Citation Nr: 21003082 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 18-05 783A DATE: January 19, 2021 ORDER For the period prior to April 23, 2019, an initial disability rating in excess of 10 percent for a low back disability is denied. For the period from April 23, 2019 to October 11, 2020, an initial increased disability rating of 40 percent for a low back disability is granted. For the period from October 12, 2020 onward, an initial disability rating in excess of 40 percent for a low back disability is denied. An initial increased disability rating of 20 percent for left lower extremity radiculopathy of the sciatic nerve is granted, effective October 12, 2020. An initial increased disability rating of 20 percent for right lower extremity radiculopathy of the sciatic nerve is granted, effective October 12, 2020. An initial increased disability rating of 20 percent for right lower extremity radiculopathy of the femoral nerve is granted, effective May 31, 2017. For the period prior to October 12, 2020, an initial increased disability rating of 30 percent for left lower extremity radiculopathy of the femoral nerve is granted. For the period from October 12, 2020 onward, an initial disability rating in excess of 20 percent for left lower extremity radiculopathy of the femoral nerve is denied. An initial disability rating in excess of 10 percent for a laminectomy scar is denied. REMANDED The issue of entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. VETERAN’S CONTENTIONS The Veteran contends that his low back disability is more severe than as reflected by the ratings currently assigned. Specifically, the Veteran contends that he has difficulty moving around and is unable to walk a mile. FINDINGS OF FACT 1. For the period prior to April 23, 2019, the Veteran’s low back disability signs and symptoms best approximated forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; they did not approximate forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees, combined range of motion of the thoracolumbar spine 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. 2. For the period since April 23, 2019, when considering additional functional loss due to flare-ups, the Veteran's low back disability signs and symptoms best approximate forward flexion of the thoracolumbar spine to 30 degrees or less. 3. The Veteran's low back disability is not manifested by unfavorable ankylosis of the entire thoracolumbar spine or unfavorable ankylosis of the entire spine. 4. Since October 12, 2020, the Veteran has experienced radiculopathy affecting the left and right lower sciatic nerves that has been productive of subjective symptoms including mild intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness. Objective findings include decreased sensation and hip flexion with active movement against some resistance. There is no evidence of muscle atrophy or trophic changes. These findings are consistent with moderate incomplete paralysis of these nerves. 5. Since May 31, 2017, the radiculopathy affecting the right lower extremity femoral nerve has been productive of objective findings of hip flexion with active movement against some resistance. There is no evidence of muscle atrophy or trophic changes. These findings are consistent with moderate incomplete paralysis of this nerve. 6. For the period prior to October 12, 2020, the radiculopathy affecting the left lower extremity femoral nerve was productive of subjective symptoms including severe intermittent pain. During this period, however, there was no evidence of complete paralysis, muscle atrophy, or trophic changes. These findings are consistent with severe incomplete paralysis of this nerve. 7. For the period since October 12, 2020, the radiculopathy affecting the left lower extremity femoral nerve has been productive of subjective symptoms including mild intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness. Objective findings include decreased sensation and hip flexion with active movement against some resistance. There is no evidence of muscle atrophy, or trophic changes. These findings are consistent with no more than moderate incomplete paralysis of this nerve. 8. The Veteran's laminectomy scar is not both painful and unstable and it does not measure 39 square centimeters or more. CONCLUSIONS OF LAW 1. For the period prior to April 23, 2019, the criteria for an initial disability rating in excess of 10 percent for a low back disability are not met. 38 U.S.C. §§ 1155; 38 C.F.R. §§ 4.1, 4.10, 4.14, 4.2, 4.21, 4.25 4.40, 4.7 38 C.F.R. § 4.71a, Diagnostic Code 5242-5238. 2. For the period from April 23, 2019 to October 11, 2020, the criteria for an initial increased disability rating of 40 percent for a low back disability are met. 38 U.S.C. §§ 1155; 38 C.F.R. §§ 4.1, 4.10, 4.14, 4.2, 4.21, 4.25 4.40, 4.7 38 C.F.R. § 4.71a, Diagnostic Code 5242-5238. 3. For the period from October 12, 2020 onward, the criteria for an initial disability rating in excess of 40 percent for a low back disability are not met. 38 U.S.C. §§ 1155; 38 C.F.R. §§ 4.1, 4.10, 4.14, 4.2, 4.21, 4.25 4.40, 4.7 38 C.F.R. § 4.71a, Diagnostic Code 5242-5238. 4. The criteria for an initial increased disability rating of 20 percent for left lower extremity radiculopathy of the sciatic nerve are met, effective October 12, 2020. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Diagnostic Code 8520. 5. The criteria for an initial increased disability rating of 20 percent for right lower extremity radiculopathy of the sciatic nerve are met, effective October 12, 2020. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Diagnostic Code 8520. 6. The criteria for an initial increased disability rating of 20 percent for right lower extremity radiculopathy of the femoral nerve are met, effective May 31, 2017. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Diagnostic Code 8526. 7. For the period prior to October 12, 2020, the criteria for an initial increased disability rating of 30 percent for left lower extremity radiculopathy of the femoral nerve are met. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Diagnostic Code 8526. 8. For the period from October 12, 2020 onward, the criteria for an initial disability rating in excess of 20 percent for left lower extremity radiculopathy of the femoral nerve are not met. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, Diagnostic Code 8526. 9. The criteria for an initial disability rating in excess of 10 percent rating for a laminectomy scar are not met. 38 U.S.C. § 1155, 5107; 38 C.F.R. §§ 4.7, 4.118, Diagnostic Code 7804. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1956 to September 1959. These matters come to the Board of Veterans' Appeals (Board) on appeal from a June 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Jurisdiction is currently with the RO in Houston, Texas. The Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) via videoconference in April 2019 and a transcript of the hearing has been associated with the claims file. These matters were previously before the Board at which time they were remanded for further development. The issue of entitlement to a TDIU has been raised by the evidence of record, to include as part and parcel of the increased rating claim. Thus, it is presently in appellate status before the Board. See Rice v. Shinseki, 22 Vet. App. 447 (2009). Entitlement to an initial disability rating in excess of 10 percent prior to October 12, 2020 and in excess of 40 percent thereafter Disability ratings are determined by applying the rating criteria set forth in VA's Schedule for Rating Disabilities (Rating Schedule) and represent the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations 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. In determining the severity of a disability, the Board is required to consider the potential application of various other provisions of the regulations governing VA compensation as well as the whole recorded history of the Veteran's disability. 38 C.F.R. §§ 4.1, 4.2; see generally Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability more closely approximates the criteria for that rating. 38 C.F.R. § 4.7. Otherwise, the lower rating is assigned. Id. Additionally, while it is not expected that all cases will show all the findings specified, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. The Board has considered whether separate ratings for different periods of time are warranted based on the facts, which is a practice of assigning ratings that is referred to as "staging the ratings." Fenderson v. West, 12 Vet. App. 119 (1999). The criteria for rating all disabilities of the spine are set forth in 38 C.F.R. § 4.71a, which provides that spine disabilities are to be evaluated either under the General Rating Formula for Diseases and Injuries of the Spine (General Formula) or under the Formula for Rating IVDS Based on Incapacitating Episodes (IVDS Formula), whichever method results in the higher evaluation when all disabilities are combined under 38 C.F.R. § 4.25. Under the IVDS Formula, a spine disability is rated based on the presence of incapacitating episodes, which are periods of acute signs and symptoms due to IVDS that require bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, IVDS Formula. The General Formula for rating a disability of the spine provides in pertinent part: 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, 10 percent evaluation is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not 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 evaluation is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees, or the combined range of motion of the thoracolumbar spine 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 evaluation 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 evaluation is warranted for unfavorable ankylosis of the entire thoracolumbar spine; and a 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Formula. Under the General Formula, associated neurologic abnormalities, including, but not limited to, bowel or bladder impairment, are evaluated separately under the appropriate diagnostic codes. Id. at Note (1). Here, after reviewing all of the clinical evidence and subjective complaints, the Board finds that the record is absent evidence of incapacitating episodes, and thus, the Veteran's low back disability must be evaluated under the General Rating Formula. Turning to the General Rating Formula, the Veteran's low back disability is currently rated 10 percent disabling prior to October 12, 2020 and 40 percent disabling thereafter under 38 C.F.R. § 4.71a Diagnostic Code 5242-5238. After a review of the evidence of record, the Board finds that for the period prior to April 23, 2019, the Veteran’s low back disability signs and symptoms best approximated forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees, entitling him to a disability rating of no higher than 10 percent. In this regard, during a May 2017 VA spine examination, range of motion testing revealed forward flexion of the thoracolumbar spine from 0 to 80 degrees and extension from 0 to 25 degrees. The Veteran was able to perform repetitive-use-testing with at least three repetitions and the examiner indicated that there was no additional limitation of range of motion after three repetitions. The examiner indicated that pain, weakness, fatigability, or incoordination did not significantly limit functional ability with repeated use over a period of time. The examiner indicated that the Veteran did not have muscle spasm of the thoracolumbar spine resulting in abnormal gait or abnormal spinal contour, ankylosis, muscle atrophy, or a history of flare-ups. The examiner indicated that there was no objective evidence of pain when the back was used in non-weight-bearing, and passive range of motion for the back was the same as active range of motion. The Veteran's VA clinical records during this period are void of any indication that the Veteran had forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees, or the combined range of motion of the thoracolumbar spine not greater than 120 degrees, or muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. They are also absent evidence that the Veteran reported experiencing flare-ups of his back disability that limited his spinal range of motion. Therefore, after a review of the evidence of record, the Board concludes that the preponderance of the evidence does not support a finding that the criteria for a disability rating higher than 10 percent under the general rating formula were met prior to April 23, 2019. On the other hand, after a review of the evidence of record, the Board finds that for the period from April 23, 2019 to October 11, 2020, the Veteran’s low back disability signs and symptoms best approximated forward flexion of the thoracolumbar spine to 30 degrees or less, entitling him to an increased disability rating of 40 percent. In this regard, the Veteran testified during the April 2019 Board hearing that he experienced flare-ups after laying or sitting down. During an October 2020 VA spine examination, range of motion testing revealed forward flexion of the thoracolumbar spine from 0 to 25 degrees and extension from 0 to 10 degrees. The Veteran was able to perform repetitive-use-testing with at least three repetitions and the examiner indicated that there was no additional loss of function or range of motion after three repetitions. The examiner indicated, however, that pain, weakness, fatigability, or incoordination significantly limited functional ability with repeated use over a period of time. Described in terms of range of motion, the examiner indicated that the Veteran’s forward flexion would be limited to 0 to 20 degrees and extension 0 to 10 degrees. The examiner indicated that the Veteran did not have ankylosis, or muscle atrophy. The examiner indicated that during a flare-up the Veteran’s forward flexion would be limited to 0 to 25 degrees and extension 0 to 10 degrees. Based on the foregoing evidence, and resolving all doubt in favor of the Veteran, the Board finds that the Veteran's low back disability was productive of forward flexion limited to 30 degrees or less for the period from April 23, 2019 to October 11, 2020. See 38 C.F.R. § 3.102. The Veteran testified during the April 2019 Board hearing that he experienced flare-ups. The October 2020 VA examiner indicated that during a flare-up the Veteran’s forward flexion was limited to 25 degrees. As stated above, a 40 percent evaluation is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine. Accordingly, an increased disability rating of 40 percent is warranted for the period from April 23, 2019 to October 11, 2020. In assigning an effective date of April 23, 2019, the Board notes that this is the first date as of which it was evidence that the signs and symptoms related to the Veteran’s low back disability had worsened in severity. See 38 C.F.R. § 3.400(o). A rating in excess of 40 percent is not warranted for the period from April 23, 2019 to October 11, 2020 or for the period from October 12, 2020 onward. In order to warrant a rating higher than 40 percent for the orthopedic manifestations of the Veteran's low back disability under the General Rating Formula, the evidence must show unfavorable ankylosis of the entire thoracolumbar spine, or unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a. In this regard, there is no objective medical evidence of ankylosis in the claims file. The Veteran's VA treatment records do not indicate that the Veteran was diagnosed with ankylosis or that his spine was fixed in an unfavorable position. During the October 2020 VA examination, the examiner indicated that the Veteran did not have ankylosis. Significantly, neither the Veteran, nor the representative have raised any assertion that the Veteran's low back disability is manifested by ankylosis. In short, the evidence of record does not reflect a diagnosis of ankylosis or that the Veteran's spine was fixed in an unfavorable position. As entitlement to a higher disability rating turns on a showing of unfavorable ankylosis of the thoracolumbar spine, or unfavorable ankylosis of the entire spine, a higher rating for the orthopedic manifestations of the Veteran's low back disability is simply not warranted. In making the above determinations, the Board considered Correia v. McDonald, 28 Vet. App. 158 (2016). However, a 40 percent rating is the maximum schedular rating available for limitation of motion of the thoracolumbar spine under the General Rating Formula, to include the functional equivalent of limitation of motion. Therefore, the Board finds that Correia is inapplicable, and no further examination is needed. Next the Board considers whether higher ratings are warranted for neurologic abnormalities associated with the Veteran's lumbar spine disability. The Board notes that the Veteran is already in receipt of separate 10 percent disability ratings for sciatic radiculopathy of the left lower and right lower extremities under 38 C.F.R. § 4.124a Diagnostic Code 8520; a separate 20 percent disability rating for femoral radiculopathy of the left lower extremity and a separate 10 percent disability rating for the right lower extremity under 38 C.F.R. § 4.124a Diagnostic Code 8526. Diagnostic Code 8526 rates incomplete or complete paralysis of the anterior crural (femoral) nerve. Mild incomplete paralysis warrants a 10 percent disability rating; moderate incomplete paralysis warrants a 20 percent disability rating; severe incomplete paralysis warrants a 30 percent disability rating; and complete: paralysis of quadriceps extensor muscles warrants a 40 percent disability rating. Diagnostic Code 8520 rates incomplete or complete paralysis of the sciatic nerve, a 10 percent evaluation is assigned for mild incomplete paralysis, a 20 percent evaluation is assigned for moderate incomplete paralysis, a 40 percent evaluation is assigned for moderately severe incomplete paralysis, and a 60 percent evaluation is assigned for severe incomplete paralysis, with marked muscular atrophy. The terms "mild," "moderate," and "severe" are not defined. Rather than applying a mechanical formula, the Board must evaluate all evidence, to the end that decisions will be equitable and just. 38 C.F.R. § 4.6. Although the use of similar terminology by medical professionals should be considered, is not dispositive of an issue. 38 C.F.R. §§ 4.2, 4.6. After review of the evidence, the Board finds the Veteran's left lower extremity and right lower extremity sciatic radiculopathy approximated moderate incomplete paralysis of the sciatic nerve, entitling him to disability ratings of 20 percent effective October 12, 2020. The Board also finds that the Veteran’s right lower extremity radiculopathy approximated moderate incomplete paralysis of the femoral nerve, entitling him to a disability rating of 20 percent effective May 31, 2017. The Veteran’s left lower extremity approximated severe incomplete paralysis of the femoral nerve, entitling him to a disability rating of 30 percent prior to October 12, 2020, yet thereafter improved, approximating moderate incomplete paralysis of the femoral nerve; entitling him to a disability rating of no higher than 20 percent from October 12, 2020 onward. In this regard, the evidence of record includes a May 2017 VA examination report in which the examiner indicated that the Veteran did not have muscle atrophy. Straight leg raising testing was negative. Reflex testing revealed a hypoactive left knee, and sensory testing revealed decreased sensation in the left foot/toes. The examiner indicated that the Veteran reported severe intermittent pain in the left lower extremity. The examiner indicated that the Veteran’s radicular symptoms of the left lower extremity best approximated severe incomplete paralysis of the femoral nerve. The examiner indicated that the right lower extremity was not affected. However, muscle strength testing revealed both left and right hip flexion with active movement against some resistance. The evidence of record also includes an October 2020 VA examination report in which the examiner indicated that the Veteran did not have muscle atrophy. Reflexes were normal. Straight leg raising testing was negative. The examiner indicated that the Veteran reported mild intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness of the left and right lower extremities. The examiner indicated that the Veteran’s radicular symptoms of the left lower and right lower extremities best approximated mild incomplete paralysis of the sciatic and femoral nerves. However, muscle strength testing revealed right and left hip flexion with active movement against some resistance, and sensory examination revealed decreased sensation in the right upper anterior thigh, right thigh/knee, and right foot/toes, and decreased sensation in the left thigh/knee, left lower leg/ankle, and left foot/toes. The Veteran's private and VA medical records are void of any indication that the Veteran's left and right lower extremity radicular signs and symptoms were productive of more than moderate incomplete paralysis of the sciatic nerve, or that the Veteran’s right lower extremity radicular signs and symptoms were productive of more than moderate incomplete paralysis of the femoral nerve. The Veteran's private and VA medical records are void of any indication that the Veteran's left lower extremity radicular symptoms were productive of more than severe incomplete paralysis of the femoral nerve prior to October 12, 2020, or more than moderate incomplete paralysis of the femoral nerve from October 12, 2020 onward. Based upon the above, the Board finds that the Veteran's left and right lower extremity radiculopathy approximated moderate incomplete paralysis of the sciatic nerve, entitling him to disability ratings of 20 percent effective October 12, 2020, and the Veteran’s right lower extremity femoral radiculopathy approximated moderate incomplete paralysis of the femoral nerve, entitling him to a disability rating of 20 percent effective May 31, 2017. The Board finds that the nature of the Veteran's sciatic radiculopathy signs and symptoms were moderate as there were objective findings of decreased right and left hip flexion with active movement against some resistance; decreased sensation in the right upper anterior thigh, right thigh/knee, and right foot/toes; and decreased sensation in the left thigh/knee, left lower leg/ankle, and left foot/toes. Comparatively, the Board finds that the nature of the Veteran’s right lower extremity femoral radiculopathy signs and symptoms were moderate as there were objective findings of right hip flexion with active movement against some resistance. Ratings higher than 20 percent are not warranted, as there is no evidence of trophic changes, muscle atrophy, or other signs indicative of incomplete paralysis of a greater severity. Turning next to left lower extremity femoral radiculopathy, the Board finds that the Veteran’s left lower extremity femoral radiculopathy best approximated severe incomplete paralysis of the femoral nerve for the period prior to October 12, 2020, entitling him to a disability rating of 30 percent for that period, whereas for the period since that date, it best approximated moderate incomplete paralysis of the femoral nerve, entitling him to a disability rating no higher than 20 percent from October 12, 2020 onward. The nature of the Veteran's radiculopathy symptoms were severe prior to October 12, 2020 as the Veteran reported severe intermittent pain in the left lower extremity and the examiner indicated that the Veteran’s radicular symptoms of the left lower extremity best approximated severe incomplete paralysis of the femoral nerve. A rating higher than 30 percent prior to October 12, 2020 is not warranted as there was no evidence of complete paralysis. A rating higher than 20 percent, however, is not warranted from October 12, 2020 onward, as the Veteran reported only mild intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness of the left lower extremity, and the examiner indicated that the Veteran’s radicular symptoms of the left lower extremity best approximated mild incomplete paralysis of the femoral nerve. There is no evidence dated since October 12, 2020 demonstrating trophic changes, muscle atrophy, or other signs indicative of incomplete paralysis of a greater severity. Lastly, the Board has considered whether a higher rating is warranted for the laminectomy scar associated with the low back disability. The Board notes that the Veteran is already in receipt of separate 10 percent disability rating for laminectomy scar, low back associated with lumbar disc disease with spinal stenosis status post laminectomy under 38 C.F.R. § 4.118 Diagnostic Code 7804. Diagnostic Codes 7800 to 7805 pertain to scars. 38 C.F.R. § 4.118. The Schedule of ratings for the skin was amended, effective August 13, 2018. See 38 Fed. Reg. 32,592 (July 13, 2018). For the appeal period prior to August 13, 2018, the Board will consider the former version of the diagnostic codes only; however, for the period beginning August 13, 2018 the Board will consider both the old and amended version of the diagnostic codes and rate based on whichever is most favorable to the Veteran. As the Veteran's scar is not on the face, head or neck, Diagnostic Codes 7800 does not apply in this case, and will not be discussed. 38 C.F.R. § 4.118, Diagnostic Codes 7800. Under Diagnostic Code 7801, a 10 percent rating is warranted for a scar that is not of the head, face, or neck, that is deep and nonlinear (former code) or associated with underlying soft tissue damage (amended code), and that has an area of at least 6 square inches (39 sq. cm.). Higher ratings are available if larger areas are affected. Under the former code, a "deep scar" is defined as one associated with underlying soft tissue damage. Under Diagnostic Code 7802, a 10 percent rating is warranted for a scar not of the head, face, or neck, that is superficial and nonlinear (former code) or not associated with underlying soft tissue damage (amended code) and which covers an area of at least 144 square inches (929 sq. cm.) or more. Under the former code, a "superficial scar" is defined as one not associated with underlying soft tissue damage. Under both the former and amended criteria for Diagnostic Code 7804, a 10 percent rating is warranted for one or two scars that are unstable or painful. Higher ratings of 20 and 30 percent are warranted if there are three or four, or five or more, unstable or painful scars, respectively. If one or more scars are both unstable and painful, a 10 percent rating is added to the rating that is based on the total number of unstable or painful scars. An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. 38 C.F.R. § 4.118, Diagnostic Code 7804, Note 1. Under both the former and amended codes, pursuant to Diagnostic Code 7805, a scar may be rated on any disabling effect(s) not considered as part of Diagnostic Codes 7801 to 7804. In this regard, the evidence of record includes May 2017 and October 2020 VA examination reports which document a scar associated with the Veteran’s low back disability. However, the examiners noted that the scar was not painful, unstable, or affecting an area equal to or greater than 39 square centimeters. Based on the foregoing, the Board finds that the Veteran's laminectomy scar associated with his low back disability is consistent with no higher than a 10 percent rating under Diagnostic Code 7804. There is nothing to support any additional disabling effects caused by the Veteran's scarring, the scar is not documented as unstable or painful, and the surface area of the Veteran's scar is less than required for a higher/additional rating under the diagnostic codes. The preponderance of the evidence is against the assignment of a disability rating in excess of 10 percent for the scar at any point during the period on appeal. REASONS FOR REMAND Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. With regard to the Veteran's TDIU claim, the Board notes that the evidence of record indicates that further development is needed regarding the Veteran’s employment history. Specifically, the Veteran submitted a VA Form 21-8940, Veteran's Application For Increased Compensation Based On Unemployability on which he reported last working full-time and becoming too disabled to work in December 1996. However, since that time the Veteran’s has filed a Worker’s Compensation claim indicating that he may have had additional employment. The Veteran's employment history and all other factors which have a bearing on the issue must be addressed. 38 C.F.R. § 4.16(b). Therefore, a remanded is necessary to obtain clarification/additional information regarding the Veteran's employment history. The matters are REMANDED for the following action: 1. Request that the Veteran provide or authorize VA to obtain records of his relevant treatment and employment that have not yet been associated with the claims file, and associate with the claims file any outstanding VA treatment records. 2. Contact the Veteran and ask him to supply additional employment information. Specifically, he should be asked to address any employment related to his 2016/2017 Worker’s Compensation claim and/or Beloit VFD. 3. Following any necessary information and authorization from the Veteran, request all records in connection with the claim for Workers' Compensation, including medical records and/or any administrative decisions. All such available documents should be associated with the claims file. S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith-Jennings, 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.