Citation Nr: 21032058 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 16-28 247 DATE: May 25, 2021 ORDER A 20 percent rating percent, but no more, for degenerative disc disease (DDD) of the lumbar spine with intervertebral disc syndrome (IVDS) prior to November 2, 2020, is granted, subject to the laws and regulations governing the payment of benefits. A rating in excess of 40 percent for DDD of the lumbar spine with IVDS since November 2, 2020, is denied. A compensable rating for traumatic deviated septum is denied. A compensable rating for maxillary sinusitis prior to November 2, 2020, is denied. A rating in excess of 50 percent for maxillary sinusitis since November 2, 2020, is denied. A total disability rating based on individual unemployability (TDIU) prior to November 2, 2020, is denied. FINDINGS OF FACT 1. The Veteran served on active duty from June 1980 to July 1989; he has been 100 percent disabled since November 2, 2020. 2. Prior to November 2, 2020, a low back disability was characterized by subjective complaints of low back pain; objective findings include forward flexion at worst to 35 degrees, but not of incapacitating episodes, ankylosis, forward flexion of the lumbar spine limited to 30 degrees or less, or the functional equivalent thereof. 3. Since November 2, 2020, a low back disability has been manifested by pain and limitation of motion but no evidence of ankylosis or incapacitating episodes of IVDS. 4. For the entire period on appeal, a deviated nasal septum has been manifested by subjective complaints of congestion/blockage on the left side of his nose; objective findings include no obstruction of the nasal passage of at least 50 percent on both sides and no complete obstruction on one side due to traumatic septal deviation. 5. Prior to November 2, 2020, maxillary sinusitis was manifested by congestion and blockage on the left side, stable symptoms over a year with no incapacitating episodes or nasal obstruction. 6. Since November 2, 2020, maxillary sinusitis has been manifested as near constant chronic maxillary sinusitis characterized by pain and tenderness of the affected sinus, headaches, and purulent discharge. 7. The Veteran's service-connected disabilities do not preclude him from securing or following a substantially gainful occupation prior to November 2, 2020. CONCLUSIONS OF LAW 1. The criteria for a 20 percent rating, but no more, for DDD of the lumbar spine with IVDS prior to November 2, 2020, have been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.59, 4.71a, Diagnostic Code (DC) 5243 (2020). 2. The criteria for a rating in excess of 40 percent for DDD of the lumbar spine with IVDS since November 2, 2020, have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.71a, DC 5243 (2020). 3. The criteria for a compensable rating for a traumatic deviated septum have not been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.20, 4.59, 4.97, DC 6502 (2020). 4. The criteria for a compensable rating for maxillary sinusitis prior to November 2, 2020, have not been met. 38 U.S.C. §§ 1117, 1155, 3.159, 5103, 5103A, 5107(b) 2012; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.3, 4.7, 4.97, DC 6513 (2020). 5. The criteria for a rating in excess of 50 percent for maxillary sinusitis since November 2, 2020, have not been met. 38 U.S.C. §§ 1117, 1155, 3.159, 5103, 5103A, 5107(b) 2012; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.3, 4.7, 4.97, DC 6513 (2020). 6. The criteria for a TDIU prior to November 2, 2020, has not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In July 2019, the Veteran testified before the undersigned Veterans Law Judge. A copy of the transcript has been associated with the claims file. In September 2020, the Board remanded the appeal for additional development. The case has now been returned to the Board for further appellate action. Increased Rating Claims Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. DDD of the Lumbar Spine with IVDS The Veteran's low back disability has been rated at 0 percent disabling under DC 5243 prior to November 2, 2020, and 40 percent disabling since. The Board will consider all relevant diagnostic codes. During the pendency of the appeal, the rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. § 4.71a were amended effective February 7, 2021. 85 Fed. Reg. 230 (Nov. 30, 2020). If a law or regulation changes during the course of a claim or an appeal, the version more favorable to the veteran will apply, to the extent permitted by any stated effective date in the amendment in question. 38 U.S.C. § 5110(g). If the amended version of the regulation is more favorable, the implementation of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. If the pre-amended regulation is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. 38 U.S.C. § 5110. Therefore, the Board will consider the claim under the pre-amended criteria prior to February 7, 2021 and both the pre-amended and amended rating criteria from February 7, 2021. The criteria that is more favorable to the Veteran will be applied. Prior to the regulatory change, a higher rating would be warranted when the objective medical evidence showed the following: Forward flexion of the thoracolumbar spine greater than 60 degrees, but not greater than 85 degrees (10% under DC 5242); Combined range of motion (ROM) of the thoracolumbar spine greater than 120 degrees, but not greater than 235 degrees (10% under DC 5242); Muscle spasms, guarding, or localized tenderness not resulting in abnormal gait or spinal contour (10% under DC 5242); Vertebral body fracture with loss of 50 percent or more of the height (10% under DC 5242); Intervertebral disc syndrome (IVDS) with incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months (10% under DC 5243); forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees (20%); combined ROM of the thoracolumbar spine not greater than 120 degrees (20%); muscle spasms or guarding that is severe enough to result in an abnormal gait or abnormal spinal contour, such as scoliosis, reversed lordosis, or abnormal kyphosis (20%); incapacitating episodes of IVDS having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months (20%); or, in the absence of limitation of motion, degenerative arthritis with x-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups with occasional incapacitating exacerbations (20%). A rating in excess of 40 percent will be warranted when the objective medical evidence shows the following: unfavorable ankylosis of the entire thoracolumbar spine (50%); unfavorable ankylosis of the entire spine (100%); incapacitating episodes having a total duration of at least 6 weeks during the past 12 months (60%). The amended regulations clarify that DC 5243 is to be assigned only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign DC 5242 for all other disc diagnoses. No other changes were made to the rating criteria for the spine. Rating Period Prior to November 2, 2020. Private treatment records reflect that in June 2013, the Veteran reported a lower backache. A physical examination revealed ROM as forward flexion to 80 degrees, extension to 15 degrees, right lateral rotation to 50 degrees and left lateral rotation to 50 degrees. Right lateral flexion and left lateral flexion were not reported. In August 2013, the Veteran again reported a lower backache. A physical examination revealed ROM as forward flexion to 70 degrees, extension to 15 degrees, right lateral rotation to 50 degrees and left lateral rotation to 50 degrees. Right lateral flexion and left lateral flexion were not reported. In a May 2014 VA Disability Benefit Questionnaire (DBQ), the Veteran reported taking Skelaxin for his back and occasionally Naproxen and Aleve. He indicated experiencing flare-ups described as low back pain and he stretched at home for relief. The examiner diagnosed DDD and Grade I spondylolisthesis of L5 and S1. A physical examination revealed ROM as forward flexion to 60 degrees, extension to 30 degrees or greater, right lateral flexion to 25 degrees and left lateral flexion to 30 degrees or greater, and right and left lateral rotation to 25 degrees, with a total combined ROM of 195 degrees. There was no additional loss of function or ROM after three repetitions. The examiner found that the Veteran had no guarding or muscle spasms of the lumbosacral spine or ankylosis or IVDS. Private treatment records in September 2014 reflect ROM as forward flexion to 35 degrees, extension to 10 degrees, right lateral rotation to 25 degrees and left lateral rotation to 20 degrees. Right lateral flexion and left lateral flexion were not reported. Private treatment records in October 2014 revealed ROM as forward flexion to 35 degrees, extension to 10 degrees, right lateral rotation to 25 degrees and left lateral rotation to 20 degrees. Right lateral flexion and left lateral flexion were not reported. Next, December 2014, January 2015, and February 2015 private treatment records indicated ROM as forward flexion to 45 degrees, extension to 20 degrees, right lateral rotation to 25 degrees and left lateral rotation to 20 degrees. Right lateral flexion and left lateral flexion were not reported. Further, March through November 2015 private treatment records revealed ROM as forward flexion to 40 degrees, extension to 15 degrees, right lateral rotation to 25 degrees and left lateral rotation to 20 degrees. Right lateral flexion and left lateral flexion were not reported. Based on the above, the evidence supports a 20 percent rating, but no more, prior to November 2, 2020. A 20 percent rating is warranted for forward flexion greater than 30 degrees but not greater than 60 degrees. In this regard, the forward flexion was measured at no greater than 35 degrees. Higher ratings are available for incapacitating episodes, ankylosis, forward flexion limited to 30 degrees or less, or the functional equivalent thereof. The evidence weighs against such manifestations. There is no evidence in the record of ankylosis or incapacitating episodes, and forward flexion has never been measured at less than 35 degrees. Accordingly, the medical evidence supports a 20 percent rating prior to November 2, 2020. Rating Period Since November 2, 2020. Turning to the medical evidence during this time period, at a November 2020 VA examination, the Veteran reported daily low back pain, back pain with prolonged sitting and that he was unable to walk more than about two blocks because of his low back pain and some numbness of both legs. He indicated experiencing flare-ups about twice a year and lasting several days and he was unable to work when he had flare-ups. The examiner diagnosed IVDS, lumbar spine DDD, spondylolisthesis, and bilateral lower extremity radiculopathy. A physical examination revealed ROM as forward flexion to 60 degrees, extension to 20 degrees, right and left lateral flexion to 20 degrees each, and right and left lateral rotation to 20 degrees, with a total combined ROM of 160 degrees. There was pain on all ranges of motion. Pain was noted on examination and caused functional loss. The examiner also indicated that there was objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue of the thoracolumbar spine. There was no evidence of pain on passive ROM testing or pain with weight-bearing. Repetitive motion testing was accomplished and after three repetitions, ROM did not change. The examiner noted that pain caused functional loss. The Veteran was not being examined after repetitive use over time, but the examiner determined that the examination was medically consistent with the Veteran's statements describing functional loss with repetitive use over time. The examiner opined that pain significantly limited functional ability with repeated use over time. The Veteran was not being examined during a flare-up, but the examiner determined that the examination was medically consistent with the Veteran's statements describing functional loss during flare-ups. The examiner opined that pain significantly limited functional ability with flare-ups. In terms of additional loss of ROM during a flare-up, forward flexion to 30 degrees, extension to 10 degrees, right and left lateral flexion to 20 degrees each, and right and left lateral rotation to 20 degrees. The examiner found that the Veteran had no guarding or muscle spasms of the lumbosacral spine or ankylosis. There was IVDS but there were no acute signs or symptoms due to IVDS that required bed rest prescribed by a physician and treatment by a physician in the past 12 months. Based on the above, the medical evidence does not support a rating in excess of 40 percent since November 2, 2020. As outlined above, the evidence does not show ankylosis of the thoracolumbar spine or ankylosis of the entire spine. While there is limitation of motion, ankylosis is defined as a fixation of the joint. As some level of ROM has been shown, ankylosis is not shown. Further, the health care providers have diagnosed IVDS but have specifically found that there were no incapacitating episodes, not has the Veteran so reported. Therefore, the medical evidence does not support a higher rating for this period. Traumatic Deviated Septum The nasal disability has been rated under DC 6502 for a deviated nasal septum. The Board will consider all relevant diagnostic codes. Under the relevant regulations, a compensable rating will be warranted when the objective medical evidence shows the following: Traumatic deviation of the nasal septum, with 50 percent obstruction of the nasal passage on both sides (10% under DC 6502); or Traumatic deviation of the nasal septum, with complete obstruction on one side (10% under DC 6502). In a June 2016 VA examination, the Veteran reported congestion/blockage on the left side but that he could still breathe through it due to his deviated nasal septum. He indicated that his right side was okay. Upon examination, he was diagnosed with a traumatic deviated nasal septum; however, the examination did not find at least 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side due to the traumatic condition. In a subsequent November 2020 VA examination, the Veteran reported continued problems with his nose, and he had septoplasty in 2017. Upon examination, he was diagnosed with a traumatic deviated nasal septum; however, the examination did not find at least 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side due to the traumatic condition. Based on the above, a compensable rating for a deviated nasal septum is not warranted. In this regard, the June 2016 and November 2020 examinations failed to find either a 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side due to his service-connected traumatic deviated nasal septum. Accordingly, the medical evidence does not support a compensable rating. Consideration has been given to assigning staged ratings for the disabilities discussed above. However, at no time during the period in question have the disabilities in question warranted higher schedular ratings than those assigned. Hart v. Mansfield, 21 Vet. App. 505 (2007). Maxillary Sinusitis Maxillary sinusitis has been rated noncompensable prior to November 2, 2020, and 50 percent disabling since under DC 6513. The Board will consider all appropriate diagnostic codes. A higher rating is warranted when the evidence shows the following: a 10% rating required one or two incapacitating episodes (requiring bed rest and treatment by a physician) per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or three or more non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting (both under DC 6513), or allergic or vasomotor rhinitis without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side (under DC 6522). A 30% rating requires 3 or more incapacitating episodes of sinusitis per year requiring prolonged (lasting 4 to 6 weeks) antibiotic treatment, or more than 6 non-incapacitating episodes of sinusitis per year characterized by headaches, pain, and purulent discharge or crusting. A 50% rating is assigned following radical surgery with chronic osteomyelitis, or for near-constant sinusitis characterized by headaches, pain, and tenderness of the affected sinus, and purulent discharge or crusting after repeated surgeries. A note following these rating criteria indicates that an incapacitating episode of sinusitis means one that requires bed rest and treatment by a physician. Prior to November 2, 2020, in a June 2016 VA examination, the Veteran was diagnosed with chronic sinusitis. The Veteran reported congestion/blockage on the left side but that he could still breathe through it due to his deviated nasal septum. He indicated that his right side was okay. The examiner noted symptoms of episodes of sinusitis and mucosal thickening in the right maxillary sinus. However, the examiner found no incapacitating episodes of sinusitis or surgery. Based on the above, the Veteran's symptoms are contemplated by a noncompensable rating. His symptoms have not required surgery or other medical treatment for more than a year. Though he reports stuffiness at night, he can manage symptoms with the use of over the counter medications. The evidence does not show incapacitating episodes causing headaches, pain, discharge, obstruction of his nasal passage, surgery, or the use of prescribed medication such as antibiotics. Therefore, the medical evidence does not support a higher rating. Since November 2, 2020, the Veteran is in receipt of the maximum possible schedular rating for his sinus disability. The Veteran's current 50 percent rating is based on findings from a November 2020 VA examination. The Veteran reported frequent nasal obstruction and treatment with nasal spray. The examiner diagnosed the Veteran with chronic sinusitis. The Veteran's symptoms of his sinusitis were found to be near constant sinusitis, headaches, pain of affected sinus, tenderness of affected sinus, and purulent discharge. In addition, within the past 12 months, the Veteran was noted to have had 7 or more non-incapacitating episodes. The Veteran was not found to have had incapacitating episodes of sinusitis or sinus surgery. The Board observes that a 50 percent evaluation represents the maximum schedular rating available under those diagnostic codes. Therefore, an evaluation in excess of 50 percent is not warranted under the regulations. In addition, evidence of record does not reflect that the Veteran has lost part of his nose, or has nasal scarring (DC 6504); has had radical or repeated surgeries or incapacitating episodes (DCs 6510-6514); suffers laryngitis or has undergone a laryngectomy (DCs 6515 to 6518); has complete organic aphonia (DC 6519), has stenosis of the larynx (DC 6520), has injuries to the pharynx (DC 6521); and/or has bacterial or granulomatous rhinitis (DC 6523 and 6524). Thus, the assignment of any separate or increased evaluation under any of these diagnostic codes is not warranted. In light of the above, the medical evidence does not support a compensable rating for maxillary sinusitis prior to November 2, 2020, and a rating in excess of 50 percent since. With respect to all the appeals for higher ratings, the Board has considered the Veteran's lay statements that his disabilities are worse. While he is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of this disorder according to the appropriate diagnostic codes. Such competent evidence concerning the nature and extent of the Veteran's service-connected disabilities of the feet, ankles and lumbosacral spine has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the examination reports and other clinical evidence) directly address the criteria under which the disabilities are evaluated. Moreover, as the examiners have the requisite medical expertise to render medical opinions regarding the degree of impairment caused by the disabilities and had sufficient facts and data on which to base the conclusions, the Board affords the medical opinions great probative value. As such, these records are more probative than the Veteran's subjective complaints of increased symptomatology. In sum, after a careful review of the evidence of record, the benefit of the doubt rule is not applicable and the appeal is denied. TDIU Prior to November 2, 2020 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 as totally disabled. 38 C.F.R. § 4.16. Substantially gainful employment is that employment that is ordinarily followed by the nondisabled to earn their livelihoods with earnings common to the particular occupation in the community where the veteran resides. Moore v. Derwinski, 1 Vet. App. 356 (1991). Marginal employment will not be considered substantially gainful employment. 38 C.F.R. § 4.16 (a). A TDIU may be assigned, if the scheduler rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that if there is only one such disability it is ratable at 60 percent or more, and that if there are two or more such disabilities at least one is ratable at 40 percent or more and the combined rating is 70 percent or more. 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 (1993). Neither nonservice-connected disabilities nor advancing age may be considered in the determination. 38 C.F.R. §§ 3.341, 4.19; Van Hoose v. Brown, 4 Vet. App. 361 (1993). As an initial matter, the Veteran is in receipt of a 100 percent schedular rating from November 2, 2020, based on the combined effect of his service-connected disabilities. The regulations pertaining to the assignment of a TDIU rating provide that such a rating may be assigned where the schedular rating is less than total. 38 C.F.R. § 4.16(a). Here, he is not seeking TDIU based on a single disability and his total schedular rating includes the disabilities for which he is seeking TDIU. Prior to November 2, 2020, he was rated at 50 percent for migraine headaches, 40 percent for traumatic brain injury (TBI), 20 percent for DDD lumbar spine with IVDS (assigned herein), 0 percent for post occiput scar, 0 percent for deviated septum, and 0 percent for maxillary sinusitis. The combined rating is 80 percent prior to November 2, 2020. Accordingly, the schedular criteria for assignment of a TDIU has been met prior to November 2, 2020. A review of the record reveals that the Veteran was last able to work in November 2012 and that he worked as a mechanic. The record further shows that he had a high school education and attended 4 years of college. As to the low back disability, in a May 2014 VA examination, the examiner found that the Veteran's lumbar spine disability impacted his ability to work in that he was unable to perform consistent manual labor; but he was able to perform light manual and sedentary labor. As to the headache disorder and TBI disorder, in a May 2014 VA examination, the examiner found that the Veteran's migraine headaches and TBI impacted his ability to work. The examiner noted that prior to the Veteran's service-connected head injury, he was able to perform complex tasks without restriction. Subsequently, the Veteran had tried (successfully) to overcome his cognitive/memory deficits and his headaches and sequelae to maintain civilian occupations. The examiner indicated that the Veteran had to give up his employment in 2012 because of worsening symptoms related to his TBI, such as the need to isolate himself during headache attacks and difficulty in getting along with others. The examiner noted that the Veteran also had to give up his employment because of disputes with management, and he could not continue in his present work capacity because of limitations imposed by his sequelae of head injury including his need for rest in a quiet room when he has prostrating headaches. However, in a July 2015 VA TBI examination, the examiner found that the Veteran's TBI did not impacted his ability to work. Next, in a June 2017 VA examination, the examiner found that the Veteran's headaches impacted his ability to work. The examiner indicated that headaches made it difficult for him to concentrate and he needed to isolate himself whenever he had headaches, which made it difficult for him to work. However, the examiner noted that the Veteran was able to perform light physical and sedentary activities. Further, in a June 2017 VA examination, the examiner found that a TBI impacted his ability to work. The examiner that frequent headaches and insomnia probably adversely affected his work in some degree. Further, the examiner noted that the Veteran worked as a mechanic until 2012, his TBI residual over the years were chronic headache and chronic insomnia, but he still had maintained his job for 20 plus years. The examiner indicated that the Veteran's TBI residuals had not gotten worse over the years. Additionally, the examiner noted that it was not clear to him why the Veteran was forced to retire since he was in a legal dispute with his former employer and he was reluctant to talk about it. As to the other service-connected disabilities mentioned above, the medical evidence did not show that they would render him unable to obtain or maintain substantially gainful employment. In sum, the medical evidence does not support a TDIU prior to November 2, 2020. Rather, the medical evidence shows that the low back disability would impose restrictions on the type of employment that he could perform. Specifically, the May 2014 VA examiner found that the Veteran was unable to perform consistent manual labor; but he was able to perform light manual and sedentary labor. Although no specific types of employment were identified, the Board finds that light manual or sedentary labor could include computer work, on-line training or teaching, filing, or greeting. Regarding the TBI disorder, although the May 2014 VA examiner indicated that the Veteran's worsening symptoms related to his TBI, such as the need to isolate himself during headache attacks, and difficulty in getting along with others, the July 2015 VA examiner found that the Veteran's TBI did not impacted his ability to work. Further, the June 2017 VA examiner found that the Veteran's TBI impacted his ability to work, including his TBI residuals which were chronic headaches and chronic insomnia, but he still had maintained his job for 20 plus years. Further, regarding the headache disorder, although both the May 2014 and June 2017 VA examiners noted that Veteran's headaches made it difficult for him to concentrate and he needed to isolate himself whenever he had headaches, the June 2017 examiner found that the Veteran was able to perform light physical and sedentary activities. This could include a position with flexible scheduling or self-employment. A decision of the Social Security Administration (SSA), dated in February 2017, shows that the SSA determined that the Veteran was disabled as of February 2014, with a primary diagnosis of disorders of back (discogenic and degenerative), and a secondary diagnosis of disorders of muscle ligament and fascia. The Board notes that while findings from SSA constitute probative evidence with respect to a TDIU claim, they are not dispositive or binding on VA. The SSA legal criteria for assessing disability differs in important respects from VA's own framework for determining entitlement to TDIU. SSA bases disability on a claimant's residual functional capacity, and whether there is substantial gainful activity that could be performed with that residual functional capacity. A VA claim for a TDIU focuses on unemployability based on impairments caused only by service-connected disabilities. Also, unlike SSA, VA does not consider age in making its determination. The Board has considered the Veteran's lay statements and testimony regarding his capacity to work prior to November 2, 2020. While he is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of symptomatology sufficient to satisfy the requirements of 38 C.F.R. § 4.16. Such competent evidence concerning the nature and extent of the Veteran's employability has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations, including his level of functional impairment due to his service connected disabilities. The medical findings (as provided in the examination report and other clinical evidence) directly address the criteria under which his employability is evaluated. Moreover, as the examiners have the requisite medical expertise to render a medical opinion regarding the impact of the Veteran's service-connected disabilities on his capacity to work and had sufficient facts and data on which to base the conclusions, the medical opinions are probative. As such, these records are more probative than the Veteran's subjective evidence of unemployability. In light of the medical evidence, and based on the Board's own analysis and determination, the appeal for a TDIU prior to November 2, 2020, is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Grzeczkowicz 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.