Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities on an extraschedular basis prior to August 30, 2022, is granted.

Board reasoning

The Board grants an extraschedular TDIU prior to August 30, 2022 based on a combination of lumbar sprain with ankylosing spondylitis, cervical spine strain, and tension headaches, finding the overall functional impact precluded substantially gainful employment despite not meeting the traditional 4.16(a) thresholds. The Board weighs the medical and lay evidence showing ongoing physical limitations (lifting, carrying, sitting, standing, walking, neck movements, and headaches) and noneconomic factors like education and work history, resolving reasonable doubt in the Veteran's favor to conclude unemployability existed in the period before August 30, 2022. The Board emphasizes that the vocational impact of multiple disabilities together, rather than individual findings, supports the extraschedular grant.