Geib v. Shinseki, 733 F.3d 1350 (Fed. Cir. Oct. 29, 2013)
In a claim for a total disability rating based on individual unemployability (TDIU), VA is not required to obtain a single medical opinion that addresses the combined effect of all the claimant’s service-connected disabilities on employability. Geib, 733 F.3d at 1353-54 (“Although the VA is expected to give full consideration to ‘the effect of combinations of disability,’  neither the statute nor the relevant regulations require the combined effect to be assessed by a medical expert.”)
In this case, the veteran was service connected for multiple disabilities. He applied for TDIU and was ultimately afforded two examinations – one for hearing loss and the other for trenchfoot. The audiology examiner opined that the veteran’s hearing loss and tinnitus do not prevent gainful employment. The trenchfoot examiner opined that his trenchfoot did not prevent gainful employment. The RO denied the TDIU claim. The veteran appealed, arguing that the Board was required to obtain a single medical opinion that addressed the impact of all his service-connected conditions. The Veterans Court affirmed the Board’s denial, and the Federal Circuit agreed.
The Federal Circuit noted that the regulations “place responsibility for the ultimate TDIU determination on the VA, not a medical examiner.” Id. at 1354 (citing 38 C.F.R. § 4.16(a)). The Court stated: “Where, as here, separate medical opinions address the impact on employability resulting from independent disabilities, the VA is authorized to assess the aggregate effect of all disabilities, as it did.” Id. The Court emphasized that “the VA is expected to give full consideration to ‘the effect of combinations of disability.’” Id. (citing 38 C.F.R. § 4.15). The Court added that “[w]here neither the regional office nor the Board addresses the aggregate effect of multiple service-connected disabilities,” the record is inadequate for review. Id.