Citation Nr: 18141655 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 15-32 756 DATE: October 11, 2018 ORDER As new and material evidence was received, the claim for entitlement to service connection for left and right knee pain (claimed as joint pain) is reopened. To this extent only the claim is granted. Entitlement to service connection for headache is denied. Entitlement to service connection for depression is denied. Entitlement to service connection for sciatic radiculopathy, left lower extremity is denied. Entitlement to service connection for sciatic radiculopathy, right lower extremity is denied. entitlement to service connection for left knee strain (claimed as joint pain) is denied. Entitlement to service connection for right knee strain (claimed as joint pain) is denied. Entitlement to service connection for left shoulder strain (claimed as joint pain) is denied. Entitlement to service connection for right shoulder strain (claimed as joint pain) is denied. Entitlement to service connection for left elbow strain (claimed as joint pain) is denied. Entitlement to service connection for right elbow strain (claimed as joint pain) is denied. Entitlement to service connection for left wrist strain (claimed as joint pain) is denied. Entitlement to service connection for right wrist strain (claimed as joint pain) is denied. Entitlement to service connection for right ankle strain (claimed as joint pain) is denied. Entitlement to service connection for hypertension (also claimed as high blood pressure) is denied. Entitlement to a rating in excess of 10 percent for pleurisy is denied. Entitlement to a compensable rating for internal hemorrhoids and anal fissure is denied. Entitlement to a rating in excess of 40 percent for thoracolumbar strain with degenerative arthritis is denied. Entitlement to an effective date prior to April 2, 2013, for a rating of 40 percent for thoracolumbar strain with degenerative arthritis is denied. FINDINGS OF FACTS 1. In a final October 1998 rating decision, the RO denied the Veteran’s claim for entitlement to service connection for bilateral knee pain. 2. The evidence received since the October 1998 rating decision is not cumulative or redundant of the evidence of record and raises a reasonable possibility of substantiating the Veteran’s claims of entitlement to service connection for bilateral knee pain. 3. There is no competent evidence of record showing that the Veteran has ever been diagnosed with a headache disorder. 4. There is no competent evidence of record showing that the Veteran has ever been diagnosed with depression. 5. There is no competent evidence of record showing that the Veteran has ever been diagnosed with sciatic radiculopathy of the left lower extremity. 6. There is no competent evidence of record showing that the Veteran has ever been diagnosed with a sciatic radiculopathy of the right lower extremity. 7. The Veteran’s bilateral knee strain did not have onset in service, did not manifest to a compensable degree within one year of separation from service, and is not otherwise related to service. 8. The Veteran’s bilateral shoulder strain did not have onset in service, did not manifest to a compensable degree within one year of separation from service, and is not otherwise related to service. 9. The Veteran’s bilateral elbow strain did not have onset in service, did not manifest to a compensable degree within one year of separation from service, and is not otherwise related to service. 10. The Veteran’s bilateral wrist strain did not have onset in service, did not manifest to a compensable degree within one year of separation from service, and is not otherwise related to service. 11. The Veteran’s right ankle strain did not have onset in service, did not manifest to a compensable degree within one year of separation from service, and is not otherwise related to service. 12. The Veteran’s hypertension did not have onset in service, did not manifest to a compensable degree within one year of separation from service, and is not otherwise related to service. 13. The Veteran does not have pulmonary disease and does not have a pulmonary function test which showed FEV-1 of 56- to 70 percent predicted, FEV-1/FVC of 56 to 70 percent, or DLCO 56- to 65- percent predicted. 14. Throughout the period on appeal, the Veteran’s service-connected hemorrhoids have been mild or moderate with consistent loss of blood with bowel movements; they have not manifested as large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences, or have they been productive of persistent bleeding with secondary anemia or with fissures. 15. Throughout the period on appeal, the Veteran’s thoracolumbar spine disability was manifested by flexion limited to 20 degrees, extension to 10 degrees, and right and left lateral rotation and flexion limited to 10 degrees. There was no evidence of ankylosis or intervertebral disc syndrome. 16. VA received the Veteran’s claim for a higher evaluation for thoracolumbar strain with degenerative arthritis on April 2, 2013, and no communication prior to April 2, 2013, was received that could be construed as an informal or formal claim for a higher evaluation of thoracolumbar strain with degenerative arthritis. CONCLUSIONS OF LAW 1. The October 1998 rating decision denying the Veteran’s claims for entitlement to service connection for bilateral knee pain is final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1100. 2. New and material evidence has been received to reopen the claim for entitlement to service connection for bilateral knee pain (claimed as joint pain). 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 3. The criteria for service-connection for headaches have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 4. The criteria for service-connection for depression have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 5. The criteria for service-connection for sciatic radiculopathy of left lower extremity have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 6. The criteria for service-connection for sciatic radiculopathy of right lower extremity have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 7. The criteria for service-connection for left knee strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 8. The criteria for service-connection for right knee strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 9. The criteria for service-connection for left shoulder strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 10. The criteria for service-connection for right shoulder strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 11. The criteria for service-connection for left elbow strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 12. The criteria for service-connection for right elbow strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 13. The criteria for service-connection for left wrist strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 14. The criteria for service-connection for right wrist strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 15. The criteria for service-connection for right ankle strain have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 16. The criteria for service-connection for hypertension have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 17. The criteria for a rating in excess of 10 percent for pleurisy have not been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. § 4.1, 4.2, 4.7, 4.130, Diagnostic Code (DC) 6845. 18. The criteria for a compensable rating for internal hemorrhoids and anal fissure have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.14, 4.114, DC 7336. 19. The criteria for a rating in excess of 40 percent for thoracolumbar strain with degenerative arthritis have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71a, DCs 5237-5242. 20. The criteria for entitlement to an effective date earlier than April 2, 2013, for the award of a 40 percent evaluation for thoracolumbar strain with degenerative arthritis have not been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1981 to June 1997. He is a recipient of the Bronze Star. These matters come before the Board of Veterans’ Appeals (Board) on appeal from February 2014 and June 2015 rating decisions. New Material Evidence Historically, an October 1998 rating decision denied the Veteran’s claim for service connection for bilateral knee pain. The October 1998 rating decision denied service connection for bilateral knee pain stating that there was no evidence of record showing a chronic bilateral knee disability. The Veteran did not appeal this decision and it is now final. 38 U.S.C. § 7104. In June 2014, the Veteran sought to reopen his claims for service connection for bilateral knee pain (claimed as joint pain). VA may reopen and review a claim that has been previously denied if new and material evidence is submitted by or on behalf of a Veteran. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a); Hodge v. West, 155 F. 3d 1356 (Fed. Cir. 1998). The Board must consider the question of whether new and material evidence has been received because it goes to the Board’s jurisdiction to reach the underlying claim and adjudicate the claim de novo. Jackson v. Principi, 265 F.3d 1366 (Fed. Cir. 2001); Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). If the Board finds that no new and material evidence has been offered, that is where the analysis must end. Butler v. Brown, 9 Vet. App. 167 (1996). New evidence is evidence not previously submitted to agency decision makers. Material evidence is evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). In determining whether new and material evidence has been received, VA must initially decide whether evidence associated with the claims file since the prior final denial is new. That analysis is undertaken by comparing newly received evidence with the evidence previously of record. After evidence is determined to be new, the next question is whether it is material. The Board must review all evidence submitted by or on behalf of a claimant since the last final denial on any basis to determine whether a claim must be reopened. Evans v. Brown, 9 Vet. App. 273 (1996). For purposes of determining whether new evidence is material, the credibility of the new evidence is presumed. Justus v. Principi, 3 Vet. App. 510 (1992). New and material evidence is not required as to each previously unproven element of a claim. Shade v. Shinseki, 24 Vet. App. 110 (2010). The Board notes that its task is to first decide whether new and material evidence has been received, as opposed to whether the evidence actually substantiates the Veteran’s claim. Pertinent evidence added to the record since the final October 1998 RO decision includes the Veteran’s statements, a VA examination, and VA medical records. A May 2015 VA examination diagnosed the Veteran with bilateral knee sprain. Consequently, as the prior October 1998 denial stated that the Veteran did not have a diagnosis of a bilateral knee disorder and there has now been evidence submitted which indicates the Veteran has a knee disorder, the Board finds that new and material evidence has been submitted regarding the Veteran’s claims for service connection for bilateral knee pain. Thus, the claims for entitlement to service connection for left and right knee pain are reopened. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. That determination requires a finding of current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); Rabideau v. Derwinski, 2 Vet. App. 141 (1992). Service connection may be granted for a disability diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability is due to disease or injury that was incurred or aggravated in service. 38 C.F.R. § 3.303(d). Service connection may be presumed for certain chronic diseases which develop to a compensable degree within one year after discharge from service, even though there is no evidence of such disease during the period of service. That presumption is rebuttable by probative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. 3.307, 3.309(a). Where the evidence, regardless of its date, shows that the Veteran had a chronic condition in service or during an applicable presumption period and still has that chronic disability, service connection can be granted. That does not mean that any manifestations in service will permit service connection. To show chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time as distinguished from merely isolated findings or a diagnosis including the word chronic. When the disease entity is established, there is no requirement of evidentiary showing of continuity. 38 C.F.R. § 3.303(b). If there is no evidence of a chronic condition during service or an applicable presumptive period, then a showing of continuity of symptoms after service may serve as an alternative method of establishing service connection. 38 C.F.R. § 3.303(b). Continuity of symptoms may be established if a claimant can demonstrate (1) that a condition was noted during service; (2) evidence of post- service continuity of the same symptomatology and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. If service connection is established by continuity of symptomatology, there must be medical evidence that relates a current condition to that symptomatology. Continuity of symptoms applies only to those conditions explicitly recognized as chronic. 38 C.F.R. § 3.309(a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The standard of proof to be applied in decisions on claims for Veterans’ benefits is set forth at 38 U.S.C. § 5107. A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence. See 38 C.F.R. § 3.102. When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The preponderance of the evidence must be against the claim for benefits to be denied. See Alemany v. Brown, 9 Vet. App. 518 (1996). The first requirement for all claims for service connection, however, is evidence of a disability. Boyer v. West, 210 F.3d 1351 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223 (1992). Factual Background In February 1981, a service treatment record (STR) report of medical examination indicated the Veteran did have any complaints or concerns regarding his health. In a concurrent report of medical history, the Veteran did not identify any concerns or symptoms regarding his health. In a May 1981 STR, the Veteran was shown to have presented for a left ankle sprain which had symptoms of severe pain with swelling. There was pain with palpitation, warmth to touch, and decreased range of motion. In a subsequent May 1981 STR, the Veteran had follow-up for left ankle sprain. He was noted to have been on an “profile” for the prior 6 days from physical training. The Veteran was noted to have stated his ankle felt fine. There was no swelling, discoloration, tenderness, or laxity and his range of motion was found to be within normal limits. The analysis was a resolved ankle injury. In an August 1989 periodic examination report, the Veteran was not have found to have any concerns or symptomology regarding his general health. In March 1998, a VA examination found the Veteran to have complaints of bilateral knee pain. His blood pressure was 110/80. In regard to his bilateral knee pain, the Veteran reported that he got occasional knee pain, which was present for approximately five years. He reported the pain only occurred after utilization. He denied daily pain or stiffness. He stated his pain was under the patella, and was equal in both knees. He denied any history of knee trauma or surgery and has no difficulty climbing stairs. The examiner stated that upon examination the Veteran’s knees were nontender to palpation, with no warmth, swelling, or edema. He did not limp and did not use his arms to push out of a chair. His knees had flexion to 140 degrees and extension to 0 degrees. There was no patellar compression tenderness and the medial and lateral collateral ligaments were stable. The examiner stated that the Veteran had bilateral knee pain with a normal examination and X-ray and that there was insufficient evidence upon clinical or radiological examination to warrant a diagnosis of any acute or chronic medical condition. In November 2014, a VA examination reported that the Veteran stated he had been diagnosed with hypertension in 2014. He reported that his hypertension had been discovered on a routine examination, but that he does not have any symptoms and does not take medication. It was unknown if his diagnosis was make with blood pressure readings taken 2 or more times over 3 different days. On the dates following his examination, the Veteran’s blood pressure readings were 150/98, 144/98; 124/80, 124/80; 144/88, 146/86. He did not have a history of diastolic blood pressure elevation predominately The examiner opined that the Veteran’s hypertension was less likely than not incurred in or caused by the claimed in-service injury, even, or illness. The examiner opined that the Veteran reported a history of intermittent elevated blood pressures with a diagnosis of hypertension within the last two years. The examiner noted that there was no evidence of elevated blood pressures while in-service and that no service connection could be determined. In December 2013, a VA examination of the Veteran’s headaches determined that the Veteran had not been diagnosed with a headache condition. The Veteran stated that he began having migraines with pounding pain and burning sensation behind his left ear. He stated that he also got nausea, vomiting, with photo and light sensitivity. He reported that he can also get the burning pain without headaches. He stated that he had never been diagnosed with a formal condition. He stated that he only took over the counter medication and did not receive treatment for them. The examiner noted that the Veteran’s headaches sounded like tension headaches. His headaches were reported to last less than 1 day. He did not have characteristics prostrating attacks of headache pain. He did have prostrating attacks of non-migraine pain more frequently than once per month. The examiner noted that there was no diagnosis as there was no pathology to render a diagnosis. A December 2013 VA examination of the Veteran’s peripheral nerves found that he did not have a peripheral nerve condition or peripheral nerve pathology. The Veteran stated that his symptoms began in the 2000’s and was pain radiating down to his lower legs. He reported being diagnosed with sciatica. He reported the pain waxed and waned with sitting. His left lower extremity symptoms were moderate and found to be constant pain, intermittent pain, paresthesias and/or dyesthesias, and numbness. His right lower extremity symptoms were severe and found to be constant pain, intermittent pain, paresthesias and/or dyesthesias, and numbness. His muscle strength testing was normal and he did not have muscle atrophy. His reflexes in the lower extremities was found to be 2+. His sensory examination was normal and he did not have any trophic changes. The median nerve tests were negative. The examiner stated that though the Veteran claimed he had sciatica, there was no diagnosis for sciatica found in the file. The examiner stated that the examination that day was negative for sciatica in a flare-up. The examiner stated that for the sciatica condition, there was no diagnosis as there was no pathology to render a diagnosis. The examiner opined that there was no diagnosis of sciatica. In May 2015, the Veteran underwent a VA examination of his right ankle, bilateral elbows, bilateral shoulders, and bilateral writs. The May 2015 VA examination determined that the Veteran had right ankle strain. The Veteran reported that his right ankle pain was 1-5 out of 10. He denied swelling and stated that his activity was limited as a result, but could not be more specific as how it related to the ankle. He denied flare-ups but stated he had functional loss of the right ankle. His range of motion was noted to be normal, with dorsiflexion to 20 degrees and plantar flexion to 45 degrees. A concurrent VA examination of the Veteran’s bilateral elbows found that the Veteran had bilateral elbow strain. He stated his elbows hurt and rated it at 1-5 out of 10. He denied swelling or radiation of pain. He stated that he was able to do the labor associated with his current job, but could not do much more than that. He was right hand dominant. His range of motion was normal in both elbows. Diagnostic testing indicated slight hypertrophic degenerative changes involving the coronoid and condylar processes of the ulna. The examiner found that given the minimal nature of the Veteran’s abnormality, the findings were not definitive for arthritis. The examiner found that there were insufficient findings present to definitely diagnose arthritis, so elbow strain was reported. A concurrent examination of the Veteran’s bilateral shoulders found that the Veteran had bilateral shoulder strain. The Veteran reported that his shoulders hurt and that the pain depended on use. He described pain that was 1-5 out of 10 and that normal activities will make the pain worse. He reported being limited to lifting 20 pounds and could not speak to any specific movement or motion that elicits pain. His flexion and abduction was to 160 degrees; external rotation was to 80 degrees and his internal rotation was to 90 degrees. As to his wrists, the Veteran reported that his wrists hurt and rated it at 1-5 out of 10. He noted some episodic swelling of the right wrist. He was diagnosed with bilateral wrist strain. He had abnormal range of motion of the right wrist, with palmar flexion to 70 degrees, dorsiflexion to 65 degrees, ulnar deviation to 45 degrees, and radial deviation to 20 degrees; his left wrist had palmar flexion to 80 degrees, dorsiflexion to 65 degrees, ulnar deviation to 45 degrees, and radial deviation to 20 degrees. X-rays determined that the Veteran’s wrists had normal bony anatomy. The examiner stated that the Veteran’s joint conditions were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned that the Veteran’s STRs were silent for elbow, knee, shoulder, and wrist complaints. The examiner noted the Veteran’s in-service complaint and treatment for right ankle sprain, which was subsequently noted to have resolved a week later, and had no further treatment. Thus, there was nothing to support a chronic process. The examiner found that it was less likely than not that the claimed joints pain was incurred in or caused by joint pain that occurred while in-service. Headaches, Depression, and Radiculopathy The United States Court of Appeals for Veterans Claims (“the Court”) consistently has held that, under the law, “[a] determination of service connection requires a finding of the existence of a current disability and a determination of a relationship between that disability and an injury or a disease incurred in service.” Watson v. Brown, 4 Vet. App. 309, 314 (1993). This principle has been repeatedly reaffirmed by the Federal Circuit Court, which has stated, “a Veteran seeking disability benefits must establish... the existence of a disability [and] a connection between the Veteran’s service and the disability.” Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). As stated above, the existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F. 3d 1328 (1997). In Brammer v. Derwinski, 3 Vet. App. 223 (1992), the Court noted that Congress specifically limited entitlement for service-connected disease or injury to cases where such incidents had resulted in a disability. See also Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992); Gilpin v. Brown, 155 F.3d 1353 (Fed. Cir. 1998) (service connection may not be granted unless a current disability exists). Here, there is no evidence of record which establishes that the Veteran had a diagnosed headache disorder, depression, or sciatic radiculopathy of the left or right lower extremity. The medical evidence of record, including the Veteran’s STRs, does not show that the Veteran has ever been diagnosed with a headache disorder, depression, left or right lower extremity radiculopathy or treated for any symptomology associated with these claimed disorders. His STRs do not indicated that the Veteran treated for any condition related to any of these claimed disorders or reported any associated symptomology to any of the conditions. Specifically regarding his headaches, while the December 2013 VA examination determined that the Veteran did have headache pain, he was not found to have a diagnosed headache disorder or migraines. As to depression, there is no indication that the Veteran has ever treated for or reported depression. Finally, as to his claims for sciatica, the December 2013 VA examination determined that there was no objective evidence of record that the Veteran had sciatica or had been diagnosed in the past with sciatica. Furthermore, the VA examination found that the Veteran did not have and had not been diagnosed with a peripheral nerve condition. Simply put, there is no evidence in the file that the Veteran has either a migraine or headache disorder, clinically diagnosed depression, or sciatic nerve radiculopathy of either the left or right lower extremity. Thus, there is no current diagnosis of or treatment for a headache disorder, depression, or sciatic nerve radiculopathy of the left or right lower extremity contained the evidence of record. Here, no underlying disabilities have been clinically diagnosed during the appeal period or proximate thereto. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). The Board has considered the Veteran’s lay statements, including his reports of headache pain, depression, and his statements about his lower extremity pain. Although the Veteran is competent to describe observable symptoms his pain and other symptomology, he is not competent to opine as to the etiology any such disorder, as he has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As such, the Veteran’s lay opinions that he may have a headache disorder, depression, or sciatica and that such conditions were caused by active service do not constitute competent medical evidence and lack probative value. The preponderance of the medical evidence of record, then, established that the Veteran does not have a diagnosis of a headache/migraine disorder, depression, or left and/or right lower extremity radiculopathy. The claims for service connection for headaches, depression, and left and right lower extremity sciatic radiculopathy, therefore, must be denied because the first essential element for the grant of service connection, competent evidence of the disability for which service connection is sought, is not met. Joint Pains In regard to the Veteran’s claim for joint pain, direct service connection necessitates a link between the Veteran’s service and his claimed joint pains. As to the Veteran’s claimed disorders of the bilateral knees, shoulders, elbows, wrists, and right ankle, no such link is supported by the evidence of record. The Veteran’s STRs are void of treatment for or diagnosis of any condition regarding any of his claimed joints, except for his right ankle. Though he did have May 1981 treatment for his right ankle, the May 1981 STR is clear that the right ankle symptomology had resolved and there was no diagnosed persistent or chronic injury or disorder involved with the right ankle. Additionally, in March 1998, after his separation from service, the Veteran underwent a VA examination and did not have complaints of right ankle pain or any symptomology regarding his other joints, save for his right knees. In that March 1998 VA examination, the Veteran’s knees were noted to have pain, but no disorder or diagnosed condition was found upon examination. Furthermore, there is no evidence of record that the Veteran had treatment for or diagnosis of any condition of his knees, shoulders, elbows, wrists, and right ankle prior to his 2015 VA examination. Thus, the Veteran’s joint disorders were not diagnosed until his May 2015 VA examinations – over 15 years after his active service. The passage of many years between discharge from active service and the documentation of a claimed disability is a factor that tends to weigh against a claim for service connection. Maxson v. Gober, 230 F. 3d 1330, 1333 (Fed. Cir. 2000); Shaw v. Principi, 3 Vet. App. 365 (1992). The Board also notes that the only evidence of record to address the etiology of the Veteran’s joint disorders, the 2015 VA examinations, did not find a link between the Veteran’s service and his joint disorders. There is no other evidence of record which directly addresses the etiology of the Veteran’s joint disorders. The Board finds the May 2015 VA opinions highly probative to the issue of whether the Veteran’s bilateral knee, shoulder, elbow, wrist, and right ankle disorders are related to service. The examiner possessed the necessary education, training, and expertise to provide the requested opinions. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). The opinions were based on a review of the claims file, which consisted of the Veteran’s STRs and post-service medical evidence, and the Veteran’s contentions contained therein, an in-person examination, and consideration of medical literature, upon which the examiner relied upon in giving her opinion. It is clear that the examiner took into consideration all relevant factors in giving her opinion. Significantly, the Veteran has not presented or identified any contrary medical opinion that supports the claims for service connection. VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991). The Board finds that the only medical opinions of record showed that the Veteran’s joint disorders – of the bilateral knees, shoulder, elbows, wrists, and right ankle – was not related to service. The Board has considered the Veteran’s statements. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428 (2011), as to the specific issue being decided herein, an opinion as to the etiology of his joint disorders, specifically of his bilateral knees, shoulders, elbows, wrists, and right ankle, and whether they are etiologically related to his active service, falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (lay persons not competent to diagnose cancer). That is, although the Board readily acknowledges that Veteran is competent to report his joint pain symptoms, there is no indication that either he was competent to etiologically link any such symptoms to his active service. Accordingly, the Veteran’s statements are lay evidence that do not constitute competent medical evidence and lack probative value. In sum, the claims file does not contain competent and credible evidence that the Veteran’s joint pain/disorders – bilateral knees, shoulders, elbows, wrists, and right ankle disorders – were related to service. Accordingly, as the preponderance of the evidence is against the claims for service connection, the benefit-of-the-doubt rule is not for application, and each of these claims must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Hypertension At the outset, the Board notes that VA regulations specify that the term hypertension means that the diastolic blood pressure is predominantly 90 mm or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160 mm or greater with a diastolic blood pressure of less than 90 mm. 38 C.F.R. § 4.104, Diagnostic Code 7101. In addition, VA regulations specify that hypertension must be confirmed by readings taken two or more times on at least three different days. Id., Note (1). As stated above, direct service connection necessitates a link between the Veteran’s service and his claimed hypertension. Pursuant to the aforementioned VA regulation, the Board notes that the Veteran’s blood pressure readings from his November 2014 VA examination – 150/98, 144/98; 124/80, 124/80; 144/88, 146/86 – do not meet the standard for a diagnosis of hypertension. Though his readings do meet the requirements of hypertension for the first day of readings taken, the readings taken on the subsequent days do not meet the VA standard for hypertension. Furthermore, assuming the Veteran’s report of his diagnosis is accurate, he was not diagnosed with hypertension until 2014, over 15 years after his active duty service. There is no indication in his STRs that the Veteran had a diagnosis of complaints of, reports of, symptoms of, or treatment for hypertension or elevated blood pressure while in service. Also, his March 1998 VA examination did not have any indication that the Veteran had any issues regarding hypertension or elevated blood pressure within a year of his active duty service. Finally, the November 2014 VA examination found that the Veteran had a reported history of intermittent elevated blood pressures with a hypertension which was less likely than not related to his active duty service. The Board finds the November 2014 VA opinion highly probative to the issue of whether the Veteran’s hypertension is related to service. The examiner possessed the necessary education, training, and expertise to provide the requested opinions. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). The opinion was based on a review of the claims file, which consisted of the Veteran’s STRs and post-service medical evidence, an in-person examination, and the Veteran’s contentions contained therein, and consideration of medical literature, upon which the examiner relied upon in giving his opinion. It is clear that the examiner took into consideration all relevant factors in giving his opinion. Significantly, the Veteran has not presented or identified any contrary medical opinion that supports the claim for service connection. VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991). The Board finds that the only medical opinion of record showed that the Veteran’s hypertension was not related to service. The Board has considered the Veteran’s statements. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428 (2011), as to the specific issue being decided herein, an opinion as to the etiology of his hypertension, and whether it is etiologically related to his active service, falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (lay persons not competent to diagnose cancer). That is, although the Board readily acknowledges that Veteran is competent to report his hypertension symptoms and history, there is no indication that he is competent to etiologically link any such symptoms to his active service. Accordingly, the Veteran’s statements are lay evidence that do not constitute competent medical evidence and lack probative value. In sum, the claims file does not contain competent and credible evidence that the Veteran’s hypertension is related to service. Accordingly, as the preponderance of the evidence is against the claim for service connection, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Increased Ratings In April 2013, the Veteran sought an increased rating for his pleurisy, hemorrhoids, and thoracolumbar back disability. In December 2013, the Veteran underwent VA examinations regarding his pleurisy and back pain. In regard to his pleurisy, the Veteran stated that the pain was a gradual pain with onset of twisting motion. He reported difficulty breathing. X-rays were noted to be normal. He was not found to have a respiratory condition. The Veteran’s back was found to have degenerative joint disease of the thoracolumbar spine with intermittent strain and myofascial pain. The Veteran reported that his condition has gotten worse, with debilitating episodes which affect normal daily activities with flares. His flare-ups were described as difficulty sitting down, bending over, twisting, and laying on his back with difficulty walking long periods of time and lifting over 35 pounds. Upon examination, he had forward flexion to 20 degrees, with painful motion evident at that same degree. His extension was to 10 degrees, with painful motion evident at 10 degrees. His right and left lateral flexion was to 10 degrees and there was no evidence of painful motion. Left and right lateral rotation ended at 20 degrees and had no evidence of painful motion. Because of pain, the Veteran was not able to perform three repetitions. His functional loss due to pain was found to be less movement than normal and pain on movement. He had abnormal gait and abnormal spinal contour. His muscle strength testing was normal and he was not found to have muscle atrophy. His reflex and sensory examination were normal. His straight-leg raising test was normal. He was not found to have any radicular pain or any other signs or symptoms due to radiculopathy or any other neurologic abnormalities. The Veteran did not have IVDS. He did not use any assistive devices. An X-ray diagnosed degenerative disc disease at T11-12 and L4-5. The Veteran reported that his back pain caused him to have stooped over posture and his gait was antalgic with slow walk. There were contributing factors of pain, weakness, fatigability, and/or incoordination and additional limitation of functional ability of the spine during flare-ups or repeated use over time. He reported that he could hardly do anything because he was stooped over with pain and had difficulty getting out of his chair. He reported that recently he could not walk, stand, bend, lift, or drive. In November 2014, a VA examination regarding the Veteran’s hemorrhoids noted that he had internal and external hemorrhoids. He reported that his current symptoms included a significant loss of blood consistently for almost 20 years. His hemorrhoids were noted to be mild or moderate with a consistent loss of blood with bowel movements. He was noted to have fissures. Upon examination, he had small or moderate external hemorrhoids and an anal fissure with friable tissue at 3 o’clock. In November 2015, a VA examination of the Veteran’s respiratory system indicated that he had a pleurisy diagnosis which the Veteran noted was stable and was treated with a regulation of activities. He did not require the use of oral or parenteral corticosteroid, inhaled medications, oral bronchodilators, or antibiotics. He did not require oxygen therapy. He did not have a pulmonary condition. A chest X-ray was normal. PFT results revealed FEV-1 of 82 percent predicted or FEV-1/FVC of 71 percent predicted. Pleurisy The Veteran’s pleurisy is assigned a 10 percent rating pursuant to DC 6845. DC 6845 assigns a 10 percent evaluation where there is FEV-1 of 71 to 80 percent predicted, or FEV-1/FVC of 71 to 80 percent, or DLCO (SB) of 66 to 80 percent predicted. A 30 percent rating is assigned when there is FEV-1 of 56 to 70 percent predicted, or FEV-1/FVC of 56 to 70 percent, or DLCO (SB) of 56 to 65 percent predicted. A 60 percent rating is assigned when there is FEV-1 of 40 to 55 percent predicted, or FEV-1/FVC of 40 to 55 percent, or DLCO (SB) of 40-to 55 percent predicted; or whether there is maximum oxygen consumption of 15 to 20 ml/kg/min (with cardiorespiratory limit). A 100 percent rating will be assigned where there is FEV-1 less than 40 percent of predicted value, or the FEV-1/FVC is less than 40 percent, or DLCO (SB) is less than 40-percent predicted; or where there is maximum exercise capacity of less than 15 ml/kg/min oxygen consumption (with cardiac or respiratory limitation), or cor pulmonale (right heart failure), or right ventricular hypertrophy, or pulmonary hypertension (shown by Echo or cardiac catheterization), or episode(s) of acute respiratory failure, or required outpatient oxygen therapy. Based on the foregoing, the Board finds that the medical evidence of record shows that the Veteran’s pulmonary function does not satisfy the criteria for a rating in excess of 10 percent rating under DC 6845, and there is no evidence that the Veteran has another respiratory condition that would warrant a separate or higher rating. Thus, a higher rating is not warranted for the entire period on appeal. The Board has also considered the statements submitted by the Veteran in support of the claim, specifically that his functional capacity is limited beyond what is set forth in his current rating criteria. The Board finds that the Veteran is a lay person and while competent to report observable symptoms he experiences through his senses he is not competent to identify a specific level of disability according to the appropriate diagnostic codes such pain and stiffness. Layno v. Brown, 6 Vet. App. 465 (1994). The identification of a disability and the determination of the effects of the disability require medical expertise that the Veteran has not shown he possesses. Determining whether the Veteran meets some of the criteria for a higher rating requires medical diagnostic testing. Competent evidence concerning the nature and extent of the Veteran’s pleurisy has been provided by the medical personnel who have examined him during the current appeal and who have made pertinent clinical findings in conjunction with the examination. The medical findings, as provided in the examination report, directly address the criteria under which his disability is rated. The Board finds that evidence is the most persuasive and outweighs the Veteran’s statements in support of his claim. Accordingly, the Board finds that the preponderance of the evidence is against the assignment of a rating in excess of 10 percent for the Veteran’s pleurisy. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Hemorrhoids & Anal Fissure The Veteran’s hemorrhoids and anal fissure is assigned a noncompensable rating pursuant to DC 7336. DC 7336 provides that external or internal hemorrhoids are evaluated at 10 percent disabling when large or thrombotic and irreducible with excessive redundant tissue and frequent recurrences. 38 C.F.R. § 4.114. A 20 percent rating is warranted when there is persistent bleeding and with secondary anemia, or with fissures. Based on the foregoing, the Board finds that a compensable rating for the Veteran’s hemorrhoids is not warranted at any time during the period on appeal. There is no evidence of record which establishes that at any time during the period on appeal were the Veteran’s hemorrhoids were found to be large, thrombotic, or productive of persistent bleeding with secondary anemia or with fissures. The VA examination indicated that his hemorrhoids were mild or moderate. Though they were found to be productive of moderate bleeding and with a fissure, the rating criteria is clear that to warrant a compensable rating the hemorrhoids must be either large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences; or with persistent bleeding and with secondary anemia or fissures. As found in the Veteran’s VA examination, these conditions were not present. Thus, the evidence of record does not support a finding that the Veteran’s hemorrhoids warrant a compensable rating pursuant to the criteria set forth by DC 7336. The Board finds the November 2014 VA examiner’s medical finding highly probative to the issue of the severity of the Veteran’s hemorrhoids. Specifically, the examiner interviewed the Veteran and conducted a physical examination. Moreover, the examiners had the requisite medical expertise and had sufficient facts and data on which to base the findings and conclusions. As such, the Board accords the VA examination opinion great probative weight. The Board has also considered the statements submitted by the Veteran in support of the claim, specifically that his hemorrhoids are more severe than reflected in his evaluation. However, though the Veteran is competent to report observable symptoms he experiences through his senses, such pain and discomfort, he is not competent to identify a specific level of disability according to the appropriate diagnostic codes. Layno v. Brown, 6 Vet. App. 465 (1994). The identification of a disability and the determination of the severity of that disability requires medical expertise that the Veteran has not shown he possesses. Competent evidence concerning the nature and extent of the Veteran’s hemorrhoids has been provided by the medical personnel who examined him and who made pertinent clinical findings in conjunction with the examination. The medical findings, as provided in the examination report, directly address the criteria under which his disability is rated. The Board finds that evidence is the most persuasive and outweighs the Veteran’s statements in support of his claim. Accordingly, the Board finds that the preponderance of the evidence is against the assignment of a compensable rating for the Veteran’s hemorrhoids. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Thoracolumbar Spine The Veteran’s thoracolumbar strain with degenerative arthritis and disc disease was assigned a 40 percent rating pursuant to DCs 5237-5242 as of his April 2013 request for an increase. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned. The additional code is shown after a hyphen. Regulations provide that when a disability not specifically provided for in the rating schedule is encountered, it will be rated under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. 38 C.F.R. § 4.20. Pursuant to Diagnostic Codes 5242-5237, a 40 percent rating is assigned for forward flexion of the thoracolumbar spine at 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. Finally, a 100 percent rating is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71(a). When rating diseases and injuries of the spine, any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, should be rated separately, under an appropriate diagnostic code. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine, Note (1). For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. 38 C.F.R. § 4.71a, Plate V. When evaluating musculoskeletal disabilities based on limitation of motion, a higher rating must be considered where the evidence demonstrates additional functional loss due to pain, pursuant to 38 C.F.R. §§ 4.40 and 4.45. The diagnostic codes pertaining to range of motion do not subsume sections 4.40 and 4.45, and the rule against pyramiding does not forbid consideration of a higher rating based on greater limitation of motion due to pain on use, including use during flare-ups. DeLuca v. Brown, 8 Vet. App. 202, 204-7 (1995); Mitchell v. Shinseki, 25 Vet. App. 32 (2011). In determining if a higher rating is warranted on this basis, pain itself does not constitute functional loss. Similarly, painful motion alone does not constitute limited motion for the purposes of rating under diagnostic codes pertaining to limitation of motion. However, pain may result in functional loss if it limits the ability to perform normal movements with normal excursion, strength, speed, coordination, or endurance, as provided in sections 4.40 and 4.45. Functional loss due to pain is to be rated at the same level as functional loss caused by some other factor that actually limited motion. Mitchell, 25 Vet. App. 32. The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. As such, painful motion should be considered to determine whether a higher rating is warranted on such basis, whether or not arthritis is present. Burton v. Shinseki, 25 Vet. App. 1 (2011). The Board notes that in order for a rating of either 50 or 100 percent, the Veteran’s spine must show some ankylosis – either of just the thoracolumbar spine or of the entire spine. The Board finds that it is clear from the evidence of record that at no time during the period of the appeal has the Veteran had documentation or a finding of any type of ankylosis of any part of his spine. Specifically, the December 2013 VA examination did not find ankylosis and did not indicate that the Veteran was unable to complete his range of motion testing due to ankylosis. Thus, a rating of either 50 or 100 percent for any time during the period on appeal is not warranted by the evidence of record. The Board considered whether an increased rating due to functional loss, weakness, excess fatigability, or incoordination was warranted. The Board notes that upon examination in December 2013, he was not able to perform three repetitions and he had abnormal gait and abnormal spinal contour. Additionally, the Veteran had contributing factors of pain, weakness, fatigability, and/or incoordination and additional limitation of functional ability of the spine during flare-ups or repeated use over time. However, his muscle strength testing was normal; he was not found to have muscle atrophy; his reflex and sensory examination were normal; his straight-leg raising test was normal; he did not have IVDS; he did not use any assistive devices. Importantly, despite his pain complaints, the Veteran’s spine condition was not found to cause any impact on his ability to work. The Board is mindful that the Veteran has complained of pain in the thoracolumbar spine. Although VA may consider any demonstrated functional loss attributable to pain, weakness, excess fatigability, or incoordination, to include with repeated use or during flare-ups, in conjunction with the rating criteria, the overall level of disability demonstrated by the Veteran was not commensurate with the degree of motion loss required for a rating higher than 40 percent even with consideration of pain. The Board finds that a disability rating in excess of 40 percent may not be granted under the pertinent rating criteria. Thus, with consideration of all pertinent disability factors, there remains no appropriate basis for assigning a schedular rating in excess of 40 percent for the functional impairment of the Veteran’s thoracolumbar spine disability at any point throughout the period on appeal. The Board finds the December 2013 VA examiner’s medical opinion highly probative to the issue of the severity of the Veteran’s thoracolumbar spine disability. Specifically, the examiner interviewed the Veteran and conducted a physical examination. Moreover, the examiner had the requisite medical expertise and had sufficient facts and data on which to base his conclusions. As such, the Board accords the VA examination opinion great probative weight. The Board has also considered the statements submitted by the Veteran in support of the claim, specifically that his functional capacity is limited beyond what is set forth in his current rating criteria. The Board again finds that though the Veteran is a lay person and is competent to report observable symptoms he experiences through his senses, such pain and stiffness, he is not, however, competent to identify a specific level of disability according to the appropriate diagnostic codes. Layno v. Brown, 6 Vet. App. 465 (1994). The medical findings, as provided in the Veteran’s examination report, directly addresses the criteria under which his disability was rated. The Board finds that evidence was the most persuasive and outweighs the Veteran’s statements in support of his claim. As to separate ratings for any associated neurological impairment, the Board notes that the December 2013 examiner did not find the Veteran to have any radiculopathy, nerve impairment, or other neurological impairment associated with his back disorder. As such, the Board does not find that other neurological impairments in conjunction with the Veteran’s back disability are supported by the evidence of record. Accordingly, the Board finds that the preponderance of the evidence is against the assignment of a rating in excess of 40 percent for the Veteran’s back disability. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Earlier Effective Date The method of determining the effective date of an increased evaluation is set forth in 38 U.S.C. § 5110(a) and (b)(2), and 38 C.F.R. § 3.400(o). The general rule with respect to the effective date of an award of increased compensation is that the effective date of such award “shall not be earlier than the date of receipt of application thereof.” 38 U.S.C. § 5110(a). This statutory provision is implemented by regulation which provides that the effective date for an award of increased compensation will be the date of receipt of claim or the date entitlement arose, whichever is later. 38 C.F.R. § 3.400(o)(1). An exception to the rule applies, however, under circumstances where evidence demonstrates that a factually ascertainable increase in disability occurred within the one-year period preceding the date of receipt of a claim for increased compensation. In that regard, the law provides that the effective date of the award “shall be the earliest date as of which it is ascertainable that an increase in disability had occurred, if application is received within one year from such date, otherwise the date of receipt of the claim.” 38 U.S.C. § 5110(b)(2). See 38 C.F.R. § 3.400(o)(2). The phrase “otherwise, date of receipt of claim” applies only if a factually ascertainable increase in disability occurred within one year prior to filing the claim for an increased rating. Harper v. Brown, 10 Vet. App. 125 (1997). Moreover, the term “increase” as used in 38 U.S.C. § 5110 and 38 C.F.R § 3.400 means an increase to the next disability level. See Hazan v. Gober, 10 Vet. App. 511 (1997). VA has amended the regulations concerning the filing of claims, including no longer recognizing informal claims and eliminating the provisions of 38 C.F.R § 3.157. See Fed. Reg. 57,660, 57,695 (Sept. 25. 2014). The amendments, however, are only effective for claims and appeals filed on or after March 24, 2015. As the claim at issue in the appeal was filed before these amendments, the prior regulatory provisions apply. The date of receipt of a claim is the date on which a claim, information, or evidence is received by VA. 38 C.F.R. § 3.1(r). A claim is a formal or informal communication in writing requesting a determination of entitlement, or evidencing a belief in entitlement, to a benefit. 38 C.F.R. §§ 3.1 (p); 3.155. The regulation which governs informal claims, 38 C.F.R. § 3.155, provides that any communication or action, indicating an intent to apply for one or more benefits under the laws administered by [VA], from a claimant...may be considered an informal claim. Such informal claim must identify the benefit sought. Id. When a claim has been filed that meets the requirements of 38 C.F.R. § 3.151 or 3.152, an informal request for increase or reopening will be accepted as a claim. Further, under 38 C.F.R. § 3.157 (b)(1), an informal claim may consist of a VA report of examination or hospitalization. Under this regulatory provision, the date of the VA outpatient examination or hospital admission will be accepted as the date of receipt of a claim if such a report relates to examination or treatment of a disability for which service connection has previously been established. A claimant is entitled to notice of any decision by VA affecting the payment of benefits or the granting of relief. 38 U.S.C. § 5104. Such notice must inform a claimant of the right to initiate an appeal by filing a notice of disagreement (NOD), plus the periods in which an appeal must be initiated and perfected. 38 C.F.R. § 3.103(f). A claimant may then initiate an appeal from a VA decision by the timely filing of a NOD in writing. 38 C.F.R. § 20.200. A substantive appeal must be filed within 60 days from the date the RO mailed a claimant the statement of the case or within the remainder of the one-year period from the date of mailing of the rating decision being appealed, whichever period ends. 38 C.F.R. §§ 20.200, 20.300, 20.302. Otherwise, the rating decision becomes final. See 38 C.F.R. § 20.1103. The Veteran is seeking an effective date prior to April 3, 2013, for the 40 percent evaluation for his thoracolumbar strain with degenerative arthritis and disc disease. On April 2, 2013, the Veteran submitted a letter which requested that VA consider the letter an informal claim for compensation benefits for his back condition (accepted as a claim for an increased rating). The Veteran’s claims file contains no communication from or documents submitted by the Veteran that remain unadjudicated prior to his April 2, 2013, letter regarding his back. Indeed, there are no communications in the file regarding the Veteran’s back after notification of an increase in his disability claims awards in December 2008. The February 2014 rating decision on appeal assigned an effective date for the higher evaluation of 40 percent for the Veteran’s back as of April 2, 2013, the date of the Veteran’s informal claim for an increased evaluation. A review of the record shows that there were no pending, unadjudicated informal or formal higher evaluation claims for his left shoulder strain prior to April 2, 2013, found in the record. Thus, in light of the foregoing, the Board has determined that April 2, 2013, is the date of receipt of the claim for a higher evaluation for the Veteran’s left shoulder strain. Next, the question is when was an increase in disability factually ascertainable. See Hazan v. Gober, 10 Vet. App. at 521. A review of the record one year prior to the date of the informal April 2, 2013, claim does not reveal any medical records regarding the Veteran’s back. Considering the above, the Board finds that the Veteran is not entitled to an effective date prior to April 2, 2013, for the award of a 40 percent evaluation for his thoracolumbar disability. Generally, the effective date can be no earlier than the date of receipt of the claim for increase. The Board has considered the exception to that general rule, however, the evidence does not demonstrate that it was factually ascertainable that the Veteran’s service-connected thoracolumbar back disability was 40 percent disabling within one year prior to April 2, 2013. 38 C.F.R. § 3.400(o)(2). Indeed, the record does not show any relevant evidence prior to April 2, 2013, that demonstrates the Veteran’s thoracolumbar disability met the schedular rating criteria for a higher evaluation. Therefore, an effective date earlier than April 2, 2013, is not warranted. The pertinent legal authority governing effective dates is clear and specific, and the Board is bound by that authority. The Board finds that as the preponderance of the evidence is against the claim, the benefit of the doubt rule does not apply, and therefore, the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Parrish, Associate Counsel