Citation Nr: 21015609 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 14-39 420 DATE: March 17, 2021 ORDER A disability rating in excess of 10 percent for peripheral neuropathy of the right lower extremity prior to July 19, 2011, is denied. Effective July 19, 2011, a disability rating of 40 percent for peripheral neuropathy of the right lower extremity is granted. A disability rating in excess of 10 percent for peripheral neuropathy of the left lower extremity prior to July 19, 2011, is denied. Effective July 19, 2011, a disability rating of 40 percent for peripheral neuropathy of the left lower extremity is granted. A total disability rating based on individual unemployability (TDIU) due to service-connected disabilities prior to July 21, 2011, is denied. FINDINGS OF FACT 1. The most probative evidence demonstrates that prior to July 19, 2011, the Veteran’s peripheral neuropathy of the right and left lower extremities were manifested by mild incomplete paralysis of the sciatic nerves; moderate incomplete paralysis of the sciatic nerves was not shown. 2. Since July 19, 2011, the Veteran’s peripheral neuropathy of the right and left lower extremities have been manifested by subjective complaints of numbness and decreased sensation; objective findings include diminished reflexes in the lower extremities, severe incomplete paralysis of the sciatic nerves was not shown. 3. The most probative evidence indicates that the Veteran’s service-connected disabilities, either singularly or jointly, did not preclude him from substantially gainful employment prior to July 21, 2011. CONCLUSIONS OF LAW 1. The criteria for entitlement to a rating higher than 10 percent for peripheral neuropathy of the right lower extremity prior to July 19, 2011, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, Diagnostic Codes 8520. 2. The criteria for entitlement to a rating higher of 40 percent, but no higher, for peripheral neuropathy of the right lower extremity effective July 19, 2011, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, Diagnostic Codes 8520. 3. The criteria for entitlement to a rating higher than 10 percent for peripheral neuropathy of the left lower extremity prior to July 19, 2011, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, Diagnostic Codes 8520. 4. The criteria for entitlement to a rating higher of 40 percent, but no higher, for peripheral neuropathy of the left lower extremity effective July 19, 2011, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, Diagnostic Codes 8520. 5. The criteria for a TDIU were not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.16(a)(b). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1970 to January 1979, and from October 1981 to November 1992. In July 2018 and September 2019, the Board remanded the appeal for additional development, which has been completed. The records show that the Veteran’s claims file was lost while in VA possession and was subsequently reconstructed. Although reconstruction efforts have permitted the recovery of documents, it is apparent from review of the file that some documents dated prior to 2014 remain missing and are unavailable for review. The United States Court of Appeals for Veterans Claims (Court) has held that in instances where a claimant’s service department records are unavailable, the Board is under a heightened obligation to explain its findings and to carefully consider whether the evidence is in equipoise, and if so, to resolve the matter in the claimant’s favor. O’Hare v. Derwinski, 1 Vet. App. 365, 367 (1991); Pruitt v. Derwinski, 2 Vet. App. 83, 85 (1992). Applying the principles of the Court’s holding in that case, the Board recognizes its obligation in this case to carefully consider the weight of the evidence and to find in the Veteran’s favor if the weight of evidence is in equipoise. It is valuable to note for the record that the Veteran has been awarded a 100 percent disability rating since July 10, 2017. Increased Rating Ratings for service-connected disabilities are determined by comparing the Veteran’s symptoms with criteria listed in VA’s Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 C.F.R. Part 4. When rating a service-connected disability, the entire history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two 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. The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2009). The assignment of a particular diagnostic code to evaluate a disability is “completely dependent on the facts of a particular case.” See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual’s relevant medical history, the diagnosis, and demonstrated symptomatology. 1. Entitlement to a disability rating in excess of 10 percent prior to July 19, 2011, and effective July 19, 2011, a disability rating of 40 percent for peripheral neuropathy of the right lower extremity 2. Entitlement to a disability rating in excess of 10 percent prior to July 19, 2011, and effective July 19, 2011, a disability rating of 40 percent for peripheral neuropathy of the left lower extremity The Veteran seeks higher disability ratings than those currently assigned for peripheral neuropathy of the right and left lower extremities associated with service-connected type II diabetes mellitus. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment and motor function, trophic changes, or sensory disturbances. 38 C.F.R. § 4.120. Under 38 C.F.R. § 4.124a, disability from neurological disorders is rated from 10 to 100 percent in proportion to the impairment of motor, sensory, or mental function. With partial loss of use of one or more extremities from neurological lesions, rating is to be by comparison with mild, moderate, severe, or complete paralysis of the peripheral nerves. The term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type of picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. 38 C.F.R. § 4.124a. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. Id. In rating peripheral nerve disability, neuritis, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete paralysis. 38 C.F.R. § 4.123. The Veteran’s right and left lower extremity peripheral neuropathy are each currently rated as 10 and 20 percent disabling under Diagnostic Codes 8599-8521, concerning paralysis of the popliteal (common peroneal) nerve. Hyphenated diagnostic codes are used when the rating for a disability under one Diagnostic Code is based upon the rating under another Diagnostic Code. 38 C.F.R. § 4.27. Despite the previously-assigned rating pursuant to Diagnostic Code 8521, based upon the objective findings of the VA examination reports throughout the appeal (which documents impairment of the sciatic nerve rather than the popliteal (common peroneal) nerve), the lower extremity peripheral neuropathy is most appropriately rated under Diagnostic Code 8520, which specifically contemplates paralysis of the sciatic nerve. Diagnostic Code 8520 provides ratings for paralysis of the sciatic nerve and, therefore, neuritis and neuralgia of that nerve. 38 C.F.R. § 4.124a, Diagnostic Code 8520. Diagnostic Code 8520 provides that mild incomplete paralysis is rated 10 percent disabling. Moderate incomplete paralysis is rated 20 percent disabling. Moderately severe incomplete paralysis is rated 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy, is rated 60 percent disabling. Complete paralysis of the sciatic nerve, the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost, is rated 80 percent disabling. Diagnostic Code 8620 refers to neuritis of the sciatic nerve while Diagnostic Code 8720 refers to neuralgia of the sciatic nerve. The Board notes that the terms “mild,” “moderate,” “moderately severe,” and “severe” are not defined in the rating schedule; rather than applying a mechanical formula, VA must evaluate all the evidence to the end that its decisions are equitable and just. 38 C.F.R. § 4.6. Although a medical examiner’s use of descriptive terminology such as “mild” is an element of evidence to be considered by the Board, it is not dispositive of an issue. On VA examination in July 2009, the Veteran reported that he was employed full time as a clerk with the US Postal Service, but had been on workman’s compensation disability since he injured his back in February 2008. The Veteran reported diabetes mellitus with paresthesias and dysesthesias in both feet. He endorsed daily symptom flare-ups lasting six to eight hours. Aggravating factors included standing, walking or siting. The examiner noted that a nerve study conducted in April 2009 showed mild neuropathy which could be contributing to foot numbness but was not a part of the work-related injury. Neurological diagnostic testing revealed muscle strength was within normal limits, and there was no decrease in sensory or motor impairment. The examiner diagnosed bilateral lower extremity peripheral neuropathy with no objective findings on clinical examination to support the diagnosis. In a statement in December 2009, Dr. LM. stated that the Veteran had mild neuropathy which could be contributing to the weakness, numbness and pain in his lower legs and feet. A VA medical examiner in July 2011, reported that the Veteran’s peripheral neuropathy was productive of mild functional impairment. His gait could not be assessed as he ambulated in an electric scooter. Reflexes were 2/4 at the patellar level (L3-4) and 0 out of 4 at the achilles level (S1). There was no evidence of atrophy or loss of tone and strength. Sensory examination showed decreased sensation of the distal calf, normal sensation to the proximal lower extremity and absent sensation of the plantar surface. VA treatment records in July 2013, noted that the Veteran complained of severe symptoms associated with his bilateral lower extremity neuropathy. He requested diabetic shoes. The clinician noted sensation to light touch was intact, sensation to filaments was partially intact and reflexes were 2/4, bilaterally. A medical treatment note in August 2013, noted that the Veteran’s lower extremities exhibited hair loss with sensory loss in a stocking distribution. No significant foot atrophy was noted. Nerve conduction studies (NCS) showed neuropathy affecting the lower extremities. An August 2014 treatment note recorded normal pulses in the lower extremities. On VA examination in June 2017, the examiner noted mild constant pain, mild paresthesias and/or dysesthesias, and mild numbness in the lower extremities. Strength was reduced to 4/5. Deep tendon reflexes were reduced at the knee level to 1+, bilaterally. Light touch/monofilament testing was normal in the knees and thighs, but absent in ankles and toes. Sensation was decreased. The examiner noted loss of extremity hair and smooth shiny skin, bilateral lower extremities. The examiner noted moderate incomplete paralysis of the sciatic nerves, bilaterally. Occupationally, the Veteran reported difficulty with standing and ambulation due to peripheral neuropathy. He used a walker and electric scooter for mobility. He was recently placed on insulin to treat his diabetes mellitus in addition to oral therapy. The Veteran underwent a VA examination in October 2018. The Veteran reported numbness, burning and tingling in his lower extremities. He described a cold sensation and lightning bolt sensation down both legs. He had reduced sensation at the bottom of his feet. He took morphine for pain. Examination showed strength was reduced to 4/5. Deep tendon reflexes were reduced at the knee and ankle level to 1+, bilaterally. The examiner noted muscle weakness. The Veteran used a scooter chair for ambulation. Occupationally, the Veteran reported that he was confined to a scooter and was unable to walk more than 20 feet or climb stairs without shortness of breath. The examiner noted shortness of breath due to chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD). On VA examination in March 2019, the examiner noted peripheral neuropathy of the bilateral lower extremities secondary to diabetes. The Veteran was in a wheelchair. He had a wide-based slowed unsteady gait. There was loss of sensation, numbness, tingling in bilateral feet causing him to walk slowly and cautiously. Examination showed strength was reduced to 2/5 in the right lower extremity, and 1/5 in the left. There was severe bilateral lower extremity weakness with atrophy. Deep tendon reflexes were reduced at the knee and ankle level to 1+ on the right, and were absent on the left lower extremity. He was unable to stand for prolonged time periods, walk more than 20 feet, climb stairs, or handle packages due to dyspnea, fatigue, and numbness in bilateral hands with left worse than right. On VA examination in September 2019, the Veteran reported numbness, parasthesia and pain in both legs. At times the pain radiated from his low back down to both feet, which the examiner noted appeared to be consistent with sciatica as due to back disability. The Veteran had generalized weakness in all muscles group of both legs, which was inconsistent with diagnosis of diabetic peripheral neuropathy of bilateral lower extremities. He was able to walk for a short distance and to transfer himself from a scooter to the examination table. The examiner noted that the findings on examination were inconsistent with the Veteran’s description of his symptoms. There was mild constant pain, numbness and paresthesias and/or dysesthesias. Strength was reduced to 5/5. There was no muscle atrophy. Deep tendon reflexes were reduced at the knee level to 1+, bilaterally. Sensation was decreased in the feet and ankles. No trophic changes in the bilateral lower extremities were noted. The examiner noted no paralysis of the nerves in the lower extremities, bilaterally. On VA examination in November 2019, the examiner noted peripheral neuropathy of the left and right lower extremities productive of moderate functional limitations. The examiner noted that the Veteran’s disability has progressed since he was last examined, as evidenced by uncontrolled A1C despite 4 diabetic medications. Examination showed mild constant pain, moderate paresthesias and/or dysesthesias, and severe numbness in the lower extremities. Strength was reduced to 4/5. Deep tendon reflexes were reduced at the knee and ankle level to 1+ on the right, and absent on the left. Light touch/monofilament and vibration sensation testing were absent in ankles and toes. Cold sensation and position sense were decreased, bilaterally. There was no muscle atrophy. The examiner noted loss of extremity hair and smooth shiny skin, bilateral lower extremities. The examiner noted moderate incomplete paralysis of the sciatic nerves, bilaterally. Prior to July 19, 2011, the Veteran’s peripheral neuropathy was manifested by mild symptoms with some deficit in sensory perception, including numbness. Significantly, the VA examiner in July 2009 noted muscle strength was within normal limits, and there was no decrease in sensory or motor impairment. The examiner diagnosed bilateral lower extremity peripheral neuropathy with no objective findings on clinical examination to support the diagnosis. However, by the time of the July 2011 examination, the Veteran’s symptoms had worsened, and were indicative of more severe impairment as it was reported that he had some sensory impairment in the lower legs with sensation of the plantar surface toes and ankles at times was noted as absent. There was loss of extremity hair and smooth shiny skin in the bilateral lower extremities. Reports of atrophy and muscle weakness varied during this period. He had a wide-based slowed unsteady gait and required assistive devices for ambulation, including a motorized scooter and a walker, and he reported difficulty standing. After consideration of such evidence, and resolving any reasonable doubt in his favor, the evidence supports a finding that increased 40 percent ratings are warranted for moderately severe incomplete paralysis of the sciatic nerve of the bilateral lower extremity peripheral neuropathy from July 19, 2011. However, the preponderance of evidence of record does not document that the Veteran’s bilateral lower extremity peripheral neuropathy resulted in worse than mild incomplete paralysis of the median nerve prior to July 19, 2011, so earlier effective dates are not warranted for the increased ratings. Similarly, the preponderance of the evidence does not support the next higher rating of 60 percent for either leg as there is no evidence of severe incomplete paralysis of the sciatic nerve with marked muscular atrophy. In 2017 it was also noted that the Veteran was placed on insulin to treat his worsening diabetes mellitus, and the VA examiner in noted moderate incomplete paralysis of the sciatic nerves, bilaterally. Similarly, the VA examiner in November 2019 noted moderate incomplete paralysis of the sciatic nerves, bilaterally, and opined that the Veteran’s peripheral neuropathy of the left and right lower extremities was productive of moderate functional limitations. Accordingly, a rating higher than 40 percent for the right or left lower extremity is not warranted under Diagnostic Code 8520. While the Board understands the Veteran’s central concerns that his bilateral leg disability has negatively impacted his quality of life and causes difficulty with activities of daily living, it is important for the Veteran to also understand that without some significant problems associated with his bilateral leg disability there would be no basis for a compensable rating, let alone 40 percent evaluations assigned for the entire period on appeal, let alone an 80 percent evaluation for both legs. Without consideration of the problems he cited and the other issues he has with his bilateral leg disability at this time, the current evaluations would not be justified. The Board has considered the applicability of other diagnostic codes but finds that, Diagnostic Codes for rating the sciatic nerve group do not provide for higher ratings than those assigned herein for the level of incomplete paralysis demonstrated by the evidence. 38 C.F.R. § 4.124a, Diagnostic Codes 8520, 8620, 8720, 8521, 8621, 8721, 8522, 8622, 8722, 8523, 8623, 8723, 8524, 8624, 8724, 8525, 8625, and 8725. In conclusion, the Board has considered all potentially applicable provisions of the rating schedule. Prior to July 19, 2011, disability ratings higher than 10 percent for the bilateral lower extremity peripheral neuropathy, are not warranted. After resolving any reasonable doubt in favor of the Veteran, separate 40 percent ratings, but no higher, are warranted for the right and left lower extremity peripheral neuropathy from July 19, 2011, but no sooner. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 3.102, 4.3; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 3. Entitlement to a TDIU prior to July 21, 2011 In terms of total disability ratings, if the schedular rating is less than total, a total disability evaluation can be assigned based on individual unemployability if the veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that the veteran has one service- connected disability rated at 60 percent or higher; or two or more service-connected disabilities, with one disability rated at 40 percent or higher and the combined rating is 70 percent or higher. Marginal employment shall not be considered substantially gainful employment. 38 U.S.C. § 1155; 38 C.F.R. § 4.16 (a). Pursuant to 38 C.F.R. § 4.16 (b), when a claimant is unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities, but fails to meet the percentage requirements for eligibility for a total rating set forth in 38 C.F.R. § 4.16 (a), such case shall be submitted s to the Director of Compensation Service for extra-schedular consideration. In determining whether a veteran can secure and follow a substantially gainful occupation, attention must be given to: (1)the veteran’s history, education, skill, and training; (2) whether the veteran has the physical ability (both exertional and nonexertional) to perform the type of activities (e.g., sedentary, light, medium, heavy, or very heavy) required by the occupation at issue. Factors that may be relevant include, but are not limited to, the veteran’s limitations, if any, concerning lifting, bending, sitting, standing, walking, climbing, grasping, typing, and reaching, as well as auditory and visual limitations; and whether the veteran has the mental ability to perform the activities required by the occupation at issue. Factors that may be relevant include, but are not limited to, the veteran’s limitations, if any, concerning memory, concentration, ability to adapt to change, handle workplace stress, get along with coworkers, and demonstrate reliability and productivity. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). The Veteran is seeking entitlement to a TDIU prior to July 21, 2011, due to his service-connected disabilities. From April 20, 2009 to March 1, 2011, service connection was in effect for: • Diabetes mellitus, evaluated as 20% disabled; • Peripheral neuropathy, right lower extremity associated with type ii diabetes mellitus, evaluated as 10% disabled; • Peripheral neuropathy, left lower extremity associated with type ii diabetes mellitus, evaluated as 10% disabled; • Hypertension, evaluated as 10% disabled; • Tinnitus, evaluated as 10% disabled; • Hernia, evaluated as 0% disabled; • Bilateral hearing loss, evaluated as 0% disabled; and • Residuals of a left ring finger fracture, evaluated as 0% disabled. The Veteran’s combined disability evaluation was 50%. From March 1, 2011 to July 21, 2011, service connection was in effect for: • CAD, evaluated as 60% disabled from March 1, 2011 to July 21, 2011; • Diabetes mellitus, evaluated as 20% disabled; • Peripheral neuropathy, right lower extremity associated with type II diabetes mellitus, evaluated as 10% disabled prior to July 19, 2011, and 40% disabled thereafter; • Peripheral neuropathy, left lower extremity associated with type ii diabetes mellitus, evaluated as 10% disabled prior to July 19, 2011, and 40% disabled thereafter; • Hypertension, evaluated as 10% disabled; • Tinnitus, evaluated as 10% disabled; • Hernia, evaluated as 0% disabled; • Bilateral hearing loss, evaluated as 0% disabled; and • Residuals of a left ring finger fracture, evaluated as 0% disabled. Therefore, prior to March 1, 2011, the Veteran did not meet the percentage requirements for consideration of a TDIU on a schedular basis. 38 C.F.R. § 4.16 (a). Since March 1, 2011, the Veteran met the schedular criteria for TDIU. 38 C.F.R. § 4.16. The question before the Board is whether the Veteran was unemployable by reason of his service-connected disabilities, taking into account his educational and occupational background. The Board finds that the greater weight of the probative evidence is against a finding that the Veteran was unable to secure and follow a substantially gainful occupation by reason of his service-connected disabilities. The evidence shows that the Veteran completed high school and two years of college. Records from the United States Postal Service in December 2009 indicated that the Veteran last worked on February 22, 2008 due to an on-the-job back injury. They also showed that the Veteran was in receipt of Workers Compensation. On VA examination in July 2009 showed that the Veteran denied having any restrictions due to his diabetes mellitus. In a statement in December 2009, Dr. LM. noted that because of the Veteran’s lower back injury he had been unable to work and was totally and permanently disabled. On VA audio examination in February 2010, the examiner determined that there were no objective findings that the Veteran’s service connected hearing loss was contributing to unemployability. A VA medical examiner in July 2011, reported that the Veteran’s peripheral neuropathy was productive of mild functional impairment. The examiner also opined that the Veteran’s diabetes and coronary artery disease were not productive of functional limitations at that time. Additionally, there is no indication that prior to July 21, 2011, the Veteran’s hypertension, tinnitus, hernia and residuals of a left ring finger fracture, interfered with the Veteran’s ability to secure and maintain gainful employment. The Board previously remanded this matter for extraschedular TDIU referral to the Director of Compensation Services. In an October 2020 advisory opinion, the Director concluded the Veteran was not entitled to a TDIU prior to March 1, 2011, including on an extraschedular basis. The Director found that there was no factual demonstration of impairment to earning capacity based on exceptional or unusual factors. The evidence failed to support the contention that any of the service-connected disabilities or a combination of the effects of those disabilities prevented gainful employment prior to March 1, 2011. Therefore, entitlement to TDIU prior to March 1, 2011, under provision 38 C.F.R. § 4.16(b) was denied. The Director based the opinion on the finding that the Veteran’s service-connected conditions could have functional impact and impair prolonged activities. A high rating, such as that in effect prior to March 1, 2011, in-itself recognized that the impairment made it difficult to obtain and keep employment. The Director noted that the American workplace had dramatically changed due to increased reliance on computer, internet and emails, and comparatively, Americans presently had less strenuous jobs in general. There were many jobs in the workplace that required only light activity. Additionally, technological advances broadened employment opportunities for the disabled with reasonable accommodations that were not previously available. The evidence shows that in April 2012 the Veteran was awarded disability benefits from the Social Security Administration Social Security Administration (SSA) due to his back disability and other unspecified arthropathy. Reportedly, he became too disabled to work in February 2008. However, an SSA award is not controlling as to his TDIU claim. SSA benefits are based on different criteria than are VA disability benefits. Moreover, while the Veteran has been found to be disabled by the SSA, it was not based solely on his service-connected disabilities. Overall, the findings of SSA provides evidence against this claim as it indicates multiple nonservice-connected problems are, in part, the cause of the issue. The SSA records and treatment records clearly indicate significant post-service disabilities that are not related to service. Therefore, the Board finds that while the Veteran’s service-connected disabilities were productive of significant occupational limitations, the objective medical evidence, to include VA examination reports, did not support a finding that the Veteran’s service-connected disabilities, separately or combined, precluded his employment prior to July 21, 2011. Following repeated examinations, the evidence in this case provides highly probative evidence against this claim. The examiners addressed the question of employability directly and their opinions are consistent. Moreover, the many VA examination opinion reports, as outlined above, fail to show that the Veteran’s service-connected disabilities either singularly or jointly, precluded the Veteran from gainful employment prior to July 21, 2011, and collectively provided evidence against this finding. The Board has reviewed this case in great detail. Nothing above should be viewed as an indication that the Veteran does not have many problems with his service-connected disabilities. If he did not, there would be no basis for the high disability evaluations. The question is without taking into consideration the Veteran’s nonservice-connected problems and, more importantly, his age, could the Veteran work. In this regard, it is important for the Veteran to understand that there is now a highly significant amount of highly probative medical evidence that weighs against this claim that the Board simply cannot ignore. The Board acknowledges lay statements from the Veteran addressing the impact of his service-connected disabilities on his ability to work during the period of the appeal. Again, no one is suggesting the Veteran’s service-connected disabilities do not cause the Veteran many problems. While the Veteran is competent to report symptoms he experiences, an opinion as to the limitations on gainful employment due to his service-connected disabilities (and not his age or nonservice-connected problems) is beyond his medical expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Thus, any such lay statements regarding him being unable to work are not competent or sufficient. Simply stated, both the best factual evidence, including occupational history reported by the Veteran, and the best medical evidence, in the form of the examinations cited above, provides evidence against this claim. In this case, there is no indication from the record that prior to July 21, 2011, the Veteran was unable to obtain and maintain substantially gainful employment solely as a result of his service-connected disabilities, either singularly or jointly. In summary, the Veteran’s combined disability evaluation of 50 percent prior to March 1, 2011, is insufficient to consider TDIU on a schedular basis. 38 C.F.R. § 4.16 (a). The evidence of record does not suggest that the Veteran is entitled to a TDIU on an extraschedular basis prior to March 1, 2011, because it does not show that he was precluded from securing or maintaining substantially gainful employment as a result of service-connected disabilities alone. The case was referred for consideration to the Director, Compensation Service, who found that an extraschedular TDIU should not be awarded prior to March 1, 2011. The Board further finds that the evidence does not support the Veteran’s eligibility for TDIU on a schedular basis from March 1, 2011 through July 21, 2011. 38 C.F.R. § 4.16 (a). As the preponderance of the evidence is against the claim for entitlement to a TDIU, the benefit of the doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Saudiee Brown Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Azizi, T. 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.