Citation Nr: 25009307 Decision Date: 07/16/25 Archive Date: 07/16/25 DOCKET NO. 19-22 842 DATE: July 16, 2025 ORDER Entitlement to a total rating based on individual unemployability due to service-connected disabilities (TDIU), to include as on an extraschedular basis, is denied. FINDING OF FACT The Veteran's service-connected disabilities alone, either individually or in combination, do not render him unable to secure or follow a substantially gainful occupation and there were no exceptional factors from the Veteran's service-connected disabilities, either individually or in combination, that precluded him from securing or following substantially gainful employment. CONCLUSION OF LAW The criteria for a TDIU, to include as on an extraschedular basis, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1969 to October 1971, to include service in the Republic of Vietnam. These matters come to the Board of Veterans' Appeals (Board) on appeal from a November 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). Jurisdiction of this appeal is currently with the RO in Columbia, South Carolina. The Veteran testified at a hearing before the undersigned Veterans Law Judge of the Board in February 2022. A transcript of the hearing has been associated with the claims file. The record was held open for 90 days following the hearing to allow for the submission of additional evidence and argument. In May 2022, the Veteran's representative requested an additional 90-day extension to submit evidence and argument. The Board granted this Motion for an Extension of Time in May 2022. In November 2022, the Board remanded the appeal to the Agency of Original Jurisdiction (AOJ) for further development. Specifically, the matter was remanded for referral to the Director of Compensation Service for consideration of TDIU on an extraschedular basis. The Director of Compensation Service considered TDIU on an extraschedular basis in July 2023. The case was returned to the Board for appellate action, and the Board determined that there had been substantial compliance with its previous remand. Additional evidence, to include updated VA treatment records, was associated with the record after the issuance of the August 2023 supplemental statement of the case. The Veteran's representative waived initial AOJ consideration in September 2023. 38 C.F.R. § 20.1305. Therefore, the Board considered the newly received evidence. In a November 2023 rating decision, the Board denied entitlement to a TDIU, to include on an extraschedular basis. The Veteran subsequently appealed this decision to the United States Court of Appeals for Veterans Claims (Court). In a February 2025, the Court granted the parties' Joint Motion for Remand, which vacated the Board's November 2023 decision and remanded the appeal to the Board. The parties agreed that vacatur and remand was warranted because the Board, in finding that the evidence did not preclude the Veteran's ability to perform the mental aspects of employment, the Board did not reconcile a May 2022 VA examination which noted that the Veteran's psychiatric symptoms did impact his ability to work. The parties agreed that the May 2022 VA examiner noted symptoms of depression, memory loss, such as forgetting directions, and difficulty establishing work relationships, and that the May 2022 examiner explained that the Veteran's PTSD-related symptoms, which included suspiciousness and memory impairment, and stated that his symptoms impacted his ability to perform active or sedentary work. A March 2025 letter informed the Veteran that the Court had issued a decision that remanded (sent back) his case to the Board for readjudication and issuance of a new decision. The letter further informed the Veteran that he had 90 days from the date of the letter to submit additional argument and/or evidence in support of his appeal and/or request a hearing. The 90-day period from the date of the Board's letter has elapsed as of June 1, 2025. Therefore, the Board will therefore proceed with its adjudication. Entitlement to a TDIU, to include as on an extraschedular basis, is denied. The Veteran seeks entitlement to a TDIU on an extraschedular basis. Specifically, the Veteran, through his representative, contends that his service-connected disabilities resulted in psychiatric impairments that impacted his ability to function independently, appropriately, and effectively; with deficiencies in mood, difficulty in adapting to stressful circumstances, unprovoked hostility and irritability, and inability to establish and maintain effective relationships. See e.g., August 2023 Third Party Correspondence. In addition, the Veteran, through his representative, assert that if he were to work full time, he would have increased absenteeism due to his service-connected psychiatric disorder. Id. The Veteran testified at his February 2022 Board hearing that his psychiatric symptoms impacted his mood, caused intolerance or becoming easily upset, reacting verbally to stressors, resulting in altercations with people, anger, depression, anxiety attacks, inability to socialize even with family, difficulty with crowds, aggression with driving, and self-medication with alcohol. See February 2022 Hearing Transcript. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that if there is only one such disability, such disability shall be ratable as 60 percent or more, and if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). Rating boards should submit to the Director of Compensation Service for extraschedular consideration all cases of veterans who are unemployable by reason of service-connected disabilities but who fail to meet the percentage standards set forth in 38 C.F.R. § 4.16(a). See 38 C.F.R. § 4.16(b). Unlike the regular disability rating schedule, which is based on the average work-related impairment caused by a disability, "entitlement to a TDIU is based on an individual's particular circumstances." Rice v. Shinseki, 22 Vet. App. 447,452 (2009). Therefore, when adjudicating a TDIU claim, VA must consider the individual veteran's education, training, and work history. Hatlestad v. Derwinski, 1 Vet. App. 164 (1991) (level of education is a factor in deciding employability); see Friscia v. Brown, 7 Vet. App. 294 (1994) (considering a 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 a veteran's 8th grade education and sole occupation as a farmer); Moore v. Derwinski, 1 Vet. App. 356 (1991) (considering a veteran's master's degree in education and his part-time work as a tutor). Age may not be considered as a factor when evaluating unemployability or intercurrent disability, and it may not be used as a basis for a total disability rating. 38 C.F.R. § 4.19. There must be a determination that the service-connected disabilities are sufficient to produce unemployability without regard to advancing age or a nonservice-connected disability. 38 C.F.R. §§ 3.340, 3.341, 4.16. The sole fact that a claimant 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. The ultimate question, however, is whether the veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. See Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). An assessment of TDIU entitlement based on the combined effects of all service-connected disabilities should address all such disabilities. Therefore, the cumulative effects (functional impairment) of all service-connected disabilities should be addressed in determining if the service-connected disabilities prevent substantially gainful employment. Floore, 26 Vet. App. 376; accord Geib v. Shinseki, 733 F.3d 1350, 1353-54 (Fed. Cir. 2013). In making such a determination, the Board must determine, as a question of fact, both the weight and credibility of the evidence. Equal weight is not accorded to each piece of evidence contained in a record and every item does not have the same probative value. The Board must analyze the credibility and probative value of all material evidence submitted by and on behalf of a claimant, account for the evidence that it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. See Struck v. Brown, 9 Vet. App. 145, 152 (1996); Caluza v. Brown, 7 Vet. App. 498, 506 (1995); Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994); Abernathy v. Principi, 3 Vet. App. 461, 465 (1992); Simon v. Derwinski, 2 Vet. App. 621, 622 (1992); Hatlestad, 1 Vet. App. at 169. The veteran's credibility affects the weight to be given to his or her testimony and lay statements, and it is the Board's responsibility to determine the appropriate weight. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). In evaluating a veteran's employability, consideration may be given to the level of education, special training, and previous work experience in arriving at a conclusion, but not to age or impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no obligation to discuss, in detail, the extensive evidence of record. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis will focus specifically on what the evidence shows, or fails to show, as it relates to the Veteran's claim. The claim for a TDIU to include as on an extraschedular basis stems from an October 2017 claim for increased rating for his posttraumatic stress disorder (PTSD). See VA Form 21-526b, October 4, 2017. Throughout the period on appeal, service connection was in effect for PTSD, rated as 50 percent disabling; tinnitus, rated as 10 percent disabling; and bilateral hearing loss, rated as noncompensable. See August 2023 Rating Decision - Codesheet. Therefore, the Veteran's total combined disability rating is only 60 percent throughout the entire period on appeal, and thus he does not meet the criteria for a grant of a TDIU on a schedular basis under 38 C.F.R. § 4.16(a), which requires either a single disability rated at 60 percent disabling or greater, or a combination of disabilities rated at 70 percent disabling with at least one of the combined disabilities rated at 40 percent disabling or greater. The Board will now consider whether a second referral to the Director of Compensation Service for consideration of entitlement to a TDIU on an extraschedular basis pursuant to 38 C.F.R. § 4.16(b) is warranted. Turning to the evidence, the Veteran was afforded a VA examination for PTSD in October 2017. At that time, the VA examiner diagnosed PTSD and opined his PTSD most closely approximated occupational and social impairment with reduced reliability and productivity. The Veteran reported he lived with his wife, was married once, and had two adult children who lived on their own. He denied having close friends, and stayed he mostly stayed at home and worked on things in his shop. The Veteran was unemployed. He was last employed as a truck driver and stopped working in June 2008. He did not participate in current mental health therapy. He avoided crowds and being around people. Notably, the Veteran reported he was a member of a Lodge but had to leave due to anger problems, and he reported problems with memory described as being more forgetful. The Veteran drank alcohol every other day and used marijuana on occasion. Symptoms attributable to his PTSD in October 2017 included a depressed mood, anxiety, chronic sleep impairment, mild memory loss, such as forgetting names, directions or recent events, disturbances of motivation and mood and difficulty in establishing and maintaining effective work and social relationships. Behavioral observations showed the Veteran presented as alert, oriented, cooperative, fluent and normal speech, linear thought process, mildly depressed mood and affect was mildly constricted. No overt psychosis was observed and suicidal and homicidal ideation were denied. Of record are November 2017 and December 2018 statements submitted by the Veteran's wife, L.D. At those times, L.D. reported that, in the last few years, the Veteran had problems with work, relationships, and relaxing, that he kept to himself, and no longer wanted to socialize with family or close friends. L.D. reported the Veteran had a significantly reduced appetite and appeared to be "deathly ill," and he would have difficulty eating. She indicated that the Veteran had difficulty adjusting to civilian life, and no longer seemed interested in activities he previously enjoyed, to include, walking, cooking, spending time with family, traveling, and building things. She reported the Veteran seemed to use alcohol and drugs to cope with his symptoms, which negatively impacted his relationship with others and their marriage. L.D. stated she felt the Veteran was withdrawn, had become emotionally and verbally abusive, and was no longer available for his children. She stated the Veteran watched TV, drank, and smoked. He reported that he made a mumbling noise all day and did not feel safe leaving the house, being on high alert, and waking up at night from nightmares. She stated she was afraid for herself, the Veteran, and their children and that he had become overly worried and obsessed with finances. She also indicated the Veteran had angry outbursts, frequent incontinence of his bowel and bladder and felt her marriage would not last. A July 2020 VA treatment record indicates the Veteran reported he had last worked in 2009 as a truck driver and lost his commercial driver's license due to a driving under the influence (DUI) charge. The Veteran subsequently confirmed the accuracy of this treatment record by his testimony in a February 2022 hearing. At his February 2022 Board hearing, the Veteran testified that he had difficulty being around others, spent time by himself or with his wife, and had changed moods. His changed moods included difficulty being around others, being upset and reacting verbally and getting in altercations with others, and mood swings. He testified he had anger, depression, anxiety attacks, avoidance and procrastination, and difficulty going in public. The Veteran testified he did not go to church or work and no longer participated in his Lodge or in family events. He stated he could go to stores and pick up packages, but that he would have difficulty waiting in line. The Veteran testified he had anger when driving, difficulty sleeping, inability to sleep at night, and difficulty maintaining hygiene regularly. He stated he had difficulty with his memory and would forget people's names. The Veteran testified that he believed he was not good for anybody, had bad memories, and resulted in an inability to work. The Veteran testified that he testified that he drank beer and alcohol to self-medicate, that he had lost his commercial driver's license due to a DUI charge, and that he did not believe he could resume work as a truck driver due to the disqualifying nature of his non-service connected vision condition. A March 2022 VA audiology examination indicates the Veteran's hearing loss and tinnitus would impact his ability to work. In this regard, the Veteran indicated he had difficulty with one-on-one conversations and was open to being issued hearing aids. He wondered why his tinnitus was happening and what it was. In support of his claim for entitlement to a TDIU, the Veteran submitted an April 2022 Application for Increased Compensation Based on Unemployability (VA Form 21-8940). At that time, the Veteran indicated that his PTSD prevented him from security or following substantially gainful occupation, and he had been hospitalized from 2018 to 2019 for treatment of his PTSD. The Veteran noted he last worked in October 2009 and that he last worked full-time in September 2009 due to his disabilities. He last worked as a truck driver, earning a maximum of $1,400.00 per month. The Veteran indicated he no longer had any income and did not receive any training or education since leaving his last job. He indicated he did not leave his last job due to his disability. Upon remand, the parties to the February 2025 Joint Motion for Remand agreed that the Board must consider and reconcile the May 2022 VA examiner's statement that Veteran's psychiatric symptoms impacted his ability to work in either active or sedentary manner when rendering its decision. The Veteran was afforded a VA examination for PTSD in May 2022. The examiner noted a diagnosis of PTSD and no other mental health diagnoses. However, the examiner did note that the Veteran's back pain, hearing loss, glaucoma, and hypertension were relevant to the understanding and management of the Veteran's PTSD. The Board notes that as of the date of this decision, neither the Veteran's vision condition of glaucoma or his hypertension are service-connected. The examiner reported that the Veteran's PTSD produced occupational and social impairment with reduced reliability and productivity. The Veteran did not participate in current mental health therapy. The Veteran reported living with his wife and family and that he was close with his family, that he had friends but did not socialize with them often, and that he did chores around the house. The Veteran reported mood swings accompanied by irritability and depression, and sometimes good days and sometimes days that were very difficult, that he did not like being around crowds, that loud noises startled him, that he remained awake at night and napped during the day and had distressing dreams of violence and difficulty being around others or connecting with others. The Veteran reported difficulty with both long-term and short-term memory, that he sometimes forgot to take his medication as scheduled and sometimes would take his medication twice. The Veteran noted that he remembered the names of close relatives but had difficulty remembering those that he did not talk to daily. The Veteran acknowledged daily drinking of up to four beers a day but reported that his drinking did not affect his relationships with family or ability to complete tasks. The examiner noted symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, flattened affect, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and inability to establish and maintain effective relationships, but no other symptoms attributable to PTSD. The examiner noted that there had been a worsening of the Veteran's symptoms since the last examination. The examiner noted that the Veteran's PTSD impacted his ability to work in either an active or sedentary manner because the Veteran noted being suspicious of others at times and noted being easily startled by noises and had an impairment of memory both short-term and long-term. The Board notes here that, for purposes of evaluating the evidence provided by the May 2022 examination, that the word "impact" has not been defined in VA regulations or by the Court. When used, as here, as a transitive verb (a verb that requires a direct object to complete its meaning, in this case, the object being "ability to work"), the dictionary definition of "impact" is "to have a direct effect or impact on; impinge on." Merriam-Webster Dictionary Online, https://www.merriam-webster.com/dictionary/impact, accessed 15 July 2025. Thus, it is distinguished in meaning from the word "unable" noted in 38 C.F.R. § 4.16 used to describe the Secretary's intent for authorizing a grant of a TDIU ("Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities"). "Unable" has dictionary definition of "not able: incapable." Id at https://www.merriam-webster.com/dictionary/unable, accessed 15 July 2025. For purposes of weighing the evidence provided by the May 2022 examination with respect to the Veteran's ability to perform the physical and mental acts required by employment, the Board notes that the examiner did not report or conclude that the Veteran's PTSD made him incapable of securing or obtaining substantially gainful employment, only that the Veteran's PTSD impacted his ability to work. In the same examination, the VA examiner assessed that the Veteran's PTSD produced impairments most closely approximating occupational and social impairment with reduced reliability and productivity, rather than the more severe impairments of occupational and social impairment with deficiencies in most areas or total occupational and social impairment. Thus, while the Board assigns probative weight to the examiner's conclusion that Veteran's PTSD impacts his ability to work in an active and sedentary manner, the Board finds that it is not dispositive as to whether the Veteran's PTSD, individually or in combination with his other service-connected disabilities, renders him unable to secure or pursue any substantially gainful occupation. In a July 2022 VA Form 21-4192, the Veteran's former employer indicated the Veteran last worked in September 2009 as a truck driver and had worked more than 40 hours per week. The employer stated he was fired due to an alcohol related charge which was against his company policy. In November 2022, the Veteran's claim was referred to the Director of Compensation Service for consideration of entitlement to a TDIU on an extraschedular basis pursuant to 38 C.F.R. § 4.16(b) by the Board. The Director of Compensation Service issued an advisory opinion in July 2023. This opinion found that the evidence did not show the Veteran would be unlikely to engage in gainful employment. The opinion noted that the Board found the Veteran's PTSD most closely approximated occupational and social impairment with reduced reliability, and that he stopped working as a truck driver due to health issues. In addition, the opinion further noted the Veteran's Social Security Administration (SSA) records indicated that the Veteran was unemployable due to osteoarthritis of his back. The opinion noted that the Veteran worked as a truck driver and that he was not employed. After a review of the medical and lay evidence, the Director concluded that there were no unusual or exceptional disability pattern demonstrated that would render application of the regular rating criteria as impractical, and the evidence did not support a higher evaluation on an extraschedular basis or entitlement to a TDIU. An August 2023 VA audiology examination indicated that the Veteran's bilateral hearing loss and tinnitus impacted his ability to work. In this regard, the Veteran noted that his hearing loss and tinnitus made daily conversation difficult and had to ask people to repeat themselves. An August 2023 private employment assessment conducted by Dr. J.R. noted that he treated the Veteran from July 2022 and had most recently evaluated the Veteran in July 2022. The provider diagnosed PTSD and found his prognosis was guarded. Clinical findings showed the Veteran presented with persistent irrational fears; deficiencies in work or school; depression affecting the ability to function independently, appropriately, and effectively; deficiencies in mood; difficulty in adapting to stressful circumstances; intrusive recollections of a traumatic experience; unprovoked hostility and irritability; and inability to establish and maintain effective relationships. In July 2022, Dr. J.R. evaluated the Veteran has having PTSD symptoms with the following impact over a normal workday and workweek, on an ongoing basis in a competitive work environment: none to mild impact on the ability to remember locations and work-like procedures, and the ability to be aware of normal hazards and take appropriate precautions' moderate impact on the ability to maintain attention and concentration for extended periods, ability to sustain ordinary routine without supervision, and the ability to complete a normal workweek without interruptions from psychologically based symptoms and to perform at a consistent pace without an unreasonable number and length of rest periods; a moderate to marked impact on the ability to perform activities within a schedule, maintain regular attendance, and be punctual within customary tolerance, the ability to respond appropriately to changes in the work setting, and the ability to set realistic goals or make plans independently; marked impairment on the ability to work in coordination with or proximity to others without being distracted by them, ability to interact appropriately with the general public, ability to accept instructions and respond appropriately to criticism from supervisors, ability to get along with co- workers or peers without distracting them or exhibiting behavioral extremes, and the ability to maintain socially appropriate behavior and to adhere to basic standards of neatness and cleanliness. The provider found the ability to travel to unfamiliar places or use public transportation could not be rated on the available evidence. Dr. J.R. continued that the Veteran's impairments would likely produce "good days" and "bad days." The provider estimated that the PTSD impairments would cause the Veteran to be absent from work more than 3 times a month and opined that the Veteran would not be capable of performing gainful employment with the symptoms and limitations stemming from his psychological impairment. In this regard, the provider noted a review of the records, clinical interview, and mental status examination in support of his opinion related to unemployability. The provider found the earliest date that the description of symptoms and limitations applied was 2008. The Board acknowledges the July 2022 private employment assessment completed by Dr. J.R., and Dr. J.R.'s opinion that the Veteran's PTSD symptoms, limitations, and impairments would prevent the Veteran from performing gainful employment. However, the Board finds Dr. J.R.'s July 2022 evaluation to limited probative value as it is conclusory and does not provide a sufficient basis to decide the claim. In this regard, Dr. J.R. opined the Veteran's limitations and impairments based on PTSD would render him unemployable, beginning in 2008 without further elaboration. It is a medical examiner's responsibility to provide a well-supported opinion so that the Board may carry out its duty to weigh the evidence of record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (concluding that medical opinion is not entitled to any weight "if it contains only data and conclusions"). Moreover, the July 2022 private evaluation does not discuss whether the Veteran's schedular rating for PTSD would adequately account for the psychiatric impairments demonstrated on evaluation and interview in July 2022. In addition, the July 2022 private evaluation found that the Veteran's PTSD would render him unemployable beginning in 2008 but does not reconcile this finding with the Veteran's own reports of working as a truck driver until September 2009 when he was fired for an alcohol related charge and violation of company policy. Therefore, the Board affords this evaluation little to no probative value. The Board considered the arguments of the Veteran for entitlement to a TDIU because of the Veteran's service-connected disabilities. However, the Board notes the Veteran's prior occupation included truck driver, however, there is no indication from the record that the Veteran was precluded from employment solely as a result of his service-connected disabilities. In fact, as noted above, the evidence of record to include the Veteran's own statements indicate that the Veteran was unable to work as a result of the combination of his service-connected disabilities and nonservice-connected osteoarthritis and visual acuity. The persuasive evidence is that an unrelated alcohol charge is what caused the Veteran to leave his then current employment. Ultimately, the question is whether the Veteran is capable of performing the physical and mental acts required by employment. Here, the evidence is not sufficient to show that the Veteran could not have performed the physical and mental acts required by employment. The Board has considered the combined effects of his PTSD, bilateral hearing loss, and tinnitus. However, the most probative evidence shows no more than a moderate impact on employability. The Board has considered the Veteran's arguments of entitlement to a TDIU because of the Veteran's service-connected disabilities. Here, the evidence, to include but not limited to the May 2022 VA examiner's observation that the Veteran's PTSD impacts his ability to work is not sufficient to show that the Veteran is incapable of performing the physical and mental acts required by employment. The Board notes the Veteran's most recent prior occupation was as a truck driver, but also that the Veteran has described no indication from the record that the Veteran left this employment because of his service-connected disabilities, but rather due to the legal consequences of a DUI. The Veteran's Social Security Administration records indicate that in addition to driving, the Veteran has previous experience as a machine mechanic, and the Veteran has reported to VA examiners that his service-connected disabilities do not prevent him from performing manual activities such as chores around the house or working in his shop. VA examination reports from October 2017 and May 2022 show that VA examiners determined the Veteran's PTSD, at worst, most closely approximated occupational and social impairment with reduced reliability, rather than the more severe evaluations of occupational and social impairment with deficiencies in most areas or total occupational and social impairment. The May 2022 VA examiner noted that the Veteran's PTSD impacted, but did not preclude the Veteran's ability to work in either an active or sedentary manner. In his April 2022 Application for Increased Compensation Based on Unemployability (VA Form 21-8940), the Veteran asserted that he had not left his employment due to a disability. While lay statements from the Veteran's spouse indicated that the Veteran used alcohol to cope with his symptoms in 2017 and 2018, and the Veteran testified at his February 2022 hearing that he used alcohol to self-medicate his PTSD symptoms and that he lost his commercial driver's license due to the legal consequences of a DUI. In May 2022, the Veteran reported that his alcohol use did not interfere with his ability to perform tasks. While the Veteran did speculate at the February 2022 hearing that his PTSD medication might prevent him from driving a truck in future, the Veteran consistently testified that his inability to regain his commercial driver's license or return to employment of choice was due primarily to his nonservice-connected vision condition. See, e.g., February 2022 Hearing Transcript, pp. 25, 26. In addition, the Veteran himself has reported that he was unable to work because of the combination of his psychiatric limitations resulting from his service-connected PTSD and his physical limitations resulting from his nonservice-connected osteoarthritis and non-service connected vision problems. The May 2022 VA examination report and a July 2022 private evaluation report both showed that the Veteran experienced psychiatric symptoms that included depressed mood, difficulty with emotions, and difficulty in establishing and maintaining effective work and social relationships. The May 2022 VA examination reported that the Veteran's symptoms of suspicious of others at times, being easily startled by noises, and impairments of memory, both short-term and long-term impacted his ability to work in an active or sedentary manner but did not conclude that such symptoms prevented the Veteran from work. The memory impairments described by the Veteran in the May 2022 VA examination included occasional forgetfulness associated with taking his medication and difficulty remembering the names of persons he does not talk to daily, but asserted no difficulty with remembering close relatives, and described no other memory impairments. The Veteran described no memory deficits associated with performing any tasks other than taking medication and reported in both October 2017 and May 2022 that he was able to perform tasks in his shop and around the house, with no reports of memory or other mental impairment. A July 2022 private evaluation indicated the Veteran left his employment due to health problems and nonservice-connected poor visual acuity rather than due to impairments produced by his service-connected disabilities. In sum, as of the date of this decision, the Veteran does not meet the criteria for a grant of TDIU on a schedular basis under 38 C.F.R. § 4.16(a). The Board has considered the evidence of the combined effects of both the Veteran's PTSD, bilateral hearing loss, and tinnitus, as well as the effects of each disability individually, and finds that the weight of the probative evidence does not show that the Veteran's service connected disabilities alone, either individually or in combination, rendered the Veteran incapable of performing the mental or physical aspects of employment; prevented the Veteran from securing or pursuing substantially gainful employment; or that exceptional factors produced by the Veteran's service-connected disabilities, either individually or in combination, precluded the Veteran from securing or following substantially gainful employment. Thus, neither a grant of a TDIU on a schedular basis nor a second referral to the Director of Compensation Services for consideration of a grant of a TDIU on an extraschedular basis under 38 C.F.R. § 4.16(b) is warranted. (Continued on the next page) ? Accordingly, the Board finds that entitlement to a TDIU, to include on an extraschedular basis pursuant to 38 C.F.R. § 4.16(b) is not warranted. The appeal is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Cusker, 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.