Citation Nr: 21071911 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 17-10 949A DATE: December 1, 2021 ORDER Entitlement to a compensable rating for limited flexion, femoral acetabular impingement, left hip is denied. Entitlement to a rating in excess of 20 percent for limited abduction impairment, femoral acetabular impingement, left hip is denied. Entitlement to a rating in excess of 10 percent for limited extension, femoral acetabular impingement, left hip is denied. Entitlement to a compensable rating for residual scars, left hip is denied. Entitlement to a 20 percent rating for left ankle impingement prior to September 2, 2020 is granted. Entitlement to a rating in excess of 20 percent for left ankle impingement from September 2, 2020 is denied. FINDINGS OF FACT 1. The Veteran's limitation of flexion did not more nearly approximate 45 degrees throughout the appellate period. 2. The Veteran is in receipt of the highest rating available for limited abduction impairment of the left hip. 3. The Veteran is in receipt of the highest rating available for limited extension of the left hip. 4. The Veteran's residual scars of the left hip are not painful, unstable or greater than 39 square centimeters. 5. The Veteran's left ankle impingement has more nearly approximated marked impairment in dorsiflexion throughout the appellate period; no ankylosis has been shown. CONCLUSIONS OF LAW 1. The criteria for a compensable rating for limited flexion, femoral acetabular impingement have not been met. 38 U.S.C. §§ 1155, 5107 (2018); 38 C.F.R. §§ 3.102, 4.40, 4.45, 4.71a, Diagnostic Code 5252 (2020). 2. The criteria for a rating in excess of 20 percent for limited abduction impairment, femoral acetabular impingement, left hip have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.40, 4.45, 4.71a, Diagnostic Code 5253 (2020) 3. The criteria for a rating in excess of 10 percent for limited extension, femoral acetabular impingement, left hip have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.40, 4.45, 4.71a, Diagnostic Code 5251 (2020) 4. The criteria for a compensable rating for residual scars, left hip have not been met. 38 U.S.C. §§ 1155, 5107 (2018); 38 C.F.R. § 4.118, Diagnostic Code 7805 (2020). 5. The criteria for a 20 percent rating for left ankle impingement prior to September 2, 2020 have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.40, 4.45, 4.71a, Diagnostic Code 5271 (2020); 85 Fed. Reg. 76464 (Feb 7, 2021). 6. The criteria for a rating in excess of 20 percent for left ankle impingement from September 2, 2020 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.40, 4.45, 4.71a, Diagnostic Code 5271 (2020); 85 Fed. Reg. 76464 (Feb 7, 2021). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1998 to December 1998 and from August 2006 to March 2007. These matters come before the Board of Veterans' Appeals (Board) on appeal of August 2014 and April 2017 rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Board remanded the matters on appeal for further development. Increased Rating 1. Entitlement to a compensable rating for limited flexion, femoral acetabular impingement, left hip is denied. 2. Entitlement to a rating in excess of 20 percent for limited abduction impairment, femoral acetabular impingement, left hip is denied. 3. Entitlement to a rating in excess of 10 percent for limited extension, femoral acetabular impingement, left hip, is denied. The August 2014 rating decision granted service connection for femoral acetabular impingement, left hip, and assigned a noncompensable rating under Diagnostic Code (DC) 5252. The April 2017 rating decision granted service connection for limited abduction impairment, femoral acetabular impingement, left hip, and assigned a 20 percent rating under DC 5253. That rating decision also granted service connection for limited extension, femoral acetabular impingement, left hip and assigned a noncompensable rating under DC 5251. A September 2020 rating decision granted an increased, 10 percent rating for limited extension for the entire appellate period. Under DC 5251 which governs the extension of the thigh, a 10 percent disability rating is warranted for extension limited to 5 degrees. 38 C.F.R. § 4.71a. Under DC 5252, a 10 percent rating is warranted for flexion limited to 45 degrees. A 20 percent rating is warranted for flexion limited to 30 degrees. A 30 percent rating is warranted for flexion limited to 20 degrees. A maximum 40 percent rating is warranted for flexion limited to 10 degrees. Id. Under DC 5253, a 10 percent disability rating is warranted if the Veteran's thigh rotation is limited, cannot toe-out, more than 15 degrees of the affected leg. A 10 percent disability rating is also warranted if the Veteran's thigh adduction is limited so that the Veteran cannot cross their legs. A maximum disability rating of 20 percent warranted if the Veteran's thigh abduction is limited to 10 degrees or less. Id. Normal range of hip motion is 125 degrees of flexion, 140 degrees of extension, and 45 degrees of abduction. 38 C.F.R. § 4.71, Plate II. In addition to the foregoing diagnostic codes, DC 5250 provides ratings for ankylosis of the hip, DC 5254 provides an 80 percent rating for flail joint of the hip, and DC 5255 provides ratings for impairment of the femur. During the course of the appeal, effective February 7, 2021, 38 C.F.R. § 4.71a Schedule of Ratings-Musculoskeletal System including DCs 5251 to 5253 were not amended. Effective February 7, 2021 the Board has considered the updated diagnostic codes but notes that the applicable diagnostic codes in this case were not updated. At an April 2017 VA examination, range of motion (ROM) testing revealed 90 degrees of flexion, 25 degrees of extension, 10 degrees of abduction and adduction, and 10 degrees of external and internal rotation. Adduction was not limited such that the Veteran could not cross legs. Pain was noted on examination and caused functional loss. There was evidence of pain with weightbearing. There was localized tenderness or pain to light touch of the anterior and lateral left hip. There was no objective evidence of crepitus. The Veteran was not able to perform repetitive use testing with at least three repetitions due to too much pain. The examination was neither medically consistent nor inconsistent with the Veteran's statements describing functional loss with repetitive use over time. The examiner was unable to say without mere speculation whether pain, weakness, fatigability or incoordination significantly limited functional ability with repeated use over a period of time, reasoning that the examination was not being conducted after repeated use over a period of time. Muscle strength was reduced (4/5) in flexion, extension, and abduction. There was no ankylosis. The Veteran used a brace as a regular mode of locomotion. At a November 2019 VA examination, the Veteran reported daily pain in the left hip that was worsened by prolonged sitting, bending, walking and standing and one motion for a prolonged period. He stated the left hip pain made intercourse with his wife uncomfortable. He stated that a change in position and heat or cold wraps helped with the pain. He reported chronic pain daily with no specific prolonged flares of pain except with usual activities throughout the day. The Veteran reported functional loss, indicating that he could not perform strenuous activity around the house like laundry or cleaning without help. He was no longer able to exercise or walk for prolonged periods more than 200 feet without stopping. He used a walker in the mornings due to hip pain and stiffness. ROM testing revealed 70 degrees of flexion, 12 degrees of extension, 35 degrees of abduction, 15 degrees of adduction, 30 degrees of external rotation, and 40 degrees of internal rotation. Adduction was limited such that the Veteran could not cross his legs. Pain was noted on examination and caused functional loss. There was evidence of pain with weightbearing. There was evidence of anterior hip joint pain on palpation. There was no objective evidence of crepitus. After three repetitions, abduction and internal rotation were additionally limited to 20 degrees. Pain significantly limited functional ability with repeated use over a period of time. The examiner opined that flexion, abduction, and internal rotation would be additionally limited to 20 degrees after repeated use over a period of time. There was no reduction in muscle strength or ankylosis on examination. The examiner stated that the Veteran's hip condition affected his ability to perform basic activities of daily living without difficulty. Additionally, the Veteran could not perform occupational tasks that required prolonged standing, prolonged walking without reasonable accommodation for rest or change in position, any degree of running or any tasks that require crawling, squatting or stooping. At an August 2020 VA hip and thigh examination, the Veteran stated that he had pain, stiffness, and clicking sensations in his hips. Pain could get to 9 out of 10. He used a heating pad, ice pack and would stop activity when possible. He had steroid injections, most recently in August 2019. The Veteran reported flare-ups, stating that he would have a burning shooting pain that moves from the outer aspects of the hips to the pelvis that could radiate to the back. He reported functional loss, noting that he had to stop activity during flares. ROM testing revealed 90 degrees of flexion, 10 degrees of extension, 0 degrees of abduction, 20 degrees of adduction and external rotation, and 15 degrees of internal rotation. Passive ROM was the same as active. Pain was noted on exam but did not result in/cause functional loss. There was objective evidence of localized tenderness or pain on palpation of the lateral aspect of the joint; noted to be moderate. There was evidence of pain with weightbearing, but not with non-weightbearing. There was no objective evidence of crepitus. The Veteran was able to perform repetitive-use testing with at least three repetitions without additional loss of function or ROM. The Veteran was not being examined immediately after repetitive use over time. The examination was medically consistent with the Veteran's statements describing functional loss with repetitive use over time. Pain significantly limited functional bility with repeated use over a period of time and during flare-ups. ROM would be reduced by 5 degrees after repeated use. The examiner noted that the examination was being conducted during a flare-up. There was no reduction in muscle strength or ankylosis. In terms of occupational impact, the examiner opined that the Veteran would have to limit walking, standing, prolonged sitting as this can result in pain and would have to take breaks to help with the pain. At a September 2020 VA hip and thigh examination, current symptoms included a constant dull aching pain that could get sharp with activity. Symptoms were worse with sitting, walking, and standing; symptoms improved with rest. During flare-up or with repeated use over time, pain could increase to 9 out of 10 and he would have significant loss of ROM. He applied an ice pack to help with the pain. ROM testing revealed 90 degrees of flexion, 15 degrees of extension, 30 degrees of abduction, 5 degrees of adduction, 25 degrees of external rotation, and 20 degrees of internal rotation. Pain began at endpoint. Adduction was not limited such that the Veteran could not cross his legs. Passive ROM was the same as active. Pain was noted on examination but did not result in/cause functional loss. There was objective evidence of localized tenderness or pain on palpation of the lateral aspect of the joint; the examiner noted the severity as moderate. There was evidence of pain with weightbearing and in non-weightbearing. There was no objective evidence of crepitus. After three repetitions, flexion was additionally limited to 85 degrees due to pain. The examiner noted that the examination was not being conducted during a flare-up, and estimated that flexion would be limited to 85 degrees during flare-ups. Disturbance of locomotion additionally contributed to his disability. There was no reduction in muscle strength or ankylosis. The Veteran regularly used a brace. At a June 2021 VA examination, the Veteran stated his condition was not improving, but stable with limited and controlled activities. Current symptoms included stiffness and a tingling sensation. He reports stiffness and throbbing, and burning pain with prolonged walking and standing. Pain was worse at the end of each day. He received injections; the last one was in October 2020. Treatment providers directed the Veteran to not sit or stand for too long. Flare-ups of the left hip occurred at the end of each day. The flare-ups were moderate. Flare-ups could last hours to days. They were precipitated by prolonged standing, sitting, and walking. They were alleviated by rest and intraarticular hip injection. The Veteran that functionally, his left hip impacted "almost everything. If I sit for too long my hip [starts] throbbing." ROM testing revealed 115 degrees of flexion, 20 degrees of extension, 30 degrees of abduction, 18 degrees of adduction, 45 degrees of external rotation, and 35 degrees of internal rotation. Pain was exhibited in flexion and abduction. A limitation in adduction did not prevent the Veteran from crossing his legs. Passive ROM was same as active ROM. There was evidence of pain in non-weight bearing, active motion, and passive motion. Pain did not result in/cause functional loss. The Veteran was able to perform repetitive use testing without additional loss of function or ROM after three repetitions. The Veteran was not being examined immediately after repeated use over time. Statements from the Veteran suggested that pain and lack of endurance significantly limit functional ability with repeated use over time. The examiner estimated that ROM would be reduced to 98 degrees of flexion, 15 degrees of extension, 20 degrees of abduction, 15 degrees of adduction, 30 degrees of external rotation, and 25 degrees of internal rotation. The examination was not being conducted during a flare-up. Statements from the Veteran suggests that pain, fatigability, weakness, and lack of endurance would significantly limit functional ability with flare-ups. The examiner estimated that ROM would be reduced to 88 degrees of flexion, 10 degrees of extension, 25 degrees of abduction, 20 degrees of adduction, 30 degrees of external rotation, and 25 degrees of internal rotation. There was objective evidence of crepitus. There was objective evidence of localized tenderness or pain on palpation of the left hip; the severity was moderate. There was no ankylosis. The Veteran used a brace for ambulation. The examiner opined that the Veteran would experience functional impairment performing tasks that require prolonged: standing, sitting or walking for 20 minutes. He would also experience left hip, stiffness, limited ROM, hip locking, clicking with prolonged standing over 45 mins to an hour. Based on the foregoing, the Board finds that higher ratings are not warranted for left hip limitation of flexion, extension, or abduction at any time during the appellate period. Initially, the Board notes that the Veteran is in receipt of the highest available ratings for extension and abduction during the entire appellate period. As there are no higher ratings under DCs 5251 and 5253, and the record does not indicate that referral for an extraschedular rating is warranted, further discussion as to whether a higher rating is warranted under DCs 5251 and 5253 is unnecessary. With regard to limitation of flexion, ROM testing during VA examinations has revealed flexion limited to 70 degrees at the lowest and 115 degrees at the highest. As noted above, the VA examiners have also provided estimates on additional ROM loss after repeated use over time and during flare-ups. The Board notes that, while the November 2019 VA examiner opined that flexion would be limited to 20 degrees following repetitive use after a period of time, no other examiner has provided nearly as low as an estimate. Indeed, the three subsequent examinations contained estimates of 85 to 98 degrees of flexion following repetitive use or during flare-ups. As such, the Board finds that the overall weight of the medical opinion evidence of record does not support a compensable rating for limited flexion of the left hip during the appellate period. See Madden v. Brown, 125 F.3d 1447 (Fed Cir. 1997) (holding that the Board has the "authority to discount the weight and probative value of evidence in light of its inherent characteristics in its relationship to other items of evidence"). In sum, the Board finds that the criteria for higher ratings for left hip limitation of extension, flexion, and abduction have not been met or more nearly approximated. Consequently, the appeals must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 4.3. 4. Entitlement to a compensable rating for residual scars, left hip The Veteran's left hip scars are rated as non-compensably disabling under DC 7805. Under this code, a compensable rating is warranted for scars with underlying tissue damage having a combined area of at least 39 square centimeters, scars without underlying soft tissue damage having a combined area of at least 144 square inches, and for one or two unstable or painful scars. Compensable ratings are also available for any other disabling effects under an appropriate diagnostic code. See 38 C.F.R. § 4.118 (2020). The Veteran's left hip scars were examined in April 2017, November 2019, August 2020, September 2020, and June 2021. Each examination revealed two asymptomatic surgical scars of the left hip. Neither scar was painful or unstable, and the scars did not have a total area equal to or greater than 39 square centimeters. At the June 2021 VA examination, the examiner opined that the scars did not result in limitation of motion and did not impact his ability to work. In light of the foregoing, the Board finds that the criteria for a compensable rating have not been met or more nearly approximated. Consequently, the appeal for a higher rating for residual scars, left hip must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 4.3. 5. Entitlement to a 20 percent rating for left ankle impingement prior to September 2, 2020 is granted. 6. Entitlement to a rating in excess of 20 percent for left ankle impingement from September 2, 2020 is denied. The Veteran's left ankle impingement is rated under DC 5271, governing limitation of motion of the ankle. Under DC 5271, a 10 percent rating is warranted for moderate limitation of motion of the ankle, and a 20 percent rating is warranted for marked limitation of motion. 38 C.F.R. § 4.71a, DC 5271. Effective February 7, 2021, VA's Schedule, 38 C.F.R. Part 4, was amended with regard to rating musculoskeletal disorders. Fed. Reg. 76453 (November 30, 2020) (codified at 38 C.F.R. § 4.71a). The amended regulations clarify that "marked" limitation of motion of the ankle requires less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion. "Moderate" limitation of motion in the ankle requires less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion. See 85 Fed. Reg. 76464 (Feb 7, 2021). Both sets of criteria will be considered for this pending appeal, and the Veteran is entitled to application of the criteria that are the most favorable to his claim, except that an award based on the amended regulations may not be made effective before the effective date of the change. See 38 U.S.C. § 5110(g); 38 C.F.R. § 3.114; VAOPGCPREC 3-2000, 65 Fed. Reg. 33,422 (2000); Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). The Board notes that normal ROM for the ankle on dorsiflexion is to 20 degrees and to 45 degrees on plantar flexion. See 38 C.F.R. § 4.71a, Plate II. The April 2017 rating decision on appeal granted service connection for left ankle impingement and assigned a 10 percent rating effective January 30, 2014. Following the July 2020 Board remand, a September 2020 rating decision granted a higher, 20 percent rating from September 2, 2020. At an April 2017 VA examination, the Veteran reported flare-ups, described as more painful in rainy weather. He reported functional loss, described as instability, inability to or jump, and inability to walk for long periods of time. ROM testing revealed 10 degrees of dorsiflexion and 20 degrees of plantar flexion. Pain was noted on examination and caused functional loss. There was evidence of pain with weight bearing. There was objective evidence of localized tenderness or pain on palpation of the anterior and lateral left ankle. There was no objective evidence of crepitus. The Veteran was able to perform repetitive use testing with at least three repetitions without additional loss of function or ROM. The Veteran was not being examined immediately after repetitive use over time or during a flare-up. The examiner stated that the examination was neither medically consistent nor inconsistent with the Veteran's statements describing functional loss with repetitive use over time or during flare-ups. The examiner was unable to say without mere speculation whether pain, weakness, fatigability or incoordination significantly limited functional ability with repeated use over a period of time or during a flare-up, reasoning that the examination was not being conducted after repeated use over a period of time or during a flare-up. Muscle strength was decreased (4/5) in plantar flexion and dorsiflexion. There was no ankylosis. Talar tilt test revealed laxity compared with the opposite side. The Veteran did not use an assistive device. At a September 2019 VA examination, the Veteran reported that his ankle disability had worsened since his last examination. He reported little flexibility of the ankle and that the ankle swells making it difficult to wear shoes. The Veteran located pain to the anterior ankle traveling to both medial and lateral aspects of the ankle. Pain was constant and aggravated by walking and standing. He stated he sometimes experienced a numbing sensation to the top of the foot. He stated he was prescribed Duexis for the pain. He reported physical therapy and chiropractor treatment to the ankle. The Veteran did not report flare-ups. He reported functional loss, stating "After sitting for long periods I have to straighten my leg out to flex the ankle. I have to stop to rest the ankle after walking a block. I try to keep my ankle elevated while in the bed to keep it from swelling." ROM testing revealed 10 degrees of dorsiflexion and 20 degrees of plantar flexion. Pain was noted on examination but did not result in/cause functional loss. There was no evidence of pain with weightbearing. There was mild tenderness on palpation over the anterior medial aspect, anterior aspect and posterior lateral aspect of the ankle. There was no objective evidence of crepitus. After three repetitions, there was 5 degrees of dorsiflexion and 15 degrees of plantar flexion. Pain significantly limited functional ability with repeated use over a period of time. Mild swelling to lateral ankle contributes to decrease in ROM. Muscle strength was decreased (4/5) in dorsiflexion. There was no ankylosis. Anterior drawer test revealed laxity compared with opposite side. The Veteran regularly used a brace to assist with locomotion. The examiner opined that the Veteran's left ankle impacted is ability to perform certain work tasks involving prolonged walking, standing, and sitting. At a September 2020 VA ankle conditions examination, the Veteran reported left ankle stiffness/sharp pain 4 to 5 hours daily, rated as a 6.5 to 7 out of 10. Pain was triggered by walking and standing and improved with rest, elevation and Duexis. His pain could result in a limp which can impact walking speed. The Veteran also reported moderate loss of ROM during flare ups and after repeated use. On ROM testing, there was 0 degrees of dorsiflexion and 35 degrees of plantar flexion. Passive ROM was the same as active ROM. Pain was noted on examination but did not result in/cause functional loss. There was no objective evidence of localized tenderness or pain on palpation of the joint. There was no evidence of pain with weightbearing but there was pain with non-weightbearing. There was no evidence of crepitus. The Veteran could perform repetitive use testing with at least three repetitions without additional loss of function or ROM. The Veteran was not being examined immediately after repetitive use over time or during a flare-up. The examiner stated that the examination was medically consistent with the Veteran's statements describing functional loss with repetitive use over time or during a flare-up. The examiner opined that pain significantly limited functional ability with repeated use over a period of time or during a flare-up. In terms of ROM, plantar flexion would be additionally limited to 30 degrees. There was no reduction in muscle strength and no ankylosis. Ankle instability or dislocation was suspected, but there was no laxity compared with opposite side on Talar Tilt and Anterior Drawer tests. The Veteran regularly used a brace. With regard to occupational impact, the examiner opined that the Veteran would have pain with walking and would have to limit activity due to the pain. At a June 2021 VA examination, the Veteran reported residual pain with prolonged standing and walking. He stated he received NSAID injections for pain management; the last injection was in October 2020. The Veteran reported daily, moderate to severe flare-ups. The flare-ups lasted for "hours." The flare-ups were precipitated by constant movement or not moving. The flare-ups were alleviated by heat and ice rotation and home remedies. The Veteran described functional impairment as limitations with climbing up and down the steps and prolonged walking. On ROM testing, the Veteran had 20 degrees of dorsiflexion and 40 degrees of plantar flexion. Passive ROM was the same as active ROM. There was evidence of pain with weightbearing, non-weightbearing, active motion, passive motion, and on rest/non-movement. Pain caused functional loss. There was no objective evidence of crepitus. There was evidence of localized tenderness or pain on palpation of the lateral ankle joint. The severity was moderate. The Veteran was able to perform repetitive-use testing with at least three repetitions without additional loss of function or range of motion. The Veteran was not being examined immediately after repeated use over time. Statements from the Veteran suggested that pain and lack of endurance significantly limited functional ability with repeated use over time. The examiner estimated that ROM after repeated use over time would be 15 degrees of dorsiflexion and 30 degrees of plantar flexion. The Veteran was not being examined during a flare-up. Statements from the Veteran suggested that pain, fatigability, and lack of endurance significantly limited functional ability with flare-ups. The examiner estimated that ROM during flare-ups would be 10 degrees of dorsiflexion and 25 degrees of plantar flexion. Additional factors contributing to disability included interference with standing, disturbance of locomotion, and interference with sitting. The examiner noted that there would be limitations with prolonged activities from 30 to 45 minutes due to left ankle pain, fatigue and lack of endurance. There was no ankylosis or instability. The Veteran regularly used a brace. In terms of occupational impairment, the examiner opined that the Veteran would experience functional impairment performing tasks that require prolonged standing, prolonged walking, and climbing up and down steps. Upon review of the evidence of record, the Board finds that a 20 percent rating, but no higher, for the left ankle disability is warranted throughout the entire rating period on appeal. Prior to the September 2020 VA examination, ROM was recorded as 5 to 10 degrees of dorsiflexion. However, the April 2017 examiner did not properly consider the Veteran's symptoms and functional limitations during flare-ups. See Sharp v. Shulkin, 29 Vet. App. 26 (2017) (addressing what constitutes an adequate explanation for an examiner's inability to estimate motion loss in terms of degrees during periods of flare-ups). Additionally, as the Board recognized in its prior remand, the October 2019 VA examination did not state at which degree painful motion began. In addition to limitation of motion of the ankle, the Board has specifically considered the Veteran's pain, instability, inflexibility, and swelling of the left ankle, as well as regular use of a brace. Additionally, the Veteran has consistently reported having difficulty with prolonged walking, standing, and sitting. As such, a 20 percent rating is warranted for marked limitation of motion throughout the entire rating period on appeal. However, a rating in excess of 20 percent is not warranted at any time during the appeal. The Board has also examined other applicable diagnostic codes, and notes that DC 5272 and 5274 limit the maximum disability rating to 20 percent. The only available diagnostic code that allows for a disability rating higher than 20 percent is DC 5270 for ankylosis of the ankle. This diagnostic code is inapplicable, as the examiners have all indicated that the Veteran does not have ankylosis. The Board also notes that through the Veteran's lay statements and testimony, at no point has he indicated that he has ankylosis of the right ankle. As such, DC 5270, the only diagnostic code that would allow for a disability rating higher than the current 20 percent, is inapplicable. (Continued on the next page) In sum, a higher, 20 percent rating is granted prior to September 2, 2020. A rating in excess of 20 percent is not warranted at any time during the appeal; to that extent, the claim for a higher rating is denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 4.3. LESLEY REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Roya Bahrami, 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.