Citation Nr: 19115484 Decision Date: 03/01/19 Archive Date: 03/01/19 DOCKET NO. 17-04 320 DATE: March 1, 2019 ORDER An effective date of February 28, 2014, but no earlier, for the grant of service connection for left lower extremity (LLE) radiculopathy of the sciatic nerve, is granted. Entitlement to an effective date prior to December 31, 2014, for the grant of service connection and an initial 10 percent rating for right lower extremity (RLE) radiculopathy of the sciatic nerve, is denied. Entitlement to an effective date prior to December 31, 2014, for the grant of service connection and an initial 30 percent rating for LLE radiculopathy of the anterior crural (femoral) nerve, is denied. Entitlement to an effective date prior to December 31, 2014, for the grant of service connection and an initial 10 percent rating for RLE radiculopathy of the anterior crural (femoral) nerve, is denied. Entitlement to an effective date prior to December 31, 2014, for the grant of service connection and an initial 10 percent rating for LLE radiculopathy of the external cutaneous nerve, is denied. Reduction of the rating for the Veteran’s service-connected lumbar spine disability from 20 percent to 10 percent, effective May 1, 2015, was not proper, and the 20 percent rating is restored, effective May 1, 2015. Entitlement to a disability rating in excess of 30 percent for posttraumatic stress disorder (PTSD) is denied. REMANDED Entitlement to an initial disability rating in excess of 40 percent for left lower extremity (LLE) radiculopathy of the sciatic nerve, is remanded. Entitlement to an initial disability rating in excess of 10 percent for right lower extremity (RLE) radiculopathy of the sciatic nerve, is remanded. Entitlement to an initial disability rating in excess of 30 percent for LLE radiculopathy of the anterior crural (femoral) nerve, is remanded. Entitlement to an initial disability rating in excess of 10 percent for RLE radiculopathy of the anterior crural (femoral) nerve, is remanded. Entitlement to an initial disability rating in excess of 10 percent for LLE radiculopathy of the external cutaneous nerve, is remanded. Entitlement to a disability rating in excess of 20 percent for a lumbar spine disability is remanded. Entitlement to service connection for insomnia is remanded. FINDINGS OF FACT 1. The Veteran’s February 28, 2014, claim for left foot paralysis can be construed as an informal or formal claim of entitlement to service connection for a left lower extremity (LLE) neurologic disability. 2. It was factually ascertainable that the Veteran had mild incomplete paralysis of the LLE sciatic nerve from May 13, 2014. 3. The Veteran filed an increased rating claim for his lumbar spine disability on December 31, 2014. 4. It was factually ascertainable that the Veteran’s diagnosed peripheral radiculopathy involved the LLE anterior crural (femoral) and cutaneous nerves and right lower extremity (RLE) sciatic and anterior crural (femoral) nerves from February 24, 2015. 5. The rating reduction for the Veteran’s service-connected lumbar spine disability from 20 percent to 10 percent effective May 1, 2015, was based on an inadequate February 2015 VA spine examination. 6. The Veteran’s PTSD has been characterized by occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. CONCLUSIONS OF LAW 1. The criteria for an effective date of February 28, 2014, but no earlier, for the grant of service connection for left lower extremity (LLE) radiculopathy of the sciatic nerve, have been met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. § 3.400 (2017). 2. The criteria for an effective date prior to December 31, 2014, for the grant of service connection for right lower extremity (RLE) radiculopathy of the sciatic nerve, have not been met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. § 3.400 (2017). 3. The criteria for an effective date prior to December 31, 2014, for the grant of service connection for LLE radiculopathy of the anterior crural (femoral) nerve, have not been met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. § 3.400 (2017). 4. The criteria for an effective date prior to December 31, 2014, for the grant of service connection for RLE radiculopathy of the anterior crural (femoral) nerve, have not been met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. § 3.400 (2017). 5. The criteria for an effective date prior to December 31, 2014, for the grant of service connection for LLE radiculopathy of the cutaneous nerve, have not been met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. § 3.400 (2017). 6. The criteria for restoration of a 20 percent rating for the Veteran’s service-connected lumbar spine disability from May 1, 2015, have been met. 38 U.S.C. §§ 1155, 5103, 5107 (2012); 38 C.F.R. §§ 3.105(e), 3.159, 3.344 (2017). 7. The criteria for a disability rating in excess of 30 percent for PTSD have not been met. 38 U.S.C. §§ 1110, 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.2, 4.6, 4.7, 4.126, 4.130, Diagnostic Code 9411 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 2006 to March 2011. This matter comes to the Board of Veterans’ Appeals (Board) from February 2015 and March 2017 rating decisions. In April 2015, the Veteran appointed J. Michael Woods as his representative via an executed VA Form 21-22a. The Veteran’s appeal was certified to the Board in November 2017. In January 2019, the Veteran’s representative filed a motion to withdraw because of factors which made the continuation of representation impossible, impracticable, or unethical. Pursuant to 38 C.F.R. § 20.608(b)(2), after an appeal has been certified to the Board, a representative may not withdraw services as a representative in the appeal unless good cause is shown on motion, and the motion is in writing and complies with the criteria set forth in 38 C.F.R. § 20.608(b)(2). In accordance with this regulatory provision, the Motion to Withdraw Representation contained those items specified by section 20.608(b)(2), to include an explanation for his decision to withdraw representation of the Veteran, the Veteran’s name and VA file number, a signed statement indicating that a copy of the motion was sent to the Veteran via U.S. mail at his current address, and proof of filing with the Board’s Senior Deputy Vice Chairman at the correct address. Upon consideration of the motion, and pursuant to 38 C.F.R. § 20.608(b)(2), the Board finds good cause for the Motion to Withdraw Representation of the Veteran in his appeal before the Board. Effective Date Claims The effective date of an award of disability compensation, in conjunction with a grant of entitlement to service connection, shall be the day following separation from active service or the date entitlement arose if the claim is received within one year of separation from service; otherwise, the effective date shall be the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C. § 5110; 38 C.F.R. § 3.400(b)(2)(i). In general, “date of receipt” means the date on which a claim, information or evidence was received by VA. 38 C.F.R. § 3.1(r). A specific claim in the form prescribed by the Secretary must be filed in order for benefits to be paid to any individual under the laws administered by VA. 38 U.S.C. § 5101(a); 38 C.F.R. § 3.151(a). A “claim” means a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 C.F.R. § 3.1(p). Any communication or action indicating an intent to apply for VA benefits from a claimant or representative may be considered an informal claim provided that such informal claim identifies the benefit being sought. 38 C.F.R. § 3.155(a); see Brannon v. West, 12 Vet. App. 32, 34 (1998). Entitlement to an effective date prior to December 31, 2014, for the grant of service connection for radiculopathy of the left lower extremity sciatic, anterior crural (femoral), and cutaneous nerves and right lower extremity sciatic and anterior crural (femoral) nerves. The Veteran contends that an earlier effective date is warranted for the grant of service connection for bilateral lower extremity radiculopathy. In an August 2011 rating decision, service connection was granted for a lumbar spine disability, effective March 11, 2011, the first day following the Veteran’s separation from service. This rating decision, without assignment of a separate disability rating for lower extremity radiculopathy, became final and the Veteran has not alleged clear and unmistakable error (CUE) in the March 2011 decision. Service connection for left lower extremity (LLE) radiculopathy of the sciatic, femoral, and cutaneous nerves, and service connection for right lower extremity (RLE) radiculopathy of the sciatic and femoral nerves, was granted in a February 2015 rating decision, with an assigned effective date of December 31, 2014. Service connection for LLE and RLE radiculopathy disabilities was granted as secondary to the Veteran’s December 31, 2014, increased rating claim for his service-connected lumbar spine disability. Because the current effective date of service connection for bilateral lower extremity radiculopathy is based upon the date his December 31, 2014, increased rating claim for his service-connected lumbar spine disability was received, the next question before the Board is whether there are any earlier, non-final, applications for service connection upon which an earlier effective date of service connection may be granted. November and December 2013 VA treatment records reflect that the Veteran reported numbness in his toes and was diagnosed with possible peripheral neuropathy in the left foot, with suspected tarsal tunnel causing neuropathic symptoms. On February 28, 2014, the Veteran filed a claim for paralysis of his left foot. A May 13, 2014, VA examination report reflects that the Veteran reported a burning pain in his left foot beginning in October 2013, with constant numbness and occasional tingling since November 2013. The Veteran reported intermittent low back pain, but denied true radicular pain. Upon examination, mild incomplete paralysis of the left sciatic nerve was found. However, the right sciatic nerve, left and right femoral nerves, and left external cutaneous nerve were all normal. The VA examiner indicated that the Veteran did not have paralysis of his left foot and that while he had signs and symptoms of peripheral neuropathy, a definitive diagnosis was not possible at the time. The examiner noted left foot symptomatology was of recent onset, and while it could be related to his in-service injuries, without a definitive diagnosis, an etiological opinion could not be provided. On December 31, 2014, the Veteran filed an increased rating claim for his service-connected lumbar spine disability. In a February 2015 VA spine examination, the Veteran reported experiencing sharp pain in his lower back with radiation into the left lower leg. The VA examiner noted diagnoses of lumbosacral strain, degenerative arthritis of the spine, intervertebral disc syndrome, and spinal stenosis, and opined that the Veteran’s degenerative disc disease was a progression of his previously diagnosed low back strain. The examiner further indicated that the Veteran’s history was consistent for chronic mid to lower back pain with radiculopathy since his time in service. On an associated February 2015 peripheral nerves VA examination, the examiner found mild incomplete paralysis of the right sciatic and femoral nerves, and moderate incomplete paralysis of the left sciatic, femoral, and external cutaneous nerves. The evidence supports an effective date of February 28, 2014, for the grant of service connection for LLE radiculopathy of the sciatic nerve only. On February 28, 2014, the Veteran filed a service connection claim for a left foot disability, claimed as paralysis. The May 2014 VA examiner indicated that the Veteran did not have paralysis of his left foot, but rather symptoms of peripheral neuropathy, although a definitive diagnosis was not possible at the time. Objective testing revealed that the Veteran had mild incomplete paralysis of the left sciatic nerve, but was negative for involvement of the LLE femoral and cutaneous nerves or for involvement of the RLE nerves. The Veteran’s left lower extremity symptoms were later diagnosed as LLE radiculopathy by the February 2015 VA examiner. The Court of Appeals for Veterans Claims (Court) has stressed that the effective date for an award of service connection is not based on the earliest medical evidence demonstrating a causal connection, but on the date of the claim for service connection. LaLonde v. West, 12 Vet. App. 377 (1999). Stated differently, based on the facts in this case, an effective date earlier than February 28, 2014, for the grant of service connection for LLE radiculopathy of the sciatic nerve is legally precluded. While the Veteran’s LLE radiculopathy of the sciatic nerve may have had its onset months before service connection was granted, it is not equivalent to finding a claim for that disability. The provisions of 38 U.S.C. § 5110 refer to the date an “application” is received. And “date of receipt” means the date on which a claim, information or evidence was received by VA. 38 C.F.R. § 3.1(r) (2017). Accordingly, affording the Veteran the benefit of the doubt, the Board finds that the February 28, 2014, claim of service connection for a left foot disability, claimed as paralysis, and later diagnosed as LLE radiculopathy, was a claim for LLE radiculopathy. Thus, the proper effective date for the grant of service connection for LLE radiculopathy of the sciatic nerve is the date of the claim, or February 28, 2014. 38 U.S.C. § 5110. On the other hand, the May 2014 VA examination was negative for involvement of the LLE femoral and cutaneous nerves. Furthermore, the medical evidence does not reflect that the Veteran reported any symptomatology associated with the RLE, and the May 2014 VA examination report was negative for RLE nerve involvement. It is not factually ascertainable that the Veteran experienced LLE radiculopathy of the femoral and cutaneous nerves or RLE radiculopathy prior to the February 2015 VA examination. Thus, the effective date for the grant of service connection for LLE radiculopathy of the femoral and cutaneous nerves and RLE radiculopathy of the sciatic and femoral nerves can be no earlier than the date of his lumbar spine increased rating claim, or December 31, 2014. In sum, based on the above, and resolving all reasonable doubt in favor of the Veteran, the Board finds that an effective date of February 28, 2014, but no earlier, is warranted for LLE radiculopathy of the sciatic nerve. The Board finds that there is no legal basis by which an effective date for the award of service connection for LLE radiculopathy of the femoral and cutaneous nerves and RLE radiculopathy of the sciatic and femoral nerves earlier than December 31, 2014, can be assigned. Consequently, the claims for an effective date prior to December 31, 2014, must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claims, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Rating Reduction Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and VA regulations governing disability compensation and pension. VA benefits recipients may be afforded greater protections under 38 C.F.R. § 3.344(a) and (b), which sets forth the criteria for reduction of ratings in effect for five years or more. 38 C.F.R. § 3.344(a) and (b) stipulate that only evidence of sustained material improvement under the ordinary conditions of life, as shown by full and complete examinations, can justify a reduction and prohibit a reduction on the basis of a single examination. Brown v. Brown, 5 Vet. App. 413, 417-18 (1995). However, with respect to other disabilities that are likely to improve (i.e., those in effect for less than five years), re-examinations disclosing improvement in disabilities will warrant a rating reduction. 38 C.F.R. § 3.344(c). Specifically, it is necessary to ascertain, based upon a review of the entire recorded history of the condition, whether the evidence reflects an actual change in disability and whether examination reports reflecting change are based upon thorough examinations. In addition, it must be determined that an improvement in a disability has actually occurred and that such improvement actually reflects an improvement in the veteran’s ability to function under the ordinary conditions of life and work. See Brown, 5 Vet. App. at 420-421; 38 C.F.R. § 3.344(c). Whether the rating reduction from 20 percent to 10 percent effective May 1, 2015, for a lumbar spine disability, was proper. The Veteran argues that any reduction in the rating for his service-connected lumbar spine disability was improper. An August 2011 rating decision granted service connection for a lumbar spine disability, evaluated at 20 percent, effective March 11, 2011, the day after the Veteran separated from service. The February 2015 rating decision on appeal reduced the rating to 10 percent, effective May 1, 2015. The 20 percent rating was in effect for less than five years. As a result, the regulations governing stabilization of disability evaluations found in 38 C.F.R. § 3.344(a) and (b) are not applicable. 38 C.F.R. § 3.344(c). Instead, reexaminations disclosing improvement will warrant a reduction in rating. Id. See also Hohol v. Derwinski, 2 Vet. App. 169 (1992) (in addressing whether improvement is shown, the comparison point generally is the last examination on which the rating at issue was assigned or continued). The examination report on which the reduction is based must be adequate. See Tucker v. Derwinski, 2 Vet. App. 201 (1992) (holding that the failure of the examiner in that case to review the claims file rendered the reduction decision void ab initio). In this case, the rating reduction was based upon a February 2015 VA examination. The Veteran reported flare-ups of his back that caused him to fall and prevented him from getting out of bed. The examiner indicated that pain and weakness contributed to functional loss during a flare-up, but noted that this could not be described in terms of motion as the examination was not being conducted during a flare-up. The Board finds that the examination does not comply with the requirements in Sharp v. Shulkin, 29 Vet. App. 26, 34-36 (2017). The examiner did not attempt to elicit relevant information regarding the description of the Veteran’s flare-ups and any additional functional loss suffered during flare-ups. Thus, the examination was inadequate to rate the Veteran’s lumbar spine disability. The rating reduction was enacted because of improved symptoms shown by the February 2015 examination. Because the February 2015 examination was inadequate, the rating reduction based upon that examination is void ab initio, and restoration of the 20 percent rating effective May 1, 2015, is granted. Increased Rating Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155 (2017); 38 C.F.R. § 4.1 (2017). Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran. 38 C.F.R. § 4.3 (2017). Where entitlement to compensation has already been established and an increase in disability rating is at issue, the present level of disability is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Within that context, VA must assess the level of disability from the date of initial application for service connection and determine whether the level of disability warrants the assignment of different disability ratings at different times over the life of the claim, a practice known as a “staged rating.” See Fenderson v. West, 12 Vet. App 119 (1999). In deciding the Veteran’s increased rating claim on appeal, the Board has considered the relevant temporal period from January 4, 2016, or one year prior to the Veteran’s increased rating claim. Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings sufficiently characteristic to identify the disease and the resulting disability and above all, coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. Generally, the Board has been directed to consider only those factors contained wholly in the rating criteria. See Massey v. Brown, 7 Vet. App. 204, 208 (1994); but see Mauerhan v. Principi, 16 Vet. App. 436 (2002) (finding it appropriate to consider factors outside the specific rating criteria in determining level of occupational and social impairment). The standard of proof to be applied in decisions on claims for veteran’s benefits is set forth in 38 U.S.C. § 5107 (2012). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence. See 38 C.F.R. § 3.102 (2017). When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The preponderance of the evidence must be against the claim for benefits to be denied. See Alemany v. Brown, 9 Vet. App. 518 (1996). Entitlement to a disability rating in excess of 30 percent for posttraumatic stress disorder. The Veteran contends that a higher rating is warranted for his service-connected posttraumatic stress disorder (PTSD). When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran’s capacity for adjustment during periods of remission. The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner’s assessment of the level of disability at the moment of the examination. 38 C.F.R. § 4.126(a) (2017). When evaluating the level of disability from a mental disorder, VA also will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment. 38 C.F.R. § 4.126(b). The Veteran’s PTSD is evaluated as 30 percent disabling under Diagnostic Code (DC) 9411 of the General Rating Formula for Mental Disorders. See 38 C.F.R. § 4.130, DC 9411 (2017). Under the applicable rating criteria, a 30 percent disability rating is warranted when there is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). Id. A 50 percent disability rating is warranted when there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped, speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. Id. A 70 percent disability rating is warranted for 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. Finally, a 100 percent disability 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. When determining the appropriate disability evaluation to assign, the Board’s primary consideration is a Veteran’s symptoms, but it must also make findings as to how those symptoms impact a Veteran’s occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013). The use of the term “such as” in the rating criteria demonstrates that the symptoms after that phrase 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 (2002). Thus, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Id. at 442. Nevertheless, all ratings in the general rating formula are also associated with objectively observable symptomatology and the plain language of the regulation makes it clear that the Veteran’s impairment must be “due to” those symptoms; a Veteran may only qualify for a given disability rating by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d at 118. VA treatment records dated from January to October 2016 reflect that the Veteran reported his mental health symptoms were well controlled and that he had learned to modulate his anger. His mood appeared normal, he dressed appropriately, he denied suicidal or homicidal ideations, and there were no signs of distrust. The Veteran reported he attended school full time and expressed excitement about starting a new job and the financial stability it would bring his family. A February 2017 VA examination report reflects that the Veteran reported worked and stayed as busy as possible so that he did not think about his experiences. He further reported chronic sleep disturbance, and the examiner noted that the Veteran’s obstructive sleep apnea affected the quality and/or quantity of his sleep. The Veteran reported he was married, with two previous marriages that ended in divorce, and that he worked and studied full time. He reported irritability and yelling, but denied physical violence. The Veteran reported that in 2011, he became drunk and held a gun to his head, but denied any current suicidal or homicidal intent or plan, identifying his children as his greatest protective factor. The Veteran endorsed guilt, but not anhedonia. He reported that his concentration was normal, but his appetite and energy were reduced. Upon examination, the Veteran appeared clean, adequately groomed, and casually dressed. Speech was normal and thoughts were clear, logical, and well organized. The Veteran’s affect was guarded, but less so as the interview progressed. The examiner found that while the Veteran was diagnosed with PTSD, the Veteran reported functioning at a relatively high level, and his symptomatology was not severe enough to either interfere with occupational and social functioning or to require continuous medication. Based upon the evidence of record, including that specifically discussed above, the Board concludes that an increased disability rating in excess of 30 percent is not warranted. Specifically, during this period, the record indicates that the Veteran's symptoms do not rise to the level of occupational and social impairment with reduced reliability and productivity. Throughout the period on appeal, the Veteran appeared appropriately groomed and adequately dressed, and did not show an inability to maintain personal hygiene. The Veteran’s speech was normal and thoughts were goal-directed. While the Veteran reported consumption of alcohol, the Veteran did not exhibit gross impairment in thought processes or communication. While the Veteran endorsed disturbances of mood and motivation, such as outbursts of anger and irritability, the Veteran also indicated that his symptoms were well-controlled. The Veteran reported sleep disturbances but endorsed no memory problems. The Veteran has generally been able to function independently, attending school and work full time. As such, the symptomology described above are contemplated by the 30 percent evaluation. A higher 50 percent schedular rating is not warranted for any period on appeal. Rather, during this period, the Veteran’s PTSD symptoms were most frequently emphasized by the Veteran were sleep disturbances, feelings of guilt, irritability, and anger. There is no evidence of occupational and social impairment with reduced reliability and productivity, including due to symptoms such as flattened affect; circumstantial, circumlocutory, or stereotyped, speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. While the Veteran reported holding a gun to his head in 2011, this was prior to the period on appeal and the evidence does not reflect that the Veteran has endorsed suicidal ideation or thoughts of death since, or at any point during the appeal period. Thus, the Board finds that an increased disability rating in excess of 30 percent is not warranted for the Veteran’s service-connected PTSD in this case. See 38 C.F.R. § 4.130, Diagnostic Code 9411. The preponderance of evidence is against the Veteran’s claim, there is no reasonable doubt to be resolved, and the claim must therefore be denied. 38 U.S.C. § 5107(b) (2012); 38 C.F.R. §§ 3.102, 4.3 (2017); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND 1. Entitlement to a disability rating in excess of 20 percent for a service-connected lumbar spine disability is remanded. As discussed above, while the record contains contemporaneous February 2015 VA spine examination, the examination does not comply with the requirements in Sharp v. Shulkin, 29 Vet. App. 26, 34-36 (2017). Thus, a remand is warranted for a new VA exmaination to assess the current severity of the Veteran’s lumbar spine disability, to include any neurological manifestations. 2. Entitlement to an initial disability rating in excess of 40 percent and 10 percent, respectively, for left and right lower extremity radiculopathy of the sciatic nerve; entitlement to an initial disability rating in excess of 30 percent and 10 percent, respectively, for left and right lower extremity radiculopathy of the anterior crural (femoral) nerve; and entitlement to an initial disability rating in excess of 10 percent for left lower extremity radiculopathy of the cutaneous nerve, are remanded. Regarding the increased rating claim for left lower extremity (LLE) radiculopathy of the sciatic nerve, in light of the Board’s grant of an earlier effective date, a remand is required for the assignment of initial disability rating and adjudication of entitlement to an increased disability rating in consideration of the expanded rating period on appeal. Due process requires that the first adjudication (assignment of the initial disability rating) must be made by the AOJ. Additionally, a remand of the increased rating claim for a lumbar spine disability could impact the ratings currently assigned for bilateral lower extremity radiculopathy. Therefore, adjudication of the increased rating claims for bilateral lower extremity radiculopathy would be premature at this time, and must also be remanded. 3. Entitlement to service connection for insomnia is remanded. The RO denied entitlement to service connection for insomnia because the Veteran’s service treatment records did not show trouble sleeping, and while VA treatment records reflect trouble staying asleep due to nightmares, this symptom was considered under the Veteran’s rating for PTSD. Subsequent to the January 2017 statement of the case, a February 2017 VA PTSD examination report reflects that the Veteran reported initial insomnia, in addition to sleep disturbances throughout the night. The Board finds that a remand is warranted for a VA examination to assess the nature and etiology of any claimed insomnia, and a clear statement as to whether such is an independent condition or a symptom of service-connected PTSD. The matters are REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from October 2016 to present. 2. Schedule the Veteran for examinations to assess of the current severity of his lumbar spine and peripheral nerve disabilities. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any insomnia. The claims folder must be reviewed in conjunction with the examination. The examiner must opine whether any diagnosed insomnia at least as likely as not is an independent disability entity or is a symptom of currently diagnosed PTSD. If insomnia is an independent condition, the examiner must opine as to whether such is at least as likely as not caused or aggravated by service or a service-connected disability 4. Upon completion of the above, and any additional development deemed appropriate, readjudicate the remanded issues. If the benefit sought remains denied, the Veteran should be provided with a supplemental statement of the case. The case should then be returned to the Board for appellate review if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Owen, Associate Counsel