Citation Nr: 21005106 Decision Date: 01/29/21 Archive Date: 01/29/21 DOCKET NO. 16-00 026 DATE: January 29, 2021 ORDER An initial rating in excess of 10 percent for left status post-bunionectomy is denied. An initial rating in excess of 10 percent for right status post-bunionectomy with hallux rigidus is denied. An initial compensable rating for surgical scars of the bilateral feet is denied. The assignment of a separate rating for painful surgical scars of the bilateral feet, evaluated as 10 percent disabling as of October 5, 2020, is proper; the appeal is denied. FINDINGS OF FACT 1. For the entire appeal period, the Veteran’s left status post-bunionectomy has been assigned the maximum schedular rating for hallux valgus, and such disability does not result in any additional manifestations or disorders. 2. For the entire appeal period, the Veteran’s right status post-bunionectomy with hallux rigidus has been assigned the maximum schedular rating for hallux valgus and hallux rigidus, and such disability does not result in any additional manifestations or disorders. 3. For the entire appeal period, the Veteran’s surgical scars of the bilateral feet are manifested by multiple superficial and linear scars that did not cover a total area of 929 square centimeters or greater, or result in any disabling effects and, with the exception of two scars as of October 5, 2020, are not painful or unstable. 4. As of October 5, 2020, the Veteran had two painful, but not unstable, scars of the bilateral feet. CONCLUSIONS OF LAW 1. The criteria for an initial rating in excess of 10 percent for left status post-bunionectomy have not been met. 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) 5280. 2. The criteria for an initial rating in excess of 10 percent for right status post-bunionectomy with hallux rigidus have not been met. 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, DC 5280. 3. The criteria for an initial compensable rating for surgical scars of the bilateral feet have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.118, DC 7805. 4. The assignment of a separate rating for painful surgical scars of the bilateral feet, evaluated as 10 percent disabling as of October 5, 2020, is proper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.118, DC 7804. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1982 to July 1985. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions issued in February 2015 and July 2015 by a Department of Veterans Affairs (VA) Regional Office. In August 2018, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In September 2019, the Board remanded the claims for additional development. While on remand, in an October 2020 rating decision, the Agency of Original Jurisdiction (AOJ) awarded a separate rating for painful surgical scars of the bilateral feet, evaluated as 10 percent disabling as of October 5, 2020. As the propriety of such separate rating is part and parcel of the Veteran’s claim for an initial compensable rating for his surgical scars of the bilateral feet, the Board has assumed jurisdiction over such issue. The October 2020 rating decision also recharacterized the Veteran’s disability of right status post-bunionectomy to include hallux rigidus and continued the initially assigned 10 percent rating. Thus, such issue has been characterized as shown on the title page of this decision. The case now returns to the Board for further appellate review. 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 v. West, 12 Vet. App. 119 (1999); 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. In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a Veteran’s service-connected disability. 38 C.F.R. § 4.14. It is possible for a Veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes, however, the critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). 1. Entitlement to an initial rating in excess of 10 percent for left post-bunionectomy. 2. Entitlement to an initial rating in excess of 10 percent for right post-bunionectomy with hallux rigidus. 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). For the entire appeal period stemming from January 29, 2013, the date of service connection, the Veteran is in receipt of a 10 percent rating for his service-connected left status post-bunionectomy and a 10 percent rating for his service-connected right status post-bunionectomy with hallux rigidus pursuant to DC 5280, exclusive of the period where temporary total ratings have been assigned. In this regard, such DC provides a maximum 10 percent rating for operated unilateral hallux valgus with resection of metatarsal head or severe unilateral hallux valgus equivalent to amputation of the great toe. At a January 2015 VA examination, the Veteran reported numbness and discomfort to both feet. While he was able to walk and drive, he reported to have some pain, and is no longer able to jog. Additionally, he reported difficulty umpiring sports, sitting and standing for prolonged periods, using stairs, and in wet and cold weather. The Veteran reported flare-ups, but such were not described beyond the foregoing symptoms and limitations. Examination of the Veteran’s feet revealed no evidence of pes planus, Morton’s neuroma, metatarsalgia, hallux rigidus, pes cavus, malunion or nonunion of tarsal or metatarsal bones, or any other foot injury or condition. Further, while a history of hammertoes was noted, such was indicated to have been resolved and there was no nexus for service connection. The examiner also noted the presence of hallux valgus affecting both feet, which was found to result in mild or moderate symptoms, without more severe symptoms with function equivalent to amputation of the great toe. It was further observed that the Veteran had undergone resection of the metatarsal head on the right in September 2013 and on the left in December 2013. In this regard, his right foot was noted to be symptomatic and he was unable to plantar flex hallux greater than 15 degrees without pain. There was pain on examination of the right foot, but not the left foot. Functional impairment was described as less movement than normal and deformity on the right feet and pain on weight-bearing and interference with standing bilaterally. However, pain, weakness, fatigability, and incoordination did not significantly limit the Veteran’s functional ability following repeated use over time or during flare-ups. At a July 2015 VA examination, the Veteran reported symptoms of pain, swelling, numbness, and discomfort to both feet. He also reported flare-ups, described as difficulty with walking and standing for long periods of time due to pain and difficulty with shoes because of a deformed right foot. Examination of the Veteran’s feet revealed no evidence of pes planus, Morton’s neuroma, metatarsalgia, hammertoes, hallux rigidus, pes cavus, malunion or nonunion of tarsal or metatarsal bones, or any other foot injury or condition. However, the examiner noted the presence of hallux valgus affecting both feet, which was found to result in mild or moderate symptoms, without more severe symptoms with function equivalent to amputation of the great toe. It was also noted that, while the Veteran underwent bunionectomies of the right and left feet in September 2013 and December 2013, respectively, the hallux valgus deformity had redeveloped in the right foot. There was also pain, numbness, and tingling anterior laterally in both feet. Functional impairment was described as pain on examination, to include on weight-bearing, less movement than normal, and interference with standing bilaterally and deformity of the right foot. With respect to functional impairment following repeated use over time and during flare-ups, it was noted that the Veteran had difficulty with walking and standing long periods of time due to pain, difficulty with shoes because of his deformed right foot, and toe swelling. VA treatment records reflect that, in August 2017, the Veteran indicated that he had chronic right foot pain. At his August 2018 Board hearing, the Veteran reported that his bilateral foot disabilities had increased in severity as he could not bend his right great toe, such toe is numb, and his right bunion had recurred post-operatively At a December 2019 VA examination, the Veteran reported bilateral foot pain, numbness of the right great toe, sensitivity to touch resulting in numbness and irritation, but denied flare-ups, swelling. There was a history of hallux valgus with medial deviation of the first metatarsal, bunions status post-surgery with lateral deviation and/or rotation of the hallux and prominence with or without medial soft tissue enlargement of the first metatarsal head on the right side. There was pain on both feet, but greater on the right. The Veteran denied flare-ups, but reported that tiptoeing is painful and he was last able to run five or six years previously. Examination of the Veteran’s feet revealed no evidence of pes planus, Morton’s neuroma, metatarsalgia, hammertoes, hallux rigidus, pes cavus, or malunion or nonunion of tarsal or metatarsal bones. However, the examiner noted the presence of hallux valgus affecting both feet, which was found to result in mild or moderate symptoms. It was also observed that the Veteran had hallux rigidus of the right foot, which resulted in mild or moderate symptoms, and metatarsal head subluxation of middle phalanx over the metatarsal with hallux valgus continued symptoms and bunion on the right foot. Functional impairment was described as pain on weight-bearing, disturbance of locomotion, and lack of endurance bilaterally, and deformity and interference with standing on the right side. However, pain, weakness, fatigability, and incoordination did not significantly limit the Veteran’s functional ability following repeated use over time or during flare-ups. He also had an inability to extend to zero and extension locked out at 35 degrees in dorsiflexion at the metatarsal phalangeal joint of the right foot. The examiner further found that the Veteran’s gout was unrelated to his bilateral foot disabilities, and such did not result in neurological impairment; rather, his relevant complaints were attributed to poor control of diabetes. At an October 2020 VA examination, the Veteran reported that he experienced chronic bunions on the right foot, limited mobility in the bilateral metatarsals, bilateral calluses, numbness, and pain. He denied flare-ups affecting the left foot, but indicated that he had flare-ups affecting the right foot twice a year, which were severe and lasted up to a week or longer. However, he indicated that, since his bunionectomy, he only had one flare-up. In regard to functional impairment, the Veteran reported an inability to run, and difficulty with prolonged standing, walking, and wearing of specific shoes. Examination of the Veteran’s feet revealed no evidence of pes planus, Morton’s neuroma, metatarsalgia, hammertoes, hallux rigidus, pes cavus, malunion or nonunion of tarsal or metatarsal bones, or any other foot injury or condition. However, the examiner noted the presence of hallux valgus affecting both feet and hallux rigidus, which were found to result in mild or moderate symptoms, without more severe symptoms with function equivalent to amputation of the great toe. The Veteran was unable to extend his right great toe completely, and had pain on active range of motion and with weight-bearing, but not on passive range of motion or nonweight-bearing. Functional impairment was described as pain on movement and weight-bearing, disturbance of locomotion, and lack of endurance bilaterally, and less movement than normal, interference with standing, and deformity on the right side. However, pain, weakness, fatigability, and incoordination did not significantly limit the Veteran’s functional ability following repeated use over time or during flare-ups. He also had inability to run, and difficulty with prolonged standing, walking, and wearing of specific shoes following repeated use over time and during flare-ups. Based on the foregoing, the Board finds that initial ratings in excess of 10 percent are not warranted for the Veteran’s bilateral foot disabilities. In this regard, he is already in receipt of the schedular maximum rating for operated unilateral hallux valgus with resection of metatarsal head or severe unilateral hallux valgus equivalent to amputation of the great toe under DC 5280. Moreover, the Board finds that the totality of the Veteran’s bilateral foot symptomatology, as described in the foregoing medical and lay evidence, has been attributed to his hallux valgus and fully contemplated by the currently assigned 10 percent ratings under DC 5280. Furthermore, while the Veteran also has hallux rigidus of the right foot, such is evaluated under DC 5281, which provides that it is rated as severe hallux valgus under DC 5280. Thus, assigning a separate rating for hallux rigidus would be tantamount to pyramiding. 38 C.F.R. § 4.14; Esteban, supra. Also, while the Veteran was noted to have a history of hammertoes, such were not found on examination during the appeal period, and the January 2015 VA examiner found that his hammertoes have resolved and there was no nexus for service connection. Thus, a separate rating under DC 5282 pertinent to such disability is not warranted. Moreover, as there is no evidence of pes planus, pes planus, weak foot, claw foot (pes cavus), metatarsalgia, or malunion or nonunion of tarsal or metatarsal bones, higher or separate ratings under DCs 5276, 5277, 5278, 5279, and 5283. Finally, DC 5284 provides ratings for “other” foot injuries. However, in Copeland v. McDonald, 27 Vet. App. 333, 338 (2015), the Court held that when a condition is specifically listed in the rating schedule, it may not be rated by analogy. Suttmann v. Brown, 5 Vet. App. 127, 134 (1993) (providing that “[a]n analogous rating... may be assigned only where the service-connected condition is ‘unlisted.’”). In Copeland, the Court explicitly rejected the appellant’s argument that to rate his disability under DC 5284 for “foot injuries, other,” would not be rating by analogy. Rather, the Court held that to do so would ignore the plain meaning of the term “other,” and would make the remaining foot-related DCs redundant. Given that the Veteran’s bilateral foot disabilities, diagnosed as hallus valgus of the bilateral feet and hallux rigidus of the right foot, are specifically listed in the rating schedule under DC 5280 and DC 5281, respectively, the Board finds that such are the appropriate DCs to apply. Thus, DC 5284 is inapplicable and a higher or separate rating is not warranted under such criteria. Finally, the December 2019 VA examiner found that the Veteran’s gout was unrelated to his bilateral foot disabilities, and such did not result in neurological impairment; rather, his relevant complaints were attributed to poor control of diabetes. Thus, higher or separate ratings for gout and/or neurological impairment associated with his bilateral foot disabilities are not warranted. 3. Entitlement to an initial compensable rating for surgical scars of the bilateral feet. 4. Propriety of the assignment of a separate rating for painful surgical scars of the bilateral feet, evaluated as 10 percent disabling as of October 5, 2020. Since March 16, 2015, the date of service connection, the Veteran’s surgical scars of the bilateral feet are rated as noncompensably disabling pursuant to DC 7805. Additionally, as of October 5, 2020, a separate 10 percent rating was assigned for painful surgical scars of the bilateral feet pursuant to DC 7804. 38 C.F.R. § 4.118. Scars are rated under 38 C.F.R. § 4.118, DCs 7800 through 7805. DC 7800 pertains to burn scars of the head, face, or neck; scars of the head, face, or neck due to other causes; or other disfigurement of the head, face, or neck. However, as the scars at issue affect the Veteran’s bilateral feet, DC 7800 is inapplicable and will not be further considered. DC 7801 pertains to burn scars or scars due to other causes, not of the head, face, or neck, that are, prior to August 13, 2018, deep and nonlinear and, after such date, associated with underlying soft tissue damage. Under this DC, a 10 percent rating is assigned when the scar(s) cover an area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.). Higher ratings are available for greater areas affected. DC 7802 pertains to burn scars or scars due to other causes not of the head, face, or neck that are, prior to August 13, 2018, superficial and nonlinear and, after such date, not associated with underlying soft tissue damage. Under this DC, a single 10 percent rating is assigned when the scar(s) cover an area or areas of 144 square inches (929 sq. cm) or greater. DC 7804 provides that one or two scars that are unstable or painful warrant a 10 percent evaluation. Three or four scars that are unstable or painful warrant a 20 percent rating, while five or more scars that are unstable or painful warrant a 30 percent evaluation. Note (1) states that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Note (2) states that if one or more scars are both unstable and painful, the rater is to add 10 percent to the evaluation that is based on the total number of unstable or painful scars. Scars evaluated under DCs 7800, 7801, 7802, or 7805 may also receive an evaluation under DC 7804, when applicable. Note (3). DC 7805 provides that other scars (including linear scars) and other effects of scars evaluated under DCs 7800, 7801, 7802, and 7804 that require the evaluation of any disabling effect(s) not considered in a rating provided under DCs 7800-7804 should be rated under an appropriate DC. During the pendency of the appeal, VA amended the criteria for rating the skin, to include scars. See Schedule for Rating Disabilities: Skin, 83 Fed. Reg. 32,592 (July 13, 2018). As pertinent to the instant appeal, such amendment changed DC 7801 by removing the term “deep and nonlinear” and replacing it with “associated with underlying soft tissue damage,” and changed DC 7802 by removing the term “superficial and nonlinear” and replacing it with “not associated with underlying soft tissue damage.” Such also amended the accompanying notes to read: Note (1): For the purposes of DCs 7801 and 7802, the six (6) zones of the body are defined as each extremity, anterior trunk, and posterior trunk. The midaxillary line divides the anterior trunk from the posterior trunk. Note (2): A separate evaluation may be assigned for each affected zone of the body under this diagnostic code if there are multiple scars, or a single scar, affecting multiple zones of the body. Combine the separate evaluations under § 4.25. Alternatively, if a higher evaluation would result from adding the areas affected from multiple zones of the body, a single evaluation may also be assigned under this DC. With regard to the effective date of the new criteria, VA indicated in the Supplementary Information to the Final Rule that its “intent is that the claims pending prior to the effective date will be considered under both old and new rating criteria, and whatever criteria is more favorable to the veteran will be applied.” The Veteran’s claim in this case was pending prior to the August 13, 2018, effective date of the new criteria and, therefore, the Board will consider both the old and new criteria. In order to afford the Veteran all possible avenues of entitlement to a higher rating, the Board has considered all applicable DCs, to include both the old and new criteria, as well as his specific reports of his symptoms and the medical evidence. The January 2015 VA examination indicates the Veteran has four scars on his right foot and five scars on his left foot. The scars of the right foot include (1) on the mid-foot which measured 6 centimeters by 0.3 cm; (2) a scar on the right second digit, measuring 2 cm by 0.2 cm; (3) a scar on the third digit, measuring 2 cm by 0.2 cm; and (4) a scar the fourth digit, measuring 0.5 cm by 0.1 cm. The left foot includes (1) a scar on the left hallux which measures 8 cm by 0.2 cm; (2) a scar on the left mid-foot which measures 3 cm by 0.2 cm; (3) a scar on the second digit which measures 2 cm by 0.2 cm; (4) a scar on the third digit which measures 1 cm by 0.1 cm; and (5) a scar on the fourth digit measuring 0.5 cm by 0.1 cm. However, the scars were not painful or unstable on examination. The July 2015 VA examination report noted two linear scars of the right lower extremity. The first scar was located at the medial-laterally over right metatarsal, hallux area, and measured 7 cm by 0.3 cm; and the second scar was located in the metatarsal area between the second and third digits, which measured 4 cm by 0.5 cm. The left lower extremity had two linear scars; the first located medial-laterally over left metatarsal, hallux area, which measured 9 cm by 0.3 cm and the second scar was located in the metatarsal area between the second and third digits, which measured 4 cm by 0.3 cm. The examiner found that, upon examination, such scars were not painful, unstable, or deep. At the August 2018 Board hearing, the Veteran testified that the scars on his right foot get irritated and that the scars on the left and right toes are elevated. At the December 2019 VA examination, the VA examiner noted five scars on the right foot and five scars on the left foot related to the Veteran’s service-connected bilateral foot disabilities. On the right foot, he had scars that measured 8 by 0.2 cm on the dorsum hallux; 5 cm by 0.2 cm on the dorsum intermetatarsal; and three scars measuring 1 cm by 0.1 cm, on the second, third and fourth digit. On the left foot, the Veteran had scars that measured 8 by 0.2 cm on the dorsum hallux; 1.2 cm by 0.2 cm on the dorsum intermetatarsal; and three scars measuring 1 cm by 0.1 cm, on the second, third and fourth digit. However, the examiner noted that the scars were not painful or unstable, and did not equal a total area to or greater than 39 square cm. At the October 2020 VA examination, the examiner noted that the Veteran had five scars on the left foot and five scars on the right foot. In this regard, two scars on the right foot were measured 4 cm by 0.5 cm and three were 1 cm by 0.2 cm, affecting a total area of 4.6 square cm. On the left foot, one scar was measured 6.5 cm by 0.5cm, one scar was measured 2.5 cm by 0.5 cm, and three scares were measured 1 cm by 0.2 cm., affecting a total area of 5.1 square cm. However, only two scars, i.e., those located on the right and left hallux, were found to be painful, described as tender to touch. Moreover, the Veteran reported that he has difficulty wearing certain shoes due to the tenderness of the scars. The examiner also noted that the Veteran has scars on the right midfoot, right second, third, and fourth right toes, the left midfoot, and the second, third and fourth left toes. However, the Veteran reported that these scars are not painful or tender, and the condition has remained the same. Furthermore no scars were noted to be unstable, or result in underlying tissue damage or limitation of function. Based on the foregoing, the Board finds that an initial compensable rating for the Veteran’s surgical scars of the bilateral feet is not warranted, and the separate rating for painful surgical scars of the bilateral feet, evaluated as 10 percent disabling as of October 5, 2020, is proper. Specifically, as pertinent to DC 7801, the Board finds that the evidence does not show that his scars of the bilateral feet are deep and nonlinear, or associated with underlying soft tissue damage, and do not affect an area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.). Thus, a higher or separate rating under such DC is not warranted. In regard to DC 7802, the Board finds that the Veteran’s scars of the bilateral feet, while superficial, but not nonlinear, and not associated with underlying soft tissue damage, do not affect an area or areas of 144 square inches (929 sq. cm) or greater. Thus, a higher or separate rating under such DC is not warranted. As pertinent to DC 7804, the Board notes that all examinations prior to October 5, 2020, have found that the Veteran’s scars of the bilateral feet are not painful. Furthermore, while the Veteran reported the scars on his right foot get irritated at his August 2018 Board hearing, the December 2019 VA examination found that such were not painful. Rather, the first indication that the Veteran’s scars were painful was on examination on October 5, 2020. Thus, a separate rating under DC 7804 for painful scars is not warranted prior to such date. Moreover, as of such date, a rating in excess of 10 percent under such DC is not warranted as only two scars were found to be painful. Moreover, at no point during the appeal period has the Veteran’s scars been unstable and, thus, higher or separate ratings based on such symptomatology under DC 7804 is not warranted. Finally, as relevant to DC 7805, the evidence does not show, nor does the Veteran contend, that his scars of the bilateral feet result in any disabling effects. Rather, VA examinations reflect that such scars do not result in limitation of function. Consequently, a higher or separate rating is not warranted under any other potentially applicable DC pursuant to DC 7805. Other Considerations In reaching its conclusions in the instant case, the Board acknowledges the Veteran’s belief that his bilateral foot and scar disabilities are more severe than as reflected by the current assigned disability ratings. In this regard, the Board must consider the entire evidence of record when analyzing the criteria laid out in the rating schedule. While the Board recognizes that the Veteran is competent to describe his symptomatology, 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 Fenderson, supra, are appropriate for the Veteran’s service-connected disabilities; however, the Board finds that his symptomatology has been stable throughout each period on appeal. Thus, assigning additional staged ratings for such disabilities is not warranted. Furthermore, neither the Veteran nor his representative have raised any other issues, nor have any other issues been reasonably raised by the record, with regard to the increased rating claims adjudicated herein. Doucette v. Shulkin, 28 Vet. App. 366 (2017). In reaching such determinations, the Board has considered the applicability of the benefit of the doubt doctrine; however, the preponderance of the evidence is against the Veteran’s claims. Thus, the benefit of the doubt doctrine is not applicable and his initial rating claims must be denied. 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.