Citation Nr: 21023186 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 14-25 333 DATE: April 20, 2021 ORDER Entitlement to an evaluation in excess of 10 percent for hallux valgus of the right and left foot (excluding periods of temporary total rating from March 7, 2012 to June 1, 2012; March 11, 2020 to June 1, 2020; and July 20, 2020 to September 1, 2020), is denied. Entitlement to a separate rating for 10 percent for bilateral pes planus from August 11, 2015, is granted. Entitlement to a total disability rating based on unemployability (TDIU) is denied. FINDINGS OF FACT 1. The Veteran is in receipt of the maximum schedular evaluation for hallux valgus of the right and left foot. 2. Resolving reasonable doubt, from August 15, 2015, the Veteran’s bilateral pes planus is manifested by pain on manipulation and use of the feet. 3. The Veteran does not meet the schedular TDIU requirements and the preponderance of the evidence is against finding that the Veteran was unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 10 percent for hallux valgus of the right and left foot have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, DC 5280. 2. The criteria for a separate 10 percent rating for bilateral pes planus from August 11, 2015, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, DC 5276. 3. The criteria for entitlement to a TDIU rating to include on an extraschedular basis, have not been met. 38 U.S.C. §§ 1155, 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.16, 4.18, 4.19. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in active duty service with the Army from February 1976 to January 1983. This matter is on appeal from an October 2011 rating decision. The Veteran was afforded an April 2017 hearing before the undersigned Judge. A transcript of the hearing has been associated with the claims record. The Board remanded this appeal in January 2018 for additional development. In an October 2019 Board decision, the Board denied entitlement to an increased evaluation in excess of 10 percent for hallux valgus of the right and left foot and entitlement to TDIU. The Veteran appealed his denial to the Court of Appeals for Veterans Claims (CAVC or the Court). The Court, in September 2020, vacated and remanded the issues back to the Board for readjudication. The Board notes that the Regional Office (RO) assigned temporary total evaluations for the Veteran’s hallux valgus of the right and left foot for the periods from March 7, 2012 to June 1, 2012; March 11, 2020 to June 1, 2020; and July 20, 2020 to September 1, 2020. Therefore, the Board’s analysis for increased ratings for hallux valgus of the right and left foot will not include those periods of temporary total evaluations. The September 2020 Court decision also found a typographical error in the October 2019 Board decision which denied an increased evaluation in excess of 10 percent of hallux valgus of the right foot and an increased evaluation in excess of 10 percent of hallux valgus of the left foot; the Court found the Veteran “was previously granted an initial 10 percent rating for bilateral hallux valgus”. As such, the issue on appeal before the Board have been recharacterized to show an appeal for an increased evaluation in excess of 10 percent for hallux valgus for the right and left foot. Increased Rating A disability rating is determined by the application of VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. VA has a duty to acknowledge and consider all regulations that are potentially applicable through the assertions and issues raised in the record, and to explain the reasons and bases for its conclusions. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. 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. When evaluating disabilities of the musculoskeletal system, 38 C.F.R. § 4.40 allows for consideration of functional loss due to pain and weakness causing additional disability beyond that reflected on range of motion measurements. DeLuca v. Brown, 8 Vet. App. 202 (1995). Further, 38 C.F.R. § 4.45 provides that consideration also be given to weakened movement, excess fatigability and incoordination. Although pain may cause a functional loss, pain itself does not constitute functional loss. Rather, pain must affect some aspect of “the normal working movements of the body” such as “excursion, strength, speed, coordination, and endurance,” in order to constitute functional loss. Mitchell v. Shinseki, 25 Vet. App. 32, 38-43 (2011) (quoting 38 C.F.R. § 4.40 ). The Court has held that a Veteran may not be compensated twice for the same symptomatology as “such a result would overcompensate the Veteran for the actual impairment of his earning capacity.” Brady v. Brown, 4 Vet. App. 203, 206 (1993). This would result in pyramiding, contrary to the provisions of 38 C.F.R. § 4.14. The Court has acknowledged, however, that when a Veteran has separate and distinct manifestations attributable to the same injury, he should be compensated under different Diagnostic Codes. Esteban v. Brown, 6 Vet. App. 259 (1994); Fanning v. Brown, 4 Vet. App. 225 (1993). The Board will consider whether separate ratings may be assigned for separate periods of time based on the facts found, a practice known as “staged ratings.” Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). If the evidence for and against a claim is in equipoise, the claim will be granted. 38 C.F.R. § 4.3. A claim will be denied only if the preponderance of the evidence is against the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3. Hallux valgus of the right and left foot The Veteran is currently service connected for hallux valgus of the right and left foot evaluated at 10 percent under Diagnostic Code (DC) 5280. As addressed above, the RO granted temporary total ratings from March 7, 2012 to June 1, 2012; March 11, 2020 to June 1, 2020; and July 20, 2020 to September 1, 2020. As such, the periods the Board is evaluating the appeal are prior to March 7, 2012, from June 1, 2012 to March 11, 2020, from June 1, 2020 to July 20, 2020, and from September 1, 2020 to the present. The Board notes that during the pendency of the appeal, portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021; however, the diagnostic codes used to evaluate the Veteran’s hallux valgus of the right and left foot was not changed. Under DC 5280, a 10 percent rating is warranted for unilateral hallux valgus that has been operated on with resection of metatarsal head. A 10 percent rating is also warranted for severe unilateral hallux valgus in that it is equivalent to amputation of the great toe. 38 C.F.R. § 4.71a, DC 5280. The Board notes that a 10 percent evaluation is the maximum rating available under this Diagnostic Code. The Veteran was afforded a January 2011 VA examination. The Veteran reported constant and localized pain in both feet described as squeezing, aching, sharp and cramping pain. The Veteran stated that standing or walking would result in pain, stiffness and weakness. The Veteran reported overall functional impairment in limited prolonged walking and standing. The Veteran noted that he recently underwent surgery for a bunionectomy in March 2010 for his left foot with residuals of pain and stiffness with no treatment, and he was to have surgery on his right foot soon. Upon physical examination, the examiner found painful motion of the right and left foot and active motion in the metatarsophalangeal joint (MPJ) of the great toes. The examiner found no evidence of edema, disturbed circulation and weakness, atrophy, tenderness, redness, or instability. The examiner observed the Veteran’s second right toe overlapped the third toe due to a severe bunion. Pes planus was present, but palpation of the plantar surfaces of both feet revealed no tenderness. The examiner found both feet with a slight degree of valgus correctable by manipulation and severe hallux valgus with no resection of the metatarsal head present. The examiner found the Veteran with no limitation with standing and walking nor require any type of support with his shoes. The examiner found on review of diagnostic tests and x-ray the right foot showed findings of moderate bunion and hallux valgus deformity; the left foot showed findings of bunionectomy and borderline pes planus. The examiner remarked the diagnosed disabilities impacted the Veteran’s usual occupation, resulting in limited prolonged walking and standing. Review of the medical treatment record shows in February 2011 the Veteran was seen for a one-week followup from a McBride bunionectomy and arthrodeses procedure with pin fixation of the second and third digit of the right foot. Physical examination of the foot found swelling of the feet but with optimal joint alignment achieved. The treating provider assessed the Veteran with bunion, hammer toe, and after care following surgery. In March 2011, the Veteran was seen for a followup evaluation for right McBride bunionectomy and hammertoe repair of the second and third digit. In a separate visit, the Veteran complained of pain the left foot third digit. The treating provider trimmed the nail of the left third digit and applied a buttress pad to the second and third digits of the right foot for biomechanical alignment. In July 2011 the Veteran reported pain in the second digit of the right foot with “good days and bad days” and was concerned with the healing timeframe. Physical examination found the right foot second digit rigid and painful on palpation. The treating provider assessed the Veteran with “acquired deformity of toe – hammer toe” of the right foot second digit and given a splint. The provider noted the Veteran had previously not returned to the clinic when notified for follow up and remarked that compliance was an issue to be considered. In September 2011 the Veteran reported pain in the plantar aspect of the right first MPJ and expressed frustration with pain and shoes; the Veteran requested treatment options. Physical examination found pain on palpation of the medial plantar right first MPJ and the right “second digit under the third digit.” The treating provider also noted “dystrophic elongated third digit nail” of the left foot. The provider assessed the Veteran with “acquired deformity of toe – hammer toe” and noted treatment options were discussed with the Veteran. In October 2011 the Veteran discussed treatment options to include surgery. Physical examination findings were the same as the September 2011 visit. The treating provider observed the Veteran’s right foot had “grossly deformed third digit that was under riding the second digit”; the provided noted that the Veteran had previously responded to treatment but due to contracture it had gone back under the second digit and hallus drifted back to some abduction. The treating provider discussed a recommended procedure to fuse the first MTPJ and to straighten the second and third digits of the right foot. The provider noted the Veteran understood “that it is not going to be totally corrected.” In February 2012 the Veteran was seen for evaluation prior to surgery. The treating provider noted the Veteran previously had surgery the past year for a deformed big toe, second and third toe but the deformity had returned. The Veteran requested that his foot be corrected and expressed his understanding what could happen and the possibility “that it could be worse than it is now due to the fact [a second surgery was to be performed.” The provider described the procedure to be akin to straightening the hallux to get pressure off the second digit and pin. The treating provider assessed the Veteran with hammer toe and bunion. On March 7, 2012 the Veteran underwent a procedure for akin bunionectomy and arthrodesis with MTPJ release of the right foot second digit. The treating surgeon gave a diagnosis of bunion and second digit hammertoe. In September 2012 the Veteran reported pain in the right foot that began this past year; the Veteran was instructed in the use of a cane. In a June 2014 form 9 statement, the Veteran stated that his hallux valgus of his right and left foot limited his ability to do anything that required standing or walking for any period or distance. The Veteran stated that he wore orthopedic shoes but that it did not alleviate his pain or ability to function normally. In an August 11, 2015 letter from the Veteran’s treating provider, the provider first stated the Veteran had been treated by the provider for several years with an initial diagnosis for contracted and deformed toes of both feet. The provider noted that the Veteran underwent surgery for correction and to straighten the underlying third toe, but the Veteran still has discomfort with ambulation due to a large bulbous pad on the plantar aspect of the toe. The provider stated that although the Veteran had some improvement, “[the Veteran] will always have some discomfort and will have to wear custom shoes.” The provider noted the Veteran had hereditary flat feet and opined it was aggravated by his military surface. In September 2015 the Veteran reported constant pain in both feet, especially the right foot. The Veteran described “a lot of excess flesh” on the underside of his right third toe that made it difficult to walk. In December 2015 the Veteran complained of pain in his right third toe and left fifth toe. Physical examination found rigid plantar flexion of the right third toe MPJ with worsening of deformity when front loaded; and on the left foot the fifth toe was observed to be under riding the fourth toe causing pain. The treating provider discussed possible treatment options to include “right third toe amputation and fourth PIPJ arthrodesis of the left foot and derotational arthoplasty with pinning.” In a separate December 2015 visit, the Veteran reported “podiatry plants to operate to straighten little toe on left foot.” The Veteran was afforded a February 2016 VA examination. The examiner diagnosed the Veteran with bilateral flat foot (pes planus); bilateral hallux valgus; and right and left severe hallux valgus status post bunionectomy with overlapping toes on the left foot and residual scarring. The Veteran reported symptoms of pain and discomfort described as throbbing and sharp pain that worsened with activity. The Veteran stated that he uses a cane to assist with walking and special shoes to help with balance and flareups; the Veteran also stated that his provider has told him that he may have another surgery later in the year. The Veteran reported flareups of throbbing pain and right knee pain and functional impairment with limited movement and range of motion. The examiner found bilateral pes planus with pain on manipulation of both feet. The examiner found no evidence of hammer toes affecting the Veteran’s toes; metatarsalgia or Morton’s neuroma; symptoms due to hallux valgus; hallux rigidus; acquired pes cavus; or malunion or nonunion of the tarsal or metatarsal bones. The examiner noted bilateral foot toe overlap of the great and second toe digits of mild severity. The examiner found pain on physical examination and resulted in functional impairment to include pain on movement and weight-bearing; and interference with sitting and standing. The examiner found no pain, weakness, fatigue or incoordination significantly limiting functional ability during flareups or repeated use over a period of time. The examiner described the functional impact of the Veteran’s disability as resulting in limited prolonged walking and standing. In March 2016 the Veteran complained of pain in the right third toe and left fifth toe. Physical examination found rigid plantar flexion of the right third toe MPJ with worsening of deformity when front loaded; and on the left foot the fifth toe was observed to be under riding the fourth toe causing pain. The provider assessed the Veteran with deformed right third toe with pain and left adductorvarus of the fifth toe. The provider discussed the option of a right third toe amputation to alleviate pain, noting the Veteran had “multiple hammertoe corrections which have resulted in overcrowded deformed toes.” The provider noted that surgery on the left fifth toe would be delayed seeing if the Veteran responded to the right third toe amputation and considered the option of amputation as well. At the Veteran’s April 2017 hearing, the Veteran testified to having pain in his feet every day. The Veteran stated that he was walking on the top of his toes because his toe was curved “under the upper toes” and asserted that he had hammer toes. The Veteran stated that due to pain he was unable to use stairs, garden, or play with his grandchildren. The Veteran stated that he was given authorization to buy special shoes but was unable to wear them because “they rub against the top” and aggravate his scars from his surgeries. In a separate April 2017 statement from the Veteran’s wife, she stated her feeling of being “partly responsible for all the trouble and pain regarding my husband’s feet…encouraged him to get the surgeries because I saw how much pain he was in walking on his toes and they told us they could fix them…” The Veteran’s wife stated that “they didn’t tell us …three surgeries later he will still have to get two toes amputated…all the scars and scar tissue would create more pain…not able to wear normal shoes again…wouldn’t be able to the simple things.” The Veteran’s wife noted that she was responsible for driving or transporting the Veteran around due to the pain in his feet and took care of him all alone. In October 2019 the Board denied an increased evaluation in excess of 10 percent for the Veteran’s hallux valgus of the right and left foot. The Board decision in considering other applicable diagnostic codes found “there was no objective evidence showing symptomatology that warrants a compensable rating under any of the aforementioned diagnostic codes.” In November 2019 the Veteran requested a consultation with podiatry for painful feet. X-ray testing found post-operation changes of the right foot first digit that was stable in appearance; stable hallux valgus alignment; bilateral pes planus; no acute fracture; and no significant changes since the prior study performed in 2015. In a December 2019 podiatry consultation, the Veteran reported bilateral foot pain with ambulation and weight-bearing. The Veteran noted he had surgery in 2011 and 2012 for hammertoes and bunions and expressed concerns that it had returned. Upon physical examination, the treating provider noted rigid plantarflexion of the second, third digits; and adductovarus deformity of the fourth and fifth digits. Bilateral deviation of the hallux toward the digits was noted, crowding of digits was observed, and contracture was observed to worsen with front foot loading. The treating provider assessed the Veteran with “return of [hallux valgus] and [hammertoes] from previous symptoms”; bilateral rigid hammertoes affecting the second through fifth digits; and bilateral hallux valgus with osteoarthritis. The provider noted the Veteran requested surgery and discussed a possible procedure involving fusion at the first MTPJ, hammertoe reduction of the second through fourth digits, and arthroplasty of the fifth digit. In a March 2020 preoperative evaluation, the Veteran reported undergoing surgery in 2011 for bunionectomy and hammertoe correction of the second through fifth digits of the left foot; surgery in 2012 for bunionectomy and hammertoe correction of the second through fourth digits of the right foot; and surgery in 2013 for hammer toe correction of the second through fourth digits of the left foot. The treating provider noted that the plan was for a surgical procedure for first MTPJ, hammertoe revision of the second through fifth digits of the left foot. The Veteran underwent surgery on March 11, 2020. The Veteran was afforded a July 2020 VA examination. The examiner diagnosed the Veteran with bilateral pes planus; bilateral degenerative arthritis; and hallux valgus post-surgery. The Veteran reported symptoms in his left foot described as a “sensation of feeling that something is poking him in the sole of his foot with pain to the dorsal foot…Feels like my foot is bound up, I keep trying to bend it but I can’t.” The Veteran stated that his right foot “just aches.” The Veteran described pain in his left foot “like I got something sharp in the middle of my sole. Where the scars and abrasions are, it feels like it is rubbing my skin raw.” The Veteran did not report any flareups. The Veteran reported functional loss and impairment from his condition. The Veteran stated that his right foot made him unable to walk or stand for long periods of time. The Veteran stated that he could not “do things like I want to…can’t play football with my 7 grandsons…I can’t walk at the beach with my foot and toes looking like this.” In describing the functional impairment for his left foot, the Veteran stated “my left foot is the same as the right. The left goes with the right and the right goes with the left.” The examiner found bilateral pes planus with pain on manipulation of both feet with decreased longitudinal arch height on weight bearing. The examiner found no toes affected by hammer toe. The examiner noted the Veteran’s past surgical history for hammer toe correction to the left foot in 2011, 2013, and in 2020; and in 2012 for the right foot. The Veteran reported residual post-operative pain in his left foot; and although reporting that his right foot aches, the examiner found the toes to be flexible. The examiner noted the Veteran’s surgery for hallux valgus in 2011 and 2012 but did not find current symptoms due to a hallux valgus condition and noted residuals symptoms were due to bilateral post-bunionectomy. The examiner did not find evidence of hallux rigidus; acquire pes cavus; malunion or nonunion of the tarsal or metatarsal bones; or other foot injuries or conditions. The Veteran was noted to report “pain, inability to flex foot and toes on the left foot” as a result from his surgery. The examiner found the Veteran’s symptoms resulted in functional loss causing pain on movement and weight-bearing, and interference with standing. The examiner did not find any pain, weakness, fatigue or incoordination significantly limiting functional ability with repetitive use. The Veteran reported regular use of a cane due to “fusion of first MTPJ, hammertoe reduction of second through fifth digits, and second MTPJ capsule release.” The examiner found the Veteran’s condition to result in functional impact affecting the ability for prolonged walking or standing. In a separate July 2020 brief, the Veteran and representative argued for the consideration of pes planus, asserting the Veteran’s initial claim for service connection also encompassed this condition; and asserted consideration for hammertoes. The brief referred to the April 2017 statements made by the Veteran’s wife regarding the Veteran’s treatment “including three surgeries resulting in toe amputation.” In a September 2020 CAVC decision, the Court vacated and remanded the issue of entitlement to an increased evaluation in excess of 10 percent for the Veteran’s hallux valgus of the right and left foot. The Court noted the October 2019 Board decision found “there is no objective medical evidence showing symptomatology that warrants a compensable rating” under applicable diagnostic codes to include DC 5282 for hammertoes. However, the Court noted the claims record showed diagnoses for hammertoes, pointing to the April 2012 letter stating diagnosis for hammertoes and a March 2016 medical record noting “acquired deformity of toe-hammertoe.” As such, the Court found the Board decision failed to provide an adequate statement of reasons and bases and remanded the issue to the Board for readjudication. After review of the claims record, the Board finds an increased evaluation in excess of 10 percent for the Veteran’s hallux valgus of the right and left foot is not warranted. As noted above, the is already receiving the maximum rating available for hallux valgus over the entire appeal period. Therefore, no higher rating is legally available under DC 5280. The Board has considered the provisions of 38 C.F.R. §§ 4.40, 4.45, 4.59, and the holdings in DeLuca v. Brown, 8 Vet. App. 202 (1995). However, an increased evaluation for the Veteran’s service-connected hallux valgus is not warranted on the basis of functional loss due to pain or weakness in this case. The provisions of DeLuca apply when a Diagnostic Code is predicated on limitation of motion. See Johnson v. Brown, 9 Vet. App. 7, 9 (1996). Here, Diagnostic Code 5280 is not based on limitation of motion. Although a rating in excess of 10 percent cannot be granted for right and left foot hallux valgus status-post bunionectomy, the Board does find after resolving reasonable doubt that a separate rating of 10 percent from August 11, 2015 is warranted under DC 5276, for pes planus. The Board notes the August 11, 2015 treating provider indicated a diagnosis of pes planus, and opined it was aggravated by his active duty service. VA examinations in February 2016 and July 2020 found bilateral pes planus with pain on manipulation of both feet. The Board finds that the assignment of a separate rating for pes planus is not pyramiding because it is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes. 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, 6 Vet. App. 259, 261-62 (1994). Pes planus is rated in accordance with 38 C.F.R. § 4.71a, Diagnostic Code 5276. A noncompensable rating is warranted for mild acquired flatfoot; symptoms relieved by built-up shoe or arch support. A 10 percent rating is warranted for moderate acquired flat foot; weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet, bilateral or unilateral. A 20 percent rating is assigned for severe unilateral acquired flat foot; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 30 percent rating is warranted for severe bilateral acquired flat foot; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 30 percent rating is also warranted for pronounced unilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. A maximum 50 percent rating is warranted for bilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, Diagnostic Code 5276. Pes planus has distinct manifestations from those being compensated for bunions and plantar fasciitis. See 38 C.F.R. § 4.14. For example, the July 2020 VA examination report shows that the Veteran’s bilateral pes planus is manifested by pain accentuated on use and on manipulation and decreased longitudinal arch height on weight-bearing and non-weight-bearing. However, the preponderance of the evidence is against a finding of severe pes planus of either foot. The Veteran does not demonstrate swelling on use or evidence of marked deformity such as pronation or abduction; and the weight-bearing line does not fall over the great toe nor is it medial to the great toe. In addition, there is no inward bowing of the Achilles tendon, or pain, weakness fatigability, or incoordination which significantly limits the functional ability of either foot during flare-ups or when the foot is used repeatedly over time. Without such evidence, an evaluation in excess of 10 percent cannot be granted. As such, the Board finds a separate rating for 10 percent is warranted for pes planus; however, the findings do not meet or more nearly approximate the criteria for a rating in excess of 10 percent for pes planus of either foot. Considering other applicable codes, the Board notes that Diagnostic Code 5284 provides for a 10 percent rating for a moderate condition, 20 percent for moderately severe, and 30 percent for a severe condition. 38 C.F.R. § 4.71a. The rating schedule does not define the terms “moderate,” “moderately severe,” and “severe” as used in this diagnostic code. Adjudicators must evaluate all of the evidence and render a decision that is “equitable and just.” 38 C.F.R. § 4.6. However, the Board finds that the primary symptomatology associated with the Veteran’s hallux valgus of the right and left foot are already specifically identified, contemplated and compensated under DC 5280. In Copeland v. McDonald, 27 Vet. App. 333, 338 (2015), the Court held that when a condition is specifically listed in the rating schedule, it may not be rated by analogy. In that case, the Court explicitly rejected the appellant’s argument to rate under DC 5284 where he had a condition specifically listed in the rating schedule. Id. The Court held, that to do so would ignore the plain meaning of the term “other,” and would make the remaining eight foot-related diagnostic codes redundant. In Scott v. Wilkie, the Federal Circuit expressly adopted the Court’s holding that disabilities specifically listed in the rating schedule may only be rated under Diagnostic Codes which specifically pertain to them. Scott v. Wilkie, 920 F.3d 1375 (Fed. Cir. 2019) (citing Copeland v. McDonald, 27 Vet. App. 333, 336 (2015)). The Federal Circuit also expressly adopted the Court’s holding that unlisted conditions may be rated by analogy to Diagnostic Codes that may not describe the unlisted disability but addresses disabilities that may be productive of similar symptoms. Scott, 920 F.3d 1375 (citing Yancy v. McDonald, 27 Vet. App. 484, 493 (2016). Finally, the Federal Circuit concluded that the Board must also consider assigning separate ratings under analogous Diagnostic Codes, when rating an unlisted service-connected foot disability exhibiting distinct manifestations, even when service connection has also been granted for one of the eight conditions listed in the rating schedule. Id. The Board as such has considered whether the Veteran’s service-connected hallux valgus of the right and left foot is entitled to a higher disability rating under any other diagnostic code. However, medical evidence does not show, weak foot, metatarsalgia, hallux rigidus, or impairment of the tarsal or metatarsal bones. See 38 C.F.R. § 4.71a, Diagnostic Codes 5277, 5279, 5281, 5283. Therefore, the Board has considered other potential diagnostic codes, but the record does not suggest that any other less appropriate diagnostic code is applicable. The record also shows the Veteran was diagnosed with hammertoes. Diagnostic Code 5282 provides a noncompensable rating for single toes and a 10 percent rating for all toes, unilateral without claw foot. However, review of the claims record does not show that Veteran has hammertoes of all toes; rather the record shows at most hammertoes of only the Veteran’s second through fifth toes of the left foot. Therefore, a separate 10 percent evaluation is not warranted. The Board acknowledges the Veteran, his wife, and representatives’ lay statements and assertions that his disability is more severe than evaluated to include his reports of pain and functional limitations. The Veteran is competent to report his symptoms and has presented credible testimony. Layno v. Brown, 6 Vet. App. 465, 469 (1994). The Board also accepts that he has functional impairment. DeLuca, supra. Neither the lay nor medical evidence, however, reflects the degree of functional limitation needed for the next higher rating. The Board finds that the most probative evidence consists of those examination reports prepared by trained medical professionals and such evidence demonstrates that the currently assigned rating is appropriate. The Board also considered whether the Veteran is entitled to a greater level of compensation on an extraschedular basis for his increased rating for hallux valgus of the right and left foot for the appeal period. According to the regulation, an extraschedular disability rating is warranted based upon a finding that the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization that would render impractical the application of the regular schedular standards. See 38 C.F.R. § § 3.321 (b)(1). An exceptional case is said to include such factors as marked interference with employment or frequent periods of hospitalization as to render impracticable the application of the regular schedular standards. See Fanning v. Brown, 4 Vet. App. 225, 229 (1993). Under Thun v. Peake, 22 Vet. App. 111 (2008), there is a three-step inquiry for determining whether a Veteran is entitled to an extraschedular rating. First, the Board must determine whether the evidence presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate. Second, if the schedular evaluation does not contemplate the Veteran’s level of disability and symptomatology and is found inadequate, the Board must determine whether the Veteran’s disability picture exhibits other related factors such as those provided by the regulation as “governing norms.” Third, if the rating schedule is inadequate to evaluate a Veteran’s disability picture and that picture has attendant thereto related factors such as marked interference with employment or frequent periods of hospitalization, then the case must be referred to the Under Secretary for Benefits or the Director, Compensation Service to determine whether, to accord justice, the Veteran’s disability picture requires the assignment of an extraschedular rating. The evidence in this case, however, does not show such an exceptional disability picture that the available schedular evaluation for the Veteran’s service-connected hallux valgus of the right and left foot are inadequate. The VA examinations and treatment records establish that the Veteran reported his symptoms of hallux valgus of the right and left foot caused pain, swelling, weakened movement and less movement than normal. Here, the rating criteria for Diagnostic Code 5280 reasonably describes the Veteran’s disability level and symptomatology for hallux valgus of the right and left foot. The Board also considers the Veteran’s statements and assertions and whether it results in an exceptional disability picture to include marked interference with employment or frequent periods of hospitalization. The Veteran has testified that he last worked in January 2009 as a clerk for the United States Treasury department and noted he was on a restriction on how much weight he could carry. However, review of the record does not show documentation the Veteran missed time at his work or was removed from his position due to his hallux valgus of the right and left feet. Regarding hospitalizations, the Board notes that review of the record shows the Veteran underwent surgery for his feet in 2010, 2012 and 2020; however the medical treatment record does not show the Veteran was otherwise hospitalized frequently due to his hallux valgus of his right and left feet. As such, the Board finds the evidence of record does not support a finding that is unusual or different as contemplated by the schedular rating criteria. As the Veteran’s disability picture is contemplated by the rating schedule, the assigned schedular evaluations are, therefore, adequate. As such, the Board also finds that referral of the Veteran’s hallux valgus of the right and left foot for extraschedular consideration pursuant to 38 C.F.R. § 3.321 (b)(1) is not warranted. As such, the Board finds that the preponderance of the evidence is against a finding of an increased evaluation in excess of 10 percent for hallux valgus of the right and left foot; however, resolving reasonable doubt, the Board finds a separate rating of 10 percent for bilateral pes planus from August 1, 2015, is warranted. Total Disability Rating Based on Individual Unemployability (TDIU) VA will grant a total rating for compensation purposes based on unemployability when the evidence shows that the Veteran is precluded from obtaining or maintaining any substantially gainful employment consistent with his education and occupational experience, by reason of his service-connected disabilities. 38 C.F.R. § § 3.340, 3.341, 4.16. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that the Veteran meets the schedular requirements. 38 C.F.R. § 3.340. Specifically, if there is only one such disability, this disability shall be ratable at 60 percent or more; if there are two or more disabilities, there shall be at least one disability that is ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § § 3.340, 3.341, 4.16(a). For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following disabilities 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). The central inquiry is, “whether the veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). In determining whether unemployability exists, consideration may be given to the Veteran’s level of education, special training, and previous work experience, but not to his age or to any impairment caused by non-service-connected disabilities. 38 C.F.R. § § 3.341, 4.16, 4.19. “Substantially gainful employment” is that employment “which is ordinarily followed by the nondisabled to earn their livelihood with earnings common to the particular occupation in the community where the veteran resides.” Moore v. Derwinski, 1 Vet. App. 356, 358 (1991). “Marginal employment shall not be considered substantially gainful employment.” 38 C.F.R. § 4.16 (a). The sole fact that a claimant is unemployed or has difficulty obtaining employment is not enough; the ultimate question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose v. Brown, 4 Vet. App. 361 (1993). Alternatively, if a veteran is found to be unemployable because of service-connected disabilities but does not meet the percentage standards set forth in 38 C.F.R. § 4.16 (a), the rating authority should refer the matter to the Director of the Compensation and Pension Service for extraschedular TDIU consideration. 38 C.F.R. § 4.16 (b) (2018). The veteran is not required to show 100 percent unemployability; the question is whether he or she is unable to pursue a substantially gainful occupation. Roberson v. Principi, 251 F.3d 1378, 1385 (Fed. Cir. 2001). Whether the veteran can actually find employment is not determinative, as the focus of the inquiry is on “whether the veteran is capable of performing the physical and mental acts required by employment.” Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993) (emphasis in original). The Board cannot consider entitlement to TDIU on an extraschedular basis in the first instance, but it is required to ensure that all cases where there is evidence of unemployability due to service-connected conditions are referred to the Director for initial consideration under 38 C.F.R. § 4.16 (b). See Bowling v. Principi, 15 Vet. App. 1 (2001). The ultimate responsibility for a TDIU determination is a factual rather than a medical question and is an adjudicative determination made by the Board or the AOJ. Geib, 733 F.3d at 1354 (citing 38 C.F.R. § 4.16 (a)). The Veteran is currently service connected for surgical scar of the left foot evaluated at 10 percent; surgical scar of the right foot evaluated at 10 percent; pseudofolliculitis barbae (PFB) evaluated at 10 percent; erythema multiforme evaluated at 30 percent from January 27, 1983 to August 1, 1985, noncompensable from August 1, 1985 to April 26, 2012, and 10 percent from April 26, 2012; hallux valgus of the right foot evaluated at 10 percent; hallux of the left foot evaluated at 10 percent; arthritis of the left knee evaluated at 10 percent; left and right ankle tendonitis evaluated at 10 percent each; and residual cysts removal at a noncompensable rating. As addressed above, the Board is also granting a separate rating of 10 percent for pes planus from August 11, 2015. Also addressed above, the Veteran was granted temporary total ratings for the periods from March 7, 2012 to June 1, 2012; March 11, 2020 to June 1, 2020; and July 20, 2020 to September 1, 2020. The Veteran’s combined rating reached 70 percent from November 19, 2015 to March 11, 2020, June 1, 2020 to July 20, 2020, and from September 1, 2020. Although the Veteran’s combined rating is at 70 percent, the Veteran does not have a service-connected disability evaluated at least 40 percent even considering the combined etiology of service-connected disabilities. As such, the Veteran has not met the schedular criteria during the appeal period. Nevertheless, even when the percentage requirements of 38 C.F.R. § 4.16 (a) are not met, individual unemployability benefits may be granted on an extraschedular basis in exceptional cases when the veteran is unable to secure and follow a substantially gainful occupation by reason of service-connected disability. 38 C.F.R. § 4.16 (b). As noted, the Board is unable to grant entitlement to a TDIU on an extraschedular basis in the first instance. The remaining issue, therefore, is whether the evidence indicates that the Veteran’s case should be submitted to VA’s Director of Compensation Service for consideration of whether entitlement to a TDIU is warranted on an extraschedular basis. The crucial inquiry is whether the Veteran is “unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities,” as outlined in 38 C.F.R. § 4.16 (b). In a January 2006 psychiatry note, the Veteran requested a letter for his job that documents his fear of enclosed spaces. The Veteran stated that he was in trouble at his job because he “did not want to work in an enclosed space and they want him to do so.” The Veteran stated that he worked for the IRS and declined to have treatment. A letter was provided to the Veteran stated that he should not work in enclosed spaces. In a followup January 2006 psychosocial assessment, the Veteran stated that his work area had changed and required him to work in a very small area. The Veteran stated that he had been reprimanded to not agreeing to work in this area and his employer had requested documentation to verify his phobia of small or confined areas. The Veteran reported that he has been employed with the IRS for the past 27 years as a tax technician. In a March 2006 primary care note, the Veteran was seen for an initial visit. The provider noted the Veteran was previously seen with mental health because while working for the IRS he was assigned to a closed room and the Veteran was experiencing claustrophobia. The provider noted the Veteran had been give a letter from mental health recommending the Veteran be given more open space. The Veteran reported that he came to VA “mainly because he received a letter to come over here.” The Veteran stated that he has received a letter from work “basically telling him that he has to sit in the assigned place” which the Veteran feels was a closed space. The Veteran noted that he has been given a disciplinary letter for not obeying his supervisor and was on suspension for five days. In an April 2006 letter from the provider of the January 2006 letter, the provider stated the Veteran reported that his office had been moved and was asked to work in a closed room; the Veteran reported having a severe anxiety response. The provider noted that while writing the letter the Veteran experienced similar symptoms while in the office and left the office three times in 30 minutes. The Veteran stated that his military experiences cause him to have intense fear while in any enclosed space, affecting him both at work and home. The Veteran requested accomodation in allowing him to work in a more open area or in an open area near the assigned office with limited visits only to pick up paperwork. In a September 2008 vocational rehabilitation initial evaluation, the Veteran reported current employed as a tax examiner statute control clerk with the United States Treasury Department. The Veteran stated that he was relocating to a different state and was interested in obtaining Federal employment in the area. The Veteran reports having several years of administrative and security experience. The treating provider noted the Veteran “has good skills and a stable work history” and found the Veteran to be considered employable. The treating provider gave the Veteran information on preparing for job interviews and provided job referral information on open positions in the area. The provider gave additional job referrals in February and March 2009. The Veteran was afforded a January 2011 VA examination for PFB and hallux valgus of the right and left foot. The Veteran reported no overall functional impairment from his PFB but reported functional impairment from his hallux valgus resulting in limited prolonged walking and standing. The Veteran was afforded a May 2011 VA examination to evaluate his scars and the examiner found they resulted in no functional impact. In November 2011 the Veteran applied for vocational rehabilitation. The Veteran stated his expectations of the program to help “possibly get back in the Federal Government workforce.” The Veteran reported a work history as a part-time security shift supervisor from 1993 to 1997 where he patrolled and controlled personnel entering and leaving the building; the Veteran stated that job ended when the security company lost the contract. The Veteran stated his most recent job was as a tax examiner with the United States Treasury Department from April 1984 to December 2008; the Veteran stated his duties were to establish and maintain control of tax returns and “working at a computer station inputting information”. The Veteran reported his reasons of leaving the job was “to take care of ailing wife”. The Veteran did not indicate that he had been working since leaving his last position in December 2008; the Veteran stated that during this period of employment he took care of his wife and looked for work. The Veteran listed disabilities of his right and left foot affecting him and stated that he could not stand or walk for long periods of time. The Veteran did not indicate the disabilities affected his job performance or satisfaction; relationships with coworkers and supervisors; caused him to miss work time; or affect job opportunities. In the followup vocational rehabilitation counseling report, the counselor noted the Veteran reported his last job was from April 1984 to December 2008 at the US Treasury Department as a tax examiner. The Veteran stated that he left this job to take care of his wife and was applying for the first time for vocational rehabilitation to go back to school to obtain a degree in order to become marketable in his career field. The counselor found the Veteran with current impairments from his hallux valgus which resulted in vocational impairment in the Veteran’s ability to stand, walk, run, climb, balance, and motor and coordination. The Veteran stated that he has not been able to maintain suitable employment based on his previous work experience or education. The counselor noted the Veteran met the criteria for employment handicap due to his service-connected disabilities causing vocational impairment; the counselor noted the lack of education and training for suitable employment contributed to significant impairment. The counselor did not find the Veteran with a serious employment handicap. The counselor noted that although the Veteran was currently unemployed, the Veteran did not rely on public assistance and did not have any other significant barriers that would warrant a decision on a serious employment handicap. The counselor found the Veteran’s impairment did not significantly prevent him from maintaining or sustaining gainful employment. The counselor found it was feasible for the Veteran to achieve his vocational goal for participation in competitive employment activities to include training, job searching and competitive employment. The counselor found the Veteran “should be able” to maintain fulltime employment in the civilian sector in a field that would not aggravate his service-connected conditions. In a September 2012 occupational therapy evaluation, the Veteran was seen for evaluation for pain, stiffness and loss of motion in his finger. The Veteran reported his occupation as retired. The Veteran was evaluated for limitations affecting his hand, arm and shoulder. In an April 2015 occupational therapy evaluation treating his hand, the Veteran reported he was retired and had a 25-pound weight restriction for lifting. In June 2015 the Veteran was seen for a tick bite sustained “while on duty, on post”. The Veteran reported that he was bitten by a tick on his ankle while on duty resulting in pain, swelling the next morning. The Veteran noted that he “reported into work” but his symptoms progressed until he “left work several hours early.” The treating provider noted the injury occurred at a security post and the place of employment for the Veteran as a security guard. The provider noted the injury was due to “civilian activity done for income or pay”; the Veteran was encouraged to obtain a sick note to provide to his captain and return to work. In December 2015 the Veteran reported podiatry plans to operate on straightening his left little toe; the Veteran asked, “about form to make him unemployable…says his foot surgery and knee kept him from working.” In February 2016 the Veteran reported he was fully retired and does not work; the Veteran indicated he was retired since 2008. In a February 2016 VA examination for the Veteran’s feet disabilities, the Veteran reported overall functional impairment in limited movement and range of motion due to pain with daily use of a cane. The examiner noted the Veteran’s symptoms resulted in functional loss with contributing factors of pain on movement and weight-bearing; and interference with sitting and standing. The examiner opined the functional impact of the Veteran’s disability was limited prolonged walking and standing. No opinion or discussion was rendered whether the Veteran’s disability prevented him from working or sustaining gainful employment. The Veteran was afforded a March 2016 VA examination to evaluate his left knee and bilateral ankle disabilities. The examiner found the symptoms resulted in functional impact in decreased ability to walk, stand and climb stairs. In March 2016 the Veteran reported that he worked for the Treasury Department until 2008 “when he resigned to move to August, GA” where he currently does not work. At the Veteran’s April 2017 hearing, the Veteran testified that he last worked in January 2009 for the United States Treasury Department as a clerk. The Veteran stated that he was on a weightlifting restriction of 20 pounds” because of my feet and also my side” and was unable to bend down to tie his shoes because of surgery. The Veteran testified on how “I’ve taken so much medication…I now have what they call dementia from taking all this medication…just wake up, get up, take pills, and sit. Because I can’t do anything.” The Veteran and Veteran’s wife testified on how the Veteran is dependent on the Veteran’s wife for care. The Veteran’s representative referred to a 2015 DBQ findings that the Veteran’s disabilities hindered him from working because he could not stand or sit with pain on movement and weight-bearing. The representative stated the Veteran uses a cane with ortho shoes and that a brace has been recommended a brace; as such, the representative stated the functional impact of the conditions limited the Veteran from employment. In a separate April 2017 statement from the Veteran’s wife, the wife stated that “knowing what I know now I would have never agreed to any of [the Veteran’s surgeries] starting with his feet and the impact it had on our lives…” The Veteran’s wife stated that “they didn’t tell us [the Veteran] would not be able to work and we would have to rely on[the Veteran’s wife’s] disability to support us which I don’t mind but it’s not enough to cover everything.” In an April 2017 VA 21-8940 form applying for TDIU, the Veteran indicated his TDIU was due to disabilities of his bilateral feet; “medial meniscus/osteoarthritis of knee”; arthroplasty of the ankles and feet; and spinal stenosis. The Veteran indicated he last worked full time in January 2009 and stated the same date as when he became too disabled to work. The Veteran stated his last place of work as a tax examining clerk with the Department of Treasury. The Veteran described the type of work as “lifting, walking, standing” and indicated he lost 8 years due to illness. The Veteran was afforded an August 2017 VA examination for his left knee and ankle. In the examination for his ankles, the Veteran reported pain in his ankles that was aggravated by walking, standing, and quick turning. The Veteran denied any functional impairment. The examiner found the Veteran’s bilateral ankle condition would not limit average physical and/or sedentary activities. In the Veteran’s examination for his left knee, the Veteran reported symptoms of “electricity, feels like on fire” in his left knee and swelling aggravated by walking. The Veteran denied any functional impairment. The examiner found the Veteran’s left knee disability would not limit average physical and/or sedentary activities. In a November 2018 VA examination for scars, the examiner did not find the Veteran’s scars resulted in functional impact. In a December 2018 VA examination for the Veteran’s left knee, the Veteran reported undergoing surgery in August 2018 for a torn meniscus but did not do any physical therapy after surgery. The Veteran denied any functional impairment, and the examiner did not find the Veteran’s disability resulted in functional impact. The examiner did note the Veteran had limited flexion in the left knee and that it could hinder squatting, kneeling or climbing elevated surfaces; pain was also noted on exam but found not to result in functional loss. In the July 2020 VA examination for the Veteran’s feet, the Veteran reported pain in both the right and left feet. The Veteran stated his right foot symptoms resulted in functional loss where “I can’t do things like I want to. I can’t walk or stand for long periods of time. I can’t play football with my 7 grandsons. I can’t walk at the beach with my foot and toes looking like this.” The Veteran described the functional impact of his left foot symptoms “goes with the right and the right goes with the left.” The examiner noted the Veteran’s disability resulted in functional loss with factors of pain on movement and weight bearing, and interference with standing. Regarding functional impact, the examiner noted the Veteran was retired and last worked in 2008 with 0 to 1 week of work time lost in the last 12 months and impact on prolonged walking or standing. The examiner found the Veteran to be independent and did not require assistance with activities of daily living. The examiner opined the Veteran was capable of performing sedentary work. In a July 2020 brief, the representative referenced the April 2017 hearing and noted the Veteran’s duties as a clerk involved sitting standing and walking for long periods of time. The representative also noted the examination findings the Veteran limited in walking and standing due to his service-connected conditions as well as asserting that the effects of pain medication for his service-connected disabilities affected his brain and memories. The Board acknowledges the Veteran’s statements and contentions of his unemployability. However, the ultimate responsibility for a TDIU determination is a factual rather than a medical question and is an adjudicative determination made by the Board or the AOJ. Geib, 733 F.3d at 1354 (citing 38 C.F.R. § 4.16 (a)). After review of the record, the Board finds that referral is not warranted for extraschedular consideration as the available evidence does not demonstrate that the Veteran’s service-connected disabilities precluded following a substantially gainful occupation. Based on the evidence of record, the Board finds that the Veteran’s disabilities did not precluded him from all forms of employment. Specifically, the evidentiary record, which includes medical evidence, opinion evidence, and the Veteran’s lay assertions, demonstrates the Veteran is not precluded from working due to his service-connected disabilities. In the Veteran’s April 2017 application for TDIU, the Veteran indicated several disabilities causing him to become unemployable but included disabilities to include spinal stenosis that are currently not service-connected. The Veteran indicated that he lost 8 years during his work period from 1984 to 2009, however review of the record does not show any documentation associated with the record to show the time lost or whether it was due to his service-connected disabilities. Review of the record show the Veteran in 2006 complained of assignment to a closed room for work and issues with claustrophobia and getting a work accomodation; however, the Board notes the Veteran is not currently service-connected for a psychiatric disorder. In September 2008 the Veteran indicated he was relocating and was seeking federal employment; the treating provider found the Veteran to be employable. The Board notes in a November 2011 vocational rehab application and in a March 2016 medical record, the Veteran reported that he resigned or left is position as a tax examiner in 2008 to take care of his wife. The Veteran did not indicate or state that his service-connected disabilities caused him to leave his position. The Veteran indicated in November 2011 that he would like to return to school in order to obtain education and find work. The record also indicates in June 2015 the Veteran was seen for a tick bite while at work as a security guard, which indicates the Veteran had obtained work, even though it is not raised by the Veteran in later statements and assertions. The July 2020 brief pointed to April 2017 hearing testimony that the Veteran stated his duties as a clerk involved sitting, standing and walking for long periods of time; review of the testimony shows the representative stating a “2015 DBQ” that the Veteran’s feet hinder him from working because he was unable to stand, sit with pain on movement and weight-bearing and the “function impact of each of these conditions limits him from employment.” However, while review of the February 2016 VA examination of the Veteran’s feet shows the examiner made findings of pain on weight-bearing, movement with interference with sitting and standing, the examiner only found the functional impact of the condition resulted in limited prolonged walking and standing and did not opine it would prevent the Veteran from obtaining and sustaining gainful employment. The medical examinations and reports on record indicate the Veteran’s disabilities caused some functional impairment but did not opine or find that the impairments prevented the Veteran from obtaining or maintaining substantially gainful employment. Taken as a whole, the Veteran’s symptoms do not suggest he has been unable to obtain and maintain employment. The Board acknowledges his physical limitations would make it difficult to work. As noted in the most recent VA examination in July 2020, the examiner found the Veteran last worked in 2008 and had functional impact on prolonged walking or standing; however, the examiner did not find the severity of the Veteran’s disabilities to preclude employment or leave him unable to secure or follow a substantially gainful occupation. The Board observes that while the Veteran’s past work experience is limited, he completed high school and as well as having many years of administrative experience. On the other hand, it is also clear that he has not sought employment in a number of years. The question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. See Van Hoose v. Brown, 4 Vet. App. 361 (1993). Overall, when considering the Veteran’s education, training and work history, while the Veteran may have been restricted from certain kinds of employment during the appeal period, the evidence did not indicate that his service-connected disabilities precluded him from doing other kinds of substantially gainful work. See Pederson v. McDonald, 27 Vet. App. 276 (2015). In sum, the Board finds that the Veteran did not meet the schedular TDIU requirements and that he has not been unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities. As such, the Board concludes that the criteria for entitlement to a TDIU have not been met and submission to VA’s Director of Compensation Service for extraschedular consideration is not warranted. The Veteran’s claim is therefore denied. 38 U.S.C. § 1155; 38 C.F.R. § 4.16. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not applicable, and the claim is denied. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Yang, Attorney-Advisor 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.