Citation Nr: 21001736 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 14-17 106 DATE: January 11, 2021 ORDER A rating in excess of 10 percent prior to August 8, 2017, and in excess of 20 percent thereafter, exclusive of the period where a temporary total rating has been assigned, for degenerative arthritis of the lumbar spine, intervertebral disc syndrome (IVDS), and spinal stenosis is denied. The assignment of a separate rating for left lower extremity (LLE) radiculopathy of the sciatic nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020, is proper; the appeal is denied. The assignment of a separate rating for LLE radiculopathy of the femoral nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020, is proper; the appeal is denied. The assignment of a separate rating for right lower extremity (RLE) radiculopathy of the sciatic nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020, is proper; the appeal is denied. The assignment of a separate rating for RLE radiculopathy of the femoral nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020, is proper; the appeal is denied. The assignment of a separate rating for mid-lumbar surgical scar, evaluated as noncompensable, effective September 6, 2017, is proper; the appeal is denied. FINDINGS OF FACT 1. For the appeal period prior to August 8, 2017, the Veteran’s degenerative arthritis of the lumbar spine, IVDS, and spinal stenosis did not result in forward flexion limited to 60 degrees or less or a combined range of motion of 120 degrees or less, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal contour, ankylosis, IVDS, or associated objective neurological abnormalities. 2. As of August 8, 2017, the Veteran’s degenerative arthritis of the lumbar spine, IVDS, and spinal stenosis did not result in forward flexion limited to 30 degrees or less, even in contemplation of functional loss due to symptoms such as pain fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups, without ankylosis, IVDS, or associated objective abnormalities, other than his separately service-connected bilateral lower extremity radiculopathy with sciatic and femoral nerve impairment. 3. For the appeal period from August 8, 2017, to July 27, 2020, the Veteran’s LLE and RLE radiculopathy resulted in no more than mild incomplete paralysis of the sciatic and femoral nerves. 4. As of July 27, 2020, the Veteran’s LLE and RLE radiculopathy resulted in no more than moderate incomplete paralysis of the sciatic and femoral nerves. 5. As of September 6, 2017, the Veteran’s mid-lumbar surgical scar measures 6 centimeters (cm) by 0.5 cm, has not been shown to be unstable or painful, and does not result in any disabling effects. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent prior to August 8, 2017, and in excess of 20 percent thereafter for degenerative arthritis of the lumbar spine, IVDS, and spinal stenosis. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code (DC) 5237-5242, 5243. 2. The assignment of a separate rating for LLE radiculopathy of the sciatic nerve, evaluated as 10 percent disabling as of August 8, 2017, and 20 percent disabling as of July 27, 2020, was proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.120, 4.124a, DC 8520. 3. The assignment of a separate rating for RLE radiculopathy of the sciatic nerve, evaluated as 10 percent disabling as of August 8, 2017, and 20 percent disabling as of July 27, 2020, was proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.120, 4.124a, DC 8520. 4. The assignment of a separate rating for LLE radiculopathy of the femoral nerve, evaluated as 10 percent disabling as of August 8, 2017, and 20 percent disabling as of July 27, 2020, was proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.120, 4.124a, DC 8526. 5. The assignment of a separate rating for RLE radiculopathy of the femoral nerve, evaluated as 10 percent disabling as of August 8, 2017, and 20 percent disabling as of July 27, 2020, was proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.120, 4.124a, DC 8526. 6. The assignment of a separate rating for mid-lumbar surgical scar, evaluated as noncompensable as of September 6, 2017, was proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.118, DC 7805. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1963 to October 1967. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In July 2015, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In August 2016 and July 2018, the Board remanded the case for additional development and it now returns for further appellate review. While on remand, in an August 2017 rating decision, the Agency of Original Jurisdiction (AOJ) assigned separate ratings for left and right lower extremity radiculopathy affecting the sciatic and femoral nerves, evaluated as 10 percent disabling, effective August 8, 2017. Additionally, in an August 2020 rating decision, the AOJ awarded increased ratings of 20 percent for the Veteran’s bilateral lower extremity radiculopathy affecting the sciatic and femoral nerves, effective July 27, 2020, and a separate noncompensable rating for mid-lumbar surgical scar, effective September 6, 2017. The Board notes that the Veteran did not appeal with respect to the propriety of the assigned ratings or effective dates for such disabilities; however, these issues are part and parcel of his claim for entitlement to an increased rating for his back disability as the rating criteria governing the evaluation of such disability specifically indicates that any associated objective neurologic abnormalities be separately evaluated under an appropriate DC, and he underwent surgery during the appeal period, which resulted in his mid-lumbar surgical scar. See 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine, Note (1). Therefore, such issues have been included in the decision and will be addressed herein. Increased Rating Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant’s favor. 38 C.F.R. § 4.3. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. Separate ratings can be assigned for separate periods based on the facts found - a practice known as “staged” ratings. Fenderson, supra; Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The appeal period before the Board stems from the Veteran’s March 13, 2013, claim for an increased rating for his back disability, plus the one-year look back period. Gaston v. Shinseki, 605 F.3d 979, 982 (Fed. Cir. 2010). 1. Entitlement to a rating in excess of 10 percent prior to August 8, 2017, and in excess of 20 percent thereafter, exclusive of the period where a temporary total rating has been assigned, for degenerative arthritis of the lumbar spine, IVDS, and spinal stenosis. The Veteran’s service-connected degenerative arthritis of the spine, IVDS, and spinal stenosis has been evaluated as 10 percent disabling as of March 13, 2013, the date of his claim for an increased rating, pursuant to DC 5237-5242, and 20 percent disabling as of August 8, 2017, pursuant to DC 5243. Additionally, a temporary total (100 percent) rating has been assigned during a period of convalescence from lumbar spine surgery for the period from September 6, 2017, to December 1, 2017. The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. 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. In Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011), the United States Court of Appeals for Veterans Claims (Court) held that, although pain may cause a functional loss, “pain itself does not rise to the level of functional loss as contemplated by VA regulations applicable to the musculoskeletal system.” Rather, pain may result in functional loss, but only if it limits the ability “to perform the normal working movements of the body with normal excursion, strength, speed, coordination, or endurance.” Id., quoting 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; DeLuca v. Brown, 8 Vet. App. 202 (1995). 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, even in the absence of arthritis. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). In this regard, 38 C.F.R. § 4.59 requires that “[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.” Correia v. McDonald, 28 Vet. App. 158 (2016). Further, 38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the DC under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). As noted previously, the Veteran’s back disability has been rated as 10 percent disabling prior to August 8, 2017, pursuant to DC 5237-5242, and 20 percent disabling thereafter (with the exception of the period he is in receipt of a temporary total rating for surgical convalescence), pursuant to DC 5243, which provides that lumbosacral strain, degenerative arthritis, and IVDS, respectively, are evaluated under either the General Rating Formula for Diseases and Injuries of the Spine (General Rating Formula) or the Formula for Rating IVDS Based on Incapacitating Episodes (IVDS Formula). Ratings under the General Rating Formula 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. Such provides for a 10 percent rating where forward flexion of the thoracolumbar spine is greater than 60 degrees but no greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted where forward flexion of the thoracolumbar spine is greater than 30 degrees but no greater than 60 degrees; the combined range of motion of the thoracolumbar spine is 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 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. Finally, a 100 percent rating is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a. Note (1): Any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, should be separately evaluated under an appropriate diagnostic code. Note (2): (See also Plate V.) For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees, and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. Note (3): In exceptional cases, an examiner may state that because of age, body habitus, neurologic disease, or other factors not the result of disease or injury of the spine, the range of motion of the spine in a particular individual should be considered normal for that individual, even though it does not conform to the normal range of motion stated in Note (2). Provided that the examiner supplies an explanation, the examiner’s assessment that the range of motion is normal for that individual will be accepted. Note (4): Round each range of motion measurement to the nearest five degrees. Note (5): For VA compensation purposes, unfavorable ankylosis is a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Note (6): Separately evaluate disability of the thoracolumbar and cervical spine segments, except when there is unfavorable ankylosis of both segments, which will be rated as a single disability. Id. As noted above, IVDS may be evaluated under either the General Rating Formula or under the IVDS Formula, whichever method results in the higher evaluation when all disabilities are combined. See 38 C.F.R. § 4.25 (combined ratings table). The IVDS Formula provides that a 10 percent evaluation is warranted when there are incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months. A 20 percent evaluation is warranted when there are incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months. A 40 percent evaluation is warranted when there are incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months. A 60 percent evaluation is warranted when there are incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. Note (1) provides that an incapacitating episode is a period of acute signs and symptoms due to IVDS that requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a. Initially, the Board finds that, while the Veteran has a diagnosis of IVDS and has reported that his back disability results in incapacitating episodes, the September 2013 and August 2017 VA examiners found that he did not have incapacitating episodes of IVDS as defined by VA regulations, i.e., required physician-prescribed bed rest. Furthermore, while the July 2020 VA examination reflects the Veteran’s report that he had symptoms due to IVDS that required bed rest prescribed by a physician that had a total duration of at least 6 weeks during the past 12 months, which he described as 3 to 5 days of bed rest most months, such is not borne out by his contemporaneous treatment records. Specifically, such are entirely negative for physician-prescribed bedrest. Thus, an increased rating for the Veteran’s back disability is not warranted under the IVDS Formula at any time pertinent to the appeal. In regard to the General Rating Formula, at a September 2013 VA examination, range of motion testing revealed normal forward flexion to 90 degrees or more, with objective evidence of painful motion beginning at 35 degrees, and a normal combined range of motion of 240 degrees. No additional loss of motion was noted with repetitive use testing; however, pain on movement and interference with sitting, standing and/or weight-bearing was noted to contribute to functional loss or impairment. Further, while the Veteran reported experiencing daily flare-ups of pain that lasted for one hour and limited his ability to lift items and walk distances, and the examiner noted that pain could significantly limit his functional ability during flare-ups or after repeated use over time, he was unable to provide limitation of range of motion in terms of degrees as he was unable to replicate a flare-up during the examination. Furthermore, while guarding and/or muscle spasm was present, such did not result in abnormal gait or spinal contour. Muscle strength testing, reflex examination, and sensory examination were all normal. No radiculopathy of the lower extremities or other neurologic abnormalities were noted on the examination. Private treatment records dated July 2015 indicate that the Veteran underwent 18 months of weekly to bi-weekly chiropractic and therapeutic treatment for his back. Additionally, VA treatment records reflect complaints of chronic low back pain and treatment, to include injections. Furthermore, an August 2015 VA treatment record reflects that the Veteran had limited range of motion on flexion and extension; however, such was not reported in terms of degrees. At the July 2015 Board hearing, the Veteran testified that his back disability and symptoms thereof are of greater severity than what was reported at the time of his previous examination in September 2013. Specifically, he reported that his functional loss is more significant than previously noted and he experienced lumbar radiculopathy. In light of the aforementioned treatment records and the Veteran’s testimony, the Board remanded the case in August 2016 in order to afford him a contemporaneous VA examination so as to determine the nature and severity of his back disability. Thus, at an August 8, 2017, VA examination, the Veteran reported loss of ability to bend and limited length of walking without pain. He also indicated that he experienced flare-ups that occur about two days a week, in which he is forced to sit in a recliner, take pain medications, and rest for a couple of hours until it passes. Upon active range of motion testing, the Veteran had forward flexion to 50 degrees, with pain at 10 degrees, and his combined range of motion was limited to 120 degrees. Pain was noted on examination with each range of motion and there was evidence of pain with weight-bearing. However, the Veteran had full range of motion without pain on passive range of motion and with nonweight-bearing. Pain to light palpitation over the entire lumbar spine was also noted. The examiner noted that the Veteran was able to perform repetitive use testing and there was no additional loss of function or range of motion after 3 repetitions. While the Veteran was not examined after repeated use over time or during a flare-up, the examiner noted that the examination was neither medically consistent or inconsistent with the Veteran’s statements describing functional loss. He was also unable to say without mere speculation as to whether pain, weakness, fatigability, or incoordination significantly limit functional ability with repeated use over time or during flare-ups. In this regard, the examiner noted that it is possible for any human joint to have limited function during a flare-up or following repetitive use over time due to pain, weakness, fatigability, or incoordination. Additionally, such occurs in joints with no history of illness or injury when subject to sufficient force, frequency and duration of movement, and extreme range of motion. The examiner also indicated that the requested opinion could be accurately provided only in the presence of a flare-up or severe aggravation due to recent overuse and, absent such testing, an assumption cannot be reasonably and consistently defended. There was no ankylosis. While the examiner noted that the Veteran’s back disability resulted in radiculopathy of the bilateral lower extremities, the severity of which will be discussed further below, he did not find any additional associated objective neurologic abnormalities, to include bladder or bowel impairment. The Veteran underwent back surgery in September 2017. Thereafter, private treatment records from April 2018 indicate that such surgery did not provide much relief, and he continues to have pain in his back and legs. Based on the Veteran’s reports of worsening symptoms, the Board remanded the claim in July 2018 to afford him another VA examination so as to determine the nature and severity of his back disability. At the July 2020 VA examination, the Veteran reported that he continues to have constant pain and his condition has progressed/worsened. He indicated that he experienced daily flare-ups, described as dull, intense pain that last a few hours. The Veteran also reported difficulty with walking, standing, sitting, climbing and lifting. Upon active range of motion testing, the Veteran had normal forward flexion to 90 degrees, with pain beginning at 10 degrees, and a normal combined range of motion to 240 degrees, with pain. However, such pain did not result in or cause functional loss. There was pain on nonweight-bearing and no pain on weight-bearing. Passive range of motion testing was not conducted as such was not medically appropriate due to risk of injury. The Veteran was able to perform repetitive use testing without loss of function or range of motion after three repetitions. He was not examined following repeated use over time or during a flare-up, but the examiner stated that the examination was medically consistent with the Veteran’s statements describing functional loss with repetitive use over time. Furthermore, he found that, while pain caused functional loss, the Veteran would not experience a loss in range of motion following repeated use over time or during flare-ups. There was no ankylosis. While the examiner noted that the Veteran’s back disability resulted in radiculopathy of the bilateral lower extremities, the severity of which will be discussed further below, he did not find any additional associated objective neurologic abnormalities, to include bladder or bowel impairment. Upon review of the foregoing, the Board finds that, prior to August 8, 2017, the Veteran’s back disability did not result in forward flexion limited to 60 degrees or less or a combined range of motion of 120 degrees or less, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal contour, or ankylosis. Thus, a rating in excess of 10 percent for such disability prior to August 8, 2017, under the General Rating Formula is not warranted. Specifically, as noted previously, the September 2013 VA examination reflects that, while guarding and/or muscle spasm was present, such did not result in abnormal gait or spinal contour and, thus, a rating in excess of 10 percent based on such symptomatology is not warranted. Furthermore, the Veteran had normal forward flexion to 90 degrees or more and a normal combined range of motion of 240 degrees at such examination. In this regard, while he had objective evidence of pain at 35 degrees of flexion, there is no indication that such pain resulted in additional functional loss limiting such range of motion to 60 degrees or less. 38 C.F.R. § 4.40; Mitchell, supra. Furthermore, there is no indication that such range of motion was further limited based on repetitive use testing, repeated use over time, or during flare-ups. In this regard, the Board notes that, while range of motion testing in the latter two capacities was not performed at the September 2013 VA examination, the Veteran described such as daily episodes of pain that lasted for one hour and limited his ability to lift items and walk distances, without a report that such limited his range of motion of his thoracolumbar spine. Furthermore, there is no evidence of ankylosis. Thus, the Board finds that, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as result of repetitive motion and/or flare-ups, the Veteran’s range of motion of the thoracolumbar spine is not limited to the degree necessary to warrant an increased rating. The Board further finds that, as of August 8, 2017, the Veteran’s back disability did not result in forward flexion limited to 30 degrees or less, even in contemplation of functional loss due to symptoms such as pain fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups, or ankylosis. Thus, a rating in excess of 20 percent for such disability as of August 8, 2017, under the General Rating Formula is not warranted. Specifically, as noted previously, the Veteran had forward flexion to 50 degrees at the August 2017 VA examination and normal forward flexion to 90 degrees at the July 2020 VA examination. In this regard, while he had objective evidence of pain at 10 degrees of flexion, there is no indication that such pain resulted in additional functional loss limiting such range of motion to 30 degrees or less. 38 C.F.R. § 4.40; Mitchell, supra. Furthermore, there is no indication that such range of motion was further limited based on repetitive use testing, repeated use over time, or during flare-ups. In this regard, while the August 2017 VA examiner could not offer an opinion as to whether the Veteran had additional limitation of range of motion following repeated use over time or during a flare-up without resorting to speculation, the July 2020 VA examiner found no additional limitation. There is also no evidence of ankylosis. Thus, the Board finds that, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as result of repetitive motion and/or flare-ups, the Veteran’s range of motion of the thoracolumbar spine is not limited to the degree necessary to warrant an increased rating. Finally, the Board has considered whether separate ratings are warranted for any associated objective neurologic abnormalities other than the Veteran’s already separately rated bilateral lower extremity radiculopathy pursuant to Note (1) of the General Rating Formula. However, the record fails to demonstrate the presence of such impairment. In this regard, the September 2013, August 2017, and July 2020 VA examinations found no evidence of any associated objective neurologic abnormalities, to include bladder or bowel impairment. Thus, no further separate ratings pursuant to Note (1) are warranted. 2. Propriety of the assignment of a separate rating for LLE radiculopathy of the sciatic nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020. 3. Propriety of the assignment of a separate rating for RLE radiculopathy of the sciatic nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020 4. Propriety of the assignment of a separate rating for LLE radiculopathy of the femoral nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020 5. Propriety of the assignment of a separate rating for RLE radiculopathy of the femoral nerve, evaluated as 10 percent disabling, effective August 8, 2017, and 20 percent disabling as of July 27, 2020. As previously noted, the Veteran was awarded separate ratings for radiculopathy of the LLE and RLE affecting the sciatic and femoral nerves associated with his back disability, which was evaluated as 10 percent disabling as of August 8, 2017, and 20 percent disabling as of July 27, 2020, pursuant to Note (1) of the General Rating Formula and DCs 8520 and 8526, respectively. Thus, the propriety of the assigned effective dates and ratings are part and parcel of the Veteran’s claim for an increased rating for his back disability. Turning first to the propriety of the effective date of August 8, 2017, for the initial assignment of the separate ratings for the Veteran’s bilateral lower extremity radiculopathy, the Board observes that the September 2013 VA examination revealed that muscle strength testing, reflex examination, and sensory examination were all normal. No radiculopathy of the lower extremities or other neurologic abnormalities were noted on the examination. Further, while an August 2015 VA examination reflects that an MRI was ordered as a result of the Veteran’s complaints of chronic lower back pain with radiculopathy into the left anterior thigh. However, as noted by the August 2017 VA examiner, such was not a diagnosis; rather, just an indication as to why an MRI was ordered. Additionally, in December 2015, the Veteran denied radicular symptoms and, at a January 2016 VA examination, denied all relevant symptomatology and muscle, reflex, and sensation testing was normal. As noted by the August 2017 VA examiner, at an April 2016 EMG consultation, a neurologist found loss of sensation on the left thigh in the distribution of the lateral femoral cutaneous nerve. Additionally, the EMG study revealed that there was evidence consistent with chronic multilevel left lumbosacral radiculopathies without ongoing denervation in any of the left lower limb muscles. It was also noted that findings in the right lower limb suggested a similar, but less prominent, process. The neurologist further observed that physical examination was consistent with left lateral femoral cutaneous neuropathy (meralgia paresthetica). Upon review of such records, the August 2017 VA examiner found that there was a finding of bilateral lower extremity radiculopathy caused by the Veteran’s back disability and a separate, isolated lateral femoral cutaneous neuropathy of unknown origin. However, the August 2017 VA examiner did not address the fact that the neurologist who interpreted the April 2016 EMG also found that the electro-diagnostic evidence was most consistent with polyneuropathy likely due to diabetes and, with respect to the notation that there was evidence consistent with lumbosacral radiculopathies, indicated that, alternative to such conclusion, a more severe diabetic polyneuropathy can also affect more proximal nerves and their muscles. Thus, the Board affords greater probative weight to the April 2016 neurologist’s interpretation of the EMG results that the findings noted therein were most consistent with diabetic polyneuropathy. Rather, LLE and RLE radiculopathy was first objectively shown on a VA examination conducted on August 8, 2017; thus, an earlier effective date for the assignment of separate ratings for such disabilities is not warranted. In regard to the propriety of the assigned ratings for the Veteran’s LLE and RLE radiculopathy, such affecting the sciatic nerve is rated pursuant to DC 8520, and such affecting the femoral nerve is rated pursuant to DC 8526. DC 8520, pertinent to the sciatic nerve, provides that a 10 percent rating is assigned where there is mild incomplete paralysis; a 20 percent rating is assigned where there is moderate incomplete paralysis; a 40 percent rating is assigned for moderately severe incomplete paralysis; a 60 percent rating is assigned for severe incomplete paralysis, with marked muscular atrophy; and a maximum 80 percent rating is assigned for complete paralysis; the foot dangles and drops, no active movement possible of muscles below the knee, flexion of the knee weakened of (very rarely) lost. 38 C.F.R. § 4.124a. DC 8526, pertinent to the femoral nerve, provides that that a 10 percent rating is assigned where there is mild incomplete paralysis; a 20 percent rating is assigned where there is moderate incomplete paralysis; a 30 percent rating is assigned for severe incomplete paralysis; and a maximum 40 percent rating is assigned for complete paralysis of the quadriceps extensor muscles. Id. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment and motor function, trophic changes, or sensory disturbances. 38 C.F.R. § 4.120. Under 38 C.F.R. § 4.124a, disability from neurological disorders is rated from 10 to 100 percent in proportion to the impairment of motor, sensory, or mental function. With partial loss of use of one or more extremities from neurological lesions, rating is to be by comparison with mild, moderate, severe, or complete paralysis of the peripheral nerves. 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 should be for the mild, or at most, the moderate degree. Id. Descriptive words such as “slight,” “moderate” and “severe” as used in the various diagnostic codes are not defined in VA’s Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all of the evidence for “equitable and just decisions.” 38 C.F.R. § 4.6. In this regard, at the August 2017 VA examination, the Veteran reported mild intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness. Objective examination revealed that reflexes were hypoactive in the bilateral lower extremities, and sensory examination showed decreased sensation in the left upper anterior thigh and left thigh/knee, but was normal in the left lower leg and foot and RLE. Further, muscle strength testing was normal bilaterally. Additionally, as noted previously, the August 2017 VA examiner found that the Veteran’s left lateral femoral cutaneous neuropathy (meralgia paresthetica), which was manifested by a loss of sensation in the left anterior thigh, was unrelated to his radiculopathy. Therefore, as muscle strength and sensation were essentially normal in regard to radiculopathy in the bilateral lower extremities, and such disabilities resulted in subjective complaints with hypoactive reflexes, the examiner found that the Veteran’s radiculopathy of the LLE and RLE resulted in no more than mild incomplete paralysis of the sciatic and femoral nerve. Consequently, for the appeal period from August 8, 2017, to July 27, 2020, the Board finds that ratings in excess of 10 percent for such disabilities is not warranted. Thereafter, upon VA examination on July 27, 2020, the Veteran reported mild constant pain, severe intermittent pain, severe paresthesias and/or dysesthesias, and severe numbness in the LLE and RLE. Upon examination, muscle strength and reflex testing was normal. Sensory examination revealed normal sensation in the right and left upper anterior thigh and thigh/knee, with decreased sensation in the right and left lower leg/ankle and foot/toes. Based on the objective evidence of decreased sensation in the lower LLE and RLE with increased subjective symptomatology, but without impairment in muscle strength or reflexes, the examiner found that the Veteran’s radiculopathy of the LLE and RLE resulted in no more than moderate incomplete paralysis of the sciatic and femoral nerves. Consequently, as of July 27, 2020, the Board finds that ratings in excess of 20 percent for such disabilities is not warranted. 6. Propriety of the assignment of a separate rating for mid-lumbar surgical scar, evaluated as noncompensable as of September 6, 2017. As mentioned previously, in August 2020, the RO granted a separate noncompensable rating for mid-lumbar surgical scar, effective September 6, 2017, the date of the Veteran’s surgical procedure resulting in such scar. As such, an earlier effective date is not warranted. The Veteran’s mid-lumbar surgical scar was assigned a noncompensable rating pursuant to 38 C.F.R. § 4.118, DC 7805, which provides that any disabling effects of other scars and other effects of scars evaluated under DCs 7800, 7801, 7802, and 7804 that are not considered in a rating provided under the aforementioned DCs should be evaluated under an appropriate DC. As noted at the July 2020 VA examination, the Veteran’s mid-lumbar surgical scar measures 6 cm by 0.5 cm and, thus, is not of a size so as to warrant a higher or separate rating under any potentially applicable DC, to include DC 7801 and 7802. Furthermore, such was not unstable or painful and, thus, do not warrant a higher or separate rating under DC 7804. Also, as such scar is not located on the head, face, or neck, DC 7800 is inapplicable. Finally, as the Veteran’s scar does not result in any disabling effects, an increased rating under DC 7805 is not warranted. Therefore, the Board finds that, as the Veteran’s mid-lumbar surgical scar measures 6 cm by 0.5 cm, has not been shown to be unstable or painful, and does not result in any disabling effects, a compensable rating for such disability is not warranted. Other Considerations In reaching the foregoing determinations, the Board acknowledges the Veteran’s sincerely held belief that his back disability, associated radiculopathy of the LLE and RLE, and surgical scar are more severe than as reflected by the currently assigned ratings. In this regard, while the Board recognizes that he is competent to describe his symptomatology and resulting functional impairment, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Ultimately, the Board finds the medical evidence in which professionals with specialized expertise examined the Veteran, acknowledged his reported symptoms, and described the manifestations of such disabilities in light of the rating criteria to be more persuasive than his own reports regarding the severity of his disabilities. The Board has also considered whether additional staged ratings under Hart, supra, are appropriate for the Veteran’s back disability, associated radiculopathy of the bilateral lower extremities, and surgical scar of; however, the Board finds that his symptomatology has been stable throughout each period on appeal. Therefore, assigning additional staged ratings for such disabilities is not warranted. Further, neither the Veteran nor his representative have raised any other issues, nor have any other issues been reasonably raised by the record, in regard to the increased rating claims adjudicated herein. Doucette v. Shulkin, 28 Vet. App. 366 (2017). In sum, the Board finds that an increased rating for the Veteran’s back disability is not warranted, and the separately assigned ratings and effective dates for LLE and RLE radiculopathy of the sciatic and femoral nerves and surgical scar are proper. In reaching such determinations, the Board has considered the applicability of the benefit of the doubt doctrine; however, as the preponderance of the evidence is against the Veteran’s claims, such doctrine is inapplicable in the instant appeal and his claims must be denied. See 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Waite 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.