Citation Nr: 18159035 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 14-33 961 DATE: December 19, 2018 ORDER Service connection for residuals of a traumatic brain injury (TBI) is denied. Service connection for residuals of an injury of the left shoulder is denied. Service connection for a disability manifested by numbness of the left upper extremity is denied. Service connection for posttraumatic stress disorder (PTSD) is denied. An initial compensable rating for a left knee strain is denied. An initial compensable rating for a right knee strain is denied. An increased rating in excess of 10 percent for radiculopathy of the left lower extremity is denied. An increased rating in excess of 10 percent for radiculopathy of the right lower extremity is denied. An effective date earlier than July 5, 2011, for the award of service connection for left lower extremity radiculopathy is denied. An effective date earlier than July 5, 2011, for the award of a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that residuals of a TBI began during active service, or is otherwise related to an in-service injury, event, or disease. 2. The preponderance of the evidence is against finding that the Veteran has a current chronic left shoulder disability, including degenerative arthritis due to a disease or injury in service, to include specific in-service event, injury, or disease. 3. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of left arm numbness. 4. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of PTSD. 5. Throughout the appeal, the Veteran’s left knee strain has been manifested by pain, without limitation of motion, recurrent subluxation, functional impairment, or X-ray evidence of degenerative changes in the knee. 6. Throughout the appeal, the Veteran’s right knee strain has been manifested by pain, without limitation of motion, recurrent subluxation, functional impairment, or X-ray evidence of degenerative changes in the knee. 7. Throughout the appeal, radiculopathy of the left lower extremity is shown to be productive of no more than mild impairment. 8. Throughout the appeal, radiculopathy of the right lower extremity is shown to be productive of no more than mild impairment. 9. The Veteran’s initial claim of service connection for left lower extremity radiculopathy was received on July 5, 2011. 10. The Veteran’s claim for TDIU was received on July 5, 2011. CONCLUSIONS OF LAW 1. The criteria for service connection for residuals of a TBI are not met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for a chronic left shoulder disability, including arthritis are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a)-(b), (d), 3.307, 3.309(a). 3. The criteria for service connection for a disability manifested by left arm numbness are not met. 38 U.S.C. §§ 1110 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 4. The criteria for service connection for PTSD are not met. 38 U.S.C. §§ 1110 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.304. 5. The criteria for an initial compensable rating for a left knee strain have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.71a, Diagnostic Code (Code) 5257. 6. The criteria for an initial compensable rating for a right knee strain have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.71a, Code 5257. 7. The criteria for a rating in excess of 10 percent for radiculopathy of the left lower extremity have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Code 8520. 8. The criteria for a rating in excess of 10 percent for radiculopathy of the right lower extremity have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Code 8520. 9. The criteria for an effective date earlier than July 5, 2011, for the award of service connection for left lower extremity radiculopathy have not been met. 38 U.S.C. § 5110(a)(b); 38 C.F.R. § 3.400(a)(b). 10. The criteria for an effective date earlier than July 5, 2011, for the award of TDIU have not been met. 38 U.S.C. § 5110(a)(b); 38 C.F.R. § 3.400(o). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran, who is the appellant, served on active duty from February 1978 to April 1992. The case was previously before the Board in June 2018. At that time, the matters on appeal were remanded for further development of the evidence or to ensure due process. This has been accomplished and the case has been returned for further appellate consideration. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease shown as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. If a condition, as identified in 38 C.F.R. § 3.309(a), noted during service is not shown to be chronic, then generally, a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Where a veteran who served for ninety days or more during a period of war (or during peacetime service after December 31, 1946) develops certain chronic diseases, such as arthritis, to a degree of 10 percent or more within one year from separation from service, such diseases may be presumed to have been incurred in service even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. See 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. In order to prevail on the issue of service connection, there must be medical evidence of current disability; medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and medical evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. See Hickson v. West, 12 Vet. App. 247 (1990). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and an evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1990); 38 C.F.R. § 3.303(a). The Board has reviewed all of the evidence in the Veteran’s claims file, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Hence, the Board will summarize the relevant evidence where appropriate and the analysis below will focus specifically on what the evidence shows, or fails to show, as to the claim. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b) (2012); 38 C.F.R. § 3.102 (2017). When all of the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). 1. Service connection for residuals of a TBI The Veteran contends that service connection is warranted for residuals of a traumatic brain injury that he believes he sustained during service. He asserts that he sustained the injury while serving in Thailand and was physically assaulted by several men. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of residuals of a TBI sustained in service and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). Review of the Veteran’s service treatment records shows that he was involved in an assault during service, in June 1990, at which time it was noted that he had multiple lacerations on his hands, low back pain, and abrasions on the toe and left shin. He reported at that time that he was not clear on whether he had had a loss of consciousness. A July 2013 VA examiner evaluated the Veteran and determined that, while he experienced symptoms of cognitive dysfunction, he did not have a diagnosis of residuals of TBI. The examiner noted that a review of the record indicated that the Veteran was assaulted during service in Thailand at which time he denied having sustained a brain injury. The Veteran’s statements during the treatment following the assault showed that he sustained multiple injuries to his body, but not to his head. The examiner also interviewed the Veteran’s girlfriend who denied that the Veteran had had cognitive or behavior problems prior to having sustained a cerebrovascular accident (CVA) many years after service. The Veteran had been able to function in full capacity prior to the CVA. Thus, the examiner concluded that the records presented in the claims folder did not support a diagnosis of TBI. While the Veteran believes he has current residuals of a TBI related to incidents that occurred while on active duty, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education or knowledge of the interaction between multiple organ systems in the body. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for residuals of a TBI, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Service connection for residuals of an injury of the left shoulder The Veteran contends that service connection is warranted for a chronic left shoulder disorder that had its onset during service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current manifestations of a left shoulder disability and a diagnosis of arthritis in the left shoulder, and evidence shows that the Veteran had complaints of left shoulder pain in service, including on examination for separation from service, the preponderance of the evidence weighs against finding that the Veteran’s current diagnosis of left shoulder arthritis began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton 557 F.3d at 1363; 38 C.F.R. § 3.303(a), (d). VA treatment records show the Veteran was not diagnosed with a chronic left shoulder disability until January 2008, years after his separation from service. While the Veteran is competent to report having experienced symptoms of left shoulder pain since service, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of his current left shoulder disorder. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body or interpretation of complicated diagnostic medical testing. Jandreau 492 F.3d at 1372. Further, a September 2018 VA examiner opined that the Veteran’s left shoulder arthritis was not at least as likely as not related to an in-service injury, event, or disease, including complaints of left shoulder pain during service. The rationale was that the Veteran’s mild degenerative arthritis was most often caused by microtrauma from wear and tear over the years, and that this was most likely the cause of the Veteran’s left shoulder arthritis. It was further noted that there were no signs of old fracture or injury, or of traumatic arthritis that would suggest that this was caused by, or incurred in service. The examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). There are no medical opinions to the contrary. While the Veteran believes his left shoulder arthritis is related to an in-service injury, event, or disease, he is not competent to provide a nexus opinion in this case. This issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body interpretation of complicated diagnostic medical testing. Jandreau 492 F.3d at 1372. Consequently, the Board gives more probative weight to the VA examination report. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a chronic left shoulder disorder, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 3. Service connection for a disability manifested by numbness of the left upper extremity The Veteran contends that service connection should be awarded for a disability manifested by left upper extremity numbness. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of a disability manifested by left upper extremity numbness and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton 557 F.3d at 1363; Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). The September 2018 VA examiner evaluated the Veteran and determined that, while he experienced subjective symptoms of left arm numbness, he did not have a diagnosis of a chronic disability. The examiner explained that the current examination and review of medical records was without evidence of a current diagnosis or pathology to make a diagnosis of any peripheral nerve condition, including one involving the left arm. While the Veteran believes he has a current diagnosis of left arm numbness, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education, knowledge of the interaction between multiple organ systems in the body, or the ability to interpret complicated diagnostic medical testing. Jandreau 492 F.3d at 1372. Consequently, the Board gives more probative weight to the competent medical evidence. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for a chronic disability manifested by left upper extremity numbness, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 4. Service Connection for PTSD The Veteran contends that service connection is warranted for PTSD, which, he asserts, is related to the physical assault in which he was involved while in service in 1990. The Board notes initially that there is evidence that this assault took place in June 1990. In addition, it is noted a claim of service connection for PTSD may encompass claims for service connection of any mental disability that may reasonably be encompassed by the symptoms the claimant describes. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). The Veteran has, however, been separately service-connected for depression. As such, there is no need to discuss any additional psychiatric disorders. Establishing entitlement to service connection for PTSD requires precise findings. These findings are: (1) a current medical diagnosis of PTSD; (2) credible supporting evidence that the claimed in-service stressor occurred; and, (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in-service stressor. See 38 C.F.R. § 3.304(f). The diagnosis of PTSD must comply with the criteria set forth in the DSM-5. Id.; see 38 C.F.R. §§ 4.125(a), 4.130 (2015). As noted, the record reflects that the Veteran’s psychiatric health has also been analyzed under the DSM-IV. See Cohen v. Brown, 10 Vet. App. 128, 140 (1997). The question for the Board is whether the Veteran has current manifestations that support a diagnosis of PTSD that began during service or is at least as likely as not related to an in-service injury, event, or disease. After review of the record, the Board concludes that the Veteran does not meet the necessary diagnostic criteria, and has not had a diagnosis of PTSD at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton 557 F.3d at 1363; Romanowsky 26 Vet. App. at 289; McClain, 21 Vet. App. at 319. A July 2013 VA examiner evaluated the Veteran and determined that, while he experienced subjective symptoms of depression, he did not meet the criteria for a confirmed diagnosis of PTSD. While the Veteran believes his psychiatric disorder should be diagnosed as PTSD, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau 492 F.3d at 1372. Consequently, the Board gives more probative weight to the competent medical evidence. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for service connection for PTSD, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) found in 38 C.F.R. Part 4. 38 U.S.C. § 1155. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. 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. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. The United States Court of Appeals for Veterans Claims (Court) has held that “staged” ratings are appropriate for an increased rating claim where the factual findings show distinct time periods when the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 5. An initial compensable rating for a left knee strain and a right knee strain Service connection for a left knee strain and a right knee strain was granted by the Regional Office (RO) in an April 2014 rating decision. The noncompensable (0 percent) initial disability ratings assigned for each knee were awarded under the provisions of Code 5257. An examination was conducted by VA in July 2013. At that time, the diagnosis was bilateral knee strain. The Veteran stated that he started experiencing bilateral knee pain during running and prolonged walking without any other symptoms. He denied grinding, locking or dislocation. He also denied having flare-ups. Range of motion in each knee was from 0 degrees extension to 140 degrees flexion. There was no evidence of objective pain on motion. The Veteran was able to perform repetitive use testing without additional limitation of motion or functional loss. There was no tenderness or pain to palpation of the joint line. Strength testing and testing of stability were all normal. Imaging studies were performed. These did not show evidence of arthritis or patellar subluxation or any other acute abnormality. Normal ranges of motion of the knee are to 0 degrees in extension, and to 140 degrees in flexion. 38 C.F.R. § 4.71, Plate II. Diagnostic Code 5003 provides that degenerative arthritis that is established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. When there is no limitation of motion of the specific joint or joints that involve degenerative arthritis, Diagnostic Code 5003 provides a 20 percent rating for degenerative arthritis with X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations, and a 10 percent rating for degenerative arthritis with X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups. Note (1) provides that the 20 percent and 10 percent ratings based on X-ray findings will not be combined with ratings based on limitation of motion. Note (2) provides that the 20 percent and 10 percent ratings based on X-ray findings, above, will not be utilized in rating conditions listed under Diagnostic Codes 5013 to 5024, inclusive. When there is some limitation of motion of the specific joint or joints involved that is noncompensable (0 percent) under the appropriate diagnostic codes, Diagnostic Code 5003 provides a rating of 10 percent for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under Diagnostic Code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. When there is limitation of motion of the specific joint or joints that is compensable (10 percent or higher) under the appropriate diagnostic codes, the compensable limitation of motion should be rated under the appropriate diagnostic codes for the specific joint or joints involved. 38 C.F.R. § 4.71a. Separate disability ratings are possible for arthritis with limitation of motion under Diagnostic Codes 5003 and instability of a knee under Diagnostic Code 5257. See VAOPGCPREC 23-97. When x-ray findings of arthritis are present and a veteran’s knee disability is rated under Diagnostic Code 5257, the veteran would be entitled to a separate compensable rating under Diagnostic Code 5003 if the arthritis results in noncompensable limitation of motion and/or objective findings or indicators of pain. See VAOPGCPREC 9-98. Diagnostic Code 5256 provides ratings for ankylosis of the knee. Favorable ankylosis of the knee, with angle in full extension, or in slight flexion between zero degrees and 10 degrees, is rated 30 percent disabling. Unfavorable ankylosis of the knee, in flexion between 10 degrees and 20 degrees, is to be rated 40 percent disabling; unfavorable ankylosis of the knee, in flexion between 20 degrees and 45 degrees, is rated 50 percent disabling; extremely be rated 60 percent disabling. 38 C.F.R. § 4.71a. Diagnostic Code 5257 provides ratings for other impairment of the knee that includes recurrent subluxation or lateral instability. Slight recurrent subluxation or lateral instability of the knee is rated 10 percent disabling; moderate recurrent subluxation or lateral instability of the knee is rated 20 percent disabling; and severe recurrent subluxation or lateral instability of the knee is rated 30 percent disabling. 38 C.F.R. § 4.71a. Separate disability ratings are possible for arthritis with limitation of motion under Diagnostic Codes 5003 and instability of a knee under Diagnostic Code 5257. See VAOPGCPREC 23-97. When x-ray findings of arthritis are present and a veteran’s knee disability is rated under Diagnostic Code 5257, the veteran would be entitled to a separate compensable rating under Diagnostic Code 5003 if the arthritis results in noncompensable limitation of motion and/or objective findings or indicators of pain. See VAOPGCPREC 9-98. Diagnostic Code 5258 provides a 20 percent rating for dislocated semilunar cartilage with frequent episodes of “locking,” pain, and effusion into the joint. 38 C.F.R. § 4.71a. Diagnostic Code 5259 provides a 10 percent rating for removal of semilunar cartilage that is symptomatic. 38 C.F.R. § 4.71a. Diagnostic Code 5260 provides ratings based on limitation of flexion of the leg. Flexion of the leg limited to 60 degrees is rated noncompensably (0 percent) disabling; flexion of the leg limited to 45 degrees is rated 10 percent disabling; flexion of the leg limited to 30 degrees is rated 20 percent disabling; and flexion of the leg limited to 15 degrees is rated 30 percent disabling. 38 C.F.R. § 4.71a. See VAOPGCPREC 09-04 (separate ratings may be granted based on limitation of flexion (Diagnostic Code 5260) and limitation of extension (Diagnostic Code 5261) of the same knee joint). Diagnostic Code 5261 provides ratings based on limitation of extension of the leg. Extension of the leg limited to 5 degrees is rated noncompensably (0 percent) disabling; extension of the leg limited to 10 degrees is rated 10 percent disabling; extension of the leg limited to 15 degrees is rated 20 percent disabling; extension of the leg limited to 20 degrees is rated 30 percent disabling; extension of the leg limited to 30 degrees is rated 40 percent disabling; and extension of the leg limited to 45 degrees is rated 50 percent disabling. 38 C.F.R. § 4.71a. See VAOPGCPREC 09-04 (separate ratings may be granted based on limitation of flexion (Diagnostic Code 5260) and limitation of extension (Diagnostic Code 5261) of the same knee joint). Diagnostic Code 5262 provides ratings based on impairment of the tibia and fibula. Malunion of the tibia and fibula with slight knee or ankle disability is rated 10 percent disabling; malunion of the tibia and fibula with moderate knee or ankle disability is rated 20 percent disabling; and malunion of the tibia and fibula with marked knee or ankle disability is rated 30 percent disabling. Nonunion of the tibia and fibula with loose moti4on, requiring a brace, is rated 40 percent disabling. 38 C.F.R. § 4.71a. In this case, the Veteran’s left and right knee strains are manifested by pain, without limitation of motion, recurrent subluxation, or functional impairment. There is no evidence on X-ray studies of degenerative changes in the left or right knee and no findings instability. Under these circumstances, there is no basis for a compensable rating for left knee strain or right knee strain. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for an increased rating for the left or right knee strains, and the claims must be denied. Because the preponderance of the evidence is against the claims, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 6. An increased rating in excess of 10 percent for radiculopathy of the left lower extremity Service connection for left lower extremity radiculopathy was granted by the RO in an April 2014 rating decision. The 10 percent initial disability rating was awarded under the provisions of Code 8520. On examination of the Veteran’s spine in October 2010, the Veteran was noted to have low back pain with occasional radiation to the left thigh. Private treatment records show that in October 2012, while being evaluated for cardiac disability, the Veteran had complaints of severe radicular low back pain. There was no indication at that time of complaints of numbness or paralysis of the lower extremities. An examination was conducted by VA in September 2018. At that time, muscle strength testing at the knees and ankles was normal at 5/5. There was no muscle atrophy. Deep tendon reflexes were also a normal 2+ at the knees and ankles. Sensory examination was normal at the upper anterior thigh, thighs, knees, lower legs and ankles and feet and toes. There were no trophic changes. Gait was normal. There was no functional impairment resulting from peripheral nerve disease of either lower extremity. Diagnostic Code 8520 provides ratings for paralysis of the sciatic nerve. Diagnostic Code 8520 provides that mild incomplete paralysis is rated 10 percent disabling; moderate incomplete paralysis is rated 20 percent disabling; moderately severe incomplete paralysis is rated 40 percent disabling; and severe incomplete paralysis, with marked muscular atrophy, is rated 60 percent disabling. Complete paralysis of the sciatic nerve, the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost, is rated 80 percent disabling. Diagnostic Code 8620 provides a rating for neuritis of the sciatic nerve. Diagnostic Code 8720 provides a rating for neuralgia of the sciatic nerve. The term “incomplete paralysis” with this and other peripheral nerve injuries indicates a degree of lost or impaired function substantially less than the type pictured 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. The ratings for the peripheral nerves are for unilateral involvement; when there is bilateral involvement, the VA adjudicator is to combine the ratings for the peripheral nerves, with application of the bilateral factor. 38 C.F.R. § 4.124a. The Veteran has complaints of radiculopathy resulting from his service-connected low back disability. While the radiculopathy was described as severe at the time he was undergoing treatment for a disability unrelated to this appeal, there were no symptoms related to the level of paralysis described at that time. On examination in 2010 and, more recently, in 2018, few neurologic symptoms were described. As such, there no basis for a finding of disability productive of greater than mild incomplete paralysis. A rating in excess of 10 percent for disability of the left lower extremity is not warranted. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for increased rating for radiculopathy of the left lower extremity, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 7. A rating in excess of 10 percent for radiculopathy of the right lower extremity As with the left lower extremity, the record shows that the Veteran has complaints of radiculopathy resulting from his service-connected low back disability that was described as severe at the time he was undergoing treatment for a disability unrelated to this appeal. Again, there were no symptoms related to the level of paralysis described at that time. Examinations in 2010 and 2018 showed few neurologic symptoms. As such, there no basis for a finding of disability productive of greater than mild incomplete paralysis and a rating in excess of 10 percent for disability of the left lower extremity is not warranted. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran’s claim for increased rating for radiculopathy of the left lower extremity, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. Id. Effective Date Except as otherwise provided, the effective date of an evaluation and award of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110(a), (b); 38 C.F.R. § 3.400(a), (b). The effective date for the grant of service connection is the day following separation from active service or the date entitlement arose, if the claim is received within one year after separation from service; otherwise, it is the date of receipt of claim, or the date entitlement arose, whichever is later. Id. The effective date for an increased rating will be the earliest date as of which it is factually ascertainable that an increase in disability had occurred, provided a claim is received within one year from such date; otherwise, the effective date for an increased rating will be the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C. § 5110(a)(b); 38 C.F.R. § 3.400(o). Effective on and after March 24, 2015, VA updated the regulations concerning the filing of claims. 38 C.F.R. Parts 3, 19, and 20. In part, the Department replaced the informal/formal claims process with a standardized and more formal process. See 79 Fed. Reg. at 57,663-64; see also 38 C.F.R. § 3.155. As a result of the rulemaking, a complete claim on an application form is required for all types of claims. 38 C.F.R. § 3.155(d). As these new regulations only became effective as of March 24, 2015, they do not apply to the current appeal. Any communication or action indicating an intent to apply for one or more benefits under the laws administered by VA, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next of friend of a claimant who is not sui juris may be considered an informal claim. Such informal claim must identify the benefit sought. 38 C.F.R. § 3.155(a). Once a formal claim for pension or compensation has been allowed or a formal claim for compensation disallowed for the reason that the service-connected disability is not compensable in degree or a claim for pension denied for the reason the disability was not permanently and totally disabling, receipt of one of the following may be accepted as an informal claim for increased benefits or an informal claim to reopen. The date of outpatient or hospital examination or date of admission to a VA hospital or uniformed services hospital. The date of receipt of evidence from a private physician when evidence furnished by or on behalf of the claimant is within the competence of the physician. 38 C.F.R. § 3.157(b). The mere receipt of medical records cannot be construed as an informal claim for the benefit. Brannon v. West, 12 Vet. App. 32, 35 (1998). 8. An effective date earlier than July 5, 2011, for the award of service connection for left lower extremity radiculopathy Review of the record shows that the Veteran submitted his initial claim for compensation benefits in January 2008. At that time, he claimed benefits for low back and left shoulder disorders only. He submitted additional claims, but made no mention of radiculopathy of the left lower extremity until correspondence received by VA on July 5, 2011. At that time, in addition to several disabilities, he stated that he had numbness down his left lower extremity. This eventually resulted in service connection being established for left lower extremity radiculopathy. As this is the earliest date that it can be ascertained that the benefit was sought, an earlier effective date for the award of service connection for left lower extremity radiculopathy is not warranted. 9. An effective date earlier than July 5, 2011, for the award of TDIU Similarly, the Veteran did not claim eligibility for TDIU until July 11, 2011, several days following the receipt of the Veteran’s claims of July 5, 2011. The RO took the earlier date as the effective date for the establishment of TDIU by rating decision dated in April 2014. The record does not show correspondence in which the Veteran claimed TDIU eligibility prior to this date. Neither is there evidence that the Veteran’s level of disability increased during the one-year period before the filing of the claim. See Gaston v. Shinseki, 605 F.3d 979, 983 (Fed. Cir. 2010). In this regard, it is noted that a statement of private treatment associated with the claims folder in March 2011 and a VA compensation examination dated in April 2011 do not demonstrate symptoms of service-connected disorders that are compatible with total disability. As such, the earliest date that may be established is the date of claim, which has been established as July 5, 2011. Under these circumstances, the appeal for an earlier effective date for TDIU is denied. (Continued On Next Page) A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Joseph P. Gervasio