Citation Nr: 21066562 Decision Date: 11/01/21 Archive Date: 11/01/21 DOCKET NO. 16-15 994 DATE: November 1, 2021 ORDER Entitlement to a disability rating of 40 percent, but no higher, from March 8, 2013, for intervertebral disc syndrome (IVDS) and degenerative arthritis of the thoracolumbar spine is granted. Entitlement to a 20 percent disability rating, but no higher, from March 8, 2013, and 40 percent from February 9, 2015, for right lower extremity radiculopathy of the sciatic nerve (claimed as peripheral neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is granted. Entitlement to a 20 percent disability rating from July 6, 2021, but no higher or earlier, for left lower extremity radiculopathy of the sciatic nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is granted. Entitlement to a rating in excess of 10 percent from February 9, 2015, for right lower extremity radiculopathy of the femoral nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is denied. Entitlement to a rating in excess of 10 percent from February 9, 2015, for left lower extremity radiculopathy of the femoral nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is denied. Entitlement to a 30 percent rating, but no higher, from March 8, 2013, for cervical spine degenerative disc disease (DDD) with IVDS is granted. Entitlement to a 40 percent disability rating, but no higher, from March 8, 2013, for right upper extremity radiculopathy (claimed as neuropathy) associated with cervical spine DDD with IVDS is granted. Entitlement to a rating in excess of 20 percent for left upper extremity radiculopathy associated with cervical spine DDD with IVDS is denied. REMANDED Entitlement to a total disability rating due to individual unemployability (TDIU) based on service-connected conditions is remanded. FINDINGS OF FACT 1. Throughout the entire period on appeal, resolving any doubt in favor of the Veteran, his IVDS and degenerative arthritis of the thoracolumbar spine manifested by forward flexion limited to 30 degrees but did not manifest in unfavorable ankylosis of the entire thoracolumbar spine and there was not a factually ascertainable increase in severity in the year prior to receipt of the Veteran's increased rating claim. 2. From March 8, 2013, the Veteran's right lower extremity radiculopathy of the sciatic nerve associated with IVDS and degenerative arthritis of the thoracolumbar spine manifested by moderate incomplete paralysis but did not amount to symptoms of moderately severe and from February 9, 2015, manifested by moderately severe symptoms but did not amount to severe symptoms with marked muscular atrophy. 3. From March 8, 2013, to July 5, 2021, the Veteran's left lower extremity radiculopathy of the sciatic nerve associated with IVDS and degenerative arthritis of the thoracolumbar spine manifested by mild symptoms and from July 6, 2021, manifested by moderate symptoms that did not amount to moderately severe. 4. From February 9, 2015, the Veteran's right and left lower extremity radiculopathies of the femoral nerve associated with IVDS and degenerative arthritis of the thoracolumbar spine manifested in mild incomplete paralysis but did not amount to moderate. 5. Throughout the entire period on appeal, resolving any doubt in favor of the Veteran, his cervical spine DDD with IVDS manifested by forward flexion limited to 15 degrees but did not manifest in unfavorable ankylosis of the entire cervical spine and there was not a factually ascertainable increase in severity in the year prior to receipt of the Veteran's increased rating claim. 6. From March 8, 2013, the Veteran's right upper extremity radiculopathy associated with cervical spine DDD with IVDS manifested in symptoms that were moderate but did not amount to moderately severe. 7. From July 6, 2021, but no earlier, the Veteran's left upper extremity radiculopathy associated with cervical spine DDD with IVDS manifested in symptoms that were mild but did not amount to moderate. CONCLUSIONS OF LAW 1. The criteria for entitlement to a disability rating of 40 percent from March 8, 2013, for IVDS and degenerative arthritis of the thoracolumbar spine have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code (DC) 5242-5243. 2. The criteria for entitlement to a 20 percent disability rating, but no higher, from March 8, 2013, and 40 percent from February 9, 2015, for right lower extremity radiculopathy of the sciatic nerve (claimed as peripheral neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 3. The criteria for entitlement to a 20 percent disability rating from July 6, 2021, but no higher or earlier, for left lower extremity radiculopathy of the sciatic nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 4. The criteria for entitlement to a rating in excess of 10 percent from February 9, 2015, for right lower extremity radiculopathy of the femoral nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8526. 5. The criteria for entitlement to a rating in excess of 10 percent from February 9, 2015, for left lower extremity radiculopathy of the femoral nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8526. 6. The criteria for entitlement to a 30 percent rating, but no higher, from March 8, 2013, for cervical spine DDD with IVDS have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, DC 5243-5242. 7. The criteria for entitlement to a 40 percent disability rating, but no higher, from March 8, 2013, for right upper extremity radiculopathy (claimed as neuropathy) associated with cervical spine DDD with IVDS have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8510. 8. The criteria for entitlement to a rating in excess of 20 percent for left upper extremity radiculopathy associated with cervical spine DDD with IVDS have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8511. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1976 to May 1980 and from April 1983 to April 1999. These matters come to the Board of Veterans' Appeals (Board) on appeal from an April 2014 rating decision issued by the Department of Veterans' Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. Preliminary matters By way of background, of relevance to this decision, the Board previously remanded the Veteran's increased rating claims for service-connected IVDS and degenerative arthritis of the thoracolumbar spine as well as service-connected cervical spine DDD with IVDS as part of an April 2021 decision. The Board finds substantial compliance with the April 2021 remand directives has been met. See Stegall v. West, 11 Vet. App. 268, 271 (1998). During the pendency of this claim, the RO has granted separate ratings for right and left lower extremity radiculopathies of the sciatic nerve associated with IVDS and degenerative arthritis of the thoracolumbar spine; right and left lower extremity radiculopathies of the femoral nerve associated with IVDS and generative arthritis of the thoracolumbar spine; and right and left upper extremity radiculopathies associated with the cervical spine DDD with IVDS. The United States Court of Appeals for Veterans Claims (CAVC or "the Court") has recently held in Chavis v. McDonough that the Board has jurisdiction to address ratings for associated radiculopathy without requiring a separate notice of disagreement (NOD) as to the radiculopathy ratings when those issues were part of the Veteran's claim for an increased rating. Chavis v. McDonough, 34 Vet. App. 1, 29, FN 17 (2021) (holding that when increased evaluations of radiculopathy ratings were part of a claim seeking a higher evaluation for the underlying lumbar spine disability, they are properly on appeal without requiring a separate notice of disagreement, but the Court specifically declined holding that higher evaluations for radiculopathy are "always" part of claims seeking higher evaluations for the underlying spine disability). Here, the Veteran filed an increased rating claim for the cervical and thoracolumbar spine and thereafter appealed the RO's rating decision denying an increased rating. While the appeal was pending, the radiculopathies mentioned above were separately granted. The Board's April 2021 decision did not address these separate ratings. Upon consideration of Chavis which was decided shortly before the Board's April 2021 decision, the Board finds it has jurisdiction to address the newly awarded ratings for all of the radiculopathies of the extremities as well as any other neurological impairments. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Increased Ratings The Veteran contends he should be assigned a higher disability rating for both service-connected IVDS and degenerative arthritis of the thoracolumbar spine and cervical spine DDD with IVDS. The Veteran's IVDS and degenerative arthritis of the thoracolumbar spine is currently rated under Diagnostic Code 5242-5243 as 20 percent disabling from March 8, 2012, and 40 percent disabling from February 9, 2015, with the following separate radiculopathy ratings associated with IVDS and degenerative arthritis of the thoracolumbar spine: right lower extremity radiculopathy of the sciatic nerve under DC 8520 as 10 percent disabling from March 8, 2013, and 40 percent from February 9, 2015; left lower extremity radiculopathy of the sciatic nerve under DC 8520 as 10 percent disabling from March 8, 2013; right lower extremity radiculopathy of the femoral nerve under DC 8526 as 10 percent disabling from February 9, 2015; and left lower extremity radiculopathy of the femoral nerve under DC 8526 as 10 percent disabling from February 9, 2015. The Veteran's cervical spine DDD with IVDS is rated under DC 5243-5242 as 20 percent disabling from March 8, 2013, and 30 percent from July 6, 2021, with associated right upper extremity radiculopathy under DC 8510 as 20 percent disabling from March 8, 2013, and left upper extremity radiculopathy under DC 8511 as 20 percent disabling from July 6, 2021. Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The Rating Schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. 38 C.F.R. § 4.1. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. 38 C.F.R. § 4.7. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. The evaluation of the same disability under several diagnostic codes, known as pyramiding, must be avoided; separate ratings may be assigned for distinct disabilities resulting from the same injury only where the symptomatology for one condition is not duplicative or overlapping with the symptomatology of the other condition. See 38 C.F.R. § 4.14; see also Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and recurrence of symptoms. Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). The Veteran's entire history is reviewed when making disability evaluations. See Schafrath v. Derwinski, 1 Vet. App. 589 (1995). After careful consideration of the evidence, any reasonable doubt remaining is resolved in the Veteran's favor. 38 C.F.R. § 4.3. Where the evidence contains factual findings that demonstrate distinct time periods in which the service-connected disability exhibits symptoms that would warrant different evaluations during the course of the appeal, the assignment of staged ratings is appropriate. See Fenderson v. West, 12 Vet. App. 119, 126-127 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007); Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Disabilities of the spine are rated under the General Rating Formula for Diseases and Injuries of the Spine (for Diagnostic Codes 5235 to 5243, unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes). Ratings under the General Rating Formula 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. Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent 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 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 rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1. Unfavorable ankylosis is defined as "a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching." Id. at Note 5. Additionally, fixation of a spinal segment in neutral position (zero degrees) is "always" considered favorable ankylosis. Id. Alternatively, disability involving disc disease may be rated under the Formula for Rating IVDS Based on Incapacitating Episodes. That formula provides a 10 percent disability rating for incapacitating episodes having a total duration of at least one week but less than 2 weeks during the past 12 months; a 20 percent disability rating for incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months; a 40 percent disability rating for incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months; and a 60 percent disability rating for intervertebral disc syndrome with incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. 38 C.F.R. § 4.71a. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria."). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint." The spine has no opposite joint. In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination. Effective February 7, 2021, VA revised the criteria for evaluating musculoskeletal disorders. See Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76464 (Nov. 30, 2020); Correction, 86 Fed. Reg. 8142, 8143 (Feb. 4, 2021). VA's General Counsel has held that where a law or regulation changes during the pendency of a claim for a higher rating, the Board must first determine whether the revised version is more favorable to the veteran. In so doing, it may be necessary for the Board to apply both the old and new versions of the regulation. If the revised version of the regulation is more favorable, the retroactive reach of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. The Board must generally apply both the former and the revised versions of the regulation for the period prior and subsequent to the regulatory change, but an effective date based on the revised criteria may be no earlier than the date of the change. Amended DC 5242 now provides: "Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)." Under the pre-amended DC 5003, degenerative and/or traumatic arthritis as shown by x-ray studies is rated based on limitation of motion of the affected joint. 38 C.F.R. § 4.71a, DCs 5003, 5010. When, however, the limitation of motion is noncompensable under the appropriate diagnostic code, a rating of 10 percent may be applied to each such major joint or group of minor joints affected by limitation of motion. A rating of 20 percent may be applied where there are occasional incapacitating exacerbations. 38 C.F.R. § 4.71a, DCs 5003, 5010. The limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Id. Effective February 7, 2021, DC 5003 is amended to provide that degenerative arthritis established by x-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under DC 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, a 10 percent rating is assigned with x-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups. A 20 percent evaluation is assigned with x-ray evidence of involvement of 2 or more major joints or 2 or more minor joints, with occasional incapacitating exacerbations. Pre-amended DC 5010 provides arthritis due to trauma and substantiated by x-ray findings will be rated as degenerative arthritis. See 38 C.F.R. § 4.71a, DC 5010. DC 5010 instructs to rate under DC 5003 (degenerative arthritis). Amended DC 5010 provides for post-traumatic arthritis to be rated as limitation of motion, dislocation, or other specific instability under the affected joint. If there are 2 or more joints affected, each rating shall be combined in accordance with § 4.25. See 38 C.F.R. § 4.71a, DC 5010. Diagnostic Code 8510 provides the rating criteria for paralysis of upper radicular group. Complete paralysis of the nerve is rated as 70 percent disabling for the major arm, and as 60 percent disabling for the minor arm. Disability ratings of 20 percent, 40 percent, and 50 percent are assignable for incomplete paralysis, which is mild, moderate, or severe in degree, for the major arm, and as 20, 30, and 40 percent, for the minor arm, respectively. 38 C.F.R. § 4.124a, DC 8510. Under Diagnostic Code 8511, 60 and 70 percent ratings are warranted for the minor and major extremity, respectively, for complete paralysis, with adduction, abduction, rotation of the arm, flexion of the elbow, and extension of the wrist severely affected. Disability ratings of 20 percent, 40 percent, and 50 percent are assignable for incomplete paralysis, which is mild, moderate, or severe in degree, for the major arm, and as 20, 30, and 40 percent, for the minor arm, respectively. 38 C.F.R. § 4.124a, DC 8511. Paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, DC 8520. Mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R. § 4.124a. Diagnostic Code 8526 governs paralysis of the femoral nerve and provides a 10 percent rating for mild incomplete paralysis, a 20 percent rating for moderate incomplete paralysis, and a 30 percent rating for severe incomplete paralysis. A 40 percent rating is provided for complete paralysis of the quadriceps extensor muscles. 38 C.F.R. § 4.124a, DC 8526. The words "mild," "moderate," and "severe" as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based on the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. According to Merriam Webster's Collegiate Dictionary 999 (11th Ed. 2007), "mild" means not very severe. "Moderate" means limited in scope or effect. "Severe" means very painful or harmful or of a great degree. Although a medical examiner's use of descriptive terminology such as "mild" is an element of evidence to be considered by the Board, it is not dispositive of an issue. The Board must evaluate all evidence in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6 The term "incomplete paralysis" indicates a degree of loss or impaired function substantially less than the type pictured 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 is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). The Board notes the Veteran was granted service connection for DDD / DJD of the lumbosacral spine with spondylolisthesis and DDD of the cervical spine sarcoidosis in a March 2000 rating decision with disability ratings assigned. The Veteran did not appeal or submit additional evidence within a year of the March 2000 rating decision. As such, it became a final decision. Thereafter, VA received the Veteran's increased rating claim on March 8, 2013. Thus, the Board will consider the severity of his lumbosacral spine and cervical spine disabilities from the date of claim, or up to one year prior to VA's receipt of the Veteran's increased rating claim, to the extent an increase in severity is factually ascertainable. See 38 C.F.R. § 3.400(o)(2). Turning to the relevant evidence regarding service connected IVDS and degenerative arthritis of the thoracolumbar spine, in 2013, the Veteran reported experiencing back pain that increased with tasks including reaching across tables and leaning over tables. See January 2013 treatment records. In 2014, the Veteran complained of chronic back pain. See May, July, and October 2014 VA treatment records. In 2015, the Veteran continued to endorse experiencing chronic back pain. See March 2015 VA treatment records. Records reference the Veteran used a cane and experienced peripheral neuropathy in both legs secondary to his back. In 2019, the Veteran reported back pain and declined bowel or bladder incontinence. See November 2019 VA treatment records. He was noted to have non-antalgic gait with transfers from sitting to standing without difficulty. In 2020 and 2021, the Veteran continued to report lower back pain with intermittent flare-ups and radicular symptoms. See September 2020 and March 2021 VA treatment records. The Veteran declined experiencing incontinence of the bowel or bladder. During the period on appeal, the Veteran has been afforded three VA examinations to determine the severity of his IVDS and degenerative arthritis of the thoracolumbar spine. The first examination occurred in December 2013 during which the Veteran reported experiencing flare-ups productive of pain and stiffness. See December 2013 VA examination. Initial range of motion (ROM) testing revealed forward flexion ending at 60 degrees with painful motion beginning at 55 degrees; extension ending at 20 degrees with painful motion at 15 degrees; right and left lateral flexion ending at 25 degrees with painful motion at 20 degrees; and right and left lateral rotation ending at 25 degrees with painful motion at 20 degrees. The Veteran was able to complete repetitive use testing with forward flexion ending at 60 degrees; extension ending at 20 degrees; right and left lateral flexion ending at 25 degrees; and right and left lateral rotation ending at 25 degrees. The examiner opined that the Veteran does not have additional limitation in ROM of the back following repetitive-use testing. Contributing factors to functional loss included less movement than normal, pain on movement, and disturbance of locomotion. The Veteran did not have localized tenderness or pain on palpitation or guarding or muscle spasm. Muscle strength testing was normal without atrophy. Reflexes were normal. The Veteran had decreased sensation in the right lower leg / ankle and right foot / toes. Otherwise, the sensory examination was normal. The Veteran was found to experience radiculopathy symptoms. Regarding the right lower extremity, moderate intermittent pain and moderate paresthesias and / or dysesthesias was indicated without constant pain or numbness. Regarding the left lower extremity, mild intermittent pain and mild paresthesias and /or dysesthesias was indicated without constant pain or numbness. The radiculopathy symptoms were noted to involve the sciatic nerve of a moderate severity on the right and mild severity on the left. Other neurologic abnormalities were not found. The Veteran was noted to have IVDS but without any incapacitating episodes over the past 12 months due to IVDS. Regular use of a brace was noted. Functional impact on the ability to work was described as an inability to do extended walking or lifting heavy objects. Gait was noted to be normal. Pain, weakness, fatigability and / or incoordination contributed to functional loss. Additional functional loss during flare-ups or with repeated use over time was noted to be an inability to lift heavy objects due to pain. A degree of additional ROM loss was unable to be provided because the examination did not occur during a flare-up. Another VA examination occurred in February 2015 during which the Veteran reported that he worked in food preparation and it is "getting more difficult" because of his lumbar radiculopathy slowing the ability to transition from one task to another. See February 2015 VA examination. The Veteran reported worsening neuropathic pain. Flare-ups were endorsed and described as limited ROM with flexion, rotation, and lateral flexion. Functional loss and impairment were reported as impaired walking and limited bending, leaning, and squatting. Initial ROM testing revealed forward flexion 0 to 60 degrees; extension 0 to 20 degrees; right and left lateral flexion 0 to 30 degrees; and right and left lateral rotation 0 to 30 degrees. The limited ROM impairs the Veteran's ability to bend, flex, and extend. Pain was noted on examination with forward flexion, extension, and right and left lateral flexion. There was no evidence of pain with weight bearing. Mild tenderness at the lower lumbar spine was found. Repetitive use testing was able to be completed with additional loss of ROM due to pain. Repetitive use testing ROM was flexion 0 to 30 degrees; extension 0 to 10 degrees; right lateral flexion 0 to 20 degrees; left lateral flexion 0 to 30 degrees; and right and left lateral rotation 0 to 30 degrees. Flare-ups were described as severe occurring weekly and lasting for 3-5 days. The examiner opined that pain significantly limits functional ability with flare-ups. Flare-ups ROM loss was estimated to be forward flexion 0 to 30 degrees; extension 0 to 10 degrees; right lateral flexion 0 to 20 degrees; left lateral flexion 0 to 30 degrees; and right and left lateral rotation 0 to 30 degrees. The Veteran had muscle spasm and localized tenderness not resulting in abnormal gait or abnormal spinal contour. Disturbance of locomotion and interference with standing were noted to be contributing factors of disability. Muscle strength testing was normal without atrophy. Sensory examination was normal except for the right foot / toes which was absent. Radiculopathy symptoms were noted with a separate peripheral nerves conditions disability benefits questionnaire (DBQ) discussed below. Ankylosis was not found or any other neurologic abnormalities. IVDS was indicated but without episodes of acute signs or symptoms due to IVDS requiring bed rest. Regular use of a brace and cane were reported. Functional impact on the ability to work was described as sedentary employment that does not require heavy physical labor or lifting more than 10 pounds, prolonged walking or standing, twisting, bending, or squatting. A separate peripheral nerves conditions DBQ was completed in February 2015. The Veteran reported worsening pain in both legs. See February 2015 DBQ. Regarding the right lower extremity, the Veteran was noted to have moderate intermittent pain, severe paresthesias and /or dysesthesias, and moderate numbness. Regarding the left lower extremity, mild paresthesias and / or dysesthesias was noted. The sensory examination was normal except for the right foot / toes which was absent. Trophic changes attributable to peripheral neuropathy were not found. The Veteran's gait was not normal and described as stiff, rightward leaning, and stable with a cane. The examiner opined the Veteran has right moderate incomplete paralysis of the sciatic nerve and left mild incomplete paralysis. The examiner also opined the Veteran has right and left mild incomplete paralysis of the femoral nerve. Use of a cane and brace was reported for pain and stabilization. Functional impact on the ability to work was described as an ability to complete sedentary employment that does not require heavy physical labor, lifting more than 10 pounds, prolonged walking or standing, bending, twisting, or squatting. Most recently, the Veteran was afforded a VA examination in July 2021 during which he endorsed experiencing sharp pain to the hands, back pain, issues with legs and knees, weakness, and numbness. See July 2021 VA examination. He endorsed daily flare-ups described as severe and lasting about a week. He reported flare-ups precipitated by bending over and alleviated by rest and medication. Functional loss and impairment were reported as limited range of motion, daily stiffness, and pain with prolonged walking and standing. Initial ROM testing revealed forward flexion to 60 degrees, extension to 25 degrees, right and left lateral flexion to 25 degrees, and right and left lateral rotation to 25 degrees. Pain was exhibited with each movement. Passive ROM testing was completed with the same results as active ROM and pain on all movements. There was evidence of pain with weight-bearing and active and passive motion causing functional loss with difficulty sitting for a prolonged period, bending, and lifting heavy objects. Objective evidence of crepitus or localized tenderness were not indicated. Repetitive use testing was able to be completed with forward flexion to 55 degrees, extension to 20 degrees, right and left lateral flexion to 20 degrees, and right and left lateral rotation to 20 degrees. Pain and lack of endurance were noted to cause the functional loss with repetitive use. Estimated ROM after repeated use over time was forward flexion to 50 degrees, extension to 15 degrees, right and left lateral flexion to 15 degrees, and right and left lateral rotation to 15 degrees. Pain and lack of endurance were noted to contribute to ROM loss during flare-ups with estimates of forward flexion to 40 degrees, extension to 10 degrees, right and left lateral flexion to 10 degrees, and right and left lateral rotation to 10 degrees. Guarding or localized tenderness was not indicated. Muscle strength testing was normal without atrophy. The Veteran had decreased sensation in the right and left upper anterior thigh, thigh / knee, lower leg / ankle, and foot / toes. Radiculopathy symptoms associated with the sciatic nerve were noted to be moderate intermittent pain, paresthesias and / or dysesthesias, and numbness in the right and left lower extremities. Ankylosis was not found. There were no other neurologic abnormalities found. The Veteran had IVDS but did not have any episodes of acute signs and symptoms due to IVDS that required bed rest prescribed by a physician and treatment by a physician in the past 12 months. Functional impact on the ability to complete occupational tasks was noted as difficulty with standing, walking, or running for long periods of time. The Board finds that the July 2021 VA examination is adequate to determine the current nature, extent, and severity of the Veteran's thoracolumbar spine disability. The requirements of DeLuca, Correia, and Sharp were all addressed by the examiner and the Veteran's own descriptions of his limitations were taken into account in determining functional impact and additional loss in terms of range of motion with repetitive use over time and during flare-ups. DeLuca, 8 Vet. App. At 202; Correia, 28 Vet. App. at 158; Sharp, 29 Vet. App. at 32. While the Board previously remanded this claim based on the 2013 VA examiner's failure to provide a ROM loss estimate during flare-ups and the 2015 VA examiner's failure to provide ROM estimates for active and passive motion or in weight-bearing and non-weight-bearing, the Board notes these examinations may still have probative value. See Monzingo v. Shinseki, 26 Vet. App. 97, 107 (2012) (holding "Furthermore, even if a medical opinion is inadequate to decide a claim, it does not necessarily follow that the opinion is entitled to absolutely no probative weight."). Indeed, the July 2021 VA examination, when considered in conjunction with the other medical evidence of record and previous VA examinations, provides an adequate basis upon which to evaluate the Veteran's thoracolumbar spine disability during the period on appeal. 1. Entitlement to a disability rating of 40 percent, but no higher, from March 8, 2013, for IVDS and degenerative arthritis of the thoracolumbar spine is granted. The Board finds, based on the evidence of record, the Veteran's IVDS and degenerative arthritis of the thoracolumbar spine warrants a 40 percent disability rating, but no higher, from March 8, 2013. The December 2013 VA examiner noted that the Veteran experiences flare-ups productive of pain and stiffness. The examiner did not provide precipitating or alleviating factors or consider duration / frequency. Further, the examiner was unable to provide a ROM loss estimate during flare-ups based on the rationale that the examination was not conducted during a flare-ups. As such, the December 2013 VA examination is not compliant with Sharp regarding flare-ups. See Sharp, 29 Vet. App. at 35. The Veteran again reported experiencing flare-ups during the February 2015 VA examination. The examiner's ROM loss during flare-ups, based on the Veteran's medical evidence and lay statements, was estimated to be forward flexion 0 to 30 degrees; extension 0 to 10 degrees; right lateral flexion 0 to 20 degrees; left lateral flexion 0 to 30 degrees; and right and left lateral rotation 0 to 30 degrees. Forward flexion 0 to 30 degrees warrants a 40 percent disability rating under the General Rating Formula for Diseases and Injuries of the Spine. The Board has also considered the July 2021 VA examination, however, the examiner indicated improved ROM during flare-ups with forward flexion to 40 degrees. Considering the Veteran's consistent reports of pain and flare-ups, the Board will resolve any doubt in favor of the Veteran and assign a 40 percent disability rating, but no higher, from March 8, 2013. The Board has considered the evidence of record in the year prior to March 8, 2013, and finds there was not a factually ascertainable increase in severity. The Board finds that the Veteran's disability is fully capable of evaluation under the rating schedule during this period. In so finding, the Board also concludes a higher disability rating for unfavorable ankylosis of the entire thoracolumbar spine under the General Rating Formula for Diseases and Injuries of the Spine is not warranted. While all of the VA examinations of record found the Veteran's thoracolumbar spine was not ankylosed, consideration must still be given to whether he is functionally ankylosed. Chavis v. McDonough, 34 Vet. App. 1, 20 (2021) (holding that consideration must still be given to whether a claimant's functional loss "is consistent with that contemplated by ankylosis in other words, if it is the functional equivalent of ankylosis."). Ankylosis is defined as "immobility and consolidation of a joint due to disease, injury, or surgical procedure." Dorland's Illustrated Medical Dictionary, 94 (32nd ed. 2012). Here, the Veteran has not contended, nor does the record suggest, the Veteran's thoracolumbar spine is immobile. The Veteran reports an inability to stand or walk for prolonged periods and he is limited in mobility including with carrying objects, bending, and squatting, but the Veteran's thoracolumbar spine is still mobile, albeit with pain. As such, a higher rating under the General Rating Formula for Diseases and Injuries of the Spine is not warranted. The Board has considered whether a higher disability rating would be achieved under the Formula for Rating IVDS Based on Incapacitating Episodes. While the Veteran has IVDS, each VA examination of record has found the Veteran has not experienced incapacitating episodes during the past 12 months. Further, the Veteran's treatment records lack any mentioned of experiencing incapacitating episodes. Thus, a higher disability rating would not be achieved under the Formula for Rating IVDS Based on Incapacitating Episodes. Additionally, the Board has considered whether a separate rating is warranted for any neurologic abnormalities during this period but finds such a rating is not warranted. Aside from the lower extremity radiculopathies addressed below, the record lacks any reference to or statements regarding other neurologic abnormalities. Indeed, the VA examinations of record found the Veteran does not have any other neurologic abnormalities and treatment records note the Veteran declined experiencing incontinence. Thus, resolving any doubt in the Veteran's favor, the Board finds a 40 percent disability rating, but no higher, for the Veteran's IVDS and degenerative arthritis of the thoracolumbar spine is warranted from March 8, 2013. 2. Entitlement to a 20 percent disability rating, but no higher, from March 8, 2013, and 40 percent from February 9, 2015, for right lower extremity radiculopathy of the sciatic nerve (claimed as peripheral neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is granted. Upon review of the totality of the record, a 20 percent disability rating, but no higher, from March 8, 2013, and 40 percent from February 9, 2015, for right lower extremity radiculopathy of the sciatic nerve is warranted. From March 8, 2013, to February 8, 2015 The December 2013 VA examiner opined the Veteran's right lower extremity radiculopathy of the sciatic nerve was "moderate." The Veteran's symptoms included intermittent pain and paresthesias and / or dysesthesias without constant pain or numbness. Based on the above, the Board finds that the disability is primarily manifest by pain and sensory disturbance during this period. The Board thus finds that the level of impairment is most analogous to moderate incomplete paralysis warranting a 20 percent disability rating under DC 8520. The Board has considered whether there was a factually ascertainable increase in severity in the year prior to March 8, 2013, but finds the evidence of record insufficient to warrant award of a separate rating prior to the date of claim. In so finding, the Board also concludes a higher rating under DC 8520 is not warranted as the Veteran did not experience impairment of motor function or trophic changes in the right lower extremity, and the Veteran's intermittent pain and paresthesias and / or dysesthesias did not amount to a moderately severe as contemplated under the rating criteria. Accordingly, a 20 percent disability rating, but no higher, is warranted from March 8, 2013, under DC 8520. From February 9, 2015 In February 2015, the Veteran completed a specific peripheral nerves conditions DBQ revealing the Veteran experienced moderate intermittent pain, severe paresthesias and / or dysesthesias, and moderate numbness in the right lower extremity. The examiner opined that the Veteran had moderate incomplete paralysis of the sciatic nerve in the right lower extremity. Based on the above, the Board finds that the disability is primarily manifested by sensory disturbance and pain including both moderate and severe symptoms, which more nearly approximates a 40 percent disability rating under DC 8520 for "moderately severe." In so finding, the Board also concludes a higher disability rating under DC 8520 is not warranted as the Veteran did not have marked muscular atrophy with impairment of motor functions, trophic changes, loss of reflexes, muscle atrophy, or complete paralysis that were "severe." The Board notes the July 2021 VA examination even showed improvement in paresthesias and / or dysesthesias noted only as "moderate." The Board thus finds that the level of impairment is most analogous to moderately severe from February 9, 2015, which has been appropriately rated as 40 percent disabling and no higher. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran's claim for a rating in excess of 40 percent for right lower extremity radiculopathy of the sciatic nerve from February 9, 2015. In denying an increased rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 3. Entitlement to a 20 percent disability rating from July 6, 2021, but no higher or earlier, for left lower extremity radiculopathy of the sciatic nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is granted. Upon review of the totality of the record, a 20 percent disability rating is warranted from July 6, 2021, but no higher or earlier, for left lower extremity radiculopathy of the sciatic nerve. From March 8, 2013, to July 5, 2021 A rating in excess of 10 percent from March 8, 2013, to July 5, 2021, for left lower extremity radiculopathy of the sciatic nerve is not warranted. The December 2013 VA examiner opined the Veteran's left lower extremity radiculopathy of the sciatic nerve was of a mild severity based on symptoms of intermittent pain and paresthesias and / or dysesthesias but without constant pain or numbness. The February 2015 peripheral nerves DBQ revealed left lower extremity radiculopathy symptoms of paresthesias and /or dysesthesias which the examiner opined was "mild" incomplete paralysis. Based on the above, the Board finds the Veteran's left lower extremity radiculopathy of the sciatic nerve is primarily manifested by pain and sensory disturbance of a mild severity, which has been appropriately rated as 10 percent disabling under DC 8520. The Board has considered whether there was a factually ascertainable increase in severity in the year prior to March 8, 2013, but finds the evidence of record insufficient to warrant award of a separate rating prior to the date of claim. The Board also finds that the most probative evidence of record is against a finding that the disability is manifest by pain or sensory disturbance of a severity warranting a rating in excess of 10 percent, nor is there evidence of impairment of motor functions, trophic changes, loss of reflexes, muscle atrophy, or complete paralysis. The Board thus finds that the level of impairment is most analogous to mild incomplete paralysis from March 8, 2013, to July 5, 2021. From July 6, 2021 The July 2021 VA examiner opined that the Veteran's left lower extremity radiculopathy of the sciatic nerve had worsened in severity. Specifically, the examiner noted the Veteran had moderate intermittent pain, moderate paresthesias and / or dysesthesias, and moderate numbness. Based on the above, the Board finds that the disability is primarily manifest by pain and sensory disturbance reflecting worsening based on the prior VA examinations of record. Indeed, the Board finds from July 6, 2021, the Veteran's left lower extremity radiculopathy of the sciatic nerve warrants a 20 percent disability rating for symptoms of a "moderate" severity. The Board also finds that the most probative evidence of record is against a finding that the disability is manifest by symptoms of a moderately severe level of impairment of motor functions, trophic changes, loss of reflexes, muscle atrophy, or complete paralysis warranting a rating in excess of 20 percent. The Board thus finds that the level of impairment is most analogous to moderate incomplete paralysis from July 6, 2021, warranting a 20 percent disability rating under DC 8520, but no higher. 4. Entitlement to a rating in excess of 10 percent from February 9, 2015, for right lower extremity radiculopathy of the femoral nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is denied. 5. Entitlement to a rating in excess of 10 percent from February 9, 2015, for left lower extremity radiculopathy of the femoral nerve (claimed as neuropathy) associated with IVDS and degenerative arthritis of the thoracolumbar spine is denied. Upon review of the totality of the record, a rating in excess of 10 percent for right and left lower extremity radiculopathy of the femoral nerve from February 9, 2015, is not warranted. The February 2015 peripheral nerves conditions DBQ revealed right and left incomplete paralysis of the femoral nerve marked as "mild." The Veteran's symptoms were noted to include right lower extremity moderate intermittent pain, severe paresthesias and /or dysesthesias, and moderate numbness and left lower extremity, and mild paresthesias and / or dysesthesias. Upon review of said symptoms, however, the examiner opined that the Veteran's femoral nerve radiculopathy in the right and left lower extremities amounts to "mild." The Board finds the examiner's assessment of the Veteran's femoral nerve radiculopathy in the right and left lower extremities to be highly probative as the examiner considered the Veteran's symptoms, which included radiculopathies of multiple nerves, and examined the Veteran prior to providing findings specific to the diagnostic criteria for which the Veteran's disabilities are evaluated. The Board also notes the Veteran's varied symptom severity has been considered and compensated for under the Veteran's separate ratings discussed above for right and left lower extremity radiculopathy of the sciatic nerve. Thus, the Board finds a rating in excess of 10 percent for right and left lower extremity radiculopathy of the femoral nerve from February 9, 2015, is not warranted. In denying an increased rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 6. Entitlement to a 30 percent rating, but no higher, from March 8, 2013, for cervical spine DDD with IVDS is granted. Turning to the relevant evidence of record regarding the cervical spine, the Veteran complained of increased neck pain with reaching across tables and leaning over. See January 2013 treatment records. He described experiencing upper back and neck pain. Pain and stiffness begin after sitting for a long period or holding the head in an erect position for long periods. In 2014, the Veteran complained of upper back and neck pain. See May 2014 VA treatment records. In 2019, treatment records reflect cervicalgia with pain. See January 2019 treatment records. The Veteran was afforded a VA examination in December 2013 and July 2021 to determine the severity of his service-connected cervical spine DDD with IVDS. During the December 2013 VA examination, the Veteran reported experiencing flare-ups that cause pain and stiffness. See December 2013 VA examination. Initial ROM testing revealed forward flexion and extension both ending at 40 degrees with evidence of painful motion at 35 degrees; right and left lateral flexion ending at 30 degrees with painful motion at 25; and right and left lateral rotation ending at 60 degrees with painful motion at 55 degrees. Repetitive use testing revealed forward flexion and extension both ending at 40 degrees; right and left lateral flexion ending at 30 degrees; and right and left lateral rotation ending at 60 degrees. Contributing factors of disability included less movement than normal and pain on movement. The Veteran did not have localized tenderness, pain on palpitation, guarding, or muscle spasm. Muscle strength testing was normal without atrophy. Sensory examinations were normal. The Veteran was noted to have radiculopathy symptoms of right upper extremity moderate intermittent pain and moderate paresthesias and / or dysesthesias involving the C5/C6 nerve roots. The examiner opined the radiculopathy was of a moderate severity. The Veteran did not have IVDS. Use of a brace was indicated regularly for his back and neck. Functional impact on the ability to work was noted to be an inability to lift heavy objects or perform overhead activities. The additional factors of pain, weakness, fatigability, and / or incoordination cause additional limitation of functional ability during flares and with repeated use described as an inability to lift heavy objects. A ROM loss estimate was unable to be provided because the Veteran was not experiencing a flare-up during the examination. In July 2021, the Veteran reported experiencing symptoms of migraines, sharp pains to the head, and ear pain. See July 2021 VA examination. He endorsed daily flare-ups described as "severe" lasting about a week precipitated by any head or neck movements. Flare-ups were alleviated by rest and medications. Functional loss was conveyed as limited ROM. Initial ROM testing revealed forward flexion and extension to 30 degrees, right and left lateral flexion to 30 degrees, and right and left lateral rotation to 50 degrees. Pain was noted on examination with each movement. Passive ROM testing was completed with the same ROM results and pain with each movement. Pain was noted with active and passive motion that causes functional loss described as difficulty with sitting at a computer for long hours and lifting heavy objects. Repetitive use testing was completed with forward flexion and extension to 25 degrees, right and left lateral flexion to 25 degrees, and right and left lateral rotation to 45 degrees. Pain and lack of endurance were noted to cause the functional loss with repetitive use. Repeated use over time ROM loss was estimated to be forward flexion and extension to 20 degrees, right and left lateral flexion to 20 degrees, and right and left lateral rotation to 40 degrees with pain and lack of endurance causing the additional functional loss. The examination did not occur during a flare-up, but the examiner estimated ROM loss during a flare-up to be forward flexion and extension to 15 degrees, right and left lateral flexion to 15 degrees, and right and left lateral rotation to 35 degrees with pain and lack of endurance causing the additional ROM loss. There was no objective evidence of crepitus or localized tenderness or pain on palpitation. The Veteran did not have localized tenderness, guarding, or muscle spasm. Muscle strength testing was normal without atrophy. There was decreased sensation in the right and left shoulder area, inner / outer forearm, and hand / fingers. Radiculopathy symptoms were noted to be mild intermittent pain, mild paresthesias and / or dysesthesias, and mild numbness in the right and left upper extremities involving the C7 nerve root. Ankylosis was not found. No other neurologic abnormalities were indicated. The Veteran had IVDS but did not have any episodes of acute signs or symptoms due to IVDS that required bedrest prescribed by a physician and treatment by a physician in the last year. The Veteran's cervical spine disability was noted to impact his ability to perform any occupational task described as difficulty with heavy lifting and limited ROM. The Board finds that the July 2021 VA examination is adequate to determine the current nature, extent, and severity of the Veteran's cervical spine disability. The requirements of DeLuca, Correia, and Sharp were all addressed by the examiner and the Veteran's own descriptions of his limitations were taken into account in determining functional impact and additional loss in terms of range of motion with repetitive use over time and during flare-ups. DeLuca, 8 Vet. App. at 202; Correia, 28 Vet. App. at 158; Sharp, 29 Vet. App. at 32. While the Board previously remanded this claim based on the 2013 VA examiner's failure to provide a ROM loss estimate during flare-ups, with passive motion, or with weight bearing / non-weight-bearing, the Board notes these examinations may still have probative value. See Monzingo, 26 Vet. App. at 107. The Board finds the July 2021 VA examination, when considered in conjunction with the other medical evidence of record and previous VA examination, provides an adequate basis upon which to evaluate the Veteran's cervical spine disability during the period on appeal. Based on the evidence of record, the Board finds a 30 percent disability rating, but no higher, is warranted throughout the entire period on appeal from March 8, 2013. The Board finds highly probative the July 2021 VA examiner's ROM loss estimate regarding flare-ups which was forward flexion to 15 degrees warranting a 30 percent disability rating under the General Rating Formula for Diseases and Injuries of the Spine. The Board notes the Veteran competently and credibly reported experiencing flare-ups as part of the 2013 VA examination, however, the examiner did not provide a ROM loss because the examination did not occur during a flare-up. Thus, the 2013 VA examination did not comply with Sharp and the rationale offered in support of a lack of ROM testing during flare-ups was not sufficient. Resolving any doubt in favor of the Veteran, and in light of the Veteran's consistent reports of experiencing flare-ups, the Board finds a 30 percent disability rating is warranted from March 8, 2013, under DC 5243-5242. The Board also finds that the Veteran's disability is fully capable of evaluation under the rating schedule. In so opining, the Board also concludes a higher disability rating under the General Rating Formula for Diseases and Injuries of the Spine is not warranted as the Veteran did not have unfavorable ankylosis of the entire cervical spine. While both VA examinations of record found the Veteran's cervical spine was not ankylosed, consideration must still be given to whether he is functionally ankylosed. Chavis, 34 Vet. App. at 20. Here, the Veteran has not contended, nor does the record suggest, the Veteran's cervical spine is immobile. The Veteran reported experiencing neck pain and stiffness, inability to lift heavy objects, inability to lift overhead, and difficulty sitting at the computer for a long period of time. While the Veteran competently and credibly reported his limitations, the Board finds the Veteran's cervical spine remained mobile, albeit with pain and stiffness. As such, a higher rating under the General Rating Formula for Diseases and Injuries of the Spine is not warranted. The Board has considered whether a higher disability rating would be achieved under the Formula for Rating IVDS Based on Incapacitating Episodes. While the Veteran has IVDS, each VA examination of record has found the Veteran has not experienced incapacitating episodes during the past 12 months. Further, the Veteran's treatment records lack any mentioned of experiencing incapacitating episodes. Thus, a higher disability rating would not be achieved under the Formula for Rating IVDS Based on Incapacitating Episodes. Additionally, the Board has considered whether a separate rating is warranted for any neurologic abnormalities during this period but finds such a rating is not warranted. Aside from the upper extremity radiculopathies addressed below, the record lacks any reference to or statements regarding other neurologic abnormalities. Thus, resolving any doubt in the Veteran's favor, the Board finds a 30 percent disability rating, but no higher, for the Veteran's cervical spine DDD with IVDS is warranted from March 8, 2013. 7. Entitlement to a 40 percent disability rating, but no higher, from March 8, 2013, for right upper extremity radiculopathy (claimed as neuropathy) associated with cervical spine DDD with IVDS is granted. Based on the above, the Board finds a 40 percent disability rating, but no higher, from March 8, 2013, for right upper extremity radiculopathy associated with cervical spine DDD with IVDS is warranted. The December 2013 VA examiner indicated the Veteran had radiculopathy symptoms of the right upper extremity including moderate intermittent pain and moderate paresthesias and / or dysesthesias. Based on the examination and the Veteran's medical records, the examiner opined the Veteran's right upper extremity radiculopathy was "moderate." The Board finds the Veteran's disability is primarily manifest by pain and sensory disturbances. The Board notes the Veteran is right handed. The Board also finds that the most probative evidence of record is against a finding that the disability is manifest by impairment of motor functions, trophic changes, loss of reflexes, muscle atrophy, or complete paralysis. The level of impairment is most analogous to moderate incomplete paralysis under DC 8510 warranting a 40 percent disability rating from March 8, 2013. 8. Entitlement to a rating in excess of 20 percent for left upper extremity radiculopathy associated with cervical spine DDD with IVDS is denied. Based on the above, the Board finds a rating in excess of 20 percent from July 6, 2021, is not warranted. March 8, 2013, to July 5, 2021 Prior to the July 2021 VA examination, a separate rating for left upper extremity radiculopathy is not warranted. Indeed, the December 2013 VA examiner found the Veteran only had radiculopathy in the right upper extremity. It was not until the July 2021 VA examination that the Veteran was noted to have left upper extremity radiculopathy. Treatment records prior to the July 2021 VA examination lack mention of a diagnosis of left upper extremity radiculopathy. Thus, the Board finds a separate rating for left upper extremity radiculopathy is not warranted prior to July 6, 2021. From July 6, 2021 The Board finds, based on the evidence of record, that the Veteran is appropriately rated as 20 percent disabled for left upper extremity radiculopathy under DC 8511. The July 2021 VA examiner indicated the Veteran had radiculopathy symptoms of the left upper extremity including mild intermittent pain, mild paresthesias and /or dysesthesias, and mild numbness. The Board finds the Veteran's disability is primarily manifest by pain and sensory disturbances. The Veteran is right handed. The Board also concludes the most probative evidence of record is against a finding that the disability is manifest by impairment of motor functions, trophic changes, loss of reflexes, muscle atrophy, or complete paralysis. As such, the level of impairment is appropriately rated as 20 percent disabling for mild incomplete paralysis under DC 8511. In denying an increased rating, the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. REASONS FOR REMAND 1. Entitlement to TDIU is remanded. Based upon review, the Board finds the issue of TDIU is reasonably raised by the record. See Rice v. Shinseki, 22 Vet. App. 447, 453-55 (2009). Indeed, 2013 treatment records reflect the Veteran reported that his employment ended due to difficulty performing tasks because reaching across tables and leaning over caused his back and neck pain to increase. Thus, the Board infers a TDIU claim from the record; and as such, takes jurisdiction over the issue. Rice, 22 Vet. App. 447. In a 2015 VA examination, however, the Veteran stated that he was employed but his job is more difficult because of his radiculopathies. As such, based upon review of the record, the Veteran's current employability status is not clear, and development of this claim needs to be completed including notifying the Veteran of the evidence required to substantiate a TDIU claim and solicitation of employment and payment history to determine whether he is eligible for TDIU. Accordingly, this issue is remanded for further development. The matters are REMANDED for the following action: 1. Send the Veteran a notice letter, pursuant to 38 U.S.C. § 5103(a) and 38 C.F.R. § 3.159(b), which advises him of the information needed to substantiate a claim for TDIU. In addition, ask the Veteran to complete a VA Form 21-8940 (Application for Increased Compensation Based on Unemployability) to obtain relevant employment information. (Continued on the next page) 2. After the above development, and any other development deemed necessary, adjudicate the claim. SHEREEN M. MARCUS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A.C. Allen, 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.