Citation Nr: 18161118 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 16-10 448 DATE: December 28, 2018 ORDER New and material evidence having been received, the claim for service connection for hepatitis C is reopened, and granted to this extent only is granted. Entitlement to service connection for tinnitus is denied. Entitlement to an initial compensable disability rating for migraine headaches is denied. Entitlement to an initial disability rating in excess of 70 percent for adjustment disorder with depressed mood is denied. Entitlement to an initial disability rating in excess of 10 percent for degenerative arthritis of the right knee is denied. Entitlement to an initial disability rating in excess of 10 percent for degenerative disc disease of the lumbar spine is denied. Entitlement to an initial disability rating of 40 percent for left lower extremity radiculopathy is granted. Entitlement to an initial disability rating in excess of 20 percent for right lower extremity radiculopathy is denied. Entitlement to an effective date earlier to March 20, 2013 for the grant of service connection for migraine headaches is denied. Entitlement to an effective date earlier to August 9, 2012 for the grant of service connection for adjustment disorder with depressed mood is denied. Entitlement to an effective date earlier than January 25, 2012 for the grant of service connection for degenerative disc disease of the lumbar spine is denied. Entitlement to an effective date earlier than January 25, 2012 for the grant of service connection for left lower extremity radiculopathy is denied. Entitlement to an effective date earlier than January 25, 2012 for the grant of service connection for right lower extremity radiculopathy is denied. Entitlement to a total disability rating based on individual unemployability (TDIU) is granted. REMANDED Entitlement to service connection for a left leg disability is remanded. Entitlement to service connection for hepatitis C is remanded. FINDINGS OF FACT 1. In an unappealed decision of September 2005, the Regional Office (RO) denied service connection for hepatitis C; this decision is final. 2. The evidence added to the record since the September 2005 rating decision was not previously submitted to agency decisionmakers, is not cumulative or redundant and, by itself or when considered with the previous evidence of record, relates to unestablished facts necessary to substantiate the claim, and raises a reasonable possibility of substantiating the claim for service connection for hepatitis C. 3. The probative evidence of record demonstrates that the Veteran’s tinnitus did not originate in service or for many years thereafter and is not related to any incident during active service. 4. The probative evidence of record demonstrates that the Veteran’s headaches have been productive of pain, nausea and sensitivity to light and sound and no evidence of characteristic prostrating attacks. 5. The probative evidence of record indicates the Veteran’s adjustment disorder with depressed mood is productive of occupational and social impairment with deficiencies in most areas, including work, judgment, thinking and mood. 6. The probative evidence of record reflects that degenerative arthritis of the right knee has been productive of, at worst, flexion limited to 140 degrees, extension limited to 0 degrees; there is no X-ray evidence of arthritis and no objective evidence of subluxation, instability or removal or dislocation of the semilunar cartilage. 7. The probative evidence of record reflects that the Veteran’s lumbar spine disability was, at worst, productive of pain which radiated to the lower extremities and objective findings of flexion to 90 degrees and extension to 30 degrees with pain noted on flexion, although pain did not cause or result in any limitation of motion or functional loss; there have been no findings of additional limitation on repetitive motion, muscle spasm or guarding, incapacitating episodes in a 12 month period or ankylosis, favorable or unfavorable, of the thoracolumbar spine or the entire spine. 8. The probative evidence of record reflects that the Veteran’s radiculopathy of the left lower extremity, at worst, has been productive of moderately severe incomplete paralysis of the sciatic nerve. 9. The probative evidence of record reflects that the Veteran’s radiculopathy of the right lower extremity, at worst, has been productive of moderate incomplete paralysis of the sciatic nerve. 10. Prior to March 20, 2013, there was no pending, unadjudicated claim or petition to reopen the claim for service connection for migraine headaches of any sort. 11. Prior to August 9, 2012, there was no pending, unadjudicated claim or petition to reopen the claim for service connection for adjustment disorder with depressed mood. 12. Prior to January 25, 2012, there was no pending, unadjudicated claim or petition to reopen the claim for service connection for degenerative disc disease of the lumbar spine. 13. Prior to January 25, 2012, there was no pending, unadjudicated claim or petition to reopen the claim for service connection for left lower extremity radiculopathy. 14. Prior to January 25, 2012, there was no pending, unadjudicated claim or petition to reopen the claim for service connection for right lower extremity radiculopathy. 15. Affording the benefit of the doubt, the probative evidence of record indicates that the Veteran’s service-connected disabilities have rendered him unable to secure and maintain substantially gainful employment. CONCLUSIONS OF LAW 1. Subsequent to the final September 2005 rating decision, new and material evidence has been presented to reopen the claim of service connection for hepatitis C. 38 U.S.C. §§ 1110, 1131, 5108, 7105; 38 C.F.R. §§ 3.104(a), 3.156(a). 2. The criteria for the establishment of service connection for tinnitus are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for an initial compensable disability rating for headaches have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, Diagnostic Code (DC) 8100. 4. The criteria for an initial disability rating in excess of 70 percent for adjustment disorder with depressed mood have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, DC 9440. 5. The criteria for an initial disability rating in excess of 10 percent for degenerative arthritis of the right knee have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.3, 4.7, 4.71a, DCs 5003, 5260, 5261. 6. The criteria for an initial disability rating in excess of 10 percent for degenerative disc disease of the lumbar spine have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.3, 4.7, 4.71a, DC 5237. 7. The criteria for the assignment of an initial disability rating of 40 percent, but no higher, for radiculopathy of the left lower extremity have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, DC 8520. 8. The criteria for the assignment of an initial disability rating in excess of 20 percent for radiculopathy of the right lower extremity have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, DC 8520. 9. The criteria for an effective date earlier than March 20, 2013, for the award of service connection for migraine headaches are not met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.1, 3.104, 3.155, 3.156, 3.157, 3.159, 3.400. 10. The criteria for an effective date earlier than August 9, 2012, for the award of service connection for adjustment disorder with depressed mood are not met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.1, 3.104, 3.155, 3.156, 3.157, 3.159, 3.400. 11. The criteria for an effective date earlier than January 25, 2012, for the award of service connection for degenerative disc disease of the lumbar spine are not met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.1, 3.104, 3.155, 3.156, 3.157, 3.159, 3.400. 12. The criteria for an effective date earlier than January 25, 2012, for the award of service connection for left lower extremity radiculopathy are not met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.1, 3.104, 3.155, 3.156, 3.157, 3.159, 3.400. 13. The criteria for an effective date earlier than January 25, 2012, for the award of service connection right lower extremity radiculopathy are not met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.1, 3.104, 3.155, 3.156, 3.157, 3.159, 3.400. 14. The criteria for a TDIU have been met. 38 C.F.R. § 4.16(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1975 to May 1978 and from April 1979 to February 1983. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from September 2013, January 2015 and January 2017 rating decisions of the Department of Veterans Affairs (VA) RO. New and Material Evidence The Veteran’s claim for connection for hepatitis C was previously denied in a September 2005 rating decision. The Veteran did not appeal that decision. Accordingly, the September 2005 rating decision is final. See 38 U.S.C. § 7105; 38 C.F.R. § 3.104. Generally, a claim, which has been denied in a Board decision or an unappealed RO decision, may not thereafter be reopened and allowed. 38 U.S.C. §§ 7104(b), 7105(c). The exception to this rule is 38 U.S.C. § 5108, which provides that if new and material evidence is presented or secured with respect to a claim which has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim. 38 U.S.C. § 5108. New evidence means existing evidence not previously submitted to agency decisionmakers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). VA must review all of the evidence received since the last final decision in order to determine whether the claim may be reopened. See Hickson v. West, 12 Vet. App. 247, 251 (1999). For the limited purpose of determining whether new and material evidence has been received to reopen a finally adjudicated claim, the recently submitted evidence will be presumed credible. See Kutscherousky v. West, 12 Vet. App. 369, 371 (1999) (per curiam). 1. New and material evidence having been received, the claim for service connection for hepatitis C is reopened, and granted to this extent only The September 2005 rating decision denied service connection for hepatitis C, finding that this condition neither occurred in nor was caused by the Veteran’s active service. The RO then specified that, in the absence of evidence of a confirmed diagnosis of hepatitis C or medical evidence relating this condition to service, service connection for hepatitis C was denied. The Board finds that the newly received evidence after the September 2005 rating decision is material. Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998). This evidence consists of VA medical records demonstrating a current diagnosis of hepatitis C confirmed by positive testing. Accordingly, this new evidence is not cumulative or redundant and, by itself or when considered with the previous evidence of record, relates to unestablished facts necessary to substantiate the claim, and raises a reasonable possibility of substantiating the claim for service connection hepatitis C. See 38 U.S.C. § 5108; 38 C.F.R. §§ 3.156(a), 3.303. Therefore, this claim is reopened. Service Connection Service connection will generally be awarded when a veteran has a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004), citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002); see also Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection will also be presumed for certain chronic diseases, including organic diseases of the nervous system such as tinnitus, if manifested to a compensable degree within one year after discharge from service. 38 U.S.C. § 1112; 38 C.F.R §§ 3.307, 3.309. This presumption, however, is rebuttable by probative evidence to the contrary. 38 U.S.C. § 1113. Alternatively, continuity of symptomatology may be established if a claimant can demonstrate: (1) that a condition was “noted” during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology under 38 C.F.R. § 3.303(b); Barr v. Nicholson, 21 Vet. App. 303 (2007). Where a claimant asserts entitlement to a chronic condition but there is insufficient evidence of a chronic disease in service, he can establish service connection by demonstrating a continuity of symptomatology since service, but only if the chronic disease is listed under 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331, 1337-39 (Fed. Cir. 2013). 2. Entitlement to service connection for tinnitus The Veteran asserts that he developed tinnitus following a motor vehicle accident in service around 1981 or 1982. See December 2014 VA examination. The Board concludes that the Veteran has a current diagnosis of tinnitus; however, there is no evidence of this specific disability during the Veteran’s active service and no evidence indicating this disability is related to the Veteran’s active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). STRs reflect treatment for injuries following a moped accident in January 1978 and a motor vehicle accident in January 1980. STRs do not reflect any complaints, treatment or findings related to hearing or tinnitus, including a ringing or buzzing in the ears or similar symptom. The separation examinations for each period of active service were absent of any findings related to abnormalities of the ears and drums upon clinical evaluation. The Veteran’s DD Form 214 reflects his military occupational specialties (MOSs) were listed as a wireman, also listed as a wire operation specialist, and construction equipment repair, indicating duties related to maintaining construction equipment and thereby indicating possible exposure to excessive noise during his active service. See 38 U.S.C. § 1154. The post-service medical evidence, including private and VA medical records, demonstrates that the Veteran was treated for tinnitus as early as October 2003 (per a private medical record), approximately 20 years after his separation from active service. In the December 2014 VA examination, the Veteran reported the onset of tinnitus following a motor vehicle accident in 1981 or 1982. The VA examiner found that numerous hearing tests during the Veteran’s active service were all within normal limits and none demonstrated a pattern of change in hearing that would be consistent with noise exposure. She explained that, while the Veteran reported onset of tinnitus following a motor vehicle accident, which was documented in the STRs in February 1980 with a sustained knee injury and head laceration without loss of consciousness, there was no documentation of tinnitus or complaints regarding hearing or tinnitus subsequent to the accident. The examiner found the first documentation of tinnitus was noted in an October 2003 VA medical record, 20 years after the Veteran’s discharge from miliary service. As the VA opinion was provided by a medical professional trained in audiological disorders and was supported by rationale that is consistent with the evidence of record, the Board affords it significant probative value. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Moreover, the opinion was made following a review of the entire claims file and clearly indicates that the examiner fully considered all potentially relevant medical evidence as well as the Veteran's contentions. See Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012). There is no contrary opinion. Accordingly, there is no evidence of a nexus between the Veteran’s active service and his current tinnitus. The Veteran's statements that he had tinnitus continuously since the motor vehicle accident in service are inconsistent with the contemporaneous medical evidence of record, and therefore the Board assigns low probative weight to them. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); but see Baldwin v. West, 13 Vet. App. 1. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997); see Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006); see also Caluza v. Brown, 7 Vet. App. 498, 511 (1995). In reaching the conclusions above, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim for service connection for tinnitus, that doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). Therefore, the claim for service connection for tinnitus is denied. Increased Rating Disability ratings are determined by applying the criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on the average impairment of earning capacity resulting from disability. Separate diagnostic codes identify the various disabilities. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for the higher evaluation; otherwise, the lower evaluation will be assigned. See 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. In order to evaluate the level of disability and any changes in condition, it is necessary to consider the complete medical history of the Veteran’s condition. Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). A claimant may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505 (2007). The analysis in the following decision is therefore undertaken with consideration of the possibility that different “staged” ratings may be warranted for different time periods. Where the question for consideration is the propriety of the initial evaluation assigned after the granting of service connection, separate ratings may also be assigned for separate periods of time based on facts found, i.e. “staged” ratings. See Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). When evaluating musculoskeletal disabilities, VA must consider granting a higher rating in cases in which the Veteran experiences functional loss due to limited or excess movement, pain, weakness, excess fatigability, or incoordination (to include during flare-ups or with repeated use), and those factors are not contemplated in the relevant rating criteria. See 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202, 204-7 (1995). The provisions of 38 C.F.R. § 4.40 and 38 C.F.R. § 4.45 are to be considered in conjunction with the diagnostic codes predicated on limitation of motion. Johnson v. Brown, 9 Vet. App. 7 (1996). Although pain may be a cause or manifestation of functional loss, limitation of motion due to pain is not necessarily rated at the same level as functional loss where motion is impeded. See Mitchell v. Shinseki, 25 Vet. App. 32, 38-43 (2011); cf. Powell v. West, 13 Vet. App. 31, 34 (1999); Hicks v. Brown, 8 Vet. App. 417, 421 (1995); Schafrath, 1 Vet. App. at 592. Pursuant to 38 C.F.R. §§ 4.40 and 4.45, the possible manifestations of functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance (38 C.F.R. § 4.40), as well as less or more movement than is normal, weakened movement, excess fatigability, and pain on movement (as well as swelling, deformity, and atrophy) that affects stability, standing, and weight-bearing (38 C.F.R. § 4.45). Mitchell, 25 Vet. App. 32. Thus, functional loss caused by pain must be rated at the same level as if the functional loss were caused by any of the other factors cited above. In evaluating the severity of a joint disability, VA must determine the overall functional impairment due to these factors. 3. Entitlement to an initial compensable disability rating for migraine headaches The Veteran’s headaches are currently rated under DC 8100, which provides ratings for migraine headaches. Migraine headaches with less frequent attacks than the criteria for a 10 percent rating are rated as noncompensably (0 percent) disabling. Migraine headaches with characteristic prostrating attacks averaging one in 2 months over the last several months are rated 10 percent disabling. Migraine headaches with characteristic prostrating attacks occurring on an average once a month over last several months are rated 30 percent disabling. Migraine headaches with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability are rated 50 percent disabling. 38 C.F.R. § 4.124a. The probative evidence of record, including private and VA medical records and the November 2016 VA examination, demonstrates that the Veteran’s migraine headaches have been productive of pain, nausea, and sensitivity to light and sound and no evidence of characteristic prostrating attacks. In the November 2016 VA examination, the Veteran reported his headaches were characterized by headache pain ranging from severe to mild but constant ringing. Therefore, the Board finds the Veteran’s migraine headaches more nearly approximate the criteria for a noncompensable disability rating under DC 8100. Accordingly, the Board concludes that the Veteran’s migraine headaches do not warrant an initial disability rating in excess of 0 percent at any time throughout the duration of the appeal. 38 C.F.R. §§ 3.102, 4.3, 4.7. See also 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990); Alemany v. Brown, 9 Vet. App. 518, 519 (1996). 4. Entitlement to an initial disability rating in excess of 70 percent for adjustment disorder The Veteran’s adjustment disorder with depressed mood has been rated under 38 C.F.R. § 4.130, DC 9440, which is evaluated under the general rating formula for mental disorders. Under this general rating formula, a 70 percent rating is warranted when there is occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); inability to establish and maintain effective relationships. Id. A 100 percent rating is warranted when there is total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation or own name. Id. The symptoms recited in the criteria in the rating schedule for evaluating mental disorders are “not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating.” Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). The Board notes that the DSM-IV has been recently updated with a Fifth Edition (DSM-V). Effective August 4, 2014, VA issued an interim rule amending the portion of its Schedule for Rating Disabilities dealing with mental disorders and its adjudication regulations to refer to certain mental disorders in accordance with DSM-V. The provisions of the interim final rule only apply, however, to all applications for benefits that are received by VA or that are pending before the agency of original jurisdiction on or after August 4, 2014. In this case, as the Veteran’s appeal for increased initial rating for a psychiatric disability was not certified to the Board until November 2017, it was pending before the RO after August 4, 2014, and therefore, the DSM-V applies. The medical evidence of record, including the private and VA medical, the July 2013 and November 2016 VA examination reports and the February 2017 Disability Benefits Questionnaire, collectively indicates that, throughout the duration of the appeal, the Veteran’s PTSD was productive of symptoms, at worst, resulting in occupational and social impairment with deficiencies in most areas, including work, judgment, thinking and mood. These records demonstrate the Veteran’s psychiatric symptoms, at worst, included: depressed mood; anxiety; suspiciousness; weekly panic attacks; near continuous panic or depression affecting the ability to act; chronic sleep impairment; mild memory loss and impairment of long term memory; flattened affect; speech intermittently illogical, obscure or irrelevant; difficulty in understanding complex commands; impaired judgment; impaired abstract thinking; gross impairment in thought process or communication; disturbances in motivation and mood; difficulty in establishing and maintaining effective work and social relationships; difficulty in adapting to stressful circumstances, including work or a worklike setting; inability to establish and maintain effective relationships; suicidal ideation; obsessional rituals; impaired impulse control, such as unprovoked irritability with periods of violence; neglect of personal appearance and hygiene; and intermittent inability to perform activities of daily living. Accordingly, the preponderance of the evidence is against a finding of entitlement to an evaluation exceeding 70 percent at any time throughout the duration of the appeal. As noted in Mauerhan, the Veteran need not have all or even most of the particular symptoms in order to warrant a 100 percent evaluation; however, his psychiatric symptomatology does not demonstrate total social and occupational impairment. See Mauerhan, 16 Vet. App. 436. The evidence of record does not indicate that the Veteran’s adjustment disorder with depressed mood has been manifested by such symptoms as persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; disorientation to time or place; memory loss for names of close relatives, own occupation or own name. Despite findings noted in the February 2017 Disability Benefits Questionnaire of suicidal thoughts and ideation, gross impairment in thought processes or communication intermittent inability to perform activities of daily living, the probative evidence of record does not demonstrate that the Veteran has been shown to be a persistent danger of hurting himself or others or that these symptoms lead to total occupational and social impairment. Most importantly, the private physician in the February 2017 Disabilty Benefits Questionnaire concluded the Veteran’s mental disorder was productive of occupational and social impairment with deficiencies in most areas and not total occupational or social impairment. Considering all the lay and medical evidence of record as it relates to the impact of adjustment disorder with depressed mood on the Veteran’s functional and occupational impairment, the Boards finds that the evidence does not demonstrate total impairment. Therefore, the probative evidence of record does not more nearly approximate the criteria for a 100 percent schedular disability rating at any time since the filing of the claim for this disability. 38 C.F.R. §§ 4.3, 4.7. 5. Entitlement to an initial disability rating in excess of 10 percent for degenerative arthritis of the right knee The Veteran’s right knee disability is currently rated under 38 C.F.R. § 4.71a, DC 5010-5260. DC 5010 states that arthritis, due to trauma, substantiated by X-ray findings, is to be rated as degenerative arthritis under DC 5003. DC 5003 provides ratings for degenerative arthritis. Degenerative arthritis (osteoarthritis or hypertrophic) 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, however, the limitation of motion of the specific joint or joints involved is noncompensably disabling under the appropriate diagnostic codes, a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under DC 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. 38 C.F.R. § 4.71a. In the absence of limitation of motion, a 10 percent rating is warranted where there is X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups. A 20 percent rating is warranted where there is X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations. In Notes (1) and (2) in DC 5003, it is indicated these 20 and 10 percent ratings based on X-ray findings will not be combined with ratings based on limitation of motion. 38 C.F.R. § 4.71a, DC 5003. When there is some limitation of motion of the specific joint or joints involved that is noncompensable (0 percent) under the appropriate diagnostic codes, DC 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 DC 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Id. 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. Id. 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. DC 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. Under DC 5258, dislocation of the semilunar cartilage of the knee with frequent episodes of "locking," pain, and effusion into the joint warrants a 20 percent rating. 38 C.F.R. § 4.71a. DC 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 (DC 5260) and limitation of extension (DC 5261) of the same knee joint). DC 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 (DC 5260) and limitation of extension (DC 5261) of the same knee joint). Separate disability ratings are possible for arthritis with limitation of motion under DC 5003 (providing rating for arthritis) and instability of a knee under DC 5257. VAOPGCPREC 23-97; 62 Fed. Reg. 63,604 (1997). When x-ray findings of arthritis are present and a veteran's knee disability is rated under DC 5257, the veteran would be entitled to a separate compensable rating under DC 5003 if the arthritis results in noncompensable limitation of motion and/or objective findings or indicators of pain. See VAOPGCPREC 9-98, 63 Fed. Reg. 56,703 (1998). VA's General Counsel has held that a claimant who has arthritis and instability of the knee may be rated separately under DCs 5003/5010 and 5257, respectively, and that a separate rating could also be provided for limitation of knee extension and flexion of the same knee joint. VAOPGCPREC 9-2004; 69 Fed. Reg. 59,990 (2004). The probative evidence of record, including the private and VA treatment records as well as the November 2016 VA examinations, demonstrates that the right knee disability was productive of, at worst, flexion limited to 140 degrees, extension limited to 0 degrees; there is no X-ray evidence of arthritis and no objective evidence of subluxation, instability or cartilage abnormality. Although pain was noted as well as less movement than normal, disturbance of locomotion and interference with standing, the examiner specifically found no additional limitation of function or motion due to pain or repetitive motion. The examiner also noted there was no history of subluxation or instability. No meniscus condition was found. The Board has considered the Veteran’s complaints of pain in his right knee required by 38 C.F.R. § 4.40, 4.45, 4.59, consistent with the decision in DeLuca v. Brown, 8 Vet. App. 202 (1995). See also Voyles v. Brown, 5 Vet. App. 451, 454 (1993). Even considering right knee pain, no additional limitation of motion of function has been demonstrated on range of motion testing or upon repetitive use testing in the November 2016 VA examination. 38 C.F.R. § 4.71a. See Johnston v. Brown, 10 Vet. App. 80, 85 (1997); see also Mitchell v. Shinseki, 25 Vet. App. 32 (2011). The Board observes that, at no time during the period of the appeal, has the probative evidence of record demonstrated the presence of instability of the right knee. Thus, consideration of a higher disability rating under DC 5257, pertaining to instability or subluxation, is not for application here. Other potentially applicable DCs also have been considered. As the Veteran’s service-connected right knee disability does not reflect findings of ankylosis, removal or dislocation of the semilunar cartilage, impairment of the tibia or fibula, or genu recurvatum at any time during the pendency of the appeal, DCs 5256, 5258, 5259, 5262 and 5263 do not apply. The evidence weighs against a finding of ankylosis. Accordingly, the probative evidence of record does not warrant an initial disability rating in excess of 10 percent, under DC 5010-5260 throughout the duration of the appeal. 38 C.F.R. §§ 4.3, 4.7, 4.71a; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). 6. Entitlement to an initial disability rating in excess of 10 percent for degenerative disc disease of the lumbar spine The Veteran’s degenerative disc disease of the lumbar spine has been rated under 38 C.F.R. § 4.71a, DC 5237. Disabilities of the spine are rated under the General Rating Formula for Diseases and Injuries of the Spine (in other words under DCs 5235 to 5242, unless evaluated instead under DC 5243, the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes). 38 C.F.R. § 4.71a. Under the General Rating Formula for Diseases and Injuries of the Spine, 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: A 10 percent evaluation is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 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 rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 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 30 percent rating is warranted for forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine. A 40 percent rating is warranted for unfavorable ankylosis of the entire cervical spine; or, forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent rating is warranted for unfavorable ankylosis of the entire spine. The Notes following the General Rating Formula for Diseases and Injuries of the Spine provide further guidance in rating diseases or injuries of the spine. Note (1) provides that any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, should be rated separately under an appropriate DC. 38 C.F.R. § 4.71a, DCs 5235-5243. Note (2) provides that, for VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. 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 combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. See also 38 C.F.R. § 4.71a, Plate V. Note (3) provides that, in exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner’s assessment that the range of motion is normal for that individual will be accepted. Note (4) provides that the rater is to round each range of motion measurement to the nearest five degrees. Note (5) provides that, for VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Note (6) provides that disability of the thoracolumbar and cervical spine segments are to be rated separately, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability. Under DC 5243, intervertebral disc syndrome (IVDS) or disc disease may be rated under the General Rating Formula for Diseases and Injuries of the Spine, which includes combining separate evaluations of the chronic orthopedic and neurologic manifestations, or under the Formula for Rating IVDS Based on Incapacitating Episodes, which are rated on the total duration of incapacitating episodes over the past 12 months, whichever results in the higher evaluation when all disabilities are combined under 38 C.F.R. § 4.25. Under the Formula for Rating IVDS Based on Incapacitating Episodes, if there are incapacitating episodes having a total duration of at least one week but less than two weeks during the past 12 months, a 10 percent rating is warranted. If there are incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months, a 20 percent rating is warranted. If there are incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months, a 40 percent rating is warranted. If there are incapacitating episodes having a total duration of at least six weeks during the past 12 months, a 60 percent rating is warranted. 38 C.F.R. § 4.71a. Note (1) in DC 5243 defines an incapacitating episode as a period of acute signs and symptoms requiring bed rest prescribed by a physician and treatment by a physician. Supplementary information in the published final regulations states that treatment by a physician would not require a visit to a physician's office or hospital but would include telephone consultation with a physician. If there are no records of the need for bed rest and treatment, by regulation, there are no incapacitating episodes. Id. The probative evidence of record, including private and VA medical records and November 2016 VA examination, demonstrates that, throughout the duration of the appeal, the Veteran’s degenerative disc disease of the lumbar spine at worst, was productive of pain which radiated to the lower extremities and objective findings of flexion to 90 degrees and extension to 30 degrees with pain noted on flexion. Although pain was noted, the November 2016 VA examiner specified that pain did not cause or result in any limitation of motion or functional loss. The probative evidence also does not demonstrate any findings of additional limitation on repetitive motion, muscle spasm or guarding, incapacitating episodes in a 12 month period or ankylosis, favorable or unfavorable, of the thoracolumbar spine or the entire spine. Therefore, the lumbar spine disability more nearly approximates the criteria for a 10 percent disability rating throughout the duration of the appeal, under DC 5237, which provides for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees, a 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. 38 C.F.R. § 4.71a. Although the November 2016 VA examination demonstrated pain during the physical examination there have been no findings of an additional limitation of motion or function due to pain or upon repetitive motion and no findings that were akin to forward flexion of the thoracolumbar spine to 60 degrees or less or ankylosis, either favorable or unfavorable, of the thoracolumbar spine or entire spine. While the examination noted tenderness that did not result in abnormal gait or abnormal spinal contour, this is provided for in the 10 percent rating criteria currently assigned. Thus, in considering the complaints of pain and additional functional loss during flare up, in conjunction with 38 C.F.R. § 4.40, 4.45, 4.59, consistent with the decision in DeLuca v. Brown, 8 Vet. App. 202 (1995), the Board finds the evidence supports no more than a 10 percent disability rating throughout the duration of the appeal period. See Voyles v. Brown, 5 Vet. App. 451, 454 (1993); Johnston v. Brown, 10 Vet. App. 80, 85 (1997); Mitchell v. Shinseki, 25 Vet. App. 32 (2011). The Board has considered whether separate ratings are warranted based on neurological manifestations of the Veteran’s lumbar spine disability; however, with exception to the right and left lower extremity radiculopathy, discussed below, no other such manifestations have been demonstrated by the objective findings of record. Accordingly, the Veteran’s thoracolumbar spine disability does not warrant an initial disability rating in excess of 10 percent at any time throughout the duration of the appeal under DC 5237. 38 C.F.R. §§ 4.3, 4.7, 4.71a; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). 7. Entitlement to initial disability ratings in excess of 20 percent for left lower extremity radiculopathy and right lower extremity radiculopathy The radiculopathy of the right and left lower extremities is currently rated under DC 8520 which provides ratings for paralysis of the sciatic nerve. DC 8520 indicates that mild incomplete paralysis is rated 10-percent disabling; moderate incomplete paralysis 20-percent disabling; moderately-severe incomplete paralysis 40-percent disabling; and severe incomplete paralysis, with marked muscular atrophy, 60-percent disabling. Complete paralysis of the sciatic nerve, that is, where the foot dangles and drops, there is no active movement possible of muscles below the knee, flexion of the knee weakened or (very rarely) lost, is rated as 80-percent disabling. 38 C.F.R. § 4.124a. 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. These descriptive words “mild,” “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. The probative evidence of record, including the private and VA medical records and the November 2016 VA examination, demonstrates that the Veteran’s radiculopathy of the left lower extremity, at worst, has been productive of moderately severe incomplete paralysis of the sciatic nerve. While the November 2016 VA examiner found the Veteran’s radiculopathy of the left and right lower extremities were productive of moderate radiculopathy, the physical examination of the severity of symptoms included mild paresthesias and/or dysesthesias and numbness of both lower extremities and mild intermittent pain on the right, while a severe intermittent pain on the left lower extremity was noted. At no point during the pendency of this appeal has the radiculopathy of the left lower extremity caused what has amounted to severe incomplete paralysis with marked muscular atrophy or complete paralysis of the sciatic nerve. In this regard, the Board observes that muscle atrophy was never found upon physical examination in any VA examination. Therefore, at most, a 40 percent rating, though no higher, is warranted under DC 8520 for radiculopathy of the left lower extremity. The probative evidence of record, including private and VA medical records and the VA examinations, demonstrates that the Veteran’s radiculopathy of the right lower extremity, at worst, has been productive of moderate incomplete paralysis of the sciatic nerve. At no point during the pendency of this appeal has the radiculopathy of the right lower extremity caused what has amounted to moderately severe or severe incomplete paralysis with marked muscular atrophy. In this regard, the Board observes that no more than mild findings were found upon physical examination in the November 2016 VA examination, although the examiner characterized the Veteran’s radiculopathy of the left and right lower extremities as moderate. Therefore, no more than the 20 percent rating currently assigned is warranted under DC 8520 for radiculopathy of the right lower extremity. Accordingly, the Veteran’s radiculopathy of the left lower extremity warrants an initial 40 percent disability rating, though no higher, under DC 8520 and, his radiculopathy of the right lower extremity does not warrant an initial disability rating in excess of 20 percent, under DC 8520. 38 C.F.R. §§ 4.3, 4.7, 4.71a, 4.124a; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). Lay Statements The Board has considered the lay statements of record regarding the severity of the Veteran’s headaches, adjustment disorder, right knee disability, lumbar spine disability, and radiculopathy of the lower extremities and has relied on these reports in determining appropriate disability rating under the benefit-of-the-doubt doctrine. 38 C.F.R. §§ 4.3, 4.7. The Veteran is competent to report on factual matters of which he has firsthand knowledge and his statements regarding his symptoms are also credible, and thus, probative. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see also Baldwin v. West, 13 Vet. App. 1 (1999). Where the Veteran has not discussed particular findings that are necessary for application to the rating criteria, the Board has accorded greater probative weight to objective medical findings of record which specifically address the rating criteria. See Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Effective Date Generally, and except as otherwise provided, the effective date of an evaluation and award of pension, compensation or dependency and indemnity compensation (DIC) 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) (2012); 38 C.F.R. § 3.400 (2017). If a claim for disability compensation, i.e., service connection, is received within one year after separation from service, the effective date of entitlement is the day following separation or the date entitlement arose. 38 C.F.R. § 3.400(b)(2)(i). A rating decision becomes final and binding if the Veteran does not timely perfect an appeal of the decision. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104(a), 3.160(d), 20.200, 20.202, 20.302, 20.1103. For an award based on receipt of new and material evidence received within the appeal period or prior to an appellate decision, the effective date will be as though the former decision had not been rendered. 38 C.F.R. § 3.400(q)(1). The proper effective date for an award based on receipt of new and material evidence received after a final disallowance is the date of receipt of the claim to reopen or date entitlement arose, whichever is later. 38 U.S.C. § 5110(i); 38 C.F.R. §§ 3.400(q)(2), 3.400(r). 8. Entitlement to an effective date prior to March 20, 2013 for the award of service connection for migraine headaches The outcome of this claim rests on whether there was an earlier date of entitlement and an earlier date of claim, which did not have a final and binding disposition. In this case, the Board observes that, prior to March 20, 3013, there was no pending, unadjudicated claim for service connection for migraine headaches of any sort. The Veteran filed his initial claim for service connection for headaches on July 12, 1988, which was denied by a November 1988 rating decision. The Veteran did not appeal this rating decision, and it became final. He did not raise another claim for service connection for headaches until March 20, 2013, which was denied in a September 2013 rating decision and was later awarded in a January 2017 Decision Review Officer (DRO) decision and assigned an effective date of March 20, 2013. He filed an NOD in February 2017 and an SOC was issued in October 2017. The Veteran perfected his appeal on this claim by filing a timely substantive appeal, via a VA form 9, in November 2017. The applicable regulation is clear that the appropriate effective date for the award of service connection in this case is the date of receipt of claim or the date entitlement arose, whichever is later. Accordingly, despite the evidence demonstrating treatment for headaches in the VA medical records prior to March 20, 2013, as there was no pending, unadjudicated claim to reopen for service connection for headaches of any sort, the proper effective date for the award of service connection for this disability under 38 C.F.R. § 3.400 can be no earlier than March 20, 2013. 9. Entitlement to an effective date prior to August 9, 2012 for the award of service connection for adjustment disorder with depressed mood The outcome of this claim rests on whether there was an earlier date of entitlement and an earlier date of claim, which did not have a final and binding disposition. In this case, the Board observes that, prior to August 9, 2012, there was no pending, unadjudicated claim for service connection for adjustment disorder with depressed mood or similar psychiatric disability of any sort. The Veteran filed an initial claim for service connection for drug and alcohol abuse on June 10, 1998, which was denied by a July 1998 rating decision. The Veteran did not appeal this rating decision, and it became final. He did not raise another claim for service connection for depression until August 9, 2012 and the September 2013 rating decision denied polysubstance dependence with substance induced mood disorder with depressive features and schizoid personality disorder. Subsequently, service connection was awarded for adjustment disorder with depressed mood in a January 2017 Decision Review Officer (DRO) decision and assigned an effective date of March 20, 2013. He filed an NOD in February 2017 and an SOC was issued in October 2017. An October 2017 rating decision then awarded an earlier effective date of August 9, 2012 for adjustment disorder with depressed mood. The Veteran perfected his appeal on this claim by filing a timely substantive appeal, via a VA form 9, in November 2017. The applicable regulation is clear that the appropriate effective date for the award of service connection in this case is the date of receipt of claim or the date entitlement arose, whichever is later. Accordingly, despite the evidence demonstrating treatment for psychiatric symptoms in the private and VA medical records prior to August 9, 2012, as there was no pending, unadjudicated claim to reopen for service connection for a psychiatric disability of any sort, the proper effective date for the award of service connection for this disability under 38 C.F.R. § 3.400 can be no earlier than August 9, 2012. 10. Entitlement to effective dates earlier than January 25, 2012 for the grant of service connection for degenerative disc disease of the lumbar spine, left lower extremity radiculopathy and right lower extremity radiculopathy The outcome of this claim rests on whether there was an earlier date of entitlement and an earlier date of claim, which did not have a final and binding disposition. In this case, the Board observes that, prior to January 25, 2012, there was no pending, unadjudicated claim for service connection for a spine or neurological disability of any sort. The Veteran filed an initial claim for service connection for a spine disability on December 9, 2004, which was denied by a September 2005 rating decision. The Veteran did not appeal this rating decision, and it became final. He did not raise another claim for service connection for the spine or neurological disorder until January 25, 2012, which were denied September 2013 rating decision. Thereafter, service connection was awarded for degenerative disc disease of the lumbar spine and radiculopathy of the lower extremities in a January 2017 Decision Review Officer (DRO) decision and assigned effective dates of August 9, 2012. The Veteran filed an NOD in February 2017 and an SOC was issued in October 2017. An October 2017 rating decision then awarded earlier effective dates of January 25, 2012 for the lumbar spine and radiculopathy of the left and right lower extremities. The Veteran perfected his appeal on this claim by filing a timely substantive appeal, via a VA form 9, in November 2017. The applicable regulation is clear that the appropriate effective date for the award of service connection in this case is the date of receipt of claim or the date entitlement arose, whichever is later. Accordingly, despite the evidence demonstrating treatment for the back and pain radiating into the legs in the private and VA medical records prior to January 25, 2012, as there was no pending, unadjudicated claim to reopen for service connection for back or neurological disabilities of any sort, the proper effective dates for the award of service connection for these disabilities under 38 C.F.R. § 3.400 can be no earlier than January 25, 2012. TDIU 11. Entitlement to a TDIU Total disability ratings are authorized for any disability or combination of disabilities provided the schedular rating is less than total, when the disabled person is unable to secure and maintain substantially gainful employment because of the severity of his service-connected disabilities. If there is only one such disability, it must be rated as at least 60 percent disabling. 38 C.F.R. § 4.16(a). If there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. Id. In this case, the Veteran meets the preliminary schedular criteria for a TDIU under 38 C.F.R. § 4.16(a) during the entire period of the appeal. Id. When viewed as a whole, the evidence supports a finding that the Veteran was not capable of substantially gainful employment as a result of his service-connected disabilities. In his July 2017 VA Form 21-8940, Application for Increased Compensation Based on Unemployability, the Veteran reported having an education of junior college for welding, which was completed in 1990. He reported his adjustment disorder, radiculopathy, right knee disability, migraines and back disability prevented him from securing or following a substantially gainful occupation. He stated he last worked on January 1, 2012 as a welder, which was the date he became too disabled to work. The Veteran stated he had not sought employment or obtained education and training since he became too disabled to work. In a February 2017 evaluation, a private psychologist provided a psychiatric evaluation (the February 2017 Disability Benefits Questionnaire) of the Veteran and reviewed information in the claims file. He opined that the Veteran’s adjustment disorder was severe enough to completely disable and preclude him from maintaining substantial gainful employment activity from the date of his claim, August 9, 2012, to the present time. He found it was most likely that the Veteran could not sustain the stress from a competitive work environment or be expected to engage or adequately function in gainful work activity due to his service-connected adjustment disorder with prolonged duration of depressed mood and serious, debilitating medical conditions. He attributed the Veteran’s functional impairment which prevented gainful employment to his symptoms of being depressed, anxious and irritable mood disorders, sleep impairment, the inability to establish and maintain effective work and social relationships, memory and concentration problems, difficulty in adapting to stressful work and work like environments, impaired impulse control and unprovoked irritability with periods of violence and suicidal ideation. While the Veteran had attended junior college for welding as his highest level of education, there is no evidence that he has data entry or computer training skills or any other skills relating to office work, and this is not a practical limitation for someone seeking gainful employment. Further, the Veteran’s psychiatric symptoms would prevent his ability to interact and communicate with co-workers and customers. Resolving all doubt in favor of the Veteran, the probative evidence of record demonstrates that he was unemployable or capable of no more than marginal employment due to his service-connected disabilities, specifically his service-connected adjustment disorder with depressed mood. In considering his education, employment history as a welder and that he stopped working due to his adjustment disorder, right knee disability, back disability, radiculopathy and migraines, the February 2017 private psychologist’s findings that his inability to work was related to his adjustment disorder, the Board finds that any employment he had or was capable of during the appeal period was marginal. Accordingly, the criteria for a TDIU are met. REASONS FOR REMAND 1. Entitlement to service connection for hepatitis C is remanded. More information is needed to allow the Board to make a fully-informed decision. Although the evidence of record reflects a current diagnosis of hepatitis C and risk factors in service, it was unclear whether the current hepatitis C disability was incurred in or related to the Veteran’s active service. VA medical records reflect a current diagnosis of hepatitis C. Further, a December 2004 Hepatitis C Risk Factor Questionnaire indicated risk factors of intravenous drugs, intranasal cocaine, high-risk sexual activity and tattoos and body piercings. STRs also demonstrate a tattoo was noted on the Veteran’s separation examination that was not found in the entrance examination and treatment for nervousness in relation to treatment for heroin abuse. Therefore, the claim for entitlement to service connection for hepatitis C should be remanded to provide a supplemental VA opinion with supporting rationale regarding this matter. McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006); Locklear v. Nicholson, 20 Vet. App. 410 (2006); see Waters v. Shinseki, 601 F.3d 1274, 1276 (2010). 2. Entitlement to service connection for a left leg disability is remanded. Although a VA examination and opinion of the Veteran’s left leg were provided in November 2016, and the examiner opined that the left leg disabilty was as likely as not due to the Veteran’s active service, the examiner did not indicate what the current diagnosis of the left leg was and did not provide an adequate rationale explaining the basis for this opinion. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). As the record reflects the Veteran has received continuing treatment at VA, any outstanding and current ongoing medical records should also be obtained. 38 U.S.C. § 5103A(c); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matter is REMANDED for the following action: 1. Obtain and associate with the claims file all outstanding pertinent VA and private medical records the Veteran adequately identifies. 2. Upon receipt of all additional records, the claims folder and a copy of this remand are to be made available to and reviewed by an appropriate VA examiner, to determine the current nature and etiology of the Veteran’s hepatitis C. The examination report is to contain a notation that the examiner reviewed the claims file, including the service treatment records (STRs) reflecting a tattoo was noted on the Veteran’s separation examination that was not found in the entrance examination and treatment for nervousness in relation to treatment for heroin abuse. The examiner is then asked to answer the following: (a). Whether it is at least as likely as not (50 percent or greater probability) that hepatitis C was incurred during the Veteran’s active service, or was otherwise caused by or related to the Veteran's military service, including the tattoo in service or documented heroin abuse in service. (b). If the examiner finds the Veteran’s hepatitis C is related to the heroin abuse documented in service, s/he is then asked to opine whether the heroin abuse in service was related to any psychiatric symptoms, including anxiety and nervousness noted in the STRs. It is essential the examiner provide explanatory rationale for opinions on these determinative issues, citing to specific evidence in the file supporting conclusions. 3. Upon receipt of all additional records, the claims folder and a copy of this remand are to be made available to and reviewed by an appropriate VA examiner, to determine the current nature and etiology of the Veteran’s current left leg disability. Reexamination of the Veteran is not needed unless deemed necessary by the examiner providing the opinion in this case. The examination report is to contain a notation that the examiner reviewed the claims file, including the November 2016 VA opinion noting it was at least as likely as not that the left leg disability was related to the Veteran’s active service. The examiner is then asked to answer the following: (a). Does the Veteran have a currently diagnosed left leg disability? Please specify the diagnosis. (b). Whether it is at least as likely as not (50 percent or greater probability) that: (1) a left leg disability was incurred during the Veteran’s active service; or (2) a left leg disability was otherwise caused by or related to the Veteran's military service. Please note the November 2016 VA opinion indicating a left leg disability was as likely as not related to the Veteran’s active service. It is essential the examiner provide explanatory rationale for opinions on these determinative issues, citing to specific evidence in the file supporting conclusions. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Saira Spicknall, Counsel