Citation Nr: 18148513 Decision Date: 11/07/18 Archive Date: 11/07/18 DOCKET NO. 16-34 839 DATE: November 7, 2018 ORDER Entitlement to an evaluation than 20 percent for right shoulder strain and tendinopathy associated with right knee anterior cruciate ligament reconstruction (ACL-R) status post status post repair (s/p-R) is denied. Entitlement to an evaluation of 40 percent, and no greater, for thoracolumbar strain is granted. Prior to January 7, 2015, entitlement to an initial compensable evaluation for left lower extremity (LLE) radiculopathy of the sciatic nerve associated with thoracolumbar strain is denied. Beginning January 7, 2015, entitlement to an initial evaluation greater than 20 percent for LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain is denied. Prior to January 7, 2015, an initial compensable evaluation for right lower extremity (RLE) radiculopathy of the sciatic nerve associated with thoracolumbar strain is denied. Beginning January 7, 2015, an initial evaluation of 20 percent, and no greater, for RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain, separate and apart from the 10 percent evaluation assigned right knee neuropathy s/p ACL-R, is granted. FINDINGS OF FACT 1. The service connected right shoulder strain and tendinopathy associated with right knee ACL-R s/p-R is manifested by limitation of motion to no greater than shoulder level with consideration for pain, pain on motion, and repetitive motion; with no findings of ankylosis, flail shoulder, false flail joint, recurrent dislocation, nonunion or malunion of the humerus, nonunion or malunion of the clavicle or scapula, or of dysfunction of a contiguous joint. 2. The service-connected thoracolumbar spine is manifested by extension motion limited to 30 degrees or less, with consideration for pain, pain on motion, and repetitive motion; with no findings of ankylosis, vertebral fracture, or other neurological impairment. 3. Prior to January 7, 2015, there are no clinical findings of LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain at any time. 4. Beginning January 7, 2015, the service-connected LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain is manifested by incomplete paralysis that is no more than moderate in severity at any time. 5. Prior to January 7, 2015, there are no clinical findings of RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain. 6. Beginning January 7, 2015, the service-connected RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain, is manifested by incomplete paralysis that is no more than moderate in severity at any time.   CONCLUSIONS OF LAW 1. The criteria for an evaluation greater than 20 percent for right shoulder strain and tendinopathy associated with ACL-R s/p-R have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1-4.10, 4.71a, Diagnostic Code (DC) 5201 (2017). 2. The criteria for an evaluation of 40 percent, and no greater, for thoracolumbar strain has been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1-4.10, 4.71a, DC 5237 (2017). 3. Prior to January 7, 2015, the criteria for an initial compensable evaluation for LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain has not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1-4.10, 4.124a, DC 8520 (2017). 4. Beginning January 7, 2015, the criteria for an initial evaluation greater than 20 percent for LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain has not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1-4.10, 4.124a, DC 8520 (2017). 5. Prior to January 7, 2015, the criteria for an initial compensable evaluation for RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain has not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1-4.10, 4.124a, DC 8520 (2017). 6. Beginning January 7, 2015, the criteria for a separate, initial evaluation of 20 percent and no greater, for RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain has been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1-4.10, 4.124a, DC 8520 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active service from January 2008 to January 2012. During the pendency of the appeal for an increased evaluation for the service-connected thoracolumbar spine disability, additional compensable evaluations were afforded for LLE & RLE radiculopathy of the sciatic nerve, associated with the service-connected thoracolumbar spine disorder, ultimately evaluated as 20 percent disabling, each, effective January 7, 2015, which is the date the agency of original jurisdiction (AOJ) received the Veteran’s informal claim for increase. As these evaluations are not the highest, and the effective dates established are not the earliest afforded by the regulations these issues remain before the Board. See AB v. Brown, 6 Vet. App. 35, 38 (1993). The issues are thus characterized as reflected on the front page of this decision. Increased Ratings Disability ratings are assigned in accordance with the VA’s Schedule for Rating Disabilities and are intended to represent the average impairment of earning capacity resulting from disability. See 38 U.S.C. § 1155; 38 C.F.R. § 3.321(a), 4.1. Separate DCs identify the various disabilities. See 38 U.S.C. Part 4. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. The evaluation of the same disability under several DCs, known as pyramiding, must be avoided. 38 C.F.R. § 4.14. “Staged” ratings are appropriate for any rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119 (1999). The Veteran’s service-connected right shoulder disability is evaluated under DC 5019-5201, which contemplates bursitis evaluated as limitation of right shoulder motion. See 38 C.F.R. § 4.27. Under DC 5201, limitation of arm motion to the shoulder level warrants a 20 percent evaluation on the major side, and 20 percent on the minor side; limitation of arm motion to midway between the side and shoulder level warrants a 30 percent evaluation on the major side, and 20 percent on the minor side; limitation of arm motion to 25 degrees from the side warrants a 40 percent evaluation on the major side, and 30 percent on the minor side. See 38 C.F.R. § 4.71a, DC 5201. Normal range of motion for the shoulder joint is depicted as zero to 180 degrees flexion; zero to 180 degrees abduction, with 90 degrees shown as shoulder level; zero to 90 degrees external rotation, with the zero degree point beginning at the shoulder level and 180 degrees point being above the shoulder level; and zero to 90 degrees internal rotation, with zero degree point beginning at the shoulder level and the 180 degrees point being below the waist. See 38 C.F.R. § 4.71, Plate I. The Veteran’s service-connected thoracolumbar spine is evaluated under the General Rating Formula for Spine, under DC 5237, for lumbosacral strain. Under the General Rating Formula, a 20 percent disability rating is assigned for forward flexion of the lumbar spine greater than 30 degrees, but not greater than 60 degrees; or, combined range of motion of the lumbar spine not greater than 120 degrees or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent disability rating is assigned for forward flexion of the lumbar spine 30 degrees or less; or, favorable ankylosis of the entire lumbar spine. A 50 percent evaluation is assigned for unfavorable ankylosis of the entire lumbar spine. A 100 percent disability rating is assigned for unfavorable ankylosis of entire spine. Note 1 following the General Rating Formula specifies that any associated objective neurologic abnormalities including but not limited to bowel or bladder impairment are to be separately evaluated under an appropriate DC. Note 2 following the General Rating Formal provides that normal forward flexion of the lumbar spine is 0 to 90 degrees, extension is 0 to 30 degrees, left and right lateral flexion are 0 to 30 degrees, and left and right lateral rotation are 0 to 30 degrees. 38 C.F.R. § 4.71a, DCs 5235 through 5242. Under the Formula for Rating IVDS based on Incapacitating Episodes, a 10 percent evaluation is warranted for incapacitating episodes having a total duration of at least one week but less than two weeks during the past 12 months. A 20 percent evaluation is warranted for incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months. A 40 percent rating is warranted for incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months. A 60 percent rating requires incapacitating episodes having a total duration of at least six weeks during the past 12 months. Note 1 following the Formula for Rating IVDS specifies that an incapacitating episode is a period of acute signs and symptoms due to IVDS that requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, DC 5243. 1. Entitlement to an initial evaluation greater than 20 percent for right shoulder strain and tendinopathy Service-connection for the right shoulder strain and tendinopathy was granted in a September 2014 rating decision, and evaluated as 10 percent disabling effective in February 2014. The Veteran disagreed with the original evaluation assigned. A temporary total evaluation was granted for the right shoulder disorder based on surgery requiring convalescence from November 4, 2015 to February 29, 2016 in a January 2016 rating decision. See 38 C.F.R. § 4.30. The 10 percent evaluation was continued effective March 1, 2016. In an August 2016 supplemental statement of the case (SSOC), the AOJ increased the evaluation assigned the right shoulder disorder to 20 percent, effective in February 2014—on the date service connection was granted. The 20 percent evaluation has been confirmed and continued to the present. The Veteran reports persistent and constant pain and functional impairment from his right shoulder disability. See September 2015 Notice of Disagreement (NOD). As such, he argues a higher evaluation is warranted therefor. There is no dispute that the Veteran has required treatment, including with surgery, prescribed medications, physical therapy, and injections for his right shoulder disorder. Yet, the medical evidence does not show that the manifestations required for a higher evaluation are present at any time during the period under appeal. The Veteran is right hand and arm dominant. VA treatment records reflect treatment for the right shoulder disorder, including with physical therapy, injections, and prescribed medications. In addition, in May 2016, he underwent right shoulder surgery, to include arthroscopy with labral debridement and synovectomy for type 1 superior labrum anterior and posterior tear. However, VA examinations conducted in 2014, 2015 and 2016 show range of right shoulder flexion motion from zero to 160, abduction zero to 150, external rotation at zero to 85 and internal rotation zero to 80 at their most limited with consideration for pain, pain on motion, and repetitive motion. These measurements do not meet the requirement, or approximate that limitation of motion required, for an evaluation greater than 20 degrees under DC 5201. Rather, VA examiners have consistently found the Veteran to be able to move his arm to a point greater than midway between the side and shoulder level. VA treatment records do not show otherwise. See August 2014, April 2015, and August 2016 VA Examinations for Shoulder and Arm. See, generally, CAPRI Treatment Records (rec’d 7/26/2016 and 9/12/2017). Higher evaluations and/or separate, compensable evaluations could be warranted at 50 percent for unfavorable ankylosis of the right shoulder joint with abduction limited to 25 degrees from the side, or at 30 percent for to favorable ankylosis with abduction limited to 60 degrees where the Veteran can reach the mouth and head, or at 40 percent for ankylosis to an intermediate state between favorable and unfavorable under DC 5200; or at 80 percent for impairment of the humerus causing loss of head (flail shoulder), at 60 percent for nonunion (false flail joint), at 50 percent for fibrous union; at 30 percent for frequent or 20 percent for infrequent episodes of recurrent dislocation with guarding of all arm movements at the scapulohumeral joint; at 30 percent for malunion with marked deformity or 20 percent with malunion with moderate deformity under DC 5202; and at 20 percent for impairment of the clavicle or scapula with dislocation; at 20 percent for nonunion of the clavicle or scapula with loose movement, at 10 percent with nonunion of the clavicle or scapula without loose movement; and at 10 percent for malunion of the clavicle or scapula under DC 5203. DC 5203 also directs that the shoulder disorder may be evaluated under the impairment of function of the contiguous joint. However, neither VA examinations nor VA treatment records show any findings of right shoulder ankylosis, flail shoulder, false flail joint, recurrent dislocation, of nonunion or malunion of the humerus, or of the clavicle or scapula, or of dysfunction of a contiguous joint. In short, VA examinations and VA treatment records do not show any other impairment of or resulting from the service-connected right shoulder disorder. See Id. The preponderance of the evidence is against an evaluation greater than 20 percent for the service-connected right shoulder strain and tendinopathy associated with right knee ACL-R s/p-R at any time during the period under appeal. An evaluation greater than 20 percent for the service-connected right shoulder disorder is not warranted. 2. Entitlement to an evaluation greater than 20 percent for thoracolumbar strain. Service-connection for a lower back disability described as thoracolumbar strain was granted in a January 2013 rating decision, and evaluated as 10 percent disabling effective in January 2012. In February 2015, the Veteran claimed an increased evaluation for his lower back disorder. In a July 2015 rating decision, the AOJ granted a 20 percent evaluation, effective in April 2015. The Veteran disagreed with the evaluation assigned. In a December 2015 rating decision, the AOJ made the award of 20 percent effective January 7, 2015, which is the date the AOJ received the Veteran’s informal claim for increase. The 20 percent evaluation has been confirmed and continued to the present. The Veteran reports constant pain and functional impairment from his lower back disorder. In addition, he avers that surgery has been suggested, but he has refused, instead preferred alternative pain treatment for his back. See September 2015 NOD. As such, he argues a higher evaluation is warranted therefor. There is no dispute that the Veteran has required treatment including prescribed medications, physical therapy, and use of a transcutaneous electrical nerve stimulation (TENS) therapy unit for his lower back disorder. In the present case, the medical evidence supports the assignment of a 40 percent evaluation, and no greater, for his service-connected thoracolumbar strain. VA examination reports dated in 2014 and 2015 show limitation of lower back motion to 30 degrees in 2014 and to 25 degrees in 2015 with consideration for pain, pain on motion, and additional limitation after repetitive loss. See August 2015 and June 2015 VA Examinations for Back. However, the required manifestations for an evaluation greater than 40 percent are not present. VA treatment records and VA examinations do not show that the Veteran’s spine has been found to be ankylosed, or that he has sustained fracture of a vertebrae. In addition, the medical evidence does not show that the service-connected thoracolumbar spine disorder has been manifested by attacks of incapacitating episodes of IVDS having a total duration of at least six weeks at any time during the period under appeal. See August 2015 and June 2015 VA Examinations for Back; see also, generally, CAPRI Treatment Records (rec’d 7/26/2016 and September 12, 2017). Under Note (1) following the General Rating Formula directs that any associated objective neurologic abnormalities including but not limited to bowel or bladder impairment are to be separately evaluated under an appropriate DC. However, in this case, the medical evidence does not show objective findings of any neurological abnormalities other than the radiculopathies of the R&L LEs, which are discussed in the next section. Thus, there are no other objective observations of neurologic findings upon that could support the award of another separate, compensable evaluation for impairment associated with the service-connected thoracolumbar spine disorder. See August 2015 and June 2015 VA Examinations for Back; see also, generally, CAPRI Treatment Records (rec’d 7/26/2016 and September 12, 2017). The medical evidence supports an evaluation of 40 percent for the service-connected thoracolumbar spine disorder. However, the preponderance of the evidence is against an evaluation greater than 40 percent for the service-connected thoracolumbar spine disorder. Therefore, an evaluation of 40 percent, and no greater, is warranted for the service-connected thoracolumbar spine disorder. 3. Entitlement to higher initial evaluations for LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain, prior to and beginning July 7, 2015. Service connection for LLE radiculopathy of the sciatic nerve was granted in a July 2015 rating decision. An evaluation of 10 percent was assigned, effective in April 2015. The Veteran disagreed with the evaluation initially assigned. In January 2016, the AOJ assigned an effective date of January 7, 2015 for the award of the 10 percent. In a July 2016 SOC, a 20 percent evaluation was assigned, effective January 7, 2015. The 20 percent evaluation has been confirmed and continued since. a) Prior to January 7, 2015 Prior to January 7, 2015, the medical evidence shows no findings of radiculopathy of the LLE that can be attributed to the service-connected thoracolumbar spine disorder. See October 2011 VA Examination; February 2014 VA Examination for Back; see also, in general, CAPRI Treatment Records. The preponderance of the evidence is against an initial compensable for LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain at any time prior to January 7, 2015. Therefore, an initial compensable evaluation prior to January 7, 2015 for LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain is not warranted. b) Beginning January 7, 2015 The Veteran argues that his LLE radiculopathy causes constant pain and shooting pain down his back into his legs, and that he requires crutches or a cane to move. See July 2016 NOD. There is no dispute that the Veteran has required treatment including prescribed medications, physical therapy, and use of a TENS unit for his lower back disorder, to include the diagnosed radiculopathy into the LLE. However, the medical evidence does not show that the Veteran exhibits the manifestations required for an initial evaluation greater than 20 percent at any time beginning January 7, 2015. A June 2015 VA examination for back shows findings of moderate intermittent pain and mild paresthesias, dysesthesias, and numbness in the LLE with an overall assessment of mild radiculopathy in L4/L5/S1/S2/S3 and clinical findings of spinal stenosis and foraminal narrowing in April 2015. Sensation to the LLE was normal throughout. There were no findings of muscle atrophy, and strength measured 5 of 5 throughout. Deep tendon reflexes measured 2+ in the knees and 1+ in the ankle, bilaterally. See June 2015 VA Examination for Back. VA treatment records show continuing back pain and pain radiating into the LEs, but no observations of incomplete paralysis of the sciatic nerve that is more than moderate in severity at any time from January 7, 2015 throughout the pendency of the appeal. See CAPRI Treatment Records (7/26/2016 and rec’d 9/12/2017). Accordingly, the preponderance of the evidence is against an initial evaluation greater than 20 percent beginning January 7, 2015 for the service-connected LLE radiculopathy of the sciatic nerve associated with thoracolumbar strain. Therefore, an initial evaluation greater than 20 percent beginning January 7, 2015 is not warranted at any time beginning January 7, 2015. 4. Entitlement to higher initial evaluations for RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain, as separate from the right knee neuropathy associated with s/p ACL-R, prior to and beginning July 7, 2015. Service connection for RLE radiculopathy of the sciatic nerve was granted in a July 2015 rating decision. An evaluation of 10 percent was assigned, effective April 21, 2015. The AOJ combined with the 10 percent granted for sciatic radiculopathy associated with the thoracolumbar spine with the 10 percent already assigned for right knee neuropathy s/p ACL-R, resulting in a 10 percent evaluation, overall, reflected as having been effective in January 2012. The Veteran disagreed with the evaluation initially assigned. In December 2015, the AOJ assigned an effective date of January 7, 2015 for the grant of service connection for RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain. In a July 2016 SOC, the AOJ assigned a combined 20 percent evaluation for the RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain, effective January 7, 2015. The combined 20 percent has been confirmed and continued since. At the outset of this discussion, the Board must address the issue of combined evaluations for RLE radiculopathy of the sciatic nerve associated with the service-connected thoracolumbar spine disorder and right knee neuropathy s/p ACL-R. These two service-connected conditions can and should be evaluated separately without violating the regulations against “pyramiding”, or evaluating and thus compensating the Veteran for the same symptoms twice. See 38 C.F.R. § 4.14. This is because these conditions arise from distinct, different events and involve different symptoms. The right knee neuropathy arises from the right knee surgery to correct the ACL which occurred in 2008 and was, in 2011, manifested by decreased sensation to pinprick and touch in the medial aspect of the right knee only, as objectively observed by a VA examiner in October 2011. See October 2011 VA Examination, pp. 15, 17 of 20. However, the VA examiner found no evidence of peripheral nerve involvement, and neurological examination found no sensory deficits of the lumbar spine (L1-L5) and no sensory deficits of the sacral spine (S1). In addition, the VA examiner found no motor weakness, pathological reflexes, or motor function pathology in the LEs; and no findings of IVDS. The VA Examiner diagnosed right knee s/p ACL-R and meniscus tear with residual scar and neuropathy. See Id. The AOJ service-connected and evaluated the findings of decreased sensation in the right medial knee as peripheral neuropathy of the lower extremity, based on mild incomplete paralysis. The 10 percent evaluation was assigned under DC 8599-8520, effective in January 2012, for mild peripheral neuropathy evaluated analogous to sciatic nerve incomplete paralysis. See January 2013 Rating Decision and Codesheet. The AOJ’s use of “99” in the first four digits indicates that the AOJ found the medial right knee loss neuropathy represented a condition unlisted by the rating criteria. Hence, the AOJ did not identify the right knee neuropathy as involving the sciatic nerve, but merely rated the right knee neuropathy by that criteria. See 38 C.F.R. § 4.28. In contrast, the RLE radiculopathy of the sciatic nerve associated with the thoracolumbar spine disorder arises from 2015 VA examination findings of IVDS and spinal stenosis in the thoracolumbar spine, documented in 2015 magnetic resonance imaging results. The VA examiner found the Veteran exhibited bilateral sciatic radiculopathy impacting the L4/L5/S1/S2/S3 nerve roots productive of mild paresthesias and/or dysesthesias and numbness, and moderate intermittent pain in both the RLE and LLE. Other findings were equal in the right LE as compared to the left LE. Deep tendon reflexes were 2+ at the knees and 1+ in the ankles, bilaterally. Strength measured 5 of 5 throughout, bilaterally. And sensation was normal, throughout, bilaterally. The VA examiner diagnosed thoracolumbar IVDS and spinal stenosis. See June 2015 VA Examination for Back. The AOJ awarded separate, compensable evaluations for both LLE and RLE for disability described as left and right “lower extremity radiculopathy of the sciatic nerve as secondary to the service-connected disability of thoracolumbar strain”, and assigned an initial 10 percent evaluation effective ultimately in January 2015 based on findings of mild incomplete paralysis for each. See July 2015 Rating Decision and Codesheet. However, whereas the LLE sciatic radiculopathy was evaluated as 10 percent disabling under DC 8520 alone, the RLE sciatic radiculopathy was evaluated as 10 percent disabling and combined with the previous right knee neuropathy under DC 8599-8520. The right knee neuropathy and RLE sciatic radiculopathy clearly arise from two different origins (2008 ACL-R vice 2015 thoracolumbar IVDS and spinal stenosis) and are manifested by clearly different symptomatology and clinical findings (decreased sensation to medial right knee absent clinical findings of neuropathy vice paresthesias/dysesthesias, pain and intermittent pain absent decreased sensation and clinical findings of right foraminal narrowing at L4-5, and left foraminal narrowing at L5-S1). Moreover, the Board stresses that the 2015 findings of sciatic radiculopathy in the LLE are matched equally with the findings of sciatic radiculopathy in the RLE, and that sensation in both RLE and LLE was found to be normal throughout. Given these differences, the Board will grant an initial compensable evaluation for RLE radiculopathy of the sciatic nerve separate and apart from the 10 percent granted effective in January 2012 for right knee neuropathy associated with right knee ACL-R. a) Prior to January 7, 2015 Prior to January 7, 2015, the medical evidence shows no findings of radiculopathy of the LLE that can be attributed to the service-connected thoracolumbar spine disorder. See October 2011 VA Examination; February 2014 VA Examination for Back; see also, in general, CAPRI Treatment Records. The preponderance of the evidence is against an initial compensable for RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain at any time prior to January 7, 2015. Therefore, an initial compensable evaluation prior to January 7, 2015, separate from that assigned for right knee neuropathy, s/p ACL-R, for RLE radiculopathy of the sciatic nerve associated with thoracolumbar strain is not warranted. b) Beginning January 7, 2015 The Veteran argues that his lower extremity radiculopathy causes constant pain and shooting pain down his back into his legs, and that he requires crutches or a cane to move. See July 2016 NOD. There is no dispute that the Veteran has required treatment including prescribed medications, physical therapy, and use of a TENS unit for his lower back disorder, to include the diagnosed radiculopathy into the RLE. In this case, the medical evidence shows that clinical findings of RLE radiculopathy of the sciatic nerve attributable to the thoracolumbar spine disorder, separate and apart from those symptoms attributed to right knee neuropathy, s/p ACL-R, were manifested in a June 2015 VA examination. However, while the medical evidence establishes that the Veteran exhibits moderate symptoms of RLE radiculopathy of the sciatic nerve associated with the service-connected thoracolumbar spine disorder beginning January 7, 2015, the medical evidence does not show objective observations of symptoms greater than moderate that would warrant an evaluation an initial separate evaluation greater than 20 percent beginning January 7, 2015. A June 2015 VA examination for back shows findings of moderate intermittent pain and mild paresthesias and/or dysesthesias, and numbness in the LLE with an overall assessment of mild radiculopathy in L4/L5/S1/S2/S3 and clinical findings of spinal stenosis and foraminal narrowing in April 2015. Sensation to the RLE was normal throughout. There were no findings of muscle atrophy, and strength measured 5 of 5 throughout. Deep tendon reflexes measured 2+ in the knees and 1+ in the ankle, bilaterally. See June 2015 VA Examination for Back. VA treatment records show continuing back pain and pain radiating into the LEs, but no observations of incomplete paralysis of the sciatic nerve that is more than moderate in severity at any time from January 7, 2015 throughout the pendency of the appeal. See CAPRI Treatment Records (7/26/2016 and rec’d 9/12/2017). Accordingly, the evidence supports an initial evaluation of 20 percent beginning January 7, 2015 for RLE radiculopathy of the sciatic nerve associated with the service-connected thoracolumbar strain, separate and apart from that assigned for right knee neuropathy s/p ACL-R. However, the medical evidence does not establish that a separate, initial evaluation greater than 20 percent is warranted at any time. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L.J. Bakke, Counsel