Citation Nr: 21042743 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 18-17 021 DATE: July 13, 2021 ORDER The appeal for a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is denied. FINDING OF FACT The Veteran's service-connected disabilities have not rendered him unable to secure or follow a substantially gainful occupation. CONCLUSION OF LAW The criteria for entitlement to a TDIU have not been met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. §§ 3.340, 4.15, 4.16. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 2006 to September 2007 with additional service in the Army National Guard. This case is before the Board of Veterans' Appeals (Board) on appeal from a December 2016 Regional Office (RO) rating decision, where the RO denied entitlement to a TDIU. In March 2021, the Veteran testified at a virtual hearing before the undersigned Veterans Law Judge. A transcript of his testimony is associated with the claims file. 1. Entitlement to a TDIU The Veteran contends that his service-connected disabilities, specifically his anxiety and physical disabilities, including his ankle, knee, back, and shoulder conditions prevent him from securing or following a substantially gainful occupation. Entitlement to TDIU requires the presence of impairment so severe that it is impossible for the average person to follow a substantially gainful occupation. Consideration may be given to the Veteran's level of education, special training, and previous work experience in arriving at a conclusion, but not to the Veteran's age or the impairment caused by any nonservice-connected disabilities. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16, 4.19. In reaching such a determination, 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). TDIU may be assigned 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. The service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue will be addressed in both instances. 38 C.F.R. § 4.16(a), (b). For a schedular TDIU, if there is only one service-connected disability, it must be rated at 60 percent or more; if there are two or more disabilities, at least one disability must be rated at 40 percent or more, with sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one service-connected 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 crucial inquiry in determining whether the Veteran is entitled to TDIU is not whether the Veteran is able to pursue his profession of choice, or indeed any particular job. Instead, the Board must inquire as to whether the Veteran can secure and follow a substantially gainful occupation in a more general sense. See Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). The fact that a veteran is unemployed is not enough. It must be determined that his service-connected disorders without regard to his advancing age make him incapable of performing the acts required by employment. Id. Consideration may be given to the veteran's education, special training, and previous work experience, but not to the veteran's age or to the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16; see also Van Hoose v. Brown, 4 Vet. App. 361 (1993). In Ray v. Wilkie, 31 Vet. App. 58 (2019), the Court defined the term "unable to secure and follow a substantially gainful occupation" in § 4.16(b) as having two components: one economic and one noneconomic. The economic component means 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. The non-economic component includes consideration of the following: the Veteran's history, education, skill, and training; whether the veteran has the physical ability to perform the type of activities required by the occupation at issue; and whether the veteran has the mental ability to perform the activities required by the occupation at issue. Whether a TDIU is warranted is a legal and not a medical determination and must take into account all of the medical and lay evidence. See Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013) ("applicable regulations place responsibility for the ultimate TDIU determination on the VA, not a medical examiner"; "neither the statute nor the relevant regulations require the combined effect [of disabilities] to be assessed by a medical expert"). The Veteran has 8 service-connected disabilities, including gastroesophageal reflux disease (GERD) with erosive esophagitis, hiatal hernia, and partially occluding Schatzki's ring, rated as 50 percent disabling from September 29, 2007; other specified trauma and stress related disorder, rated at 30 percent from September 29, 2007; thoracolumbar strain, rated at 20 percent from September 29, 2007; left trapezius strain, status post left acromioclavicular separation (major), rated at 10 percent from September 29, 2007 and 20 percent from May 9, 2016; patellofemoral pain syndrome status post left knee contusion, rated at 10 percent from September 29, 2007; left ankle degenerative arthritis with history of sprain and instability, rated at 10 percent from September 29, 2007, 100 percent from June 13, 2014, and 10 percent from October 1, 2014; dermatophytosis pedis, bilateral, rated as noncompensable from September 29, 2007, and post-operative left ankle scar associated with left ankle degenerative arthritis with history of sprain and instability, rated as noncompensable from June 13, 2014. The Veteran is in receipt of special monthly compensation (SMC) under 38 U.S.C. § 1114(s) and 38 C.F.R. § 3.350(i) from June 13, 2014 to October 1, 2014. His combined evaluation was 80 percent from September 29, 2007, 100 percent from June 13, 2014, and 80 percent from October 1, 2014. The Veteran met the schedular percentage threshold requirements for consideration of a TDIU under 38 C.F.R. § 4.16(a) as of September 29, 2007 because since that time, he had at least one disability rated at least 40 percent, with additional service-connected disabilities that combined to 80 percent. In the June 30, 2016 TDIU application, the Veteran stated that his anxiety disorder prevents him from securing or following any substantially gainful occupation. He stated that his disability affected full-time employment as of February 26, 2013, that he last worked on May 1, 2015, and that he became too disabled to work on May 9, 2016. The Veteran reported working as a cashier, coordinator, soldering, and as owner/operator, and he noted that he completed three years of college, with training in computer engineering from September 2009 to May 2012. He remarked that he is unable to work with fellow VA staff, and that the DAV released him from his job because he could not handle the requirements of working with other staff. In April 2014 and May 2014 statements, the Veteran reported that he is limited by his ankle, noting an inability to stand for even short periods of time, 30 minutes maximum, without major swelling and pain. He stated that this affects his daily life, that he has slipped and fallen in the past, and that he is unable to perform activities that require him to stand or walk for more than 30 minutes at a time because of the pain, swelling, and instability. He stated that he has to take multiple breaks during activities. The Veteran stated that not too many jobs allow a person to work at home in a controlled environment, that he has applied for multiple jobs but has problems with the requirements, and that no employer wants to hire him because he is a liability. In a June 2016 statement, the Veteran stated that his anxiety has been interfering with his ability to work and continues to create difficulties with employment. He stated that his mental health affects his ability to work and that anything beyond part-time work further aggravates his condition, and that on average he can work for about 6 months before he is let go. He stated that he has increased panic attacks, once daily on average, and that he began working a third shift in order to minimize panic attacks at work by avoiding large crowds, but that work causes half of his panic attacks. He stated that there are times that he encounters crowds at work and feels confined, triggering stress, panic, and other attacks. He stated that there are few jobs that he can find in the area offering a night position, but that finding another job is almost impossible. He stated that he has a strained working relationship with management and coworkers, with constant problems due to his attitude and that constant tension compounds his anxiety, which affects him at work and at home, affecting his ability to maintain gainful employment. In a March 2017 statement, the Veteran stated that he has pursued higher education in order to relieve some of his symptoms resulting from working with others that exacerbate his PTSD but that there is not a suitable job in his current area that will provide him employment. He reported fears that relocating or any drastic change in his support system would worsen his condition, and he stated that based on his work history there is no guarantee that the new job would work out or not aggravate his condition. In an August 2017 statement, the Veteran stated that prior to being deployed in 2006 he was able to hold jobs for longer periods of time, working from 2001 until 2003, and was able to handle a steady job without any conflict or lost time. In a March 2018 VA Form 9, the Veteran stated that he attempted to use his computer engineering degree in his own business, and then he worked with a company where he was able to use his degree until he left. He stated that since then he has not been able to use his degree because the area where he lives does not have many opportunities. He began taking jobs requiring physical labor because he was not qualified for anything else, and that his employers made accommodations for him, but that he had confrontations with them. He stated that he was let go because employers knew they could hire someone else without limitations, and that he left some jobs because it was too difficult to perform tests. He stated that his inability to handle the job requirements shows his ability to retain employment does not meet VA's standard. He indicated that his work history shows that he is not able to find work in his field without relocating, and that he continues to apply for jobs requiring physical labor because it is the best available option for a living wage in his area. Regarding employment history, a June 2016 form shows that the Veteran was employed from December 17, 2014 until May 1, 2015, after performing office work, phone and computer, 5.5 hours per day. He was terminated from employment due to differences with his employer. A June 2016 form shows that he was currently employed, starting on October 19, 2015 and was working as a third-shift cashier, 8 hours a day, 24 hours a week. In an October 2016 form, the employer noted that the Veteran worked as a technician from January 3, 2013 to February 23, 2013, working 8 hours a day, 40 hours a week, until he resigned. In an August 2017 form, the Veteran's employer stated he worked as a line cook, 5 to 10 hours a day, 20 to 23 hours a week from May 16, 2017 to June 1, 2017. No concessions were made, and he was terminated because he was on a trial period but "performance was not where it needed to be during the probationary period." In another August 2017 form, the employer reported that the Veteran performed dishwashing and light prep, 4 to 7 hours a day, from June 7, 2017 to July 4, 2017. The employer stated that the Veteran put in his notice roughly 7-10 days after his first shift, despite concessions made to the Veteran, including offering to have cooks lift things above his head and having someone help him. In a May 2019 form, the same employer reported that the Veteran worked from January 24, 2019 to April 26, 2019 but that the Veteran walked out and did not return to work. A November 2007 VA examination shows that the Veteran was employed full-time and lost no time from work during the previous year. It shows that his usual occupation was bus driver, which he had been doing for two to five years. Medical records received in January 2008 include a December 20, 2007 record showing that the Veteran worked as a bus driver for three and half years as well as construction jobs on the side. A February 2008 VA examination report shows that the Veteran's gastroesophageal reflux disease (GERD) had a moderate effect on feeding but no effect on any other tasks. In the April 2014 VA examination report and the May 2015 DBQ, the examiners stated that the Veteran's esophageal conditions do not impact his ability to work. However, in a November 2017 DBQ, the examiner stated that his esophageal conditions, GERD with erosive esophagitis, hiatal hernia, and partially occluding Schatzki's ring, impact his ability to work, noting that he should avoid heavy physical labor as that likely would increase intraabdominal pressure and increase risk for reflux with vomiting. Regarding the Veteran's ankle condition, in the January 2014 DBQ, the examiner stated that his ankle condition did not impact his ability to work. The Veteran reported that he was unemployed since October 2012 but previously built squad cars, emergency vehicles, and two-way communications for a year and a half, and that prior to that he was a bus and a truck driver for six years. The RO later determined that the January 2014 DBQ was inadequate and provided the Veteran with a new VA examination in November 2015. In the November 2015 report, the examiner stated that the Veteran's chronic left ankle sprain with instability, and degenerative arthritis impacts his ability to perform occupational tasks, noting that pain affects his ability to stand for extended periods of time. In a November 2017 DBQ, the examiner stated that his ankle conditions, impact his ability to perform occupational tasks, noting no running, jumping, repetitive or prolonged squatting, and to avoid prolonged walking and repetitive stair climbing. However, the examiner stated that he is able to perform sedentary labor and work that does not include the listed limitations. VA treatment records include a July 21, 2015 record where the Veteran reported that he was mainly interested in getting his life back on track and working as best he can, physically and mentally. The examiner noted that the Veteran has a very positive attitude and that hopefully with some help he would be able to get a job he can handle and feel productive again. In a June 4, 2015 mental health progress note the Veteran indicated that he had been having a hard time trying to find work. In a June 9, 2015 vocational rehabilitation counseling note it shows that they found a few IT jobs that interested the Veteran, noting that his goal was to find a full-time position in electronics, computer repair, and assembly. The record shows limitations including heavy lifting due to his left shoulder and large groups, and that his education includes an applied science degree in computer engineering. VA treatment records include a December 31, 2015 record where the examiner noted that the Veteran began to work on October 30, 2015, standing 8 hours a day, 24 hours a week, performing jobs such as cashiering and cleaning conveyor belts and cash registers. Prior to this job, he was unemployed for several months but worked as a VA coordinator setting up vans for about six months until he quit, due to personal conflicts. In a June 3, 2015 record, it notes that the Veteran was not currently working, and he reported sitting for four hours per day when completing computer work. A March 26, 2015 mental health physician note shows that the Veteran had been having some work-related issues, and that he stated that his symptoms made it somewhat difficult for him at work or to get along with others. VA treatment records include a mental health progress note from February 9, 2017 where the examiner stated that the Veteran had been seen in the mental health clinic since 2007 and diagnosed with PTSD symptoms in 2009. The examiner stated that the Veteran had several jobs which he worked for relatively short periods of time before the combination of his medical conditions exacerbated his PTSD symptoms, noting that one of his most troublesome medical conditions was his acid reflux. The examiner noted that he has tried a variety of medications and rys to keep the lid on his positive reaction to determine if the medications are working, and that he has remained treatment compliant. The examiner stated that the Veteran could not keep his previous employment due to stress levels being overrun by workers not showing up for their shift and his having to stay to cover long shifts, draining him physically and mentally. He reported that he was unemployed and was helping his brother with the administrative aspect of their local VFW but that it was exacerbating his PTSD symptoms and causing problems dealing with stress. In a November 2017 disability benefits questionnaire (DBQ), the examiner stated that the Veteran's skin condition, infectious, bilateral dermatophytosis pedis, does not impact his ability to work, noting no effect on his ability to function in an occupational environment. In the December 2017 DBQ, the examiner stated that the Veteran's muscle injuries impact his ability to work, noting that he would need to avoid repetitive and heavy lifting and avoid work overhead but that he would be able to perform sedentary labor and work that does not include the described limitations. In the December 2017 back conditions DBQ, the examiner stated that the Veteran's thoracic strain and lumbosacral strain impacts his ability to work. The Veteran reported that he is not able to stand for more than 2-3 hours. The examiner stated that the functional impact of each condition is to avoid heavy and repetitive lifting and bending, running, and jumping and that he is able to perform sedentary labor and work that does not include the described limitations. In the December 2017 DBQ, the Veteran reported functional loss or impairment related to his left knee, noting that during a flare up he cannot stand more than a few hours. The examiner stated that the Veteran's left patellofemoral pain syndrome and leg length discrepancy bilaterally impacts his ability to work, specifying that he should avoid jumping, running, repetitive squatting, and repetitive heavy lifting. The examiner stated that the Veteran is able to perform sedentary labor and work that does not include the described limitations. VA treatment records include a July 3, 2018 mental health progress note where the examiner noted that the Veteran is battling chronic pain in his joints and has not been able to get a job due to his medical conditions. However, he can do light things and thus helps his brother with computers, as there is no lifting or carrying involved, and he can operate a computer, although not for very long periods of time. The examiner noted the Veteran's mood level as somewhat depressed due to chronic pain and frustration at not being able to handle physical work, as he has a strong work ethic and would love to work and hold a job. Regarding the Veteran's shoulder conditions, in a November 2017 DBQ, the examiner stated that his shoulder conditions impacted his ability to perform occupational tasks, specifically that the Veteran should avoid heavy and repetitive lifting and reaching and work overhead. He stated that the Veteran is able to perform sedentary labor and work that does not include the described limitations. In the September 2018 DBQ, the examiner stated that the Veteran's left shoulder conditions, left trapezius strain, status post left acromioclavicular separation impacts his ability to perform occupational tasks, noting that it would adversely affect his ability to perform occupations requiring repetitive or strenuous use of the upper extremity at the shoulder level. The examiner stated that it would interfere with his ability to perform occupational tasks requiring overhead reach, heavy lifting or carrying, pushing, pulling, or climbing but that there is no restriction from sedentary occupational activity with reasonable accommodation. In a January 2019 DBQ, the Veteran reported that he has not lifted more than 5 pounds since left shoulder surgery and that his strength was gradually improving, but he has not attempted to reach or lift overhead. The examiner stated that his shoulder condition impacts his ability to perform occupational tasks including light lifting and reaching and lifting overhead. Regarding the Veteran's mental disorders, in the July 2008 PTSD VA examination report, the examiner stated that it is difficult to discern whether the Veteran functions well vocationally, "as he has changed jobs several times for reasons apparently unrelated to his own conduct." The examiner stated that he did not have information either from the Veteran or the file to suggest that his combat or military service generally has impacted his job functioning in a significantly negative way. He reported that his limited ability to make friends and relate normally with others has been injured by his service, such that he is now relatively socially isolated and spends most of his time alone. The examiner stated that his social ineptness, aggravated by combat, is likely to hinder him vocationally, but that none of his Axis I diagnoses are serious enough to prevent him from working at a job for which he has the requisite skills. In the August 2016 mental disorders VA examination report, the examiner stated in terms of employability that the Veteran's work history shows various terms of employment and departing from jobs due to discontent or disagreements with management. The examiner noted that while the Veteran previously indicated in a May 2016 statement that he had to work third shift due to panic attacks, having strained work relationships, and difficulties finding work due to avoidance of large crowds, upon examination, the Veteran reported that he was not aware that his last position was a third shift job when he applied. The Veteran reported that he experiences increases in anxiety in relation to safety concerns at home but denied panic attacks, generally gets along with his coworkers, and has issues with being confined to a restricted area but minimal problems with large groups. In addition, the Veteran did not note any mental health problems as contributory to previous terminations of employment. The August 2016 examiner also pointed to an October 2015 letter indicating that a reported inability to hold or maintain a job was due to chronic ankle pain and that a mental health note on June 29, 2016 shows that he is unable to handle any physically demanding employment, noting feet and back pain; the examiner noted that the Veteran did not mention pain until questioned. The examiner stated that his statements suggest, as noted in a previous VA examination, characterological features of longstanding problems with authority and interactions with others, inflexible mindset, and physical complaints, are more likely to be influential in frequent job changes than his mental health concerns. The examiner stated that his educational history, including attainment of an advanced degree in computer engineering, suggests adequate educational preparedness for vocational pursuits and that he has the intelligence to meet job demands. The Veteran endorsed maintaining adequate social contact with family and some friends, has not displayed increases in behavioral disruptions, is able to function independently, and engages in a range of interests, with noted decrease in enjoyment. He indicated that he is generally able to tolerate crowds but has some issues if he feels confined and cannot get away when he needs to distress. The examiner noted that his work history suggests some moderate difficulties collaborating with others or flexibility in thinking, but that he expressed strong work ethic and overall commitment to the job until he feels ignored by his employer. The examiner stated that a review of mental health symptomatology demonstrates some symptoms that would have relevance for possible vocational limitations, including depression, anxiety, some mild trauma related residual symptoms, and disrupted sleep period, noting that they appear to be a combination of symptoms and characterological features. The examiner noted that the Veteran is in ongoing mental health treatment and his psychiatric medication may preclude him from certain types of employment. The examiner noted that "while these symptoms could create interface and impose work restrictions in certain job environments which necessitate a confining workspace, strong hierarchical structure, and demanding physicality with few breaks, it does not necessarily preclude him from potential employment under the right conditions." In a November 2017 mental disorders DBQ, the examiner noted occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks although generally functioning satisfactorily with normal routine behavior, self-care, and conversation. The Veteran reported that he was able to get along well with military personnel and denied having problems with authority figures. He reported that he has lost three jobs because some people do not understand him and because he has told employers what was wrong with their company. The examiner noted that the Veteran graduated from high school, previously worked as a cashier and cart attendant, and has driven a school bus, noting that he got along well with employers and coworkers. He stated that he obtained a computer engineering degree but was unable to find a job in that field because he and his employer had different views of how to get things done, and that his next job lasted about five months because he left due to not agreeing with their procedures. The Veteran reported that he left his last job due to his physical problems, and that he was currently unemployed and not actively looking for work because of his shoulder disability. He stated that most employers require lifting more than 20 pounds, so it is not worth the effort to look for a job. The Veteran reported getting 3 to 5 hours of sleep a night, causing him to be tired the next day, affecting his motivation. During the March 2021 Board hearing, the Veteran testified that his physical disabilities, his ankle, knee, back and shoulder, affect any type of work that includes standing or sitting, and that after a while his body just gives out. He testified that sometimes he works for a couple of weeks but that most recently he worked for a year, performing a job involving driving and a lot of sitting for a security job. He stated that he had to seek consistent chiropractor appointments to treat his back because it could not handle his job. He stated that standing, walking, or heavy lifting for long periods of time, causes his body to give out and takes time to recover. He stated that when he is not working, he is receiving physical therapy. He stated that due to his mental condition, he performs low management supervisor jobs, and that most of his supervisors do not do their job, making it very stressful for him. He stated that the last time he worked full time was from 2014 to 2015, and that since then he has worked part time jobs. He testified that his longest job was for a little less than a year, working as a security guard, but that other than that he has only been able to work for a few months. He stated that his most recent full-time job was as a security guard, and that for the first six months he was working alone at night, mainly driving around checking that the buildings were secure. He stated that it was very low stress and easy because he did not have to deal with a lot of people but that his boss realized he was doing such a good job, and moved him to days, even though he did not want to be moved. He stated that had he known they were going to put him on the day schedule he would not have accepted the job because he knew it would be too much. He stated that he tried to keep the security job, but his body is still recovering. He stated that he has had 12 different jobs within the last 13 years, five since 2017. The Veteran stated that he is trying to find any job that he thinks he can mentally and physically handle and that they are willing to hire him, but that nothing has been working out. The Veteran stated that he received his computer engineering degree and that if he had wanted to travel nationwide or even internationally, he could have had several other jobs, but that he did not want to travel. He also testified as to difficulty with finding a job in his field because he has been out of the field for more than six months and would need a second degree or certificate. The Veteran stated that prior to his shoulder surgery he could not lift anything, but that now it has improved. He stated that he does not think that he can hold down a full-time job, nothing that he would not be able to handle it mentally or physically. He stated that he does not think part-time work is possible and stated that he could try but did not think he would be successful. The Veteran stated that mentally it is a stress of dealing with people not doing their jobs, and that physically, standing too long each day, his back steadily worsened. He also reported difficulties with performing as a cashier, scanning groceries, lifting 24 pack cases of soda, and moving them across the scanner day after day, and that with all of the heavy stuff his shoulder slowly goes out, followed by his knee and ankle. He stated that repetitive actions and laborious work causes his body to give out at a certain point and that it is tiring to deal with all of his issues. While the Veteran contends that his service-connected disabilities preclude him from securing and following any substantially gainful employment, the evidence does not support a finding that he is incapable of maintaining all forms of gainful employment consistent with his work history and level of education. While the evidence discussed above shows that many of the Veteran's physical disabilities do impact his ability to work, it does not show that he is so limited by his mental health conditions so as to preclude all forms of employment, including sedentary work in information technology (IT) given his computer engineering skills. The examiners' descriptions of the impairment caused by the Veteran's service-connected disabilities are consistent with the currently assigned ratings, and even with all of the symptoms considered together, the overall disability picture does not suggest that he is incapable of working in certain environments. Although no examiner has considered the Veteran's overall functional impairment due to the combined effects of all of his service-connected disabilities, the Board has done so, and finds that even when the combined effects are considered, the preponderance of the evidence is against the claim. There is no doubt that the Veteran's various disabilities may make employment difficult at times, but his service-connected disabilities, as a whole, do not render the Veteran completely incapable of performing the duties necessary to maintain gainful employment. Notably, the ultimate question of whether a Veteran is capable of substantial gainful employment is an adjudicatory determination, not a medical one. See Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013). The Veteran's disabilities for which service connection has been established are listed above, and by the assigned schedular rating, he has been compensated for the symptomatology associated with those disabilities. Thus, impairment of industrial capacity due to service-connected disabilities has already been taken into consideration via the disability ratings assigned. While the evidence does indicate that the Veteran's service-connected disabilities limit his performance of physical acts required by employment, the evidence does not show that he is incapable of performing the mental acts required by employment. The record shows that his service-connected disabilities have had some effect on his employment, namely physical or labor-intensive employment; however, it does not indicate that any single disability or combination of disabilities results in total unemployability. The Veteran's physical conditions, while placing limitations on physical employment, do not preclude him from securing or maintaining a substantially gainful occupation consistent with his work history, training, and education, including his computer engineering degree. Many of the listed limitations might necessitate reasonable accommodations for the Veteran but do not completely preclude all types of employment. At times, the Veteran has asserted difficulty getting along with others in the workplace; however, review of the record reveals that the Veteran, at other times, has reported no difficulties with co-workers. Regardless, there is nothing to indicate that the Veteran is incapable of obtaining or maintaining gainful employment in a setting that would allow the Veteran to work alone in a position that would not require him to lift above shoulder level, lift heavy things, stand or sit for extended periods of time without breaks, or which would not accommodate his physical disabilities. In addition, the Veteran has indicated that possible employment exists but asserted that he is unable to find suitable employment in the location where he resides. The Board notes, however, that a determination of TDIU is based, not on location, but rather on the effect that his service-connected disabilities have on his employment. As noted above, the crucial inquiry in determining whether the Veteran is entitled to TDIU is not whether the Veteran is able to pursue his profession of choice, or indeed any particular job. Instead, the Board must inquire as to whether the Veteran can secure and follow a substantially gainful occupation in a more general sense. See Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). (Continued on the next page) Based on a review of all of the evidence of record as to the extent of functional loss, the Board finds that the preponderance of evidence shows that the Veteran's service-connected disabilities, without consideration of non-service-connected disabilities, do not render him unable to engage in all forms of substantially gainful employment, consistent with his work experience, training, and education level. The preponderance of the evidence is against this claim for entitlement to TDIU. There is no reasonable doubt to be resolved, and the appeal must be denied. 38 U.S.C. § 5107(b), 38 C.F.R. § 3.102. L. B. CRYAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A.L. 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.