Citation Nr: A21016546 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 210823-180355 DATE: October 12, 2021 ORDER New and relevant evidence having been submitted, the application to reopen a previously denied claim for entitlement to service connection for a rash is granted, and the claim is reopened. New and relevant evidence having been submitted, the application to reopen a previously denied claim for entitlement to service connection for a left knee condition is granted, and the claim is reopened. New and relevant evidence has not been received, and the service connection claim for a left-hand condition will not be readjudicated. Service connection for a rash is denied. Service connection for a left knee condition is denied. An effective date prior to February 28, 2018, for service connection for a left femoral nerve radiculopathy, is denied. An effective date prior to February 28, 2018, for service connection for a right femoral nerve radiculopathy, is denied. A compensable rating for a posterior trunk scar is denied. A rating in excess of 20 percent for left sciatic nerve radiculopathy is denied. A rating in excess of 20 percent for right sciatic nerve radiculopathy is denied. A rating in excess of an initial 20 percent for right femoral nerve radiculopathy is denied. FINDINGS OF FACT 1. The Veteran was denied service connection for a rash, a left knee condition, and a left-hand condition in an August 2017 rating decision. The Veteran did not appeal the decision or submit new evidence within a year, and the decision became final. 2. The evidence added to the record since the August 2017 rating decision tends to prove the service connection claim for a rash and a left knee condition. 3. The evidence added to the record since the August 2017 rating decision does not tend to prove the service connection claims for a left-hand condition. 4. The weight of the evidence is against finding that the Veteran's rash is related to his active-duty service. 5. The weight of the evidence is against finding that the Veteran's left knee condition is related to his active-duty service. 6. VA received the Veteran's intent to file on February 28, 2018. 7. VA received the Veteran's VA Form 21-526EZ on February 27, 2019, claiming that he had radiculopathy of both lower extremities. 8. The weight of the evidence is against finding that the Veteran's posterior trunk scar is deep, covering an area of at least 6 square inches (39 sq. cm.); is not superficial, covering an area of at least 144 square inches (929 sq. cm.); and is not painful or unstable. 9. The Veteran's bilateral sciatic nerve radiculopathy has not been shown to have been productive of moderately severe incomplete paralysis, neuritis, or neuralgia, of the sciatic nerve, or worse. 10. The Veteran's right femoral nerve radiculopathy has not been shown to have been productive of moderately severe incomplete paralysis, neuritis, or neuralgia, of the sciatic nerve, or worse. CONCLUSIONS OF LAW 1. New and relevant evidence has been received regarding the service connection claim for a rash. 38 U.S.C. §§ 5107, 5108, 7105; 38 C.F.R. § 3.156. 2. New and relevant evidence has been received regarding the service connection claim for a left knee condition. 38 U.S.C. §§ 5107, 5108, 7105; 38 C.F.R. § 3.156. 3. The criteria for readjudication of the previously denied service connection claim for a left-hand condition have not been met. 38 U.S.C. §§ 5108, 7104(b), 7105(c); 38 C.F.R. §§ 3.156 (d), 3.2501(a)(1). 4. The criteria for service connection for a rash have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 5. The criteria for service connection for a left knee condition have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 6. The criteria for an earlier effective date (EED), prior to February 28, 2018, for left femoral nerve radiculopathy, have not been met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.400. 7. The criteria for an EED, prior to February 28, 2018, for right femoral nerve radiculopathy, have not been met. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.400. 8. The criteria for a compensable rating for the posterior trunk scar have not been met. 38 U.S.C. § 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 4.118, Diagnostic Code 7805. 9. The criteria for a rating in excess of 20 percent for left sciatic nerve radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.7, 4.124a, Diagnostic Codes 8520, 8620, 8720. 10. The criteria for a rating in excess of 20 percent for right sciatic nerve radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.7, 4.124a, Diagnostic Codes 8520, 8620, 8720. 11. The criteria for an initial rating in excess of 20 percent for right femoral nerve radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.7, 4.124a, Diagnostic Codes 8526, 8626, 8726. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1963 to July 1967. VA received the Veteran's request for Higher Level Review on April 8, 2020. On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55 (to be codified as amended in scattered sections of 38 U.S.C.), 131 Stat. 1105 (2017), also known as the Appeals Modernization Act (AMA). This law creates a new framework for Veterans dissatisfied with VA's decision on their claim to seek review. This case comes to the Board after the Veteran filed a form 10182 selecting direct review, following the issuance of the August 26, 2020 rating decision. Of note, the rating decision serves as the decisional document which closes the record for adjudication. That is, by selecting direct review, the Veteran accepted that the Board's review would be limited to the evidence that was of record as of August 26, 2020. NEW AND RELEVANT EVIDENCE Generally, a final and unappealed decision issued by the Agency of Original Jurisdiction (AOJ) or a decision from the Board may not thereafter be readjudicated and allowed. 38 U.S.C. §§ 7104 (b), 7105(c). An exception exists if new and relevant evidence is presented or secured with respect to a claim which has been disallowed, then VA shall readjudicate the claim taking into consideration all of the evidence of record. 38 U.S.C. § 5108. "New evidence" means evidence not previously part of the actual record before agency adjudicators. "Relevant evidence" means information that tends to prove or disprove a matter at issue in a claim, and includes evidence that raises a theory of entitlement that was not previously addressed. 38 C.F.R. § 3.2501 (a)(1). The Veteran was denied service connection for a rash, a left knee condition, and a left-hand condition in an August 2017 rating decision. The Veteran did not submit a notice of disagreement and did not provide any new evidence within a year of the August 2017 rating decision. As such, the August 2017 rating decision became final. Since the August 2017 rating decision, the Veteran submitted a statement from his treating dermatologist regarding the onset of his rash and an etiology opinion. The service connection claim was denied by the August 2017 rating decision because a nexus had not been established. Similarly, the Veteran's treating physician provided a statement that his knee pain was more likely than not related to his military service. This evidence is new and pertains to whether there is a nexus between the Veteran's active-duty service and his current diagnoses for a rash and a left knee condition, which is consistent with relevant evidence under 38 U.S.C. § 3.2501(a)(1). As such, the Board finds that the Veteran's dermatologist's and physician's statements constitute new and relevant evidence and the service connection claims for a rash and a left knee condition are reopened. Accordingly, service connection for a rash and a left knee condition will be readjudicated. Regarding the service connection claims for a left-hand condition, the physician did not provide an opinion and the updated VA treatment records do not appear to have any notes about the left hand. Here, evidence received since the final August 2017 rating decision does not include any competent medical evidence indicating a medical nexus between the Veteran's left hand to his active-duty service. The August 2017 rating decision acknowledged that there was a diagnosis for a left-hand condition and that the service treatment records (STRs) showed complaints for left hand symptoms. However, the rating decision stated that there was no continuity of symptoms from service to present, and that a VA medical opinion found no link between the left-hand condition and his active-duty service. The Board acknowledges that the threshold to readjudicate a claim is low, but nevertheless the threshold must be met, and as previously stated, the evidence regarding the left hand, received since the August 2017 rating decision does not meet the threshold for new and relevant evidence. As such, the service connection claim for a left-hand condition will not be readjudicated, and the claim is denied. Service Connection Service connection for rash is denied. The Veteran asserts that a rash that affects the arms and legs first began while he was serving in the military and is related to his exposure to herbicide agents, while stationed in Vietnam. The Veteran's STRs show that he presented to sick call with a rash on his upper body. See STR dated November 12, 1965. The July 1967 separation examination showed a normal clinical evaluation of the skin. The Veteran was afforded a VA examination in December 2016. The examiner noted that he was diagnosed with dermatitis in 1965. The Veteran reported that he has a history of itching skin since military service in Vietnam. He reported that he has not developed a rash since the initial onset, although the itching was persistent. A physical examination showed that none of his body was affected by dermatitis. After the in-person examination and a review of the Veteran's claims file, the examiner provided a negative nexus opinion in July 2017. The examiner noted that there was no evidence of any ongoing rash during the physical examination and also pointed out that the Veteran reported that he never developed a rash since the rash he had during his service. The Veteran provided a statement from his private treating dermatologist in November 2018. The physician stated that he had three office visits between May and October 2018. The physician noted that the Veteran had a history of extremity rash affecting the arms and legs and has been recurring for over 20 years, which first began in the military. However, the physician also noted that his previous records were not available for review. The physician reported that it was likely based on his history and presentation that the rash could have been caused by exposures during his military service. Here, there are two competent opinions of record, provided by the July 2017 VA examiner and the Veteran's private dermatologist. The Board affords the VA examiner's opinion slightly more probative weight because they used the correct evidentiary standard of, at least as likely as not. The VA examiner also provided a rationale to support their opinion. On the other hand, the dermatologist used the incorrect evidentiary standard, the dermatologist stated that his rash could have been caused by exposures during his military service, and did not provide a rationale to support why they believed the rash could have been caused by exposures. Further, the dermatologist reported that the Veteran had a 20 history of rash affecting the arms and legs, even though the Veteran reported that he had not developed any rash since the initial in-service rash, only that he experienced itching. As such, the dermatologist's opinion is afforded little probative weight. The Board has also considered whether service connection is warranted based on a continuity of symptomatology. However, the evidence does not show that his rash manifested to a compensable degree within one year of separation. Here, the Veteran reported at the December 2016 VA examination that he had itching, but never developed a rash since the rash he had during his service. His dermatologist also reported that the rash affecting the arms and legs has been recurring for over 20 years. However, in 2018, the Veteran was separated from the military for about 51 years. Here, statements from the Veteran and his treating dermatologist indicate a severance of a continuity of symptomatology and weigh against a finding of presumptive service connection. Regarding the Veteran's assertion that his rash is related to herbicide exposure, the Board acknowledges that the Veteran served in the Republic of Vietnam. However, dermatitis is not a presumptive disease associated with herbicide exposure under 38 C.F.R. § 3.309 (e). Further, and as previously discussed, there is no competent evidence of record that suggests a relationship between his rash and herbicide exposure. Here, the Board acknowledges the positive evidence provided by the Veteran's treating dermatologist. Unfortunately, the weight of the evidence is against the claim that the Veteran's rash was due to exposure to herbicide agents, or is otherwise related to his active duty service. Accordingly, service connection for a rash is denied. Service connection for a left knee condition is denied. The Veteran asserts that his left knee condition is related to his participation at boot camp at Camp Pendleton. The Veteran's STRs show that he complained of knee pain, but was noted to have no history of trauma with the knees. See STR dated October 29, 1965. He also requested light duty due to knee pain. See STR dated December 15, 1965. The July 18, 1967 separation examination shows a normal clinical evaluation of the lower extremities. The Veteran was afforded a VA examination in December 2016, where he was diagnosed with left knee osteoarthritis. A nexus opinion was provided by the same VA examiner in July 2017. After the in-person examination and a review of the Veteran's claims file, the examiner provided a negative nexus opinion. The examiner acknowledged the Veteran's STRs that showed complaints of left knee pain, but noted that there was insufficient records to support any chronicity of left knee pain. The examiner pointed to the July 1967 separation examination which did not note any findings for a knee condition, which further confirms that there was no sequalae of the left knee pain noted in 1965. The Veteran provided a statement from his private treating physician in October 2018. The physician noted that the Veteran was currently under their care since May 2015. The physician reported that he was diagnosed with knee pain and that after reviewing his records, it was more likely than not that the disability was started or aggravated by his military service. Here, there are two competent opinions of record, provided by the July 2017 VA examiner and the Veteran's private physician. The Board affords the VA examiner's opinion more probative weight than the private physician because the VA examiner provided a well-reasoned explanation to support their nexus opinion. Whereas, the private physician simply provided a conclusory statement, without any rationale to support their opinion. For example, the physician did not explain why their review of the Veteran's records showed that it was more likely than not that his left knee condition was due to his military service. The Board is sympathetic to the Veteran's assertions and acknowledges the positive evidence provided by the Veteran's treating physician. Unfortunately, the weight of the evidence is against the claim that the Veteran's left knee condition was due to the knee pain he experienced during his active-duty service. Accordingly, service connection for a left knee condition is denied. Earlier Effective Date An effective date prior to February 28, 2018, for service connection for a left femoral nerve radiculopathy, is denied. An effective date prior to February 28, 2018, for service connection for a right femoral nerve radiculopathy, is denied. The Veteran asserts that he is entitled to an EED for the grant of service connection for bilateral femoral nerve radiculopathy. However, the Veteran has not provided an explanation as to why he believes he is entitled to an EED. Generally, the effective date of an award of disability compensation based on an original claim shall be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. The provisions of 38 C.F.R. § 3.400 (b)(2) allow for assignment of an effective date the day following separation from active service if a claim is received within one year after separation from service. With regard to the date of entitlement, the term "date entitlement arose" is not defined in the current statute or regulation. However, it is the date when the Veteran met the requirements for the benefits sought, which is determined on a "facts found" basis. 38 U.S.C. § 5110 (a); McGrath v. Gober, 14 Vet. App. 28, 35 (2000). An effective date generally can be no earlier than the "facts found." DeLisio v. Shinseki, 25 Vet. App. 45 (2011). These "facts found" include the date the disability first manifested and the date entitlement to benefits was authorized by law and regulation. For instance, if a Veteran filed a claim for benefits for a disability before he actually had the disability, the effective date for benefits can be no earlier than the date the disability first manifested. Ellington v. Peake, 541 F.3d 1364, 1369-70 (Fed. Cir. 2008). Any communication or action, indicating intent to apply for one or more benefits under the laws administered by VA may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. 38 C.F.R. § 3.155 (a). Prior to March 24, 2015, informal claims were recognized. Any communication or action, indicating an intent to apply for one or more VA benefits may be considered an informal claim. 38 C.F.R. § 3.155. VA received the Veteran's Intent to File on February 28, 2018. VA received the Veteran's formal claim for a radiculopathy of both lower extremities, due to agent orange exposure on February 27, 2019, within a year of his Intent to File. The Veteran also submitted a claim for an increased rating for his service-connected low back disability. The Board notes that the Veteran was already in receipt of a disability rating for bilateral lower extremity sciatic nerve radiculopathy, effective October 2, 2012. A May 2019 rating decision granted service connection for right femoral nerve radiculopathy, effective February 28, 2018, and an August 2020 rating decision granted service connection for left femoral nerve radiculopathy, effective February 28, 2018. Here, the Veteran's February 27, 2019 VA Form 21-526EZ shows that he claimed bilateral lower extremity radiculopathy. However, it is not clear whether he is claiming service connection or an increased rating for the sciatic nerve radiculopathy, he was already in receipt of. After a careful review of the Veteran's claims file, the record is absent for statements or assertions indicating a desire to apply for service connection for femoral nerve radiculopathy prior to the Intent to File, received on February 28, 2018. During the development of the Veteran's increased rating claim for his service-connected lower back disability, an April 2019 VA examination showed involvement of his femoral nerve root. As a result of that finding, service connection was granted for bilateral femoral nerve radiculopathy, effective February 28, 2018. Additionally, the record is absent for a formal application prior to February 28, 2018. A lack of formal or an informal claim indicates the Veteran had no intention to assert a claim for service connection for bilateral femoral nerve radiculopathy prior to February 2018. The Board notes that neither the Veteran, nor his representative, has stated why he believes he is entitled to an effective date earlier than May 24, 2017. The Board acknowledges that VA received the Veteran's VA 21-526EZ on November 10, 2016, regarding the low back. However, a subsequent December 2016 VA examination showed normal findings for the femoral nerve. Further, a February 2017 rating decision increased the Veteran's low back disability rating to 40 percent, effective November 1, 2016. The Veteran did not disagree with that rating decision and thereby became final. Given the foregoing, the Board cannot recognize November 1, 2016 as the effective date for bilateral femoral nerve radiculopathy. As noted above, the effective date of an award based on an original claim for compensation benefits shall be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110 (a). While the Veteran asserts that he is entitled to an earlier effective date, the claims folder reflects that the Veteran expressed his intent to file on February 28, 2018 and he was assigned the date of claim as the effective date. As such, the Veteran has been assigned the earliest possible effective date for his service connection claim for bilateral femoral nerve radiculopathy. Accordingly, an effective date earlier than February 28, 2018, for the grant of service connection for bilateral femoral nerve radiculopathy, is denied. Increased Ratings 1. A compensable rating for a posterior trunk scar is denied. The Veteran asserts that he is entitled to a compensable rating for his posterior trunk scar. However, the Veteran has not explained why he believes he is entitled to an increased rating. The Veteran's scar is rated under Diagnostic Code 7805. VA received the Veteran's formal claim for an increased rating for his low back in February 2019, and was submitted within a year of the February 28, 2018, Intent to File. The rating criteria for evaluating scars are set forth at 38 C.F.R. § 4.118, Diagnostic Codes 7800-7805. Diagnostic Code 7805 provides that scars (including linear scars) not otherwise rated under Diagnostic Codes 7800-7804 are to be rated based on any disabling effects not provided for by those codes. In addition, the effects of scars otherwise rated under Diagnostic Codes 7800-7804 are to be considered. 38 C.F.R. § 4.118, Diagnostic Code 7805. Therefore, the Board has considered all applicable Diagnostic Codes. Diagnostic Code 7801 provides that scars other than on the head, face, or neck that are deep, nonlinear, and cover an area of at least 6 square inches (39 sq. cm.) warrant a compensable evaluation. 38 C.F.R. § 4.118, Diagnostic Code 7801. A deep scar is one associated with underlying soft tissue damage. Id. As documented in the October 2014 VA examination report, there is no evidence that the Veteran's scar covers an area of at least 6 square inches, or that it is deep. Thus, Diagnostic Code 7801, is inapplicable. Diagnostic Code 7802 provides that scars, other than on the head, face, or neck, that are superficial and nonlinear, and cover an area of at least 144 square inches (929 sq. cm.) warrant a compensable evaluation. Id., Diagnostic Code 7802. A superficial scar is one not associated with underlying soft tissue damage. Id. Here, the Veteran's scar does not cover a surface area of 144 square inches or greater. Thus, Diagnostic Code 7802, is inapplicable. Diagnostic Code 7804 contemplates scars that are unstable or painful. Id., Diagnostic Code 7804. A 10 percent disability rating is assigned for one or two scars that are unstable or painful. Id. An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Id., Note 1. If one or more scars are both unstable and painful, an additional 10 percent is to be added to the evaluation based on the total number of unstable or painful scars. Id., Note 2. Diagnostic Code 7805 applies to other scars (including linear scars) and other effects of scars evaluated under DC 7800, 7801, 7802 and 7804. Any disabling effects not considered in a rating provided under Diagnostic Code 7800 through 7804 should be evaluated under an appropriate Diagnostic Code. The Veteran was afforded a VA examination in April 2019. The examiner noted that the Veteran had a back scar that measured 13 centimeters x .5 centimeters and noted that the scar was not painful or unstable. The Veteran was afforded a VA examination in February 2021. The examiner noted the presence of a back scar, but did not note the size of the scar and there was no indication that the scar was painful or unstable. A careful review of the Veteran's post-service treatment records does not reveal any complaints or treatment regarding the back scar. There is no medical evidence of record that the scarring is unstable or painful. The Board finds that the clinical findings of record do not support a compensable rating for the posterior trunk scar. The Veteran's scar is rated as noncompensable pursuant to Diagnostic Code 7805, on the basis that it is superficial, linear, not painful or unstable, and measures less than 6 square inches. To warrant a compensable schedular evaluation, the Veteran must show that his posterior trunk scar is deep (associated with underlying soft tissue damage) and nonlinear measuring at least 6 square inches, or superficial and nonlinear, measuring at least 144 square inches, or unstable or painful, or functionally disabling (criteria for a 10 percent evaluation). 38 C.F.R. § 4.118, Diagnostic Codes 7801-7805. Here, the Veteran has been afforded numerous VA examinations for his lower back, all of which noted the presence of the scar. However, none of the examiners noted that the scar was painful or unstable. Further, the Veteran has not provided any lay statements regarding the symptoms he experiences, regarding the posterior trunk scar. For example, he did not report at any of the VA examinations of any pain or instability of the scar, nor has he provided any statements in any correspondence with VA of any symptoms associated with his posterior trunk scar. As such, the criteria for a compensable rating have not been met. Accordingly, a compensable rating for a posterior trunk scar is denied. 2. A rating in excess of 20 percent for left sciatic nerve radiculopathy is denied. 3. A rating in excess of 20 percent for right sciatic nerve radiculopathy is denied. 4. A rating in excess of an initial 20 percent for right femoral nerve radiculopathy is denied. The Veteran asserts that he is entitled to increased ratings for his bilateral sciatic nerve radiculopathy and his right femoral nerve radiculopathy. However, the Veteran has not explained why he believes that he is entitled to higher ratings. His bilateral sciatic nerve radiculopathy has been evaluated under Diagnostic Code 8520 and his right femoral nerve radiculopathy has been evaluated under Diagnostic Code 8526. The Board recognizes that the Veteran is also service-connected for left femoral nerve radiculopathy, but his August 2021 VA Form 10-182 did not show any disagreement with the assigned rating. As such, the Board recognizes that the increased rating claims regarding the bilateral sciatic nerve radiculopathy and the right femoral nerve radiculopathy, are on appeal. VA received the Veteran's formal claim for an increased rating for his low back in February 2019, and was submitted within a year of the February 28, 2018, Intent to File. The Board notes that the January 2016 rating decision increased the Veteran's rating for the bilateral sciatic nerve radiculopathy to 20 percent based on a January 2016 VA examination showing moderate incomplete paralysis. A May 2019 rating decision granted service connection for right femoral nerve radiculopathy and assigned a 20 percent rating based on moderate incomplete paralysis. The criteria for evaluating the severity or impairment of the sciatic nerve is set forth under Diagnostic Codes 8520, 8620, and 8720; and the femoral nerve is set forth under Diagnostic Codes 8526, 8626, and 8726. Under Diagnostic Code 8520 and 8526, a 10 percent rating requires mild incomplete paralysis of the sciatic nerve. A 20 percent rating requires moderate incomplete paralysis of the sciatic nerve. A 40 percent rating requires moderately severe incomplete paralysis of the sciatic nerve. A 60 percent rating requires severe incomplete paralysis of the sciatic nerve, with marked muscular atrophy. Diagnostic Codes 8620, 8626, 8720 and 8726 address the criteria for evaluating neuritis and neuralgia of the sciatic nerve, respectively. The criteria are consistent with the criteria for evaluating degrees of paralysis as set forth above. 38 C.F.R. § 4.124a, Diagnostic Code's 8520, 8620, 8720 and 8526, 8626, and 8726. A note in the Rating Schedule pertaining to "Diseases of the Peripheral Nerves" provides that the term "incomplete paralysis" indicates a degree of lost or impaired function which is substantially less than that which results from complete paralysis of these nerve groups, whether the loss is due to the varied level of the nerve lesion or to partial nerve regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. 38 C.F.R. § 4.124a, Diagnostic Code's 8510 through 8540. Neuritis of the peripheral nerves, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum rating equal to severe, incomplete, paralysis. The maximum rating that may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatic nerve involvement, for moderately severe, incomplete paralysis. 38 C.F.R. § 4.123. Neuralgia of a peripheral nerve characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. The term incomplete paralysis, with peripheral nerve injuries, indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. The ratings for the peripheral nerves are for unilateral involvement; when bilateral, combine with application of the bilateral factor. 38 C.F.R. § 4.124. The words "slight," "moderate" and "severe" as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6. It should also be noted that use of terminology such as "severe" by VA examiners and others, although an element of evidence to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. The Veteran was afforded a VA examination in April 2019. The examiner noted that there was involvement of both the sciatic and femoral nerve roots. The examiner reported that the Veteran had mild intermittent pain, mild paresthesias, and mild numbness in both lower extremities. The examiner indicated that the severity of the lower extremity radiculopathy was mild. The Veteran was afforded a VA examination in February 2021. The examiner reported that the Veteran had mild paresthesias and mild numbness in both lower extremities. A review of the Veteran's post-service treatment records do not show complaints or treatment for radiculopathy. There were no findings consistent with a rating in excess of 20 percent for bilateral sciatic nerve radiculopathy or right femoral nerve radiculopathy. Given the above, the Board finds that the Veteran's bilateral sciatic nerve radiculopathy and right femoral nerve radiculopathy are not shown to have been manifested by moderately severe symptoms, such that a rating in excess of 20 percent is warranted under Diagnostic Codes 8520 or 8526. During this period on appeal, at worst, the Veteran was only found to have mild symptoms, in both lower extremitates, and the April 2019 VA examiner indicated that the severity of the lower extremity radiculopathy was mild. A careful review of the Veteran's medical records did not show complaints for radiculopathy and the Veteran has not provided any statements describing the severity of his radiculopathy symptoms. Further, the Board notes that the Veteran has been assigned a 20 percent rating for his right femoral nerve radiculopathy, although there were no clinical findings of moderate incomplete paralysis. However, the Board will not disturb the Veteran's 20 percent rating. Here, the Board acknowledges that the Veteran experiences lower extremity radiculopathy and does not wish to minimize his symptoms. However, there has been simply no clinical or lay evidence indicating that the Veteran experiences moderately severe incomplete paralysis of the bilateral sciatic nerve or right femoral nerve radiculopathy of the lower extremities, or worse. Accordingly, the criteria for an initial rating in excess of 20 percent for right femoral nerve radiculopathy and bilateral sciatic nerve radiculopathy have not been met and the claims for increased ratings are denied. Carole R. Kammel Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Fu, Associate 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.