December 2013 Veteran’s Application for Increased Compensation Based on Unemployability shows that the Veteran last worked in November 2010 as a sales clerk. This document also shows that the Veteran has a high school education. October 2018 vocational rehabilitation documents in the file show that the Veteran completed a Network System Administrator Professional program and a course entitled Business Efficiencies at New Horizons Computer Learning Centers in May 2018. December 2018 Vocational Rehabilitation documents also show that the Veteran completed an Information Technology Security Professional Program at New Horizons Computer Learning Centers in October 2015 and received several other certificates from New Horizons Computer Learning Centers from May 2015 through June 2017. A June 2015 private examination submitted as part of an application for Social Security Disability benefits states that the Veteran was “cognitively capable of understanding, remembering, and carrying out simple to moderately complex instructions” and “would not seem to have difficulty adjusting to simple changes in a work routine. He can communicate effectively with others verbally.” The private examiner also wrote that “whether [the Veteran] is able to persist [at] task and work quickly is deferred to physicians, as [the Veteran] does report significant physical problems. [The Veteran] would appear to have significant difficulty consistently interacting appropriately with coworkers, supervisors, or the public. He seems to have distortions in his perceptions, at times seems paranoid, and experiences chronic irritability… [the Veteran] appears to have significant difficulty tolerating stress and interacting in an appropriate fashion consistently with others due to his mood disturbance.” A January 2012 examination by the Department of Disability Determination states that the Veteran was able to use a telephone and a computer, manage his own medication regimen and finances, and perform occasional errands for his family. The examiner also wrote that the Veteran enjoyed visiting with friends and family often, reported that he managed stress well, and that his ability to complete tasks was limited due to chronic back pain. A February 2012 psychiatric assessment states that the Veteran experienced a moderate level of restriction of activities of daily living, a moderate level of difficulty maintaining social functioning, a moderate level of difficulty in maintaining concentration, persistence, or pace due to a mental disorder, and that the Veteran has a medically documented history of a mental disorder of at least two year’s duration that has caused more than a minimal limitation of ability to do any basic work activity. December 2016 Social Security records show that the Veteran is unable to work due to multiple disabilities including a traumatic brain injury and bone grafting in his hip. The Board notes that the Veteran has not received service connection for a traumatic brain injury or bone grafting in his hip. A March 2017 VA examiner wrote that “in relationship to usual occupational and daily activities, the Veteran’s ability to understand and follow instructions is considered mildly impaired. Ability to retain instructions as well as sustain concentration to perform simple tasks is considered mildly impaired. Ability to sustain concentration to task persistence and pace is considered moderately impaired. Ability to respond appropriately to coworkers, supervisors, or the general public is considered moderately impaired. Ability to respond appropriately to changes in the work setting is considered moderately impaired.” The VA examiner also wrote that “due to the complex interaction between job and individual, it is impossible to state whether employment is precluded or not. Such absolute statements would require speculation about multiple complex events and interactions including totally unpredictable random events. It is clear that the Veteran would have difficulty in any job setting that does not address his above difficulties in sustaining task performance and responding appropriately to change and others. Success would be much more likely in a job with stable demands and little interaction with others.” The VA examiner also wrote that the Veteran experienced difficulty in establishing and maintaining effective work and social relationships and difficulty in adapting to stressful circumstances, including work or a worklike setting. A November 2017 Vocational Rehabilitation Narrative Report states “The Veteran’s physical and mental conditions permit preparation to obtain employment within a reasonable time period. The Veteran agrees to participate in a program of services provided by the Department of Veterans Affairs to prepare for and obtain suitable employment. Therefore, achievement of a suitable vocational goal is found to be reasonably feasible. A September 2020 VA examiner wrote that the service-connected thoracolumbar spine condition impacts his ability to work in that the Veteran should not lift anything weighing more than 25 pounds, cannot perform repetitive bending or repetitive lifting irrespective of weight, and cannot work in a stooped posture. A November 2020 private examiner opined that the Veteran experienced social and occupational impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. Having reviewed and carefully considered all of the evidence of record, both lay and medical, the Board finds that the weight of the lay and medical evidence demonstrates that the criteria for a TDIU have not been met for any period on appeal. The evidence reflects that the Veteran was not precluded from securing and maintaining substantially gainful employment solely by reason of the service-connected disabilities. Rather, multiple evaluations during the period on appeal show that the Veteran was capable of securing and maintaining employment despite experiencing occupational and social impairment with reduced reliability and productivity, and the inability to lift heavy objects, perform repetitive lifting, or work in a stooped position. For these reasons, the Board finds that referral to the Director of Compensation and Pension is not warranted for the period from December 12, 2013 through September 8, 2020. The Board also finds that the preponderance of the lay and medical evidence is against a finding for assignment of a TDIU rating for the period from September 8, 2020 through September 28, 2020, when the combined rating percentage requirements for TDIU were met. 9. TDIU for the Period from September 28, 2020 Forward is Moot For the period from September 28, 2020 forward, the Veteran is in receipt of a combined schedular disability rating of 100 percent. For this period, a TDIU is mooted by the 100 percent (“total”) combined schedular rating for all disabilities, leaving no question of fact or law for the Board to decide. 38 U.S.C. § 7104; 38 C.F.R. § 4.16(a) (providing a TDIU only where the combined schedular disability rating is “less than total”). The Board has assessed all service-connected disabilities and finds there is no combination of the disabilities establish eligibility for special monthly compensation (SMC) under 38 U.S.C. § 1114(s). See Buie v. Shinseki, 24 Vet. App. 242, 250-51 (2010); Bradley v. Peake, 22 Vet. App. 280, 294 (2008). The instant matter is distinguishable from both Bradley and Buie. Under the unique facts of Bradley, SMC was available where a veteran had been granted TDIU based on a “less than total” 70 percent rating for only one disability and had subsequently obtained service connection for multiple orthopedic disabilities that combined to 60 percent. Under those circumstances, there was no “duplicate counting of disabilities.” Bradley at 293. In this case, the Veteran is in receipt of a 100 percent (“total”) schedular disability rating for an acquired psychiatric disorder. (Continued on the next page)   Concerning both Bradley and Buie, in this case, the Veteran has not contended, and the evidence of record does not reflect, that any single service-connected disability has rendered him unable to secure or follow a substantially gainful occupation. The Veteran is currently service connected for multiple disabilities and has contended that the combination of these disabilities renders him unemployable. To award a TDIU rating for the period when the 100 percent combined disability rating began would result in duplicate counting of disabilities. 38 C.F.R. § 4.14. As neither Bradley nor Buie is applicable, the question of entitlement to a TDIU has been rendered moot for this period. See 38 U.S.C. § 7104; Sabonis v. Brown, 6 Vet. App. 426, 429-30 (1994). J. PARKER Veterans Law Judge Board of Veterans’ Appeals Department of Veterans Affairs A. Caruso, Attorney for the Board 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.