Citation Nr: 21013130 Decision Date: 03/08/21 Archive Date: 03/08/21 DOCKET NO. 14-13 792 DATE: March 8, 2021 ORDER Entitlement to an initial rating higher than 10 percent for a skin disability prior to June 23, 2019 and higher than 60 percent thereafter is denied. Entitlement to an initial rating higher than 30 percent for a psychiatric disability prior to January 29, 2013 is denied. Entitlement to a rating of 50 percent, and no higher, for psychiatric disability effective January 29, 2013 is granted. Entitlement to a total disability rating based on individual unemployability (TDIU) is denied. FINDINGS OF FACT 1. Prior to June 23, 2019, the Veteran’s psoriasis did cover 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; require systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more during the past 12-month period. 2. As of June 23, 2019, the Veteran is in receipt of the maximum schedular rating of 60 percent for the service-connected psoriasis. 3. Prior to January 29, 2013, the Veteran’s psychiatric disability was not shown to cause occupational and social impairment with reduced reliability and productivity. 4. As of January 29, 2013, the Veteran’s psychiatric disability was not shown to cause occupational and social impairment with deficiencies in most areas. 5. The Veteran did not return a completed VA Form 21-8940 to support a claim for TDIU, and the preponderance of the evidence shows that no single service-connected disability rendered the Veteran unemployable/unable to secure and follow a substantially gainful occupation. CONCLUSIONS OF LAW 1. The criteria for a rating higher than 10 percent for a skin disability prior to June 23, 2019 and higher than 60 percent thereafter have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321(b)(1), 4.1, 4.3, 4.7, 4.10, 4.118, Diagnostic Code (Code) 7816. 2. The criteria for a rating higher than 30 percent for a psychiatric disability prior to January 29, 2013 have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.125, 4.126, 4.130, Code 9435. 3. Effective January 29, 2013, the criteria for a 50 percent rating, and no higher, for psychiatric disability have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.125, 4.126, 4.130, Code 9435. 4. The criteria for TDIU have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16, 4.18. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1997 to August 2009. These matters come to the Board of Veterans’ Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). In January 2018, these matters were remanded for further development. Increased Rating Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the appellant working or seeking work. 38 C.F.R. § 4.2. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. 1. Entitlement to a rating higher than 10 percent for a skin disability prior to June 23, 2019 and higher than 60 percent thereafter The Veteran contends that he is entitled to higher ratings for service-connected psoriasis. He has been assigned a 10 percent rating under Code 7816 for psoriasis effective August 28, 2009, the date following service discharge; and 60 percent effective from June 23, 2019, the date of the VA examination showing worsening symptoms. At the outset, the Board observes that the Veteran has separate disability ratings for psoriatic arthritis to various joints. These issues are not presently before the Board. VA amended the criteria for rating skin disabilities effective from August 13, 2018. These new regulations apply to all applications for benefits received by VA or that are pending before the AOJ on or after August 13, 2018. Claims pending prior to the effective date will be considered under both old and new rating criteria, and whatever criteria is more favorable to the Veteran will be applied. The Board may not apply a current regulation prior to its effective date, unless the regulation explicitly provides otherwise. Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). The Board; however, is not precluded from applying prior versions of the applicable regulation to the period on or after the effective dates of the new regulation if the prior version was in effect during the pendency of the appeal. Prior to August 13, 2018, under Code 7816, a 10 percent rating is assigned for at least 5 percent, but less than 20 percent, of the entire body, or; at least 5 percent, but less than 20 percent, of exposed areas affected, or; intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of less than six weeks during the past 12-month period. A 30 percent rating is assigned for 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more, but not constantly during the past 12-month period. A 60 percent rating is assigned for more than 40 percent of the entire body or more than 40 percent of exposed areas affected, or; constant or near- constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12- month period. Or rate as disfigurement of the head, face, or neck (Code 7800) or scars (Codes 7801, 7802, 7803, 7804, or 7805), depending on the predominant disability. For claims filed prior to August 13, 2018, the Court held that a systematic therapy is one that that affects the entire body in its treatment of the condition at issue, and that the Board must determine (1) whether a topical treatment affects the body as a whole in treating a veteran’s skin condition; and (2) whether the given treatment is “like a corticosteroid or other immunosuppressive drug.” Burton v. Wilkie, 30 Vet. App. 286 (2018). Only the second question need be addressed if the treatment is clearly systemic. Effective August 31, 2018, VA regulations explicitly state that systemic therapy is treatment that is administered through any route other than the skin, and topical therapy is treatment that is administered through the skin. 38 C.F.R. § 4.118(a). Additionally, effective August 13, 2018, a new General Rating Formula for the Skin applies to Code 7816. Under this formula, a 10 percent rating is assigned for at least one of the following: characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or at least 5 percent, but less than 20 percent, of exposed areas affected; or intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12- month period. A 30 percent rating is assigned at least one of the following: characteristic lesions involving more than 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period. A 60 percent rating is assigned for at least one of the following: characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period. Or rate as disfigurement of the head, face, or neck (Code 7800) or scars (Codes 7801, 7802, 7803, 7804, or 7805), depending on the predominant disability. 38 C.F.R. § 4.118, General Rating for the Skin for Code 7816. During a September 2009 VA examination, the Veteran’s scalp revealed no scales or red plaques. The Veteran’s face, neck, trunk, and arms/elbows were all clear. There were some red plaques over the finger joints. His legs exhibited multiple red plaques on knees and feet. The examiner found 3 to 5 percent body surface area was involved in exposed areas and 0 percent body surface area involved in unexposed areas. Treatment in the last 12 months included clobetasol ointment twice a day when the Veteran had a bad outbreak. The Veteran was on topical steroids. He had no treatment with tumor necrosis factor (TNF) inhibitors. He had no treatment with systemic drugs or phototherapy for psoriasis. A February 2013 VA examination revealed active psoriasis of the knees, hips, elbows, hands, wrists, and shoulders. The examiner concluded that the skin disability currently affects 5 to 20 percent of the total body area and less than 5 percent of the exposed area. The examiner noted that the Veteran’s skin disability is continuously treated with topical therapy. VA and private treatment records indicate the presence of psoriasis and are consistent with findings in the September 2009 and February 2013 VA examination reports. During June 2019 VA examination, the examiner noted that the Veteran’s psoriasis had worsened in terms of body area covered. The Veteran continued to require no more than topical therapy in the form of hydrocortisone to treat this condition. The examiner noted that more than 40 percent of his body to include the bilateral legs, arms, and scalp showed active psoriasis. After review of the record, the Board finds that prior to June 23, 2019, the preponderance of the evidence is against the assignment of a rating higher than 10 percent under the pre-August 13, 2018, regulations and under the August 13, 2018, regulations. The evidence prior to June 23, 2019, indicates that the Veteran’s psoriasis did not more nearly approximate 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or; require systemic therapy such as corticosteroids or other immunosuppressive drugs required for a total duration of six weeks or more during the past 12-month period. During this period, the Veteran’s psoriasis covered between 5 and 20 percent of his body. The record indicates that the Veteran used topical corticosteroids on those parts of the body for treatment. Although the Veteran’s representative argued that his skin symptoms did not just worsen on the day of the June 23, 2019 VA examination, there is no probative evidence prior to June 23, 2019 to show worsening symptoms that would warrant a higher rating. Beginning June 23, 2019, the Board finds that the evidence indicates that the Veteran’s psoriasis covered over 40 percent of his body. Under both the former and present rating criteria, this results in a 60 percent rating. This is the maximum rating allowed under Code 7816. The Board has considered whether any other Codes related to disabilities of the skin would provide for a higher disability evaluation. However, the evidence does not reflect that he would warrant a higher rating under a different Code. 38 C.F.R. § 4.118. Indeed, although the Veteran is shown to have active psoriasis on his scalp, there is no indication in the treatment records that there is a disfigurement of the head. See Code 7800. Accordingly, the Board finds that prior to June 23, 2019, the preponderance of the evidence is against the Veteran’s claim of a rating higher than 10 percent for psoriasis. As of June 23, 2019, the Veteran is in receipt of the maximum 60 percent rating for psoriasis. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Further, there is no indication for a higher rating under Code 7800. 2. Entitlement to a rating higher than 30 percent for a psychiatric disability prior to January 29, 2013 and higher than 50 percent thereafter The Veteran contends that he is entitled to higher ratings for service-connected psychiatric disability. He has been assigned a 30 percent rating under Code 9435 for unspecified depression effective from August 28, 2009, the date following his service discharge, and 50 percent effective from February 15, 2013, the date of a VA examination. The Board observes that the VA examination date that the AOJ based the increase on was actually January 29, 2013. As such, the Board has recharacterized the issue by way of the effective date. Under the General Rating Formula for Mental Disorders, a 30 percent evaluation is assigned when a veteran’s mental disability causes 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, Code 9435. A 50 percent rating requires occupational and social impairment, but with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, 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 task); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. Id. A 70 percent rating is warranted for even greater occupational and social impairment with deficiencies in most areas, such as work, school, family relationships, judgment, thinking or mood, due to such symptoms as: suicidal ideation; obsessional rituals that interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting 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. Id. A 100 percent rating is warranted if there is 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. Id. When rating a mental disorder, VA must consider the frequency, severity, and duration of the Veteran's psychiatric symptoms, the length of remissions, and the Veteran’s capacity for adjustment during periods of remission. The rating agency must assign a rating based on all the evidence of record that bears on occupational and social impairment, rather than solely on the examiner’s assessment of the level of disability at the moment of the examination. When rating the level of disability from a mental disorder, the rating agency must consider the extent of social impairment but cannot assign a rating solely on the basis of social impairment. 38 C.F.R. § 4.126. The Veteran’s actual symptomatology, and resulting social and occupational impairment, will be the primary focus when assigning a disability rating for a mental disorder, and the Veteran may qualify for a particular rating by demonstrating the particular symptoms associated with that percentage, or other symptoms of similar severity, frequency, and duration. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116-17 (Fed. Cir. 2013). An initial rating higher than 30 percent for psychiatric disability prior to January 29, 2013 As will be explained below, the Board concludes that an initial evaluation exceeding 30 percent for the period prior to January 29, 2013 is not supported, therefore a higher rating is not warranted for this period on appeal. VA treatment records dated from August 2009 to January 2013 show no specific treatment for his psychiatric disability. During the September 2009 VA exam, the Veteran was shown to have mild anxiety which did not seriously compromise his function, although the symptoms kept him chronically uncomfortable. The examiner noted that the Veteran’s description of panic-type symptoms did not meet criteria for the full syndrome of a panic disorder and some of the symptoms reported may have been confounded with actual diagnosed medical conditions. The examiner also noted the Veteran provided no information that was suggestive of depression, but on psychometric evaluation came up as having depressive symptoms of moderate intensity in the last two weeks. The examiner noted that symptoms were that the Veteran was worried at times about “something being wrong somewhere,” but the Veteran was unable to specify where or what or with whom things may be wrong. He also reported periods of having hyper aroused kind of symptoms, which appeared subclinical for a panic attack. For the period prior to January 29, 2013, an evaluation exceeding 30 percent is not demonstrated. The record does not establish that the Veteran’s psychiatric disability results in 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, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, or difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130, Code 9435. Indeed, at no time during this period, does the record reflect that the Veteran had difficulty maintaining social relationships. According to the Veteran, he has a good relationship with his spouse and a few close friends. Further, the record does not show any episodes of impaired judgment, impaired abstract thinking or disturbances of motivation and mood, contemplating a 50 percent rating. Rather, the September 2009 VA examiner that personally examined the Veteran observed him to be neatly groomed, cooperative and pleasant, with his memory, attention, insight, and judgment intact. Clearly, such findings are not consistent with a higher 50 percent rating. In short, the Board finds that the Veteran’s symptoms during this period prior to January 29, 2013 do not impact his social and occupational functionality in such a way to result in occupational and social impairment, with reduced reliability and productivity. Although the Veteran’s representative argued that the Veteran’s psychiatric symptoms did not worsen on the day of the January 29, 2013 VA examination, the probative, contemporaneous evidence dated prior to the January 29, 2013 VA examination does not reflect that the Veteran’s service-connected psychiatric disability was manifested by symptoms of such severity to warrant an evaluation in excess of 30 percent. The Veteran’s psychiatric symptoms prior to January 29, 2013 are of the same severity, nature, type, and duration as those associated with a 30 percent rating. A rating higher than 50 percent for psychiatric disability from January 29, 2013 The Veteran is currently evaluated at 50 percent effective February 15, 2013. As noted above, a 50 percent rating is warranted effective from January 29, 2013. The Board observes; however, the competent evidence of record does not establish findings consistent with a higher rating. During January 29, 2013 VA examination, the Veteran reported symptoms of depressed mood, chronic sleep impairment, decreased or absent libido, irritability, difficulty concentrating, social phobia, and anxiety with panic attacks that occur weekly or less often. He also reported experiencing disturbances of motivation and mood with difficulty in establishing and maintaining effective work and social relationships. He had no deficits with attention, concentration, or memory noted. Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks were noted. During June 2019 VA examination, the Veteran was alert and oriented to person, place, the date, time, and situation. The Veteran’s clothing was appropriate to the situation and weather. He maintained appropriate eye contact. He exhibited acceptable hygiene. His speech was within normal limits with regard to rate, rhythm and volume. He walked with a slow gait. The Veteran was cooperative and actively participated in the evaluation procedures. His affect was appropriate to discussion but constricted. He did not report current suicidal ideation. He also did not report homicidal thinking. The Veteran did not report, nor were there clear indications of, obsessions, compulsions, or manic symptoms. The examiner indicated that there is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. As demonstrated above, the Veteran clearly experienced psychiatric symptomatology as a result of his PTSD with symptoms such as depressed mood, anxiety, and chronic sleep impairment. The probative evidence of record; however, does not establish that his PTSD was manifested by occupational and social impairment with deficiencies in most areas, such as work, school, family relationships, judgment, thinking or mood due to such symptoms as: suicidal ideation; obsessional rituals that interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting 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. Significantly, the Veteran consistently denied any history of suicidal attempts and expressly denied any passing/active suicidal ideations or homicidal ideation. He also denied any intent and/or plan to hurt himself or others. In fact, there is no evidence to show that at any time during the appeal period the Veteran exhibited or resorted to violence or acted upon such impulses. Furthermore, the record does not show any episodes of obsessional rituals, speech intermittently illogical, obscure, or irrelevant; impaired impulse control, spatial disorientation, neglect of personal appearance and hygiene or an inability to establish and maintain effective relationships, which is consistent with a 70 percent evaluation. In short, the Board finds that the Veteran’s psychiatric symptoms during this appeal period does not impact his social and occupational functionality in such a way to result in social and occupational impairment with deficiencies in most areas. The psychiatric symptoms dated since January 29, 2013, as discussed above, are of a similar type, severity, duration, and nature as those associated with a 50 percent rating, and no higher. For these reasons, the Board finds that the Veteran’s psychiatric disability has not been manifested by symptomatology more nearly approximating the criteria for a 70 percent disability rating under 38 C.F.R. § 4.130, Code 9435 for any period on appeal. The benefit-of-the-doubt doctrine is not for application, and an increased rating under this code is not warranted. See 38 U.S.C.§ 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Accordingly, the claim for a higher rating must be denied. 3. Entitlement to a TDIU As an initial matter, this issue was previously before the Board in January 2018, at which time the Board found that the issue of entitlement to TDIU was inferred as part of the increased initial rating claims on appeal at that time as under Rice v. Shinseki, 22 Vet. App. 447, 453-454 (2009). Entitlement to TDIU was remanded for further development. The 2018 remand instructed the AOJ to provide a Form 21-8940 (Increased Rating Based on Unemployability) to the Veteran in order to obtain relevant employment information and to contact current and former employers to develop the claim. In May 2019, the AOJ sent the Veteran a letter explaining the requirements for developing his TDIU claim and requesting that he provide a completed Form 21-8940 to obtain employment information; however, he did not respond and did not otherwise submit the requested form. In addition, the AOJ also called and spoke with the Veteran in May 2020, to ascertain whether he had received the March 2020 supplemental statement of the case (SSOC) which denied entitlement to TDIU and whether the Veteran had additional evidence to submit. The Veteran confirmed he had received the 2020 SSOC and stated he had nothing to submit. Although VA has a statutory duty to assist in developing evidence pertinent to a claim, a veteran also has a duty to assist and cooperate with VA in developing evidence; the duty to assist is not a one-way street. Wood v. Derwinski, 1 Vet. App. 190 (1991). Therefore, VA has satisfied its duty to assist in the development of the TDIU claim and has sufficiently complied with the terms of the Board’s prior remand. At present, the claim has been returned to the Board for additional adjudicative action. As he was requested but failed to provide the necessary completed form, there is no prejudice in adjudicating the claim. Turning to the relevant laws and regulations, total disability based on unemployability exists where there is present any impairment of mind and body that is sufficient to render it impossible for the average person to follow a substantially gainful occupation. See 38 C.F.R. § 3.340. When the schedular rating is less than total, a TDIU may be assigned if the Veteran meets certain schedular criteria under 38 C.F.R. § 4.16(a) and is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. If there is only one service-connected disability, this disability should be rated at 60 percent or more; if there are two or more disabilities, at least one disability should be rated at 40 percent or more and the combined evaluation should be 70 percent or more. See 38 C.F.R. § 4.16(a). The fact that a veteran is in receipt of a combined schedular rating of 100 percent does not preclude the availability of a TDIU. Although no additional disability compensation may be paid when a total schedular rating is already in effect, a separate award of a TDIU predicated on a single disability may form the basis for an award of SMC, and thus must be considered by the Board. Bradley v. Peake, 22 Vet. App. 280, 293-94 (2008). During the appeal period, the Veteran has been service-connected for his heart, psoriasis, sleep apnea, psychiatric disability, bilateral lower extremity radiculopathy, lumbar spine, tinnitus, and psoriatic arthritis to the right hip disability, his left hip disability, bilateral elbows, bilateral wrists, bilateral knees, hands, toes, feet, thumbs. His combined rating for these disabilities was 100 percent throughout the entirety of the appeal period. He therefore cannot be considered for a TDIU based on multiple disabilities, but rather can only be considered for a schedular TDIU based on a single disability rated at 60 percent or higher under Bradley. Here, to also award a separate TDIU rating in addition to the combined schedular 100 percent rating based on the Veteran’s combined service-connected disabilities would result in duplicate counting of the disabilities. See VAOPGCPREC 66-91 (Aug. 15, 1991) (several separately ratable disabilities cannot be combined to achieve a single total rating in order to qualify for SMC). See also Bradley, 22 Vet. App. at 293-94 (holding that multiple disabilities arising from a single incident that establish entitlement to a schedular TDIU under 38 C.F.R. § 4.16 (a) may not be considered as one disability that satisfies that requirement of a service-connected disability rated as total). The Board finds that the Veteran has not identified a single disability that has rendered him unemployable, and the evidence does not indicate a single disability that would preclude all types of employment. Furthermore, the Veteran has never provided whether or not he has been unemployable due to his service-connected disabilities, but the Board inferred the claim as part and parcel to his increased rating claims. Further, as noted, the Veteran has not returned VA Form 21-8940, nor has he made any specific allegations regarding an inability to work due to his service-connected conditions. The VA Form 21-8940 would have provided information regarding his employment and educational histories. The Board has reviewed the record as discussed above in an effort to discern the Veteran’s employment and disability history, but this evidence does not reveal factors outside the norm resulting in the Veteran being precluded from securing or following substantially gainful employment due to the Veteran’s service-connected conditions. Again, it is not clear if the Veteran is, in fact, gainfully employed; and he has failed to cooperate with developing this claim. As such, this claim is denied. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. McPhaull, 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.