RECTUM AND ANUS IMPAIRMENT OF SPHINCTER CONTROL

ARDIE A. BLAND · 2026 · Case ID: A26033812

MIXED

Summary

The veteran, who served in the United States Air Force from November 1975 to January 1994 and again from October 2008 to March 2009, appeals a July 2022 rating decision. The veteran sought an increased rating for impairment of rectal sphincter control and entitlement to Total Disability based on Individual Unemployability (TDIU). The Board granted an increased rating for impairment of rectal sphincter control, finding the veteran's symptoms warranted a 60 percent evaluation for the entire period on appeal, resolving doubt in her favor. The Board denied entitlement to TDIU for the period prior to April 13, 2018, noting the veteran was employed full-time and did not demonstrate marginal employment or require accommodations. However, the Board granted entitlement to TDIU for the period from April 13, 2018, to February 23, 2021, finding that the combined impact of her service-connected disabilities, including rectal sphincter impairment, lumbar spine, cervical spine, bilateral knee, right wrist, and left elbow conditions, precluded her from substantially gainful employment. For the period after February 23, 2021, the TDIU claim was dismissed as moot because the veteran received a 100 percent schedular rating. The Board also granted an earlier effective date of April 13, 2018, for Dependents' Educational Assistance (DEA) benefits, aligning with the TDIU effective date.

Rationale

Symptoms more closely approximate criteria for 60% rating under DC 7332.; Resolving reasonable doubt in veteran's favor.; Lay statements and private medical opinion support extensive leakage and frequent involuntary bowel movements.

Service Branch

AIR FORCE

Special Benefit

TDIU

Diagnostic Code

7332

Docket No.

230707-360206

Full Decision Text

Citation Nr: A26033812
Decision Date: 04/13/26 Archive Date: 04/13/26

DOCKET NO. 230707-360206
DATE: April 13, 2026

ORDER

Entitlement to an initial rating of 60 percent, but no higher, for impairment of rectal sphincter control is granted.

Entitlement to a total disability rating based on individual unemployability (TDIU) for the period prior to April 13, 2018, is denied.

Entitlement to a TDIU from April 13, 2018, until February 23, 2021, is granted.

Entitlement to a TDIU from February 23, 2021, is dismissed as moot.

An effective date of April 13, 2018, for the grant of eligibility for Dependents' Educational Assistance (DEA) under 38 USC chapter 35 is granted.

FINDINGS OF FACT

1. Throughout the appeal period, the Veteran's service-connected impairment of rectal sphincter control manifested in extensive leakage and fairly frequent involuntary bowel movements.

2. For the period on appeal prior to April 13, 2018, the evidence reflects that the Veteran was employed in a substantially gainful occupation and was not in a protected or sheltered work environment.

3. Resolving all reasonable doubt in the Veteran's favor, the Veteran's service-connected disabilities rendered her unable to secure and follow a substantially gainful employment from April 13, 2018, until February 23, 2021.

4. For period from February 23, 2021, the Veteran's service-connected disabilities resulted in a combined 100 percent schedular rating; the issue of entitlement to TDIU is rendered moot.

5. The Veteran's award of DEA Benefits under 38 U.S.C. is predicated on the award of a TDIU, which, pursuant to this decision, is effective April 13, 2018.

CONCLUSIONS OF LAW

1. The criteria for a 60 percent rating, but no higher, for the Veteran's service-connected impairment of rectal sphincter control have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.114, Diagnostic Code 7332.

2. The criteria for entitlement to a TDIU for the period prior to April 13, 2018, have not been met or approximated. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 4.3, 4.16 (b), 4.18.

3. For the period from April 13, 2018, until February 23, 2021, the criteria for entitlement to a TDIU have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.340, 3.341, 4.16.

4. For the period from February 23, 2021, entitlement to a TDIU has been rendered moot due to a schedular 100 percent evaluation. 38 U.S.C. § 7105; 38 C.F.R. § 4.16.

5. The criteria for entitlement to an effective date of April 13, 2018, for the award of eligibility to DEA Benefits under 38 U.S.C. Chapter 35 have been met. 38 U.S.C. §§ 3510, 5110, 5113; 38 C.F.R. §§ 3.807.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Air Force from November 1975 to January 1994 and from October 2008 to March 2009.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2022 Higher Level Review (HLR) decision of the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ).

In May 2022, the Veteran submitted a VA Form 20-0996 (Decision Review Request: HLR) and requested review of a June 2021 rating decision which denied the benefits sought on appeal. The July 2022 HLR decision on appeal considered the evidence of record at the time of the June 2021 rating decision.

In a VA Form 10182, received by the Board in July 2023, the Veteran requested Board review of the July 2022 rating decision under the Direct Review option by a Veterans Law Judge. Therefore, the Board may only consider the evidence of record
Level Review (HLR) decision of the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ).

In a VA Form 10182, received by the Board in July 2023, the Veteran requested Board review of the July 2022 rating decision under the Direct Review option by a Veterans Law Judge. Therefore, the Board may only consider the evidence of record at the time of the June 2021 claim decision. 38 C.F.R. § 20.301.

In February 2025 the Board issued a decision denying increased ratings for impairment of rectal sphincter control, cervical spine degenerative arthritis, lumbar spine degenerative arthritis, right carpal tunnel syndrome with upper extremity radiculopathy, left elbow degenerative arthritis, right wrist strain, bilateral knee degenerative arthritis, bilateral knee instability, right ankle disability, atopic dermatitis and hypertension. The Board also denied earlier effective dates for the awards of service connection for bilateral lower extremity radiculopathy disabilities and right knee instability, as well as for the award of Dependents' Educational Assistance under 38 U.S.C chapter 35. Finally, the February 2025 decision dismissed entitlement to a TDIU as moot.

The Veteran filed an appeal to the Court of Appeals of Veterans Claims (CAVC) to the extent that the February 2025 Board decision denied entitlement to a rating in excess of 30 percent for impairment of rectal sphincter control, dismissed entitlement to a TDIU and denied an earlier effective date for the award of DEA benefits. In November 2025, CAVC vacated the Board's decision to such extent, and remanded for compliance with the instructions in the Joint Motion for Partial Remand (JMPR). The parties of the JMPR agreed that the Board's February 2025 decision erred when it failed to provide an adequate statement of reasons or bases for its decision. After vacating the portion of the Board's decision, the case was remanded pursuant to 38 U.S.C. § 7252 (a) for readjudication of the above-named claims.

The matter has since returned to the Board to adequately address the CAVC remand directives.

Consistent with the JMPR, the Board notes that if the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Increased Ratings- General

Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the Veteran. 38 C.F.R. § 4.3.

1. Entitlement to initial rating of 60 percent, but no higher, for impairment of rectal sphincter control is granted.

Initially, as it relates to the period on appeal for the increased rating claim, the Board recognizes that the claims file includes a notification letter that VA received the Veteran's intent to file a claim on December 10, 2017. On January 13, 2018, the Veteran submitted a fully developed claim, seeking service connection for rectal incontinence. In a February 2018 rating decision, the AOJ denied the claim for service connection for impairment of rectal sphincter control.

The Veteran submitted a notice of disagreement (NOD) with the February 2018 rating decision. An SOC was issued in August 2019, and the Veteran perfected an appeal to the Board in October 2019.

In a March 2020 Board decision, the Board granted the claim for service connection for impairment of rectal sphincter control. A March 2020 rating decision
intent to file a claim on December 10, 2017. On January 13, 2018, the Veteran submitted a fully developed claim, seeking service connection for rectal incontinence. In a February 2018 rating decision, the AOJ denied the claim for service connection for impairment of rectal sphincter control.

The Veteran submitted a notice of disagreement (NOD) with the February 2018 rating decision. An SOC was issued in August 2019, and the Veteran perfected an appeal to the Board in October 2019.

In a March 2020 Board decision, the Board granted the claim for service connection for impairment of rectal sphincter control. A March 2020 rating decision implemented the Board decision, and assigned a 30 percent evaluation, effective December 10, 2017.

In February 2021 the Veteran submitted a VA Form 20-0996, Supplemental Claim, seeking review of the March 2020 rating decision. The AOJ issued a rating decision in June 2021 which continued the 30 percent evaluation for impairment of rectal sphincter control.

In a May 2022 VA Form 20-0996, Request for a Higher Level Review (HLR), the Veteran sought an increased rating for her impairment of sphincter control. In a July 2022 HLR decision, the AOJ continued the 30 percent evaluation for impairment of sphincter control. In July 2023 the Veteran initiated the current appeal by submitting a NOD with the July 2022 HLR decision.

The Board notes that a claimant may continuously pursue a claim or an issue following notice of a decision on an initial claim by timely and properly filing a supplemental claim, request for higher-level review, or appeal to the Board. 38 C.F.R. § 3.2500(c)(1). If a claimant continuously pursues an issue by timely filing in succession any of the three specified review options with one year of notice of the decision, the effective date will be fixed in accordance with the date of receipt of the initial claim or the date entitlement arose, whichever is later. C.F.R. § 3.2500(h)(1).

In this case, the Board finds that the Veteran has continuously pursued this claim. Therefore, the Board may consider the period on appeal for the increased rating to be from December 10, 2017, the date of the award of service connection for impairment of sphincter control.

The Veteran's sphincter control impairment of is currently rated 30 percent disabling under Diagnostic Code 7332.

Effective May 19, 2024, VA amended the Schedule for Rating Disabilities for the digestive system, including Diagnostic Codes 7319 and 7332. See 89 Fed. Reg. 38340 (May 8, 2024). These revisions apply to all claims filed on or after May 19, 2024. VA will consider claims filed before and pending as of May 19, 2024, under both the old and new rating criteria, and will apply the criteria that are more favorable to the Veteran. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003).

Under the pre-May 19, 2024, version of Diagnostic Code 7332, a 30 percent rating is warranted for occasional involuntary bowel movements that necessitate wearing a pad. A 60 percent rating is warranted for extensive leakage and fairly frequent involuntary bowel movements. A 100 percent rating is warranted for complete loss of sphincter control. 38 C.F.R. § 4.114 (2023).

Under the revised Diagnostic Code 7332, a 30 percent disability rating is assigned for complete or partial loss of sphincter control characterized by incontinence or retention that is fully responsive to a physician-prescribed bowel program and requires digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per month, which requires wearing a pad two or more times per month. 38 C.F.R. § 4.114 (2024).

A 60 percent disability rating is warranted for complete or partial loss of sphincter control characterized by incontinence or retention that is partially responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids or liquids two or more times per week, which requires wearing a pad two or more times per week. Id.

A 100 percent disability rating is warranted for complete loss of sphincter control characterized by incontinence or retention that is not responsive to a physician-prescribed bowel program and requires either surgery or digital stimulation, medication (beyond laxative use), and special diet; or incontinence to solids and/or liquids two or more times per day, which requires changing a pad two or more times per day. Id.

A review of the record demonstrates that an initial rating of 60 percent is warranted for the Veteran's sphincter control impairment.

Evidence and Analysis

As the Veteran has asserted that her service-connected impairment of rectal sphincter control has impacted her ability to work during the period on appeal, her claim for an increased rating for her impairment of rectal sphincter control and entitlement to a TDIU, as they both relate to evidence of the Veteran's occupational functioning during the relevant period, can be discussed in concert. Thus, within the discussion of the Veteran's increased rating claim may also relate to her ability to secure or follow substantially gainful employment.

In a January 2018 lay statement, the Veteran reported that she had a very weak sphincter muscle that she could not control, which led to her having accidents at unwanted times. She would have to wear pads and carry a small bag with soap and a change of underwear. She also had to watch what she would eat. She reported that sometimes she was not able to clean up as quickly as she would like, and this would cause rashes around her rectum.

The Veteran attended a VA examination in February 2018. The examiner noted that the Veteran experienced impairment of the rectal sphincter control with leakage that necessitated wearing of pad. The Veteran reported changing her pad two times a day. The examiner opined that the condition would not impact her ability to work.

In a February 2019 lay statement, the Veteran wrote that she did her best to manage her condition by wearing diaper pads and controlling her diet. She stated that if she knew she had to be around people or away from a bathroom for an extended period of time, she would not eat for a day or so beforehand. She stated that it had become harder to control her condition through diet, and accidents were becoming more frequent. She would wake up every day with feces on her underclothes, and had to wear a pad every single day, even if she did not plan to leave the house. She reported that her condition had impacted every aspect of her life, including her career. She stated that before she left her job in 2018, she would not be able to leave her workspace every time she needed to clean up, causing her to sit in the stool until she had the opportunity to go to the bathroom.

In a January 2020 private medical opinion, Dr. M.C., a gynecologic oncologist, provided an opinion on the severity of the Veteran's condition. After a review of the claims file, particularly the February 2019 lay statement, the examiner opined that from at least January 2018 until present, the Veteran's impairment of rectal sphincter control had resulted in excessive leakage and fairly frequent involuntary bowel movements.

In a February 2021 Affidavit, the Veteran reported that her service-connected condition caused her to have accidents at least three times a week, and sometimes several times a day.

The Veteran attended another VA examination in May 2021. The Veteran reported that her condition had remained the same. She still was adjusting her diet but was not receiving any other treatment or medication. The examiner indicated that her impairment of rectal sphincter control resulted in occasional moderate leakage and occasional involuntary bowel movements. The examiner opined that the condition may impact her ability to work as frequent restroom visits may hinder her work productivity.

As noted above, under the pre-May 19, 2024, version of DC 7332, a 60 percent requires evidence of bowel impairment that results in extensive leakage and fairly frequent involuntary bowel movements. Resolving reasonable doubt in her favor, the Board finds that the Veteran's symptomatology more closely approximates the criteria required for a 60 percent evaluation under Diagnostic Code 7332 for the entire period on appeal. Although the May 2021 VA examiner found less severe symptoms, including only "occasional involuntary bowel movements," the Board finds, with resolution of reasonable doubt in the Veteran's favor, that the overall evidence of record supports a 60 percent evaluation throughout the claim period. This findings is primarily due to the Veteran's consistent, competent lay statements that her bowel impairment episodes result in symptoms that can reasonably be characterized as extensive leakage and frequent involuntary bowel movements, as well as the findings of the January 2020 private examiner that the Veteran's impairment of rectal sphincter control has resulted in "excessive leakage and fairly frequent involuntary bowel movements". While the regulations prior to May 19, 2024, do not define "extensive" and "fairly frequent", the Board finds that the Veteran's symptoms at that time would qualify as such. She reported during the February 2018 examination that she had to change her pad around two times a day, which would speak to experiencing extensive leakage. Furthermore, having two bowel movements a day, both of which could have been involuntary with no warning, would qualify as "fairly frequent."

A higher 100 percent rating is not warranted, however, as the symptomology during the relevant period does not show complete loss of sphincter control.

Accordingly, after careful review, and resolving all reasonable doubt in the Veteran's favor, the Board finds that for the entire period on appeal, the Veteran's service-connected impartment of rectal sphincter control warrants a 60 percent evaluation under Diagnostic Code 7332, and, therefore, the claim is granted to that extent. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. The evidence is persuasively against a rating in excess of 60 percent and, to that extent, the benefit of the doubt rule is inapplicable.

TDIU- Legal Criteria

The Veteran asserts that for the periods on appeal she was unable to maintain substantially gainful employment due to her service-connected disabilities.

Entitlement to a TDIU requires the presence of impairment so severe that it is impossible for the average person to follow a substantially gainful occupation. See 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. In reaching such a determination, the central inquiry is "whether the Veteran's service-connected disabilities alone are of sufficient severity to produce unemployability." See Hatlestead v. Brown, 5?Vet. App.?524, 529 (1993). Consideration may be given to the Veteran's level of education, special training and previous work experience in arriving at a conclusion, but not to age or to the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19.

Substantially gainful employment must be reviewed in a practical manner, and mere theoretical ability to engage in substantial gainful employment is not a sufficient basis to deny benefits. The test is whether a particular job is realistically within the physical and mental capabilities of the claimant. Moore v. Derwinski, 1?Vet. App.?356 (1991), Timmerman v. Weinberger, 510 F.2d 439 (8th Cir. 1975).

Where the schedular rating is less than total, a total disability rating for compensation purposes may be assigned when the disabled person 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, this disability shall be ratable at 60 percent or more, or if there are two or more disabilities, there shall be at least one ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a).

In Ray v. Wilkie, 31?Vet. App.?58, 73 (2019), the Court defined the term "unable to secure and
for compensation purposes may be assigned when the disabled person 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, this disability shall be ratable at 60 percent or more, or if there are two or more disabilities, there shall be at least one ratable at 40 percent or more, and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a).

In Ray v. Wilkie, 31?Vet. App.?58, 73 (2019), the Court defined the term "unable to secure and follow a substantially gainful occupation" as having two components: one economic and one noneconomic. The economic component means an occupation earning more than marginal income (outside of a protected environment) as determined by the U.S. Department of Commerce as the poverty threshold for one person. The non-economic component includes consideration of the following: The Veteran's history, education, skill, and training; whether the Veteran has the physical ability to perform the type of activities required by the occupation at issue; and whether the Veteran has the mental ability to perform the activities required by the occupation at issue.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3.

Evidence and Analysis

The Board incorporates the discussion from the sections above by reference.

As of this decision, during the relevant period, the Veteran is in receipt of service connection for impairment of rectal sphincter control, rated 60 percent disabling; right carpal tunnel syndrome, rated 10 percent disabling prior to February 23, 2021, and rated 40 percent thereafter; atopic dermatitis, rated 30 percent disabling; cervical spine disability, rated 10 percent disabling prior to February 23, 2021, and rated 20 percent disabling thereafter; lumbar spine disability, rated 20 percent disabling; right ankle disability, rated 10 percent disabling; left elbow disability, rated 10 percent disabling; left knee instability, rated 10 percent disabling; right knee instability, rated 10 percent disabling from February 23, 2021; left and right knee degenerative arthritis, each rated 10 percent disabling; right wrist strain, rated 10 percent disabling; left and right sciatic nerve radiculopathy, each rated 10 percent disabling from February 23, 2021; left and right femoral nerve radiculopathy, each rated 10 percent disabling from February 23, 2021; and hypertension rated as non-compensable. Her combined disability rating was 90 percent for the period prior to February 23, 2021, and 100 percent thereafter. Thus, she meets the schedular requirements for TDIU.

Turning to the evidence of record, during the course of the appeal period the Veteran submitted a formal TDIU claim in February 2021. On her VA Form 21-8940, Application for Increased Compensation Based on Unemployability, the Veteran indicated that she was unable to work due to her atopic dermatitis, impairment of rectal sphincter control, degenerative arthritis, lumbar spine, bilateral knees, left elbow, cervical spine, right wrist, right ankle, right carpal tunnel, left knee instability and hypertension. She reported that she last worked full-time in security at an Air Force base from October 2012 until April 13, 2018. She reported that she had left her last job due to her disability. Her highest education was two years of college. She had not completed any other education or training since becoming too disabled to work.

In a January 2020 private medical opinion, Dr. M.C. noted that the Veteran had left her job in 2018 due to the difficulties related to her fecal incontinence. The examiner noted that as it had become harder for her to control her bowel movements, the frequency of her accidents had increased. The examiner noted the Veteran's reports of not being able to clean up her accidents right away, and her avoiding eating to avoid accidents. The examiner explained that in her professional opinion, the habit was unsustainable and could clearly negatively impact her overall health. The examiner concluded that it was at least as likely as not that the service-connected impairment of rectal sphincter control had precluded her ability to secure and follow substantially gainful employment.

In a February 2021 Affidavit the Veteran wrote that she was last employed in personal security for an Air Force Base. At the job she spent the vast majority of her workday using a desktop computer
it had become harder for her to control her bowel movements, the frequency of her accidents had increased. The examiner noted the Veteran's reports of not being able to clean up her accidents right away, and her avoiding eating to avoid accidents. The examiner explained that in her professional opinion, the habit was unsustainable and could clearly negatively impact her overall health. The examiner concluded that it was at least as likely as not that the service-connected impairment of rectal sphincter control had precluded her ability to secure and follow substantially gainful employment.

In a February 2021 Affidavit the Veteran wrote that she was last employed in personal security for an Air Force Base. At the job she spent the vast majority of her workday using a desktop computer and performing interviews over the phone and in-person for people who needed security clearances. She reported that her back and knees made it difficult for her to sit for long periods of time, and after three or four hours she would have to get up for a break. She also wrote that the consistent computer use was difficult for her because of her right carpal tunnel syndrome, and the repetitive motions would cause her hand, wrist, arm and shoulder to ache for days. She also reported that her knees and feet would cause her pain and lock up on her while she was at work. Due to her impairment of rectal sphincter control she would sometimes have accidents on her way to work. She would have accidents anywhere from three times a week to several times per day. She would have to go to the bathroom three to four times a day to check that she did not have accidents, and each clean up would take about 10-15 minutes. She reported that while she was performing interviews at work, accidents would be very distracting and embarrassing because she could not clean up until they were over.

The Veteran was afforded several VA examinations in May 2021 in which the examiner opined as to the occupational impact of the service connected disabilities. The examiner opined that the service-connected hypertension and atopic dermatitis would not impact the Veteran's ability to work. As noted above, the VA examiner opined that the impaired may impact her ability to work as frequent restroom visits may hinder her work productivity. The examiner opined that the service-connected lumbar spine and knee disabilities would cause the Veteran difficulty with extended standing and walking if the work required but would not have an impact on sedentary work. The examiner also opined that the Veteran would have difficulty lifting over 15 pounds. The examiner opined that the Veteran would also have difficulty lifting weight due to her left elbow disability. Due to the service-connected neck disability the examiner opined that the Veteran would need to avoid commercial driving as quick observations would be limited by neck range of motion. Finally, the examiner opined that the Veteran's dexterity would be limited due to her service-connected right wrist disability.

The Board finds all of the VA and private examination reports and opinions discussed to be of great probative value to the extent that they show impact of the Veteran's service-connected disabilities on her ability to gain and maintain suitable employment for the relevant period. Indeed, the pertinent examiners considered the Veteran's contention, the claims file, and clinical medical evidence before providing opinions and assessments of the Veteran's disabilities and their functional impacts. See Nieves-Rodriguez v. Peake, 22?Vet. App.?295, 304 (2008) (the probative value of a medical opinion is derived from a factually accurate, fully articulated, and soundly reasoned opinion).

2. Entitlement to a total disability rating based on individual unemployability (TDIU) for the period prior to April 13, 2018, is denied.

Upon review of the claims file, the Board finds that a TDIU is not warranted for the period prior to April 13, 2018, as the weight of the evidence shows that the Veteran was employed full-time for this entire period. As she indicated on the VA Form 21-8940, she was employed until April 13, 2018. The Veteran does not contend, nor does the evidence show that she received an income less than the poverty threshold limit during the period on appeal. Additionally, the record does not reflect that at any point during the period on appeal the Veteran has asserted that her position was sheltered or protected. She has not provided evidence that she required any accommodation that may have rendered her full-time employment sheltered or marginal. As such, entitlement to a TDIU for the period on prior to April 13, 2018, is denied.

3. Entitlement to a TDIU from April 13, 2018, until February 23, 2021, is granted.

The Board has specifically considered the impact of the symptoms of her service-connected conditions on her ability to obtain and maintain substantially gainful employment for the
less than the poverty threshold limit during the period on appeal. Additionally, the record does not reflect that at any point during the period on appeal the Veteran has asserted that her position was sheltered or protected. She has not provided evidence that she required any accommodation that may have rendered her full-time employment sheltered or marginal. As such, entitlement to a TDIU for the period on prior to April 13, 2018, is denied.

3. Entitlement to a TDIU from April 13, 2018, until February 23, 2021, is granted.

The Board has specifically considered the impact of the symptoms of her service-connected conditions on her ability to obtain and maintain substantially gainful employment for the period from April 13, 2018, until February 23, 2021. After considering all of the evidence of record, including the Veteran's statements and VA and private medical evidence and opinions, and resolving all reasonable doubt in the Veteran's favor, the Board finds that the evidence of record is sufficient to find that the combined functional limitations imposed by the Veteran's service-connected disabilities precluded her performance of substantially gainful employment in both physical and sedentary work environments for the relevant period.

In consideration of the above, the Board finds that the evidence of record is sufficient to find that the Veteran's service-connected rectal sphincter impairment, lumbar spine, cervical spine, bilateral knee, right wrist and left elbow disabilities limited her ability to work in both sedentary and active occupations for the period on appeal from April 13, 2018, until February 23, 2021. As the Veteran reported in the February 2021 Affidavit, she would have accidents anywhere from three times a week to several times per day. While working she would have to get up from her desk several times a day to clean up and was not always able to in a timely fashion. The Veteran would also avoid eating in an effort to control her bowel movements while around other people, and Dr. M.C. opined that this behavior would have a negative impact on her overall health. Further, the Veteran reported that her back and knees caused her pain at work while sitting at her desk. The May 2021 VA examiner also opined that these conditions would cause her limitations in positions which required extended walking and standing. The Veteran wrote in the Affidavit that her wrist condition caused her difficulties when working on a computer, and the May 2021 VA examiner found that the Veteran's dexterity was limited due to the condition. The Board notes that the Veteran was last employed in 2018, working in a desk job at a security position. This is the type of job which required frequently sitting at her desk, typing on the computer and interacting with others. As such, the medical evidence of record suggests that the Veteran's ability to find substantially gainful employment in her prior field or in another profession or field would be impaired due to the symptoms associated with her service-connected disabilities.

For the foregoing reasons, the evidence is thus at least evenly balanced as to whether the combined impact of the Veteran's service-connected disabilities have precluded her from securing or following a substantially gainful occupation for the period on appeal from April 13, 2018, until February 23, 2021. Accordingly, after resolving all reasonable doubt in the Veteran's favor, the Board finds that an entitlement to a TDIU for the period from April 13, 2018, until February 23 2021, is warranted.

4. Entitlement to a TDIU from February 23, 2021, is dismissed as moot

The Veteran is currently in receipt of a combined 100 percent schedular rating for her service-connected disabilities beginning February 23, 2021. While this renders the issue of entitlement to a TDIU moot, it does not make the issue of entitlement to a TDIU irrelevant. See Locklear v. Shinseki, 24 Vet. App. 311, 314 n.2 (2011) (finding entitlement to TDIU mooted from the effective date of a 100 percent schedular disability rating); see also Herlehy v. Principi, 15 Vet. App. 33, 35 (2001) (finding a request for TDIU moot where 100 percent schedular rating was awarded for the same period).

The Court held in Buie and Bradley that a 100 percent schedular rating does not render TDIU moot if the TDIU would assist a veteran in obtaining special monthly compensation (SMC) pursuant to 38 U.S.C. § 1114 (s). See Buie v. Shinseki, 24 Vet. App. 242, 250-51 (2011) and Bradley v. Peake, 22 Vet. App.
100 percent schedular disability rating); see also Herlehy v. Principi, 15 Vet. App. 33, 35 (2001) (finding a request for TDIU moot where 100 percent schedular rating was awarded for the same period).

The Court held in Buie and Bradley that a 100 percent schedular rating does not render TDIU moot if the TDIU would assist a veteran in obtaining special monthly compensation (SMC) pursuant to 38 U.S.C. § 1114 (s). See Buie v. Shinseki, 24 Vet. App. 242, 250-51 (2011) and Bradley v. Peake, 22 Vet. App. 280 (2008). A veteran who has a service-connected disability rated as 100 percent disabling and (1) has an additional service-connected disability or disabilities independently rated at 60 percent or more, or (2) by reason of such service-connected disability or disabilities is permanently housebound, shall receive SMC under the provisions of 38 U.S.C. § 1114 (s). 38 C.F.R. § 3.350 (h)(3)(i).

This case, however, is distinguished from the case in Bradley, in that, as explained above, the grant of the Veteran's TDIU is not predicated on a single disability but is predicated on multiple service-connected disabilities. Therefore, this grant of TDIU is based on impairment from several service-connected disabilities, and not just a single disability.

Thus, for this period, the Veteran has no individual service-connected disability that is rated at 100 percent, and the Veteran's TDIU is predicated on multiple service-connected disabilities, the percentage rating criteria for SMC at the housebound rate have not been met at any point during the period on appeal. As such, for the period from February 23, 2021, entitlement to TDIU is considered moot, as the Veteran is already in receipt of a combined schedular evaluation of 100 percent, and the findings in Bradley are not applicable in this case. See Herlehy v. Principi, 15 Vet. App. 33, 35 (2001) (finding a request for TDIU moot where 100 percent schedular rating was awarded for the same period).

5. An effective date of April 13, 2018, for the grant of eligibility for Dependents' Educational Assistance under 38 USC chapter 35 is granted.

For the purposes of educational assistance under 38 U.S.C. Chapter 35, the child or surviving spouse of a veteran will have basic eligibility if the following conditions are met: (1) the veteran was discharged from service under conditions other than dishonorable, or died in service; and (2) the veteran has a permanent total service-connected disability; or (3) a permanent total service-connected disability was in existence at the date of the veteran's death; or (4) the veteran died as a result of a service-connected disability. 38 U.S.C. § 3501 (a)(1)(A); 38 C.F.R. §§ 3.807 (a), 21.3021. Except as provided in subsections (b) and (c), effective dates relating to awards under Chapters 30, 31, 32, and 35 of this title or Chapter 106 shall, to the extent feasible, correspond to effective dates relating to awards of disability compensation. 38 U.S.C. § 5113.

Accordingly, the only method of eligibility for Chapter 35 benefits which is relevant to the appellant is through the Veteran having a service-connected disability which has been rated 100 percent or to have been granted a TDIU.

The criteria pertaining to the award of educational benefits provides that for effective dates assigned following the grant of benefits under Chapters 30, 31, 32, and 35 shall, to the extent feasible, correspond to the effective dates relating to awards of disability compensation. 38 U.S.C. § 5113.

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As discussed in this decision, the Veteran has been granted an award of a TDIU effective April 13, 2018.

As such, an earlier effective date for the award of DEA benefits is also warranted in this case. The earliest possible effective date for DEA benefits is April 13, 2018, the newly assigned effective date for the award of a TDIU. Accordingly, an earlier effective date of April 13, 2018, for the assignment of DEA benefits is granted.

Ardie A. Bland

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Nettey, Counsel

The Board's decision in this case is binding only with respect

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