Citation Nr: 18145301 Decision Date: 10/26/18 Archive Date: 10/26/18 DOCKET NO. 16-48 934 DATE: October 26, 2018 ORDER Entitlement to an initial compensable rating for right lower extremity external cutaneous nerve radiculopathy is denied. Entitlement to an initial compensable rating for left lower extremity external cutaneous nerve radiculopathy is denied. FINDING OF FACT The impairment of the Veteran’s right and left external cutaneous nerve radiculopathy most nearly approximate, at worst, moderate paralysis. CONCLUSIONS OF LAW 1. The criteria for an initial compensable rating for right lower extremity external cutaneous nerve radiculopathy are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.124a, Diagnostic Code 8529 (2017). 2. The criteria for an initial compensable rating for left lower extremity external cutaneous nerve radiculopathy are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.124a, Diagnostic Code 8529 (2017). REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from September 1980 to February 1993. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. Laws and Analysis The Veteran’s radiculopathy associated with the right and left external cutaneous nerves is currently rated as noncompensable under 38 C.F.R. § 4.124a, Diagnostic Code 8529, for paralysis of the external cutaneous nerve of the thigh. See 38 C.F.R. § 4.124a, Diagnostic Code 8529. A noncompensable rating is warranted for mild or moderate paralysis of the nerve. Id. An increased rating of 10 percent, the highest rating available, and is warranted when there is severe to complete paralysis of the nerve. Id. The Board notes that the Veteran has also been awarded 10 percent ratings for radiculopathy of the right and left lower extremity associated with incomplete paralysis of the sciatic nerve roots under Diagnostic Code 8520. See September 2015 rating decision. The Veteran has not disagreed with these ratings; as such, the discussion below will be limited to the external cutaneous nerve. The evidence includes a July 2015 VA peripheral nerves examination report. During the evaluation, the Veteran reported intermittent numbness of the lateral right thigh and numbness and tingling in both legs. A sensory examination showed decreased light touch sensation to both upper thighs. The examiner specifically indicated that the Veteran had “moderate” incomplete paralysis of the right and left external cutaneous nerve of the thighs. An August 2015 private electrodiagnostic report shows findings regarding many nerves, including the lateral femoral cutaneous nerve. Dorland’s Illustrated Medical Dictionary [Dorland’s] states in its definition of the word “external” that “many anatomical structures formally called external are now more correctly termed lateral.” Dorland’s, 671, (31st ed. 2007). The Dorland’s definition of “cutaneous nerves, femoral” directs the reader to “cutaneous nerve of the thigh.” Thus, the Board acknowledges that the lateral femoral cutaneous nerve of the thigh is synonymous with the external cutaneous nerve of the thigh. The August 2015 private electrodiagnostic report found “lower than average measures” for the right and left lateral femoral cutaneous nerves, measuring them as “-1 Hyper.” The interpretation of these findings explains, “Lower than average measures suggest irritation which warrants investigation to detect possible concomitant pathology.” The deviation index from normal runs from mild (1) to very severe (5). Thus, this study showed only mild deviation from the norm in the bilateral external cutaneous nerves of the thighs. The Board does not find that this evidence supports a finding of severe or complete paralysis of these nerves. The remaining evidence of record, to include the July 2015 and December 2017 VA spine examination reports, do not explicitly address the severity of the Veteran’s bilateral external cutaneous nerve disability. The July 2015 examination, however, found the Veteran’s lower extremity radiculopathy was at a “moderate” severity level bilaterally. The December 2017 examiner found the Veteran’s lower extremity bilateral radiculopathy was at a “moderate” severity level of usually dull intermittent pain, with mild paresthesias and/or dysesthesias and mild numbness. The examiner affirmatively found there was neither constant nor sometimes excruciating pain. The Veteran has reported that her legs feel like they will give out and that she experiences pain, warranting a higher rating. However, while she is competent and credible to report her subjective symptoms, she has not demonstrated the specialized training or expertise to diagnose varying degrees of nerve paralysis in a particular nerve. This diagnosis is made by tests administered by trained professionals, such as the electrodiagnostic private record and neurologic testing conducted by the VA examiner. It therefore falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007) (lay persons not competent to diagnose cancer). Her lay evidence is not competent evidence of the severity level of the paralysis of the external cutaneous nerves of the thighs. Based upon the above referenced evidence of moderate paralysis, a compensable rating is not warranted. Only severe to complete paralysis of the external cutaneous nerve warrants a compensable rating. Consequently, the Veteran is not entitled to compensable ratings for impairment of the external cutaneous nerves under Diagnostic Code 8529. As such, the claims are denied. LAURA E. COLLINS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Casadei, Counsel