Citation Nr: 21061756 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 18-29 604 DATE: October 5, 2021 ORDER Entitlement to an initial compensable rating for residuals of Dupuytren's contracture of the right ring finger is denied. FINDING OF FACT Right ring finger disability has been manifested by pain and limitation of motion but has not resulted in ankylosis of the finger joint or in amputation of that finger. CONCLUSION OF LAW The criteria for a compensable rating for service-connected right ring finger disability are not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.71a. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1966 to October 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a rating decision by a U.S. Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Veteran testified in a hearing before the Board. A transcript of the hearing is included in the record and has been reviewed. In April 2020, the Board remanded the claim on appeal for additional development. The claim is again before the Board for appellate review. Increased rating The Veteran has been service connected for right ring finger disability since May 2017. The disorder has been rated as 0 percent disabling since then. He asserts entitlement to a compensable rating. In the decision below, the Board will consider whether a higher initial disability rating has been warranted. Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. "Staged" ratings are appropriate for any rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119 (1999). When assessing the severity of a musculoskeletal disability that is rated on the basis of limitation of motion, VA must consider the extent that the veteran may have additional functional impairment above and beyond the limitation of motion objectively demonstrated, such as during times when symptoms are most prevalent ("flare-ups") due to the extent of pain (and painful motion), weakness, premature or excess fatigability, and incoordination. See DeLuca v. Brown, 8 Vet. App. 202, 204-7 (1995); see also 38 C.F.R. §§ 4.40, 4.45, 4.59. In rating disabilities, VA is precluded from differentiating between symptomatology attributed to a nonservice-connected disability and a service-connected disability in the absence of medical evidence that does so. Mittleider v. West, 11 Vet. App. 181, 182 (1998) (per curiam). In such cases, the reasonable doubt doctrine dictates that all symptoms be attributed to the service-connected disability. Id. Ring finger disability is rated under Diagnostic Code (DC) 5230 of 38 C.F.R. § 4.71a. This DC addresses limitation of motion of the ring and little fingers and authorizes a sole rating of 0 percent. The evidence in this matter consists of private and VA treatment records, lay assertions from the Veteran, and VA compensation examination reports dated in July 2017 and May 2019. The record indicates that the Veteran did not attend an examination scheduled in response to the Board remand seeking additional medical inquiry into the disorder. As such, the decision below is based on the evidence currently of record. See 38 C.F.R. § 3.655. The evidence indicates that the Veteran has a Duypren's contracture in his right ring finger which causes pain and limitation of motion. Based on this evidence, a compensable rating is not warranted under DC 5230 for the right ring finger. In assessing whether a compensable rating should be assigned under an analogous DC, the Board has reviewed other DCs addressing the fingers. The other provisions addressing the ring finger are DC 5227, which addresses ankylosed fingers and which may lead to a compensable rating, and DC 5155, which authorizes compensable ratings for finger amputation. Ankylosis is defined as "stiffening or fixation of a joint as the result of a disease process, with fibrous or bony union across the joint[.]" Dinsay v. Brown, 9 Vet. App. 79, 81 (1996). The record contains no evidence indicating ankylosis in the finger. And there is no evidence in the record indicating that the Veteran's finger has been amputated, that the disorder is tantamount to amputation, or that he would be equally served by amputation and prosthesis. Each VA report found the Veteran without ankylosis and without amputation and found that the Veteran would not be equally served by amputation with prosthesis. Further, none of the VA treatment records indicates ankylosis or amputation. As such, DCs 5227 and 5155 cannot be utilized to assign a compensable rating. The Board has also reviewed DCs 5003 and 5010, which compensate for traumatic and degenerative arthritis. See 38 C.F.R. § 4.71a. However, as the disability at issue concerns a single minor joint the ring finger these DCs may not be utilized for a higher rating either. Id. Based on the foregoing, a compensable rating is unwarranted for service-connected finger disability. 38 C.F.R. § 4.3. G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Christopher McEntee 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.