Citation Nr: 21052813 Decision Date: 08/26/21 Archive Date: 08/26/21 DOCKET NO. 10-32 295 DATE: August 26, 2021 ORDER Entitlement to a total disability evaluation based on individual unemployability (TDIU) due to service-connected disabilities on a schedular or extraschedular basis prior to May 6, 2019 is denied. Entitlement to a total disability evaluation based on individual unemployability (TDIU) due to service-connected disabilities from May 6, 2019 is considered moot. FINDINGS OF FACT 1. The evidence of record does not show that the Veteran's service-connected disabilities alone preclude him from obtaining or maintaining substantially gainful employment consistent with his level of education and work history on a schedular or extraschedular basis prior to May 6, 2019. 2. The Veteran's coronary artery disease is rated at 100 percent on a schedular basis as of May 6, 2019, and the Veteran has already been awarded special monthly compensation (SMC) pursuant to 38 U.S.C. § 1114(s) from May 6, 2019 forward. CONCLUSIONS OF LAW 1. The criteria for entitlement to a TDIU prior to May 6, 2019 have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.340, 3.341, 4.3, 4.16, 4.19 (2020).The issue of entitlement to a TDIU from May 6, 2019 is moot. 38 U.S.C. § 7105 (2012); Bradley v. Peake, 22 Vet. App. 280 (2008). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1966 to November 1969 and from May 1970 to March 1972. These matters come to the Board of Veterans' Appeals (Board) on appeal from an October 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. By way of background, in that October 2015 rating decision the RO granted service connection for right ankle degenerative arthritis effective February 20, 2009 and rated as 20 percent prior to June 2, 2014 and 10 percent thereafter; and service connection for a left knee replacement rated as 30 percent effective February 20, 2009. The Veteran filed a timely notice of disagreement (NOD) in response to the October 2015 rating decision, seeing higher ratings than initially awarded. This appeal was originally certified to the Board with two additional issues: an earlier effective date for service connection for each the right ankle degenerative arthritis and a left knee replacement. However, in a December 2016 rating decision, the RO granted entitlement to earlier effective date for service connection for right ankle degenerative arthritis and left knee replacement, each now effective from January 2, 2004. As such, the issues are no longer in appellate status before the Board. Grantham v. Brown, 114 F.3d 1156, 1159 (Fed. Cir. 1997). The Board remanded the issues on appeal for additional development in January 2018 and November 2020. The directives having been substantially complied with, the matter again is before the Board. D'Aries v. Peake, 22 Vet. App. 97, 105 (2008); Stegall v. West, 11 Vet. App. 268 (1998). The Veteran testified in a Board video hearing before the undersigned Veterans Law Judge (VLJ) in September 2020. A transcript of the hearing is of record. The Board notes a Privacy Act request from the Veteran's representative dated June 11, 2019, requesting a portion of the Veteran's records to assist in the appeal. VA responded to that request with written correspondence to the Veteran dated July 29, 2019 with the requested records, satisfying that request in full. As such, the Board will proceed with the adjudication of the Veteran's appeal. When a Veteran files a claim for an increased rating, he is presumed to be seeking the maximum benefit under any applicable theory, including TDIU. See generally Roberson v. Principi, 251 F.3d 1378 (Fed. Cir. 2001); Rice v. Shinseki, 22 Vet. App. 447 (2009). In light of this principle, entitlement to special monthly compensation (SMC) has been found to be an inferable issue anytime a veteran is requesting increased benefits. Akles v. Derwinski, 1 Vet. App. 118 (1991). In this case, TDIU is part of this claim and will be discussed below. Also, in a January 2021 rating decision, SMC housebound was granted, effective May 6, 2019. There is no further lay or medical evidence the Veteran requires aid and attendance, or that his disabilities result in loss of use of a limb or blindness. 38 U.S.C. §§ 1114(s), (l), (k); 38 C.F.R. § 3.350(a), (b), (i). As such, the Board will not infer the issue of further entitlement to SMC at this time. Veterans Claims Assistance Act of 2000 (VCAA) The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5107 (2012); 38 C.F.R. § §§ 3.102, 3.156(a), 3.159, 3.326(a) (2020). The Board notes the complaints of the adequacy of the VA examinations by the Veteran's representative, especially the June 2018 examination that was performed by a nurse practitioner. The Veteran's representative asserted in her attorney brief that the Veteran should be examined only by a board-certified orthopedic surgeon given the nature of his disabilities. Where VA provides the veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Factors to consider in determining whether an examination is adequate include a review of the medical history, subjective complaints, clinical findings/tests, clear diagnosis, an opinion, and a basis for the opinion. However, "[t]he Board is entitled to assume the competence of a VA examiner." Cox v. Nicholson, 20 Vet. App. 563, 569 (2007); see also Sickels v. Shinseki, 643 F.3d 1362 (Fed. Cir. 2011) (holding that the Board is entitled to presume the competence of a VA examiner and the adequacy of his opinion). "We have never required, nor do we intend to do so here, that medical examinations under section 5103A only be conducted by physicians." See Cox v. Nicholson, 20 Vet. App. 563, 568 (2007) (citing Goss v. Brown, 9 Vet. App. 109, 114 (1996) (upholding VA nurses' statements regarding medical nexus as well-grounded medical evidence) and Williams v. Brown, 4. Vet. App. 270, 273 (1993) (finding opinions of a VA registered nurse therapist to be competent medical evidence)). With regard to nurse practitioners, the Court noted in Cox v. Nicholson, 20 Vet. App. 563, 568 (2007), that, because of their medical education and training, they "fit[] squarely into the requirement of § 3.159(a)(1) as one competent to provide diagnoses, statements, or opinions." The Board notes the complaints and assertions of the Veteran's representative but finds the VA's choice of examiner to be acceptable for the purposes of the examinations afforded. The Veteran in this case has not referred to any other deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015, cert. denied, U.S.C. Oct. 3, 2016) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board"); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to an appellant's failure to raise a duty to assist argument before the Board). The Board has reviewed all of the evidence in the Veteran's claims file. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-130 (2000). Total Disability Evaluation Based On Individual Unemployability (TDIU) It is the established policy of the Department of Veterans Affairs that all veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 4.16. A total disability exists where there is any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Generally, TDIU is awarded on a schedular basis, which requires that, if there is only one such disability, this disability shall be ratable at 60 percent or more, and that, if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more, and sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). Legal Standards A total disability rating may be assigned, where the schedular rating is less than total, when it is found that the disabled person is unable to secure or follow a substantially gainful occupation as the result of service-connected disabilities. See 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. Consideration may be given to a veteran's level of education, special training, and previous work experience in arriving at a conclusion, but not to his age or the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19; see also Todd v. McDonald, 27 Vet. App. 79, 85-86 (2014). To qualify for a total rating for compensation purposes, the evidence must show: (1) a single disability rated as 100 percent disabling; or (2) that the veteran is unable to secure or follow a substantially gainful occupation as a result of his service-connected disabilities and there is one disability ratable at 60 percent or more, or, if more than one disability, at least one disability ratable at 40 percent or more and a combined disability rating of 70 percent. 38 C.F.R. § 4.16(a). For the purpose of establishing one 60 percent disability, or one 40 percent disability in combination, disabilities affecting a single body system are considered as one disability. Id. Disabilities that are not service connected cannot serve as a basis for a total disability rating. 38 C.F.R. §§ 3.341, 4.19. Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, "entitlement to TDIU is based on an individual's particular circumstance." Rice v. Shinseki, 22 Vet. App. 447, 452 (2009) (quoting Thun v. Peake, 22 Vet. App. 111, 116 (2008)); see also Todd, 27 Vet. App. at 85-86. Therefore, in adjudicating a TDIU claim, VA must take into account the individual veteran's education, training, and work history. Hatlestad v. Derwinski, 1 Vet. App. 164, 168 (1991) (level of education is a factor in deciding employability); see Friscia v. Brown, 7 Vet. App. 294 (1994) (considering veteran's experience as a pilot, his training in business administration and computer programming, and his history of obtaining and losing 19 jobs in the previous 18 years); Beaty v. Brown, 6 Vet. App. 532 (1994) (considering veteran's 8th grade education and sole occupation as a farmer); Moore v. Derwinski, 1 Vet. App. 356 (1991) (considering veteran's master degree in education and his part-time work as a tutor). When considering a TDIU, the overriding issue is unemployability, not unemployment. The sole fact that a veteran is unemployed for non-service- connected reasons, or has difficulty obtaining employment because of economic circumstances, is not enough for a TDIU grant. A high schedular rating, in itself, is recognition that the impairment makes it difficult to obtain and retain employment. The question is whether the veteran is capable of performing the physical and mental acts required by employment, not whether the veteran can, in fact, find employment. See 38 C.F.R. §§ 4.1, 4.15. As noted, the Veteran's service-connected disabilities, alone, must be sufficiently severe to produce unemployability. Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). In determining whether unemployability exists, consideration may be given to the Veteran's level of education, special training, and previous work experience, but not to his age or to any impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. The Veteran's employment history, his educational and vocational attainment, and his particular disabilities are to be considered in making a determination on unemployability. The VA General Counsel has concluded that VA regulations generally provide that veterans who, in light of their individual circumstances, but without regard to age, are unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities shall be rated as totally disabled, without regard to whether an average person would be rendered unemployable by such circumstances. Thus, the criteria include a subjective standard. It was also held that unemployability is synonymous with the inability to secure and follow a substantially gainful occupation. VAOPGCPREC 75-91 (1991). "Substantially gainful employment" contains economic and noneconomic components; 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," while the noneconomic component requires consideration of a veteran's ability to secure or follow that type of employment. Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). In determining whether a veteran can secure and follow a substantially gainful occupation, attention must be given to: the veteran's history, education, skill, and training; whether the veteran has the physical ability (both exertional and nonexertional) to perform the type of activities (e.g., sedentary, light, medium, heavy, or very heavy) required by the occupation at issue. Factors that may be relevant include, but are not limited to, the veteran's limitations, if any, concerning lifting, bending, sitting, standing, walking, climbing, grasping, typing, and reaching, 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. Factors that may be relevant include, but are not limited to, the veteran's limitations, if any, concerning memory, concentration, ability to adapt to change, handle workplace stress, get along with coworkers, and demonstrate reliability and productivity. Ray, 31 Vet. App. at 73-74. As noted above, in determining whether the veteran is entitled to individual unemployability, neither his non-service-connected disabilities nor his advancing age may be considered. Van Hoose v. Brown, 4 Vet. App. 361 (1993). Thus, in deciding the claim, the Board may not favorably consider the effects of the non-service-connected disabilities with respect to their degree of interference with his employability. Indeed, the Court stated that in order for a veteran to prevail on a claim for TDIU, the record must reflect some factor which takes his case outside of the norm. The sole fact that he is unemployed or has difficulty obtaining employment is not enough. The question is whether the veteran is capable of performing the physical and mental acts required by employment, not whether he can find employment. See Van Hoose v. Brown, supra. If total industrial impairment has not been shown, the VA is not obligated to show that a veteran is incapable of performing specific jobs in considering a claim for a total rating based on individual unemployability. See Gary v. Brown, 7 Vet. App. 229 (1994). A high rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether a veteran is capable of performing the physical and mental acts required by employment, not whether a veteran can find employment. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in a veteran's favor. 38 C.F.R. § 4.3. As noted, consideration may not be given to the impairment caused by non-service-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. However, when it is not possible to separate the effects of a non-service-connected condition from those of a service-connected disorder, reasonable doubt should be resolved in the claimant's favor with regard to the question of whether certain signs and symptoms can be attributed to the service-connected disability. Mittleider v. West, 11 Vet. App. 181, 182 (1998); see also 38 C.F.R. § 3.10. Under applicable criteria, VA shall consider all lay and medical evidence of record in a case with respect to benefits under laws administered by VA. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); see also Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Schedular TDIU A total disability rating for individual unemployability may be granted where the schedular rating is less than total and the service-connected disabilities preclude the veteran from obtaining or maintaining substantially gainful employment consistent with his education and occupational experience. 38 C.F.R. §§ 3.340, 3.341, 4.16. If there is only one such disability, it must be rated at 60 percent or more, and if there are two or more disabilities, there shall be at least one disability rated at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent. 38 C.F.R. § 4.16(a). Service connection has been previously established for coronary artery disease, rated at 30 percent disabling from August 14, 2012 to May 6, 2019, and 100 percent disabling from May 6, 2019 forward. The Veteran is also rated for left knee disability at 30 percent disabling from January 2, 2004, exclusive of a period of temporary total evaluation; diabetes mellitus at 20 percent disabling from August 14, 2012; right ankle degenerative arthritis at 20 percent disabling from January 2, 2004; and a noncompensable rating for left knee surgical scar. With bilateral factor included in the calculation, the Veteran has an overall 50 percent combined rating from January 2, 2004 to August 14, 2012; an overall 70 percent combined rating (but with no single disability 40 percent or greater) from August 14, 2012 to May 6, 2019, and an overall 100 percent combined rating from May 6, 2019 forward. Thus, the Veteran does not meet the minimum schedular requirements for a TDIU under 38 C.F.R. § 4.16(a) prior to May 6, 2019, due to the lack of a single disability at 60 percent or more, or a combined 70 percent overall with at least one disability at 40 percent or more. The possibility of a TDIU after May 6, 2019 will be discussed further below. Consequently, a TDIU rating on a schedular basis under 38 C.F.R. § 4.16(a) prior to May 6, 2019 is not warranted. See Sabonis v. Brown, 6 Vet. App. 426 (1994). Extraschedular TDIU If the above percentage thresholds are not met, the Veteran's claim may still be referred to the Director, Compensation Service for consideration of an extraschedular rating, when the evidence of record shows that Veteran is "unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities." 38 C.F.R. § 4.16(b); Fanning v. Brown, 4 Vet. App. 225, 229 (1993). However, as the Board does not have the authority to assign an extraschedular TDIU in the first instance, referral to the Director, Compensation Service, for consideration of entitlement to a TDIU was warranted and remanded to the RO in an April 2019 Board decision and remand. Bowling v. Principi, 15 Vet. App. 1 (2001). For the TDIU claim, the Veteran has an overall 50 percent combined rating from January 2, 2004 to August 14, 2012; and an overall 70 percent combined rating (but with no single disability 40 percent or greater) from August 14, 2012 to May 6, 2019, with the primary disabilities being coronary artery disease along with knee and ankle disabilities. The Board notes that it is precluded from an assigning an extraschedular rating in the first instance, as previously discussed. See Kellar v. Brown, 6 Vet. App. 157, 162 (1994). The Board previously remanded in November 2020 for an opinion regarding extraschedular consideration of a TDIU from the Director, Compensation Service. Colayong v. West, 12 Vet. App. 524, 537 (1999); see Bagwell v. Derwinski, 9 Vet. App. 337, 339 (1996). VA's Director, Compensation Service, provided a negative advisory opinion dated February 5, 2021. 38 C.F.R. § 4.16(b). The Director noted the Veteran last worked as a mechanic for a state public works authority and retired in 2005. The Social Security Administration noted the Veteran was disabled due to his back and diabetes mellitus disabilities at the time. The overall medical evidence indicated the Veteran has difficulties with prolonged standing or walking, as well as crawling, kneeling, or repetitive bending. However, these examiners also indicated the Veteran was able to work with certain restrictions. The Veteran's coronary artery disease prevented participation in strenuous activities. While the Director stated the Veteran's service-connected disabilities do cause functional limitations, the preponderance of the evidence does not show the Veteran is unable to obtain or maintain gainful employment due to his service-connected conditions. The Director concluded her negative opinion by stating that the overall evidence fails to support the contention that any of the service-connected disabilities or a combination of the effects of those disabilities prevents employment. However, the Board is not bound by any determination of the Director. Anderson v. Shinseki, 22 Vet. App. 423 (2009). Additionally, the ultimate responsibility for determining the effects of disabilities on the question of employability rests with the adjudicator and not a medical examiner. See Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013). As noted by the Director, a high rating in itself recognizes that the impairment makes it difficult to obtain and keep employment. Further, the ultimate question is whether the Veteran, because of service-connected disabilities, is incapable of performing the physical and mental acts required by employment, not whether or not he can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). As noted in Withers v. Wilkie, 30 Vet. App. 139 (2018), Geib v. Shinseki, 733 F.3d 1350 (Fed. Cir. 2013), et al, the finding of an ability to work is not a medical determination, but is a legal determination made on a case-by-case basis. This decision is based on a review of medical and lay evidence presented in light of each veterans' education, training, and work history. Careful consideration has been given to all of these facets. See also Pederson v. McDonald, 27 Vet. App. 276 (2015) and Ray v. Wilkie, Mar 14, 2019, 31 Vet. App. 58 (2019). As noted in Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) the Federal Circuit has held while the entire evidence record must be reviewed, there is no need to discuss each piece of evidence. In this case, after giving consideration to all relevant evidence; including, but not limited to the Veteran's education, training, and work history, the Director of Compensation Service has determined the overall evidence fails to support the contention that any of the service-connected disabilities or a combination of the effects of those disabilities support an exceptional situation that prevented gainful employment. To establish a total disability rating based on individual unemployability, there must be impairment so severe that it is impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. In reaching such a determination, the central inquiry is whether the claimant's service-connected disabilities alone are of sufficient severity to produce unemployability. Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation; provided that permanent total disability shall be taken to exist when the impairment is reasonably certain to continue throughout the life of the disabled person. 38 C.F.R. § 4.15. For a Veteran to prevail on a claim for a total compensation rating based on individual unemployability, the record must reflect some factor, which takes this case outside the norm. The sole fact that a Veteran is unemployed or has difficulty obtaining employment is not enough. A high rating in itself is recognition that the impairment makes it difficult to obtain or keep employment, but the ultimate question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether the Veteran can find employment. Van Hoose v. Brown, 4 Vet. App. 361 (1993). The Board notes the statements of the Veteran and his representative regarding his award of Social Security Administration (SSA) disability in 2005, based on a July 2004 decision, for his back and diabetes disabilities at the time, and attempted to obtain those Social Security medical records. However, SSA responded in May 2019 that the Veteran's Social Security medical records had been destroyed and were unobtainable. See Golz v. Shinseki, 590 F.3d 1317 (Fed. Cir. 2010); Murincsak v. Derwinski, 2 Vet. App. 363 (1992). The Veteran's examinations for his orthopedic disabilities, namely the service-connected left knee and right ankle, both show limitations of motion with pain on motion which would affect the Veteran's ability to walk or stand for prolonged periods of time. The Veteran is service-connected for diabetes mellitus, type II, and his medical records show the use of insulin is required and his diet is restricted. However, multiple records from both private and VA sources in January 2013, January 2014, October 2014, and June 2016 do not indicate that any regulation of activities is required. The Veteran's coronary artery disease, first service-connected in 2012, was treated primarily in private medical facilities. Multiple medical records from both private and VA sources indicate the Veteran's level of disability was greater than 5 metabolic equivalents (METs) but not greater than 7 METs, resulting in dyspnea, fatigue, angina, dizziness, or syncope. Not until May 6, 2019 did medical evidence indicate worsening of the Veteran's coronary artery disease, where submitted medical records indicated 3 METs or less, which resulted in the increased rating to 100 percent effective from that date. The Veteran submitted a VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability. The Veteran claimed that his left knee, right ankle, and ischemic heart disease prevented him from securing or following any substantially gainful occupation, and that he last worked in 2005. The Veteran noted he had four years of high school, but no further college-level or other training. The Veteran provided no additional remarks. The Veteran, through his representative, submitted a private vocational consultant's opinion in January 2021 regarding his potential to work. This opinion noted the Veteran's left knee, right ankle, and coronary heart disease disabilities as the present reason for unemployability, but also opined that that the 2004 SSA finding regarding the Veteran's unemployability should be determinative in the VA's consideration of the Veteran's TDIU claim. This writer did note he factored in the Veteran's age and all disabilities into his opinion, and that the Veteran could not therefore return to his previous relevant work. The opinion recommended that the Veteran's TDIU be granted back to the same date as the Social Security Administration's finding of disability, which was July 28, 2004. 1. Entitlement to a total disability evaluation based on individual unemployability (TDIU) on a schedular or extraschedular basis prior to May 6, 2019 The Board finds the medical and other evidence of record does not show the Veteran is precluded from securing and following gainful employment by his service-connected disabilities prior to May 6, 2019. To establish a total disability rating based on individual unemployability, there must be impairment so severe from service-connected disabilities that it is impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Service connection has been previously established for coronary artery disease, rated at 30 percent disabling from August 14, 2012 to May 6, 2019, and 100 percent disabling from May 6, 2019 forward. The Veteran is also rated for left knee disability at 30 percent disabling from January 2, 2004, exclusive of a period of temporary total evaluation; diabetes mellitus at 20 percent disabling from August 14, 2012; right ankle degenerative arthritis at 20 percent disabling from January 2, 2004; and a noncompensable rating for left knee surgical scar. With bilateral factor included in the calculation, the Veteran has an overall 50 percent combined rating from January 2, 2004 to August 14, 2012; an overall 70 percent combined rating (but with no single disability 40 percent or greater) from August 14, 2012 to May 6, 2019, and an overall 100 percent combined rating from May 6, 2019 forward. The Veteran therefore does not have a combined evaluation of at least 70 percent with at least a single disability rated 40 percent or higher, and no single disability at 60 percent or greater prior May 6, 2019. The Board acknowledges the Veteran's statements and that of his representative that he was unable to work after 2005, and that he receives an award of Social Security disability from that time. The Board also notes that the Director, Compensation Service opined in February 2021 that the Veteran's service-connected disabilities did not preclude seeking and maintaining gainful employment prior to May 6, 2019. As noted, consideration may not be given to the impairment caused by non-service-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19. It is undisputed that the Veteran's service-connected coronary artery disease, left knee, and right ankle disabilities prior to May 6, 2019 resulted in at least some functional impairment, which could make it more difficult to find employment. However, such interference is contemplated in the assigned ratings for the Veteran's service-connected disability, and the evidence of record does not demonstrate that his service-connected disability result in unemployability in the appeal period on either a schedular or extraschedular basis prior to May 6, 2019. The Board notes and acknowledges the limitations of the Veteran's diagnosed sleep apnea, hepatitis C, kidney insufficiency, hypothyroidism, and low back pain. However, those disabilities are not service-connected. In determining whether unemployability exists, consideration may be given to the Veteran's level of education, special training, and previous work experience, but not to his age or to any impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19; see Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). While not binding on the Board, the Board notes with great probative weight the negative opinion regarding entitlement to a TDIU from the Director, Compensation Service, as discussed above. See Bloom v. West, 12 Vet. App. 185, 187 (1999); Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998); see also Claiborne v. Nicholson, 19 Vet. App. 181, 186 (2005). The Veteran's service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue have been addressed. 38 C.F.R. § 4.16(b). Thus, the evidence of record does not demonstrate that the service-connected disabilities alone render the Veteran unemployable prior to May 6, 2019. The Board notes and acknowledges the limitations of the Veteran's other diagnosed conditions. However, those other physical disabilities are not service-connected, and are thus not pertinent to the Veteran's claim for a TDIU. In determining whether unemployability exists, consideration may be given to the Veteran's level of education, special training, and previous work experience, but not to his age or to any impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19; see Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). Under these circumstances, the Board concludes that schedular or extraschedular TDIU prior to May 6, 2019 is not warranted. Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). 2. Entitlement to a total disability evaluation based on individual unemployability (TDIU) on a schedular or extraschedular basis from May 6, 2019 TDIU was inferred as an issue for this Veteran in a September 2015 Board remand, pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009). TDIU remained appellate status as other claims of this Veteran were adjudicated and remanded over time, until the RO's July 2019 rating decision, which granted an increased rating for coronary artery disease with a 100 percent evaluation effective from May 6, 2019. Here, the Board notes the Veteran has a 100 percent evaluation for his service-connected coronary artery disease, effective since May 6, 2019, with additional service-connected disabilities for his left knee, right ankle, and diabetes. The Veteran also has a noncompensable rating for a scar related to his left knee disability. In some cases, but not all, the assignment of a total schedular rating renders a TDIU claim moot. See Bradley v. Peake, 22 Vet. App. 280, 294 (2008); see also Buie v. Shinseki, 24 Vet. App. 242, 250 (2010). Although no additional disability compensation may be paid when a total schedular disability rating is already in effect, the United States Court of Appeals for Veterans Claims (Court) decision in Bradley recognizes that a separate award of a TDIU predicated on a single disability may form the basis for an award of special monthly compensation (SMC). SMC pursuant to 38 U.S.C. § 1114(s), what is referred to as SMC(s) or SMC housebound, may be warranted in addition to his regular compensation if the Veteran has a total disability rating for a single disability, and additional service-connected disability or disabilities rated at 60 percent or more. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i); (emphasis added.) The total rating for the single disability for SMC purposes may be schedular, or may be based on TDIU, so long as TDIU was granted solely because of that single disability. Id. The Board notes the Veteran has already been awarded SMC housebound effective from May 6, 2019 in a January 2021 rating decision. Here, the Board notes the Veteran's service-connected disabilities beyond his coronary artery disease, to include the left knee, right ankle, diabetes mellitus, and a left knee scar, which add up to 70 percent in additional disability. VA medical records show that the Veteran's coronary artery disease results in 100 percent disability from May 6, 2019. The Board notes that while SMC is conceivably available for a Veteran with a single service-connected disability rated at 100 percent and additional, separate, disabilities independently ratable at 60 percent. 38 U.S.C. § 1114(s); 38 C.F.R. § 3.350(i). Here, the Veteran has been awarded SMC housebound pursuant to his service-connected disabilities effective from May 6, 2019, and no such award is available from an earlier date. Here, to award a separate TDIU rating, in addition to the schedular 100 percent rating based on the Veteran's service-connected coronary artery disease, would result in duplicate counting of disabilities. 38 C.F.R. § 4.14. As such, entitlement to a TDIU is moot for the period after May 6, 2019, the effective date for the Veteran's coronary artery disease. See Bradley v. Peake, 22 Vet. App. 280, 293-4 (2008); Sabonis v. Brown, 6 Vet. App. 426 (1994). Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 36970 (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). MICHAEL A. PAPPAS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Setter, 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.