Citation Nr: 21040813 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 16-58 426 DATE: July 7, 2021 ORDER Entitlement to an increased rating of 50 percent, but no higher, for bilateral hearing loss, for the period from September 9, 2013 through January 9, 2020, is granted, subject to the regulations governing the payment of monetary awards. Entitlement to an increased rating for bilateral hearing loss, from January 10, 2020, currently rated at 50 percent, is denied. Entitlement to a total disability based on individual unemployability due to service-connected disabilities (TDIU), prior to January 1, 2017, is denied. Entitlement to a TDIU, from January 1, 2017, is dismissed. FINDINGS OF FACT 1. From September 9, 2013, the evidence is at least in equipoise that the Veteran's hearing loss has been manifested by no worse than Level VIII hearing in each ear. 2. From January 10, 2020, the Veteran's hearing loss has been manifested by no worse than Level VIII for each ear. 3. Prior to January 1, 2017, the preponderance of the evidence is against a finding that the Veteran's service-connected disabilities rendered him unable to secure or follow a substantially gainful occupation. 4. From January 1, 2017, the issue of entitlement to a TDIU is moot in light of the 100 percent combined rating assigned for the Veteran's service-connected disabilities and because there is no indication that any of his service-connected disabilities alone render him unemployable. CONCLUSIONS OF LAW 1. From September 9, 2013 through January 9, 2020, the criteria for a rating of 50 percent, but no higher, for bilateral hearing loss have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.321, 4.1, 4.3, 4.7, 4.10, 4.85, 4.86, Diagnostic Code 6100. 2. From January 10, 2020, the criteria for a rating in excess of 50 percent for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.321, 4.1, 4.3, 4.7, 4.10, 4.85, 4.86, Diagnostic Code 6100. 3. Prior to January 1, 2017, the criteria for entitlement to a TDIU were not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 3.341, 4.3, 4.16. 4. From January 1, 2017, the issue of entitlement to a TDIU is moot. 38 U.S.C. § 1114(s); 38 C.F.R. § 4.16(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from February 1976 to February 2006. The matter of an increased rating for bilateral hearing loss initially came before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision, in which the agency of original jurisdiction (AOJ) denied entitlement to an increased (compensable) rating for bilateral hearing loss. The Veteran raised the issue of entitlement to a TDIU on his November 2016 VA Form 9. In June 2019, the Board expanded the appeal include the issue of entitlement to a TDIU as part and parcel of the claim for an increased rating for bilateral hearing loss. See Rice v. Shinseki, 22 Vet. App. 447 (2009). The Board remanded the Veteran's appeal to the AOJ for further evidentiary development. Specifically, the Board instructed the AOJ to ask the Veteran to complete a TDIU claim form and provide federal income tax returns from 2013 to 2019 and complete a VA Form 21-4142 for any private treatment records not in evidence, obtain the Veteran's outstanding VA treatment records, and obtain a VA examination to determine the current severity of his hearing loss. Pursuant to the Board's remand, the Veteran was asked to complete a TDIU claim form, provide federal income tax returns and identify any outstanding treatment records and to complete the appropriate authorization forms by way of a November 2019 letter. The Veteran provided the requested documents in December 2019 and August 2020. VA then obtained updated VA treatment records and obtained a Disability Benefits Questionnaire (DBQ) for Hearing Loss in January 2020. As explained in more detail below, the January 2020 DBQ is adequate and of substantial probative value. Therefore, the AOJ substantially complied with the Board's remand instructions. See Dyment v. West, 13 Vet. App. 141, 146- 47 (1999); Stegall v. West, 11 Vet. App. 268 (1998). On remand, the AOJ increased the Veteran's rating for bilateral hearing loss to 50 percent, effective January 10, 2020, by way of a June 2020 rating decision. As the increased rating is less than the maximum under the applicable criteria, the claim remains on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). The Board has characterized the issue accordingly. 1. Entitlement to a compensable rating for bilateral hearing loss from September 9, 2013 through January 9, 2020, and to a rating in excess of 50 percent from January 10, 2020 On September 9, 2014, the Veteran claimed that his bilateral hearing loss warranted an increased rating. Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule). 38 C.F.R. Part 4. The Rating Schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations is the ability of the body as a whole to function under the ordinary conditions of daily life, including employment. See 38 C.F.R. § 4.10. Evidence to be considered in the appeal of an assignment of a disability rating is not limited to that reflecting the then current severity of the disorder. Fenderson v. West, 12 Vet. App. 119 (1999). In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary importance. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). 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 the higher rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All reasonable doubt is resolved in the Veteran's favor. 38 C.F.R. § 4.3. In cases where the evaluation of hearing loss is at issue, an examination for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a pure tone audiometry test. Examinations will be conducted without the use of hearing aids. 38 C.F.R. § 4.85(a). The horizontal lines in Table VI (in 38 C.F.R. § 4.85) represent nine categories of the percentage of discrimination based on the controlled speech discrimination test. The vertical columns in Table VI represent nine categories of decibel loss based on the pure tone audiometry test. The numerical designation of impaired efficiency (I through XI) will be determined for each ear by intersecting the horizontal row appropriate for the percentage of discrimination and the vertical column appropriate to pure tone decibel loss. For example, with the percentage of discrimination of 70 and an average pure tone decibel loss of 64, the numeric designation level is 'V' for one ear. The same procedure will be followed for the other ear. 38 C.F.R. § 4.85(b). The percentage evaluation will be found from Table VII (in 38 C.F.R. § 4.85) by intersecting the horizontal row appropriate for the numeric designation for the ear having the better hearing and the vertical column appropriate to the numeric designation level for the ear having the poorer hearing. For example, if the better ear has a numeric designation level of 'V' and the poorer ear has a numeric designation level of 'VII,' the percentage evaluation is 30 percent. 38 C.F.R. § 4.85(e). Additionally, an alternate rating table (Table VIA) may be used for "exceptional patterns of hearing impairment," including cases where the pure tone thresholds at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) are 55 decibels or more, or where the pure tone thresholds are 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. 38 C.F.R. § 4.86. Turning to the evidence, the Veteran requested an increased rating for bilateral hearing loss in September 2014. A VA examination of the Veteran was provided in October 2014. The audiologist stated that the hearing loss could not be measured due to poor inter-test consistency. In January 2015, the Veteran wrote to VA and stated that he could hardly carry on a conversation anymore due to his hearing loss. VA provided another examination for hearing loss in September 2016. The examiner stated that he was unable to report the current severity of the Veteran's hearing loss due to poor inter-test consistency and responses consistent with non-organic hearing loss. The Veteran's November 2016 Substantive Appeal (VA Form 9), in response to statements in a November 2016 Statement of the Case, stated that the Veteran fully cooperated with the hearing examiner. He said that his hearing loss leads to difficulty with work and with social events. In December 2019, the Veteran submitted a VA Form 21-8940 for TDIU. He said that his hearing loss and back pain made it necessary for him to retire in December 2016. A December 2019 VA Form 21-4192 (Request for Employment Information) stated that the Veteran struggled to hear during staff meetings and that his disabilities led to his retirement in December 2016. The Veteran underwent a VA hearing examination in January 2020. Pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 30 50 70 85 59 LEFT 40 50 70 95 64 Speech audiometry revealed speech recognition ability of 50 percent in the right ear and of 50 percent in the left ear. The examiner diagnosed moderate to profound bilateral sensorineural hearing loss in the frequency range of 500-4000Hz. Concerning functional impact, the Veteran reported great difficulty hearing in most listening situations, a heavy reliance on context and facial cues, and that he had to retire because he could not hear during meetings. The Veteran reported great difficulty hearing in groups and noise, including restaurants, and said that he avoids crowds. The examiner also noted that the Veteran may be unable to hear alarms, sirens, and alerting devices. A July 2020 letter from the Veteran stated that his hearing loss and other disabilities make it impossible for him to work. For the period beginning September 9, 2013, there are no valid hearing examinations for application of Table VI or VII from 38 C.F.R. § 4.85. However, the Veteran had applied for an increase in September 2014 and stated as early as January 2015 that his hearing had worsened so that he could hardly carry on a conversation. The earliest completed hearing examination in January 2020 called for a 50 percent rating. Giving the Veteran the benefit of the doubt, a disability rating of 50 percent (but no higher) is warranted for the period from September 9, 2013 through January 9, 2020. For the period beginning January 10, 2020, a 50 percent rating is currently assigned. Application of Table VI for the results recorded in the January 2020 VA audiology examination yield Roman numeral VIII for both the right and left ear. Application of Table VII to Roman numerals VIII as both the better and poorer ear yields a disability rating of 50 percent. 38 C.F.R. § 4.85. The Veteran does not have an extraordinary pattern of hearing loss for the purposes of Table VIA. 38 C.F.R. § 4.86. Thus, a rating in excess of 50 percent is not warranted according to the schedular criteria for hearing loss. The Veteran is competent to report the symptoms of his hearing disability and the Board has no legitimate basis to challenge the credibility of his contentions. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). However, ratings for hearing loss are determined by a mechanical application of the VA rating schedule to the numeric designations assigned based on audiometric test results. Lendenmann v. Principi, 3 Vet. App. 345 (1992). The lay statements of record do not show that the Veteran has met the specific pure tone thresholds and/or speech discrimination percentages required for a rating higher than 50 percent for bilateral hearing loss at any time during the claim period. The Veteran has contended that his hearing loss warrants extraschedular consideration. The Board has also considered the potential application of extraschedular consideration under 38 C.F.R. § 3.321(b)(1) for exceptional cases where schedular evaluations are found to be inadequate. See Schafrath v. Derwinski, 1 Vet. App. 589 (1991). On an individual basis, the Board has considered whether referral for consideration of an extraschedular rating under 38 C.F.R. § 3.321(b) is required for the Veteran's bilateral hearing loss. As a threshold issue, the Board must determine whether the Veteran's disability picture is contemplated by the rating schedule. See Thun v. Peake, 22 Vet. App. 111 (2008). If so, the rating schedule is adequate, and an extraschedular referral is not necessary. In determining whether a veteran's symptomatology is adequately contemplated by the rating schedule, the United States Court of Appeals for Veterans Claims (Court) has provided some guiding principles as to how to recognize whether symptomatology is exceptional under 38 C.F.R. § 3.321 (b)(1). First, symptomology is exceptional only when it is of such nature or severity that conventional rating tools are not adequate to evaluate it properly. Second, the initial step in determining whether symptomatology is adequately contemplated by the rating schedule focuses solely on the functional impairments/symptoms of the disability at issue (as opposed to the functional effects of those impairments/symptoms). Third, if a symptom/impairment is not at all compensable under the rating schedule, then it does not warrant extraschedular consideration. Also, extraschedular consideration is not warranted for any symptom/impairment that clearly lacks a relationship to service or a service-connected disability. Long v. Wilkie, 33 Vet. App. 167 (2020). Here, the Veteran and the January 2020 examiner have indicated that he has difficulty hearing people speaking to him, particularly in crowds, and that he may be unable to hear alarms, sirens, and alerting devices. It is noted that he relies on context and facial expressions to help understand speech. A former co-worker stated that the Veteran was unable to understand people speaking during company meetings. In this case, with respect to the first prong of Thun, considering the pertinent evidence in light of the applicable criteria and considerations delineated above, the Board finds that the evidence does not establish such an exceptional disability picture as to render the schedular criteria for evaluating hearing loss inadequate. The schedular rating criteria for rating hearing loss provide for disability ratings based on testing during audiological evaluations, to include speech discrimination and pure tone testing. Here, all of the symptoms and functional impairments associated with the Veteran's hearing loss, as described above, are contemplated by the schedular rating criteria and the conventional rating tools are adequate to evaluate them properly. In this regard, the Board points out that the applicable schedular rating criteria (38 C.F.R. §§ 4.85, 4.86) specifically provide for ratings based on all levels of hearing loss in various contexts, as measured by both audiometric testing and speech recognition testing. The ability of the Veteran to hear sounds and voices is measured and rated by an audiometric test, as this test measures different frequencies and captures high frequency hearing loss from sources including voices, music, sirens, and certain high-pitched sounds. The ability of the Veteran to understand people is rated by a speech recognition test, as this test measures conversation comprehension, words, and missed conversations. The schedular rating criteria specifically provide for ratings based on all levels of hearing loss, including exceptional hearing patterns, as measured by both audiometric testing and speech recognition testing. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (holding "that the rating criteria for hearing loss contemplate the functional effects of difficulty hearing and understanding speech"). The decibel loss and speech discrimination ranges designated for each level of hearing impairment in Tables VI and VIa of the rating schedule were chosen in relation to clinical findings of the impairment experienced by veterans with certain degrees and types of hearing disability. The regulatory history of 38 C.F.R. §§ 4.85 and 4.86 includes revisions, effective June 10, 1999. See 64 Fed. Reg. 25,202 (May 11, 1999). In forming these revisions, VA sought the assistance of the Veteran's Health Administration (VHA) in developing criteria that contemplated situations in which a veteran's hearing loss was of such a type that speech discrimination tests may not reflect the severity of communicative functioning these veterans experienced or that was otherwise an extreme handicap in the presence of any environmental noise, even with the use of hearing aids. VHA had found through clinical studies of veterans with hearing loss that, when certain patterns of impairment are present, a speech discrimination test conducted in a quiet room with amplification of the sounds does not always reflect the extent of impairment experienced in the ordinary environment. The decibel threshold requirements for application of Table VIa were based on the findings and recommendations of VHA. The intended effect of the revision was to fairly and accurately assess the hearing disabilities of veterans as reflected in a real life industrial setting. 59 Fed. Reg. 17,295 (Apr. 12, 1994). The inherent purpose of the schedular rating criteria is to determine, as far as practicable, the severity of functional impact resulting from a service-connected disability, including any resultant occupational and social impairment, and therefore contemplates the Veteran's difficulties with functioning in a social environment due to hearing loss. Accordingly, the Board finds that the Veteran's reported hearing related difficulties are factors contemplated in the regulations and schedular rating criteria. See also Doucette, 28 Vet. App. at 366 (holding that "the rating criteria for hearing loss contemplate the functional effects of decreased hearing and difficulty understanding speech in an everyday work environment, as these are precisely the effects that VA's audiometric tests are designed to measure... an inability to hear or understand speech or to hear other sounds in various contexts... are contemplated by the schedular rating criteria"). The Board sympathizes with the contentions made by the Veteran and former co-worker. However, difficulty in distinguishing sounds in a crowded environment, difficulty hearing others speaking, and a possible inability to hear alarms, sirens, or alerting devices are each a manifestation of difficulty hearing or understanding speech and other sounds, which is contemplated by the schedular rating criteria for hearing loss. As noted above, the case of Doucette v. Shulkin, 28 Vet. App. 366 (2017), held that the rating criteria for §§ 4.85 and 4.86 contemplate, and thus compensate for, the functional effects of hearing loss, namely difficulty understanding speech and the inability to hear sounds in various contexts. While leaving open the possibility that extraschedular consideration for hearing loss might be warranted by other symptoms or functional effects associated with that disability, Doucette further held that extraschedular referral is not reasonably raised when complaints of difficulty hearing are the only complaints of record, which is the case here. The Board therefore concludes that the Veteran's symptomatology is not of such severity as to warrant referral for extraschedular consideration. As the threshold issue is not applicable, the criteria for referral for an assignment of an extraschedular rating of the disability are not met. 38 C.F.R. § 3.321(b)(1). As a final point, the Board notes that in conjunction with the claim for an increased rating for bilateral hearing loss, other than the issue of entitlement to a TDIU which is addressed below, neither the Veteran nor his representative have raised any other related issues, and no other such issues have been reasonably raised by the record. See Doucette, 28 Vet. App. at 369-70 (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). 2. Entitlement to a TDIU A TDIU may be assigned where a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16. The phrase "unable to secure and follow a substantially gainful occupation" contains both economic and noneconomic components. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). The economic component refers to an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person. Id. The noneconomic component requires a determination as to a veteran's ability to secure and follow such employment. Id. Attention should be given to the veteran's history, education, skills, and training; whether the veteran has the physical ability (both exertional and nonexertional) to perform the types of activities required by the occupation at issue (e.g., lifting, bending, sitting, standing, walking, climbing, as well as auditory and visual limitations); and whether the veteran has the mental ability to perform the activities required by the occupation at issue (e.g., memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity). Id. An award of a TDIU is an individualized determination, specific to a veteran's particular circumstances, e.g., their history, education, skills, and training. See Todd v. McDonald, 27 Vet. App. 79, 85 (2014). It does not require a showing of 100 percent unemployability. Roberson v. Principi, 251 F.3d 1378, 1385 (Fed. Cir. 2001). The ultimate question is whether they are capable of performing the physical and mental acts required by employment, not whether they can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). A. Period Prior to January 1, 2017 The evidence is not at least in equipoise that the Veteran's service-connected disabilities prevented him from securing or following a substantially gainful occupation during the claim period prior to January 1, 2017. The evidence indicates that the Veteran was employed on a full-time basis as an Executive Director for AETC/IA/AFSAT from 2012 to December 31, 2016. The evidence does not show that his service-connected disabilities precluded him from securing or following a substantially gainful occupation prior to January 1, 2017. Marginal employment shall not be considered substantially gainful employment. Marginal employment is defined as when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce as the poverty threshold for one person. Marginal employment may also be held to exist on a fact found basis, including, but not limited to, employment in a protected environment, such as a family business or sheltered workshop. 38 C.F.R. § 4.16(a). However, the evidence does not show that the Veteran's employment as an executive manager for AETC/IA/AFSAT was either marginal or protected employment. In a December 2019 VA Form 21-4192, Request for Employment Information in Connection with Claim for Disability Benefits, AETC/IA/AFSAT indicated that during the 12-month period preceding his resignation, the Veteran earned $129,723.00. The Veteran also reported in his VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability, that his highest gross earnings per month were $10,800, which equates to $129,600 per year. During the period prior to December 31, 2016, the highest poverty threshold amount for one person was in 2016 and was $11,880. Therefore, a preponderance of the evidence is against a finding that the Veteran's employment at AETC/IA/AFSAT was marginal as his salary is shown to have exceeded the poverty threshold by over $110,000. The record also does not show evidence of accommodations made to the Veteran due to his service-connected disabilities and his employment at AETC/IA/AFSAT was not a family business or sheltered workshop or other type of protected employment. As the evidence shows that the Veteran was employed full time through December 31, 2016, and does not show that the Veteran's employment was in a protected environment or otherwise marginal, the Board finds that a preponderance of the evidence is against a finding that the Veteran's service-connected disabilities rendered him unable to secure or follow all forms of substantially gainful employment consistent with his educational background and occupational experience prior to January 1, 2017, and entitlement to a TDIU for that period is not warranted. In so finding, the Board in no way doubts the clear impact that the Veteran's disabilities had on his daily life and employment during this period; however, such impact has already been taken into consideration in the assignment of the percentage disability ratings. The evidence establishes that while the Veteran's service-connected disabilities may have impacted employment, he was not precluded from employment and, in fact, was gainfully employed during this period. Accordingly, the preponderance of the evidence is against the assignment of a TDIU for the claim period prior to January 1, 2017. B. Period from January 1, 2017 This decision by the Board increases the disability rating for bilateral hearing loss from 0 to 50 percent, effective September 9, 2013. This increase gives the Veteran a combined disability rating of 100 percent for the entire period after he stopped working on December 31, 2016. Here, the Board finds that any question of a TDIU rating has been rendered moot for the period from January 1, 2017 (when the Veteran was no longer employed). A TDIU from January 1, 2017, would result in duplicate counting of disabilities. The Board notes that a grant of a 100 percent schedular rating does not necessarily render the issue of entitlement to a TDIU moot, as the TDIU could in certain circumstances render the Veteran eligible for special monthly compensation (SMC). SMC may be warranted if the Veteran has a 100 percent disabling rating for a single disability, and VA finds that TDIU is warranted based solely on disabilities other than the disability that is rated at 100 percent. See Buie v. Shinseki, 24 Vet. App. 242 (2011); Bradley v. Peake, 22 Vet. App. 280 (2008). With respect to the remaining claim period from January 1, 2017, this case is distinguishable from both the Bradley and Buie exceptions to the rule that a 100 percent combined schedular disability rating moots a TDIU. Under the unique facts of Bradley, SMC was available where a veteran had been granted TDIU based on a "less than total" 70 percent rating for only one disability and had subsequently obtained service connection for multiple orthopedic disabilities that combined to 60 percent. Under those circumstances, there was no "duplicate counting of disabilities." Bradley at 293. This case is distinguishable from Bradley because, in this case, the Veteran is not in receipt of a less than 100 percent schedular disability rating for any one service-connected disability upon which a TDIU is granted. Rather, the 100 percent schedular disability rating assigned during this period is based on the combined ratings of multiple service-connected disabilities. Concerning both Bradley and Buie, in this case, the Veteran is currently service connected for multiple disabilities and has previously contended that the combination of these disabilities renders him unemployable. To award a TDIU rating for the period since January 1, 2017 (when the Veteran was no longer gainfully employed) would result in duplicate counting of disabilities. 38 C.F.R. § 4.14. As neither Bradley nor Buie is applicable, the question of entitlement to a TDIU rating has been rendered moot by the 100 percent combined schedular disability rating for all service-connected disabilities that has been in effect during this period. There is no indication that any of the Veteran's service-connected disabilities alone renders him unemployable. In his TDIU application, he identified his service-connected bilateral hearing loss and back pain as causing his unemployability. Similarly, a VA Form 21-4192 Request for Employment Information received in December 2019 indicated that the Veteran struggled to hear during staff meetings and his chronic back pain caused him difficulties in the daily routine of business. The co-worker stated that "it was his disabilities that led to the early retirement decision." The disability rating for bilateral hearing loss was 50 percent throughout this period. The Veteran reported that he was unable to understand people speaking in business meetings, relying on context and facial expressions to understand their speech. A VA examiner stated that the Veteran may be unable to hear alarms, sirens, and alerting devices. The Veteran's back condition for this period resulted in reduced range of motion, pain on movement, excess fatigability, lack of endurance, and reduced strength in the left hip and knee. A VA examiner commented that the Veteran is unable to perform physical labor involving high-impact activities, lift, push, pull, or carry more than five pounds, climb ladders, or engage in prolonged walking or sitting. See C&P Exam, January 13, 2017. The evidence does not support a TDIU based solely on the service-connected hearing loss disability or back disability alone, or any other service-connected disability alone. Hence, entitlement to TDIU is moot for the period beginning on January 1, 2017. See 38 U.S.C. § 1114(s). Brian J. Elwood Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Dean, Associate Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.