Case A26039439

B. D. WATSON · 2026 · Case ID: A26039439

GRANTED

Summary

The Veteran, an Army veteran who served from July 1982 to October 1986, appeals the denial of Total Disability based on Individual Unemployability (TDIU). The case was previously denied by the Board in February 2025, but remanded by the Court of Appeals for Veterans Claims due to the Board's failure to discuss a vocational expert's opinion regarding sedentary employment limitations. The Veteran claims that his service-connected disabilities prevent him from securing and maintaining substantially gainful employment. The Board considered the Veteran's service-connected disabilities, including coronary artery disease/cardiac transplantation (rated 60% to 100%), PTSD (rated 50%), paralysis of the external popliteal nerve (rated 40%), and various physical impairments. The Board found the Veteran's combined disabilities met the schedular criteria for TDIU. The Veteran's own statements and a private vocational opinion from L.P. were key evidence. L.P. concluded that the Veteran's PTSD symptoms, including difficulty concentrating, work-related stress, and attendance issues, combined with physical limitations from his hip, knee, and nerve conditions (pain, limited mobility, fall risk, need to change positions frequently), prevented him from meeting employer expectations for focus, attendance, and productivity. The Board found L.P.'s opinion more persuasive than the VA examiners' regarding the impact on sedentary work, concluding that the Veteran's combined physical and mental conditions preclude him from substantially gainful employment. Therefore, TDIU was granted.

Rationale

Veteran meets schedular criteria for TDIU with a 60% disability and combined rating of 90% or more.; Private vocational opinion found Veteran unable to perform sedentary work due to combined physical and mental limitations.; Board found private vocational opinion more persuasive than VA exams regarding impact on employment.

Service Branch

ARMY

Special Benefit

TDIU

Docket No.

241108-491165

Full Decision Text

Citation Nr: A26039439
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 241108-491165
DATE: April 28, 2026

ORDER

Entitlement to total disability based on individual unemployability (TDIU) is granted.

FINDING OF FACT

The persuasive weight of the evidence supports the conclusion that the Veteran's service-connected disabilities prevent him from being able to obtain and maintain substantially gainful employment.

CONCLUSION OF LAW

The criteria for total disability based on individual unemployability (TDIU) have been met. 38 U.S.C. §§ 1155, 5110; 38 C.F.R. §§ 3.400, 4.16(a).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the United States Army from July 1982 to October 1986.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2024 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO).

This matter was last before the Board in February 2025, at which time it was denied. The Veteran timely filed an appeal to the United States Court of Appeals for Veterans Claims. In a December 2025 Joint Motion for Remand (JMR), the parties agreed that the Board erred when it failed to discuss the vocational expert's opinion that the Veteran is unable to perform sedentary employment. As such, the Court vacated the Board's February 2025 decision and remanded this matter to the Board for compliance with the terms of the JMR.

1. Entitlement to total disability based on individual unemployability (TDIU) is granted.

The Veteran seeks a TDIU and contends that his service-connected disabilities cause him to be unable to secure or follow substantially gainful employment.

A TDIU may be assigned, where the schedular rating is less than total, where a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities. 38 C.F.R. § 4.16(a). To qualify for schedular consideration of a TDIU, if there is only one such disability, this disability shall be ratable at 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. Id.

For the purposes 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, one or both lower extremities, including the bilateral factor, if applicable; (2) disabilities resulting from common etiology or a single accident; (3)disabilities affecting a single body system, e.g., orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric; (4) multiple injuries incurred in action; or (5) multiple disabilities incurred as a prisoner of war. 38 C.F.R. § 4.16(a); see Moody v. Wilkie, 30 Vet. App. 329, 339 (2018) (combining disabilities as "one disability" to meet the rating threshold of § 4.16(a) requires the use of the combined rating table).

The phrase "unable to secure and follow a substantially gainful occupation" contains both economic and noneconomic components. See Ray v. Wilkie, 31 Vet. App. 58, 73 (2019). The economic component refers to 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. Id. The noneconomic component requires a determination as to a veteran's ability to secure and follow such employment. Id. Attention should be given to the veteran's history, education, skills, and training; whether the veteran has the physical ability (both exertional and nonexertional) to perform the types of activities required by the occupation at issue (e.g., lifting, bending, sitting, standing, walking, climbing, as well as auditory and visual limitations); and whether the veteran has the mental ability to perform the activities required by the occupation at issue (e.g., memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity). Id.

An award of TDIU is an individualized determination, specific to a veteran's particular circumstances, e.g., their history, education, skills, and training. See Todd v. McDonald, 27 Vet. App. 79, 85 (2014). It does not require a showing of
ertional) to perform the types of activities required by the occupation at issue (e.g., lifting, bending, sitting, standing, walking, climbing, as well as auditory and visual limitations); and whether the veteran has the mental ability to perform the activities required by the occupation at issue (e.g., memory, concentration, ability to adapt to change, handle work place stress, get along with coworkers, and demonstrate reliability and productivity). Id.

An award of TDIU is an individualized determination, specific to a veteran's particular circumstances, e.g., their history, education, skills, and training. See Todd v. McDonald, 27 Vet. App. 79, 85 (2014). It does not require a showing of 100 percent unemployability. Roberson v. Principi, 251 F.3d 1378, 1385 (Fed. Cir. 2001). The ultimate question is whether they are capable of performing the physical and mental acts required by employment, not whether they can find employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993).

The Veteran has the following disabilities that are service connected: coronary artery disease/cardiac transplantation, rated at 60 percent from June 1, 2023, and 100 percent from February 12, 2025; posttraumatic stress disorder (PTSD), rated at 50 percent from June 1, 2023; paralysis of the external popliteal nerve, rated at 40 percent from August 1, 1999; left hip strain, rated at 10 percent from June 1, 2023; painful right knee scar, rated at 10 percent from June 1, 2023; right knee degenerative arthritis, rated at 10 percent from June 1, 2023; coronary artery bypass surgical scar, rated at 0 percent from June 1, 2023; and right posterior knee scar, rated at 0 percent from June 1, 2023. The Veteran's total combined disability rating was 40 percent from August 1, 1999, 90 percent from June 1, 2023, and 100 percent from February 12, 2025.

Based on the foregoing, the Veteran has one disability rated at 60 percent or more and at least one disability rated at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. Accordingly, the Board may consider the claim for a TDIU on a schedular basis. 38 C.F.R. § 4.16(a).

For the reasons that follow, the Board finds that a TDIU is warranted.

In May 2015 Social Security Administration (SSA) records received by VA in December 2023, the Veteran stated he was unable to work due to arthritis, knee injuries, back pain, neck pain, and disc disease. Regarding his previous job as a financial consultant, the Veteran explained that his job required 75 to 80 percent travel, which he could no longer do because of his bilateral knee conditions. The Veteran indicated that his disabilities impacted his ability to lift, squat, bend, stand, walk, kneel, and climb stairs. He explained that he could not lift more than ten pounds or walk more than 50 yards without either a limp or discomfort. He further stated that he could follow written and spoken instructions fairly well, get along with authority figures fairly well, handle stress fairly well, and could handle changes in routine fairly well. However, while SSA found that the Veteran's physical disabilities resulted in some work-related restrictions, they did not prevent him from being able to work. SSA noted that the Veteran performed seated consultant and accounting work in the past, and his conditions do not prevent him from doing this type of work.

The Veteran submitted a VA Form 21-8940, Veterans Application for Increased Compensation based on Individual Unemployability, in November 2023. At that time, he stated that all of his service-connected disabilities prevented him from being able to work. He stated that he became too disabled to work as of April 2014, and that was also the last time he was employed fulltime. The Veteran completed four years of college, and his occupation from 2002 to 2014 was a financial analyst. The Veteran explained that he last worked in April 2014 due to his PTSD and resulting substance abuse problems leading him to frequently miss work, as well as switched companies multiple times because of issues working with others and his unpredictability. Additionally, he stated that his last job was made possible due to him being able to work from home and the fact that he had an understanding supervisor who made a lot of allowances for him.

Regarding the Veteran's left hip condition, the July 2023 examiner found that the Veteran reported regularly
to work as of April 2014, and that was also the last time he was employed fulltime. The Veteran completed four years of college, and his occupation from 2002 to 2014 was a financial analyst. The Veteran explained that he last worked in April 2014 due to his PTSD and resulting substance abuse problems leading him to frequently miss work, as well as switched companies multiple times because of issues working with others and his unpredictability. Additionally, he stated that his last job was made possible due to him being able to work from home and the fact that he had an understanding supervisor who made a lot of allowances for him.

Regarding the Veteran's left hip condition, the July 2023 examiner found that the Veteran reported regularly using a cane and occasionally using a walker, and he had difficulty completing occupational tasks due to pain. The December 2023 examiner indicated that the Veteran reported that he experienced shooting and throbbing pains, and he took gabapentin, Percocet, and methocarbamol to help with the pain. He also reported that his hip condition impacts his ability to sit, stand, or walk for prolonged periods, and he required mobile support with a cane. In the January 2024 examination, the Veteran again reported experiencing pain and aching all the time. However, the examiner ultimately found that the Veteran's left hip condition did not affect his ability to perform sedentary and nonambulatory activities.

Regarding the Veteran's right knee condition, the July 2023 examiner noted that the Veteran reported experiencing right knee pain, for which he received a pain management injection every three months and took gabapentin and oxycodone. However, the examiner found that the Veteran's right knee condition did not cause any functional impact. The January 2024 examiner noted that the Veteran reported experiencing pain, weakness, and limited movement due to his right knee condition, and he used Voltaren gel, Celebrex caps, and oxycodone for treatment. The examiner found that the Veteran's right knee condition resulted in a limited ability to perform duties that require prolonged standing, walking, squatting, or going up and down stairs. However, his condition would not affect his ability to perform sedentary, nonambulatory duties.

Regarding the Veteran's scars, the July 2024 examiner found the Veteran's scars had no functional impact, while the January 2024 examiner found his painful right knee scar had no effect on his ability to perform any occupational tasks.

Regarding the Veteran's peripheral nerve condition, the July 2023 examiner noted that the Veteran had moderate constant pain, paresthesias/dysesthesias, and numbness in both lower extremities. However, his nerve condition did not result in any functional impact. The January 2024 examiner noted that the Veteran's right popliteal nerve condition resulted in foot drop and a decreased ability to move his right foot. The Veteran was prescribed oxycodone, gabapentin, and Voltaren gel for treatment, and he used a cane. He also had moderate constant pain and paresthesias/dysesthesias, severe intermittent pain and numbness in the right lower extremity, and moderate dysesthesias/paresthesias and numbness in the left lower extremity. The examiner concluded that the Veteran's nerve conditions would limit his ability to perform weightbearing activities like standing, walking, or squatting, but it would not affect sedentary and nonambulatory activities.

Regarding the Veteran's heart condition, the July 2023 examiner found that the Veteran's CAD impacted his ability to work because it resulted in fatigue and made it difficult for the Veteran to complete household tasks within a timely manner. Private treatment records show that the Veteran was found to have acute or chronic systolic heart failure, NYHA Class IV, cardiogenic shock in January 2025, and an article from the American Heart Association notes that this means there are symptoms of heart failure at rest, with any physical activity causing further discomfort.

Regarding the Veteran's PTSD, the August 2023 examiner found that the Veteran had additional diagnoses of opioid and stimulant use disorders that were in sustained remission. He also had symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, and disturbances of motivation and mood. The examiner found that the Veteran's PTSD resulted in occupational and social impairment with reduced reliability and productivity. The December 2023 examiner noted that the Veteran had an additional diagnosis of mild alcohol use disorder. The Veteran had symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, and difficulty in adapting to stressful circumstances. Overall, the Veteran's psychiatric conditions resulted in occupational and social impairment with reduced reliability and productivity, which the examiner found would impact the Veteran in all settings.

In November 2024, the Veteran submitted
that were in sustained remission. He also had symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, and disturbances of motivation and mood. The examiner found that the Veteran's PTSD resulted in occupational and social impairment with reduced reliability and productivity. The December 2023 examiner noted that the Veteran had an additional diagnosis of mild alcohol use disorder. The Veteran had symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, and difficulty in adapting to stressful circumstances. Overall, the Veteran's psychiatric conditions resulted in occupational and social impairment with reduced reliability and productivity, which the examiner found would impact the Veteran in all settings.

In November 2024, the Veteran submitted a private vocational opinion by L.P. In her opinion, L.P. acknowledged that she reviewed the VA examinations of record regarding the Veteran's left hip, right knee, peripheral nerve, and PTSD. She also noted that the Veteran had a bachelor's in accounting and had worked in multiple accounting or financial analyst positions between 1992 and 2014. The Veteran reported experiencing PTSD symptoms such as becoming easily stressed and overwhelmed at work, self-medicating in an attempt to alleviate his symptoms, isolating himself, fatigue, crying spells, depressed mood, losing relationships with family and friends, oversleeping, suicidal thoughts, insomnia, lack of appetite, lack of motivation related to personal hygiene, anxiety, panic attacks at work, difficulty focusing and concentrating, being unable to work on a team, issues with authority figures, irritability at work with verbal outbursts, needing assistance from coworkers to complete work, missing work, and leaving work early due to these symptoms at least four days per month. He also explained that his nerve condition, bilateral hip and thigh pain, and right knee pain caused additional issues for him while working, including flareups in pain that cause him to be unable to get out of bed, self-medicating to deal with the pain, a history of falling, using a cane and walker for balance, inability to use the stairs or bend over to pick something up off the floor, difficulty walking or standing for more than two to three minutes, difficulty sitting for more than 30 minutes at a time, needing to constantly change positions, pain disrupting his sleep that results in daytime sleepiness, pain contributing to his irritability, requiring the assistance of his wife for dressing and getting in and out of the shower, and missing work at least three days per month due to pain and discomfort.

After reviewing the claims file and interviewing the Veteran, L.P. ultimately concluded that the Veteran's service-connected disabilities (except for CAD, which was not granted service connection until a June 2025 rating decision) prevented him from being able to find and maintain substantially gainful employment. L.P. described how, per industry standards, employers will only allow an employee to be off task up to 10 percent of the workday, expect employees to maintain focus on work tasks for at least two consecutive hours, attend work on a regular schedule, remain free from distraction or interruption from coworkers but cannot work in isolation, consistently produce a minimal amount of work, and adapt to a least minimal work place changes. However, the Veteran's conditions all impact his ability to focus, whether due to fatigue and concentration issues related to his PTSD or pain from his physical disabilities. He would experience difficulty staying alert throughout the workday, with him either falling asleep during work or requiring naps and additional breaks as a result of both his PTSD symptoms and the pain from all of his physical disabilities. The Veteran's disabilities would also impact his work attendance, leading to tardiness or absence more than the one day per month often accepted by many employers.

Regarding sedentary employment, L.P. opined that the Veteran could not be accommodated with a sit-stand option for sedentary work due to his use of a cane or other assistive device for ambulation and standing, his need to elevate his legs and feet to waist level while sitting, and his history of falls. The Veteran's physical disabilities prevent him from being able to stand or walk for more than two to three minutes, sit for more than 30 minutes, and cause him to need to constantly change positions. Thus, between the Veteran's fall risk and the frequency with which he needs to change positions while sitting would lead to him being off task for more than 10 percent of the workday, which would exceed the accepted standard of many employers. As such, L.P. concluded that the combined impacts of the Veteran's service-connected conditions prevented him from being able to find and maintain substantially gainful employment at any level.

The Veteran's ability to secure and follow a substantially gainful occupation is impacted by the physical effects of all of his service-connected conditions. The Veteran's CAD and PTSD are shown to result in fatigue, while the Veteran's left hip, right knee, and peripheral nerve conditions all result in difficulty sitting, walking, or standing for prolonged periods of time due to pain, limited motion, and foot drop. While the January examiner found that the Veteran's hip, knee, and nerve conditions did not prevent him from being able to perform sedentary work, the Board finds the November 2024 vocational opinion to be more persuasive regarding the impact of the Veteran's conditions on his ability to perform sedentary work. Although the January 2024 examiner is competent to discuss functional impacts of the Veteran's conditions and how they may impact his ability to perform occupational movements and tasks, as a vocational expert, L.P. is more familiar with how such symptoms and limitations will impact the Veteran's employment when considering what a standard employer is willing to tolerate. Thus, the Board finds that the Veteran's physical conditions prevent him from performing even sedentary employment.

The Veteran's ability to secure and follow a substantially gainful occupation is impacted by the mental effects of his PTSD, with difficulties with focus and concentration, difficulty adapting to stressful situations, anxiety, depression, and disturbances of motivation of mood. These symptoms impact the Veteran's ability to concentrate, show up to work in a timely fashion, stay on task throughout the workday, and produce the minimum amount of work required. As discussed by L.P. in her vocational opinion, many employers have a baseline of what they tolerate regarding how often an employee requires breaks, is tardy or absent, is off task, or underproduces. Here, the Veteran's mental symptoms would negatively impact his ability to perform across multiple areas that, when taken in combination, would likely result in the Veteran exceeding an employer's baseline, and thus prevent him from being able to find and maintain substantially gainful employment.

(continued on next page)

Given the foregoing, the evidence of record supports the conclusion that the Veteran's service-connected disabilities preclude him from the ability to secure and follow a substantially gainful occupation consistent with his education, skills, training, and work history. Accordingly, a TDIU is warranted.

B. D. WATSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Ongies, Gabrielle L.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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