I don't think it's a hardware issue considering that another program recognizes my key press for CTRL + ALT + (Any Keys)
But I find it weird that tv paint lists them as an option but won't let me use them.

(here's a short youtube video just to show what I'm trying to do)
[youtube]https://www.youtube.com/watch?v=isstCppBEVQ[/youtube]
Again I might have set up something wrong on my end.