Citation Nr: 21065240 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 13-25 173 DATE: October 25, 2021 ORDER 1. Entitlement to an initial disability rating for the thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 10 percent prior to May 22, 2012 is denied. 2. Entitlement to an initial increased disability rating for the thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 20 percent from May 22, 2012 to October 30, 2014 is denied. 3. Entitlement to an initial increased 20 percent disability rating for the thoracolumbar spine degenerative arthritis with wedge fracture of T8 from October 30, 2014 to June 28, 2017 is granted. 4. Entitlement to an initial increased disability rating for the thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 20 percent from June 28, 2017 to May 28, 2019 is denied. 5. Entitlement to an initial increased disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 40 percent from May 28, 2019 is denied. 6. Entitlement to an initial evaluation in excess of 10 percent for left lower extremity radiculopathy throughout the appeal period is denied. 7. Entitlement to an initial evaluation in excess of 10 percent for right lower extremity radiculopathy since June 23, 2021 is denied. FINDINGS OF FACT 1. From October 31, 2011 to May 22, 2012, thoracolumbar spine degenerative arthritis with wedge fracture of T8 was not manifested by forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees, or 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. Additionally, during this time period, left lower extremity radiculopathy was not manifested by moderate incomplete paralysis of the sciatic nerve. 2. From May 22, 2012 to October 30, 2014, thoracolumbar spine degenerative arthritis with wedge fracture of T8 was not manifested by forward flexion of the thoracolumbar spine 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine (or its functional equivalent). Additionally, during this time period, left lower extremity radiculopathy was not manifested by moderate incomplete paralysis of the sciatic nerve. 3. From October 30, 3014 to June 28, 2017, thoracolumbar spine degenerative arthritis with wedge fracture of T8 was manifested by painful flexion between 60 to 80 degrees but was not manifested by forward flexion of the thoracolumbar spine 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine (or its functional equivalent). Additionally, during this time period, left lower extremity radiculopathy was not manifested by moderate incomplete paralysis of the sciatic nerve. 4. From June 28, 2017 to May 28, 2019, thoracolumbar spine degenerative arthritis with wedge fracture of T8 was not manifested by forward flexion of the thoracolumbar spine 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine (or its functional equivalent). Additionally, during this time period, left lower extremity radiculopathy was not manifested by moderate incomplete paralysis of the sciatic nerve. 5. From May 28, 2019, thoracolumbar spine degenerative arthritis with wedge fracture of T8 was not manifested by unfavorable ankylosis of the entire thoracolumbar spine. Additionally, from May 28, 2019, left lower extremity radiculopathy was not manifested by moderate mild incomplete paralysis of the sciatic nerve. Similarly, from June 23, 2021, right lower extremity radiculopathy was not manifested by moderate incomplete paralysis of the sciatic nerve. CONCLUSIONS OF LAW 1. The criteria for an initial disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 10 percent from October 31, 2011 to May 22, 2012 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) 5242. 2. The criteria for an increased disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 20 percent from May 22, 2012 to October 30, 2014 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 5242. 3. The criteria for an increased 20 percent disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 from October 30, 2014 to June 28, 2017 have 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 5242. 4. The criteria for an increased disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 20 percent from June 28, 2017 to May 28, 2019 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 5242. 5. The criteria for an increased disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 40 percent from May 28, 2019 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 5242. 6. The criteria for an initial disability rating for left lower extremity radiculopathy in excess of 10 percent throughout the appeal period have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, DC 8520. 7. The criteria for an initial disability rating for right lower extremity radiculopathy in excess of 10 percent since June 23, 2021 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, DC 8520. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from December 2007 to October 2011. This matter comes to the Board of Veterans' Appeals (Board) from a November 2011 rating decision of the Department of Veterans Affairs (VA), which granted service connection for a thoracolumbar spine disability, rated as 10 percent disabling from October 31, 2011. During the pendency of the appeal, a July 2013 rating decision granted an increased 20 percent disability rating for the Veteran's thoracolumbar spine disability, effective May 22, 2012; a July 2015 rating decision decreased the assigned disability rating to 10 percent, effective October 30, 2014; an August 2017 rating decision increased the assigned disability rating to 20 percent, effective June 28, 2017; and an October 2019 rating decision increased the assigned disability rating to 40 percent, effective May 28, 2019. As the grants of staged increased ratings are not a full grant of the benefit sought on appeal, and the Veteran did not indicate that he agreed with the increased ratings, the matter remains on appeal from the initially assigned effective date. See AB v. Brown, 6 Vet. App. 35, 38-39 (1993). Additionally, to the extent that the assigned disability rating was decreased during the pendency of the appeal, the Board notes that the provisions of 38 C.F.R. § 3.105 concerning rating reductions are inapplicable, as the Veteran's overall combined disability rating (and his resulting level of VA disability compensation based thereon) was not reduced for any period on appeal. This matter was previously remanded by the Board in July 2018 and December 2019 in order to obtain an adequate medical opinion with findings consistent with Correia v. McDonald, 28 Vet. App. 158 (2016), which held, in essence, that to be adequate, an examination of a joint must include range of motion testing of the joint in the following areas: active motion, passive motion, weight-bearing, and nonweight-bearing. The Board finds that the most recent June 2021 VA examination contains findings sufficient to comply with Correia such that there has been substantial compliance with prior remand directives. Regardless, the Board notes here that the Correia case is less applicable when evaluating a spine disability rather than, for example, a knee disability, which is the disability that Correia addressed. First, there cannot be an opposite undamaged joint in the case of a spine disability. Second, the examination reports of record noted the range of motion of the spine in all directions, and, where applicable, the specific point at which painful motion begins. Additionally, VA spine examinations generally conduct range of motion testing by assessing active motion, rather than passive, by having the Veteran stand and attempt to lean the thoracolumbar spine forward to test flexion, lean the thoracolumbar spine backward to test extension, and lean/turn the body sideways to test lateral movement. This standing testing is considered to be testing on weight-bearing, as the Veteran must support the weight of his body while undergoing such testing. Although it may be possible to test passive motion without weight-bearing by having the Veteran lie down on a table and have the examiner move the spine by bending the Veteran's body, such testing would be awkward and would not reveal useful information, which is further supported by the June 2021 VA examiner's finding that passive range of motion testing of the spine was not performed, as it was not medically advisable and required two examiners to be performed safely. Moreover, that active range of motion testing produces range of motion test result figures, which are more restricted than the results produced by passive range of motion testing in which the physician forces the joint through its motions. Similarly, the Board finds that testing on weight-bearing would generally produce more restrictive results than testing done without weight-bearing. Therefore, in spite of prior Board remands in order to obtain examination findings consistent with Correia, the Board concludes that there is no prejudice to the Veteran in relying on the several VA examinations of record that each involved active range of motion testing on weight-bearing, because such results tend to produce the "worst case scenario" of impairment and thus would tend to support the highest possible rating. The issue of entitlement to a total disability rating for compensation based upon individual unemployability (TDIU) is not part of the current appeal, as the Veteran has been in receipt of a TDIU rating since service discharge in October 2011 and in receipt of a combined 100 percent disability rating since June 28, 2017. At the time he filed his claim for a TDIU rating in October 2012, he claimed that posttraumatic stress disorder, thoracolumbar spine disability, hearing loss, sciatica, knee disability, and shoulder disability precluded his ability to perform substantially gainful employment. Thus, the Veteran is in receipt of a 100 percent disability rating since service discharge and throughout the appeal period. Increased ratings The Veteran has consistently asserted that his thoracolumbar spine disability is more severe than that which is contemplated by his assigned staged disability ratings. Disability evaluations are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. Evidence of pain, weakened movement, excess fatigability, or incoordination must be considered in determining the level of associated functional loss, taking into account any part of the musculoskeletal system that becomes painful on use. DeLuca v. Brown, 8 Vet. App. 202 (1995). The provisions regarding the avoidance of pyramiding do not forbid consideration of a higher rating based on greater limitation of motion due to pain on use, including flare ups. However, those provisions should only be considered in conjunction with the diagnostic codes predicated on limitation of motion. 38 C.F.R. §§ 4.40, 4.45. The intent of the rating schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. Painful motion is an important factor of joint disability which is entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. However, the evaluation of painful motion as limited motion only applies when the limitation of motion is noncompensable under the applicable diagnostic code. Mitchell v. Shinseki, 25 Vet. App. 32 (2011). The Veteran's service-connected thoracolumbar spine degenerative arthritis with wedge fracture of T8 is currently rated as 10 percent disabling prior to May 22, 2012, as 20 percent disabling prior to October 30, 2014, as 10 percent disabling prior to June 28, 2017, as 20 percent disabling prior to May 28, 2019, and as 40 percent disabling from May 28, 2019 under the General Rating Formula for Diseases and Injuries of the Spine, DC 5242, regarding degenerative arthritis of the spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine, DC 5242. The General Rating Formula for Diseases and Injuries of the Spine provides the following, in pertinent part: a 10 percent disability rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, the combined range of motion of the thoracolumbar spine great 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 disability rating 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 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 disability 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 disability rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine, and a maximum schedular 100 percent disability rating is warranted for unfavorable ankylosis of the entire (thoracolumbar and cervical) spine. These ratings 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. The General Rating Formula for Diseases and Injuries of the Spine also provides further guidance in rating diseases or injuries of the spine. Note (1) provides that any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, should be rated separately under an appropriate diagnostic code. See 38 C.F.R. § 4.71a , General Rating Formula for Diseases and Injuries of the Spine. The Veteran is already in receipt of separate disability ratings for left lower extremity radiculopathy of the sciatic nerve associated with his thoracolumbar spine disability, rated as 10 percent disabling from October 31, 2011, and right lower extremity radiculopathy of the sciatic nerve associated with his thoracolumbar spine disability, rated as 10 percent disabling from June 23, 2021. As such, these disabilities will be addressed within the relevant rating periods discussed below; however, the probative evidence of record does not document any other objective neurologic abnormalities for any period on appeal. During the pendency of the Veteran's increased rating claim on appeal, the rating criteria for evaluating arthritis and certain musculoskeletal disabilities were amended, effective on February 7, 2021. The change added certain diagnostic codes and amended the rating criteria for several diagnostic codes listed under 38 C.F.R. § 4.71a. With respect to the thoracolumbar spine, the February 7, 2021 revised criteria instruct to assign DC 5243 for intervertebral disc syndrome (IVDS) only when there is disc herniation with compression and/or irritation of the adjacent nerve root; and, to assign DC 5242 for all other disc diagnoses. A review of the evidence does not document that the Veteran has been diagnosed with IVDS for any period on appeal; therefore, neither the previous criteria nor the amended criteria concerning IVDS are relevant to the Veteran's claim. Following a review of the evidence of record, including as discussed below, the Board finds that the preponderance of evidence weighs against the Veteran's claim of entitlement to an initial disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 10 percent prior to May 22, 2012 and in excess of 20 percent prior to October 30, 2014. As discussed herein, the Board grants the Veteran's claim for an increased disability rating in excess of 10 percent prior to June 28, 2017, finding that the evidence supports a 20 percent disability rating for the staged rating period only. However, the Board finds that the preponderance of evidence weighs against the claims for disability ratings in excess of 20 percent prior to May 28, 2019, and in excess of 40 percent from May 28, 2019. The reasons for this decision follow. I. From October 31, 2011 to May 22, 2012 Upon VA examination prior to service discharge in January 2011, the Veteran reported experiencing back pain and trouble with physical activities such as walking, grocery shopping, sexual activity, sitting, lawn mowing, dog walking, jogging, driving, and lifting. The VA examiner diagnosed degenerative disc disease (DDD) and upon physical examination, initial range of motion findings included forward flexion to 90 degrees, extension to 30 degrees, bilateral lateral flexion to 30 degrees, and bilateral lateral rotation to 30 degrees, each with noted pain upon motion. The Veteran was able to perform repetitive use testing with no additional limitation in range of motion. There was no resulting radiating pain on movement, muscle spasm, tenderness, guarding, weakness, muscle atrophy, or ankylosis. The Veteran's joint function of the spine was not additionally limited by pain, fatigue, weakness, lack of endurance, or incoordination after repetitive use testing. Motor function, sensory, and reflex tests were all normal, and there was no finding of IVDS. Upon follow up in August 2011 and September 2011, the Veteran displayed thoracic spine and lumbar spine tenderness on palpation, with lumbosacral spine pain upon motion; however, there are no recorded range of motion findings in degrees as measured by a goniometer. Similarly, upon follow up in March 2012, the Veteran displayed limited range of motion of the spine with pain noted in lumbar flexion and extension, moderate pain on palpation, and without focal neurologic deficit. Again, there were no recorded range of motion findings in degrees. Given the above, the Board finds that the preponderance of evidence weighs against the Veteran's claim for an initial disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 10 percent prior to May 22, 2012. Significantly, the preponderance of the probative evidence of record is against a finding that the Veteran's service-connected thoracolumbar spine disability resulted in the required severity of limitation of motion to warrant an increased 20 percent disability rating for the rating period on appeal. Rather, the objective findings above document no worse than forward flexion to 90 degrees and combined range of motion to 240 degrees with pain, which is most closely approximated by the currently assigned 10 percent disability rating during the staged rating period. Additionally, the objective medical evidence of record does not document muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. As such, the Board finds that the preponderance of evidence weighs against an initial disability rating in excess of 10 percent for the Veteran's thoracolumbar spine degenerative arthritis with wedge fracture of T8 prior to May 22, 2012. The Board has considered if the impact of functional loss in the Veteran's thoracolumbar spine due to flare-ups, pain, fatigability, incoordination, repeated use, lack of endurance, and weakness would equate to a higher rating. 38 C.F.R. §§ 4.40, 4.45, 4.59; Sharp v. Shinseki, 29 Vet. App. 26 (2017); DeLuca, 8 Vet. App. at 206-07. The Veteran has functional limitations caused by pain. The current 10 percent rating specifically contemplates pain and functional loss. At the time of the 2011 VA examination, the Veteran had normal muscle tone and musculature, which is evidence against more than mild functional impairment and weakness. Accordingly, the Veteran's claim for an increased initial rating for his thoracolumbar spine disability for this part of the appeal period is denied. Additionally, the Veteran's left lower extremity radiculopathy of the sciatic nerve associated with his thoracolumbar spine disability is currently rated as 10 percent disabling from October 31, 2011 pursuant to DC 8520, regarding paralysis of the sciatic nerve. 38 C.F.R. § 4.71a, DC 8520. Thereunder, a 10 percent disability rating is warranted for mild incomplete paralysis of the sciatic nerve; a 20 percent disability rating is warranted for moderate incomplete paralysis of the sciatic nerve; a 40 percent disability rating is warranted for moderately severe incomplete paralysis of the sciatic nerve; a 60 percent disability rating is warranted for severe incomplete paralysis of the sciatic nerve with marked muscular atrophy; and a maximum schedular 80 percent disability rating is warranted for complete paralysis of the sciatic nerve, where the foot dangles and drops, and there is no active movement possible of muscles below the knee, and flexion of the knee is weakened or very rarely lost. The Board has considered the evidence of record prior to May 22, 2012 to determine whether an initial rating in excess of 10 percent is warranted for this separate disability associated with the Veteran's thoracolumbar spine disability; however, the probative evidence of record discussed in detail above does not document that the Veteran's left lower extremity radiculopathy has resulted in worse than mild incomplete paralysis of the sciatic nerve for the rating period on appeal. Notably, upon VA examination in January 2011, motor function, sensory, and reflex tests were all normal, which is evidence against moderate incomplete paralysis of the sciatic nerve. As such, an initial disability rating in excess of 10 percent is also not warranted for the Veteran's left lower extremity radiculopathy associated with his thoracolumbar spine disability prior to May 22, 2012. II. From May 22, 2012 to October 30, 2014 Turning to the staged rating period from May 22, 2012 and prior to October 30, 2014, upon VA examination on May 22, 2012, when the Veteran's thoracolumbar spine disability is rated at 20 percent, the Veteran reported a history of mid-back pain since active service, with low back pain upon overuse that worsened with numbness to his left leg and foot. He further reported flare-ups of back pain with moving or lifting that prevents him from walking the dogs, grocery shopping, or mowing the lawn. Upon physical examination, initial range of motion findings included forward flexion to 40 degrees, extension to 10 degrees, bilateral lateral flexion to 15 degrees, and bilateral lateral rotation to 20 degrees, with functional loss and/or functional impairment including less movement than normal, weakened movement, pain on movement, disturbance of locomotion, and interference with sitting, standing, and/or weight-bearing, but without additional loss in range of motion upon repetition. There was no localized tenderness or pain to palpation for the joint and/or soft tissue of the thoracolumbar spine, and no guarding or muscle spasm of the thoracolumbar spine. Muscle strength was mostly normal (4/5 in left hip flexion and knee extension, indicating active movement against some resistance) without any muscle atrophy. Reflexes were hypoactive bilaterally and a sensory examination was normal, with a negative straight-leg raising (SLR) test, bilaterally. The examiner noted that the Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy, and no other neurologic abnormalities. There was no IVDS and no other pertinent physical findings, complications, conditions, signs and/or symptoms, although the Veteran reported regular use of a back brace as an assistive device. The examiner found that the Veteran's thoracolumbar spine (back) condition impacted his ability to work and opined that the Veteran was restricted to light work, lifting 20 pounds or less, changing positions while sitting, and standing every hour as needed for symptoms. VA treatment records from July 2012 document the Veteran's report of ongoing low back pain that was progressively getting worse, with intermittent radiation down his thigh to the top of the foot (worse on his left side) and weakness and associated numbness and tingling. He denied bowel or bladder changes but noted flare ups with increased activity or prolonged sitting or standing. Upon physical examination, it was noted that his lumbar range of motion was "moderately reduced" in all planes with increased central lower back pain. Upon follow up in March 2013, the Veteran displayed limited forward flexion secondary to pain. A previous MRI from January 2013 showed L4-5 and L5-S1 degenerative disc disease with a small left central focal disc protrusion at L5-S1 abutting but not contacting the left S1 root, with no significant lumbar canal stenosis and mildly narrowed foramina at L5-S1 bilaterally secondary to facet arthropathy. Electromyography (EMG) findings showed no compelling electrodiagnostic evidence of active ongoing denervation, a right L4-S1 radiculopathy, a peripheral polyneuropathy., or a left common peroneal/fibular neuropathy. The examining physician noted that the Veteran did not meet electrodiagnostic criteria for radiculopathy, although his EMG findings suggested chronic neurogenic changes in left L5 nerve root distribution, with no compelling electrodiagnostic evidence of active ongoing denervation. In May 2013, the Veteran displayed range of motion described as "fingertips to knees with lumbar flexion" and a mild decrease in lumbar extension to 20 degrees, with no noted pain with lumbar range of motion. A full neurologic examination was deferred, but a seated SLR test was negative, and it was noted that there were no signs of acute radiculopathy or myelopathy. Within the Veteran's August 2013 VA Form 9, Appeal to the Board, he reported that he was having continuing lower back symptoms with neuropathy, sacroiliac (SI) nerve damage and deterioration, and MRIs that showed bulging and herniated discs, bone degeneration, sciatica, and more. Upon follow up in September 2013, the Veteran reported constant lower back pain since 2009, which was exacerbated by physical activities such as lifting, transitioning, and standing or sitting for prolonged periods. He also reported occasional electrical pain and weakness down his left leg, though he denied any falls or required assistive devices. He also denied any bladder or bowel issues. He reported having previously tried a number of treatments, including a TENs unit that did not help, minor improvement with lumbar injections, and physical therapy exercises without much improvement. A musculoskeletal examination showed normal back tone, flexion to 90 degrees with pain, extension to 15 degrees with pain, and no pain on palpation of the spine. Muscle strength was normal, and sensation of L1-S1 remained intact, with a negative SLR test. In July 2014, the Veteran again reported lower back pain with radiation of pain and numbness into his left leg, and new onset of numbness in his right leg. He reported a baseline dull and achy pain increased with prolonged sitting, standing, walking, or lifting. He denied weakness, sharp/shooting pain, loss of bowel/bladder control, loss of sensation, or other complaints. Lumbar spine range of motion included 90 degrees flexion and 10 degrees extension, each with pain, and lower extremity strength was normal. In September 2014, the Veteran presented for lumbar facet injection to treat his chronic back pain, which he reported was localized to the facet joint area of his lower back and did not radiate down the lower extremities. He reported that sitting or standing for prolonged periods worsened his pain, while laying down made it better. His gait was normal, without pain on walking, and examination of his back revealed normal flexion and extension. A straight leg raise test was negative bilaterally, muscle strength was full (5/5) in the bilateral upper and lower extremities, and sensation was intact in the bilateral upper and lower extremities. Given the above, the Board finds that the preponderance of evidence weighs against an evaluation in excess of 20 percent from May 22, 2012 to October 30, 2014. Significantly, the preponderance of the evidence is against a finding that the Veteran's service-connected thoracolumbar spine disability resulted in the required severity of limitation of motion, including forward flexion of the thoracolumbar spine to 30 degrees or less or, favorable ankylosis of the entire thoracolumbar spine, in order to warrant an increased 40 percent disability rating for the rating period on appeal. Rather, the clinical findings described above, including within the May 2012 VA examination report, document no worse than forward flexion to 40 degrees and combined range of motion to 120 degrees with pain, which is most closely approximated by the currently assigned 20 percent disability rating during the staged rating period. While the Board notes that the additional VA treatment records describe the Veteran's thoracolumbar range of motion as "moderately limited" or "fingertips to knees with lumbar flexion," such findings are less probative than the objective VA examination results discussed above, because they do not provide range of motion findings in degrees as measured by a goniometer, which is required under the relevant rating criteria. As such, the Board finds that the preponderance of evidence weighs against an increased disability rating for thoracolumbar spine degenerative arthritis with wedge fracture of T8 in excess of 20 percent from May 22, 2012 to October 30, 2014. The Board has considered if the impact of functional loss in the Veteran's thoracolumbar spine due to flare-ups, pain, fatigability, incoordination, repeated use, lack of endurance, and weakness would equate to a higher rating. 38 C.F.R. §§ 4.40, 4.45, 4.59; Sharp, 29 Vet. App. 26; DeLuca, 8. Vet. App. at 206-07. The Veteran has functional limitations caused by pain. The current 20 percent rating specifically contemplates pain. At the time of the May 2012 VA examination, the Veteran had full muscle strength (5/5) with right hip flexion, right knee extension, bilateral ankle plantar flexion, bilateral ankle dorsiflexion, and bilateral great toe extension, but had 4/5 muscle strength with left hip flexion and left knee extension. There was no muscle atrophy. These facts are evidence against more than moderate weakness and functional impairment, which does not support a rating in excess of 20 percent for the thoracolumbar spine disability. Accordingly, the Veteran's claim for an increased initial rating for his thoracolumbar spine disability for this part of the appeal period is denied. Additionally, the Board has considered the evidence of record during this time period to determine whether an increased rating in excess of 10 percent is warranted for the Veteran's left lower extremity radiculopathy; however, the probative evidence of record discussed in detail above does not document that the Veteran's left lower extremity radiculopathy has resulted in moderate incomplete paralysis of the sciatic nerve for the rating period on appeal. Notably, upon VA examination in May 2012, a sensory examination was normal, with a negative SLR test, bilaterally, and the examiner noted that the Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy. Similarly, the March 2013 EMG test results showed that the Veteran did not meet electrodiagnostic criteria for radiculopathy, although such findings suggested chronic neurogenic changes in left L5 nerve root distribution. The Board finds that this is probative evidence against a finding of moderate incomplete paralysis of the sciatic nerve. As such, an increased disability rating in excess of 10 percent is not warranted for the Veteran's left lower extremity radiculopathy associated with his thoracolumbar spine disability prior to October 30, 2014. To the extent that the Veteran's lay statements during the rating period assert that his thoracolumbar spine disability and associated lower extremity radiculopathy are more severe than currently rated, the Board acknowledges that his lay reports are probative insofar as they report observable symptoms such as limited range of motion, pain, and numbness; however, the Board affords more probative weight to the objective findings discussed above, including within VA examination reports, as the Veteran does not possess medical expertise to adequately assess an internal and complex musculoskeletal or neurologic condition. III. From October 30, 2014 to June 28, 2017 During this part of the appeal period, the RO reduced the Veteran's rating for the thoracolumbar spine disability to 10 percent. Upon subsequent VAX examination on October 30, 2014, the Veteran reported that he had constant pain, pressure, and stabbing lower back pain most of the time, with numbness and pain in his left leg, and tingling and numbness in the right leg. He denied any incontinence. He did not report that flare-ups that impact the function of the thoracolumbar spine. Upon physical examination, initial range of motion findings included forward flexion to 80 degrees, extension to 26 degrees, right lateral flexion to 26 degrees, left lateral flexion to 24 degrees, and bilateral lateral rotation to 30 degrees or greater, each without objective pain, and with no additional loss of range of motion upon repetition. The examiner identified functional loss and/or functional impairment of the thoracolumbar spine as less movement than normal. There was no localized tenderness or pain to palpation for joints and/or soft tissue of the thoracolumbar spine, and no muscle spasm or guarding of the thoracolumbar spine resulting in abnormal gait or abnormal spinal contour. Muscle strength was normal, bilaterally, without muscle atrophy, and a sensory examination was also normal, bilaterally, with and negative SLR test bilaterally and without any radicular pain or any other signs or symptoms due to radiculopathy. There were no other neurologic abnormalities, no spinal ankylosis, no IVDS, and the Veteran denied the use of any assistive devices. The examiner stated that the Veteran maintained a normal gait and noted that he was "heavily muscular" and had the appearance of someone who lifts weights. The examiner documented the Veteran did not have a thoracic vertebral fracture with loss of 50 percent or more of height, and his thoracolumbar spine (back) condition did not have a functional impact on his ability to work. The examiner remarked that the Veteran's back condition was of "mild severity" and noted that "no flares were witnessed during or following the three repetitions of motion; therefore, significant additional limitations of functional ability due to pain, weakness, fatigability, or incoordination cannot be determined or described without mere speculation." Upon follow up with VA in January 2015, the Veteran reported worsening back pain with subjective numbness and weakness. An MRI showed no interval change compared to a previous January 2013 MRI, with a left central disc protrusion at L5-S1 near the left S1 nerve root. Upon examination, the Veteran displayed full motor strength, bilaterally, with a negative SLR test. The examining physician recommended a lumbar injection and ordered a new EMG test. Upon VA examination in June 2015, the Veteran reported extreme, stabbing pain in his low back and sciatica pain in the left leg. He reported being in pain all day and that he was unable to work due to his bad back and stated that he did not want to go through with another scheduled EMG test. He further reported flare ups of back pain and sciatic pain that prohibited all activity and reported functional loss or functional impairment including an inability to run or lift more than 10-15 pounds. Upon physical examination, initial range of motion findings included forward flexion to 30 degrees, extension to 10 degrees, bilateral lateral flexion to 10 degrees, and bilateral lateral rotation to 10 degrees. The examiner stated that the range of motion itself did not contribute to a functional loss, and there was no evidence of pain with weight bearing or objective evidence of localized tenderness or pain on palpation of the joints or associated soft tissue of the thoracolumbar spine. Additionally, the examiner found there was no additional loss of function or range of motion after three repetitions. The examiner stated that the Veteran was not being examined immediately after repetitive use over time but noted that the examination is medically inconsistent with the Veteran's statements describing functional loss with repetitive use over time, as the Veteran was very muscular in both the upper and lower body, making it unlikely that he has significant disability from his thoracolumbar spine disability. As such, the examiner concluded that pain, weakness, fatigability, or incoordination did not significantly limit functional ability with repeated use over a period of time. Similarly, the examiner noted that the exam was not being conducted during a flare-up, but that the examination was medically inconsistent with the Veteran's statements describing functional loss during flare-ups, because the examiner documented the Veteran had a physique that would be impossible to attain with a severe back disability. As such, the examiner concluded that pain, weakness, fatigability, or incoordination did not significantly limit functional ability with flare-ups. Additionally, the examiner noted that there was no guarding or muscle spasm of the thoracolumbar spine, and no additional contributing factors of disability. The examiner documented the Veteran displayed normal muscle strength, bilaterally, without muscle atrophy, normal reflexes, bilaterally, and a normal sensory examination, bilaterally, with a negative SLR test, bilaterally. The Veteran reported severe intermittent pain bilaterally, moderate paresthesias and/or dysesthesias bilaterally, and moderate numbness bilaterally, with no other signs or symptoms of radiculopathy; however, the examiner indicated that there were no left or right radiculopathy. The examiner also wrote there was no ankylosis of the spine, no other neurologic abnormalities, no IVDS, no assistive devices, and no other pertinent physical findings, complications, conditions, signs or symptoms, including scars. The examiner remarked that the Veteran had reported right-sided radiculopathy several months ago but had not followed up with any treatment since. Additionally, the examiner stated that given the fact that the Veteran reported severe symptoms due to his thoracolumbar spine disability that would leave him very disabled, and that he had a very athletic physique, it was impossible to determine without resorting to mere speculation what the Veteran's current level of symptoms are, including his reports of right-sided sciatica. The examiner acknowledged the Veteran's report of radicular symptoms but stated that it was "unlikely" that the Veteran could have radicular symptoms and still be able to obtain his current physique. Upon follow up in January 2017, the Veteran reported back pain but denied any radicular symptoms. In June 2017, the Veteran presented for right L5-S1 facet injection for his chronic low back pain. He reported no change in his back pain, which was constant, dull and aching, with occasional shooting pain up his back. He stated that pain is made worse with sitting for long periods of time, twisting or bending motions, and lifting, and his pain is improved with lying down and resting. He denied radiation of his pain below the knee, any bowel/bladder dysfunction, or weakness in the lower extremities. He denied currently taking any medications for pain but noted he had previously tried several pain medications in the past, none of which helped with his pain. He also had prior facet joint injections, and trigger point injections without improvement, and had participated in PT and aquatherapy, as well as chiropractic therapy in the past, without benefit. Upon physical examination, he displayed a non-antalgic gait with neutral posture and good balance. The paraspinal muscles and SI joint were nontender to palpation. He displayed lumbar range of motion including flexion to 60 degrees without concordant pain and extension to 15 degrees with exacerbation of pain. His lower extremity strength was full (5/5) and symmetric, light touch sensation remained equal in the bilateral lower extremities, and reflexes were normal and symmetric. Given the above, the Board finds that the evidence weighs in favor of a finding that the thoracolumbar disability warrants a 20 percent disability rating from October 30, 2014 to June 28, 2017. While the October 2014 VA examination report documents range of motion findings consistent with the 10 percent disability rating assigned by the Regional Office (RO), the Board finds that the preponderance of the evidence of record during the rating period is more closely approximated by a 20 percent disability rating. Notably, the June 2015 VA examiner documented forward flexion to 30 degrees, which would generally support a rating of 40 percent under the relevant criteria; however, the examiner specifically documented that the Veteran's reports were inconsistent with his reports of such severe back symptoms and with his muscular physique. Additionally, the Board finds it probative that upon physical examination during VA follow up in early June 2017, the Veteran's forward flexion was to 60 degrees. This documented range of motion is consistent with a 20 percent disability rating under the relevant rating criteria. Thus, after considering the three documented forward flexion findings during the staged rating period (80 degrees in October 2014, 30 degrees in June 2015, and 60 degrees in June 2017) the Board resolves doubt in favor of the Veteran and finds that his thoracolumbar spine disability during the rating period most closely approximates a 20 percent disability rating, but no higher. As stated above, while the 30 degree finding would generally support a 40 percent disability rating under the relevant rating criteria, the Board is mindful that 30 degrees is on the threshold of the rating criteria, as anything higher than 30 degrees, for example, 31 degrees, would warrant a 20 percent disability rating. Additionally, at the time of the June 2015 VA examination, the examiner made a finding that Veteran's complaints of low back pain were not consistent with the Veteran's overall physique. Thus, the clinical findings within that VA examination report are less probative. As such, the Board is satisfied that a 20 percent disability rating for the staged rating period most closely approximates the Veteran's thoracolumbar spine symptomatology. Moreover, this is consistent with the existing 20 percent disability ratings in effect for the staged rating periods immediately prior to and following the rating period in question. Therefore, to this limited extent only, the Veteran's claim is granted for the staged rating period from October 30, 2014 to June 28, 2017. The Board has considered if the impact of functional loss in the Veteran's thoracolumbar spine due to flare-ups, pain, fatigability, incoordination, repeated use, lack of endurance, and weakness would equate to a higher rating. 38 C.F.R. §§ 4.40, 4.45, 4.59; Sharp, 29 Vet. App. 26; DeLuca, 8. Vet. App. at 206-07. The Veteran has functional limitations caused by pain The now-assigned 20 percent rating specifically contemplates pain and functional loss. At the times of the October 2014 and June 2015 VA examinations, the Veteran had full muscle strength (5/5) with bilateral hip flexion, bilateral knee extension, bilateral ankle plantar flexion, bilateral ankle dorsiflexion, and bilateral great toe extension with no muscle atrophy, which is evidence against more than moderate weakness and functional impairment. These findings are against an award of an evaluation in excess of 20 percent for this part of the appeal period. The Board has also considered the evidence of record prior to June 28, 2017 to determine whether an increased rating in excess of 10 percent is warranted for the Veteran's left lower extremity radiculopathy; however, the probative evidence of record discussed in detail above does not show that the Veteran's left lower extremity radiculopathy has resulted in moderate incomplete paralysis of the sciatic nerve for the rating period on appeal. Notably, upon VA examination in October 2014, a sensory examination was normal, bilaterally, with a negative SLR test, bilaterally, and without any radicular pain or any other signs or symptoms due to radiculopathy. In January 2015, the Veteran also had a negative SLR test. While the Veteran reported radicular symptoms upon VA examination in June 2015, including severe intermittent pain, bilaterally, moderate paresthesias and/or dysesthesias bilaterally, and moderate numbness, bilaterally, the Board finds that his lay assertions of radicular symptoms are outweighed by the clinical findings of the VA examiner that the Veteran displayed normal muscle strength, bilaterally, without muscle atrophy, as well as normal reflexes, bilaterally, and a normal sensory examination, bilaterally, with a negative SLR test, bilaterally. Moreover, when asked if the Veteran had radiculopathy, the examiner indicated that there was no left or right radiculopathy. The examiner acknowledged that the Veteran had subjectively reported right-sided radiculopathy several months ago but the examiner stated that given the fact that the Veteran reported severe symptoms due to his thoracolumbar spine disability that would leave him very disabled, and that he had a very athletic physique, it was impossible to determine without resorting to mere speculation what his current level of symptoms are, including his reports of right-sided sciatica. Additionally, the examiner stated that it was "unlikely" that the Veteran could have radicular symptoms and still be able to obtain his current physique. As such, the Board affords lessened probative weight to the Veteran's lay reports of radicular symptoms during the June 2015 VA examination and during this part of the rating period. As such, the Board finds that an increased disability rating in excess of 10 percent is not warranted for the Veteran's left lower extremity radiculopathy associated with his thoracolumbar spine disability from October 30, 2014 and prior to June 28, 2017. To the extent that the Veteran's lay statements during the rating period assert that his thoracolumbar spine disability and associated lower extremity radiculopathy are more severe than currently rated, the Board acknowledges that his lay reports are probative insofar as they report observable symptoms such as limited range of motion, pain, and numbness; however, the Board affords more probative weight to the clinical findings discussed above, including within VA examination reports, as the Veteran does not possess medical expertise to adequately assess an internal and complex musculoskeletal or neurologic condition. IV. From June 28, 2017 to May 28, 2019 Turning to the evidence of record from June 28, 2017 and prior to May 28, 2019, the record reflects that the Veteran filed a claim for an increased disability rating for his service-connected low back disability on June 28, 2017, which is the basis of the currently assigned effective date for the staged rating period. Upon subsequent VA examination in August 2017, the Veteran complained of ongoing lower back pain that increased with walking and activity, and which radiated to his right buttock and right leg, and which pain limited his walking to less than 4 blocks and sitting and standing to less than 15 minutes. The Veteran reported numerous steroid injection in the past, with three facet blocks recently, with no improvement of his pain. He reported flare-ups of the thoracolumbar spine every couple of months during which time he required complete bed rest and a visit to the ER, with tapering doses of prednisone during flares. He did not report having any functional loss or functional impairment of the thoracolumbar spine. Upon physical examination, initial range of motion findings included forward flexion to 60 degrees, extension to 20 degrees, bilateral lateral flexion to 30 degrees, and bilateral lateral rotation to 25 degrees. The examiner stated that the abnormal range of motion itself did not contribute to a functional loss, and that pain noted on exam (in both forward flex and extension) did not result in/cause functional loss. There was no evidence of pain with weight bearing but objective evidence of localized tenderness or pain on palpation of the joints or associated soft tissue of the thoracolumbar spine, as the lower back was sensitive to pressure. There was no additional loss of function or range of motion after three repetitions. The examiner noted that the Veteran was being examined immediately after repetitive use over time and stated that pain, weakness, fatigability, or incoordination did not significantly limit functional ability with repeated use over a period of time. The Veteran was not being conducted during a flare-up, and the examiner noted that the examination was neither medically consistent nor inconsistent with the Veteran's statements describing functional loss during flare-ups. Additionally, the examiner was unable to say without mere speculation whether pain, weakness, fatigability, or incoordination significantly limited functional ability with flare-ups, because the Veteran did not have any flares during the examination. There was no guarding or muscle spasm of the thoracolumbar spine. Muscle strength was full, without atrophy, and reflexes and sensory examinations were normal. There was no radicular pain or any other signs or symptoms of radiculopathy and no other neurologic abnormalities. Additionally, there was no ankylosis, no IVDS, and no use of assistive devices. The examiner stated that the Veteran's ability to bend, lift, or carry heavy objects was significantly limited because of his back condition, which was mild to moderately worse than his previous exam in June 2015. During an April 2018 VA physical therapy visit, the Veteran reported that his back pain started in his lower back during active service and progressed to his upper back in 2015 while performing work-related activity as an automotive technician, and that he was now unable to perform tasks that require prolonged sitting as this increases his lower back pain. The physical therapist examined the Veteran's range of motion and estimated his trunk flexion as "20-25 deg[rees]," limited by lower back pain Upon follow up with physical therapy in June 2018, the Veteran reported ongoing back pain, but denied having radiating symptoms into his lower legs. The therapist noted his "pre DN" trunk flexion as "24 cm from floor" and "post DN" trunk flexion as "33 cm from floor." During an August 2018 VA neurosurgery consultation, the Veteran reported pain mostly over the right side of his lower back that did not radiate. The physician reviewed a July 2018 MRI report which showed thoracic spine chronic compression fracture with less than 25 percent loss of height and no retropulsion, without significant canal or foraminal narrowing of the thoracolumbar spine, and mild degenerative changes in the L4/5 and L5-S1 discs with mild disc bulges present. The physician stated that the Veteran's back pain symptoms in multiple regions were not consistent with the presence of radiculopathy and that the etiology of his pain was not entirely clear, as he may have a myofascial pain type process or there may be an underlying neurologic/muscular disorder. Given the above, the Board finds that the preponderance of evidence weighs against the Veteran's claim for an evaluation in excess of 20 percent from June 28, 2017 to May 28, 2019. Significantly, the preponderance of the evidence is against a finding that the Veteran's service-connected thoracolumbar spine disability resulted in the required severity of limitation of motion, including forward flexion of the thoracolumbar spine to 30 degrees or less or, favorable ankylosis of the entire thoracolumbar spine, in order to warrant an increased 40 percent disability rating for the rating period on appeal. Rather, the clinical findings described above, including at the August 2017 VA examination, document range of motion findings that are most closely approximated by the currently assigned 20 percent disability rating during the staged rating period. To the extent that VA physical therapy treatment records from April 2018 document a finding of trunk flexion of "20-25" degrees, the Board finds this finding to be less probative, as it appears to be an estimation by the physical therapist, and it is unclear as to how the measurement was taken and whether it included the use of a goniometer. Additionally, the June 2018 physical therapy record measured the Veteran's trunk flexion as a distance from the floor, rather than in degrees of flexion as measured by a goniometer. As such, the Board concludes that these isolated findings are less probative than the objective August 2017 VA examination findings discussed above, which do not weigh in favor of an increased disability rating in excess of 20 percent during the staged rating period prior to May 28, 2019. The Board has considered if the impact of functional loss in the Veteran's thoracolumbar spine due to flare-ups, pain, fatigability, incoordination, repeated use, lack of endurance, and weakness would equate to a higher rating. 38 C.F.R. §§ 4.40, 4.45, 4.59; Sharp, 29 Vet. App. 26; DeLuca, 8. Vet. App. at 206-07. The Veteran has functional limitations caused by pain. The current 20 percent rating specifically contemplates pain and functional loss. At the time of the August 2017 VA examinations, the Veteran had full muscle strength (5/5) with bilateral hip flexion, bilateral knee extension, bilateral ankle plantar flexion, bilateral ankle dorsiflexion, and bilateral great toe extension with no muscle atrophy, which is evidence against more than moderate weakness and functional impairment. These findings are against an award of an evaluation in excess of 20 percent. Accordingly, the Veteran's claim for an increased rating for his thoracolumbar spine disability for this part of the appeal period is denied. The Board has considered the evidence of record prior to May 28, 2019 to determine whether an increased rating in excess of 10 percent is warranted for the Veteran's left lower extremity radiculopathy; however, the probative evidence of record discussed in detail above does not document that the Veteran's left lower extremity radiculopathy has resulted in worse than mild incomplete paralysis of the sciatic nerve for the rating period on appeal. Notably, upon VA examination in August 2017, a sensory examination was normal and there was no radicular pain or any other signs or symptoms of radiculopathy and no other neurologic abnormalities. Similarly, the August 2018 neurosurgery consultation record documents that the Veteran's back pain symptoms in multiple regions were not consistent with the presence of radiculopathy. The Board finds that this is probative evidence against an increased disability rating in excess of 10 percent for his left lower extremity radiculopathy. As such, an increased disability rating in excess of 10 percent is not warranted for the Veteran's left lower extremity radiculopathy associated with his thoracolumbar spine disability prior to May 28, 2019. To the extent that the Veteran's lay statements during the rating period assert that his thoracolumbar spine disability and associated lower extremity radiculopathy are more severe than currently rated, the Board acknowledges that his lay reports are probative insofar as they report observable symptoms such as limited range of motion, pain, and numbness; however, the Board affords more probative weight to the clinical findings documented by medical professionals, including within VA examination reports, as the Veteran does not possess medical expertise to adequately assess an internal and complex musculoskeletal or neurologic condition. V. From May 28, 2019 From this date, the Veteran's thoracolumbar spine is in receipt of a 40 percent disability rating. Upon VA examination on May 28, 2019, the Veteran reported that he was previously advised to see a neurologist to rule out a musculoskeletal condition, but he never saw a neurologist as advised. He also reported that he stopped going to the VA physical therapy clinic because felt no significant change in his clinical condition. He also stated that he had chiropractic treatment and got no relief in his back condition. He reported that he was not currently on any medication to manage his chronic pain and that he was not seeing any healthcare provider for his pain management. He reported symptoms of constant aching in the lower back with daily flare ups of increased pain aggravated by any transitional movement, with very occasional flare ups of intense pain. He denied any pain radiating down into his legs but reported muscle spasms of his lower back muscles. He also reported functional loss or impairment including bedrest from a few minutes to hour to help with pain relief but denied ever being incapacitated for more than a few minutes to hours due to increased low back pain and stated that he remained physically independent with all activities of daily living and mobility without any assistive device. He also denied any problems with bladder and bowel control. Upon physical examination, his initial range of motion findings included forward flexion to 20 degrees, extension to 20 degrees, bilateral lateral flexion to 25 degrees, and bilateral lateral rotation to 25 degrees. The range of motion itself did not contribute to a functional loss, and pain noted on exam during forward flexion also did not result in/cause functional loss. There was no evidence of pain with weight bearing, no objective evidence of localized tenderness or pain on palpation of the joints or associated soft tissue of the thoracolumbar spine, and no additional loss of function or range of motion after three repetitions. The examiner noted that the Veteran was being examined immediately after repetitive use over time and during a flare up, but stated that pain, weakness, fatigability, or incoordination did not significantly limit functional ability with repeated use over a period of time or with flare-ups. There was no guarding or muscle spasm of the thoracolumbar spine noted. Muscle strength testing was normal, without muscle atrophy, and sensory and reflex examinations were also normal, with a negative SLR test, bilaterally and no radicular pain or any other signs/symptoms due to radiculopathy or other neurologic abnormalities. There was no ankylosis, no IVDS, and no use of assistive devices. The examiner stated that the Veteran's condition resulted in functional impact on his ability to work but that he could perform sedentary work with pacing. Most recently, upon VA examination in June 2021, the Veteran reported that his thoracolumbar spine disability had progressed, with current symptoms of constant low/mid back pain that could travel into both legs, and weekly severe flare ups of sharp throbbing pain which travels into both legs and causes numbness and makes it difficult to walk or stand, lasting 6 to 12 hours. Upon physical examination, initial range of motion findings included forward flexion to 50 degrees, extension to 10 degrees, bilateral lateral flexion to 20 degrees, and bilateral lateral rotation to 10 degrees, with pain noted in all ranges of motion. The examiner stated that passive range of motion testing was not performed because it was not medically advisable to conduct passive range of motion testing as it needs to be performed with two examiners to be performed safely. The examiner noted that there was pain with weight-bearing, active motion, and on rest/non-movement, which causes functional loss (prolonged sitting standing and walking can increase pain and radiculopathy and decreased mobility and function). There was no evidence of crepitus, localized tenderness, or pain on palpation of the joint or associated soft tissue. The examiner noted that repetitive use resulted in additional loss of range of motion, including forward flexion to 45 degrees, extension to 5 degrees, bilateral lateral flexion to 15 degrees, and bilateral lateral rotation to 5 degrees, which this functional loss resulting from pain and fatigability. The examiner noted that the Veteran was not being examined immediately after repeated use over time but that procured evidence (statements from the Veteran) suggested that pain significantly limits functional ability with repeated use over time, which the examiner estimated as forward flexion to 40 degrees, extension to 0 degrees, bilateral lateral flexion to 10 degrees, and bilateral lateral rotation to 0 degrees. Similarly, the examiner stated that the Veteran was not being examined during a flare-up, but the procured evidence (statements from the Veteran) suggested that pain, fatigability, weakness, lack of endurance, and incoordination significantly limits functional ability with flare-ups, which the examiner estimated as forward flexion to 35 degrees, extension to 0 degrees, bilateral lateral flexion to 5 degrees, and bilateral lateral rotation to 0 degrees. There was no localized tenderness, guarding or muscle spasm of the thoracolumbar spine, and no additional contributing factors of disability. Muscle strength testing was normal bilaterally in all ranges of motion, without muscle atrophy. Reflexes were normal bilaterally at the knees and hypoactive bilaterally at the ankles, while a sensory examination was normal bilaterally. Additionally, there was a positive SLR test bilaterally, and the examiner noted that the Veteran had radicular pain or any other signs or symptoms due to radiculopathy, including moderate intermittent pain bilaterally and mild numbness bilaterally. The examiner identified the nerve involved as the bilateral sciatic nerve. There was no ankylosis, no other neurologic abnormalities, no IVDS, and no use of assistive devices. The examiner noted functional impact resulting from the Veteran's thoracolumbar spine disability, including prolonged sitting, standing, and walking that increase pain and radiculopathy and decrease mobility and function. Given the above, the Board finds that the preponderance of evidence weighs against the Veteran's claim of entitlement to an evaluation in excess of 40 percent for the thoracolumbar spine disability from May 28, 2019. Significantly, the preponderance of the probative evidence of record is against a finding that the Veteran's service-connected thoracolumbar spine disability resulted unfavorable ankylosis of the entire thoracolumbar spine to warrant an increased 50 percent disability rating for the rating period on appeal. Rather, the objective findings of the May 2019 VA examination report documents range of motion findings which are most closely approximated by the currently assigned 40 percent disability rating during the staged rating period. The Board has considered if the impact of functional loss in the Veteran's thoracolumbar spine due to flare-ups, pain, fatigability, incoordination, repeated use, lack of endurance, and weakness would equate to a higher rating. 38 C.F.R. §§ 4.40, 4.45, 4.59; Sharp, 29 Vet. App. 26; DeLuca, 8. Vet. App. at 206-07. The Veteran has functional limitations caused by pain. The 40 percent rating assigned during this part of the appeal period specifically contemplates pain. At the times of the May 2019 and June 2021 VA examinations, the Veteran had full muscle strength (5/5) with bilateral hip flexion, bilateral knee extension, bilateral ankle plantar flexion, bilateral ankle dorsiflexion, and bilateral great toe extension with no muscle atrophy, which is evidence against more than moderate weakness. These findings are against an award of an evaluation in excess of 40 percent for this part of the appeal period. At this point, the Veteran had maintained his full muscle strength from at least October 2014 to June 2021a period of almost seven years, which shows that the Veteran's weakness and functional impairment is not severe. Accordingly, the Veteran's claim for an increased initial rating for his thoracolumbar spine disability for this part of the appeal period is denied. Additionally, the Board has considered the evidence of record from May 28, 2019 to determine whether an increased rating in excess of 10 percent is warranted for the Veteran's left lower extremity radiculopathy and whether an initial increased disability rating in excess of 10 percent is warranted for his right lower extremity radiculopathy from June 23, 2021; however, the probative evidence of record discussed in detail above does not document that the Veteran's left or right lower extremity radiculopathy has resulted in moderate incomplete paralysis of the sciatic nerve for any period of the staged rating period on appeal. Notably, the May 2019 VA examination report documents a negative SLR test, bilaterally, and no radicular pain or any other signs/symptoms due to radiculopathy or other neurologic abnormalities. The June 2021 VA examination report documents a positive SLR test, bilaterally, and the examiner noted that the Veteran had radicular pain or any other signs or symptoms due to radiculopathy, including no constant pain, bilaterally, moderate intermittent pain, bilaterally, no paresthesias and/or dysesthesias, bilaterally, and mild numbness, bilaterally. The examiner then identified the nerve involved as the bilateral sciatic nerve. The Board finds that these findings are most closely approximated by the Veteran's 10 percent disability ratings for his left and right lower extremity radiculopathy; therefore, there is not a preponderance of evidence is against a finding that the Veteran had moderate incomplete paralysis of the sciatic nerve, bilaterally. As such, an increased disability rating in excess of 10 percent is not warranted for the Veteran's left lower extremity radiculopathy associated with his thoracolumbar spine disability from May 28, 2019, and an increased disability rating in excess of 10 percent is not warranted for the Veteran's right lower extremity radiculopathy associated with his thoracolumbar spine disability from June 23, 2021. To the extent that the Veteran's lay statements during the rating period assert that his thoracolumbar spine disability and associated lower extremity radiculopathy are more severe than currently rated, the Board acknowledges that his lay reports are probative insofar as they report observable symptoms such as limited range of motion, pain, and numbness; however, the Board affords more probative weight to the objective findings discussed above, including within VA examination reports, as the Veteran does not possess medical expertise to adequately assess an internal and complex musculoskeletal or neurologic condition. VI. Final disability ratings throughout the appeal period for the thoracolumbar spine disability To make clear to the agency of original jurisdiction (AOJ) as to the final ratings for the thoracolumbar spine disability, the Board will lay out what the Codesheet should look like for this disability as a result of the determinations made within the decision. Thoracolumbar spine degenerative arthritis with wedge fracture of T8 10% from 10/31/2011 20% from 05/22/2012 40% from 5/28/2019 A. P. SIMPSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Chad Johnson, 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.