doc25

If you are rated at 70% you can apply for IU if the evidence shows that your SC condition keeps you from "gainful employment". Meaning it keeps you from staying employed or won't allow you to be promoted. If you can't keep a job for more than 6 months or you miss alot of work because of your disability. IU may be granted.
I concur with MPsgt, take a look at the regs, but also take a look at what a veteran-friendly law firm says and what the va says and research if you meet IU requirements.
https://www.hillandponton.com/unemployability-iu-guide/
https://www.va.gov/disability/eligibility/special-claims/unemployability/
Unfortunately, the burden falls on us veterans to educate ourselves and do the heavy lifting for the VBA ratings schedulers. But, the good thing is that you are not alone in this process you have fellow vets to help lessen that burden. Don't give up, and never give in. 
 
Best wishes.

Reading the evidence in your letter just shows how erroneous these VA examiners can be. What does it even matter whether or not you had a congenital foot issue when entering the military?  It seems clear based in the evidence that you developed bilateral foot issues while in service. 
 
I had flat feet noted on my entrance exam and had some issues while in active duty. It was noted on my exit exam that I had an abnormal gait.  Being ignorant about how VA disability worked,  I didn’t know I could file all of the issues I had when I was sent to the VA to file claims as part of my out processing. I only filed for an ankle and a varicocele that was aggravated during my service. These were also on my entrance exam. Even then the examiner just told me think of anything that bothered me on active duty. There were others like allergies and sinusitis that I had no idea VA would service connect. 
My initial flat foot claim was denied on an ACE exam because the examiner said I didn’t go to the doctor enough times for it while on active duty.  There is no such requirement on how many time you have to go get seen for an issue.  I asked for a DRO review and it was granted on appeal  
 

doc25 I am not a CUE expert by any means, but I think the CC&K submittal is very strong. Good luck.

OK, it is early Monday morning and I have not had my drugs but why did CC&K file this claim as a CUE.  If your claim was rated and issued on or around April 23, 2019 and this letter was submitted on April1, 2020 why didn't they just submit a disagreement since it would be a lot easier to win than a CUE claim (within a year time frame of your last denial).  Don't get me wrong you can still win a CUE claim and they would result in the same benefits but a CUE claim has a higher threshold to meet than a simple disagreement.
Sometimes it is best to get service connected then fight for the effective date.

The citations are very good .
I would have written this differently however.
It looks to me as if the VA did obtain your SMRs ( that would be listed in the decision's evidence list)
However they violated 38 CFR. 4.6 because it appears they did not even read them , even regarding the past denials.
And I would have filed CUE  in April 2019,  probably a day after I got the decision,.
Hopefully the HLR will do the right thing.
CCK had more info than we have here so , I do think it will help,but I will check the Citations, as soon as I get time.
38 CFR 4.6 covers a multitude of legal errors the VA can make . It is my Favorite regulation.
"§ 4.6 Evaluation of evidence. The element of the weight to be accorded the character of the veteran's service is but one factor entering into the considerations of the rating boards in arriving at determinations of the evaluation of disability. Every element in any way affecting the probative value to be assigned to the evidence in each individual claim must be thoroughly and conscientiously studied by each member of the rating board in the light of the established policies of the Department of Veterans Affairs to the end that decisions will be equitable and just as contemplated by the requirements of the law."
https://www.law.cornell.edu/cfr/text/38/4.6
Short and sweet.
 
 

§4.114   Schedule of ratings—digestive system.
Ratings under diagnostic codes 7301 to 7329, inclusive, 7331, 7342, and 7345 to 7348 inclusive will not be combined with each other. A single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation.
Unfortunately,  this statute would rebut your CUE, to seperate the combined IBS and GERD; but there's some good news.
My understanding of the bolded part, is that if a single rating is going to be assigned; the highest rating must be given from either 7319 and 7346 depending on the severity of the symptoms.
What does this mean? The highest rating of the two diagnostic codes would fall under 7346 Hiatal Hernia [GERD is assigned this code]at 60%. (That is the highest that is allowable.)
7346 Hernia hiatal: (hiatal hernia)
Here is a case where the veteran was granted 60% for combined GERD and IBS. Please read carefully. This case outlines exactly how the board used the medical evidence and the LAW to get it granted. You may have a CUE for getting assigned the highest rating. 
https://www.va.gov/vetapp09/files2/0919318.txt
I apologize if this isn't what would be ideal to hear, but I believe I found a way for attaining a higher evaluation, under your circumstances.
 

Congrats!
Go to Ebenefits in your dashboard there will be a menu to the right.
1. Click on "Your Letters" Letter Generator. 
2. Click on "Benefits Summary-Veterans Benefits"  Towards the bottom of the letter you should see if you're P&T or not.
If it's not there, give it a few days to update.

Well, let's see what those folks at the VBA do with the evidence you provided. They seem to do what they want.

Screwed? Not so fast. Let's take into consideration:
#1. There is  a link that was made.
#2. A specialist made the link. A pulmonologist opinion carries more weight than a General Practice Dr., Physician Assistant, or a Nurse Practitioner as a C&P examiner
It doesn't hurt to ask your dr. to write it in the format that was mentioned. 
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You seem to have met the Caluza elements for secondary connection, anyway. 
#1. You met the criteria for current diagnosis of Sleep Apnea.
#2. You met the criteria for a service-connected disability.
#3. A nexus of opinion was provided. Albeit, it does not contain the legal terminology. It does raise a significant amount of reasonable doubt in your favor.
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What we need to also look at is that:
#1. You had a sleep study done.
#2. The sleep study confirms you have sleep apnea.
#3. A diagnosis for sleep apnea was made. The diagnosis also has to state you need a "medically necessary" CPAP Machine
#4. You were issued a CPAP machine.

My claim was denied also. That was my third time getting denied, so I got with a lawyer. I went with Chisholm & Chisholm Kilpatrick. Hill & Ponton is reputable also.
CCK is doing it pro bono. If I get denied again, I don't owe them anything. But, if I get it granted they're asking for 30% from the retropay. I don't mind it because I'll see that money anyway after a few months.

There is some good news, but please start your own topic so we can point you in the right direction.
I'll initiate some of that good news on here.
#1. Don't beat yourself up over something that you did or didn't do.
#2. All the other issues you are having can be secondary connected to Psoriatic Arthritis, once you get it service-connected.
#3. Since the pain is severe enough that it is causing you to not get sleep that is called Insomnia; you can claim that secondary as well. Is this condition also causing you to have Depression? This can also be claimed, as secondary. The Insomnia and Depression will be combined because both are mental health disorders.
I'll explain further once you create your own topic.
 

Do you have an unprotected disability, such as a mental health disorder? You will want to continue going to therapy at least every six months to establish that your disability has gotten worse or is unchanged from your current symptoms.
 

I just wanted to give everyone an update;
     We just got our phone call from the higher level reviewer- (HLR request filed May 10).  He was out of the Seattle Office and we FINALLY got someone who knows how to read!!! 😄   I was getting ready to start quoting law to him and he told us immediately he's a veteran himself and wanted to apologize profusely for the clear errors on this claim.  He stated that he is documenting that the VA failed in their duty to assist and that the medical opinion listed in the file is "complete and total crap".  Apparently the Dr who wrote the medical opinion contacted the VA and offered her apologies stating that she realized she was mistaken in stating that his STRs had no documentation of intestinal issues or resection. (It might have had something to do with a certified letter we sent to her advising her we were considering legal action for medical malpractice due to her completing medical documentation in gross deviation from the facts of record available to her which she inaccurately cited.)  He said that the VA already ordered a NEW opinion which is completed and favorable but since it was done AFTER the HLR was filed, he technically is not allowed to use that for consideration.  
So, Long story short is he is filing the notice of error and basically "remanding" it back to the decision board because he said once that happens, they will officially have access to the new opinion and can issue the service connection.  He is also documenting that our claim has been continuously executed for the last 2 1/2 + years and that the service connection date should go back to the original filing date.  Nothing "official" yet, but he estimated we should have service connection within 60 days.  I will post an update when we get it confirmed!
 

File a Notice of Disagreement. This will preserve the earliest effective date. Your dad has 1 year from the denial to appeal.
They'll reopen a denied claim if you have "new and relevant" evidence that the VA did not have before. You'll want to do this under the Supplemental Claim Lane. You'll be afforded another C&P exam, if needed.
A nexus of opinion, is what you'll really need, because it sounds like a Disability Benefits Questionnaire was filled out once and you had another one filled out again. Although you will have  a "new" DBQ and it's "relevant" to the claim  it will only reopen the claim, but will get denied because it will more likely than not; will have the same information.
The nexus of opinion will add weight to your dad's A/A claim. 
If you do not have any "new and relevant" evidence you can appeal in the higher review lane. BEWARE: You can not use "new and relevant" evidence in this lane while it is in progress.
It's in your dad's best interest to remain in the Supplemental Claim Lane or Appeal to the Board of Veteran's Appeals Lane. 
Can you post the denial letter? This will give us a better picture of what the RO used for evidence.Redact or Darken out any personal identifying information, such as SSN/Names/Date of Birth

I picked up on the tone of his post,as well. It's a red flag for depression caused by this issue. I second that motion for Ward to get help.
John Ward two fellow vets agree you need to get seen sooner rather than later for the depression you are experiencing. Please seek help as soon as you can. 
 
 

It's for the questionnaire only. That happened to me on my last claim and they did not ask for a Nexus. My claim ended up denied.
I had asked the LHI examiner if a nexus would help my claim. His exact words were, as follows, "Yes. But the VA only asked me for the DBQ, not the Nexus. So, I can't write one in if they did not request for one." 
Although, MY claim was denied. It doesn't mean yours will.

I picked up on the tone of his post,as well. It's a red flag for depression caused by this issue. I second that motion for Ward to get help.
John Ward two fellow vets agree you need to get seen sooner rather than later for the depression you are experiencing. Please seek help as soon as you can. 
 
 

You can submit any evidence during the claims process up until the day it is decided, if I'm not mistaken.
Don't reopen to try direct service connection, unless there was a diagnosis in-service and you were given a CPAP in-service. APPEAL. APPEAL. APPEAL the secondary connection.
You have a case for secondary connecting OSA to MDD. You want to preserve your earliest effective date to when you submitted the claim. As long as, you continue to prosecute the claim, you'll get more in retropay.
Read the article I provided closely. A VA DOCTOR was on the panel doing the study linking OSA to Psychological Disorders.

Total knee replacements are temporary ratings, but after one year are required to be reevaluated, from my understanding. 
So, you should be getting a follow up C&P exam letter sometime this year to be reevaluated. If you don't, then good for you.

You can submit any evidence during the claims process up until the day it is decided, if I'm not mistaken.
Don't reopen to try direct service connection, unless there was a diagnosis in-service and you were given a CPAP in-service. APPEAL. APPEAL. APPEAL the secondary connection.
You have a case for secondary connecting OSA to MDD. You want to preserve your earliest effective date to when you submitted the claim. As long as, you continue to prosecute the claim, you'll get more in retropay.
Read the article I provided closely. A VA DOCTOR was on the panel doing the study linking OSA to Psychological Disorders.

I don't make up the rules man. This will better explain what I meant.
 
VA Disability - Step 6: When the initial decision finds no "nexus"
What is the "nexus" and why is it important? 
To get benefits, you must meet three tests. You need to show:
eligibility by your military service, diagnosis of a "condition," and evidence that the condition started during your military service or, if your condition was preexisting, that it was aggravated by military service. This third test is the connection or "nexus" between what happened to you in the military and your current medical condition.
Case in point: the back injury story
In many cases this connection, or "nexus" may be tenuous at best. Let's consider, for example, a back injury. You may have hurt your back in some fashion while serving your country. That was in 1970 and you went on sick call. Your sore back was diagnosed as a "pulled muscle" or something similar.  You were given some APC tablets and sent on your way to light duty for 3 days. The back became more painful so you were back on sick call a week later. This time an x-ray was ordered and you were given some stronger pain pills. Your light duty was increased to  restricted duty for a month with orders of no lifting, no PT and so on.
The military culture demands that we don't complain of our "minor" aches and pains. The team depends on each member being ready to complete the mission and the mission is all that counts. From day one we're trained that complaints of pain will bring about scorn from superiors. Fellow soldiers will know that they have to carry your load as well as their own. "Pain", we learn, "is weakness leaving your body." Pain is good. If J.B. Books [John Wayne character in the 1976 movie "The Shootist"] didn't complain about his back pain, why should you?
So you toughed it out, used a lot of aspirin. While your back did improve, you always guarded it and were cautious that you didn't injure yourself again. Your civilian career wasn't as physical as the military. So during the years since your ETS you've had a chronic, low level back pain but it hasn't required much treatment...until now.  In the last year you've had to seek more intensive medical care, and finally you had an MRI. The MRI study shows numerous issues with disks and nerves. You realize that your old service injury is here to haunt you.
You file for service-connected disability compensation. You have a C & P exam. And about a year later you have a denial letter. The VA tells you that although you had complaints during your service, your condition today is new and unrelated to those old problems. Now what?
How do I prove this "nexus"?
The "nexus letter" is the key to winning your appeal. Nexus is defined as "the means of connection between things linked in series."
Your next task is to seek an expert physician who will review your complete medical records. You'll ask him or her to write a letter stating their opinion that your condition today is related to your military service. 
Any physician who is qualified to write a "nexus" letter on your behalf may do so. While it is commonly believed that VA physicians aren't allowed to write such letters, that isn't true. VA physicians, as with many civilian physicians, simply don't like to write such letters. They may not be skilled at this task or may not have the tools at hand to write the letter. And typically they are so busy caring for a heavy load of patients that your issue isn't a priority.
What does the letter look like? 
The nexus letter should follow a similar format to all letters that you use to communicate to VA. It should record only the facts and the doctor's conclusions. It may be addressed directly to you or "To Whom It May Concern." Also, see if the physician is willing to provide you with a current resume to attach to the letter; this will help to support the physician's expertise.  View sample letter.
Note the specific language in the opening and closing paragraphs. Less specific language may not meet the VA standard.  The C & P Service Clinicians Guide  gives the examining physician the exact phrasing to be used in the "nexus" statement. Here is the relevant section of the Guide:
"When asked to give an opinion as to whether a condition is related to a specific incident during military service, the opinion should be expressed as follows:
“is due to” (100% sure) “more likely than not” (greater than 50%) “at least as likely as not” (equal to or greater than 50%) “not at least as likely as not” (less than 50%) “is not due to” (0%) " The importance of using the language  at # 1, 2, or 3 is apparent.
Here is another sample letter.  Again, note the "more likely than not" language in the "nexus" statement. Also, notice that the other medical information is pared down to the essential facts. Here is another note about this letter from it's author,  Jim Strickland: "The only thing missing from this letter is an often-used statement to point out that there are no other known or apparent causes for the current condition. That might read like; "There is no known history of the veterans family having this condition..." or "The veteran has no other known history that would cause or contribute to this condition...". I only include that statement when the cause of the condition is less than apparent. I might use that to show that a cancer was more likely than not caused by exposure to Agent Orange and that the veteran had no family history or exposure to other carcinogenic chemicals that may be seen as a possible cause for the current condition. In this case there were 2 documented traumatic events that were the likely cause of the injury making any reference to other possible causes unnecessary."
How do I get a doctor to support my claim?
It's best to make a routine appointment and meet face-to-face with the doctor. Ask her directly to draft or sign the letter.  Assuming that the physician agrees with your "nexus" claim, it is perfectly acceptable for you to draft the letter on her behalf. Then ask her to review and sign it, or edit and then sign, if she feels more comfortable with that. I advise you not to ask a nurse or clerk to perform the task of getting the physician's signature. These members of the care team often see themselves as "gatekeepers," to guard and protect the physician from tasks that will only take up more valuable time. They may believe that "rules" or "law" won't allow the physician to sign such a document and may refuse you access to the doctor.  Most physicians will sign such a letter if it is brief, to the point and factual.
What if I can't find a doctor who wants to do the letter?
Some physicians are specialists who perform records reviews and/or Independent Medical Examinations and provide opinions. These doctors usually do a very good job with writing nexus letters, assuming that you can't get one some other way. These independent physicians can charge from about $1000.00 and up, depending on the extent of the services. You must pay that fee in advance with no guarantee that the physician will agree with your theory or that you will get benefits. The Independent Medical Exam doctor does not treat or prescribe and provides only a records review and report.
Conclusion
The importance of the nexus letter can't be overstated. In many situations the nexus letter from an expert is the only evidence that will tip the scales in your favor. 

The DBQ's are not sufficient evidence for a nexus of opinion. They are only good to give the rater a better picture of your symptoms.
If you were not provided a C&P exam, this might fit in as "failure to apply the Duty to Assist".
APPEAL this, because it's well known in the medical community that back conditions, especially chronic pain, can cause mental disorders.
Read this:
https://www.medicalnewstoday.com/articles/314493.php
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)12479-8/fulltext
https://www.practicalpainmanagement.com/resources/news-and-research/international-study-finds-back-pain-mental-health-closely-tied
 
You can provide these articles as additional medical evidence. You don't have to be a medical professional to provide evidence of what's already been researched and linked by actual medical professionals. 
 

The DBQ's are not sufficient evidence for a nexus of opinion. They are only good to give the rater a better picture of your symptoms.
If you were not provided a C&P exam, this might fit in as "failure to apply the Duty to Assist".
APPEAL this, because it's well known in the medical community that back conditions, especially chronic pain, can cause mental disorders.
Read this:
https://www.medicalnewstoday.com/articles/314493.php
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)12479-8/fulltext
https://www.practicalpainmanagement.com/resources/news-and-research/international-study-finds-back-pain-mental-health-closely-tied
 
You can provide these articles as additional medical evidence. You don't have to be a medical professional to provide evidence of what's already been researched and linked by actual medical professionals. 
 

I think vets should also be compensated for doing the raters job...GS11 pay sounds like a good starting point. lol. 

I think vets should also be compensated for doing the raters job...GS11 pay sounds like a good starting point. lol.