Citation Nr: 20052981 Decision Date: 08/10/20 Archive Date: 08/10/20 DOCKET NO. 14-32 339 DATE: August 10, 2020 ORDER Entitlement to service connection for a cervical spine disability is denied. Entitlement to service connection for left upper extremity radiculopathy is denied. Entitlement to a rating in excess of 40 percent for degenerative disc disease (DDD) of the lumbar spine, s/p lumbar laminectomy and partial fasciotomy effective May 1, 2019 is denied. Entitlement to a rating in excess of 10 percent for left sciatic neuritis, effective December 3, 2009 through July 6, 2011 is denied. Entitlement to a 60 percent rating for left sciatic neuritis, effective September 19, 2019 is granted. Entitlement to a rating in excess of 10 percent for right sciatic neuritis, effective December 3, 2008 through December 2, 2008 is denied. Entitlement to a rating in excess of 20 percent for right sciatic neuritis, effective December 3, 2009 through September 18, 2019 is denied. Entitlement to a rating in excess of 40 percent for right sciatic neuritis, effective September 19, 2019 is denied. Entitlement to a rating of 30 percent for left femoral neuritis, effective September 19, 2019 is granted. Entitlement to a 30 percent for right femoral neuritis, effective September 19, 2019 is granted. FINDINGS OF FACT 1. The Veteran’s cervical spine arthritis was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; the disability is not otherwise etiologically related to an in-service injury or disease; it is not secondary to service-connected DDD of the lumbar spine; and it is not otherwise related to an in-service injury or disease. 2. The Veteran’s left upper extremity radiculopathy is not secondary to service connected DDD of the lumbar spine and is not otherwise related to an in-service injury or disease. 3. The Veteran’s DDD of the lumbar spine is manifested by complaints of severe pain, muscle spasm, and weakness, forward flexion to at least 10 degrees, and flare-ups without unfavorable ankylosis. 4. From December 3, 2009 through July 6, 2011, the Veteran’s left sciatic neuritis was manifested by no more than mild incomplete paralysis. 5. Since September 19, 2019, the Veteran’s left sciatic neuritis has been manifested by severe incomplete paralysis. 6. From December 3, 2008 through December 2, 2009, the Veteran’s right sciatic neuritis was manifested by no more than mild incomplete paralysis. 7. From December 3, 2009 through September 18, 2019, the Veteran’s right sciatic neuritis was manifested by no more than moderate incomplete paralysis. 8. Since September 19, 2019, the Veteran’s right sciatic neuritis has been manifested by no more than moderately severe incomplete paralysis. 9. Since September 19, 2019, the Veteran’s left femoral neuritis has been manifested by severe incomplete paralysis. 10. Since September 19, 2019, the Veteran’s right femoral neuritis has been manifested by severe incomplete paralysis. CONCLUSIONS OF LAW 1. The criteria for service connection for DDD of the cervical spine are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for left upper extremity radiculopathy are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. 3. The criteria for a rating in excess of 40 percent for DDD of the lumbar spine have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5242. 4. From December 3, 2009 through July 6, 2011, the criteria for a disability rating in excess of 10 percent for left sciatic neuritis have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8620. 5. Since September 19, 2019, the criteria for a 60 percent disability rating for left sciatic neuritis have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.124a, Diagnostic Code 8620. 6. From December 3, 2008 through December 2, 2009, the criteria for a disability rating in excess of 10 percent for right sciatic neuritis were not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8620. 7. From December 3, 2009 through September 18, 2019, the criteria for a disability rating in excess of 20 percent for right sciatic neuritis were not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8620. 8. Since September 19, 2019, the criteria for a 60 percent disability for right sciatic neuritis were not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8620. 9. Since September 19, 2019, the criteria for a 30 percent disability rating for left femoral neuritis have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8626. 10. Since September 19, 2019, the criteria for a 30 percent disability rating for right femoral neuritis have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.124a, Diagnostic Code 8620. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1984 to September 1992. The Service Connection Claims The Veteran seeks service connection for cervical spine arthritis and radiculopathy affecting his left upper extremity. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Certain chronic diseases, such as arthritis and radiculopathy, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). 1. The Cervical Spine The Veteran contends that he injured his neck in service in an accident in which he was loading a helicopter. He states that he has had neck pain since that time, and therefore, he maintains that service connection is warranted. However, after reviewing the record in light of the applicable law and regulations, the Board finds the preponderance of the evidence against that claim. The Veteran’s June 1984 service entrance examination shows that his neck was normal prior to his entry in service. In April 1990, the Veteran was treated for a possible bruised tibia or muscle strain after hitting the side of his head while sling loading a truck. He was found to be doing well but was concerned about discomfort and tightness. However, there were no complaints or clinical findings of any abnormalities of his cervical spine. In November 1990, the Veteran reported a half day history of neck pain, and the diagnosis was neck muscle strain. However, he served the remaining two years of service without any complaints or clinical findings of a neck disorder, and during his July 1992 service separation examination, his neck was, again, found to be normal. The Veteran did not complain of neck pain again until August 1996, during treatment at the Baton Rouge Clinic. Although he reported neck pain radiating to his right triceps, x-rays of the cervical spine were negative, and the diagnosis was musculoskeletal pain. A chronic, identifiable neck disability was not demonstrated until VA treatment in July 2007, when cervical spine x-rays showed degenerative joint disease (arthritis, hereinafter DJD). Not only was it mild in degree, the examiner found that it was related to the aging process. While the Veteran now reports a history of neck pain since service, it is reasonable to expect that he would have reported his cervical spine symptoms to his health care provider more than once during the 17 years between the time of the injury in service and the diagnosis of arthritis. Such evidence years apart does not demonstrate the continuity of symptomatology necessary for a grant of service connection for chronic disease. Moreover, the preponderance of the competent, credible evidence of record is against a finding of a nexus between the arthritis and the neck strain in service. In August 2014, the G.W.B., MD, noted that he had been treating the Veteran since March 2006. Dr. B. opined that the Veteran had sustained a significant injury in 1990, and his symptoms gradually increased through the years and he had developed posttraumatic degenerative changes. However, in reviewing Dr. B.’s records, including the report of the Veteran’s initial visit, the Board notes that there were no symptoms or clinical findings of a neck disorder until October 2010, when the Veteran reported new neck pain with some left radiculopathy. Again, it is reasonable to expect that had he been experiencing neck pain, he would have reported it to his treating physician at some time during the first four years of their relationship. In addition, the Board notes that Dr. B.’s opinion is based on a history reported by the Veteran rather than a review of the Veteran’s records. A bare transcription of a lay history is not transformed into competent medical evidence merely because the transcriber happens to be a medical professional. LeShore v. Brown, 8 Vet. App. 406, 409 (1995). Nevertheless, in September 2019, the Veteran was examined by VA to determine the nature and etiology of his cervical spine arthritis. Citing the foregoing evidence and lack of continuing symptomatology, the VA examiner opined that it was less likely than not that the Veteran’s cervical spine arthritis was due to the claimed inservice injury, event, or disease. Unlike Dr. B., the VA examiner reviewed the Veteran’s claims file, including the Veteran’s medical records and his appellate brief supporting his contentions. Therefore, the Board places greater probative value on the VA examiner’s opinion than that of Dr. B. Absent chronic, identifiable neck pathology in service, continuing of symptomatology after service, or the requisite nexus between the inservice injury and the current cervical spine arthritis, the Veteran does not meet the criteria for direct or presumptive service connection. Accordingly, service connection is not warranted on either of those bases. In the alternative, the Veteran contends that his cervical spine arthritis is secondary to his service connected DDD of the lumbar spine. Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. The question for the Board is whether the Veteran’s cervical spine arthritis is proximately due to or the result of or is aggravated beyond its natural progress by service-connected disability. The Board concludes that, while the Veteran has a current disability, cervical spine arthritis, the preponderance of the evidence is against finding that it is proximately due to or the result of or aggravated beyond its natural progression by service-connected disability. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). Following his September 2019 VA examination and review of the Veteran’s service medical records, the examiner opined that it was not medically possible that the Veteran’s cervical spine disability of status post cervical fusion with residuals, spinal stenosis, DJD and DDD and cervical IVDS are proximately due to the Veteran’s lumbar spine disability. The examiner noted that they are two entirely different anatomical sites affecting their own independent nerves and dermatomes. Therefore, she concluded that it was less likely than not that the Veteran’s current claimed condition of cervical spine disability of status post cervical fusion with residuals, spinal stenosis, DJD and DDD and cervical IVDS have been aggravated beyond their natural progression by the Veteran’s service connected lumbar spine condition. That opinion comports with the finding of the July 2007 VA examiner who found the Veteran’s cervical spine arthritis was age-related. While the Veteran believes his cervical spine arthritis is proximately due to or has been aggravated beyond its natural progression by his service-connected DDD of the lumbar spine, he is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of orthopedics and the interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of in this case because the record does not show that he has the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Accordingly, the Board gives more probative weight to the opinion of the VA examiner. Absent competent credible evidence of a nexus to a service-connected disability, the Veteran does not meet the criteria for secondary service connection. Accordingly, the claim of entitlement to service connection for cervical spine is denied. There is no doubt to resolve. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. The Left Arm The Veteran does not contend, and the evidence does not show that his left arm radiculopathy is due to any injury, event, or illness in service. Rather, he maintains that it is secondary to his service connected DDD of the lumbar spine. Because the Veteran has not raised, and the record does not reasonably raise, entitlement to direct service connection, the Board’s adjudication will consider only entitlement to secondary service connection. As noted above, the Veteran does not have service connection for a cervical spine disability. Consequently, a claim of service connection for left upper extremity radiculopathy on a secondary basis is moot. Therefore, the appeal must be denied. There is no doubt to resolve. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The Increased Rating Claims The Veteran seeks increased ratings for multiple disabilities. Disability evaluations are determined by comparing the manifestations of a particular disability with the criteria set forth in the Diagnostic Codes of the VA Schedule for Rating Disabilities. 38 U.S.C. § 1155, 38 C.F.R. Part 4. The percentage ratings represent, as far as can practicably be determined, the average impairment in earning capacity (in civilian occupations) resulting from service-connected disability. 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation 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. During the course of an appeal, a veteran may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505 (2007). Similarly, when service connection is granted and an initial rating award is at issue, separate ratings can be assigned for separate periods from the time service connection became effective. Fenderson v. West, 12 Vet. App. 119 (1999). Therefore, the following analysis is undertaken with consideration of the possibility that different ratings may be warranted for different time periods. Lay persons, such as the Veteran, are competent to report his experiences and symptoms which are capable of lay observation. For example, he is competent to report that he first experienced back pain radiating down his lower extremities. Layno v. Brown, 6 Vet. App. 465 (1994). However, there is no evidence to suggest that he is competent by training or experience to diagnose the pathology causing that difficulty. The question of an etiologic relationship between his current symptoms and any incident during his service involves a medical issue. Thus, the question of etiology of his symptoms may not be competently addressed by lay evidence. Davidson v. Shinseki, 581 F.3d 1313 (2009). 3. DDD, Lumbar Spine The Veteran contends that he is entitled to a higher rating for DDD of the lumbar spine because his back is manifested by constant, severe radiating back pain, muscle spasms and guarding, severe flare-ups, and functional impairment to the extent that he had to retire from his employment with the police department. Therefore, he maintains that a rating in excess of 40 percent is warranted. However, after reviewing the record in light of the applicable law and regulations, the Board finds the preponderance of the evidence against that claim. The Veterans degenerative disc disease of the lumbar spine is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5242. Under the General Rating Formula for Diseases and Injuries of the Spine, a 40 percent rating is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1. In this case, the Veteran has separate ratings for radiculopathy of the sciatic and femoral nerves which are considered below. He also has a separate rating for urinary dysfunction which is not at issue in the current appeal and will not be considered below. Unfavorable ankylosis is defined as a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Id. at Note 5. Additionally, fixation of a spinal segment in neutral position (zero degrees) is always considered favorable ankylosis. Id. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also, Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ([I]t is clear that the guidance of 4.40 is intended to be used in understanding the nature of the veterans disability, after which a rating is determined based on the 4.71a criteria.). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). The Board acknowledges the Veteran’s reports of symptoms and that there was functional loss due to low back pain and weakened movement, particularly during flare-ups. The Board also acknowledges the functional impact on his employment and his reports and co-workers statements that his back disability caused him to retire from the police department. In addition, the Board acknowledges his inability to participate in physical activities he used to enjoy. However, even considering the lay reports of symptoms and noted functional loss, the degree of additional limitation would not result in symptoms more nearly approximating unfavorable ankylosis of the entire thoracolumbar spine. VA has considered multiple treatment records, including those from VA and private non-government practitioners, such as G.W.B., M.D. and the reports of VA examinations performed in May and July 2010, December 2014, and in April and September 2019. Private treatment records show several therapeutic regimens including medication, epidural steroid injections, rhizotomy, an implanted neurostimulator, and laminectomy at L4-L5. However, they are negative for findings of unfavorable ankylosis of the entire thoracolumbar spine. Moreover, the multiple VA examiners concur that the Veteran does not have ankylosis and that he is able to flex his spine to at least 10 degrees (VA examination of the thoracolumbar spine, September 19, 2019). Even if the Veteran’s spine was fixed in the neutral position, the foregoing law and regulations show that it would always be considered favorable ankylosis (which comports with the criteria for a 40 percent rating). The Board acknowledges the lay assertions that the Veteran’s symptoms during a flare-up are more severe due, primarily to pain, weakness, and spasms. However, even when considering the functional limitation during a flare-up, the Veteran’s symptoms do not more nearly approximate the entire spine fixed in flexion or extension and one of the additional symptoms set forth in Note 5, such as difficulty walking because of a limited line of vision. Consideration has been given to assigning a rating under the Formula for Rating Intervertebral Disc Syndrome (IVDS) based on Incapacitating Episodes. However, the Veteran does not have IVDS and the evidence of record is against a finding that the Veteran was ever prescribed bed rest by a physician for a duration that meets the criteria for a higher rating. See 38 C.F.R. § 4.71a, Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes. While the Veteran is competent to report symptomatology that he experiences, he has not shown that he has the medical experience or training to relate that symptomatology to his DDD of the lumbar spine. That is a medically complex determination that cannot be based on lay observation alone. Jandreau. Accordingly, the Board assigns greater probative weight to the reports from the medical examiners and health care practitioners. For the foregoing reasons, the preponderance of the evidence is against the Veterans claim for a rating in excess of 40 percent for DDD of the lumbar spine. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. § 4.3, 4.7. 4. Entitlement to a rating in excess of 10 percent for left sciatic neuritis, effective December 3, 2009 through July 6, 2011 The Veteran contends that he is entitled to a higher rating effective December 3, 2009, because his left sciatic neuritis was manifested primarily by constant, moderate shooting pain down his left lower extremity which limited his ability to walk and had a significant functional impact on his employment as a police officer. Therefore, he maintains that a rating higher than 10 percent was warranted. However, after reviewing the record in light of the applicable law and regulations, the Board finds the preponderance of the evidence against that claim. Paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8520. (Neuritis and neuralgia of that group are evaluated under Diagnostic Codes 8620 and 8720.). In this case, the neurologic impairment of the Veteran’s sciatic nerves is rated as neuritis. Neuritis is characterized by loss of reflexes, muscle atrophy, sensory disturbances and constant pain, at times excruciating. 38 C.F.R. § 4.123. Mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R. § 4.124a. The words “mild,” “moderate,” and “severe” as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. The term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at “Diseases of the Peripheral Nerves.” The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). The maximum rating which may be assigned for neuritis not characterized by organic changes will be moderately severe incomplete paralysis for sciatic nerve involvement. See 38 C.F.R. § 4.123. In evaluating the rating effective December 3, 2009, the Board has considered reports of VA examinations in July 2007, December 2008, and May and July 2010; statements from G.W.B., M.D., dated in March 2008, and November 2009; treatment records from Dr. B. through June 2011; statements from J.M., M.D. reflecting the Veteran’s treatment from March 2009 to July 2010; and lay statements, dated in November 2009 from the Veteran’s wife and from his immediate supervisor at the police department where he worked. The Veteran’s wife reported that the Veteran back condition had almost crippled the Veteran and that he limped due to nerve pain in his legs. She stated that he had had to give up all his hobbies and that his radiculopathy had had a significant impact on his functional ability to do his job as a police officer. The Veteran’s immediate supervisor reported that the Veteran was in constant back pain and that he had difficulty walking and standing. The supervisor noted that his condition had harmed his advancement and that many days, he had to assign the Veteran to desk duty to keep him from exerting himself. Regarding impairment of motor functions, the VA examinations of the Veteran’s lumbar spine in December 2008 and May and July 2010 show that the Veteran complained of weakness. On examination, however, his strength was normal with normal muscle tone and no atrophy, and his gait was normal. Regarding trophic changes, there were none. Regarding sensation, Dr. B. reported diminished sensation the Veteran’s right lower extremity but did not do so for the left lower extremity. Indeed, during the December 2008 VA examination, the sensation was normal in the Veteran’s left lower extremity. During the VA examination in July 2010, the sensation was diminished in both lower extremities Regarding pain, the Veteran demonstrated pain on active and passive motion in all planes. Regarding muscle atrophy, there was none. Regarding complete paralysis, there was none. The Veteran’s left foot did not dangle and drop, and the muscles in the right lower extremity were reportedly normal. Based on the above, the Board finds that effective December 3, 2009 through July 6, 2011, the Veteran’s lumbar spine disability was primarily manifested by pain on motion and diminished sensation. The most probative evidence of record is against a finding that the disability was manifested by impairment of motor functions, trophic changes, sensory disturbance, loss of reflexes, muscle atrophy, or complete paralysis. The Board thus finds that the level of impairment was most analogous to mild incomplete paralysis of the left sciatic nerve. The Board acknowledges the lay assertions of a significant functional impact on his usual occupation as police officer and the effects on usual daily activities. However, the Board finds the medical of evidence of record to be more probative because it focuses on the level of impairment specifically attributable to the left sciatic nerve. The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for a rating in excess of 10 percent, effective December 3, 2008. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 5. Entitlement to a rating in excess of 40 percent for radiculopathy of the left sciatic nerve, effective July 7, 2011 The Veteran contends that he is entitled to a higher rating effective July 7, 2011, because his left sciatic neuritis was manifested primarily by weakness in his legs and an inability to lift the front of his left foot. He states that he has to drag it when walking and that he wears a left ankle fixation orthotic. He states that his left sciatic neuritis had a significant functional impact on his employment as a police officer; and therefore, he maintains that a rating higher than 40 percent was warranted effective July 7, 2011. After reviewing the record in light of the applicable law and regulations, the Board agrees to the extent indicated. Evidence on file includes lay statements from the Veteran, his wife, and his former employer; reports of VA examinations in December 2014 and April and September 2019; treatment records from G.W.B., M.D. dated through June 2015; and VA treatment records dated through June 2019. Regarding impairment of motor functions, the VA examinations of the Veteran’s lumbar spine and peripheral nerves in December 2014 and April and September 2019 show that the Veteran complained of weakness. On examination in December 2014 and April 2019, his were reduced to active movement against some resistance (4/5) for right knee extension and right ankle plantar flexion and dorsiflexion. His left knee extension was reduced to active movement against gravity (3/5), and his left ankle dorsiflexion and plantar flexion reduced such that active movement was possible with gravity eliminated (2/5). He demonstrated a slow and unsteady gait with weakness of both lower extremities and use of an ankle fixation orthotic on his left ankle. Following the examination, the examiner opined that the Veteran had moderate incomplete paralysis of both sciatic nerves, mild incomplete paralysis of the right femoral nerve, and moderate incomplete paralysis of the left femoral nerve. During the September 2019 VA examinations, the examiner found that the strength in the Veteran lower extremities was reduced to active movement against some resistance (4/5) in the hips; right ankle dorsiflexion, bilateral knee extension, bilateral ankle plantar flexion, and bilateral great toe extension were reduced to active movement against gravity (3/5). However, his left ankle dorsiflexion demonstrated no more than palpable or visible muscle contraction and no joint movement (1/5). Sensation was normal in his thighs and knees, bilaterally but decreased from the lower leg to the toes, bilaterally. There were also trophic changes manifested by decreased hair growth on the lower extremities. Regarding sensory disturbance, the Veteran’s sensation was decreased in both lower extremities, bilaterally. His deep tendon reflexes were absent in both knees; normal at the right ankle; and hypoactive in the left ankle. During his September 2019 VA examinations, the sensation was normal in his thighs and knees, bilaterally but decreased from the lower leg to the toes, bilaterally. In addition, the Veteran’s deep tendon reflexes were hypoactive in both knees and absent in both ankles. Regarding pain, the Veteran complained of severe, constant pain in both lower extremities, severe numbness in both lower extremities, severe paresthesias and/or dysesthesias in his right lower extremity, and moderate paresthesias and/or dysesthesias in his left lower extremity. Regarding muscle atrophy, the Veteran reported a loss of muscle mass, and September 2019 examiner described the Veteran’s legs as thin. In addition, there was muscle atrophy with the Veteran’s lower left extremity measuring 2 cm less in circumference than his right. Regarding complete paralysis, there was none. Although the Veteran wore a left ankle fixation orthotic, he retained active movement in his left lower extremity. His left foot did not dangle and drop, and active movement was possible in most muscles below the knee. Following the September 2019 VA examinations, the examiner opined that the Veteran had severe incomplete paralysis of both sciatic nerves, mild incomplete paralysis of the right femoral nerve, and moderate incomplete paralysis of the left femoral nerve. The examiner stated that the Veteran’s peripheral nerve impairment had a functional impact on his job as a police supervisor in that he could not stay in his vehicle for over 15 or 20 minutes and that he could not run or walk/stand for over 3 to 4 minutes. In light of the foregoing, the Board finds that effective September 19, 2019, the Veteran demonstrated organic changes associated with the impairment of his left sciatic nerve. 38 C.F.R. § 4.123. Given the deterioration in the strength in the Veteran’s left ankle with only palpable or visible muscle contraction but no joint movement, the need for a left ankle fixation orthotic, the suggestion of muscle atrophy in the left lower extremity, the decreased or absent deep tendon reflexes in his knees and ankles, the diminished sensation in his knees and ankles, and the trophic changes the Board finds that effective September 19, 2019, the Veteran met or more nearly approximated the criteria for a 60 percent rating for severe incomplete paralysis due to left sciatic neuritis. To that extent, the appeal is granted. In arriving at this decision, the Board has considered the possibility of a higher rating for complete paralysis. However, the preponderance of the evidence is against a finding of complete paralysis or a finding of left foot drop, and the Veteran does retain active movement of most muscles below the knee. Accordingly, he does not meet or more nearly approximate the criteria for an 80 percent rating for left sciatic neuritis. The Board acknowledges the lay assertions of significant functional impact on his usual occupation as police officer and the effects on usual daily activities. However, the Board finds the medical evidence of record to be more probative, because it focuses on the level of impairment specifically attributable to the left sciatic nerve. While the lay statements are competent to cite the Veteran’s symptoms, they are not competent to identify the etiology of those symptoms. The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. In conclusion, the Board finds that the competent, credible evidence of record supports the Veteran’s claim for a rating 60 percent rating for left sciatic neuritis, effective September 19, 2019. In so finding, the Board has resolved all reasonable doubt in favor of the Veteran. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 6. Entitlement to a rating in excess of 10 percent for right sciatic neuritis, effective December 3, 2008 through December 2, 2009 The Veteran contends that for the period from December 3, 2008 through December 2009, the 10 percent rating for his right sciatic neuritis did not adequately reflect the level of impairment caused by that disorder. He reports that he had moderate, constant, shooting, burning pain in lower back radiating to both lower extremities. He notes that he has had multiple epidural steroid injections to his back and that he is unable to walk more than a few yards. Therefore, he maintains that an increased rating is warranted. However, after reviewing the record in light of the applicable law and regulations, the Board finds the preponderance of the evidence against that claim. Relevant evidence include lay statements from the Veteran, reports of VA examinations in July 2007 and December 2008, records and statements from G.W.B., M.D. through November 2009, and a November 2009 lay statement from the Veteran’s immediate supervisor at the police department. Regarding impairment of motor functions, the VA examinations of the Veteran’s lumbar spine in December 2008 showed a history of weakness in his lower back that the Veteran complained of weakness. Although atrophy was reported, his lower extremity strength was normal with normal muscle tone; and his gait was normal. There were no trophic changes. Dr. B. reported diminished sensation in the Veteran’s right lower extremity, and that was confirmed during the Veteran’s December 2008 VA examination. His deep tendon reflexes in the lower extremities were normal during the VA examinations. Regarding pain, the Veteran reported constant, moderate burning pain radiating into both lower extremities. He had pain on active and passive motion in all planes. Regarding complete paralysis, there was none. His right foot did not dangle and drop, and the muscles in the right lower extremity were reportedly normal. Based on the above, the Board finds that from December 3, 2008 through December 2, 2009, the Veteran’s lumbar spine disability was primarily manifest by pain on motion and diminished sensation. The most probative evidence of record is against a finding that the disability is manifest by impairment of motor functions, trophic changes, loss of reflexes, muscle atrophy, or complete paralysis. The Board thus finds that the level of impairment is most analogous to mild incomplete paralysis of the left sciatic nerve. The Board acknowledges the lay assertions of a significant functional impact on his usual occupation as police officer and the effects on usual daily activities. However, the Board finds the medical of evidence of record to be more probative because it focuses on the level of impairment specifically attributable to the left sciatic nerve. While the lay statements are competent to cite the Veteran’s symptoms, they are not competent to identify the etiology of those symptoms. The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for a rating in excess of 10 percent, effective December 3, 2008 through December 2, 2009 for the Veteran’s right sciatic neuritis. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 7. Entitlement to a rating in excess of 20 percent for radiculopathy of the right sciatic nerve, effective December 3, 2009 through September 18, 2019 The Veteran contends that the 20 percent rating in effect from December 3, 2009 through September 18, 2019 did not adequately reflect the level of impairment caused by his right sciatic neuritis. He reported daily sharp, shooting low back pain with flare ups which preclude prolonged sitting or standing. He also reported multiple therapeutic regimens, including medication, a history of multiple epidural steroid injections, rhizotomies, implantation of a neurostimulator, and a laminectomy at L4-L5 in January 2019. Therefore, he maintains that a rating in excess of 20 percent was warranted. However, after reviewing the record in light of the applicable law and regulations, the Board finds that the preponderance of the evidence is against the claim. Relevant evidence includes lay statements from the Veteran, his wife, and his former employer; reports of VA examinations in May and July 2010, December 2013 and April 2019; private treatment records through September 2018, including records and statements from G.W.B., M.D. through June 2015; and VA treatment records through June 2019. Regarding impairment of motor functions, the VA examinations of the Veteran’s lumbar spine and peripheral nerves in May and July 2010, and April 2019 show that the Veteran complained of weakness. On examination, however, his strength was full (5/5) with normal muscle tone and no atrophy, and his gait was normal. In December 2014, the strength throughout his right lower extremity was reduced to motion against gravity (4/5), and he wore a left ankle fixation orthotic as a normal mode of locomotion. There were no trophic changes. Regarding sensory disturbance, Dr. B. reported diminished sensation the Veteran’s right lower extremity, and during the VA examinations in July 2010 and December 2014, the sensation was diminished in both lower extremities. Regarding pain, the Veteran consistently reported pain down both lower extremities. For example, during his May 2010 VA examination, the Veteran reported constant, moderate, shooting, burning pain radiating down both lower extremities. However, there was no objective evidence of pain on active motion or following repetitive motion. During his December 2014 VA examinations, the Veteran reported constant, severe right lower extremity pain which occurred daily and was exacerbated many times a day when he moved the wrong way. He demonstrated pain at rest and on weight-bearing. Regarding muscle atrophy, his VA examinations in May and July 2010, December 2014, and April 2019 showed that there was no atrophy and that his muscle tone was normal. Regarding complete paralysis, there was none. The VA examinations from May 2010 through April 2019 are negative for a diagnosis of right foot drop. Although VA issued a right ankle fixation orthotic in April 2019, his multiple VA examinations from May 2010 through April 2019, revealed that he had active movement of the muscles below the right knee. Following the December 2014 VA examination, the examiner stated that based on the available medical evidence, there was no increase in the level of severity. While the reported symptoms seemed severe, she noted that the objective radiological findings showed the opposite, i.e., the most recent (May 2010) lumbar study was found to be consistent with the “mild” level of severity DDD and mild disc narrowing. Based on the above, the Board finds that effective December 3, 2009 through September 18, 2019, the Veteran’s lumbar spine disability was primarily manifested by pain on motion and diminished sensation. The most probative evidence of record is against a finding that the disability is manifested by impairment of motor functions, trophic changes, loss of reflexes, muscle atrophy, or complete paralysis. The Board thus finds that the level of impairment is most analogous to no more than moderate incomplete paralysis of the left sciatic nerve. The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for a rating in excess of 20 percent, effective December 3, 2009 through September 18, 2019. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 8. Entitlement to a rating in excess of 40 percent for radiculopathy of the left sciatic nerve, effective September 19, 2019 The Veteran contends that the 40 percent rating effective September 19, 2019 did not adequately reflect the level of impairment caused by his right sciatic neuritis. He reported daily sharp, shooting low back pain with flare ups which precluded prolonged sitting or standing. He also reported his history of multiple therapeutic regimens. Therefore, he maintains that a rating in excess of 40 percent was warranted. However, after reviewing the record in light of the applicable law and regulations, the Board finds that the preponderance of the evidence is against the claim. Relevant evidence on file includes the Veteran’s lay statements and the reports of his VA examinations of his spine and peripheral nerves on September 19, 2019. Regarding impairment of motor functions, the VA examinations of the Veteran’s lumbar spine and peripheral nerves in September 2019 show that he complained of bilateral lower extremity weakness. During the lumbar spine examination, the Veteran had a slow and guarded gait, and it was noted that he wore bilateral fixation orthotics. He had bilateral ankle dorsiflexion weakness related to back pain, greater on the left than the right. His legs were thin and he reported a loss of lower extremity muscle mass. Although the examiner stated that she did not have a baseline measurement for comparison, his right quadriceps circumference was 48 cm (2 cm greater than his left). On examination, he demonstrated active movement against some resistance in both hips (4/5). The strength throughout his right lower extremity was reduced to motion against gravity (3/5). During the September 2019 VA examination of his peripheral nerves, the Veteran demonstrated trophic changes manifested by decreased hair growth on each lower extremity. Regarding sensory disturbance, the September 2019 VA examinations revealed diminished sensation throughout the Veteran’s right lower extremity. He also had decreased reflexes at his knees and absent reflexes at his ankle. Regarding pain, during his September 2019 VA examinations, the Veteran reported constant, severe, shooting, burning pain radiating down both lower extremities with severe paresthesias and/or dysesthesias and numbness. He reported that he was unable to walk more than 20 feet and that he was in danger of falling. Regarding complete paralysis, there was none. Although he wore a right ankle fixation orthotic, his right foot did not dangle and drop, and during his September 2019 VA examinations, he continued to demonstrate active movement of the muscles below the right knee. Based on the above, the Board finds that effective September 19, 2019, the Veteran’s right lower extremity radiculopathy was manifested, primarily, by pain, weakness, trophic changes manifested by decreased hair growth, diminished sensation, and diminished/absent reflexes at his knee and ankle respectively. The Board acknowledges that the examination of the Veteran’s lumbar spine revealed severe radiculopathy of the right sciatic nerve. However, an examination focused specifically on his peripheral nerves revealed no more than moderately severe incomplete paralysis. Given the narrower focus of that examination, the Board finds it to be of greater probative value. Moreover, although the Veteran’s lower extremities were reportedly thin, marked muscular atrophy of the right lower extremity has not been demonstrated. On balance, such findings do not meet or more nearly approximate the criteria for a rating in excess of 40 percent for right sciatic neuritis. The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran’s claim for a rating in excess of 40 percent for right sciatic neuritis, effective September 19, 2019. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 9. Entitlement to an initial rating in excess of 20 percent for radiculopathy of the left femoral nerve, effective December 31, 2014 The Veteran contends that the initial 20 percent rating for his radiculopathy of the left femoral nerve does not adequately reflect the level of impairment caused by that disorder. Not only does he report pain and weakness in the left lower extremity, he states that he has muscle atrophy in the left lower extremity compared to the right. In addition, he notes that he walks with a cane and left ankle fixation orthotic as a normal mode of locomotion. Therefore, he maintains that an initial rating in excess of 20 percent for her radiculopathy of the left lower extremity is warranted. However, after reviewing the record in light of the applicable law and regulations, the Board finds the preponderance of the evidence against that claim. Relevant evidence includes VA treatment records from February 2014 through June 2019; treatment records and reports from G.W.B., M.D., dated from April 2014 through June 2015; VA examination reports, dated in December 2014 and April and September 2019, and records dated in June 2015, concerning the Veteran’s municipal employment. Paralysis of the anterior crural nerve (femoral) is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8626. The anterior crural nerve is associated with quadriceps extensor muscles. Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling, severe incomplete paralysis is rated as 30 percent disabling. The words “mild,” “moderate,” and “severe” as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. The term “incomplete paralysis” indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at “Diseases of the Peripheral Nerves.” The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). Regarding impairment of motor functions, the December 2014 and September 2014 VA examinations of the Veteran’s lumbar spine and peripheral nerves show that he complained of weakness and that he wore an ankle fixation orthotic on his left foot. The strength on left knee extension was reduced to active movement against gravity (3/5). During the September 2019 examinations, his lower extremities were thin, and he reported a substantial loss of quadriceps mass. The examiner stated that the Veteran had muscle atrophy in his upper and lower extremities, bilateral. However, she noted that both sides were compromised and offered no basis for comparison to the normal side. His right quadriceps measured 48 cm in circumference, and his left quadriceps measured 46 cm in circumference. It was noted that he started to have a tremor when trying to exert strength in his lower extremities. During the December 2014 VA examinations, the Veteran’s sensation was decreased (1+) in both lower extremities, bilaterally. During the September 2019 examination of his back, his sensation was normal in his thighs and knees, bilaterally but decreased from the lower leg to the toes, bilaterally. The Veteran’s deep tendon reflexes were variously reported as non-existent to hypoactive in both knees and both ankles. During the September 2019 VA examinations, the Veteran’s deep tendon reflexes were hypoactive at the knees and non-existent at the ankles. During the December 2014 VA examinations, the Veteran demonstrated no trophic changes. During the September 2019 VA examination of his peripheral nerves, he demonstrated trophic changes manifested by decreased hair growth on each lower extremity. Regarding pain, during his September 2019 VA examinations, the Veteran reported constant, severe, shooting, burning pain radiating down both lower extremities with severe paresthesias and/or dysesthesias and numbness. He reported that he was unable to walk more than 20 feet and that he was in danger of falling. Regarding complete paralysis, the Board notes that there are no findings of complete paralysis of the quadriceps extensor muscles. Though reduced, he does maintain active movement against gravity in those muscles. Based on the above, the Board finds that after the examination of the peripheral nerves in 2014, the examiner (a specialist in neurology) opined that the left femoral nerve impairment was productive of moderate incomplete paralysis. Following the examination of the Veteran’s lumbar spine in December 2014, a different examiner stated that they were productive of severe radiculopathy of the left femoral nerve. She qualified that opinion, however, reporting that while the symptoms seemed severe, the objective radiological findings showed the opposite. She noted that the most recent lumbar study (May 2010) was found to be consistent with the “mild” level of severity. Therefore, based on the available medical evidence, the examiner concluded that there had been no change in the level of severity. Given that qualification and the opinion of the specialist in neurology, the Board finds that the preponderance of the evidence was against a finding of severe impairment. In September 2019, however, the Veteran’s left femoral neuritis was manifested by atrophy in addition to the organic changes of the left lower extremity noted above. Moreover, the Veteran had retired from the police department due the radiculopathy affecting his lower extremities. Finally, the Board notes that the same examiner conducted the VA examinations of the spine and peripheral nerves and rendered equivocal opinions. Following the spine examination, she opined that the Veteran had severe radiculopathy affecting the femoral nerves and following the peripheral nerve examination, she reported moderate incomplete paralysis of the left femoral nerve. When there is an approximate balance of evidence both for and against a claim, the Board will resolve all reasonable doubt in favor of the Veteran. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Accordingly, the Board finds that effective September 19, 2019, the Veteran met or more nearly approximated the criteria for a 30 percent rating for severe incomplete paralysis of the left femoral nerve. To that extent, the appeal is granted. In arriving at this decision, the Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. 10. Entitlement to an initial rating in excess of 10% for radiculopathy of the right femoral nerve, effective December 31, 2014 The Veteran contends that the initial 20 percent rating for his radiculopathy of the right femoral nerve does not adequately reflect the level of impairment caused by that disorder. Therefore, he maintains that an initial rating in excess of 10 percent for his right femoral neuritis is warranted. After reviewing the record in light of the applicable law and regulations, the Board agrees to the extent indicated. In evaluating this claim, the Board has considered VA treatment records from February 2014 through June 2019, treatment records and reports from G.W.B., M.D., dated from April 2014 through June 2015, VA examination reports, dated in December 2014 and April and September 2019, and records dated in June 2015, concerning the Veteran’s municipal employment. Regarding motor function, the VA examinations of the lumbar spine and peripheral nerves in December 2014 show that he complained of weakness. The strength in his right lower extremity from his hip to his great toe was reduced to active movement against some resistance (4/5). During the September 2019 VA examinations of the Veteran’s back and peripheral nerves, the strength in his lower extremities was reduced to active movement against some resistance (4/5) in the hips. However, it was reduced to active movement against gravity (3/5) on bilateral knee extension. His lower extremities were thin, and he reported a substantial loss of quadriceps mass. His right quadriceps measured 48 cm in circumference, and his left quadriceps measured 46 cm in circumference. It was noted that he started to have a tremor when trying to exert strength in his lower extremities. During the December 2014 and September 2019 VA examinations, the Veteran’s sensation was decreased in both lower extremities, bilaterally. The Veteran’s deep tendon reflexes were variously reported as non-existent to hypoactive in both knees and both ankles. During the December 2014 VA examinations, the Veteran demonstrated no trophic changes. During the September 2019 VA examination of his peripheral nerves, he demonstrated trophic changes manifested by decreased hair growth on each lower extremity. Regarding pain, during his September 2019 VA examinations, the Veteran reported constant, severe, shooting, burning pain radiating down both lower extremities with severe paresthesias and/or dysesthesias and numbness. He reported that he was unable to walk more than 20 feet and that he was in danger of falling. Regarding complete paralysis, the September 2019 VA examinations show that is right knee extension was reduced to active movement against gravity (3/5). He wore a right ankle fixation orthotic and used a cane as a normal mode of locomotion. Based on the above, the Board finds that after the examination of the peripheral nerves in 2014, the examiner (a specialist in neurology) opined that the right femoral nerve impairment was productive of mild incomplete paralysis. Following the examination of the Veteran’s lumbar spine in December 2014, a different examiner stated that they were productive of severe radiculopathy of the right femoral nerve. Inasmuch as the opinion after the peripheral nerve examination was rendered by a specialist in neurology, the Board places greater probative value on her opinion than that of the examiner who performed the lumbar spine examination. However, the examiner who examined the Veteran’s lumbar spine also qualified her opinion. She noted that while the symptoms seemed severe, the objective radiological findings showed the opposite. She noted that the most recent lumbar study (May 2010) was found to be consistent with the “mild” level of severity. Therefore, based on the available medical evidence, the examiner concluded that there had been no change in the level of severity. Given that qualification and the opinion of the specialist in neurology, the Board finds that the preponderance of the evidence was against a finding of severe impairment. Accordingly, the Board confirms the initial rating of 10 percent for mild incomplete paralysis of the femoral nerve. In September 2019, however, the Veteran’s left femoral neuritis was manifested by atrophy in addition to the organic changes of the left lower extremity noted above. The Board also notes that the Veteran had retired from the police department due the radiculopathy affecting his lower extremities. Moreover, the same examiner conducted the 2019 VA examinations of the spine and peripheral nerves had rendered equivocating opinions. Following the spine examination, she opined that the Veteran had severe radiculopathy affecting the femoral nerves and following the peripheral nerve examination, she reported moderate incomplete paralysis of the left femoral nerve. In light of the foregoing, the Board finds that as of September 19, 2019, there was an approximate balance of evidence both for and against the claim for an increased rating for right femoral neuritis. Accordingly, the Board concludes that effective September 19, 2019, the Veteran met or more nearly approximated the criteria for a 30 percent rating for severe incomplete paralysis of the right femoral nerve. To that extent, the appeal is granted. In arriving at this decision, the Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. J. SMITH Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Harold A. Beach, 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.