06-05 127, 06-05 127

Veteran served 1967–1969; retired from state employment in 2007; college-educated and last worked in administration.
Veteran filed for TDIU in May 2009 and has argued his service‑connected orthopedic conditions (back, knee, ankle, foot scars) and medication side effects render him unemployable.
Since earlier exams, VA granted service connection for hypertension, tinnitus, and bilateral hearing loss; current combined rating is 80% effective May 2009.
Prior VA exams (2011, 2012) found the Veteran capable of sedentary work; recent treatment notes (2016) document worsened pain, cane use, dizziness, and functional decline.
Board finds need for a new VA examination addressing the impact of all service‑connected conditions (individually and combined) on work-related activities and remands for development.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Entitlement to TDIU	Veteran: service‑connected orthopedic conditions and medication effects prevent lifting, standing, walking, and other work tasks; requires accommodations; currently unemployable.	VA/RO: prior examinations conclude he can perform sedentary activities; continued denial of TDIU.	Remanded for a new exam and readjudication; Board did not grant TDIU and directed further development.
Entitlement to an extraschedular rating	Veteran: combined effect of service‑connected disabilities may warrant rating in excess of the schedular range.	VA/RO: no extraschedular rating granted; further development needed.	Remanded for new examination and readjudication because updated evidence may affect extraschedular consideration.

Brambley v. Principi, 17 Vet. App. 20 (Vet. App. 2003) (holding that development relevant to TDIU may affect extraschedular consideration)
Jones v. Shinseki, 23 Vet. App. 382 (Vet. App. 2010) (requiring examiners to state whether opinions would require impermissible speculation)
Kutscherousky v. West, 12 Vet. App. 369 (Vet. App. 1999) (appellant may submit additional evidence after remand)