Citation Nr: 18155817 Decision Date: 12/06/18 Archive Date: 12/06/18 DOCKET NO. 11-16 893 DATE: December 6, 2018 ORDER Entitlement to a rating in excess of 10 percent prior to February 20, 2013 for service-connected lumbosacral strain with degenerative joint disease (low back disability) is denied. Entitlement to a rating in excess of 20 percent from February 20, 2013 to November 24, 2016 for a service-connected low back disability is denied. A rating of 40 percent, but no higher, for a service-connected low back disability is granted from November 25, 2016. Entitlement to a separate compensable rating prior to February 20, 2013 and in excess of 10 percent thereafter for service-connected left lower extremity femoral radiculopathy is denied. Entitlement to a separate compensable rating prior to February 20, 2013 and in excess of 10 percent thereafter for service-connected right lower extremity femoral radiculopathy is denied. FINDINGS OF FACT 1. Prior to February 20, 2013, the Veteran’s low back disability was manifested by flexion limited to no worse than 70 degrees; no muscle spasm or guarding severe enough to result in abnormal gait or spinal contour was shown. 2. From February 20, 2013 to November 24, 2016, the Veteran’s low back disability was manifested by flexion limited to no worse than 50 degrees; ankylosis and intervertebral disc syndrome (IVDS) were not shown. 3. From November 25, 2016, the Veteran’s low back disability is manifested by forward flexion less than 30 degrees; ankylosis and IVDS are not shown. 4. The first evidence of left lower extremity femoral radiculopathy is from February 20, 2013, and the evidence of record shows no more than mild incomplete paralysis of the femoral nerve from that time. 5. The first evidence of right lower extremity femoral radiculopathy is from February 20, 2013, and the evidence of record shows no more than mild incomplete paralysis of the femoral nerve from that time. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for service-connected lumbosacral strain with degenerative joint disease prior to February 20, 2013 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5242. 2. The criteria for a rating in excess of 20 percent for service-connected lumbosacral strain with degenerative joint disease from February 20, 2013 to November 24, 2016 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5242. 3. The criteria for a rating of 40 percent for service-connected lumbosacral strain with degenerative joint disease from November 24, 2016 have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5242. 4. The criteria for separate compensable ratings for bilateral lower extremity femoral radiculopathy prior to February 20, 2013 have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.7, 4.124a, Diagnostic Code 8526. 5. The criteria for ratings in excess of 10 percent for bilateral lower extremity femoral radiculopathy from February 20, 2013 have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.7, 4.124a, Diagnostic Code 8526. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1979 to April 1994 and from February 2006 to February 2008. He had additional Reserve service. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions dated in February 2010 and March 2013 of a Department of Veterans Affairs (VA) Regional Office (RO). The February 2010 rating decision continued a 10 percent disability rating for a low back disability. The March 2013 rating decision increased the low back disability rating to 20 percent, effective February 20, 2013, and granted service connection for femoral radiculopathy of the lower extremities and rated each 10 percent disabling, effective February 20, 2013. An August 2014 Board decision denied entitlement to increased ratings for a low back disability and remanded the issues of entitlement to increased staged ratings for right and left lower extremity radiculopathy for additional development. The Veteran appealed the denial to the United States Court of Appeals for Veterans Claims (Court). In April 2015, the Court granted a Joint Motion for Partial Remand (Joint Motion) by the parties, vacating the Board’s decision and remanding the matter to the Board for action consistent with the terms of the Joint Motion. In August 2015, October 2016, and April 2017, the issues were remanded (by Veterans Law Judges other than the undersigned) for additional development. Increased Ratings A disability rating is 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. Separate diagnostic codes identify the various disabilities. 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 rating 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. The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as staged ratings. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 1. Entitlement to a rating in excess of 10 percent prior to February 20, 2013, in excess of 20 percent from February 20, 2013 to August 22, 2018, and in excess of 40 percent from August 23, 2018 for service-connected lumbosacral strain with degenerative joint disease. In a February 2010 rating decision, the RO continued a disability rating of 10 percent for the Veteran’s service-connected lumbosacral strain with degenerative joint disease (low back disability). Subsequently, in a March 2013 rating decision, the RO increased the low back disability rating to 20 percent, effective February 20, 2013. Most recently, in October 2018, the RO assigned a 40 percent disability rating with an effective date of August 23, 2018. The Veteran contends that his low back disability is more severe than currently evaluated for the entire period of appeal. Disabilities of the spine are rated under the General Rating Formula for Diseases and Injuries of the Spine (for Diagnostic Codes 5235 to 5243, unless 5243 is evaluated under the Formula for Rating IVDS Based on Incapacitating Episodes). Ratings under the General Rating Formula for Diseases and Injuries of the Spine are made with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease. The General Rating Formula for Diseases and Injuries of the Spine provides a 10 percent disability rating for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, the combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent disability rating is assigned 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. A 40 percent disability rating is assigned for forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent disability rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. Finally, a 100 percent disability rating is assigned for unfavorable ankylosis of entire spine. 38 C.F.R. § 4.71a. Note (2) provides that, for VA compensation purposes, normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The normal combined range of motion of the thoracolumbar spine is 240 degrees. See also Plate V, 38 C.F.R. § 4.71a. When rating degenerative arthritis of the spine (Diagnostic Code 5242), in addition to consideration of rating under the General Rating Formula for Diseases and Injuries of the Spine, rating for degenerative arthritis under Diagnostic Code 5003 should also be considered. 38 C.F.R. § 4.71a. However, Diagnostic Code 5003 only provides higher ratings when range of motion results are noncompensable. As the Veteran’s decreased lumbar spine range of motion results amount to a compensable rating for the entire period on appeal, Diagnostic Code 5003 is not for application. Diagnostic Code 5243 provides that intervertebral disc syndrome (IVDS) is to be rated either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher rating when all disabilities are combined under 38 C.F.R. § 4.25. The Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes provides a 20 percent disability rating for IVDS with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months; a 40 percent disability rating for IVDS with incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months; and a 60 percent disability rating for IVDS with incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. 38 C.F.R. § 4.71a. Note (1) to Diagnostic Code 5243 provides that, for purposes of ratings under Diagnostic Code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. Note (2) provides that, if intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, each segment is to be rated on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment. 38 C.F.R. § 4.71a. The Veteran’s post-service treatment notes include a physical therapy assessment for back pain in January 2010, when he noted that his back pain was constant. The Veteran stated that he had increased pain with prolonged standing and decreased pain with sitting in a chair with back support. He was issued a TENs unit. The Veteran was afforded a VA examination in February 2010. At that time, he was taking medication and using the TENS unit for his progressively worsening low back pain. There were no associated urinary symptoms, erectile dysfunction, numbness, or paresthesias. The examiner found no evidence of decreased motion, but the Veteran reported stiffness and pain. The pain was described as mild, constant, and occurring daily. The Veteran noted that the pain radiated to his left buttock. He further stated that he had moderate flare-ups every 1 to 2 months lasting 1 to 2 days that is relieved by a heating pad, TENs unit, and using a recliner. The Veteran denied incapacitating episodes and stated that he was able to walk more than a quarter of a mile but less than 1 mile. His muscle strength and reflexes were normal. Range of motion testing showed flexion to 75 degrees, extension to 30 degrees, left lateral flexion and rotation to 30 degrees, and right lateral flexion and rotation to 20 degrees. There was no objective evidence of pain on active range of motion. On repetition, there was evidence of pain but no reduction of range of motion. The Veteran was employed, and the examiner said there were no significant effects of his low back disability on his occupation. During an additional VA examination in May 2010, the Veteran reported moderate to severe pain and severe stiffness every day. He indicated that the pain was so severe as to keep him out of work for a day at a time 3 times in the previous 6 months. His treatment plan included use of a TENs unit, muscle relaxant, topical analgesic cream, and a back brace for stability. He noted he was able to walk one-half mile often, as required during his rounds in prison as a guard. He reported a history of falling. On examination, his gait and posture were normal. There was tenderness, guarding, and decreased motion on formal examination, and the examiner noted that the subjective complaints were out of proportion to the objective findings. Range of motion testing showed flexion to 70 degrees, extension to 20 degrees, left and right lateral flexion to 20 degrees, and left and right lateral rotation to 20 degrees. The examiner indicated that during informal observation, during dressing and moving about the room, the Veteran was able to accomplish over 70 degrees of flexion and that his body habitus is such that 80 degrees would be considered normal full flexion. Pain was noted on the examination, but there was no additional loss on repetition. No sensory or motor impairments were indicated. The Veteran’s reflex and sensory examinations were normal, and he denied incapacitating episodes in the previous 12 months. During VA treatment in December 2012, the Veteran continued to report chronic back pain. During an examination in February 2013, the Veteran reported chronic pain that increased with prolonged standing, walking, bending, and lifting. He noted flare-ups of pain that required rest along with use of a heating pad and a TENs unit. In the previous 12 months, he required bed rest on 2 occasions. Range of motion testing showed flexion to 60 degrees, extension to 20 degrees, left and right lateral flexion to 20 degrees, and left and right lateral rotation to 30 degrees. There was objective evidence of pain at the stopping point for each measurement. There was no loss of range of motion on repetition. The examiner noted very mild tenderness on percussion of the lower lumbar area. Muscle strength, reflex, and sensory examinations were normal. The Veteran did not have IVDS or any incapacitating episodes over the previous 12 months. Arthritis was documented on imaging studies. During a January 2016 VA examination, the examiner noted the Veteran’s ongoing reports of back pain in his treatment records. The Veteran denied flare-ups. Range of motion testing showed flexion to 50 degrees, extension to 5 degrees, left and right lateral flexion to 30 degrees, and left and right lateral rotation to 30 degrees. The examiner indicated that the Veteran’s range of motion was outside of the normal range but indicated that his extreme morbid obesity made the range normal for the Veteran. There was pain on examination for all ranges of motion. There was no evidence of pain with weight-bearing. There was symmetrical bilateral tenderness to palpation over the paraspinal muscles at the lower lumbosacral level. There was no additional loss of function or range of motion after 3 repetitions. Although the Veteran had muscle spasm of the thoracolumbar spine, it did not result in an abnormal gait or abnormal spinal contour. Muscle strength, reflex, and sensory examinations were normal. No neurologic abnormalities were noted. The Veteran did not have IVDS but imaging studies documented arthritis. The examiner further stated that the Veteran’s morbid obesity and deconditioning make major contributions to his pain and disability. In an April 2016 opinion, the VA examiner indicated that there are no incapacitating episodes manifested by physician-prescribed bed rest in the previous 12 months. Additionally, the examiner found no physical findings supporting a diagnosis of IVDS during the examination. The examiner estimated that 80 percent of the Veteran’s pain and loss of range of motion was related to the obesity and deconditioning while 20 percent was related to his mild degenerative joint disease of the lumbar spine. During a November 2016 VA examination, the Veteran denied flare-ups of back pain. Range of motion testing showed flexion to 10 degrees, extension to 5 degrees, left and right lateral flexion to 5 degrees, and left and right lateral rotation to 10 degrees. The examiner indicated that the Veteran’s range of motion was outside of the normal range but indicated that his morbid obesity and deconditioning “would play a role in this remarkable lack of mobility.” The examiner further described the range of motion as “negligible” and stated that pain behavior was evident during the examination for all ranges of motion. There was no evidence of pain with weight-bearing or localized tenderness or pain on palpation of the joints or associated soft tissue of the thoracolumbar spine. There was no additional loss of range of motion on repetition or muscle spasm or guarding noted on examination. Muscle strength testing was normal though he had hypoactive reflexes on testing of the bilateral knees and ankles. A sensory examination was normal aside from decreased sensation in the lower legs and feet. Ankylosis was not shown nor was IVDS. The Veteran did not have any associated neurologic abnormalities. Mild multilevel degenerative disc disease/arthritis was documented in imaging studies of the spine. The Veteran indicated that he left his job in the prison in 2015 related to his back pain and was not currently working. The Veteran submitted private treatment records from February 2017 reflecting reports of back pain. He was noted to be severely obese and prescribed Cyclobenzaprine for back pain management. In an addendum opinion in May 2017, the November 2016 VA examiner indicated that the ranges of motion recorded at that time were the best he could record on that day. Morbid and increased obesity and a learned examination/pain behavior (in the examiner’s opinion) played a role in the markedly restricted range of motion as described. The examiner was unable to specify the exact proportion attributable to his degenerative joint disease without resorting to speculation. The examiner further indicated that the ranges of motion were recorded in both weight bearing and non-weightbearing in addition to in passive and active movements. The motions recorded were similar in all phases. During an August 2018 VA examination, the Veteran reported flare-ups of back pain every other day for 10 to 15 minutes that result in sharp, throbbing pain and require him to walk with a bending over position of the trunk. The Veteran was not able to run, walk for more than 15 minutes, pick up objects from the floor, or lift objects which weigh more than 15 pounds. Range of motion testing showed flexion to 10 degrees, extension to 5 degrees, left and right lateral flexion to 5 degrees, and left and right lateral rotation to 10 degrees. The examiner indicated that the Veteran appeared to be in pain during all range of motion testing as evidenced by facial grimacing. Tenderness was noted on palpation in the midline and over the lumbosacral paraspinal muscles. No additional loss of range of motion was noted on repetition. There was no evidence of guarding or muscle spasm of the thoracolumbar spine. Muscle strength testing was normal but he had hypoactive reflexes on testing of the bilateral knees and ankles. A sensory examination was normal aside from decreased sensation in the lower legs and feet. Ankylosis was not shown nor was IVDS. The Veteran did not have any associated neurologic abnormalities. Multilevel degenerative disc disease/arthritis was documented in an imaging study of the Veteran’s spine done in March 2018. The examiner noted that average range of motion was the same in weight bearing and with non-weightbearing. The Veteran reported that he retired in 2015. Upon review of the record, the Board finds, first, that a disability rating in excess of 10 percent for the Veteran’s service-connected low back disability is not warranted prior to February 20, 2013. To obtain a higher rating for the Veteran’s spine disability, it is necessary to show forward flexion of no worse 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. Here, however, the Veteran’s forward flexion was shown to be no worse than 70 degrees, even when pain on motion is considered, and no abnormal gait, scoliosis, reversed lordosis, or abnormal kyphosis was shown. Further, there is no evidence that the Veteran experienced incapacitating episodes of at least 2 weeks’ duration during this time. Thus, the Board finds that a disability rating in excess of 10 degrees is not warranted for the Veteran’s spine disability prior to February 20, 2013. Second, the Board finds that the competent and credible evidence of record establishes that a 20 percent disability rating most nearly approximates the severity of the Veteran’s low back disability from February 20, 2013 to November 24, 2016. During this time, his forward flexion was no worse than 50 degrees, including consideration of pain. There is also no evidence of ankylosis or IVDS during this time. Thus, the Board finds that a disability rating in excess of 20 degrees is not warranted for the Veteran’s spine disability from February 20, 2013 to November 24, 2016. See 38 C.F.R. § 4.71a, Diagnostic Code 5242. The Board next finds that the preponderance of the competent and credible evidence of record establishes that a 40 percent disability rating most nearly approximates the severity of the Veteran’s service-connected low back disability from November 25, 2016, the date of the examination showing worsening range of motion. During that examination, the Veteran’s flexion was limited to 10 degrees with pain. As the examiner was unable to distinguish the proportion of pain caused by the Veteran’s service-connected disability versus his obesity, the total impairment is attributed to the Veteran’s service-connected low back disability. However, there is no evidence of ankylosis or IVDS from this time to warrant an increased rating. Even considering the Veteran’s reports of flare-ups, there is no evidence of physician-prescribed bedrest or that such amounts to a total duration of 6 weeks of incapacitation. As such, a rating of 40 percent, but no higher, for the Veteran’s service-connected low back disability is warranted from November 25, 2016. See 38 C.F.R. § 4.71a, Diagnostic Code 5242. 2. Entitlement to a separate compensable rating prior to February 20, 2013 and in excess of 10 percent thereafter for service-connected left lower extremity femoral radiculopathy. 3. Entitlement to a separate compensable rating prior to February 20, 2013 and in excess of 10 percent thereafter for service-connected right lower extremity femoral radiculopathy. In a March 2013 rating decision, the RO granted service connection for bilateral lower extremity femoral radiculopathy and assigned disability ratings of 10 percent for each lower extremity, effective from February 20, 2013. The Veteran contends that his femoral radiculopathy existed prior to February 20, 2013 and that the symptomatology of his femoral radiculopathy of the lower extremities is more severe than reflected by his current disability ratings. The Board notes that the Veteran was awarded an additional 10 percent disability rating for each lower extremity for radiculopathy of the sciatic nerve, effective from August 23, 2018. The Veteran has not contested these ratings. Accordingly, those issues are not currently before the Board. Diagnostic Code 8526 provides the rating criteria for disabilities of the femoral nerve. Under this code, a 40 percent rating is warranted for complete paralysis of the anterior crural nerve (femoral) resulting in paralysis of the quadriceps extensor muscles. Incomplete paralysis of the anterior crural nerve (femoral) warrants a 30 percent rating if it is severe, a 20 percent rating if it is moderate, or a 10 percent rating if it is mild. 38 C.F.R. § 4.124a, Diagnostic Code 8526. The Board acknowledges that words such as “moderate,” “moderately severe,” and “severe,” are not defined in the Rating Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decisions are equitable and just. 38 C.F.R. § 4.6. Use of terminology such as “severe” by VA examiners and others, although evidence to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. The term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. 38 C.F.R. § 4.124a. During a February 2010 VA examination, the Veteran reported radiating sharp pain from his lumbar spine into his left buttock. However, a sensory examination was normal at that time. During a May 2010 VA examination, there was no evidence of sensory impairment. During a September 2012 VA examination, the examiner did not find that the Veteran had radiculopathy. The Veteran described back pain that radiates down both legs about once a month for about 10 to 15 minutes and then resolves. He denied any other symptoms in his legs and was not receiving treatment. Muscle strength, reflex, and sensory testing was normal. EMG studies were not performed but the examiner found that all nerve groups were normal. The examiner stated that there was no evidence of radiculopathy in the available medical record or on examination. During a February 2013 VA examination, the examiner found that the Veteran had radicular pain causing mild intermittent pain in the bilateral lower extremities. The examiner indicated that the bilateral femoral nerves were involved and that the radiculopathy was mild. In a December 2014 VA opinion, the examiner opined that the February 2010 complaints of pain into the left buttock were less likely than not indicative of a left lower extremity radiculopathy. The examiner based this opinion on a lack of objective evidence showing that the Veteran had radiculopathy, including impaired reflexes, muscle weakness, sensory abnormalities, or atrophy. The examiner pointed to subsequent examinations with identical findings and further noted that the February 2013 examiner could have been responding that there were “symptoms” of radiculopathy without “signs”. Additionally, there were no imaging findings or EMG studies to support a diagnosis of radiculopathy and none of the examiners listed radiculopathy as a diagnosis. During a January 2016 VA examination, the examiner found no evidence of radicular pain. During a November 2016 VA examination, the examiner noted mild constant pain and numbness in the bilateral lower extremities. Muscle strength testing was normal and there was no evidence of atrophy. The Veteran’s reflexes were hypoactive in the bilateral knees and ankles. He had decreased sensation in the lower legs and feet. There was no evidence of trophic changes attributable to peripheral neuropathy. The examiner indicated that bilateral femoral nerve radiculopathy was not confirmed by the examination. During an August 2018 VA examination, the Veteran complained of low back pain radiating to both buttocks, the back of both thighs, legs, and ankles. He stated he had tingling and numbness in both lower extremities. The Veteran reported mild constant pain, paresthesias/dysesthesias, and numbness in the bilateral lower extremities. Muscle strength testing was normal and there was no evidence of atrophy. The Veteran’s reflexes were hypoactive in the bilateral ankles. He had decreased sensation in the lower legs and feet. There was no evidence of trophic changes attributable to peripheral neuropathy. The examiner found mild incomplete paralysis of the bilateral sciatic nerves and that the femoral nerves were normal. Based on the above, the Board finds that a separate compensable rating for bilateral lower extremity femoral radiculopathy is not warranted prior to February 20, 2013. There is no evidence that femoral radiculopathy existed at any point during that time. Indeed, the Board finds the December 2014 VA opinion highly probative indicating that the February 2010 complaints of radicular pain do not amount to a diagnosis of radiculopathy and weighs heavily the subsequent examinations that failed to diagnose femoral radiculopathy. Further, Board finds that the Veteran is not entitled to a rating higher than the 10 percent currently assigned for his service-connected radiculopathy of the bilateral femoral nerves. The medical evidence shows that the Veteran’s radiculopathy is sensory and reflects, at most, mild incomplete paralysis of the femoral nerve. Indeed, the record contains conflicting evidence about whether the Veteran has femoral radiculopathy at all. The Veteran is shown to report no more than mild symptomatology, and there are only slight impairments noted on reflex and sensory examinations. Accordingly, the Board does not find the Veteran’s symptomatology is most nearly approximated by moderate incomplete paralysis of either femoral nerve, and therefore an evaluation in excess of 10 percent for the Veteran’s femoral radiculopathy of the bilateral lower extremities is not warranted at any point during the appeal period. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Lindsey Connor