Citation Nr: 18150371 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 09-22 660 DATE: November 15, 2018 ORDER Entitlement to an initial rating for the Veteran’s service connected right knee patellofemoral pain syndrome in excess of 10 percent is denied. Entitlement to an initial rating for the Veteran’s thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy in excess of 10 percent for the period from April 3, 2007, to November 3, 2015 (excluding the period assigned for a temporary total convalescent rating), and in excess of 20 percent from November 2, 2015, to thereafter, is granted. FINDINGS OF FACT 1. Throughout the period on appeal, the Veteran’s right knee patellofemoral pain syndrome is manifested by painful motion that limits his right knee flexion to 110 degrees and extension to 0 degrees. 2. Excluding the period assigned for a temporary total convalescent rating, the Veteran’s thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy, is manifested by a forward flexion of the thoracolumbar spine to 20 degrees due to pain, but with no ankylosis or incapacitating episodes having a total duration of at least 6 weeks during a 12 month period. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for the Veteran’s service connected right knee patellofemoral pain syndrome has not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.45, 4.59, 4.71a, Diagnostic Code 5099-5024 (2017). 2. The criteria for a higher rating of 40 percent, but no more, for the Veteran’s thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy (excluding the period assigned for a temporary total convalescent rating), has been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.45, 4.59, 4.71a, Diagnostic Codes 5242-5237 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1995 to December 2000, and from May 2005 to April 2007, including in support of Operation Enduring Freedom. He also had additional unverified U.S. Naval Reserve (USNR) service. This appeal to the Board of Veterans’ Appeals (Board) arose from a September 2008 rating decision issued by the Department of Veterans Affairs (VA), which granted the Veteran’s claim of service connection with an disability rating of 10 percent, effective November 28, 2007. See October 2008 Notice of Disagreement (NOD); May 2009 Statement of the Case (SOC); June 2009 Substantive Appeal (VA Form 9). During the pendency of the appeal, the Veteran was assigned a temporary total convalescent rating for his service connected thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy, from January 5, 2010, to April 1, 2010. See February 2010 and June 2010 rating decisions. The Veteran testified before the undersigned Veterans Law Judge (VLJ) in a July 2011 hearing. A transcript of the hearing is associated with the claims file. In November 2011, the Board denied the Veteran’s claim for a higher initial rating for his service connected right knee patellofemoral pain syndrome and remanded his claim for a higher initial rating for lumbar spine disability to the Agency of Original Jurisdiction (AOJ) for additional development. Pursuant to a settlement agreement in National Org. of Veterans’ Advocates, Inc. v. Secretary of Veterans Affairs, 725 F.3d 1312 (Fed. Cir. 2013), the November 2011 Board decision denying the Veteran’s claim for a higher initial rating for his service-connected right knee patellofemoral pain syndrome was identified as having been potentially affected by an invalidated rule relating to the duties of the VLJ who conducted the July 2011 hearing. In order to remedy any such potential error, the Board sent the Veteran a letter notifying him of an opportunity to receive a new hearing and/or a new decision from the Board. The Veteran requested only to have the November 2011 Board decision vacated and a new one issued in its place. See October 2013 Correspondence; April 2014 Board decision. In May 2014, the Board denied the Veteran’s claims of higher initial ratings for a lumbosacral spine disability and right knee patellofemoral pain syndrome. The Veteran appealed the May 2014 Board decision to the United States Court of Appeals for Veterans Claims (Court). The Veteran and VA’s Office of General Counsel filed with the Court a Joint Motion for Partial Remand (“Joint Motion”). The Court granted the Joint Motion in March 2015, vacating and remanding the Board’s May 2014 decision denying the Veteran’s claims of higher initial ratings for a lumbosacral spine disability and right knee patellofemoral pain syndrome to afford the Veteran updated VA examinations. In August 2015, the Board remanded the Veteran’s claims of higher initial ratings for lumbosacral spine disability and right knee patellofemoral pain syndrome to the AOJ for further development per the Joint Motion. A May 2016 rating decision increased the disability rating for the Veteran’s lumbosacral spine disability, now claimed as thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy, from 10 percent to 20 percent, effective November 3, 2015. In February 2017, the Board remanded the claims for the AOJ to issue a Supplemental SOC. In August 2017, the Board remanded the claims to afford the Veteran new VA examinations that are in accordance with the Court’s holding in Correia v. McDonald, 28 Vet. App. 158 (2016). The claims have now been returned to the Board for adjudication. The Board notes that during the pendency of the appeal, the Veteran filed a claim for left knee chondromalacia with arthroscopic scar, which was previously associated with the current matter. However, the Veteran had a separate hearing conducted by a different VLJ in October 2016. The claim for left knee chondromalacia will, thus, be addressed in a separate Board decision issued by the VLJ who conducted the October 2016 hearing. A May 2018 rating decision also granted service connection for right knee instability, associated with patellofemoral pain syndrome, with an initial disability rating of 10 percent, effective February 7, 2018, that is not part of the current appeal. Increased Rating Disability ratings are determined by the application of the VA’s Schedule for Rating Disabilities. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § Part 4. Ratings for service-connected disabilities are determined by comparing the Veteran's symptoms with criteria listed in VA’s Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. See 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, the higher evaluation will be assigned to the disability picture that more nearly approximates the criteria required for that rating. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. Assigning separate ratings for combination may not be permitted to result in pyramiding under 38 C.F.R. § 4.14 - which prohibits “[t]he evaluation of the same disability under various diagnoses.” See Brady v. Brown, 4 Vet. App. 203, 206 (1993). See, too, Esteban v. Brown, 6 Vet. App. 259, 262 (1994) (the critical element is if symptoms of one condition are duplicative of or overlapping of another). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt ot the Veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 1. Entitlement to an initial rating for right knee patellofemoral pain syndrome in excess of 10 percent. The Veteran’s right knee patellofemoral pain syndrome is currently rated by analogy as 10 percent disabling under 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5099-5024, based on painful or limited motion of a major joint. When an unlisted disease, injury, or residual condition is encountered, requiring rating by analogy, the DC will be “built-up” as follows: the first 2 digits will be selected from that part of the schedule most closely identifying the part, or system, of the body involved; the last 2 digits will be “99” for all unlisted conditions. The disability is then rated by analogy under a DC for a closely related disability that affects the same anatomical functions and has closely analogous symptomatology. 38 C.F.R. §§ 4.20, 4.27. Here, the Veteran’s right knee patellofemoral pain syndrome is found most closely related to tenosynovitis, which is rated on limitation of motion of the affected parts, as degenerative arthritis. See 38 C.F.R. § 4.71a, DC 5024. The Veteran’s right knee patellofemoral pain syndrome is, thus, rated on limitation of flexion or extension of the leg. See 38 C.F.R. § 4.71a, DCs 5024, 5260, 5261. Separate ratings may be assigned for limitations of flexion and extension in the same knee. Specifically, where a Veteran has both a compensable level of limitation of flexion and a compensable level of limitation of extension in the same leg, the limitations must be rated separately to adequately compensate for functional loss associated with injury to the leg. VAOPGCPREC 9-04 (Sept. 17, 2004), 69 Fed. Reg. 59990 (2005). When evaluating joint disabilities rated on the basis of limitation of motion, VA may consider granting a higher rating in cases in which functional loss due to pain, weakness, excess fatigability, or incoordination is demonstrated, and those factors are not contemplated in the relevant rating criteria. See 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202 (1995). Under DC 5260, a leg flexion limitation to 60 degrees is noncompensable, a limitation to 45 degrees warrants a 10 percent rating, and flexion limitation to 30 degrees warrants a 20 percent rating. 38 C.F.R. § 4.71a, DC 5260. Under DC 5261, a leg extension limitation to 5 degrees is noncompensable, a limitation to 10 degrees warrants a 10 percent disability rating, and a limitation to 15 degrees warrants a 20 percent rating. Arthritis shown by X-ray studies is rated based on limitation of motion of the affected joint. When limitation of motion would be noncompensable under a limitation-of-motion code, but there is at least some limitation of motion, a 10 percent rating may be assigned for each group of minor joints so affected. 38 C.F.R. § 4.71a, DC 5003, 5010. After careful review of the evidence, the Board finds that the Veteran’s right knee patellofemoral pain syndrome warrants no more than a 10 percent disability rating by analogy under 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5099-5024 based on imaging evidence that supports at least some limitation of motion that is noncompensable under a limitation of motion code. The Veteran testified during the July 2011 hearing that he has right knee pain when using stairs, and feels some locking or catching when physically active. While the Veteran is competent to report his right knee symptoms, he is not competent to state whether his symptoms warrant a specific rating under the schedule for rating disabilities. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed Cir. 2006); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Here, his statements about his right knee symptoms do not specifically address the limitation of motion in his right knee. Moreover, the Veteran also testified that he has occasional falls due to his left leg, not the right knee, and that he does not have right knee issues during exercise, but not with normal walking. See July 2011 Hearing testimony. Instead, the Board gives probative weight to the January 2018 private medical opinion by N.Y.E., D.O., in evaluating the Veteran’s right knee patellofemoral pain syndrome. Dr. N.Y.E. opined that the Veteran has right knee pain that results in less movement than normal, excess fatigability, pain on movement, swelling, instability, and disturbance of locomotion. January 2018 Knee and Lower Leg Conditions Disability Benefits Questionnaire. Dr. N.Y.E. found an initial right knee flexion range of motion up to 110 degrees, and extension to 0 degrees. Id. Dr. N.Y.E. found that repetitive use further restricted the Veteran’s right knee flexion to 100 degrees and opined that there would be an even further flexion restriction to 90 degrees during a flare-up. Id. Dr. N.Y.E. recently examined the Veteran, reviewed the evidence in the claims file, and is a medical professional qualified to evaluate the Veteran’s right knee disability severity. In addition, the examination and findings by Dr. N.Y.E. address the range of motion testing as described at 38 C.F.R. § 4.59, as well as during flare-ups. See Correia v. McDonald, 28 Vet. App. 158 (2016) and Sharp v. Shulkin, 29 Vet. App. 26 (2017). Thus, the Board finds Dr. N.Y.E.’s opinion is entitled to probative weight. The findings and opinion by Dr. N.Y.E. are also consistent with the medical treatment evidence. VA treatment records show the Veteran complained of knee pain since at least April 2008. A January 2008 right knee x-ray showed no fractures or other acute osseous or articular abnormalities. An October 2013 right knee MRI showed patellofemoral and medial compartmental cartilaginous irregularity, and probable degenerative free edge irregularity of the medial meniscus. A VA treatment provider reviewing the MRI assessed the Veteran with right knee patellofemoral arthrosis, found no obvious meniscal pathology, and noted that the Veteran was able to ambulate with a steady gait without distress. See December 2013 VA treatment record. This evidence supports continuing right knee pain since at least 2008, but the ability to independently walk. The Veteran was also afforded several VA examinations for his right patellofemoral pain syndrome that the Board finds are less probative, but consistent with right knee flexion restriction of no more than 90 degrees and extension to 0 degrees. The January 2008 VA examiner opined that the Veteran’s right knee has negative crepitus, can flex to 140 degrees and extend to 0 degrees, and has no flare ups, pain, or additional limitations from repetitive use. The January 2011 VA examiner opined that the Veteran’s right knee had no instability, weakness, incoordination, or locking episodes, but that pain restricted his active flexion limited to 113 degrees. The May 2016 VA examiner found a right knee flexion limited to 135 degrees and extension to 0 degrees, but did not assess the Veteran’s range of motion restriction during a flare up or after repeated use over time, and only indicated that it would be mere speculation to opine on whether there would be a change in range of motion, and to what degree. The September 2017 VA examiner found a right knee flexion up to 135 degrees with no pain on weight bearing, and opined that the Veteran would have no additional restriction with repetitive use or during a flare up. Finally, the February 2018 VA examiner found that the Veteran has a right knee flexion range of motion to 125 degrees, and extension to 0 degrees, but only indicated that it would be mere speculation to assess additional restrictions due to a flare up or after repeated use over time, with no other rationale. The Board finds the VA examiners’ findings and opinions are probative as to the general condition of the Veteran’s right knee due patellofemoral pain syndrome throughout the pendency of the appeal, but that they are less probative than the findings and opinion by Dr. N.Y.E.. The VA examiners do not consider the both the range of motion testing described at 38 C.F.R. § 4.59 and assess the Veteran’s right knee condition during a flare-up. While the VA examiners’ findings and opinions support a continuing right knee disability, the specific range of motion findings are less probative. Based on the findings and opinions by Dr. N.Y.E., the VA examiners, and the medical treatment evidence, the Board finds that the Veteran’s right knee flexion range of motion was limited to no more than 90 degrees, and extension range of motion limited to no more than 0 degrees, throughout the period on appeal. The Board finds the Veteran’s right knee range of motion limitation more closely approximates a noncompensable rating. See 38 C.F.R. § 4.71a, DCs 5260, 5261. There is also no evidence that he Veteran’s right knee patellofemoral pain syndrome was manifested by imaging evidence showing the involvement of two or more major or minor joint groups with occasional incapacitation exacerbations. See 38 C.F.R. § 4.71a, DCs 5003, 5024. The Board, accordingly, finds the preponderance of the evidence is against a disability rating for the Veteran’s right knee patellofemoral pain syndrome in excess of 10 percent for the period from November 28, 2007, and thereafter. The Board considered the other diagnostic codes relating to the knee. Specifically, DC 5256 for ankylosis, DC 5257 for recurrent subluxation or lateral instability, DC 5258 and 5259 for symptomatic dislocation or removal of semilunar cartilage, DC 5262 for impairment of tibia and fibula, and DC 5263 for genu recurvatum. The Veteran’s right knee instability under DC 5257 is already rated by the May 2018 rating decision and not part of this appeal. The findings and opinions from Dr. N.Y.E. and the VA examiners, and the medical treatment evidence discussed above indicate that the Veteran’s right knee shows no ankylosis, subluxation, meniscal conditions, impairment of the tibia and fibula, or genu recurvatum. This is consistent with the medical treatment evidence discussed above. As these conditions are not shown on examination of the Veteran, or in the medical evidence of record, the Board finds that application of these diagnostic codes is not warranted. 38 C.F.R. § 4.71a. As the preponderance of the evidence is against a rating in excess of 10 percent, the benefit-of-the-doubt doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). 2. Entitlement to a rating for thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy, in excess of 10 percent for the period from April 3, 2007, to November 3, 2015 (excluding the period assigned for a temporary total convalescent rating), and in excess of 20 percent from November 2, 2015, to thereafter. The Veteran asserts that the evidence supports a 20 percent rating for his back disability for the entire period on appeal based on his trouble walking, standing, and sleeping prior to his back surgery and that he requires a reasonable accomodation to perform his light duty job after his surgery. See October 2008 NOD; June 2015 Written statement. In his June 2009 Substantive Appeal, the Veteran contends that his back disability diagnosis should be scoliosis. During the July 2011 hearing, the Veteran testified that his back has worsened since his January 2010 surgery and that he uses pain medication to sleep. The Veteran also contends in a July 2017 correspondence that his lumbar strain and spinal stenosis should be rated separately, and his use of pain medication, left hip strain, and pelvic torsion should be considered in rating his back disability. The Veteran’s service connected thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy, is evaluated under 38 C.F.R. § 4.71a, DCs 5242-5237. Excluding the period assigned for a temporary total convalescent rating, the Veteran was assigned an initial rating of 10 percent from April 3, 2007, to November 2, 2015, and 20 percent from November 2, 2015, to thereafter. The General Rating Formula for Diseases and Injuries of the Spine provides that a 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar 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. The next higher rating is 40 percent, which is warranted for thoracolumbar spine forward flexion of 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. The next higher rating of 50 percent is warranted for unfavorable ankylosis of the entire thoracolumbar spine. 38 C.F.R. § 4.71a. Note 5 of the General Rating Formula for Diseases and Injuries of the Spine indicates that for VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Id. Under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, a 20 percent rating is warranted for incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months. A 40 percent rating is warranted for incapacitating episodes having a total duration of at least 4 weeks, but less than 6 weeks, during the past 12 months. A 60 percent rating is warrant for incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. Id. The Board notes that while the Veteran is competent to report his pain and other experienced symptoms caused by his thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy, he is not competent to state the cause of his symptoms and whether his symptoms warrant a specific rating under the schedule for rating disabilities. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed Cir. 2006); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). For instance, the medical evidence shows that while the January 2008 x ray showed a slight left lumbar scoliosis, the Veteran was not diagnosis with scoliosis and a later February 2010 x ray showed lumbar alignment within normal limits. In addition, as the Veteran notes, the schedule for ratings can allow for separate evaluation of disability for the thoracolumbar and cervical spine segments, but the assignment of separate ratings for the same disability resulting from different diagnoses for his back impairment would be impermissible pyramiding. See 38 C.F.R. § 4.14; Esteban, 6 Vet. App. at 262. That said, the Board finds the Veteran’s statements about his symptoms credible, and that the totality of the evidence reflects a disability rating of 40 percent, but no higher, for the period prior to January 5, 2010, and from April 1, 2010 to thereafter. In making its finding, the Board gives probative weight to the January 2018 opinion by Dr. N.Y.E. In evaluating the Veteran’s thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy, Dr. N.Y.E. found the Veteran’s back has a forward flexion up to 30 degrees, which is further restricted to 20 degrees due to pain, repetitive movement, or during a flare up. See January 2018 Back (Thoracolumbar Spine) Conditions Disability Benefits Questionnaire. Dr. N.Y.E. opined that the Veteran is limited from prolonged sitting, standing, and walking; his pain medication causes drowsiness; and he misses work or has to leave early during severe flares. Id. Dr. N.Y.E.’s findings are consistent with the medical evidence showing complaints of painful lumbar motion with all planes at least since 2008, with flexion being the most limited. See May 2008 Private treatment record. After the Veteran’s January 2010 back surgery, the Veteran still complained of pain in the mid lumbar spine that radiates to his left side and imaging studies show scar tissue formation, but no significant gait deviation. See June 2010, September 2010, and December 2010 VA treatment records. The claims file contains no evidence of ankylosis or incapacitating episodes having a total at least 6 weeks during a 12-month period to warrant a 60 percent disability rating during the period on appeal. The Board recognizes that the Veteran was afforded several VA examinations for his thoracolumbar disability, which the Board finds less probative than the opinion by Dr. N.Y.E. The January 2008 VA examiner opined that the Veteran can forward flex to 90 degrees with pain starting at 40 degrees, but then opines that there is no pain on range of motion or flare ups in any of his joints. The January 2011 VA examiner opined that the Veteran’s thoracolumbar spine flexion is limited to 66 degrees and that there is evidence of pain with active range of motion, but it is unclear if the range of motion limitation was assessed with pain considered. The January 2016 VA examiner opined the Veteran had a forward flexion up to 55 degrees and that he complained of daily flare up, but only indicated that any assessed additional restrictions from the flare ups would be mere speculation. Finally, the January 2018 VA examiner found the Veteran had a forward flexion up to 45 degrees with complaints of almost daily flare ups and also only indicating that any assessed additional restrictions from the flare ups would be mere speculation. The Board finds the VA examiners’ findings probative in that their findings show the Veteran had a maximum thoracolumbar forward flexion limit ranging from 40 to 66 degrees at various times during the period on appeal. The VA examiners also consistently found no evidence of ankylosis. However, Board finds the VA examiners’ findings and opinions less probative than those from Dr. N.Y.E. because the two most recent VA examiners’ opinions provided insufficient rationale as to why they could not assess the Veteran’s restrictions during a flare up without speculating, and it is unclear whether pain was considered by the earlier VA examiners. The Board also considered the November 2015 opinion by private chiropractor R.M., D.C. Dr. R.M. assessed the Veteran with a forward flexion of 50 degrees and indicates there is no increase restriction with repetitive use or during a flare up. However, Dr. R.M. then indicated that a flare up would result in further restriction if the Veteran stood for more than 5 to 10 minutes or stand for more than 15 to 30 minutes. Given this inconsistency, the Board gives the opinion little probative weight. Based on the most probative evidence from Dr. N.Y.E.’s and the VA examiners, the Board finds the Veteran’s thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy is manifested by a thoracolumbar forward flexion limit to 20 degrees and that this more closely approximates a of 40 percent disability rating. 38 C.F.R. § 4.71a. However, the preponderance of the evidence, including the findings and opinions from Dr. N.Y.E. and the VA examiners, is against finding that the Veteran has unfavorable ankylosis of the entire thoracolumbar spine, and there is no evidence that the Veteran has had incapacitating episodes having a total at least 6 weeks during a 12-month period during the period on appeal. The Board, therefore, finds that the Veteran’s thoracolumbar spine strain with degenerative disc disease, status post hemilaminectomy and discectomy did not manifest to require a disability rating for more than 40 percent. 38 C.F.R. § 4.71a. DEBORAH W. SINGLETON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Lin, Associate Counsel