Citation Nr: 18151756 Decision Date: 11/20/18 Archive Date: 11/20/18 DOCKET NO. 16-22 794 DATE: November 20, 2018 ORDER New and material evidence has been received and the claim of entitlement to service connection for a right shoulder disability secondary to the service-connected left shoulder disability is reopened. Entitlement to service connection for a right shoulder disability secondary to the service-connected left shoulder disability is granted. Entitlement to a 50 percent rating for residuals of left shoulder replacement (prosthesis) is granted. Entitlement to a rating higher than 30 percent prior to January 29, 2016 for residuals of total left knee replacement and higher than 60 percent from January 29, 2016 is denied. Entitlement to a temporary total rating for status post left shoulder dislocation based on surgery performed November 28, 2007 and convalescence is denied. FINDINGS OF FACT 1. An April 1997 rating decision denied the Veteran’s claim of entitlement to service connection for a right shoulder disability; evidence received since that time tends to relate to an unestablished fact necessary to substantiate the claim and raises a reasonable possibility of substantiating the claim. 2. The Veteran’s right shoulder disability has been shown to be proximately due to his service-connected left shoulder disability. 3. The Veteran’s left shoulder disability is manifested by chronic residuals consisting of severe, painful motion or weakness in the affected extremity. 4. Prior to January 29, 2016, the Veteran’s service-connected left knee disability was manifested by subjective complaints of pain and some limited range of motion, but objectively, no evidence of chronic residuals consisting of severe painful motion or weakness in the left knee. 5. From January 29, 2016, the Veteran’s service-connected left knee disability is manifested by chronic residuals consisting of severe painful motion or weakness in the left knee. 6. The Veteran’s claim of entitlement to a temporary total rating for status post left shoulder dislocation based on surgery performed November 28, 2007 and convalescence and supporting medical evidence was received more than one year after the surgery was performed. CONCLUSIONS OF LAW 1. New and material evidence has been received, and the claim of service connection for a right shoulder disability is reopened. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. § 3.156. 2. The criteria for entitlement to service connection for a right shoulder disability secondary to the service-connected left shoulder disability have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.310. 3. The criteria for entitlement to a 50 percent rating for residuals of left shoulder replacement (prosthesis) have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.71a, Diagnostic Code (Code) 5051. 4. The criteria for entitlement to a rating higher than 30 percent prior to January 29, 2016 for total left knee replacement and higher than 60 percent from January 29, 2016 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.71a, Code 5055. 5. The criteria for entitlement to a temporary total rating for status post left shoulder dislocation based on surgery performed November 28, 2007 and convalescence have not been met. 38 U.S.C. §§ 5103, 5107; 38 C.F.R. § 3.109(a)(b), 3.110. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from December 1978 to December 1983 and from December 1984 to August 1992. These matters are before the Board of Veterans’ Appeal (Board) on appeal from a March 2012 rating decision (notice sent April 2012) by a Department of Veterans Affairs (VA) Regional Office (RO) that, in pertinent part, continued the denial of the previously denied claim of entitlement to service connection for a right shoulder disability, increased the rating for status post left shoulder dislocation to 20 percent effective September 24, 2010, continued a 30 percent rating each for total right and left knee replacements (previously rated as degenerative arthritis), and denied a temporary total rating because of treatment for a service-connected or other condition subject to compensation under 38 C.F.R. § 4.30. An interim, May 2016, rating decision assigned a 100 percent temporary total rating effective October 2, 2013, based on surgical or other treatment necessitating convalescence for the left knee. A 30 percent rating is assigned from January 1, 2014; and a 60 percent rating is assigned from January 29, 2016. In May 2016, the Veteran perfected the appeal to the Board only as to the issues of reopening the claim of entitlement to service connection for a right shoulder disability, a rating higher than 20 percent for left shoulder replacement (prosthesis), a rating higher than 30 percent prior to January 29, 2016 for residuals of total left knee replacement and higher than 60 percent from January 29, 2016, and a temporary total rating for status post left shoulder dislocation based on surgery performed November 28, 2007 and convalescence. Petition to Reopen Pertinent evidence received since the April 1997 final unappealed rating decision, regarding the claim of entitlement to service connection for a right shoulder disability, includes the Veteran’s September 2015 statement wherein he asserts his right shoulder disability is secondary to his service-connected left shoulder disability because he had to over-compensate all of his work using the right shoulder since the left shoulder was “totally useless.” In addition, a May 2016 favorable opinion by the Veteran’s private physician, Dr. ADB, was received since the April 1997 final unappealed rating decision. Dr. ADB opined that the Veteran’s right shoulder pain and conditions are the result of him overusing and compensating for his left shoulder problems. To establish whether new and material evidence has been submitted, the credibility of evidence is presumed unless the evidence is inherently incredible or consists of statements that are beyond the competence of the person or persons making them. Thus, the credibility of the Veteran’s statement and the opinion of Dr. ADB must be presumed at this juncture. See Fortuck v. Principi, 17 Vet. App. 173, 179-80 (2003). When viewing this evidence in the light most favorable to the Veteran, and considering the “low threshold” standard for reopening endorsed by the United States Court of Appeals for Veterans Claims (Court) in Shade v. Shinseki, 24 Vet. App. 110 (2010), the Board finds the evidence received since the April 1997 final rating decision is new and material. This follows because it is not cumulative or redundant of the evidence previously of record, and it tends to show the etiology of the Veteran’s right shoulder disability. Accordingly, the claim of entitlement to service connection for a right shoulder disability is reopened. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disability which is aggravated by a service connected disability. To prevail on the issue of secondary service connection, the record must show (1) evidence of a current disability; (2) evidence of a service connected disability; and (3) medical nexus evidence establishing a connection between the service connected disability and the current disability. The Veteran contends his right shoulder disability is the result of overuse of his right shoulder due to not being able to use his service-connected left shoulder. Specifically, he asserts his left shoulder is totally useless and he had to overcompensate for that loss by putting undue stress on his right shoulder to perform everyday activities as well as carry out his job duties at work. For example, he had to “ manhandle ” 50 to 70-pound sacks of mail and throw them into containers, some of the containers were 6 feet high, and he performed this with just one arm. Using the left arm only to guide sacks and packages caused enormous stress and pain to his right shoulder. He stated that by 2013 he had endured the pain for 6 years. In November 2015 he underwent a right shoulder replacement. In a May 2016 letter, the Veteran’s private physician opined that the Veteran’s right shoulder pain and conditions are the result of him overusing and compensating for his left shoulder problems. Weighing the Veteran’s credible statements and the private physician’s positive nexus opinion, the Board finds that it is at least as likely as not that the Veteran’s right shoulder disability is etiologically related to his service-connected left shoulder disability. Accordingly, the claim of entitlement to service connection for a right shoulder disability secondary to the service-connected left shoulder disability is granted. Increased Ratings Disability evaluations are determined by the application of VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. 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 for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Where entitlement to compensation already has been established and an increase in the evaluation is at issue, the present level of disability is of primary importance. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). However, separate ratings may be assigned for separate periods of time based on the facts found. This practice is known as a “staged” rating. See Hart v. Mansfield, 21 Vet. App. 505 (2007). When evaluating musculoskeletal disabilities that are at least partly rated based on range of motion, VA must consider granting a higher rating in cases in which the Veteran experiences functional loss due to limited or excess movement, pain, weakness, premature or excess fatigability, or incoordination (including during flare-ups or with prolonged or repeated use), assuming these factors are not already contemplated in the relevant rating criteria. See 38 C.F.R. §§ 4.40, 4.45, 4.59. Pursuant to 38 C.F.R. § 4.59, painful motion should be considered limited motion, even though a range of motion may be possible beyond the point when pain sets in. See DeLuca v. Brown, 8 Vet. App. 202 (1995). A finding of functional loss due to pain, however, must be supported by adequate pathology and evidenced by the visible behavior of the Veteran. 38 C.F.R. § 4.40. Moreover, although pain may cause a functional loss, pain itself does not constitute functional loss. Mitchell v. Shinseki, 25 Vet. App. 32 (2011). Rather, pain must affect some aspect of “the normal working movements of the body ‘such as ‘excursion, strength, speed, coordination, and endurance,’ in order to constitute functional loss.” Id.; see 38 C.F.R. § 4.40. Residuals of Left Shoulder Replacement (Prosthesis) The Veteran contends that a rating higher than 20 percent is warranted for his left shoulder disability. Specifically, he asserts that after his total reverse replacement of the left shoulder in November 2014, he continues to have “no strength”, very limited range of motion in his left arm and severe pain. The Veteran’s residuals of left shoulder disability are rated under Code 5051. Under Code 5051, for one year following implantation of a shoulder prosthesis for a service-connected shoulder disability, a 100 percent rating is assigned. 38 C.F.R. § 4.71a, Code 5051. Thereafter, a 50 percent rating is assigned when there are chronic residuals consisting of severe painful motion or weakness in the affected extremity; or, a minimum 20 percent rating is assigned. Id. When there are intermediate degrees of residual weakness, pain, or limitation of motion, these intermediate residuals are to be rated by analogy under 38 C.F.R. § 4.71a, Codes 5200 or 5203. Id. The evidence shows the Veteran is right handed; the evaluation of the criteria will correspond to the minor extremity. On review of the evidence of record, especially the January 2016 VA examination, the Board finds the Veteran has chronic residuals consisting of severe, painful motion or weakness in the left shoulder. The evidence shows he has limited mobility. He is not able to hold anything or go behind his back. He cannot move his arms out to the sides very well. He reports he has been on light duty since 2014 with a 2-pound restriction. He has constant pain and sleeps in a chair. He is not able to sleep in a bed. He reported he is not able to carry more than 2 pounds and he has very limited range of motion. Range of motion testing of the left shoulder reveals flexion to 55 degrees, abduction to 40 degrees, external rotation to 0 degrees and internal rotation to 40 degrees. Range of motion contributes to functional loss in that the Veteran has difficulty with putting on a jacket. Flexion, abduction, external rotation and internal rotation all exhibited pain on range of motion testing. There was pain with weight bearing. Ankylosis (favorable) in abduction up to 60 degrees was shown. The Veteran can reach his mouth and head. The Veteran’s functionality is affected in that he has difficulty with dressing and lifting and carrying. He reports he is on a 2-pound weight restriction for his left shoulder. The Board finds the Veteran’s reports of symptoms associated with his left shoulder credible and consistent with objective medical findings on examination. Accordingly, a 50 percent rating under Code 5051 for left (minor) shoulder disability is warranted. The Board has also considered a total disability based on individual unemployability (TDIU), as a claim for increased compensation can encompass a claim for TDIU. Rice v. Shinseki, 22 Vet. App. 447, 452-53 (2009). In the Veteran’s January 2016 VA examination report, he reported that he is currently employed full-time with the postal service and has worked there for about 22 years. Accordingly, the Board finds that a TDIU is not part of the Veteran’s claim for an increased rating in this instance. Moreover, neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017). Residuals of Left Knee Replacement and Convalescence In May 2015 correspondence, the Veteran asserts that rehabilitation and therapy for his left knee exceeded the convalescent period he was assigned. He was awarded convalescence under 4.30 for his left knee disability from October 13, 2013 to December 31, 2013. He stated he was confined to the use of a walker, crutches or a cane for 10 weeks. He asserts entitlement to 100 percent temporary total convalescence for a full year. A May 2016 rating decision assigned a rating of 100 percent effective October 2, 2013, based on surgical or other treatment necessitating convalescence. A 30 percent rating was assigned from January 1, 2014, the first of the month after the temporary total rating ends. A 60 percent rating was assigned from January 29, 2016, the date medical evidence supports residuals consisting of severe painful motion or weakness in the left knee. A total disability rating (100 percent) will be assigned without regard to other provisions of the rating schedule when it is established by report at hospital discharge (regular discharge or release to non-bed care) or outpatient release that entitlement is warranted under paragraph (a) (1), (2) or (3) of this section effective the date of hospital admission or outpatient treatment and continuing for a period of 1, 2, or 3 months from the first day of the month following such hospital discharge or outpatient release. Such total rating will be followed by appropriate schedular evaluations. When the evidence is inadequate to assign a schedular evaluation, a physical examination will be scheduled and considered prior to the termination of a total rating. 38 C.F.R. § 4.30. Total ratings will be assigned under this section if treatment of a service-connected disability resulted in: (1) surgery necessitating at least one month of convalescence; (2) surgery with severe postoperative residuals such as incompletely healed surgical wounds, stumps of recent amputations, therapeutic immobilization of one major joint or more, application of a body cast, or the necessity for house confinement, or the necessity for continued use of a wheelchair or crutches (regular weight-bearing prohibited); or, (3) immobilization by cast, without surgery, of one major joint or more. The total rating will be followed by an open rating reflecting the appropriate schedular evaluation; where the evidence is inadequate to assign the schedular evaluation, a physical examination will be scheduled prior to the end of the total rating period. 38 C.F.R. § 4.30(a). The Veteran’s left knee disability has been rated under Code 5055, which pertains to total knee replacement. Under Code 5055, for one year after a prosthetic replacement of the knee joint, the knee is rated at 100 percent. Thereafter, a 60 percent rating is assignable for chronic residuals consisting of severe painful motion or weakness in the affected extremity. Intermediate degrees of residual weakness, pain or limitation of motion are rated under Codes 5256 (ankylosis), 5261 (limitation of extension) and 5262 (impairment of the tibia and fibula). The minimum rating after a knee replacement is 30 percent. 38 C.F.R. § 4.71a, Code 5055. Under Code 5256 (ankylosis of the knee), a 30 percent rating is assignable for a favorable angle in full extension, or in slight flexion between 0 degrees and 10 degrees. A 40 percent rating is assignable for flexion between 10 degrees and 20 degrees. A 50 percent rating is assignable for flexion between 20 degrees and 45 degrees. A 60 percent rating is assignable for extremely unfavorable flexion at an angle of 45 degrees or more. 38 C.F.R. § 4.71a. Ankylosis is defined as “immobility and consolidation of a joint due to disease, injury, surgical procedure.” Lewis v. Derwinski, 3 Vet. App. 259 (1992) (citing Saunders Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health at 68 (4th ed. 1987)). Under Code 5261 (leg limitation of extension), a 30 percent evaluation is assignable for extension limited to 20 degrees. A 40 percent evaluation is assignable for extension limited to 30 degrees. A 50 percent evaluation is assignable when extension is limited to 50 degrees. 38 C.F.R. § 4.71a. Under Code 5262, malunion of the tibia or fibula warrants a rating of 30 percent for marked knee or ankle disability. Nonunion of the tibia or fibula, with loose motion, requiring a brace, warrants a 40 percent rating. 38 C.F.R. § 4.71a. For purposes of this appeal, the Veteran was granted a temporary total 100 percent rating for convalescence purposes related to his service-connected left knee disability from October 2, 2013 to December 31, 2013. Therefore, only the period during which the Veteran’s left knee was less than totally disabling are under consideration. In June 2012 the Veteran underwent a private examination of the knees by his private physician, Dr. ADB. The Veteran reported he was having progressively increasing pain in both knees. The pain in his knees was 5/5; it began in December 2011 and had gotten progressively worse. He complained of instability. The pain was sharp. He denied any swelling. The pain was constant and he had been wearing a knee brace at work at the post office. There was moderate laxity in both knees to varus and valgus stress. There was pain on range of motion. His range of motion was “pretty” full. It was difficult to assess any effusion. There was no ecchymosis or erythema. X-rays of the knees showed no evidence of loosening of the components or excessive plastic wear. The patellar component was in good position. No evidence of fracture or infection was seen. No osteolysis was noted. The impression was laxity bilateral total knee replacements. The physician recommended revision of the tibial plastic in both total knees. The Veteran was informed that his obesity was a contributing factor to his knee problems. The physician explained that because of the level of pain the Veteran was experiencing it was imperative to proceed with surgical intervention. On October 2, 2013 the Veteran had a tibial plastic exchange, left total knee replacement operation performed by his private surgeon, Dr. ADB. The pre- and post-operative diagnoses were laxity, left total knee replacement. On January 2016 VA knee and lower leg conditions examination, the Veteran reported he had left knee replacement in 2013. He reported he continues to have non-stop constant pain that worsens when he negotiates stairs. He reported functional loss or functional impairment in that he is not able to walk long distances, has difficulty at work with walking from one side of the building to the other, and he is not able to bend or stoop. He currently works at the post office full-time; he has been assigned to work at the windows selling stamps. He did not report flare-ups of the knee. On range of motion testing, left knee flexion was to 90 degrees and extension was from 90 to 0 degrees. Range of motion contributed to his functional loss in that the Veteran had difficulty with stooping – he had to guide himself down with sitting, and his gait was antalgic. The Veteran exhibited pain on left knee flexion and extension and with weightbearing. There was no objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. There was no objective evidence of crepitus. There was no additional functional loss or range of motion after three repetitions. Pain, weakness, fatigability or incoordination did not significantly limit functional ability with repeated use over a period of time. Additional contributing factors of the left knee disability was the Veteran had difficulty with getting in and out of a chair due to pain. His gait was antalgic-slow. On muscle strength testing, left knee forward flexion and extension were 4/5 with a reduction in muscle strength due to left knee replacement. There was no muscle atrophy. There was no ankylosis of the left knee. There was no history of recurrent subluxation, lateral instability or recurrent effusion of the left knee. The Veteran did not have or had every had recurrent patellar dislocation, “shin splints” stress fractures, chronic exertional compartment syndrome or any other tibial and/or fibular impairment. Surgical procedures include total left knee joint replacement in 2002 and 2013 with chronic residuals consisting of severe painful motion or weakness, arthroscopic knee surgery 1991, 1995 and 2003, with residual signs or symptoms due to meniscectomy, arthroscopic or other knee surgery, and pain. The Veteran’s scars are not painful or unstable or have a total area equal to or greater than 39 square centimeters (6 square inches), or located on the head, face or neck. He occasionally uses a cane. He stated he uses it when he must walk more than a short distance and when he has pain in the knees. The diagnosis was bilateral knee replacements, diagnosed 2002. The functional impact results in the Veteran having difficulty with walking distances and coming from sitting to standing position and standing for periods of time. He has difficulty with stooping and bending and kneeling and difficulty with going up stairs. By a May 2016 rating decision, a temporary total rating was assigned effective October 2, 2013, based on surgical or other treatment necessitating convalescence. A 30 percent rating was continued effective January 1, 2014, the first of the month after the temporary total evaluation. A 60 percent was assigned from January 29, 2016, the date medical evidence supports residuals consisting of severe painful motion or weakness in the affected extremity. The Veteran contends he is entitled to a rating higher than 30 percent prior to January 29, 2016 and higher than 60 percent from that date. A disability rating higher than 30 percent for the Veteran’s service-connected left knee disability, prior to January 29, 2016, is not warranted under Code 5055. While the evidence shows painful motion and weakness of the left knee, it does not rise to the level of a severe disability such that a 60 percent rating is warranted under Code 5055. Specifically, range of motion findings show flexion to be no worse than 90 degrees and extension to 0 degrees. At the January 2016 VA examination, the Veteran exhibited pain on left knee flexion and extension and with weightbearing, but, findings from the January 2016 VA examination report do not show the Veteran has chronic residuals consisting of severe painful motion or weakness in his left lower extremity. Thus, a rating higher than 30 percent is not warranted prior to January 29, 2016 under Code 5055. As previously noted, under Code 5055, the Veteran’s disability may be considered by analogy under Codes 5256, 5261, or 5262. However, there is no evidence of the left knee being ankylosed since he demonstrated movement of his left knee in all planes of excursion during the January 2016 VA examination. Similarly, higher ratings are not warranted under Codes 5261 or 5262. There is no evidence showing extension limited to 30 degrees or more, or evidence of nonunion of the tibia and fibula. As previously mentioned, the Veteran demonstrated extension to 0 degrees, and there is no mention in the examination report of any impairment to the tibia or fibula. While the record reflects that the Veteran wears a knee brace at times, his service-connected left knee disability is not characterized by nonunion of the tibia and fibula with loose motion requiring a brace. Moreover, flexion of the knee joint is to, at least, 75 degrees, which is noncompensable under the rating schedule. See 38 C.F.R. § 4.71a, Code 5260. Thus, a higher rating, prior to January 29, 2016 is not warranted under Codes 5256, 5261, or 5262. The Board has considered functional loss due to pain and weakness that causes additional disability beyond that which is reflected on range of motion measurements. See 38 C.F.R. § 4.40; DeLuca, 8 Vet. App. 202. The Board must consider the effects of weakened movement, excess fatigability and incoordination. See 38 C.F.R. § 4.45. In this case, a higher rating based on functional loss is not warranted. The Veteran was having difficulty with walking distances and coming from a sitting to a standing position and standing for periods of time. He had difficulty with stooping and bending and kneeling and difficulty with going up stairs. The Board notes, however, that the 30 percent rating already assigned under Code 5055 contemplates the potential problems associated with a knee replacement, such as the degree of weakness and painful motion demonstrated here. Additionally, as discussed above, objectively the Veteran has limitation of extension to 0 degrees and limitation of flexion to no less than 90 degrees on the left knee. These results do not entitle the Veteran to a higher rating for the period prior to January 29, 2016 under the codes for rating limitation of motion. Further, the evidence includes a June 2012 private treatment record reflecting the Veteran’s complaint of instability and a showing of moderate laxity in both knees to varus and valgus stress testing. In addition, a postoperative diagnosis of laxity is shown in the October 2013 private operative report. However, on VA examination in January 2016 there was no history of recurrent subluxation, or lateral instability of the left knee. Neither did the Veteran have or had every had recurrent patellar dislocation. The Veteran is competent to report his symptoms, and the Board does not doubt the sincerity of the Veteran’s belief that his service-connected left knee disability has worsened. However, the objective findings do not support his assertions for the reasons stated above as to range of motion loss. The preponderance of the evidence is against the Veteran’s claim and an increased rating higher than 30 percent for his service-connected left knee disability, prior to January 29, 2016, is denied as to loss of range of motion. See 38 C.F.R. § 3.102. In consideration of whether a rating higher than 60 percent from January 29, 2016 is warranted for residuals of left total knee replacement, the Board finds the 60 percent rating under Code 5055 currently in effect is the highest allowable rating, and a rating higher than 60 percent is not warranted pursuant to Code 5055. The only rating higher than 60 percent under Code 5055 is the assignment of a temporary 100 percent rating following the surgery, which the Veteran received from October 2, 2013 to December 31, 2013. Furthermore, such a schedular rating is precluded by law. Specifically, the Board notes that the amputation rule set forth at 38 C.F.R. § 4.68 provides that the combined rating for disabilities of an extremity shall not exceed the rating for amputation at the elective level, were amputation to be performed. For example, the combined evaluations shall not exceed the 60 percent evaluation set forth under Codes 5162, 5163, and 5164 for an amputation of the thigh at the mid or lower thirds; for amputation of the leg with defective stump, thigh amputation recommended; and, amputation not improvable by prosthesis controlled by natural knee action. 38 C.F.R. § 4.68. Thus, as the provisions of 38 C.F.R. § 4.68 limit the combined rating for the Veteran’s residuals of a total knee replacement to 60 percent, the currently assigned 60 percent rating is the maximum rating that can be assigned for the left knee. Therefore, as a matter of law, a disability rating higher than 60 percent from January 29, 2016 cannot be awarded for residuals of left total knee replacement. Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). As noted, in this case, a TDIU is not part of the Veteran’s claim as he is currently a full-time employee with the postal service. Rice, 22 Vet. App. at 452-53. Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette, 28 Vet. App. 366. Temporary Total Rating for Status Post Left Shoulder Dislocation The Veteran claims entitlement to a temporary total rating for status post left shoulder dislocation based on surgery performed November 28, 2007 and convalescence. The evidence shows the Veteran filed a claim for a temporary total rating based on surgery and convalescence in September 2010. Also in September 2010 the RO received an operative report, by the Veteran’s private physician, showing the Veteran underwent a resurfacing hemiarthroplasty replacement of the left shoulder operation on November 28, 2007. If a claimant’s application is incomplete, the claimant will be notified of the evidence necessary to complete the application. If the evidence is not received within one year from the date of such notification, compensation will not be paid by reason of that application. 38 C.F.R. § 3.109(a)(1). The provisions of this regulation are applicable to original initial applications and to applications for increased benefits by reason of increased disability. See 38 C.F.R. § 3.109(a)(2). Time limits within which claimants or beneficiaries are required to act to perfect a claim or challenge an adverse VA decision may be extended for good cause shown. 38 C.F.R. § 3.109(b). Here, the Veteran’s claim and supporting medical evidence was received more than one year after the surgery was performed. Entitlement to the benefit is denied as the medical evidence was not received within the time limits under 38 C.F.R. § 3.109; and there is no evidence showing good cause as to why the claim was not timely received. (Continued on the next page)   In sum, the criteria for entitlement to a temporary total rating for status post left shoulder dislocation based on surgery performed November 28, 2007 and convalescence have not been met and the Veteran’s claim therefore must be denied. 38 C.F.R. § 3.109. L. BARSTOW Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Young, Counsel