Citation Nr: 21025192 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 15-46 937 DATE: April 27, 2021 ORDER Entitlement to a rating higher than 10 percent for bilateral hearing loss is denied. Entitlement to a 20 percent rating, but no higher, for right lower extremity peripheral neuropathy is granted. Entitlement to a compensable rating scar on the right foot under Diagnostic Code (DC) 7801 is denied. Entitlement to rating a 20 percent rating under DC 7804 for painful and unstable scar on the right foot is granted. Entitlement to special monthly compensation (SMC) for loss of use of the right lower extremity under 38 U.S.C. § 1114 (k) is denied. REMANDED Entitlement to a total disability rating based upon individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDINGS OF FACTS 1. The Veteran’s bilateral hearing loss has been manifested by hearing acuity of no worse than Level IV in the right ear and no worse than Level IV in the left ear. 2. Resolving reasonable doubt in the Veteran’s favor, his right lower extremity peripheral neuropathy is manifested by severe incomplete paralysis. 3. The Veteran’s scar on the right lower extremity measures less than 39 sq. cm. 4. Resolving reasonable doubt in the Veteran’s favor, he has one scar that is painful and unstable. 5. The Veteran’s service-connected disability does not result in the loss of use of his right leg. CONCLUSIONS OF LAW 1. The criteria for a rating higher than 10 percent for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code (DC) 6100. 2. The criteria for a disability rating of 20 percent for right lower extremity peripheral neuropathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8522. 3. The criteria for a compensable disability rating for scar under DC 7801 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, DC 7801. 4. The criteria for a 20 percent rating for scar that is painful and unstable have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, DC 7804. 5. The criteria for SMC based on loss of use of the right lower extremity are not met. 38 U.S.C. §§ 1114 (k), 1115; 38 C.F.R. §§ 3.350, 4.63. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1975 to April 1976. The claim for increased rating for bilateral hearing loss comes from an April 2014 rating decision. The claim was denied by the Board of Veterans’ Appeals (Board) in May 2019. The Veteran appealed the Board’s denial to the United States Court of Appeals for Veterans Claims (Court). By Order dated May 2020, the Court granted a Joint Motion for Remand (JMR) vacating the May 2019 decision and remanded the case to the Board. The JMR was issued because the Board adjudicated the claim before fulfilling the Veteran’s request for copies of medical records in his claims file. A correspondence from September 2020 reflects that the Veteran’s representative was provided with a copy of the Veteran’s entire claims file. An October 2020 report of contact with the Veteran’s representative reflects that all documents requested have been provided. Thus, the Board will proceed to adjudicate the claim on its merits. The claims for increased ratings for peripheral neuropathy of the right lower extremity and scar on the right foot, as well as SMC for loss of use of the right lower extremity, were appealed from a December 2015 rating decision. Notably, the Veteran’s Notice of Disagreement and substantive appeal raise the issue of increased rating for the Veteran’s bilateral pes planus with traumatic arthritis. That issue will be addressed in a separate decision because a VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement) was filed in May 2020, where the Veteran opted that issue into the modernized review system. The claim for TDIU was filed in April 2019. Because the Veteran contends that he is precluded from employment, in part, due to his service-connected bilateral hearing loss, peripheral neuropathy of the right lower extremity and scar on the right foot, the Board has taken jurisdiction of the claim as part and parcel of the claims for increased rating. Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009); see August 2020 Correspondence; see also April 2019 Veteran Application for Increased Compensation Based on Unemployability. 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 DCs identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which two evaluations should 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. 1. Entitlement to a rating higher than 10 percent for bilateral hearing loss is denied. The Veteran contends that he is entitled to a higher rating for his bilateral hearing loss, which is currently assigned a 10 percent rating. The appeal period begins on March 27, 2013, when the Veteran filed his claim for increased rating. Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz). 38 C.F.R. § 4.85, DC 6100. To evaluate the degree of disability from bilateral service-connected hearing loss, the schedule establishes 11 auditory hearing acuity levels designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. 38 C.F.R. § 4.85, Tables VI and VII. With his increased rating claim, the Veteran submitted a December 2012 private audiogram which showed the following speech recognition score (SRT) and pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg SRT RIGHT 25 35 65 65 48 92 % LEFT 25 40 70 70 51 96 % Applying the results to Table VI, the findings yield a numeric designation of Level I hearing loss in both ears. Entering the resulting bilateral numeric designation of Level IV in both ears to 38 C.F.R. § 4.85, Table VII, equates to a noncompensable percent disability rating under DC 6100. The Veteran submitted another private audiology report in June 2013: HERTZ 1000 2000 3000 4000 Avg SRT RIGHT 30 45 70 75 55 90 % LEFT 40 55 75 85 64 80 % These values result in Level II hearing in the right ear, and Level IV in the left, which corresponds with a noncompensable rating. It is unclear whether the Maryland CNC word list was used to determine the speech recognition score in these examinations. If the speech recognition scores are not based on Maryland CNC word list, then the audiometric evaluation is not adequate for rating purposes under § 4.85(a). The Board has considered whether the claim should be remanded to determine if Maryland CNC word list was used. See Savage v. Shinseki, 24 Vet. App. 259 (2011). However, assuming without conceding that Maryland CNC word list was used, the Board finds that the average hearing threshold and speech recognition scores from these exams do not reflect a level of hearing loss that is compensable under Table VII. Therefore, a remand to clarify whether Maryland CNC word list was used would not confer any benefit on the Veteran and is unnecessary. A February 2014 VA audiological examination reveals that the Veteran reported difficulty hearing and understanding speech. The Veteran’s Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 20 25 60 70 44 70 % LEFT 25 30 60 70 46 70% Applying the results to Table VI, the findings yield a numeric designation of Level IV hearing loss in both ears. Entering the resulting bilateral numeric designation of Level IV in both ears to 38 C.F.R. § 4.85, Table VII, equates to a 10 percent disability rating under DC 6100. VA treatment records dated in January 2016 state an audiogram was performed and that his hearing had actually improved from the 2013 results. While the specific values from this examination is not in the record, the Board finds that a remand to obtain them is not necessary because the evidence shows the hearing was improved from the 2013 results, which (as described above) corresponded with noncompensable hearing loss. Similarly, the Veteran underwent an audiological evaluation in December 2018, where he again reported difficulty hearing in noisy environments. The results of the examinations were as follows: HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 35 50 65 70 55 86 % LEFT 35 50 70 75 58 90% Applying the results to Table VI, the Veteran’s right ear is manifested by Level II impairment in the right ear and Level III in the left ear. Pursuant to Table VII, these results are consistent with noncompensable rating. The Board considered the lay statements submitted by the Veteran and his spouse, which indicate that he has difficulty hearing well, especially in noisy environments. See January 2017 buddy statement, August 2020 brief. The Veteran and his spouse are both competent to describe the Veteran’s hearing difficulties. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, their reports must be considered in conjunction with the clinical evidence of record as well as the pertinent rating criteria. In this regard, the Board emphasizes that disability ratings are derived by a mechanical application of the rating schedule. See Lendenmann v. Principi, 3 Vet. App. 345 (1992). The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran describes is contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Veteran’s main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned. See Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). In August 2020, the Veteran’s representative submitted a statement asserting that the Veteran’s bilateral hearing loss should be rated higher on extraschedular basis. The correspondence references a March 2010 and February 2012 evaluations. The Board notes that those evaluations are outside the appeal period for this claim, which starts on March 27, 2013. Notwithstanding, the Board has considered whether extraschedular evaluation is warranted. In exceptional ratings cases, an extraschedular evaluation may be provided if (1) the established schedular criteria is inadequate to describe the severity and symptoms of the claimant’s disability; (2) the case presents other indicia of an exceptional or unusual disability picture, such as marked interference with employment or frequent periods of hospitalization; and (3) the award of an extraschedular disability rating is in the interest of justice. Thun v. Peake, 22 Vet. App. 111 (2008), aff’d, Thun v. Shinseki, 572 F.3d 1366 (Fed. Cir. 2009). The first element of Thun compares a veteran’s symptoms to the rating criteria, while the second element considers the resulting effects of those symptoms; if either prong is not met, then referral for extraschedular consideration is not appropriate. See Yancy v. McDonald, 27 Vet. App. 484 (2016). Here, regarding the first prong of Thun, the evidence in this case does not show such an exceptional disability picture that the available schedular evaluation for the service-connected disability is inadequate. The functional effect the Veteran’s hearing loss causes, such as his difficulty hearing phone conversation, television, the car blinkers, as well as difficulty hearing when there is background noise are contemplated by the rating schedule. The speech recognition scores, and the average hearing threshold level measured by pure tone audiometry tests capture the level of the Veteran’s hearing loss. Accordingly, the rating criteria fully considers the impairment caused by the Veteran’s bilateral hearing loss. Doucette. Thus, the first element of Thun has not been met and further consideration of an extraschedular rating is not warranted. In summary, the record does not have evidence to support a rating higher than assigned for the Veteran’s bilateral hearing loss. Therefore, the Board concludes that the preponderance of the evidence is against assigning a higher rating for the Veteran’s bilateral hearing loss, and the benefit-of-the-doubt doctrine is inapplicable. 38 C.F.R. § 4.3. For these reasons, the claim is denied. 2. Entitlement to a 20 percent rating, but no higher, for right lower extremity peripheral neuropathy is granted. The Veteran’s left lower extremity peripheral neuropathy is rated under DC 8522 as paralysis of the musculocutaneous nerve (superficial peroneal). Under DC 8522, a 10 percent rating is warranted for moderate incomplete paralysis; a 20 percent rating is warranted for severe incomplete paralysis; and a 30 percent rating is warranted for complete paralysis, eversion of foot weakened. 38 C.F.R. § 4.124 a, DC 8522. The rating schedule provides guidance for rating neurological disabilities. With regard to rating neurological disabilities, cranial or peripheral 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 term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type pictured for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. 38 C.F.R. § 4.124a. In this case, reviewing the evidence in light most favorable to the Veteran and affording him the benefit of the doubt, the Board concludes that his disability approximates a level contemplated by 20 percent rating. To that end, during a November 2015 VA examination, the Veteran’s condition was manifested by severe numbness, reduced muscle strength during ankle plantar flexion and dorsiflexion, as well as absent sensation on the right foot/toes. The examiner concluded that the Veteran has severe incomplete paralysis of musculocutaneous (superficial peroneal) nerve, which causes functional loss to the extent it results in abnormal gait. A May 2019 examination found that the Veteran has intermittent numbness and tingling. Symptoms noted during the exam include mild intermittent pain, and mild paresthesias and/or dysesthesias. The Veteran’s muscle strength and reflexes were normal. However, he had decreased sensation of the right foot/toes. The examiner concluded that the Veteran has mild incomplete paralysis of musculocutaneous nerve. The exam shows that the Veteran has functional loss to the extent his condition impairs his balance. This finding is consistent with the Veteran’s report that he has weakness in the right lower extremity that requires him to seek assistance from his wife to avoid a fall. See March 2019 substantive appeal. The Board recognizes that a January 2019 evaluation found that the Veteran’s sciatic nerve was affected. Based on this examination, the Veteran asserts that his peripheral neuropathy of the right lower extremity should be rated as moderate incomplete paralysis of the sciatic nerve that is consistent with 40 percent rating under DC 8520. However, the medical evidence, particularly, a March 2020 VA back examination, attributes radiculopathy affecting the sciatic nerve to the Veteran’s back disability. As the issue currently before the Board is peripheral neuropathy of the right lower extremity associated with bilateral pes planus, the Board finds that sciatic nerve due to back disability is not within its jurisdiction at this time and it need not consider DC 8520. Overall, reviewing the evidence in light most favorable to the Veteran, the Board concludes that the evidence is at least in equipoise as to whether a rating higher than 10 percent is warranted. The medical evidence of record reflects symptoms such as numbness, pain, impaired reflexes, reduced muscle strength, and reduced sensation. Combined with the evidence showing functional loss involving his gait and balance, the Board concludes that the Veteran’s symptoms are more than sensory and approximate a level contemplated by severe incomplete paralysis under DC 8522. However, the November 2015, January 2019, and May 2019 peripheral nerve condition examinations all found that the Veteran’s condition is manifested by incomplete paralysis of the nerve. Because the evidence does not show complete paralysis a rating higher than 20 percent is not warranted. 3. Entitlement to a compensable rating scar on the right foot under DC 7801 is denied. 4. Entitlement to rating a 20 percent rating under DC 7804 for painful and unstable scar on the right foot is granted. The Veteran has one scar on the right great toe, which is assigned a noncompensable rating under DC 7801 and 10 percent rating under DC 7804. He contends that his scar is both painful and unstable. See March 2019 substantive appeal. VA amended the criteria for rating skin disabilities effective from August 13, 2018. These new regulations apply to all applications for benefits received by VA or that are pending before the agency of original jurisdiction on or after August 13, 2018. Claims pending prior to the effective date will be considered under both old and new rating criteria, and whatever criteria is more favorable to the veteran will be applied. The Board may not apply a current regulation prior to its effective date, unless the regulation explicitly provides otherwise. Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). However, the Board is not precluded from applying prior versions of the applicable regulation to the period on or after the effective dates of the new regulation if the prior version was in effect during the pendency of the appeal. Prior to August 13, 2018, DC 7801, was for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are deep and nonlinear. Under these criteria, a scar with an area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.) warrants a 10 percent rating. A scar with an area or areas of at least 12 square inches (77 sq. cm.) but less than 72 square inches (465 sq. cm.) warrants a 20 percent rating. A scar with an area or areas of at least 72 square inches (465 sq. cm.) but less than 144 square inches (929 sq. cm.) warrants a 30 percent rating. A scar with an area or areas of 144 square inches (929 sq. cm.) or greater warrants a 40 percent rating. 38 C.F.R. § 4.118. Prior to August 13, 2018, Note 1 to DC 7801 instructed that a deep scar is one associated with underlying soft tissue damage. Id. Since August 13, 2018, DC 7801 is for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are associated with underlying soft tissue damage. 38 C.F.R. § 4.118. DC 7801 was otherwise unchanged by the August 13, 2018, amendments. As to DC 7804, that rating criteria was not changed by the August 13, 2018, amendments. Under DC 7804, one or two scars that are unstable or painful warrant a 10 percent rating. Three or four scars that are unstable or painful warrant a 20 percent rating. Five or more scars that are unstable or painful warrants a 30 percent rating. 38 C.F.R. § 4.118. Note 1 to DC 7804 instructs that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Id. Note 2 states that if one or more scars are both unstable and painful, 10 percent is to be added to the total evaluation based on the total number of unstable or painful scars. The Board finds that the preponderance of the evidence is against the assignment of a compensable rating under DC 7801 because the Veteran’s scar does not cover 6 square inches (39 sq. cm). However, reviewing the evidence in light most favorable to the Veteran and affording him the benefit of the doubt, the Board concludes that his scar is both painful and unstable, as such a 20 percent rating is warranted under DC 7804. A November 2015 VA examination found that the Veteran’s scar measured 6 by 0.3 cm and affected 1.8 square cm of the right lower extremity. During a May 2019 examination, the scar was measured at 5 cm by 0.3 cm. According to a January 2019 evaluation, the Veteran’s scar measured 2 cm by 1 cm. The examiner also noted that there is underlying tissue damage on the area that measures 2 square cm. Based on these examinations, at no time during the appeal period did the Veteran’s scar measure 39 square cm to warrant a compensable rating under DC 7801. However, reviewing the evidence in light most favorable to the Veteran, the Board concludes that the evidence is at least in equipoise as to whether the scar is both painful and unstable. To that end, while the November 2015 examiner concluded that the Veteran’s scar is not painful or unstable, he also noted that the scar “slows down the [Veteran’s] physical activities.” Similarly, the May 2019 examiner concluded that the Veteran’s scar is not painful or unstable but acknowledged that it would be painful for him to wear shoes. In addition, that examiner found that the scar will limit the Veteran’s mobility. The record also has a scar disability benefit questionnaire (DBQ) from January 2019 that reflects that the Veteran’s scar is painful. The examiner noted that the Veteran reports “burning pain, itching, and numbness.” Notably, the examiner also attributed the symptoms of “burning pain, itching and numbness” to the Veteran’s neuropathy and the Board has considered these symptoms in the rating assigned to the Veteran’s peripheral neuropathy of the right lower extremity. The Veteran submitted an affidavit in April 2019, where he explained that the skin covering his scar is very sensitive. He explained that “[t]he slightest rubbing of any material on [his] foot or heat can cause [the] scar to swell and bleed.” Specifically, the Veteran indicated that his scar gets irritated when he wears certain types of shoes, or when he takes hot shower or bath. Moreover, his scar can bleed when sheets rub against it at night or when the Veteran’s shoes or socks rub against it. The Veteran is competent to report observable symptoms, to include bleeding and irritation of the skin covering the scar, and his report is credible. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Thus, reviewing the evidence in light most favorable to the Veteran, the Board concludes that his scar is painful and unstable. Pursuant to Note (2) of DC 7804, the Board finds that 10 percent should be added to the evaluation assigned. Thus, a 20 percent rating is warranted for the Veteran’s scar under DC 7804. A higher 30 percent is not warranted because the Veteran does not have five or more scars. The Board has also considered the other DCs pertaining to scars. However, the Veteran’s scar is not of the head, face, or neck, is not deep and nonlinear, and is not associated with underlying soft tissue damage. Nor does the scar cover an area or areas of 144 square inches or greater. Therefore, DC 7800 through 7802, both prior to and from August 13, 2018, are inapplicable. Finally, the evidence of record shows no other disabling effect(s) not considered in a rating provided under DC 7800-04 as contemplated under both pre- and post-August 13, 2018, DC 7805. Therefore, a rating under DC 7805 is not warranted. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for a compensable disability rating under DC 7801. However, a 20 percent rating, but no higher, is warranted under DC 7804. 5. Entitlement to SMC for loss of use of the right lower extremity under 38 U.S.C. § 1114 (k) is denied. This issue was adjudicated at the AOJ as loss of use of the right foot, but in his substantive appeal the Veteran’s representative clarified that he sought SMC for loss of use for the right lower extremity due to pain, weakness, and instability of the right lower extremity due to service-connected peripheral neuropathy and pes planus. See March 2019 substantive appeal. SMC is payable if a veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of one foot. 38 U.S.C. § 1114 (K). Loss of use of a foot exists when “no effective function remains other than that which would be equally well served by an amputation stump at the site of election below the knee with the use of a suitable prosthetic appliance.” 38 C.F.R. § 3.350 (a)(2)(i). The regulation also provides that the determination as to whether such loss of use exists will be made on the basis of the actual remaining function, whether the acts of balance, propulsion, etc., in the case of a foot, could be accomplished equally well by an amputation stump with prosthesis. Id. Examples given include complete paralysis of the external popliteal nerve with consequent foot drop accompanied by characteristic organic changes including trophic and circulatory disturbances and other concomitants confirmatory of complete paralysis of this nerve. 38 C.F.R. § 3.350 (a)(2)(i)(a), (b). In this case, the Veteran’s representative’s argues that “[t]he record contains no evidence that a prosthetic right lower limb would provide worse functionality than the [Veteran’s] current limb,” as such the Board should resolve reasonable doubt in the Veteran’s favor and find that the Veteran has loss of use of his right lower extremity. See March 2019 substantive appeal. This argument, however, disregards the numerous VA examinations, particularly, the November 2015, January 2019, and May 2019 peripheral nerve condition examinations, where the examiners specifically answered no when asked if the Veteran’s functional impairment of the extremity is of such severity to that no effective function remains other than that which would be equally well served by an amputation with prosthesis. The Board recognizes that the Veteran’s service-connected right lower extremity disabilities affect his gait and limit his mobility. Such functional impairment, however, is specifically contemplated with the disability ratings assigned. For the foregoing reasons, the Board finds that the criteria for entitlement to SMC for loss of the use of the right lower extremity have not been met. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.350. REASONS FOR REMAND 6. Entitlement to a TDIU is remanded. The Veteran contends that he is unemployable due to his service-connected disabilities. The Board finds the overall evidence, including an April 2019 vocational opinion and January 2017 private medical opinion, are persuasive that the Veteran is not capable of substantially gainful employment due to his service-connected disabilities. Implementing the grants herein, the Veteran has a combined schedular disability of at least 70 percent during the appeal period. However, no single disability is rated at least 40 percent disabling. Accordingly, the criteria for a schedular grant of TDIU under the provisions of 38C.F.R. §4.16 (a) have not been met. However, it is the established policy of VA that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. The Board may not consider the claim for an extraschedular TDIU in the first instance but will refer it to the Director, Compensation Service, if there is a reasonable possibility that the Veteran is unemployable by reason of service-connected disabilities. 38 C.F.R. § 4.16(b). The Board may not award extraschedular TDIU claims that have not been so considered. See Wages v. McDonald, 27 Vet. App. 233 (2015). As such, a remand is necessary before the claim can be adjudicated. The matters are REMANDED for the following action: Refer the Veteran’s claim to the Director, Compensation Service, for consideration of an extraschedular TDIU. LAURA E. COLLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Solomon 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.