Citation Nr: 20009950 Decision Date: 02/06/20 Archive Date: 02/05/20 DOCKET NO. 19-16 402 DATE: February 6, 2020 ORDER Entitlement to service connection for a right knee disorder is denied. Entitlement to service connection for a left knee disorder is denied. Entitlement to service connection for a right elbow disorder is denied. Entitlement to service connection for a left elbow disorder is denied. Entitlement to service connection for a neck disorder, to include as secondary to a back disorder, is denied. Entitlement to service connection for a left-hand joints and fingers disorder is denied. Entitlement to service connection for a left ankle disorder is denied. Entitlement to an initial rating in excess of 20 percent for right ear frostbite is denied. Entitlement to an initial rating in excess of 20 percent for left ear frostbite is denied. Entitlement to an initial compensable rating for right ear frostbite scarring is denied. Entitlement to an initial compensable rating for left ear frostbite scarring is denied. Entitlement to an initial rating in excess of 10 percent for rhinitis is denied. Entitlement to a non-initial rating in excess of 10 percent prior to March 25, 2019 and in excess of 20 percent thereafter, for low back strain, is denied. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right or left knee disorder. 2. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of a right or left elbow disorder. 3. The preponderance of the evidence of record is against finding that the Veteran’s has, or has had at any time during the appeal, a current diagnosis of a neck disorder. 4. The preponderance of the evidence of record is against finding that the Veteran’s left hand and finger pain is due to a disease or injury in service. 5. The preponderance of the evidence of record is against finding that the Veteran’s left ankle pain is due to a disease or injury in service. 6. The Veteran’s right and left ear frostbite is manifested by cold sensitivity and locally impaired sensation in each ear. 7. The Veteran’s right and left ear residuals of frostbite scarring is manifested by hypopigmentation that covers at most 0.75 square centimeters, tenderness on palpation, and abnormal texture that covers at most 0.75 square centimeters of each ear. 8. The Veteran’s rhinitis is not manifested by polyps. 9. Prior to March 25, 2019, considering the complaints of pain, limited range of motion, and functional loss, the Veteran’s lumbar strain did not result in forward flexion greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion not greater than 120 degrees; or, muscle spasms or guarding severe enough result in abnormal gait or abnormal spinal contour. 10. After March 25, 2019, the Veteran’s lumbar strain is not manifested by forward flexion of the lumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. CONCLUSIONS OF LAW 1. The criteria for service connection for a right knee disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a left knee disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for a right elbow disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for a left elbow disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for service connection for a neck disorder due to service or service-connected lumbar strain are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 6. The criteria for service connection for a left-hand joint and finger disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 7. The criteria for service connection for a left ankle disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 8. The criteria for a rating in excess of 20 percent for right ear frostbite have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.104, Diagnostic Code 7122. 9. The criteria for a rating in excess of 20 percent for left ear frostbite have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.104, Diagnostic Code 7122. 10. The criteria for a compensable rating for right ear frostbite scarring have not been met. 38 U.S.C. §§ 1155; 38 C.F.R. § 4.118, Diagnostic Code 7800. 11. The criteria for a compensable rating for left ear frostbite scarring have not been met. 38 U.S.C. §§ 1155; 38 C.F.R. § 4.118, Diagnostic Code 7800. 12. The criteria for a rating in excess of 10 percent for rhinitis have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.321(b), 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.97, Diagnostic Code 6522. 13. Prior to March 25, 2019, the criteria for a rating in excess of 10 percent for lumbar strain have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.7, 4.40, 4.45, 4.71a, Diagnostic Code 5237. 14. After March 25, 2019, the criteria for a rating in excess of 20 percent for lumbar strain have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.7, 4.40, 4.45, 4.71a, Diagnostic Code 5237. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United Air Force from January 1996 to December 2001. Service Connection 1. Entitlement to service connection for a right knee disorder. 2. Entitlement to service connection for a left knee disorder. The Veteran asserts that he has symptoms of the bilateral knees to include pain and instability caused by service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of a bilateral knee disorder and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). In an October 2001 service treatment record (STR), the Veteran complained of bilateral knee pain. The medical provider assessed the Veteran to have bilateral knee pain. In a February 2009 private treatment record, the Veteran complained of right knee pain that has been intermittent for the last several years. He stated that while he was in the Army he was required to sit down and press a heavy foot pedal with his knee hyperextended. He stated he does not remember a specific injury. The medical provider found that the Veteran’s right knee is clinically normal, aside from the lateral joint line tenderness. The medical provider also stated the right knee X-rays showed normal joint space and no osteoarthritis. In the August 2015 VA knee examination, the examiner indicated that the Veteran does not have a current diagnosis associated with the bilateral knees. The Veteran did not report experiencing flare-ups or functional loss. The examiner acknowledged the Veteran’s complaint of mild medial knee pain with no history of injury or treatment. The examiner commented that he observed no evidence of flare-ups leading to a functional disability. In a December 2017 VA treatment record, the Veteran reported that he experiences the feeling that both knees may “give way” and he may fall. He complained of pain in the left knee. In a June 2019 VA treatment record, the Veteran stated he has experienced bilateral knee pain since 1998. He stated the pain was constant and mild with episodes of worsening with prolonged walking and climbing stairs. He stated that sometimes both knees feel unstable and he has had a few falls. While the Veteran believes he has a current diagnosis of a bilateral knee disorder, he is not competent to provide a diagnosis in this case. The issue is medially complex, as it requires specialized medical eduction. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; see Degmetich v. Brown, 104 F. 3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the Veteran currently has a right or left knee disorder for which benefits are being claimed. Because the evidence does not establish that the Veteran has a right or left knee disorder, either in-service or post-service, the Board finds that the Veteran is not entitled to service connection for a bilateral knee disorder. In coming to this conclusion, the Board is mindful of Saunders v. Wilkie, in which the Federal Circuit explained that where pain alone results in functional impairment that affects earning capacity, even if there is no identified underlying diagnosis, it can constitute a disability. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). There is no evidence indicating that the Veteran’s claimed bilateral knee pain is so severe as to cause a functional impairment, nor has the Veteran so alleged. Indeed, during the August 2015 VA examination, the examiner specifically noted that the Veteran’s claimed bilateral knee disorder did not cause functional loss. Based on the foregoing, the Board does not find that the Veteran’s bilateral knee pain rises to the level of a disability under Saunders. The claims must be denied. 3. Entitlement to service connection for a right elbow disorder. 4. Entitlement to service connection for a left elbow disorder. The Veteran asserts that he has a right and left elbow disorder. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service, event, or disease. The Board concludes that that the Veteran does not have a current diagnosis of a right or left elbow disorder and has not had one at any time during the pendency of the claim or recent filing of the claim. 38. U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). In a July 2001 STR, the Veteran complained of bilateral elbow pain with the right elbow worse than the left. In an October 2001 STR, the Veteran complained of bilateral elbow pain. The medical provider assessed the Veteran to have bilateral medial epicondylitis. On the August 2015 VA elbow examination, the examiner indicated that the Veteran does not have a diagnosis of any elbow disorder. The examiner indicated that the Veteran’s elbow pain does not impact his ability to perform occupational tasks. The examiner also stated there is no evidence of flareups leading to functional disability. In an April 2016 statement, the Veteran stated his elbows hurt and pop. In a June 2017 VA treatment record, the Veteran stated he elbow feels tight at times with no injury at onset. In a June 2019 VA treatment record, the Veteran stated that he has experienced bilateral elbow pain since 1998 while performing a very manual job. He stated the pain is constant and mild with flares of pain. He stated sometimes the right elbow locks in the flexed position. While the Veteran believes that he has a current diagnosis of a bilateral elbow disorder, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; see Degmetich v. Brown, 104 F. 3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the Veteran currently has a bilateral elbow disorder for which benefits are being claimed. Because the evidence does not establish that the Veteran has a right or left elbow disorder at any time during the appeal period, the Board finds that the Veteran is not entitled to service connection for a right or left elbow disorder. In coming to this conclusion, the Board is mindful of Saunders v. Wilkie, in which the Federal Circuit explained that where pain alone results in functional impairment that affects earning capacity, even if there is no identified underlying diagnosis, it can constitute a disability. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). There is no evidence indicating that the Veteran’s claimed bilateral elbow pain is so severe as to cause a functional impairment, nor has the Veteran so alleged. Indeed, during the August 2015 VA examination, the examiner specifically noted that the Veteran’s claimed bilateral elbow pain would not have an impact on his ability to perform occupational tasks or lead to functional disability. Based on the foregoing, the Board does not find that the Veteran’s bilateral elbow pain rises to the level of a disability under Saunders. The claims must be denied. 5. Entitlement to service connection for a neck disorder, to include as secondary to a lumbar strain. The Veteran asserts that he has symptoms of a neck disorder. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, disease, or service-connected disability. The Board concludes that the Veteran does not have a current diagnosis of a neck disorder and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). The STRs show no complaints or treatment of a neck disorder. On the August 2015 VA neck examination, the examiner indicated that the Veteran did not now have or ever have a diagnosis of the neck. The examiner stated that there is no history of complaints related to the neck. Further, the examiner indicated the Veteran’s neck pain does not impact his ability to work and there is no evidence of flare-ups leading to functional disability. In an April 2016 statement, the Veteran stated that he experiences pain, especially in the right back area. He stated he experiences pain when turning his head. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; see Degmetich v. Brown, 104 F.3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must show that the Veteran currently has a neck disorder for which benefits are being claimed. Because the evidence does not establish that the Veteran has a neck disorder, either in-service or post-service or caused or aggravated by service-connected lumbar spine disorder, the Board finds that the Veteran is not entitled to service connection for a neck disorder. In coming to this conclusion, the Board is mindful of Saunders v. Wilkie, in which the Federal Circuit explained that where pain alone results in functional impairment that affects earning capacity, even if there is no identified underlying diagnosis, it can constitute a disability. Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). There is no evidence indicating that the Veteran’s claimed neck pain is so severe as to cause a functional impairment, nor has the Veteran so alleged. Indeed, during the August 2015 VA examination, the examiner specifically noted that the Veteran’s claimed neck pain would not have an impact on his ability to work or lead to functional disability. Based on the foregoing, the Board does not find that the Veteran’s neck pain rises to the level of a disability under Saunders. The claim must be denied. 6. Entitlement to service connection for a left hand joints and fingers disorder. The Veteran asserts that he is entitled to service connection for a left hand joint and finger disorder on a direct basis. However as outlined below, the preponderance of the evidence of record demonstrates that the Veteran’s left-hand joints and fingers disorder did not manifest during, within the year following, or as a result of active service. As such, service connection cannot be established on a direct basis. Service connection may be granted for 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). To establish a right to compensation for a present disability, a Veteran must show: (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 - the so-called “nexus” requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially 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). In addition, service connection for certain chronic diseases, including arthritis, may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When all of the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert. v. Derwinski, 1 Vet. App. 49, 55 (1990). The STRs are silent for any complaints or treatment of the left hand and fingers. In an April 2016 statement, the Veteran stated he experiences arthritis type pain in the hands and fingers. In a June 2017 VA treatment record, the Veteran stated that for the past year his wrists and hands have on and off pain, but he denied any decreased strength in handgrips. Based on the foregoing, the Board concludes that there is no evidence that the Veteran’s left-hand joint and finger pain was manifested in service or to a compensable degree in the first year following his separation from service. The first complaint of left hand joint and finger pain is the Veteran’s March 2015 claim, over ten years after separation from service. Consequently, service connection for a left hand joints and fingers disorder on the basis that such became manifest in service and persisted, or on a presumptive basis (as a chronic disease under 38 U.S.C. § 1112), is not warranted. Notably, the Veteran has not submitted competent evidence to show that he has suffered from a left hand joint or finger disorder continuously since service. See 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 495-96 (1997). There is also no evidence that the Veteran’s left-hand joint or finger pain is otherwise related to service. The Veteran’s post-service private treatment records are silent for an opinion relating his left hand joint and finger pain to service. The Board acknowledges that the Veteran has not been afforded a VA examination for the left-hand joint and finger pain but finds no such examination was required because the evidence does not indicate that the claimed disability has exhibited symptoms, treatment, or diagnosis in or since the Veteran’s active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Also, there is no competent and credible evidence of a current diagnosis or symptom of the disability. The Veteran has not indicated any symptoms or treatment for this pain, nor are there any treatment or diagnosis in VA treatment records. As such, the Board finds that a VA examination was not required. Further, the Veteran’s own statements relating his left hand joint and finger pain to service are not competent evidence, as he is a layperson and lacks the training to provide adequate opinion regarding medical etiology. Specifically, the Veteran lacks the training to opine whether arthritis or arthritis-like pain, in the absence of credible evidence of continuity, as here, is related to an incident in service. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007) (Whether lay evidence is competent and sufficient in a particular case is a fact issue to be addressed by the Board rather than a legal issue to be addressed by the Veterans Court). Also, the Veteran’s pain is a symptom of the musculoskeletal system, and the record does not show that the Veteran has training or education in this medical field; therefore, lay evidence of the etiology is not competent nexus evidence as it is not capable of lay observation. See Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007); Layno v. Brown, 6 Vet. App. 465, 469. Thus, the Veteran is not competent or qualified, as a layperson, to render an opinion on medical causation. In light of the foregoing, the Board concludes that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for a disability manifested by left hand joint and finger pain. Accordingly, it must be denied. 7. Entitlement to service connection for a left ankle disorder. The Veteran asserts that he is entitled to service connection for a left ankle disorder on a direct basis. However, as outlined below, the preponderance of the evidence of record demonstrates that the Veteran’s left ankle disorder did not manifest during, within the year following, or as a result of active service. As such, service connection cannot be established on a direct basis. The STRs are silent for complaints of or treatment for left ankle pain or disorder. In a July 2015 VA treatment record, the Veteran complained of left ankle pain for one month and underwent an X-ray. The X-ray was negative with no evidence of fracture, dislocation, or other significant bony abnormality. In an April 2016 statement, the Veteran stated his ankles ache, pop, and sometimes turn. Based on the foregoing, the Board finds that there is no evidence that the Veteran’s left ankle disorder was manifested in service or to a compensable degree in the first year following his separation from service. The first mention of a left ankle disorder occurred in 2015, with the claim and treatment at VA, over ten years after separation from service. Consequently, service connection for a left ankle disorder on the basis that such became manifest in service and persisted, or on a presumptive basis (as a chronic disease under 38 U.S.C. § 1112), is not warranted. Notably, the Veteran has not submitted competent evidence to show that he has suffered from the left ankle disorder continuously since service. See 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 495-96 (1997). There is also no evidence that the Veteran’s left ankle disorder is otherwise related to service. The Veteran’s post-service private treatment records are silent for an opinion relating his left ankle disorder to service. The Board acknowledges that the Veteran has not been afforded a VA examination for the left ankle but finds no such examination was required because the evidence does not indicate that the claimed disability has exhibited symptoms, treatment, or diagnoses since the Veteran’s active service. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Also, there is no competent and credible evidence of a current diagnosis or symptoms of the disability. The Veteran has not indicated any treatment or diagnosis in VA treatment records. As such, the Board finds that a VA examination was not required. Further, the Veteran’s own statements relating his left ankle disorder to service are not competent evidence, as he is a layperson and lacks the training to provide adequate opinion regarding medical etiology. Specifically, the Veteran lacks the training to opine whether symptoms of pain, in the absence of credible evidence of continuity, as here, is related to an incident in service. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007) (Whether lay evidence is competent and sufficient in a particular case is a fact issue to be addressed by the Board rather than a legal issue to be addressed by the Veterans Court). Also, the Veteran’s pain is a symptom of the musculoskeletal system, and the record does not show that the Veteran has training or education in this medical field; therefore, lay evidence of the etiology is not competent nexus evidence as it is not capable of lay observation. See Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007); Layno v. Brown, 6 Vet. App. 465, 469-70. Thus, the Veteran is not competent or qualified, as a layperson, to render an opinion on medical causation. In light of the foregoing, the Board concludes that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for a left ankle disorder. Accordingly, it must be denied. Increased Rating Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. The Board should consider only those factors contained in the rating criteria. Massey v. Brown, 7 Vet. App. 204 (1994). Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Board will also consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 8. Entitlement to an initial rating in excess of 20 percent for right ear frostbite. 9. Entitlement to an initial rating in excess of 20 percent for left ear frostbite. The Veteran asserts that his service-connected bilateral ear frostbite is more disabling than reflected by the 20 percent rating for the right ear and 20 percent rating for the left ear. Under Diagnostic Code 7122, regarding cold injury residuals, a 20 percent rating requires arthralgia or other pain, numbness, or cold sensitivity plus tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, or X-ray abnormalities (osteoporosis, subarticular punched out lesions, or osteoarthritis). A 30 percent rating requires arthralgia or other pain, numbness, or cold sensitivity plus two or more of the following: tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, or X-ray abnormalities (osteoporosis, subarticular punched out lesions, or osteoarthritis). 38 C.F.R. § 4.104, Diagnostic Code 7122. On the August 2014 VA cold injury examination, the examiner stated that the Veteran had a diagnosis of frostbite of the ears. The Veteran reported that he experiences pain of the ears when exposed to cold weather and sensitivity to direct sunlight. He also stated his ears are sensitive to touch. On examination, the examiner observed the Veteran to experience pain, cold sensitivity, and locally impaired sensation in the bilateral ears. The examiner observed scars on the ears. The examiner observed that the skin on the ears is mildly erythematous, skin intact, marked tenderness to light palpation, and scarring. On the October 2015 NOD, the Veteran stated his bilateral ear frostbite warrants a higher rating under Diagnostic Code 7800 because he has visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features, or with two or three characteristics of disfigurement. He asserts his rating should be 50 percent. In an April 2016 statement, the Veteran stated his ears hurt in cold weather and when exposed to the sun. In a March 2019 VA cold injury examination, the Veteran stated he experiences increased sensitivity to cold and ear pain which is heightened in the cold months. The examiner stated that the Veteran’s current treatment is sunscreen at all times when outside and ears covered during the winter months. The examiner indicated that the Veteran’s symptoms are pain and cold sensitivity of the right and left ear, that includes sensitivity to heat and cold. The examiner stated that the Veteran’s symptoms have worsened. Upon review of the record, the Board finds that a rating in excess of 20 percent for the right ear and 20 percent for the left ear frostbite is not warranted. In order to warrant a higher rating, the Veteran’s bilateral ear frostbite would have to be manifested by arthralgia or other pain, numbness, or cold sensitivity plus two or more of the following: tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, or X-ray abnormalities. Here, however, the April 2015 and March 2019 VA examinations reports show that the Veteran experienced cold sensitivity with one additional symptom, locally impaired sensation. Accordingly, a rating in excess of 20 percent is not warranted for the Veteran’s right or left ear frostbite. 10. Entitlement to an initial compensable rating for right ear frostbite scarring. 11. Entitlement to an initial compensable rating for left ear frostbite scarring. The Veteran asserts that his service-connected bilateral ear frostbite scarring is more disabling than reflected by the non-compensable ratings currently assigned. Under Diagnostic Code 7800, regarding scar(s) of the head, face, or neck, a 10 percent rating requires one characteristic of disfigurement. A 30 percent rating requires visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with two or three characteristics of disfigurement. A 50 percent rating requires visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with four or five characteristics of disfigurement. An 80 percent rating requires visible or palpable tissue loss and either gross distortion or asymmetry of three or more features or paired sets of features (nose, chin, forehead, eyes, ears, cheeks, lips), or; with six or more characteristics of disfigurement. 38 C.F.R. § 4.118, Diagnostic Code 7800. Note(1) states that the 8 characteristics of disfigurement, for purposes of evaluation under § 4.118 are: scar 5 or more inches (13 or more centimeters (cm)) in length; Scar at least one-quarter inch (0.6 cm) wide at widest part; surface contour of scar elevated or depressed on palpation; scar adherent to underlying tissue; skin hypo-or hyper-pigmented in an area exceeding six square inches (39 sq. cm); skin texture abnormal (irregular, atrophic, shiny, scaly, etc.) in an area exceeding six square inches (39 sq. cm.); underlying soft tissue missing in an area exceeding six square inches (39 sq. cm.); and skin indurated and inflexible in an area exceeding six square inches (39 sq. cm.). The Board notes that the Schedule for Rating Skin Disabilities was amended in August 2018 so that it more clearly reflects VA’s policies concerning the evaluation of skin disorders, specifically, 38 C.F.R. § 4.118, Diagnostic Codes 7801, 7802, 7805 7806, 7813, 7815-7817, 7820-7822, and 7824-7829. However, these amendments are inapplicable here, as the Veteran’s bilateral ear scars are properly rated under Diagnostic Code 7800. On the August 2015 VA scars examination, the examiner observed scars on the Veteran’s head, face, or neck. The examiner observed a scar on the right ear that is well healed, hypopigmented, and tender to palpation, and is 3.5 centimeters (cm.) by 0.1 cm in length and width. The examiner also observed a scar on the left ear that is well healed, hypopigmented, tender to palpation and is 4.0 cm by 0.1 cm in length and width. The examiner observed the scar on the left ear to have an abnormal texture that is uneven. The total area of the head, face or neck with hypopigmented area is 0.75 square (sq.) cm. and the approximate total area of head, face or neck with abnormal texture is 0.75 sq. cm. The examiner found no gross distortion or asymmetry of facial features or visible or palpable tissue loss. On the October 2015 NOD, the Veteran stated his bilateral ear frostbite scarring warrants a higher rating because there is obvious disfigurement and vitiligo, pursuant to Diagnostic Code 7623. He asserts the rating for each ear should be 10 percent. On the March 2019 VA scar VA examination, the examiner observed the Veteran to have two painful scars of the head, face, or neck. The Veteran reported pain when the scars are palpated at an intensity of an eight on a scale of zero to ten. The examiner observed that the scars are not unstable with frequent loss of covering skin over the scar. The examiner also did not observe any elevation, depression, adherence to underlying tissue, or missing underlying soft tissue. The examiner indicated there is no gross distortion or asymmetry of facial features or visible or palpable tissue loss. The examiner also observed hypopigmentation of the scars on the right and left ear. The examiner also indicated that the scars of the right and left ear are tender to palpation. The examiner measured the scar on the right ear to be 4.1 cm by 0.1 cm. The left ear is measured to be 3.2 cm by 0.1 cm. The examiner measured the total area of the scars with hypopigmentation to be 0.73 square cm. The Board recognizes the Veteran’s assertion that the bilateral ear frostbite scarring should be rated under Diagnostic Code 7823 for Vitiligo. However, the Board finds that rating under this Diagnostic Code is not appropriate as the VA examiners diagnosed the Veteran with bilateral ear frostbite and bilateral ear scars. No diagnosis of vitiligo has been shown. Upon review of the record, the Board finds that a compensable rating for right and left ear frostbite scarring is not warranted. In order to warrant a compensable disability rating, the Veteran’s bilateral ear scars would have to be manifested by one characteristic of disfigurement. Here, the August 2015 and March 2019 VA examinations show that the Veteran’s right and left ear scarring does not have one characteristic of disfigurement. The Veteran asserts that his scarring causes hypopigmentation, a characteristic of disfigurement, and is therefore entitled to a higher rating. However, the Diagnostic Code requires the skin hypopigmented area exceed six square inches (39 sq. cm). Here, the August 2015 examiner measured the Veteran’s hypopigmented area to be 0.75 sq. cm and the March 2019 examiner measured the hypopigmented area to be 0.73 sq. cm. Therefore, the Board finds that although the Veteran has scarring with hypopigmentation, that hypopigmentation is less than 39 sq. cm and is not found to be a characteristic of disfigurement. Accordingly, a compensable disability rating is not warranted for the Veteran’s right and left ear frostbite scarring. 12. Entitlement to an initial rating in excess of 10 percent for rhinitis. The Veteran asserts that his service-connected rhinitis is more disabling than reflected by the 10 percent rating currently assigned. Under Diagnostic Code 6522, regarding allergic or vasomotor rhinitis, a 10 percent rating requires rhinitis without polyps, but with greater than 50 percent obstruction of nasal passage on both sides or complete obstruction on one side. A 30 percent rating requires polyps. 38 C.F.R. § 4.97. In an April 2015 VA treatment record, the Veteran stated that his nasal obstruction is “annoying” about half of the time, but it is not debilitating. The medical provider observed the Veteran to have moderate nasal obstruction. On the August 2015 VA sinusitis and rhinitis examination, the examiner indicated the Veteran had a deviated nasal septum, sinusitis, and rhinitis. The examiner indicated that the Veteran has had two non-incapacitating episodes over the last 12 months and has not had any incapacitating episodes over the last 12 months. The examiner also indicated the Veteran has greater than 50 percent obstruction of the nasal passage on both sides due to rhinitis without complete obstruction on either side, without permanent hypertrophy of the nasal turbinates, no nasal polyps, and no granulomatous conditions. On the October 2015 NOD, the Veteran asserts his sinusitis warrants a higher rating under Diagnostic Code 6514 because he has had radical surgery that provided no relief and he has near constant rhinitis/sinusitis characterized by headaches, pain, tenderness, and purulent discharge or crusting. The Veteran asserts the rating should be 50 percent. In an April 2016 statement, the Veteran stated his sinus symptoms persist and include difficulty breathing through the nose and blood when the nose is blown. In a September 2016 VA treatment record, the medical provider observed the Veteran’s nasal cavity to show a little deviation in the septum. The medical provider observed no polyps, mass, lesions or drainage. In a March 2017 VA treatment record, the Veteran reported pain of his nose. The medical provider stated that imaging of the Veteran’s sinus is normal with no findings of acute or chronic sinusitis and no residual mucosal thickening. In the March 2019 VA sinusitis and rhinitis examination, the examiner stated that the Veteran’s sinusitis and rhinitis has progressed. The Veteran stated he currently experiences pain in the maxillary sinuses, headaches, facial tenderness, nasal congestion, and post nasal drip. The examiner observed that the Veteran’s maxillary is currently affected by his disorder and has the signs or symptoms of near constant sinusitis that occurs monthly and lasts five to seven days, headaches, pain of affected sinus, tenderness of affected sinus, purulent discharge, crusting, pain, headaches, facial tenderness, nasal congestion, and post nasal drip. The examiner found that the Veteran has had non-incapacitating episodes of sinusitis characterized by headaches, pain, and purulent discharge or crusting 7 or more times in the past 12 months. The examiner also found that the Veteran has had incapacitating episodes of sinusitis requiring prolonged (4 to 6 weeks) of antibiotics treatment three or more times in the past 12 months. The examiner indicated that the Veteran’s rhinitis has not caused greater than 50 percent obstruction of the nasal passage on both sides, complete obstruction on the left side, complete obstruction on the right side, permanent hypertrophy of the nasal turbinates, nasal polyps, or any granulomatous conditions. The examiner opined that the Veteran’s sinusitis is a progression of the rhinitis. In a May 2019 VA treatment record, the medical provider noted that the Veteran has been seen several times in the emergency department for recurrent sinus infections. In a July 2019 VA treatment record, the Veteran complained of post nasal drip and globus sensation. The medical provider assessed the Veteran to have chronic rhinitis. Upon review of the record, the Board finds that a rating in excess of 10 percent is not warranted. In order to warrant a rating in excess of 10 percent, the Veteran’s rhinitis would have to be manifested by polyps. Here, however, the August 2015 and March 2019 VA examination reports show that the Veteran’s rhinitis has not caused polyps. Accordingly, a rating in excess of 10 percent is not warranted for the Veteran’s rhinitis. Also, the Board acknowledges that the Veteran experiences symptoms of sinusitis and alleges that his rhinitis should be rated under the General Rating Formula for Diseases of the Nose and Throat. The Board, however, notes that the Veteran is rated under separate Diagnostic Codes for his sinusitis. Therefore, an increased or separate rating is not warranted for the sinusitis in the context of his rating for rhinitis. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). 13. Entitlement to a non-initial rating in excess of 10 percent prior to March 25, 2019 and in excess of 20 percent thereafter for a low back strain. The Veteran asserts that his lumbar strain is more severe than currently evaluated. Disabilities of the spine are currently rated under the General Rating Formula for Diseases and Injuries of the Spine (for Diagnostic Codes 5235 to 5243, unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes). Ratings under the General Rating Formula for Diseases and Injuries of the Spine are made with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease. The General Rating Formula for Diseases and Injuries of the Spine provides a 10 percent disability rating for forward flexion of the thoracolumbar spine greater than 60 degrees but no greater than 85 degrees; or 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 spine contour, or vertebral body fracture with loss of 50 percent or more of the height. A 20 percent disability rating for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent disability rating for forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent disability rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. Finally, a 100 percent disability rating is assigned for unfavorable ankylosis of entire spine. 38 C.F.R. § 4.71a. Note (2) provides that, for VA compensation purposes, normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The normal combined range of motion of the thoracolumbar spine is 240 degrees. See also Plate V, 38 C.F.R. § 4.71a. When rating degenerative arthritis of the spine (Diagnostic Code 5242), in addition to consideration of rating under the General Rating Formula for Diseases and Injuries of the Spine, rating for degenerative arthritis under Diagnostic Code 5003 should also be considered. 38 C.F.R. § 4.71a. Diagnostic Code 5243 provides that IVDS is to be rated either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher rating when all disabilities are combined under 38 C.F.R. § 4.25. The Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes provides a 10 percent disability rating for IVDS with incapacitating episodes having a total duration of at least one week but less than two weeks during the past 12 months. A 20 percent disability rating for IVDS with incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months. A 40 percent disability rating for IVDS with incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months; and a 60 percent disability rating for IVDS with incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. 38 C.F.R. § 4.71a. Note (1) to Diagnostic Code 5243 provides that, for purposes of ratings under Diagnostic Code 5243, an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. Note (2) provides that, if intervertebral disc syndrome is present in more than one spinal segment, provided that the effects in each spinal segment are clearly distinct, each segment is to be rated on the basis of incapacitating episodes or under the General Rating Formula for Diseases and Injuries of the Spine, whichever method results in a higher evaluation for that segment. 38 C.F.R. § 4.71a. More generally, disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. Functional loss may be due to the absence or deformity of structures or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior in undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. § 4.40. With respect to joints, in particular, the factors of disability reside in reductions of normal excursion of movements in different planes. Inquiry will be directed to more or less than normal movement, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity or atrophy of disuse. 38 C.F.R. § 4.45. In addition, the intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. This regulation also provides that the intent of the Rating Schedule is to recognize painful motion with joint or periarticular pathology as productive of disability, and that crepitation should be noted carefully as points of contact which are diseased. Thus, when assessing the severity of a musculoskeletal disability that, as here, is at least partly rated on the basis of limitation of motion, VA must also consider the extent that the veteran may have additional functional impairment above and beyond the limitation of motion objectively demonstrated, such as during times when his symptoms are most prevalent (“flare-ups”) due to the extent of his pain (and painful motion), weakness, premature or excess fatigability, and incoordination-assuming these factors are not already contemplated by the governing rating criteria. DeLuca v. Brown, 8 Vet. App. 202, 204-07 (1995). A finding of functional loss due to pain must be supported by adequate pathology and evidenced by the visible behavior of the claimant. 38 C.F.R. § 4.40; Johnston v. Brown, 10 Vet. App. 80, 85 (1997). And although VA is required to apply 38 C.F.R. §§ 4.40 and 4.45, pertaining to functional impairment for disabilities evaluated on the basis of limitation of motion, where the Veteran is in receipt of the maximum schedular evaluation based on limitation of motion and a higher rating requires ankylosis, these regulations are not for application. Johnston, 10 Vet. App. at 84-85. Moreover, pain itself does not constitute functional loss. Mitchell v. Shinseki, 25 Vet. App. 32 (2011). Rather, pain must affect some aspect of “the normal working movements of the body” such as “excursion, strength, speed, coordination, and endurance,” in order to constitute functional loss. Id.; see 38 C.F.R. § 4.40. On the August 2015 VA back examination, the examiner confirmed the Veteran’s diagnosis of a lumbar strain. On examination, the examiner observed the Veteran’s range of motion to be forward flexion to 90 degrees; extension to 30 degrees; right lateral flexion to 30 degrees; left lateral flexion to 30 degrees; right lateral rotation to 30 degrees; and left lateral rotation to 30 degrees. The examiner indicated there was no pain on weightbearing. The examiner did find objective evidence of localized tenderness or pain on palpation of the joints or associated soft tissue that is very mild over the lumbar spine. The examiner indicated there is no ankylosis of the spine, no neurologic abnormalities, and no intervertebral disc syndrome (IVDS). On the August 2015 VA medical opinion, the examiner stated the Veteran’s back is essentially asymptomatic. In an April 2016 statement, the Veteran stated that he experiences pain in his back, pain with certain leg movements, a limp or an adjustment to walk to reduce pain, and pain when twisting in the torso. In a December 2016 VA treatment record, the Veteran stated his back pain is more bothersome after prolonged standing or sitting. In a December 2017 VA treatment record, the Veteran reported that he continues to be bothered with intermittent low back pain. On a March 25, 2019 VA back examination, the Veteran stated he experiences pain with activities that involve bending, twisting, or lifting heavy items, muscle tension, muscle spasms, radiating pain to the bilateral lower extremities that is sharp, stabbing, and shooting. The Veteran stated he has flare ups if he sits for prolonged periods of time. The Veteran also reported function loss or impairment in that he is unable to play with his children and go on hikes. He also stated he requires help to put on his boots. The Veteran reported that during flareups the loss of range of motion is variable, depending on how strenuously the joint was used. He stated that at the flareups worst, he cannot move at all due to pain, fatigue, and weakness, but there are other times where the range of motion loss is minimal. The March 2019 examiner observed the Veteran’s range of motion to be forward flexion to 65 degrees; extension to 18 degrees; right lateral flexion to 18 degrees; left lateral flexion to 18 degrees; right lateral rotation to 15 degrees; and left lateral rotation to 15 degrees. The examiner noted pain on examination, but the pain does not result in or cause functional loss. The examiner observed pain on forward flexion, extension, right lateral flexion, left lateral flexion, right lateral rotation, and left lateral rotation. The examiner observed localized tenderness or pain in the Veteran’s lower back that is moderate. The examiner indicated there is no pain on weight bearing. After repetitive use testing, the examiner observed range of motion to be forward flexion to 60 degrees; extension to 14 degrees; right lateral flexion to 14 degrees; left lateral flexion to 14 degrees; right lateral rotation to 12 degrees; and left lateral rotation to 12 degrees. The examiner noted that pain, fatigue, and weakness cause the Veteran’s functional loss. The examiner indicated that the Veteran’s examination was not conducted during a flare-up, but found that pain, weakness, fatigability, or incoordination significantly limits function ability with flare-up. The examiner is unable to describe the Veteran’s flare-ups in range of motion but did note the Veteran’s statements about limitations during a flare-up. The examiner indicated the Veteran has guarding or muscle spasms of the lumbar spine not resulting in abnormal gait or abnormal spinal contour. The examiner described the spasms as cramping and tightening of the muscle fibers. The examiner did not find the Veteran to experience guarding. The examiner found that other factors contributing to the Veteran’s back disorder are disturbance of locomotion, interference with sitting, interference with standing, and pain that limits prolonged walking, standing, and sitting. The examiner indicated the Veteran does not have ankylosis or any other neurologic abnormalities. The March 2019 VA examiner noted the Veteran has a diagnosis of IVDS but does not experience acute signs and symptoms that required bed rest prescribed by a physician in the past 12 months. The March 2019 VA examiner also observed the Veteran to experience moderate radiculopathy of the bilateral lower extremity involving the femoral nerve and the sciatic nerve. The examiner opined that the Veteran’s bilateral lower extremity radiculopathy and IVDS are progressions of the low back strain with history of a herniated and bulging disc. Upon review of the record, prior to March 25, 2019, the Board finds that a disability rating in excess of 10 percent for the Veteran’s lumbar strain is not warranted. To obtain a higher rating, it is necessary to show forward flexion of the lumbar spine greater than 30 degrees but not greater than 60 degrees; or, a combined range of motion of the lumbar spine not greater than 120 degrees; or, muscles spasms or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. Here, however, prior to March 25, 2019, the Veteran has not been found to have limitation of motion greater than 30 degrees but less than 60 degrees, a combined range of motion not greater than 120 degrees, or muscle spasms or guarding resulting in abnormal gait or spinal contour. Also, prior to March 25, 2019, the Veteran did not have a diagnosis of IVDS to warrant consideration of Diagnostic Code 5243. Thus, the Board finds that a higher rating is not warranted for the Veteran’s lumbar strain prior to March 25, 2019. After March 25, 2019, the Board finds that a disability rating in excess of 20 percent for the Veteran’s lumbar strain is not warranted. To obtain a higher rating, it is necessary to show forward flexion of 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. Here, the Veteran has not been found to have limitation of 30 degrees of less or favorable ankylosis of the entire thoracolumbar spine. Further, there is evidence that the Veteran was diagnosed with IVDS, however, the examiner specifically found that the Veteran did not experience incapacitating episodes of at least four weeks but less than six weeks during the past 12 months. Thus, the Board finds that a higher rating is not warranted for the Veteran’s lumbar strain after March 25, 2019. Also, the Veteran experiences radiating or radicular pain of the bilateral lower extremities. The ratings under the General Rating Formula for Disease and Injuries of the Spine are made with or without symptoms of such pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease. The Board, however, notes that the Veteran is rated under separate Diagnostic Codes for his bilateral lower extremity radicular pain. Therefore, an additional increased or separate rating is not warranted for the radicular pain. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). The Board has considered the applicability of the benefit-of-the-doubt doctrine. However, because the preponderance of the evidence is against the Veteran’s claim, that doctrine is not helpful to the Veteran. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Thompson, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.