Citation Nr: 23014644 Decision Date: 03/10/23 Archive Date: 03/10/23 DOCKET NO. 18-09 847 DATE: March 10, 2023 ORDER Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) prior to January 26, 2011, not including periods of temporary total rating, is denied. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) from January 26, 2011, and to prior to September 12, 2012, is granted. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) as of September 12, 2012, not including periods of temporary total rating, is denied. FINDINGS OF FACT 1. The service-connected disabilities did not preclude substantially gainful employment prior to January 26, 2011. 2. Resolving reasonable doubt in favor of the Veteran, the service-connected disabilities precluded substantially gainful employment from January 26, 2011, and prior to prior to September 12, 2012. 3. The service-connected disabilities did not preclude substantially gainful employment as of September 12, 2012. CONCLUSIONS OF LAW 1. The criteria for entitlement to TDIU prior to January 26, 2011, have not been met. 38 U.S.C. § 1155; 38C.F.R. §4.16(a). 2. The criteria for entitlement to TDIU from January 26, 2011, and prior to September 12, 2012, have been met. 38 U.S.C. § 1155; 38C.F.R. §4.16(a). 3. The criteria for entitlement to TDIU as of September 12, 2012, have not been met. 38 U.S.C. § 1155; 38C.F.R. §4.16(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1981 to January 1988. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision issued by Regional Office (RO) of the Department of Veterans Affairs (VA). In November 2020, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. In July 2021 and March 2022, the Board remanded this claim for additional development. The Board finds that there has been substantial compliance with the remand requests. Stegall v. West, 11 Vet. App. 268 (1998). TDIU 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. 38 C.F.R. § 3.340. If the total rating is based on a disability or combination of disabilities for which the Schedule for Rating Disabilities provides a rating of less than 100 percent, it must be determined that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age. 38 C.F.R. § 3.341. In evaluating total disability, full consideration must be given to unusual physical or mental effects in individual cases, to peculiar effects of occupational activities, to defects in physical or mental endowment preventing the usual amount of success in overcoming the handicap of disability and to the effects of combinations of disability. 38 C.F.R. § 4.15. The crucial inquiry for the Board is not whether the Veteran is able to pursue a profession of choice, or 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. Van Hoose v. Brown, 4 Vet. App. 361 (1993). The fact that a Veteran is unemployed is not enough. It must be determined that the service-connected disabilities, without regard to advancing age make the Veteran incapable of performing the acts required by employment. The applicable regulations place responsibility for the ultimate TDIU determination on VA, not a medical examiner. Geib v. Shinseki, 733 F.3d 1350 (Fed. Cir. 2013). Whether a Veteran could perform the physical and mental acts required by employment at a given time is an issue about which a lay person may provide competent evidence. If the schedular rating is less than total, a total disability rating can be assigned based on individual unemployability if the Veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disability, provided that the Veteran has one service-connected disability rated 60 percent or higher; or two or more service-connected disabilities, with one disability rated 40 percent or higher and the combined rating is 70 percent or higher. 38 C.F.R. § 4.16(a). For the purpose of one 60 percent disability, or one 40 percent disability in combination, the following will be considered as one 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, such as orthopedic, digestive, respiratory, cardiovascular-renal neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. It is provided further that the existence or degree of non-service-connected disabilities or previous unemployability status will be disregarded where the percentages referred to in this paragraph for the service-connected disability or disabilities are met and in the judgment of the rating agency such service-connected disabilities render the Veteran unemployable. The term substantially gainful occupation is not defined in the rating schedule. The phrase has two components, economic and noneconomic. In assessing the Veteran's ability to secure and follow a substantially gainful occupation, the Board is to consider the Veteran's history, education, skill, and training, and physical abilities and mental abilities required. Such specific physical ability-factors include lifting, bending, sitting, standing, walking, climbing, grasping, typing, reaching, auditory, and visual. Specific mental ability-factors include memory, concentration, ability to adapt to change, handle work-place stress, getting along with coworkers, and demonstrating reliability and productivity. Ray v. Wilkie 31 Vet. App. 58 (2019). The central inquiry is whether the service-connected disabilities alone are of sufficient severity to produce unemployability. Hatlestad v. Brown, 5 Vet. App. 524 (1993). Consideration may be given to the Veteran's level of education, special training, and previous work experience when arriving at a conclusion, but factors such as age or impairment caused by nonservice-connected disabilities are not to be considered. 38 C.F.R. §§ 3.341, 4.16, 4.19. Turning to the evidence of record, a November 1996 record shows that the Veteran reported that she had completed high school and one year of college and had clerical and computer training. In January 2000, the Veteran reported that she was unemployed and stated that she "really d[idn't] want to work." In August 2000, the Veteran stated that she was returning to school. In June 2001, she reported doing well in school and stated that she was training at a VA medical center. In November 2005, the Veteran reported that she was unemployed but planned to start a new job with the Census Bureau in January 2006. In December 2005, a medical professional stated that the Veteran's challenges to employment were a history of drug additions, lack of marketable skills, sporadic work history, and lack of recent work history. It was noted that the Veteran was motivated to secure gainful employment and liked working with people. In October 2007, the Veteran report that she was back in school. July 2008 Social Security Administration (SSA) records show that the Veteran applied for benefits due to the inability to work caused substance abuse and a psychiatric disability. A mental status examination diagnosed mild depression with frequent mood variability. The examiner stated that although the Veteran seemed to be more stable than she was at CPD, the doctor rated the beneficiary's ability to withstand work stress to be markedly impaired by mood swings. The doctor stated that would interfere with maintaining the routine structure of regular employment. In March 2010, the Veteran reported that chronic back pain had started to have an impact on her life. The Veteran was not on any medication for pain and declined medication in March 2010. A January 2011 VA medical record shows that the Veteran reported that back pain had improved. However, for the past week she had been unable to get comfortable due to back pain and left sided buttock and sciatica pain. The Veteran reported pain with sitting or standing for any time for longer than 20 minutes. The Veteran stated that she wanted to work, but activity increased back pain. The Veteran stated that the prescribed pain medications helped temporarily, but she did not want to be dependent on chemicals. A February 2011 medical record shows that use of assistive devices, to include a cane. The Veteran was prescribed Vicodin in June 2011. The Veteran reported left side weakness and numbness which caused her to fall. The doctor noted that the Veteran had not been monitoring her blood pressure or blood sugar levels. A September 2011 record shows a refill Vicodin for six months. The Veteran was encouraged to take Ibuprofen. In October 2011, it was noted that the Veteran resided alone, functioned independently in activities of daily living, ambulated with a walker and a cane, and used an elevated toilet. The Veteran reported that she used crack and took more pain pills than prescribed to cope with back pain. She stated that her primary concern at that time was to deal with diabetes and a heart condition. In October 2011, the Veteran submitted VA 21-8940, Veterans Application for Increased Compensation Based on Unemployability, stating that service-connected disabilities of the right foot and back precluded employment. A November 2011 psychiatric record shows that the Veteran reported that she preferred to stay off all psychotropic medications because she was unable to obtain or retain employment. March 2012 medical records show that the Veteran reported pain with sitting, right leg pain and heaviness with movement, and inability to stay in any position for longer than ten minutes. The Veteran reported that she chose to take very little pain medication. The Veteran's doctor opined that the Veteran was unemployable due to the need for chronic pain medication, frequent position changes, and pain level. Additionally, the Veteran's psychiatrist did not "think" the Veteran could work. In May 2012 correspondence to VA, the Veteran requested reconsideration of the denied TDIU claim. The Veteran referenced the March 2012 findings and stated that the back disability prevented her from standing, sitting, and lying down without the use of pain medication. The Veteran stated that the pain medication would prevent any gainful employment because no company would hire her and chance an injury to herself or others in the work force, because the insurance company would increase their rates or drop them altogether. The Veteran stated that the right foot disability caused balance issues and falls. A June 2012 domiciliary admission evaluation note shows that the Veteran had tested positive for cocaine and negative for prescribed opiates for pain. Therefore, the prescription for Vicodin was discontinued in May 2012. The Veteran reported that she had been using crack cocaine every day and denied the use of any other substances. The Veteran reported that drug use affected her job performance. A July 2012 note shows that the Veteran was managing without the use of addictive pain medication. September 2012 mental health records show that the Veteran reported that she volunteered by providing "transportation, grocery shopping, etc." on a weekly to two older individuals. It was noted in October 2012, that the Veteran attend several AA/NA/DD groups each week to support her own sobriety, and she helped to bring a 12-step recovery group to women at a local correctional facility. VA medical records dated from January 2013 to June 2013 show that the Veteran reported sobriety since June 2012. The Veteran reported that she managed pain with prescription medications. The Veteran denied concerns with medication or pain. She reported that she attended classes, participated in groups three to four days a week, and was also involved in activities such as chairing a weekly AA Women's meeting at the Montgomery County jail, chairing two other AA meetings on VA grounds, co-chairing another women's meeting, visiting and assisting two elderly neighbors, spending time with grandchildren and friends, attending church weekly, grocery shopping, and shopping at the mall weekly. The Veteran denied having difficulties participating in those community activities. In a July 2013 notice of disagreement, the Veteran stated that she was unable to work due to pain medication. The Veteran stated that she would not pass any employment drug tests. In September 2013, the Veteran reported that she volunteered daily at a VA Medical Center. A November 2013 record shows that the Veteran was trained as a peer support volunteer and had been the lead in peer support groups. The Veteran also attended a weeklong training to facilitate another group. In December 2013, the Veteran reported that she did not exercise but was able to walk without any difficulty in the grocery store pushing a full grocery cart. At a February 2014 VA examination, the Veteran reported worsening back pain with pain radiating to the thighs. She reported the use of four Vicodin per day and stated that she very much limited her activity so as to not aggravate or exacerbate the back pain. The examiner opined that the back impacted the Veteran's ability to work a job requiring prolonged standing, sitting, walking, and heavy lifting. In March 2014, the Veteran reported that she had had a busy week. She reported that she had driven a veteran to Cincinnati, she helped her aunt who had had knee surgery, and she shopped at all of the local stores of her favorite store which was going out of business. In April 2014, the Veteran stated that she had taken over more babysitting duties. She reported that she did her own shopping, cooking, and cleaning in June 2014. The Veteran reported that she had been getting around well. She stated that she climbed steps into church without any problem and while sitting on the hard pew was not comfortable, she felt great. She stated that she had been walking around the hospital, although using a walker. At an August 2014 group meeting, the Veteran shared that through hard work she was now actively volunteering as a peer support at a VA Medical Center and in the community. She also stated that she was seeking additional peer support training in the community to become a certified peer support through a state. At a February 2015 VA examination, the Veteran reported less back pain since an August 2014 surgery. The Veteran reported that she was doing a lot of volunteer work. The examiner stated that the Veteran was capable of employment requiring medium exertion and was capable of sitting, standing, and walking without restriction. The Veteran was impaired in lifting over 50 pounds. A March 2015 VA examiner stated that the right foot disability did not affect the Veteran's ability to function in an occupational environment. A March 2015 emergency department record shows that the Veteran reported chest pain and pressure. The Veteran stated that initially she was unsure of whether the pain was coming from the back and neck or from the chest. She reported that the pain was relieved with Percocet, which was prescribed for back and shoulder pain. She denied any medication changes and reported taking all of her prescribed medications. The Veteran reported that she was typically very active at home, and able to walk around the mall, and that the pain had only slightly limited her. In April 2015, the Veteran requested sponsorship from vocational rehabilitation for training as a mental health and substance abuse counselor in order to obtain and sustain employment in the field of mental health and substance abuse. A January 2017 medical record shows that the Veteran was prescribed Hydrocodone three times a day for pain. In February 2017, the Veteran reported that she was trying to obtain employment at a VA medical facility. She reported that she was staying busy with volunteer work and babysitting her grandchildren. During an August 2017 mental health consultation, the Veteran reported five years of sobriety. She reported that she continued to volunteer with VA, attended recovery groups regularly, and stayed "busy with all kind of activities during the day." She reported that she took an increased dose of Vicodin, for back and neck pain, twice a day. In an October 2017 statement to VA, the Veteran asserted that she was unable to sit or stand for prolonged periods due to back pain. At a November 2017 VA psychiatric examination, the Veteran reported that she felt depressed all the time and did not want to do anything. The Veteran reported an inconsistent work history since separation from service due to a long-term history of substance abuse. The Veteran stated that using crack cocaine was her job. The Veteran reported that she did volunteer work but had been unable to secure employment. She stated that she wanted to work, had been looking, but had not been hired. She stated that she did not think that she could work because of her background of legal problems and substance abuse, physical issues, and inability to use a computer. The Veteran reported that chronic pain limited the type of employment she could perform. The examiner opined that a psychiatric disability had a moderate impact on social and occupational functioning. A November 2017 rating decision established service connection for adjustment disorder with depressed mood and unspecified bipolar and related disorder by history (claimed as depression), and assigned a 50 percent rating, effective October 10, 2017. During a January 2018 VA examination, the Veteran reported that she was unemployed, last worked in 2016, and was not looking for employment. In June 2018, the Veteran reported that she was starting a new job in July 2018. She reported volunteering for mental health for five years and working as a transportation assistant for 30 days in mental health in 2016. The Veteran reported that she did not anticipate any problem doing her job. The Veteran reported feeling frustrated due to not being able to find a satisfactory job in February 2019. The Veteran reported working part time in June 2019. She reported that she continued to volunteer and attend church. In December 2019, the Veteran was hired as a peer support specialist at a VA Medical Center. She reported that things were going well. June 2020 medical records show that the Veteran reported continued pain, that she walked a lot, and that she liked her new job. In October 2020, the Veteran reported to her pulmonologist that she lived alone, had an active lifestyle, worked full time, and was able to walk a block and up three flights of stairs. At a November 2020 Board hearing, the Veteran testified that she had not worked since 2016. The Veteran stated that she did not think she would be able to work full time because of the service-connected disabilities. The Veteran testified that she was unable to carry groceries and clean her home. She testified that she did not drive. A March 2021 medical report shows that the Veteran reported that she walked for exercise. In April 2021, the Veteran's doctor noted that the Veteran could return to work without any restrictions. The Veteran continued to report that things were going well with work and that she liked her job in May and April 2021 and in February, March, and April 2022. In a September 2022 statement, the Veteran's then representative stated that "the mere ability of the veteran to perform certain tasks does not necessarily meet the regulatory criteria for employability. Even assuming that the veteran can perform certain tasks, the Board should note the pervasiveness of her service-connected disabilities, i.e., neurological disorders, foot disorders and spinal and pelvic conditions. These coupled with her psychiatric conditions are key factors that contraindicate the ability of the veteran to engage in gainful employment." The representative stated that "the operative word in the regulation is "gainful" with respect to employment. We submit that the [V]eteran's service connected physical impairments negate the "gainful" aspect of any employment." 1. Entitlement to TDIU prior to January 26, 2011, not including periods of temporary total rating Service connection is established for pelvic inflammatory disease, rated 10 percent from January 14, 1988, 100 percent from December 20, 1990, 100 percent from February 1991, and 50 percent from August 1, 1991; a psychiatric disability, rated 50 percent from October 2017; a back disability, rated 20 percent from June 24, 2005, 40 percent from January 26, 2011, 100 percent from June 19, 2014, and 40 percent from August 1, 2014; a right foot disability, rated 0 percent from January 1988 and 10 percent from August 11, 2009; right and left lower extremity radiculopathy, each rated 10 percent from January 26, 2011; a painful right foot scar, rated 0 percent from October 31, 2011; a lower abdominal scar, rated 0 percent from June 5, 2012; and a thoracolumbar spine scar, rated 0 percent from June 19, 2014. The combined service-connected disability rating was 10 percent as of January 14, 1988; 100 percent as of December 1990; 50 percent as of August 1, 1991; 60 percent as of June 24, 2005; 80 percent as of January 26, 2011; 100 percent as of June 19, 2014, and prior to August 1, 2014; 80 percent as of August 1, 2014; and 90 percent as of October 10, 2017. The Board finds that the Veteran did not meet the percentage requirements for consideration of entitlement to TDIU prior to January 26, 2011. Specifically, prior to January 26, 2011, the Veteran did not have one service-connected disability rated 60 percent or higher; or two or more service-connected disabilities, with one disability rated 40 percent or higher and the combined rating is 70 percent or higher. 38 C.F.R. § 4.16(a). The Board finds that the persuasive weight of the evidence show does not show that the service-connected disabilities precluded substantially gainful employment prior to January 26, 2011. The Board has considered the economic and noneconomic components of the TDIU claim. Ray v. Wilkie, 31 Vet. App. 58 (2019). The Board has also considered whether a referral to Director of Compensation for consideration of extra-schedular evaluation is warranted under 38 C.F.R. § 4.16(b). Such a referral follows along the same analysis as regular schedular TDIU, with the difference that the Board cannot grant TDIU under 38 C.F.R. § 4.16(b) in the first instance, and rather must refer to the Director of Compensation for consideration. The Board finds that the symptoms of the service-connected disabilities were not reported with the frequency, duration, and severity sufficient to produce unemployability. Bankhead v. Shulkin, 29 Vet. App. 10 (2017). Primarily, the Veteran specifically reported to her doctors and SSA that substance abuse and a psychiatric disability caused unemployability. Prior to January 26, 2011, service connection had not been established for a psychiatric disability and any substance abuse, and those symptoms and limitations cannot be considered in determining whether the service-connected disabilities made the Veteran unemployable. Prior to January 26, 2011, the Veteran completed high school, attended college, participated in several types of training programs to include clerical training, and had experience working as a clerk and in clerical positions. The Board finds that with consideration of the limitation caused by the service-connected disabilities, and the Veteran's education, training, and employment experience shows that the Veteran was capable of a variety of forms of employment that required some degree of physical labor, writing, basic arithmetic, filing, administrative tasks, or other tasks, even considering the physical and mental limitations caused solely by the service-connected disabilities. Withers v. Wilkie, 30 Vet. App. 139 (2018). Even considering the Veteran's physical and mental limitations caused by the service-connected disabilities, to include the use of narcotic pain medication, it cannot be said that the disabilities prevented sedentary work of an unskilled or semi-skilled nature such as driving, inspection, stocking shelves, or light assembly work; or performing cognitive activities such as ordering materials, data entry, scheduling work projects, and maintaining records in a small group or solitary environment. The Board finds that the Veteran could perform the physical and mental acts required by employment. However, prior to January 26, 2011, the Veteran reported that she did not want to work. The Board finds that the evidence does not support a finding that prior to January 26, 2011, the service-connected disabilities prevented the Veteran from securing and following substantially gainful employment considering reasonable accommodations as specified in the Americans with Disabilities Act (ADA). The Board notes that where a veteran's employer is required by law to provide reasonable accommodations pursuant to the ADA and those accommodations allow the veteran to engage in a substantially gainful occupation, a TDIU award would, in effect, constitute a second paycheck on the back of the taxpayer. Cantrell v. Shulkin, 28 Vet. App. 382 (2017). The Board acknowledges that service-connected disabilities caused functional impairment as the assigned ratings are recognition of a level of occupational impairment. However, at no time prior to January 26, 2011, were symptoms and impairments severe or frequent enough to render the Veteran unable to obtain or maintain substantial gainful employment. Further, prior to January 26, 2011, the evidence does not show that the service-connected disabilities individually or combined, to include treatment for the disabilities, presented such an exceptional disability picture, such as marked interference with employment or frequent periods of hospitalization, that the available schedular ratings for the service-connected disabilities were inadequate or impractical for rating the severity of the disabilities. The Board finds that the symptoms, severity, and functional impairment of the service-connected disabilities were fully contemplated in the ratings assigned. Therefore, referral for consideration of the assignment of TDIU pursuant to 38 C.F.R. § 4.16(b) is not warranted. Thun v. Peake, 22 Vet. App. 111 (2008). The Board finds the evidence persuasively weighs against a finding that the service-connected disabilities precluded substantially gainful employment prior to January 26, 2011. Accordingly, as the combined disability rating of the service-connected disabilities did not meet the schedular criteria of 38 C.F.R. § 4.16(a) prior to January 26, 2011, and the persuasive weight of the evidence is against the claim that the service-connected disabilities alone precluded the Veteran from securing and maintaining substantially gainful employment prior to January 26, 2011, referral to VA officials for consideration is not warranted and the claim for TDIU must be denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board finds that the evidence is not in approximate balance and there is no reasonable doubt to resolve in favor of the Veteran. 2. Entitlement to TDIU from January 26, 2011, to prior to September 12, 2012, not including periods of temporary total rating The medical evidence shows that the Veteran took Vicodin for back pain. In May 2012, although the Veteran reported that she took little pain medication, the Veteran's doctor stated that the Veteran was unemployable due to chronic pain medication, frequent position changes, and pain level. The Veteran stated that prescription medication precluded substantially gainful employment. The Veteran did not assert any functional impairment caused by prescribed medication. Instead, the Veteran stated that pain medication would prevent an employer from hiring her because she would pose a liability and she would be unable to pass a drug test. In May 2012, Vicodin was discontinued because a drug test was negative for any prescription opiates but positive for cocaine. The Veteran admitted to using cocaine and no other substances. A July 2012 record shows that the Veteran was not using any narcotic pain medication. Despite the lack of reported or noted functional impairments caused by narcotic pain medication and the discontinuance of pain medication in July 2012, the Board resolves reasonable doubt in the Veteran's favor and finds that TDIU was warranted from January 26, 2011, and to prior to September 12, 2012, based on the Veteran's reports of narcotic pain medication use interfering with employment. Accordingly, resolving reasonable doubt in favor of the Veteran, the Board finds that substantially gainful employment was precluded from January 26, 2011, to prior to September 12, 2012. Therefore, entitlement to TDIU from January 26, 2011, and to prior to September 12, 2012, not including periods of temporary total rating, is warranted. 3. Entitlement to TDIU as of September 12, 2012, not including periods of temporary total rating The Board has considered the economic and noneconomic components of the TDIU claim and finds that the persuasive weight of the evidence show does not show that the physical and mental service-connected disabilities precluded substantially gainful employment as of September 12, 2012. The Board finds that the symptoms of the service-connected disabilities, and any functional impairment caused by the treatments for the service-connected disabilities, were not reported with the frequency, duration, and severity sufficient to produce unemployability. Specifically, beginning on September 12, 2012, despite resuming narcotic pain medication use and reported pain and functional impairment caused by service-connected disabilities, the Veteran had significantly increased her community service activities, social activities, skills training, and job seeking efforts while regularly attending group and individual mental health therapy. The Veteran denied any difficulty with maintaining those daily and weekly activities despite the service-connected disabilities and treatment for the disabilities. The Board finds the Veteran's consistent participation in those activities show that the Veteran was capable of performing the physical and mental acts required by employment. The Board finds that the Veteran's education, training, and employment experience shows that the Veteran was capable of a variety of forms of employment that required some degree of physical labor, writing, basic arithmetic, filing, administrative tasks, or other tasks, even considering the physical and mental limitations caused solely by the service-connected disabilities. The physical and mental limitations caused by the service-connected disabilities did not prevent sedentary work of an unskilled or semi-skilled nature such as driving, inspection, stocking shelves, or light assembly work; or performing cognitive activities such as ordering materials, data entry, scheduling work projects, and maintaining records in a small group or solitary environment. The Board finds that the evidence does not support a finding that from September 12, 2012, the service-connected disabilities prevented the Veteran from securing and following substantially gainful employment considering reasonable accommodations as specified in the ADA. The Board acknowledges that service-connected disabilities caused functional impairment. However, as of September 12, 2012, the symptoms and impairments were not severe or frequent enough to render the Veteran unable to obtain or maintain substantial gainful employment. The Board finds that the service-connected disabilities did not present such an exceptional disability picture that the available schedular ratings for the service-connected disabilities were inadequate. The Board finds that the symptoms, severity, and functional impairment of the service-connected disabilities were fully contemplated in the ratings assigned. The Veteran is competent to report observable symptoms. Layno v. Brown, 6 Vet. App. 465 (1994). The Board acknowledges that the Veteran's statements and testimony to VA described a more severe disability picture than the evidence of record. During the November 2020 Board hearing, the Veteran testified that she had not worked since 2016 and that she was unable to work full time due to service-connected disabilities. However, the evidence shows that the Veteran had been working full time since December 2019. The November 2020 Board testimony contradicts the Veteran's October 2020 report in which the Veteran reported to her pulmonologist that she was working full time and she endorsed an active lifestyle. In addition, the evidence does not show that the Veteran's employment was less than substantially gainful or was in any kind of protected environment. The Board assigns greater probative weight to the lay statements in the contemporaneous medical records, such as the October 2020 report, as the statements were made by the Veteran and were noted by objective medical professionals in the process of providing professional care to the Veteran. The Board assigns less probative value to the statements and testimony made in conjunction with a claim for benefits. Cartright v. Derwinski, 2 Vet. App. 24 (1991) (pecuniary interest may affect the credibility of a claimant's testimony); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (VA can consider bias in lay evidence and conflicting statements of the veteran in weighing credibility); Macarubbo v. Gober, 10 Vet. App. 388 (1997) (credibility of lay evidence can be affected and even impeached by inconsistent statements, internal inconsistency of statements, inconsistency with other evidence of record, facial implausibility, bad character, interest, bias, self-interest, malingering, desire for monetary gain, and witness demeanor). Therefore, to the extent that the Veteran's statements and testimony related to the claim for entitlement to TDIU contradict the contemporaneous medical evidence, the Board does not find those statements to be as persuasive as the statements made during treatment. The Board notes the September 2022 statement that service-connected disabilities "negate the gainful aspect of any employment that the Veteran might obtain." However, the evidence shows that the Veteran began working in December 2019, continued to report working through 2022, and stated that employment was going well. Further, in March 2022, VA sent a letter requesting detailed employment information necessary to determine whether TDIU was warranted. Specifically, the Veteran was asked to complete and return the enclosed VA Forms 21-8940 and 21-4192. The Veteran did not respond to the request. Therefore, the Board cannot find that the employment is less than substantially gainful or in a protected environment as the Veteran did not supply the requested information. The duty to assist is not a one-way street. If a veteran wants help, the Veteran cannot passively wait for it in those circumstances where the Veteran may or should have information that is essential in obtaining evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). Moreover, the Board does not find that the physical and mental limitations caused by the service-connected disabilities prevented sedentary work of an unskilled or semi-skilled nature or precluded substantially gainful employment considering reasonable accommodations as specified in the ADA. To the extent that the Veteran argues otherwise, the Board finds the Veteran's statements in seeking benefits and in seeking treatment contradictory, and of less persuasive value. The Board finds the evidence persuasively weighs against a finding that the service-connected disabilities precluded substantially gainful employment as of September 12, 2012. Accordingly, as the persuasive weight of the evidence is against the claim that the service-connected disabilities precluded the Veteran from securing and maintaining substantially gainful employment as of September 12, 2012, the claim for TDIU must be denied. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board finds that the evidence is not in approximate balance and there is no reasonable doubt to resolve in favor of the Veteran. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.O., 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.