Citation Nr: 21076303 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 09-05 067 DATE: December 23, 2021 ORDER Entitlement to a rating in excess of 10 percent for chondromalacia of the left knee with arthritis is denied. Entitlement to a rating in excess of 10 percent for chondromalacia of the right knee with arthritis is denied. Entitlement to a rating in excess of 20 percent for lumbar spine degenerative disc disease (DDD) prior to March 20, 2018, is denied. Entitlement to a rating in excess of 40 percent for lumbar spine DDD from March 20, 2018, is denied. Entitlement to a separate rating for radiculopathy, femoral nerve, bilateral lower extremities, prior to February 25, 2015, is denied. Entitlement to a 30 percent rating, and no more, for radiculopathy, femoral nerve, right lower extremity, from February 25, 2015, is granted. Entitlement to a 30 percent rating, and no more, for radiculopathy, femoral nerve, left lower extremity, from February 25, 2015, is granted. Entitlement to an initial 20 percent rating, but no more, for radiculopathy, sciatic nerve, left lower extremity, prior to February 25, 2015, is granted. Entitlement to an initial 20 percent rating, but no more, for radiculopathy, sciatic nerve, right lower extremity, prior to February 25, 2015, is granted. Entitlement to a 40 percent rating, and no more, for radiculopathy, sciatic nerve, left lower extremity, from February 25, 2015, is granted. Entitlement to a 40 percent rating, and no more, for radiculopathy, sciatic nerve, right lower extremity, from February 25, 2015, is granted. Entitlement to a total disability rating based on individual unemployability (TDIU) is denied. FINDINGS OF FACT 1. The Veteran's left knee disability has been manifested primarily by pain and decreased flexion to no less than 110 degrees. 2. The Veteran's right knee disability has been manifested primarily by pain and decreased flexion to no less than 120 degrees. 3. Prior to March 20, 2018, the Veteran's lumbar spine DDD has not been manifested by forward flexion limited to 30 degrees or less, favorable ankylosis of the entire thoracolumbar spine, incapacitating episodes lasting a total duration of at least 4 weeks but less than 6 weeks during the last 12 months, or disc herniation with compression and/or irritation of the adjacent nerve root. 4. From March 20, 2018, the Veteran's lumbar spine DDD has been manifested primarily by back pain and decreased flexion to no less than 40 degrees; however, it was not productive of ankylosis or intervertebral disc syndrome (IVDS). 5. There is no evidence of record suggesting that the Veteran had radiculopathy, femoral nerve, left or right lower extremity, prior to February 25, 2015. 6. From February 25, 2015, the Veteran has exhibited symptoms consistent with severe incomplete paralysis of the femoral nerve in the left lower extremity. 7. From February 25, 2015, the Veteran has exhibited symptoms consistent with severe incomplete paralysis of the femoral nerve in the right lower extremity. 8. After affording the Veteran the benefit of the doubt and prior to February 25, 2015, his radiculopathy, sciatic nerve, right lower extremity has been productive of moderate incomplete paralysis, neuritis, or neuralgia. 9. After affording the Veteran the benefit of the doubt and prior to February 25, 2015, his radiculopathy, sciatic nerve, left lower extremity has been productive of moderate incomplete paralysis, neuritis, or neuralgia. 10. From February 25, 2015, the Veteran has exhibited symptoms consistent with moderately severe incomplete paralysis of the sciatic nerve in the right lower extremity. 11. From February 25, 2015, the Veteran has exhibited symptoms consistent with moderately severe incomplete paralysis of the sciatic nerve in the left lower extremity. 12. The preponderance of the evidence is against finding that the Veteran's service-connected disabilities render him unable to secure or follow substantially gainful employment. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for left knee disability have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.7, 4.40, 4.45, 4.71a, Diagnostic Code (DC) 5010-5260. 2. The criteria for a rating in excess of 10 percent for right knee disability have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.7, 4.40, 4.45, 4.71a, DC 5010-5260. 3. Prior to March 20, 2018, the criteria for a rating in excess of 20 percent for lumbar spine DDD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, DC 5242-5237. 4. From March 20, 2018, the criteria for a rating in excess of 40 percent for lumbar spine DDD have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.71a, DC 5242-5237. 5. The criteria for a separate rating for radiculopathy, femoral nerve, left and right lower extremities, prior to February 25, 2015, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1 4.14, 4.123, 4.124a, DC 8626. 6. From February 25, 2015, the criteria for a rating of 30 percent, and no more, for radiculopathy, femoral nerve, left lower extremity, have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.7, 4.20, 4.27, 4.40, 4.124a, DC 8626. 7. From February 25, 2015, the criteria for a rating of 30 percent, and no more, for radiculopathy, femoral nerve, right lower extremity, have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.7, 4.20, 4.27, 4.40, 4.124a, DC 8626. 8. Prior to February 25, 2015, the criteria for an initial 20 percent rating, but no more, for radiculopathy, sciatic nerve, right lower extremity, have been met. 38 U.S.C. §§ 1155, 5110, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.124a, DC 8620. 9. Prior to February 25, 2015, the criteria for an initial 20 percent rating, but no more, for radiculopathy, sciatic nerve, left lower extremity, have been met. 38 U.S.C. §§ 1155, 5110, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.124a, DC 8620. 10. From February 25, 2015, the criteria for a rating of 40 percent, and no more, for radiculopathy, sciatic nerve, right lower extremity, have been met. 38 U.S.C. §§ 1155, 5110, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.124a, DC 8620. 11. From February 25, 2015, the criteria for a rating of 40 percent, and no more, for radiculopathy, sciatic nerve, left lower extremity, have been met. 38 U.S.C. §§ 1155, 5110, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 4.124a, DC 8620. 12. The criteria for TDIU have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1968 to November 1975. In November 2011, the Veteran testified before a Veterans Law Judge (VLJ) who is no longer at the Board. A transcript of the hearing is of record. In November 2012, the Veteran was informed that the VLJ who conducted the hearing is no longer at the Board. The Veteran was asked if he would like a new hearing. In December 2012, the Veteran stated that he wished to appear at a hearing before another VLJ. In October 2014, the Veteran testified before the undersigned VLJ. A transcript of the hearing is of record. In March 2012, February 2013, November 2014, January 2017, and January 2018, the Board remanded the claims for further development. Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. Disabilities must be reviewed in relation to their history. Where there is a question as to which of two evaluations apply, the Board assigns the higher of the two where the disability picture more nearly approximates the criteria for the next higher rating. See 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.7, 4.10; Schafrath v. Derwinski, 1 Vet. App. 589 (1991). A Veteran may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Accordingly, separate ratings may be assigned for separate periods of time based on the facts found, which is a practice known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 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 required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the United States Court of Appeals for Veterans' Claims stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the preponderance of the evidence must be against the claim. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996) (citing Gilbert, 1 Vet. App. at 54). 1. Entitlement to a rating in excess of 10 percent for chondromalacia with arthritis, bilateral knees The Veteran's bilateral knee disability is rated under 38 C.F.R. § 4.71a, DC 5010-5260. Hyphenated DCs are used when a rating under one code requires use of an additional DC to identify the basis for the rating, with the first code representing the underlying condition and the second code representing the residuals. 38 C.F.R. § 4.27. Here, the hyphenated DCs indicate that the bilateral knee disability is rated by analogy based on traumatic arthritis and limitation of flexion. During the pendency of the Veteran's appeal, VA amended the criteria for rating musculoskeletal disabilities. Effective February 7, 2021, DC 5010 was amended to provide that post-traumatic arthritis is to be rated based on limitation of motion, dislocation, or other specified instability under the affected joint. If there are 2 or more joints affected, each rating shall be combined in accordance with 38 C.F.R. § 4.25. Under the pre-amended criteria, DC 5010 provides that 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, DC 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, 2010. The limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Id. The Board notes that DCs 5268, 5269, 5260, and 5261 remain unchanged. Under DC 5260, limitation of flexion, flexion limited to 30 degrees warrants a 20 percent rating and flexion limited to 15 degrees warrants a 30 percent rating. See 38 C.F.R. § 4.71a, DC 5260. Under DC 5261, limitation of extension, extension limited to 15 degrees warrants a 20 percent rating; extension limited to 20 degrees warrants a 30 percent rating; extension limited to 30 degrees warrants a 40 percent rating; and extension limited to 45 degrees warrants a 50 percent rating. See 38 C.F.R. § 4.71a, DC 5261. Under Diagnostic Code 5258, a 20 percent rating is assigned for a knee with dislocated semilunar cartilage with frequent episodes of locking, pain, and effusion into the joint. 38 C.F.R. § 4.71a. DC 5259 provides a 10 percent evaluation for symptomatic removal of semilunar cartilage. Id. The normal ROM of the knee is 0 degrees of extension and 140 degrees of flexion. See 38 C.F.R. § 4.7, Plate II. The new regulation revises the rating criteria for DC 5257. Under the new regulation, a 20 percent rating is warranted for either (a) sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribing a brace and/or assistive device (e.g., cane(s), crutch(es), walker) for ambulation; or (b) unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribing either an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation. A 30 percent is warranted for recurrent subluxation or instability for unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device (e.g., cane(s), crutch(es), walker) and bracing for ambulation along with one of the following: (a) Sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribes a brace and/or assistive device (e.g., cane(s), crutch(es), walker) for ambulation. (b) Unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation warrants a 20 percent rating. Sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device (e.g., cane(s), crutch(es), walker) or bracing for ambulation warrants a 10 percent rating. Regarding patellar instability, a 20 percent is warranted for a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace, cane, or walker. A 30 percent is warranted for a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker. Note (1): For patellar instability, the patellofemoral complex consists of the quadriceps tendon, the patella, and the patellar tendon. Note (2): A surgical procedure that does not involve repair of one or more patellofemoral components that contribute to the underlying instability shall not qualify as surgical repair for patellar instability (including, but not limited to, arthroscopy to remove loose bodies and joint aspiration). Under the old regulation, moderate recurrent subluxation or lateral instability warrants a 20 percent rating, and severe recurrent subluxation or lateral instability warrants a 30 percent rating. 38 C.F.R. § 4.71a. The words "slight," "moderate," and "severe" as used in the various DCs are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all the evidence, to the end that its decisions are equitable and just. 38 C.F.R. § 4.6. In evaluating disabilities of the musculoskeletal system, it is necessary to consider, along with the schedular criteria, functional loss due to flare-ups of pain, fatigability, incoordination, pain on movement, and weakness. DeLuca v. Brown, 8 Vet. App. 202 (1995). Although pain may cause functional loss, pain itself does not constitute functional loss. Rather, pain must affect some aspect of "the normal working movements of the body," such as "excursion, strength, speed, coordination, and endurance," in order to constitute functional loss. Mitchell v. Shinseki, 25 Vet. App. 32, 38-43 (2011) (quoting 38 C.F.R. § 4.40). 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive motion, in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. Correia v. McDonald, 28 Vet. App. 158 (2016). Analysis The Veteran contends that his disability is more severe than the ratings depict. In June 2008, the Veteran was afforded a VA examination to determine the severity of his bilateral knee disability. The Veteran's knee disability began early in service. He had no specific injury. Since onset, he has had continual aching of the right knee. He reported the aching to be 5/10 or 6/10 in severity. He experienced pain in his left knee that was rated at 7/10 in severity. The left knee pain was progressive and slowly worsening over time. Bilaterally, the pain limited the Veteran's activity, i.e., he avoided walking 20 minutes and was unable to do any karate. The Veteran was unable to kneel and did not like to squat. He took Advil for his disability. The examiner confirmed the Veteran's bilateral knee strain. The Veteran did not report flare-ups of the right knee, i.e., the pain was present on a constant basis. However, he reported left knee flare-ups that were more or less constant with varying level of discomfort. The Veteran's right and left flexion were to 130 and 120 degrees, respectively, and bilateral knee extension was to zero degrees. He was able to perform repetitive use testing with three repetitions. There was no change in ROM after repetitive use testing with three repetitions. The examiner noted pain with manipulation and movement. There was no obvious laxity or instability of the knee. Regarding the DeLuca criteria, the examiner stated that there was no change with repetitive ROM of his knees after three repetitions. The examiner stated that pain caused major functional impact. In his September 2008 Notice of Disagreement (NOD), the Veteran requested a separate 10 percent rating for each knee based on functional loss under 38 C.F.R. § 4.40 and 4.45. He reported having recurrent pain, swelling, popping, laxity, instability, and degenerative arthritis in the joints. The pain was aggravated by activity and decreased the mobility/stability of the knees. In May 2012, the Veteran was afforded a VA examination to determine the severity of his knee disability. The Veteran's doctor prescribed medicine for the knee pain. The Veteran also saw a chiropractor. He had not been hospitalized or had an operation on his knee. The Veteran's pain was located throughout the knees and reported that left knee hurt more than the right. He used a cane and braces to keep him stable. The examiner noted no aspiration of fluid. The examiner confirmed the Veteran's knee strain diagnosis. The Veteran did not report flare-ups. Bilateral knee flexion was to 120 degrees and extension to zero degrees. There was no objective evidence of painful motion. The Veteran was able to perform repetitive-use testing with 3 repetitions. There was no change in ROM after repetitive use testing. The Veteran had additional limitation in ROM following repetitive-use testing. The examiner also noted functional loss and/or functional impairment of the knee and lower leg, to include pain on movement. The Veteran did not have tenderness or pain to palpation for joint line or soft tissues of either knee. Muscle strength and stability tests were normal. There was no evidence or history of recurrent patella subluxation/dislocation. The Veteran did not have any meniscal conditions or surgical procedures for a meniscal condition or total knee joint replacement. He did not have any residual signs and/or symptoms due to arthroscopic or other knee surgery. There were no other pertinent physical findings, complications, conditions, signs and/or symptoms, and/or scars related to the Veteran's condition. The Veteran used a brace and cane on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. The Veteran's disability impacted his ability to work, i.e., he had difficulty bending his knees and walking too far. The Veteran was a VA employee who work for the computer department and also the president of the labor union. The examiner stated that, technically, the Veteran did sedentary work. The Veteran claimed he was able to walk about three miles, around. In February 2015, the Veteran was afforded a VA examination to determine the severity of his bilateral knee disability. The Veteran stated that his disability had worsened. The examiner confirmed the Veteran's bilateral knee degenerative joint disease (DJD) diagnosis. The Veteran reported flare-ups of the knee, i.e., he stated that his knee pain flared up with walking 100 yards or sitting more than 30 minutes. The knee pain flares were rated 9/10. The constant pain in the knees was 7/10. He took Aleve and hydrocodone two times per day. The Veteran reported functional loss or functional impairment, to include, limits in walking 100 yards or more or sitting more than 30 minutes. The Veteran's knee flexion was to 130 degrees, bilaterally, and extension was to zero degrees, bilaterally. The Veteran's abnormal ROM contributed to functional loss, i.e., it limited the Veteran's ability to squat/bend his knees. Pain was noted on the exam and caused functional loss. The examiner also noted evidence of pain with weight bearing and objective evidence of crepitus. There was no objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional functional loss or ROM after three repetitions. The Veteran was examined immediately after repetitive use over time and during a flare-up. Pain significantly limited functional ability with repeated use over a period of time and during a flare-up. Because there was inadequate information available, the examiner was unable to describe the additional loss in terms of ROM without resorting to speculation. There were no additional contributing factors of the disability. Bilaterally, muscle strength testing was normal with no reduction in muscle strength and no muscle atrophy. The Veteran did not have ankylosis or joint instability. The Veteran stated that after service, he had dislocation of both kneecaps but had not dislocated them in over eight years. He stated that both kneecaps subluxed and spontaneously relocated. During the exam, he pushed on the kneecaps to relocate them, but there were no dislocations since 2003, and he had not stressed his knees since then. The examiner stated that the Veteran had bilateral moderate recurrent patellar dislocation. The examiner noted moderate instability of both knees due to pain and no subluxation since 2003. The Veteran did not now have or had ever had a meniscus (semilunar cartilage) condition. There were other pertinent physical findings, complications, conditions, signs, or symptoms related to the Veteran's bilateral knee condition, i.e., his patellar apprehension test was negative. He did not have scars (surgical or otherwise) related to his condition or to the treatment of his condition. He used a brace on a constant basis and a cane on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. Imaging revealed degenerative or traumatic arthritis and minor productive change involving the medial tibial spine, bilaterally. The Veteran's disability impacted his ability to work. At the time of the exam, the Veteran worked at VA as a computer system analyst. The Veteran stated that due to limited ambulation and limited bending and squatting or bending at the knee, he was limited in his ability to do inventory. Due to knee and back pain, the Veteran had been off duty since December 2014. In the January 2017 Board remand, the Board noted that the Veteran's most recent VA exam was performed in February 2015. However, subsequent to the February 2015 VA exam, the United States Court of Veterans Appeals in Correia v. McDonald, 28 Vet. App. 158 (2016), held that the final sentence of 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive ROM as well as in weight bearing and nonweight bearing and if possible, with ROM measurements of the opposite undamaged joint. However, after reviewing the Veteran's previous VA examinations, the Board concluded that the examiners did not test active and passive ROM and weight and nonweight bearing. As such, the Board remanded the claim for further development. In March 2017, the Veteran was afforded a VA examination to determine the severity of his bilateral knee disability. The Veteran stated that his condition had worsened. He reported constant pain rated at 5-7/10 most days, more severe more often. There was no overt swelling. The examiner confirmed the Veteran's bilateral degenerative arthritis and patellofemoral pain syndrome diagnoses. The Veteran reported flare-ups and functional loss or functional impairment of the knee. The Veteran stated that his baseline functional limitations included being unable to ski because of pain, and he was unable to kneel. Additionally, squatting was tough, and walking was limited to less than a couple of blocks prior to resting. The Veteran rated the pain due to flares at 7/10. He stated that weakness limited further ambulation without rest. The Veteran's bilateral knee flexion was to 130 degrees and extension to zero degrees. The ROM itself did not contribute to functional loss. Pain was noted on flexion and caused functional loss. There was evidence of pain with weight bearing, objective evidence of crepitus, and objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue, i.e., the pain was located in the inferolateral patellar area of the right knee and superior patellar area of the left knee. The Veteran was able to perform repetitive use testing with at least three repetitions. Bilaterally, there was no additional functional loss or ROM after three repetitions. After repetitive use, the Veteran reported no additional functional limitations over that stated in flare. There was no other significant decrease in functional capacity for issues of pain, weakness, fatigability, or incoordination described in the past year. He was not examined immediately after repetitive use over time or during a flare-up; the examiner noted that the examination was medically consistent with the Veteran's statements describing functional loss with repetitive use over time or during a flare-up. Pain, fatigue, weakness, and lack of endurance significantly limited functional ability with repeated use over a period of time or during a flare-up. Because the Veteran was not examined after repetitive use or during a flare-up, the examiner was unable to describe in terms of ROM. There were no additional contributing factors of the disability. Muscle strength testing was normal with no reduction in muscle strength and no muscle atrophy. He did not have ankylosis. The Veteran stated that his left knee went out, and his right leg felt weaker; however, the examiner stated that there was no instability on the exam. Additionally, there was no history of recurrent effusion. The Veteran did not now have or had ever had recurrent patellar dislocation, "shin splints" (medial tibial stress syndrome), stress fractures, chronic exertional compartment syndrome or any other tibial and/or fibular impairment or a meniscus (semilunar cartilage) condition. There were other pertinent physical findings, complications, conditions, signs, or symptoms related to the Veteran's conditions, to include additional pain with weightbearing. The examiner stated that the Veteran preferred to wear braces and use a cane to mitigate pain. The Veteran also had crepitus with patellofemoral motion, bilaterally. Neg apprehension test revealed no gross evidence for abnormal patellar tracking, and there was no evidence for internal derangement. The Veteran was able to squat and recover with mild difficulty. His gait was antalgic, and cane assisted. He did not have scars related to his condition or to the treatment of his condition. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. The Veteran's disability impacted his ability to perform any type of occupational task. The examiner stated that the Veteran's service-connected conditions made his work capacity limited to seated and sedentary positions. Additionally, because of difficulty with prolonged sitting, he may additionally require accommodation for a sit/stand station or more frequent breaks to allow stretching, etc. In July 2017, the Veteran was seen by a private examiner for a consultation regarding the Veteran's rest and postural tremors. The Veteran reported balance issues, i.e., he felt, among other things, he was tripping over and banging his feet and randomly falling. The examiner felt that the Veteran's balance issues are secondary to multiple factors to include significant decrease bilateral vibration which could be due to diabetes and chronic alcohol use. The examiner also stated that the Veteran's balance problems are secondary to his knee and spinal cord issues. Additionally, in November 2017, the Staff Physician, Neurology Services, submitted a statement in support of the Veteran's TDIU claim. The examiner stated that the Veteran had a complex medical history, and several of his problem related to the function of his nervous system. The examiner stated that the Veteran had a history of cervical myelopathy, i.e., a condition in which the spinal cord in the neck was compressed and damaged. Over the last few years, the Veteran's balance had been gradually worsening which is likely due to chronic effects of his spinal cord injury. In September 2017, the Veteran was afforded a VA examination to determine the severity of his bilateral knee condition. At the time of the exam, the Veteran stated that he had constant pain in both knees and difficulty with walking, standing, and climbing stairs. Additionally, his left knee frequently locked and popped, and his right knee was chronically tender. He stated that he was diagnosed with chondromalacia and only conservative treatment was recommended. The examiner confirmed the Veteran's bilateral knee patellofemoral pain syndrome (PFPS) and degenerative arthritis diagnoses. The examiner stated that there was a progression of osteoarthritis to the prior rated disability of PFPS. The Veteran did not report flare­ups of the knee; however, he reported functional loss or functional impairment of the joint, to include functional loss/impairment due to pain which limited his ability to walk for long periods and walk upstairs. The Veteran's right and left knee flexion were to 120 and 110 degrees, respectively. Bilateral extension was to zero degrees. The ROM itself contributed to functional loss. Pain was noted on flexion and caused functional loss. There was also evidence of pain with weight bearing, but there was no objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue or objective evidence of crepitus. There was evidence of pain on passive ROM testing, but no evidence of pain when the joint was used in non­weight bearing. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. He was not examined immediately after repetitive use over time or during a flare-up; the examiner stated that the examination was neither medically consistent or inconsistent with the Veteran's statements describing functional loss with repetitive use over time or during a flare-up. Pain significantly limited functional ability with repeated use over a period of time. However, neither pain, weakness, fatigability, nor incoordination significantly limited functional ability with flare-ups. After repetitive use testing, the Veteran's ROM remained unchanged. The examiner noted additional contributing factors of the disability, to include less movement than normal due to ankylosis, adhesions, etc. Muscle strength testing was normal with no reduction in muscle strength and no muscle atrophy. The Veteran did not have ankylosis, and joint stability testing was normal. He did not now have or had ever had recurrent patellar dislocation, "shin splints" (medial tibial stress syndrome), stress fractures, chronic exertional compartment syndrome or any other tibial or fibular impairment or a meniscus (semilunar cartilage) condition. There were no other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to his condition. He did not use an assistive device, and functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. The Veteran's disability impacted his ability to perform any type of occupational task, i.e., the Veteran reported that he had functional loss/impairment due to pain which limited his ability to walk for a long time and walking upstairs. The examiner stated that the Veteran could perform any type of occupational task without significant restrictions. In March 2018, the Veteran was afforded another VA examination to determine the severity of his bilateral knee disability. The Veteran stated that the symptoms began in 1968. He was seen for this condition but never received any treatment. Since then, he had gotten knee braces. X-rays and MRIs were also performed. He had been given pain medications to take. At the time of the exam, the Veteran experienced constant aching pain that was aggravated by prolonged walking/sitting. The examiner confirmed the Veteran's bilateral knee joint osteoarthritis chondromalacia diagnoses. The examiner stated that the VA established diagnosis of chondromalacia had changed, and it is a progression of the previous diagnosis. The Veteran reported flare-ups of the knees which included constant aching pain that was aggravated by prolonged walking/sitting. He also reported functional loss or impairment of the joint, i.e., he stated that he did not perform physical activities and had difficulty walking/sitting, running, squatting, and climbing stairs. Bilaterally, forward flexion was 130 degrees and extension to zero degrees. Pain was noted on flexion and caused functional loss. There was evidence of pain with weight bearing. The ROM itself did not contribute to functional loss. The examiner noted objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue, i.e., mild medial line related to the right knee condition and mild-mod medial line and patella consistent with his left knee. There was no objective evidence of crepitus. The Veteran was able to perform repetitive-use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. The Veteran was not examined immediately after repetitive use over time or during a flare-up; the examiner noted that the examination was neither medically consistent nor inconsistent with the Veteran's statements describing functional loss with repetitive use over time or during a flare-up. Because the Veteran was not experiencing a flare up during the exam and was not using the joints repeatedly, 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. There were no additional contributing factors of the disability. The examiner noted objective evidence of pain on passive ROM testing, bilaterally. There was no evidence of pain on non-weight bearing testing, bilaterally. Muscle strength testing was normal with no reduction of muscle strength and no muscle atrophy. The Veteran did not have ankylosis, recurrent effusion, and joint stability testing was normal. He did not now have or had ever had recurrent patellar dislocation, "shin splints," stress fractures, chronic exertional compartment syndrome or any other tibial or fibular impairment, or a meniscus condition. The Veteran did not have any other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to his condition. He wore braces and used a cane and walker on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. The Veteran's disability impacted his ability to perform any type of occupational task, i.e., he did not engage in physical activities, and he reported having difficulty walking/sitting, running, squatting, and climbing stairs. In March 2021, the Veteran was afforded a VA examination to determine the severity of his bilateral knee disability. The Veteran reported continuous bilateral knee pain with decreased ROM which made performing daily activities difficult. He was limited in his ability to bend, squat, climb stairs, and prolonged sitting. He utilized a walker for ambulation, wore bilateral knee braces, and took Tylenol as needed for relief. The examiner confirmed the Veteran's bilateral knee degenerative arthritis and chondromalacia diagnoses. The examiner stated that the Veteran has a diagnosis of osteoarthritis, bilateral knees, which is a progression of service-connected chondromalacia, bilateral knees. The Veteran denied flare-ups. He reported functional loss or impairment which limited his ability to bend, squat, climb stairs, and sit for a prolong period of time. Right and left knee flexion were to 125 and 120 degrees, respectively, and extension was to zero degrees. The ROM itself contributed to functional loss, i.e., the Veteran reported limited ROM when bending, squatting, and climbing stairs. Bilaterally, pain was noted on flexion and extension and caused functional loss. There was no objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue, pain with weight bearing, or objective evidence of crepitus. The Veteran was able to perform repetitive-use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. The Veteran was not examined immediately after repetitive use over time or during a flare-up; the examiner noted that the examination was neither medically consistent nor inconsistent with the Veteran's statements describing functional loss with repetitive use over time. Pain significantly limited functional ability with repeated use over a period of time. After repetitive use over time, the Veteran's right and left knee flexion was to 120 and 115 degrees, respectively, and extension was to zero degrees. Because the Veteran was not experiencing a flare-up during the exam, the examiner was unable to say whether pain, weakness, fatigability, or incoordination significantly limited functional ability during a flare-up. There were no additional contributing factors of the disability. The examiner noted no objective evidence of pain on passive ROM testing of the right and left knee or on non-weight bearing testing of the right or left knee. Muscle strength testing revealed active movement against some resistance, bilaterally. The reduction was entirely due to the Veteran's bilateral knee disability. There was no muscle atrophy. The Veteran did not have ankylosis, and joint stability testing was normal. He did not now have or had ever had recurrent patellar dislocation, "shin splints," stress fractures, chronic exertional compartment syndrome or any other tibial or fibular impairment, or a meniscus condition. The Veteran did not have any other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to his condition. He wore braces on a regular basis and used a walker on a constant basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. The Veteran's disability impacted his ability to perform any type of occupational task. The Veteran lost zero to one-week of work in the last 12 months. The examiner stated that the Veteran had difficulty with tasks involving prolonged ambulation, bending, reaching, and lifting moderate objects due to lumbar spine DDD. In April 2021, the Veteran was afforded another VA examination to determine the severity of his bilateral knee disability. The Veteran stated that in 2020, he completed physical therapy sessions for bilateral knee pain. The physical therapy sessions were beneficial. He denied bilateral knee surgery or orthopedic care. The examiner confirmed the Veteran's bilateral knee chondromalacia diagnosis. The Veteran denied flare-ups. He reported functional loss or impairment which limited his ability to bend or stand for a prolong period of time. He did not have a history of instability or recurrent subluxation or frequent effusion of the knees. His ROM was abnormal, but normal for body habitus, age, and was of no clinical significance. The ROM itself did not contribute to functional loss. Bilateral knee flexion was to 130 degrees, and extension to zero degrees. Passive ROM was the same as active ROM. There was no evidence of pain, objective evidence of crepitus, or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. The Veteran was able to perform repetitive-use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. He was not examined immediately after repetitive use over time or during a flare-up. Pain significantly limited functional ability with repeated use over a period of time. After repetitive use over time, the Veteran's bilateral knee flexion was to 125 degrees, and extension was to zero degrees. The Veteran reported bilateral knee pain with bending and prolonged standing. As the Veteran denied flare-ups, pain, fatigability, weakness, lack of endurance, or incoordination did not significantly limit functional ability with flare-ups. There were no additional contributing factors of the disability. The Veteran did not have muscle atrophy, ankylosis, recurrent subluxation or persistent instability, ligament tear, or patellar instability. He did not now have or had ever had recurrent patellar dislocation, "shin splints," stress fractures, chronic exertional compartment syndrome or any other tibial or fibular impairment, or a meniscus condition. He had not undergone knee surgery. The Veteran did not have any other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to his condition. The Veteran wore braces and walker on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. The Veteran's disability impacted his ability to perform any type of occupational task. He lost zero to one-week of work in the last 12 months. The examiner stated that the Veteran had difficulty with tasks involving bending and prolonged standing due to bilateral knee chondromalacia. The Veteran's gait was assisted with a walker with no ataxia noted. He demonstrated an ability to bear weight without noted pain and the ability to sit in a chair with flexion at hips and knees a minimum of 90 degrees. The Veteran's VA treatment record documents complaint and treatment for chronic knee pain. Based on the evidence of record, the Board finds that a rating in excess of 10 percent for the Veteran's left and right knee disability is not warranted. There is no evidence that the Veteran has had limitation of flexion to 30 degrees or less or limitation of extension to 15 degrees or more. The record shows that, at worse, his left flexion was to no less than 110 degrees and right knee flexion was to no less than 120 degrees. Additionally, his extension was normal. As such, the criteria for a disability rating in excess of 10 percent under DC 5260 are not met, and a separate rating under 5261 is not warranted. The Board recognizes that, under DeLuca v. Brown, 8 Vet. App. 202 (1995), VA must consider "functional loss" of a musculoskeletal disability separately from consideration under the DCs. "Functional loss" may occur as a result of weakness or pain on motion. Here, the evidence shows that pain has been a constant and predominant symptom. The Veteran also reported limits in his ability to bend, squat, climb stairs, and sit for a prolong period of time. The Board notes that the examiners noted evidence of pain on active and passive motion with and without weight bearing. However, given the extent of bilateral knee motion, there is no evidence of a disability picture that is commensurate to a limitation of flexion to the extent necessary to establish entitlement to a higher disability rating, even after taking his reported pain into full consideration. See DeLuca, 8 Vet. App. at 204-07; 38 C.F.R. §§ 4.40, 4.45, 4.71a, DC 5260 and 5261. In this regard, the Board emphasizes that a 10 percent disability rating under DC 5260 already contemplates an otherwise non-compensable degree of limitation of motion verified by objective evidence of symptoms such as painful motion. Further, the Board has considered the potential application of the other provisions of 38 C.F.R., Parts 3 and 4. Schafrath v. Derwinski, 1 Vet. App. 589, 593 (1991). The other criteria for rating knee disabilities are provided under DCs 5256 (ankylosis), 5257 (instability), 5258 (dislocated semilunar cartilage with frequent episodes of locking, pain, and effusion into the joint), 5259 (cartilage, semilunar, removal of, symptomatic), 5262 (impairment of the tibia and fibula), and 5263 (genu recurvatum or traumatic genu recurvatum). The evidence does not show that the Veteran's bilateral knee disability manifestations have included ankylosis, a meniscus condition, shin splints, or genu recurvatum. Therefore, the Board finds that separate or higher ratings under DCs 5256, 5258, 5259, 5262, and 5263 are not warranted. Regarding instability, the July 2017 private examiner noted that the Veteran had balance problems and the examiner attributed the balance problems to the Veteran's diabetes, alcohol, and knee and spinal cord issues. Additionally, the 2015 VA examiner noted instability. However, the 2015 VA examiner also stated that the knee instability had not occurred since 2003. Additionally, the other VA examiners noted that the Veteran did not have instability of either knee. The Board also notes that the Veteran's November 2017 Staff Physician, Neurology Services, noted that the Veteran's balance issues are likely due to chronic effects of the spinal cord injury. As such, the Board finds that separate or higher rating is not warranted under DC 5257. The Veteran did not have scars related to his bilateral knee disability. Therefore, separate ratings under DC 7800-7805 are not warranted. The Board has considered the Veteran and his representative's statements regarding the severity of the Veteran's bilateral knee disability. However, as lay persons, they do not have the training or expertise to render a competent opinion which is more probative than the VA examiners' opinions on this issue, as this is a medical determination that is complex. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 309 (2007); Layno v. Brown, 6 Vet. App. 465, 469-71 (1994)). Thus, the lay opinions by themselves are outweighed by the VA examiners' findings and the other evidence of record. See id.; see also King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012) (affirming the Court's conclusion that the Board did not improperly discount the weight of a lay opinion in finding a medical expert's opinion more probative on the issue of medical causation). In sum, the preponderance of the evidence is against ratings in excess of 10 percent for the Veteran's left and knee disability. As such, the benefit-of-the-doubt doctrine is not applicable. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001). 2. Entitlement to an increased rating lumbar spine DDD prior to and after March 20, 2018 The spine is rated under 38 C.F.R. § 4.71a, DCs 5235-5243 according to a General Rating Formula for Disease and Injuries of the Spine (General Formula) unless DC 5243 is evaluated under the Formula for Rating IVDS based on incapacitating episodes. During the pendency the Veteran's appeal, VA amended criteria for rating musculoskeletal disabilities. The new regulation applies to claims received on or after February 7, 2021 or previously filed claims that are pending on February 7, 2021 if the new regulation will render more favorable result for the Veteran. As such, the Board will evaluate the Veteran's disability under both old and new regulations for the entire appeal period and choose the more favorable result. The new regulation revises the rating criteria for DCs 5242 for degenerative arthritis, degenerative disc disease other than IVDS. It notes that the rater should also see either DC 5003 or 5010. Diagnostic Code 5243, IVDS, was also revised. The revision states that 5243 is assigned only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign DC 5242 for all other disc diagnoses. Under the old regulation, DC 5003 was assigned to evaluate degenerative arthritis (hypertrophic or osteoarthritis). 38 C.F.R. § 4.71a. Diagnostic Code 5003 is now assigned to evaluate degenerative arthritis (other than post-traumatic). Under both regulations, degenerative arthritis established by X-ray findings will be rated based on 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 DCs, 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 20 percent rating is warranted if there is X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations. The lumbar vertebrae are considered groups of minor joints, rated on a parity with major joints. 38 C.F.R. § 4.45. NOTE (1) states that the 20 percent and 10 percent ratings based on X-ray findings, above, will not be combined with ratings based on limitation of motion. The Board notes that the other DCs remain unchanged. Normal ROM of the thoracolumbar spine is 90 degrees of flexion, and 30 degrees for each of extension, left and right lateral flexion, and left and right rotation. 38 C.F.R. § 4.71a, Plate II. Under the General Formula, a 20 percent rating is warranted when forward flexion of the thoracolumbar spine was greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine is not greater than 120 degrees; or, when there is muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. Under the IVDS Formula, a 20 percent rating is warranted when there are incapacitating episodes of IVDS having a total duration of at least two weeks, but less than four weeks during the past 12 months. Under the General Formula, a 40 percent rating contemplates forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. Alternatively, under the IVDS Formula, a 40 percent rating contemplates incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months. Under the General Formula, a 50 percent rating contemplates unfavorable ankylosis of the entire thoracolumbar spine. There is no equivalent rating under the IVDS Formula. Under the IVDS Formula, a 60 percent rating contemplates incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. There is no equivalent rating under the General Formula. Under the General Formula, a 100 percent rating contemplates unfavorable ankylosis of the entire spine. There is no equivalent rating under the IVDS Formula. In evaluating disabilities of the musculoskeletal system, it is necessary to consider, along with the schedular criteria, functional loss due to flare-ups of pain, fatigability, incoordination, pain on movement, and weakness. DeLuca v. Brown, 8 Vet. App. 202 (1995). Although pain may cause functional loss, pain itself does not constitute functional loss. Rather, pain must affect some aspect of "the normal working movements of the body," such as "excursion, strength, speed, coordination, and endurance," in order to constitute functional loss. Mitchell v. Shinseki, 25 Vet. App. 32, 38-43 (2011) (quoting 38 C.F.R. § 4.40). 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with ROM measurements of the opposite undamaged joint. Correia v. McDonald, 28 Vet. App. 158 (2016). Associated objective neurologic abnormalities are evaluated separately under an appropriate diagnostic code. See 38 C.F.R. § 4.71a (General Formula, Note 1). Analysis The Veteran contends that his disability is more severe than the ratings depict. In June 2008, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The Veteran stated that in 1971, he was lifting a 75-pound transmitter when he injured his left sacroiliac joint. Since the injury, he has had increased pain. The examiner confirmed the Veteran's lumbar strain and lumbar spine DDD diagnoses. The Veteran reported flare-ups that occurred twice a year. Flare-ups included severe pain which he rated at 11 out of 10 in intensity and lasted for two weeks. When his pain flared, he required bedrest for two weeks; however, he did not have any physician prescribed bedrest. The flare-ups also limited his ability to perform activities. The Veteran stated in between the flare-ups, he had sensation of mild to moderate constant discomfort in his low back. Forward flexion was to 90 degrees, extension to 15 degrees, right and left lateral flexion to 20 degrees, and right and left lateral rotation to 25 degrees. The Veteran had 4/5 strength in dorsiflexion and plantar flexion of the right lower extremity. At the time of the exam, he worked as a computer specialist. He was not limited in his work but did not stand more than 15 minutes or sit more than 45 minutes. The Veteran stated that he lost about three months of work in the last year because of his low back pain. He took Vicodin and/or Aleve for flares. He stated that he worked around his disabilities. In his September 2008 NOD, the Veteran stated that his disability had increased in severity. He stated that his DDD had progressed and now involved L3 to L5 with recurrent muscle spasms; localized pain; and radiation of numbness, and tingling radiating down both posterior legs. He wore a corset back brace and took medication to help ease the pain. He reported experiencing urinary urgency, sleep patterns two to four hours, and he woke with stiffness/pain. He rated the pain between zero to 10. The pain level increased with activity and weather changes. In May 2012, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The Veteran stated that he sustained his injury in 1971 when he was lifting 75 pounds. Since his last VA examination, he reported locking episodes once every six months. He took pain medication and saw a chiropractor. The Veteran had not been hospitalized or had an operation. His condition was aggravated by lifting a backpack or getting out of a vehicle. He reported no incontinence or foot drop. On occasions, he used a cane and wore a back brace. He reported radiation of pain with associated numbness from his anterior thighs to his feet and his great toes. The examiner confirmed the Veteran's lumbar strain diagnosis. The Veteran reported flare-ups that impacted the function of his spine, i.e., with his episodes of aggravation, he needed bedrest from one to seven days. The Veteran's forward flexion was to 70 degrees with objective evidence of painful motion beginning at 50 degrees, extension was to 20 degrees with objective evidence of painful motion beginning at 20 degrees, and right and left lateral flexion and right and left lateral rotation all ended at 30 degrees or greater with objective evidence of painful motion beginning at 20 degrees. The Veteran was able to perform repetitive-use testing with 3 repetitions. There was no change in ROM after 3 repetitive-use testing. The examiner noted additional limitation in ROM following repetitive-use testing. The Veteran also had functional loss and/or functional impairment of the spine, to include less movement than normal and pain on movement. The examiner noted localized tenderness or pain to palpation of the lower lumbar spine. The Veteran also had guarding or muscle spasm which was severe enough to result in abnormal gait. His muscle strength testing was normal with no muscle atrophy. The Veteran did not have IVDS or any other neurologic abnormalities or findings related to his condition (such as bowel or bladder problems/pathologic reflexes). He used a brace and cane on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. The Veteran did not have drop foot, a vertebral fracture, or scars related to his condition. The Veteran's condition had an impact on his ability to work, i.e., he had difficulty bending his back, lifting heavy objects, and walking "too far." In February 2015, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The Veteran stated that since the last VA examination, his disability had gotten worse. He stated that the pain was constant and radiated down both legs into the big toe and heel. He rated the pain at 7-9/10. The Veteran reported using a cane since 2003 for stability when walking. The examiner confirmed the Veteran's lumbar spine DDD diagnosis. The Veteran did not report flare-ups that impacted the function of his spine. He reported functional loss or functional impairment of the spine, to include back pain that limited his ability to take out the trash, move the trash to the curb, carry groceries and laundry, and lift computer parts at work. Forward flexion was to 65 degrees, right lateral rotation was to 10 degrees, and extension, right and left lateral flexion and left lateral rotation were all to 15 degrees. The ROM itself contributed to functional loss, i.e., limited his ability to bend and twist his spine. Pain was noted on forward flexion, extension, right and left lateral flexion, and right and left lateral rotation and caused functional loss. There was evidence of pain with weight bearing and localized tenderness on the right side of the low back, and he had bilateral lumbar spasms in the paravertebral muscles. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. He was examined immediately after repetitive use over time and during a flare-up. Pain significantly limited functional ability with repeated use over a period of time and during a flare-up. Because there was inadequate information available, the examiner was unable to describe the additional loss in terms of ROM without speculating. The Veteran experienced muscle spasm and localized tenderness of the spine; however, they did not result in abnormal gait or abnormal spinal contour. He did not experience guarding. There were no additional contributing factors of the disability. Muscle strength testing was normal with no muscle atrophy. The Veteran did not have ankylosis, IVDS, or any other neurologic abnormalities or findings related to his condition (such as bowel or bladder problems/pathologic reflexes). He used a brace on a constant basis as a regular mode of locomotion. The examiner stated that there was no functional impairment of an extremity such that no effective function remained other than that which would be equally well served by an amputation with prosthesis. There were no other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to his condition. The Veteran did not have a thoracic vertebral fracture with loss of 50 percent or more of height. The Veteran's condition impacted his ability to work, i.e., his back pain limited his ability to walk, sit at work, and lift computer parts. He stated that he worked in pain and lost three months' work in the last year. The Veteran stated that he worked full time; however, he had been off work since December 3rd due to back and knee pain and partly due to difficulty commuting from Stockton to San Francisco. In the January 2017 Board remand, the Board noted that the Veteran's most recent VA exam was performed in February 2015. The Board noted that ROM studies must test active and passive ROM as well as in weight bearing and nonweight bearing. However, after reviewing the Veteran's previous VA examinations, the Board concluded that because the examiners did not test active and passive ROM and weight and nonweight bearing, the exams were inadequate. Based on the holding in Correia, the Board remanded the claim for further development. In March 2017, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The Veteran stated that since his last VA examination, his disability had gotten worse. The examiner confirmed the Veteran's multilevel lumbar DDD with bilateral lower extremity radiculopathy, facet DJD, and IVDS diagnoses. The Veteran reported flare-ups and functional loss or functional impairment of the spine. His baseline functional limitations included less mobility and durability in multiple activities. At the time of the exam, the Veteran's symptoms and stated functional impairment included constant pain in the left section of his lower back. He rated the pain between 7-9/10, the left leg pain greater than right. He also had constant pain on the left which he rated 8/10 and pain on the right which ranged from 7-9/10. The examiner noted additional functional limitation in flares, and the Veteran had to rest for a bit due to severe pain. The Veteran's forward flexion was to 65 degrees; right lateral flexion was to 20 degrees; and extension, right and left lateral rotation and left lateral flexion were all to 30 degrees. The ROM itself contributed to functional loss, i.e., the Veteran experienced pain in multiple planes and in moderate flexion, and the pain affected multiple daily activities. Pain was noted on forward flexion and right lateral flexion and caused functional loss. There was evidence of pain with weight bearing and objective evidence of localized tenderness or pain on palpation, i.e., mild paravertebral TTP near L4-S1 area left. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. However, he reported flares of pain associated with repetitive use during prolonged sitting, standing, and ambulation and bending, stooping, and lifting. After repetitive use, the Veteran stated that there were no additional functional limitations over that stated in flare. There was no other significant decrease in functional capacity for issues of pain, weakness, fatigability, or incoordination described in the past year for the spinal condition. The Veteran was not 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. Pain, fatigue, weakness, and lack of endurance significantly limited functional ability with repeated use over a period of time and during a flare-up. The examiner was unable to describe in terms of ROM because the Veteran was not examined after repetitive use or during a flare-up; therefore, the answer would be based on mere speculation. The Veteran did not have guarding or muscle spasms of the spine. There were no additional contributing factors of the disability. Muscle strength testing was normal with no muscle atrophy. The Veteran did not have ankylosis or any other neurologic abnormalities or findings related to his condition (such as bowel or bladder problems/pathologic reflexes). The Veteran had IVDS; however, he 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. The Veteran used a brace and cane on a regular basis as a normal mode of locomotion. There was no functional impairment of an extremity such that no effective function remained other than that which would be equally well served by an amputation with prosthesis. The Veteran had other pertinent physical findings, complications, conditions, signs, or symptoms related to his conditions, i.e., there was no noted deformity or surgical scar, his gait was antalgic and cane-assisted, and he moved with mild difficulty throughout the exam. The examiner also stated that active ROM was painful in terminal flexion and RLF, and passive ROM was not attempted past the stated level of active pain. Additionally, pain was noted with weightbearing. The Veteran stated that he preferred to be braced and walk with a cane when weight bearing. The examiner noted tenderness to palpation. The Veteran did not have scoliosis. He did not have a thoracic vertebral fracture with loss of 50 percent or more of height. The Veteran's condition impacted his ability to work, i.e., his service-connected conditions made his work capacity limited to seated and sedentary positions. The examiner stated that because of difficulty with prolonged sitting, he may additionally require accommodation for a sit/stand station or more frequent breaks to allow stretching, etc. In September 2017, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The Veteran first injured his back in 1973 in a lifting accident. Since onset, the disability had become worse. At the time of the exam, the Veteran complained of a constant low back pain and pain in the lower lumbar area that radiated to both feet. This increased with walking, bending, and lifting. It improved with rest. The examiner confirmed the Veteran's degenerative arthritis of the spine diagnosis. The Veteran did not report flare­ups of the spine; but, he reported functional loss or functional impairment due to pain which limited his ability to lift and bend. Forward flexion was to 80 degrees and extension, right and left lateral flexion, and right and left lateral rotation were all to 25 degrees. The ROM itself contributed to functional loss. The abnormal ROM were caused by pain which limited the Veteran's ability to bend, twist, and turn. Pain was noted on forward flexion, extension, right and left lateral flexion, and right and left lateral rotation and caused functional loss. There was evidence of pain with weight bearing but no objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue of the spine. The examiner noted evidence of pain on passive ROM testing but no evidence of pain when the joint was used in non­weight bearing. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. The Veteran was not examined immediately after repetitive use over time or during flare-ups; 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 a flare-up. Pain significantly limited functional ability with repeated use over a period of time; however, ROM remained the same. Neither pain, weakness, fatigability, nor incoordination significantly limited functional ability during flare-ups. The Veteran did not have guarding or muscle spasms of the spine. The examiner noted additional contributing factors of the disability, to include less movement than normal due to ankylosis, limitation, or blocking, adhesions etc. Muscle strength testing was normal with no muscle atrophy. The Veteran did not have ankylosis, IVDS, or any other neurologic abnormalities or findings related to his spine condition. The Veteran did not use an assistive device as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran, and there were no other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to the conditions. The Veteran did not have a thoracic vertebral fracture with loss of 50 percent or more of height. His disability impacted his ability to work, i.e., he reported that he had functional loss/impairment due to pain which limited his ability to lift and bend. The examiner stated that the Veteran could perform any type of occupational task without significant restrictions. In March 2018, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The Veteran stated that his back pain began sometime around 1974 after lifting something heavy. He was seen for the injury and was prescribed rest. Since then, he had been under the care of an orthopedic surgeon and chiropractor. The examiner confirmed the Veteran's DDD diagnosis. The Veteran reported flare-ups of his spine which he described as constant pain in his back and neck. He also reported constant shooting pain/tingling down his legs. The condition was aggravated by walking/sitting. He reported functional loss or impairment of the spine, to include being unable to perform physical activities. He also had difficulty walking, sitting, standing, bending, and lifting. Forward flexion, extension, right and left lateral flexion and right lateral rotation were all from zero to 20 degrees. Left lateral rotation was from zero to 30 degrees. The ROM itself contributed to functional loss which resulted in limited ROM. Pain was noted on forward flexion, extension, right and left lateral flexion, and right lateral rotation and caused functional loss. There was no evidence of pain with weight bearing. The examiner noted objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue of the spine, i.e., mild mod tender to palpation B/L paravert muscles and L4-5 consistent with his back. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. The Veteran was not examined immediately after repetitive use over time; 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. Because the joint was not being used repeatedly during the exam, the examiner was unable to say without resorting to mere speculation whether pain, weakness, fatigability, or incoordination significantly limited functional ability with repeated use over a period of time. However, the exam was conducted during a flare-up. Pain and weakness significantly limited functional ability with flare-ups. After flare-ups, the Veteran's ROM remained the same. The Veteran did not experience guarding or muscle spasms of the spine. The examiner noted additional contributing factors of the disability, to include disturbance of locomotion and less movement than normal due to ankylosis, limitation or blocking, adhesions, etc. The examiner stated that contributing factors of the disability were described as "he looked, he was in pain when walking." Muscle strength testing was normal except the Veteran's great toe extension revealed active movement against some resistance. The Veteran did not have muscle atrophy. He did not have ankylosis, IVDS, or any other neurologic abnormalities or findings related to his spine condition. He used a brace, cane, and walker on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran, and there were no other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to the condition. The Veteran's disability impacted his ability to work. The examiner stated that the Veteran was unable to perform physical activities and had difficulty walking, sitting, standing, bending, and lifting. In March 2021, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The Veteran reported continuous lumbar spine pain with decreased ROM which made performing daily activities difficult. He was limited in reaching, lifting, bending, and prolonged standing. He utilized a walker for ambulation, wore a back brace, and took Tylenol as needed. The examiner confirmed the Veteran's lumbar spine DDD diagnosis. He did not report flare-ups of the back. However, he reported functional loss or impairment of the spine, to include difficulty with prolonged ambulation, bending, reaching, and lifting moderate objects. Forward flexion was to 70 degrees; extension and right and left lateral flexion were to 20 degrees; and right and left lateral rotation were to 30 degrees. The ROM itself contributed to functional loss which resulted in limited ROM for bending, reaching, and lifting moderate objects. Pain was noted on forward flexion, extension, and right and left lateral flexion and caused functional loss. There was no evidence of pain with weight bearing or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue of the spine. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. The Veteran was not 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 a flare-up. Pain significantly limited functional ability with repeated use over a period of time. However, pain, weakness, fatigability, or incoordination did not significantly limit functional ability with flare ups. After repetitive use over time, forward flexion was to 65 degrees; extension and right and left lateral flexion were to 15 degrees; and right and left lateral rotation were to 25 degrees. However, as the Veteran did not have flare-ups, the examiner was unable to describe in terms of ROM. There was no objective evidence of pain when the spine was non-weight bearing. Passive ROM of the spine was not performed as it was not feasible to do this in a safe and reasonable manner. The examiner stated that the opposing joint assessment was not applicable because the spine does not have an opposing joint. The Veteran experienced guarding, but it did not result in abnormal gait or abnormal spinal contour. There were no other additional contributing factors of the disability. Muscle strength testing revealed normal strength in the bilateral hips but active movement against some resistance in the bilateral knees, ankle plantar and dorsiflexion, and great toe extension. There was no muscle atrophy. The Veteran did not have ankylosis, IVDS, or any other neurologic abnormalities or findings related to his spine. The Veteran used a brace on a regular basis and a walker on a constant basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran, and there were no other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to the conditions. The Veteran's disability impacted his ability to work. He lost zero to one-week work time in the last 12 months. The Veteran reported having difficulty with tasks involving prolonged ambulation, bending, reaching, and lifting moderate objects. In April 2021, the Veteran was afforded another VA examination to determine the severity of his lumbar spine disability. The Veteran reported continued lumbar spine pain within the lumbar area, and, at the time of the exam, he denied radiculopathy to the bilateral lower extremities. His lumbar spine pain occurred with bending and prolonged standing. He took Tylenol as needed. The examiner confirmed the Veteran's DDD other than IVDS diagnosis. The Veteran did not report flare-ups. However, he reported functional loss or impairment of the spine, to include being limited in bending and prolonged standing. The Veteran's ROM was abnormal; however, it was normal for the Veteran's body habitus, age, and was of no clinical significance. The ROM itself did not contribute to functional loss. Forward flexion was to 65 degrees, extension was to 25 degrees, right and left lateral flexion were to 20 degrees, and right and left lateral rotation were to 30 degrees. Passive ROM was not performed so as to prevent pain and the risk of injury. There was no evidence of pain, objective evidence of crepitus, or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. The Veteran was not examined immediately after repetitive use over time or during flare-ups. Pain significantly limited functional ability with repeated use over time. After repetitive use testing, forward flexion was to 60 degrees, extension was to 20 degrees, right and left lateral flexion were to 15 degrees, and right and left lateral rotation were to 25 degrees. The Veteran stated that he experienced lumbar pain with prolonged standing. Because the Veteran denied flare-ups, pain, fatigability, weakness, lack of endurance, or incoordination did not significantly limit functional ability with flare-ups. He did not have localized tenderness, guarding, or muscle spasms of the spine. There were no other additional contributing factors of the disability. Muscle strength testing revealed normal strength in the bilateral hips but active movement against some resistance in the bilateral knees, ankle plantar and dorsiflexion, and great toe extension. There was no muscle atrophy. He did not have ankylosis, IVDS, or any other neurologic abnormalities or findings related to his spine. He used a brace and a walker on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran, and there were no other pertinent physical findings, complications, conditions, signs, symptoms, or scars related to the conditions. Imaging did not reveal evidence of a thoracic vertebral fracture with loss of 50 percent or more of height. The Veteran's disability impacted his ability to work. He is a former radio mechanic who lost zero to one-week work time in the last 12 months. Due to lumbar spine DDD and radiculopathy, femoral and sciatic nerve, bilateral lower extremities, the Veteran had difficulty with tasks involving bending and prolonged standing. The examiner stated that the Veteran's gait was assisted with a walker with no ataxia noted. The Veteran demonstrated an ability to bear weight without noted pain and the ability to sit in a chair with flexion at hips and knees a minimum of 90 degrees. The Veteran's VA treatment record documents complaint and treatment for chronic back pain. The Board finds that, prior to March 20, 2018, a rating in excess of 20 percent is not warranted for the Veteran's disability. As noted above, a 40 percent rating contemplates forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. Here, at worst, even considering the Veteran's subjective complaints of pain and other symptoms described in DeLuca, his forward flexion was from zero to 65 degrees. Additionally, he did not have ankylosis. See 38 C.F.R. § 4.71a, DC 5235-5243. Therefore, the Board finds that a rating in excess of 20 percent is not warranted. See id. The Board also finds that, from March 20, 2018, the preponderance of the evidence is against a rating in excess of 40 percent for lumbar spine disability. As previously noted, a 50 percent disability rating is warranted if there is evidence of unfavorable ankylosis of the entire thoracolumbar spine. 38 C.F.R. § 4.71a, DC 5242. There is no evidence on record that the Veteran suffers from ankylosis, favorable or unfavorable. Therefore, under the General Rating Formula for Diseases and Injuries of the Spine, the Veteran is not entitled to a rating in excess of 40 percent. Additionally, the Board finds that a higher rating is not warranted under the IVDS formula. Under the old IVDS formula, a 40 percent contemplates incapacitating episodes having a total duration of at least two weeks, but less than four weeks, during the past 12 months and a 60 percent rating contemplates incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. See 38 C.F.R. § 4.71a, DC 5243. Under the new regulation, 5243 is assigned only when there is disc herniation with compression and/or irritation of the adjacent nerve root. In March 2017, the VA examiner noted that the Veteran had IVDS; however, the Veteran 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. From March 20, 2018, the Veteran was not diagnosed with IVDS. Additionally, there is no evidence of disc herniation with compression and/or irritation of the adjacent nerve root. Accordingly, a higher rating is not warranted under the IVDS formula. See 38 C.F.R. § 4.71a, IVDS Formula, Note (1). The Board has also considered the effect of pain and weakness in evaluating the Veteran's disability. 38 C.F.R. §§ 4.40, 4.45, 4.59, DeLuca, 8 Vet. App. 202 (1995). The Board notes that the Veteran had some functional loss/impairment which resulted in less movement than normal, pain on movement, and less durability in multiple activities. Although the Veteran experienced additional functional limitation, the loss in ROM is not commensurate with that for the next higher rating. Based on the evidence, the Board finds that the current 20 and 40 percent evaluations adequately portray any functional impairment, pain, and limitation of motion that the Veteran experienced due to his back disability. See DeLuca, 8 Vet. App. 202; 38 C.F.R. §§ 4.40, 4.45, 4.59. The Veteran has a current diagnosis of lumbar spine DDD, as confirmed by X-ray imaging. As noted above, the 20 percent rating based on X-ray findings will not be combined with ratings based on limitation of motion. As the Veteran has already been assigned a rating for lumbar degenerative arthritis to compensate for painful motion, a separate compensable disability cannot be awarded for arthritis. When evaluating disabilities of the spine, any associated objective neurologic abnormalities are to be rated separately under an applicable DC. 38 C.F.R. § 4.71a, General Formula, Note 1. Here, the Veteran is already service connected for radiculopathy of the left and right lower extremities, and he did not have any neurologic abnormalities or findings such as bowel or bladder problems related to his lumbar spine condition. Additionally, the Veteran did not have any scars related to his lumbar spine disability. Therefore, a separate rating under 7800 to 7806 is not warranted. With respect to conducting a rating examination relative to joint dysfunction, the Court held that a VA examination of the joints must, wherever possible, include the results of the ROM testing described in the final sentence of § 4.59 which are tests as to pain on active and passive motion, including weight-bearing and non-weight-bearing and, if possible, with range of the opposite undamaged joint. Correia v. McDonald, 28 Vet. App. 158, 168-70. Here, the spine is a single group of joints and, as such, there is no opposite joint, much less an undamaged opposite joint. Thus, the holding in Correia is not applicable. In sum, the Board finds that, prior to and from March 20, 2018, ratings in excess of 20 and 40 percent are not warranted for the Veteran's lumbar spine disability. 3. Radiculopathy, bilateral lower extremities In June 2008, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The examiner confirmed the Veteran's bilateral lumbar radiculopathy, lower extremities diagnosis. Straight leg raising test was negative. The Veteran's reflexes were normal except his left knee jerk had no reflexes. Muscle strength testing in the dorsiflexion and plantar flexion of the right lower extremity was 4/5. His sensation was intact to light touch in the right lower extremity. In May 2012, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. Reflex exams revealed no reflexes in the Veteran's knees and hypoactive reflexes in the ankles. Sensory exam in the bilateral upper anterior thigh, thigh/knee, and lower leg/ankle was normal. Sensory exam revealed decreased sensation in the foot/toes. Straight leg raising test was negative. The examiner noted mild intermittent pain (usually dull) and moderate numbness in the bilateral lower extremities. The examiner noted that nerve roots L4/L5/S1/S2/S3 of the sciatic nerve were involved. The disability was moderate in severity. In February 2015, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The examiner stated that muscle strength testing was normal with no muscle atrophy. Reflex exam revealed hypoactive reflexes in the right and left ankles. Reflexes in the bilateral knees were absent. Sensory exam revealed decreased senses in the right and left upper anterior thigh (L2) and thigh/knee (L3/4). The examiner also noted decreased sensation to light touch both anterior inferior thighs and anterior knees, bilaterally. Straight leg raising test was positive, bilaterally. The examiner noted moderate constant pain in the right and left lower extremity and severe paresthesias and/or dysesthesias in the right and left lower extremity. There were no other signs or symptoms of radiculopathy. The examiner noted that nerve roots L2/L3/L4 of the femoral nerve and L4/L5/S1/S2/S3 of the sciatic nerve were involved. The disability was moderate in severity. In March 2017, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. The examiner noted left lower extremity shooting pains, classic L5 radicular pattern. There was radicular pain in the right medial thigh which extended to the great toe. The Veteran also experienced paresthesias on a constant basis which was described as not truly numb except for the right medial thigh. Muscle strength testing was normal with no muscle atrophy. The Veteran's reflex exam revealed normal reflexes in the left knee and hypoactive reflexes in the left and right ankles and the right knee. Sensory exam revealed decreased senses in the right thigh/knee (L3/4) and left leg/ankle (L4/L5/S1). Straight leg testing was positive. The Veteran had constant mild pain in the bilateral lower extremity, moderate paresthesias and/or dysesthesias and intermittent pain in the bilateral lower extremity, and mild numbness in the right lower extremity. He did not have any other signs or symptoms of radiculopathy. The examiner noted that nerve roots L2/L3/L4 of the femoral nerve and L4/L5/S1/S2/S3 of the sciatic nerve were involved. The disability was moderate in severity. In September 2017, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. Muscle strength testing was normal with no muscle atrophy. Reflex and sensory exams and straight leg raising test were all normal. The Veteran had bilateral lower extremity mild intermitted pain, mild paresthesias and/or dysesthesias, and mild numbness. He did not have any other signs or symptoms of radiculopathy. The examiner noted that nerve roots L2/L3/L4 of the femoral nerve and L4/L5/S1/S2/S3 of the sciatic nerve were involved. The disability was mild in severity. In March 2018, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. Muscle strength testing was normal except great toe extension revealed active movement against some resistance. The Veteran did not have muscle atrophy. Sensory exam revealed decreased senses in the foot/toes (L5). Reflex exam of the right knee revealed absent reflexes. Reflexes in the left knee and bilateral ankles were normal. Straight leg raising test was negative. The Veteran experienced moderate intermittent pain, paresthesias and/or dysesthesias, and numbness in the right lower extremity and severe intermittent pain, paresthesias and/or dysesthesias, and numbness in the left lower extremity. The Veteran did not have any other signs or symptoms of radiculopathy. The examiner noted that nerve roots L2/L3/L4 of the femoral nerve and L4/L5/S1/S2/S3 of the sciatic nerve were involved. The disability was moderate in severity. In March 2018, the Veteran was also afforded a VA examination to determine the severity of his peripheral nerve condition. The Veteran reported constant shooting pain/tingling down his legs. His condition was aggravated by walking and/or sitting. The Veteran stated that the radiculopathy could be debilitating. The examiner confirmed the Veteran's lumbar spine radiculopathy, bilateral lower extremity. The Veteran had moderate intermittent pain, paresthesias and/or dysesthesias, and numbness in the right lower extremity and severe intermittent pain, paresthesias and/or dysesthesias, and numbness in the left lower extremity. Muscle strength testing was normal with no muscle atrophy. Reflex exam was normal except right knee reflexes were absent. Sensory exam revealed decreased senses in the foot/toes (L5). The Veteran did not have trophic changes (characterized by loss of extremity hair, smooth, shiny skin, etc.) attributable to peripheral neuropathy. Due to his back and feet problems, his gait was abnormal, i.e., he walked slightly hunched over. The examiner noted bilateral lower extremity incomplete paralysis of the sciatic and femoral nerves. The paralysis for each nerve was noted to be moderate in severity. The Veteran used a brace, cane, and walker on a regular basis as a normal mode of locomotion. Functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. He did not have scars, or any other pertinent physical findings, complications, conditions, signs, or symptoms associated with his disability. His peripheral nerve condition and/or peripheral neuropathy impacted his ability to work, i.e., the peripheral neuropathy made it difficult to sit for long periods. There were no other signs or symptoms of radiculopathy. The examiner noted that nerve roots L2/L3/L4 of the femoral nerve and L4/L5/S1/S2/S3 of the sciatic nerve were involved. The Veteran's disability was moderate in severity. In March 2021, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. Muscle strength testing revealed normal strength in the bilateral hips but active movement against some resistance in the bilateral knees, ankle plantar and dorsiflexion and great toe extension. There was no muscle atrophy. Reflex and sensory exams were normal, and straight leg raising testing was negative. The examiner noted moderate intermittent pain, paresthesias and/or dysesthesias, and numbness in the bilateral lower extremities. There were no other signs or symptoms of radiculopathy. The examiner noted that nerve roots L2/L3/L4 of the femoral nerve and L4/L5/S1/S2/S3 of the sciatic nerve were involved. The Veteran's disability was moderate in severity. In April 2021, the Veteran was afforded a VA examination to determine the severity of his lumbar spine disability. At the time of the exam, the Veteran denied radiculopathy to his bilateral lower extremities. Muscle strength testing revealed normal strength in the bilateral hips but active movement against some resistance in the bilateral knees, ankle plantar and dorsiflexion and great toe extension. There was no muscle atrophy. Reflex and sensory exams were normal, and straight leg raising testing was negative. The Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy. a. Separate rating for radiculopathy, bilateral lower extremity, femoral nerve prior to February 25, 2015 The evaluation of the same disability under various diagnoses is to be avoided. 38 C.F.R. § 4.14. Section 4.14 does not preclude the assignment of separate evaluations for separate and distinct symptomatology where none of the symptomatology justifying an evaluation under one DC is duplicative of or overlapping with the symptomatology justifying an evaluation under another DC. Esteban v. Brown, 6 Vet. App. 259, 262 (1994). VA must consider all favorable lay evidence of record. 38 U.S.C. § 5107(b); Caluza v. Brown, 7 Vet. App. 498 (1995). The Veteran is competent to testify in regard to the onset and continuity of symptomatology. Heuer v. Brown, 7 Vet. App. 379, 384 (1995); Falzone v. Brown, 8 Vet. App. 398, 403 (1995); Caldwell v. Derwinski, 1 Vet. App. 466 (1991). Analysis The Veteran contends that he is entitled to separate rating for radiculopathy, bilateral lower extremities, femoral nerve, prior to February 25, 2015. In April 2008, the Veteran filed a claim for increased rating for his back disability. In September 2008 and based on the June 2008 VA examination, the AOJ denied the claim. The Veteran appealed the denial. In February 2009 and based on the June 2008 VA examination, the AOJ granted entitlement to service connection for radiculopathy, bilateral lower extremities and assigned a 10 percent rating effective April 10, 2008, i.e., the date of receipt of the claim for increase. During the Veteran's May 2012 VA examination, the examiner noted that the nerve root involved was L4/L5/Sl/S2/S3 or the sciatic nerve. During his February 2015 VA examination, the examiner noted that along with the sciatic nerve roots, the Veteran's L2/L3L/L4 or femoral nerve roots were also involved. Based on this information, in May 2016, the AOJ granted service connection for radiculopathy, femoral nerve, bilateral lower extremities and assigned a 20 percent rating, effective February 25, 2015, the date the VA examination showed a worsening of the condition. Based on the foregoing, the Board finds that separate ratings for radiculopathy, left and right lower extremities, femoral nerve, prior to February 25, 2015, is not warranted. There is no evidence showing that the Veteran had neurological impairment associated with any other peripheral nerves that have not already been service connected. Specifically, the Veteran was not shown to have radiculopathy, bilateral lower extremities, femoral nerve at any time prior to February 25, 2015. The Board has considered all other potentially applicable DCs, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service connected. Therefore, a separate rating under a different DC for either the left or right lower extremity is not warranted. For the foregoing reasons, the preponderance of the evidence is against the claims for separate ratings for radiculopathy, left and right lower extremities, femoral nerve, prior to February 25, 2015. The appeal is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. b. Increased rating for radiculopathy, bilateral lower extremity As noted above, while portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, DCs 8620 and 8626 were not changed. The Veteran's radiculopathy, femoral nerve is rated under DC 8626 which pertains to neuritis of the femoral nerve. Neuritis of the femoral nerve utilizes the same criteria as DC 8526 and is rated in the same manner. Under DC 8526, a 30 percent is warranted for severe incomplete paralysis, and 40 percent is warranted with complete paralysis of the femoral nerve. 38 C.F.R. § 4.124a, DC 8526. The Veteran's radiculopathy, sciatic nerve is rated under DC 8620 which pertains to neuritis of the sciatic nerve. Neuritis of the sciatic nerve utilizes the same criteria as DC 8520 and is rated in the same manner. Under DC 8520, a 20 percent evaluation is warranted for moderate incomplete paralysis, 40 percent is warranted for moderately severe incomplete paralysis, 60 percent is warranted for severe incomplete paralysis with marked muscular atrophy, and 80 percent is warranted for complete paralysis. The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. 38 C.F.R. § 4.124a. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. The words "mild," "moderate," and "severe" as used in the various DCs are not defined in the Rating Schedule. Although medical professionals' use of similar terminology should be considered, such use is not dispositive of an issue. Instead, all evidence must be evaluated in deciding on a request for an increased disability rating. 38 U.S.C. § 7104; 38 C.F.R. §§ 4.2, 4.6. Regulations provide that ratings for peripheral neurological disorders are 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. i. Entitlement to increased ratings for radiculopathy, bilateral lower extremities, femoral nerve The Veteran contends that his disability is more severe than the ratings depict. From February 25, 2015, based on the evidence of record, and after affording the Veteran the benefit of the doubt, the Board finds that a 30 percent rating and no more is warranted for the Veteran's radiculopathy, bilateral lower extremity, femoral nerve. The VA examiners noted that the Veteran's disability was moderate in severity; however, the February 2015 VA examiner noted that reflexes in the bilateral knees were absent; sensory exam revealed decreased senses in the right and left upper anterior thigh and thigh/knee; decreased sensation to light touch both anterior inferior thighs and anterior knees, bilaterally; and the Veteran experienced severe paresthesias and/or dysesthesias in the right and left lower extremities. Additionally, the March 2018 examiner stated that reflex exam of the right knee revealed absent reflexes and severe intermittent pain, severe paresthesias and/or dysesthesias, and severe numbness in the left lower extremity. The Board finds that when considering the totality of the Veteran's disability picture, the evidence is in relative equipoise as to whether the Veteran's femoral nerve has resulted in severe incomplete paralysis. However, there is no indication in the record that the Veteran's disability resulted in complete paralysis of the nerve; thus, a rating in excess of 30 percent is not warranted. The Board finds that a 30 percent rating, and no more, under DC 8526 for each lower extremity is warranted. 38 C.F.R. § 4.124a, DC 8526. ii. Entitlement to increased ratings for radiculopathy, bilateral lower extremities, sciatic nerve The Veteran contends that his disability is more severe than the ratings depict. Based on the evidence of record, the Board finds that, prior to February 25, 2015, the Veteran's disability more nearly approximate symptoms manifested by moderate incomplete paralysis of the nerve. As noted above, the June 2008 VA examiner found the Veteran's reflexes were normal except he had no reflexes in his left knee jerk, he had had 4/5 strength in dorsiflexion and plantar flexion of the right lower extremity, and his sensation was intact to light touch in the right lower extremity. The May 2012 VA examiner noted no reflexes in the knees and hypoactive reflexes in the ankles. The examiner noted mild intermittent pain (usually dull) and moderate numbness in the bilateral lower extremity. Additionally, the Veteran's sensory exams revealed decreased sensation in the foot/toes. The Board also notes that the May 2012 examiner noted that the disability was moderate in severity. Therefore, based on the foregoing, and after resolving all doubt in the Veteran's favor, the Board finds that a 20 percent rating is warranted prior to February 25, 2015. However, prior to February 25, 2015, the Board finds that a disability rating in excess of 20 percent is not warranted. Diagnostic Code 8520 provides a 40 percent rating for moderately severe incomplete paralysis of the sciatic nerve. There is no evidence to support a finding that the Veteran has worse than moderate incomplete paralysis of right and left lower extremities. 38 C.F.R. § 4.124a, DC 8520. As such, a rating in excess of 20 percent is not warranted. From February 25, 2015, based on the evidence of record, and after affording the Veteran the benefit of the doubt, the Board finds that a 40 percent rating and no more is warranted for the Veteran's radiculopathy, bilateral lower extremity, sciatic nerve. The VA examiners noted that the Veteran's disability was moderate in severity; however, as noted above, the February 2015 VA examiner noted that reflexes in the bilateral knees were absent; sensory exam revealed decreased senses in the right and left upper anterior thigh and thigh/knee; decreased sensation to light touch both anterior inferior thighs and anterior knees, bilaterally; and the Veteran experienced severe paresthesias and/or dysesthesias in the right and left lower extremities. Additionally, the March 2018 examiner stated that reflex exam of the right knee revealed absent reflexes and severe intermittent pain, severe paresthesias and/or dysesthesias, and severe numbness in the left lower extremity. The Board finds that when considering the totality of the Veteran's disability picture, the evidence is in relative equipoise as to whether the Veteran's sciatic nerve has resulted in moderately severe incomplete paralysis. However, there is no indication in the record that the Veteran's disability resulted in severe incomplete paralysis with marked muscular atrophy; thus, a rating in excess of 40 percent is not warranted. The Board finds that a 40 percent rating, and no more, under DC 8520 for each lower extremity is warranted. 38 C.F.R. § 4.124a, DC 8520. 4. Entitlement to TDIU Total disability will be considered to exist where there is present any impairment of mind and body that is sufficient to render it impossible for the average person to follow a substantially gainful occupation. 38 C.F.R. § 3.340. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is unable to secure or follow a substantially gainful occupation because of service-connected disabilities, provided that the Veteran meets the schedular requirements. Specifically, if there is only one such disability, this disability shall be ratable at 60 percent or more; if there are two or more disabilities, there shall be at least one disability that is ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). If a Veteran fails to meet the threshold minimum percentage standards enunciated in 38 C.F.R. § 4.16(a), rating boards should refer to the Director of Compensation and Pension Service for extraschedular consideration all cases where the Veteran is unable to secure or follow a substantially gainful occupation because of service-connected disability. 38 C.F.R. § 4.16(b); see also Fanning v. Brown, 4 Vet. App. 225 (1993). Thus, despite the Veteran not meeting the percentage requirements for TDIU, the Board must evaluate whether there are circumstances in the Veteran's case, apart from any non-service-connected conditions and advancing age which would have justified TDIU. 38 C.F.R. §§ 3.341(a), 4.19; see Van Hoose v. Brown, 4 Vet. App. 361 (1993); see also Hodges v. Brown, 5 Vet. App. 375 (1993); Blackburn v. Brown, 4 Vet. App. 395 (1993). The veteran's service-connected disabilities, employment history, educational and vocational attainment, and all other factors having a bearing on the issue must be addressed. 38 C.F.R. § 4.16(b). "Substantially gainful employment" is employment "which is ordinarily followed by the nondisabled to earn their livelihood with earnings common to the particular occupation in the community where the veteran resides." Moore v. Derwinski, 1 Vet. App. 356, 358 (1991). "Marginal employment shall not be considered substantially gainful employment." 38 C.F.R. § 4.16(a). In determining whether unemployability exists, consideration may be given to the veteran's level of education, special training, and previous work experience, but not to his age or to any impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19. Analysis The Veteran contends that his service-connected disabilities prevent him from securing and maintaining substantially gainful employment. In the November 2014 Board remand, the Board found that the issue of TDIU had been raised in the record. See Rice v. Shinseki, 22 Vet. App. 477 (2009). This Board notes that the Veteran retired from his position at the VA on April 4, 2015. As such, the period relevant to the appeal begins on April 5, 2015, the day after his retirement. From April 5, 2015, the Veteran was service connected for other specified bipolar and related disorder rated at 70 percent effective July 24, 2017; DDD, lumbar spine rated at 20 percent effective December 1, 2002, and 40 percent effective March 20, 2018; radiculopathy, sciatic nerves, left and right lower extremities each rated at 20 percent effective February 25, 2015; radiculopathy, femoral nerves, left and right lower extremities each rated at 20 percent effective February 25, 2015; chondromalacia, left and right knees each rated at 10 percent effective October 8, 2009; and hemorrhoids and infectious hepatitis each with noncompensable ratings effective December 31, 1981, and December 1, 2002, respectively. From April 5, 2015, the Veteran's overall rating was 80 percent (with consideration of the bilateral factor). Thus, he met the schedular criteria for TDIU when considering bilateral factor and disabilities resulting from a common etiology. See 38 C.F.R. § 4.16(a). From July 24, 2017 to March 19, 2018, the Veteran's overall rating was 90 percent. He met the threshold requirement for TDIU. 38 C.F.R. § 4.16(a). From March 20, 2018, the Veteran's overall rating was 100 percent with consideration of the bilateral factor). The Board notes that a grant of a 100 percent disability does not always render the issue of TDIU moot. VA's duty to maximize a claimant's benefits includes consideration of whether his disabilities establishes entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114. See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011); Bradley v. Peake, 22 Vet. App. 280, 294 (2008). The Court held in Bradley v. Peake, 22 Vet. App. 280 (2008), that there could be a situation where a veteran has a schedular total rating for a particular service-connected disability, and could establish a TDIU rating for another service-connected disability in order to qualify for SMC under 38 U.S.C. § 1114(s) by having an "additional" disability of 60 percent or more ("housebound" rate). See 38 U.S.C. § 1114(s). Thus, Bradley made it such that even with the assignment of a total schedular rating, the issue of TDIU was potentially not moot. The Board concludes that the facts of Bradley are sufficiently distinguishable from the facts of this case such that the holding in Bradley is inapplicable, and the Veteran's TDIU claim is in fact moot. This case, however, is distinguished from the case in Bradley in that the grant of TDIU would not be predicated on a single disability but on the cumulative symptomatology associated with the Veteran's service-connected disabilities. As the Veteran has no single service-connected disability that is rated at 100 percent, and the Veteran's TDIU would be predicated on multiple service-connected disabilities, the percentage rating criteria for SMC at the housebound rate have not been met at any point during the period under consideration in this appeal. As such, entitlement to TDIU for the period from March 20, 2018, is considered moot, as the Veteran is already in receipt of a combined schedular evaluation of 100 percent, from March 20, 2018. The findings in Bradley are not applicable in this case. See Herlehy v. Principi, 15 Vet. App. 33, 35 (2001). As such, there remain no allegations of error of fact or law for appellate consideration, the Board has no jurisdiction to review this appeal for the issue of entitlement to TDIU for the period from March 20, 2018, and it is dismissed in this regard. 38 U.S.C. § 7105(d)(5); 38 C.F.R. § 20.202. In July 2017, the Veteran submitted VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability. The Veteran completed four years of college. He last worked full-time as an IT specialist on April 3, 2015. He reported becoming too disabled to work in October 2014 and reported that his knees and back prevented him from securing and following any substantially gainful occupation. Before and since becoming too disabled to work, he did not have other education and/or training. Although outside the period on appeal, in June 2013, the Veteran was seen at the mental health note. The examiner noted that the Veteran was employed as the union president for the San Francisco VA. The Veteran previously worked in computer analyst positions at the VA. During a February 2014 mental health follow up, the Veteran stated that he lost election by 19 votes for his leading position in the Union. He reported still working for the union but in a different capacity. In March 2017, the Veteran was afforded a VA examination to determine the severity of his bilateral knee and lumbar spine disabilities. The examiner confirmed the Veteran's bilateral degenerative arthritis and patellofemoral pain syndrome diagnoses. The Veteran reported flare-ups and functional loss or functional impairment of the knee. He stated that his baseline functional limitations included being unable to ski because of pain. Additionally, he was unable to kneel, and his disability made squatting tough and walking was limited to less than a couple of blocks prior to resting. He walked with a cane. The pain due to flares was rated at 7/10. He stated that weakness limited further ambulation without rest. The Veteran's disability impacted his ability to perform any type of occupational task. The examiner stated that the Veteran's service-connected disabilities made the Veteran's work capacity limited to seated and sedentary positions. Additionally, because of difficulty with prolonged sitting, the Veteran may additionally require accommodation for a sit/stand station or more frequent breaks to allow stretching, etc. In July 2017, the Veteran was seen at the Palo Alto, PAD: Neurology Attending Note for essential tremors. The Veteran was prescribed new medication that nearly eliminated his tremor. He stated that he only noticed problems when he was trying to do very fine motor tasks. The Veteran's neurological exam revealed normal strength in upper and lower extremities. The dexterity of his hands was only slightly diminished and partially affected by his tremor. His gait was slightly wide based, and he walked with a cane with braces in both of his legs. The examiner stated, with regard to his gait difficulties and dexterity problems with his hands, this was most likely related to cervical myelopathy. The examiner further stated that the Veteran's cervical myelopathy and degenerative arthritis of the spine would likely limit his ability to perform most manual labor activities; however, there was a likelihood that this would affect this ability to do fine motor tasks that may be necessary for more white collar type jobs. In June 2017, the Veteran submitted a statement from his landlord, G.C. G.C. was the owner and operator of a marine supply store. The Veteran requested a job from G.C. The Veteran stated that he was limited to sitting and standing jobs and he also noted that he needed frequent breaks to allow for moving and stretching so that the pain would not be unbearable. The Veteran suggested a sit/stand workstation would allow him to be even more productive. G.C. suggested the Veteran volunteer until the boating season began. G.C. stated that the Veteran was enthusiastic and tried very hard to accomplish tasks; however, it became apparent that due to his physical limitations, he could not work more than four or five hours a day, even though he was free to stand or sit at his convenience. The Veteran was also unreliable in regard to his attendance. Most weeks, he only felt well enough to go in to work two or three days. On some weeks, the Veteran would go to work four days. G.C. stated that he could not hire the Veteran as G.C. needed someone more dependable, reliable; however, the Veteran's physical challenges did not allow him the freedom to work in the shop. In September 2017, the Veteran was afforded a VA examination to determine the severity of his bilateral knee and lumbar spine disabilities. The examiner confirmed the Veteran's bilateral knee patellofemoral pain syndrome and degenerative arthritis diagnoses. The Veteran reported functional loss or functional impairment of the joint due to pain which limited his ability to walk for long periods and walk upstairs. The Veteran was able to perform repetitive use testing with at least three repetitions. There was no additional loss of function or ROM after three repetitions. Muscle strength testing was normal with no reduction in muscle strength and no muscle atrophy. The Veteran's disability impacted his ability to perform any type of occupational task, i.e., the Veteran reported that he had functional loss/impairment due to pain which limited his ability to walk for a long time and walking upstairs, lift, and bend. The examiner stated that the Veteran could perform any type of occupational task without significant restrictions. In November 2017, the Staff Physician, Neurology Services, VA Palo Alto Health Care System, submitted a statement in support of the Veteran's TDIU claim. The examiner stated that the Veteran is his patient. The examiner stated that the Veteran has a history of cervical myelopathy, i.e., a condition in which the spinal cord in the neck is compressed and damaged. The examiner further stated that even with proper treatment, persons with cervical myelopathy often have persistent problems with motor control (strength), sensation, manual dexterity, and balance, among other problems. The Veteran underwent successful surgery, but the examinations reveal persistent problem with balance and dexterity of his hands. Over the last few years, the Veteran's balance has been gradually worsening which is likely due to chronic effects of his spinal cord injury. The Veteran also has a diagnosis of carpal tunnel syndrome, which causes pain and loss of dexterity of his hands. Further complicating his neurological health is that he has developed a tremor, which makes fine motor tasks especially difficult. His handwriting is shaky, and even using a keyboard is difficult. The examiner stated that as a consequence of the Veteran's multiple medical problems, it is very difficult for him to perform a number of different jobs. Occupations that require physical activity are not advised because of his residual disability from his cervical myelopathy. Jobs that involve writing, use of a computer, and fine motor tasks are impractical because of his tremor. The examiner stated that, given the Veteran's prior work experience, because of the Veteran's physical limitations, the Veteran is disabled from a large number of jobs that are reasonably available to him. On March 13, 2018, the Veteran was afforded a VA examination to determine the nature and etiology of his acquired psychiatric disorder. The examiner diagnosed the Veteran with other specified bipolar and related disorder. at the time of the exam, the Veteran's symptoms included depressed mood; anxiety; suspiciousness; panic attacks more than once a week; chronic sleep impairment; circumstantial, circumlocutory or stereotyped speech; impaired impulse control, such as unprovoked irritability with periods of violence; disturbance of motivation and mood, difficulty establishing and maintaining effective work and social relationship; and inability to establish and maintain effective relationships. The examiner stated that the Veteran experienced occupational and social impairment with reduced reliability and productivity. Although outside the period on appeal, in January 2019, the Veteran was seen at the Palo Alto pain clinic. The Veteran stated that he was retired. Although the Veteran reported that pain prevented him from engaging in any prolonged physical activity and reported that he could only tolerate standing and movement for short intervals, he reported engaging in regular activities. He also reported engaging in sedentary hobbies at home such as genealogy research. After considering the medical and lay evidence of record, the Board finds that the preponderance of record does not show that TDIU is warranted. The central inquiry is whether the Veteran's service-connected disabilities, alone, is of sufficient severity to preclude him from obtaining and maintaining all forms of substantially gainful employment. See Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). The Board notes that the Veteran's landlord, G.C. stated that due to the Veteran's disabilities, he was unable to work more than four or five hours per day, and he was unreliable. The Board also notes that in the November 2017 statement from the Veteran's treating physician, the physician stated that the Veteran is disabled from a large number of jobs that are reasonably available to him. In determining that the Veteran was disabled from a large number of jobs, the November 2017 examiner stated that this was due to the Veteran's cervical myelopathy/spinal cord injury, carpel tunnel syndrome, and tremors. The Board notes that the Veteran is not service connected for these conditions. The law is clear, the Board may only consider service-connected disabilities in a claim of entitlement to TDIU. Additionally, the March 2017 VA examiner noted that although the Veteran's disabilities affected his ability to work, and even though he may additionally require accommodation for a sit/stand station or more frequent breaks to allow stretching, etc., his service-connected conditions made his work capacity limited to seated and sedentary positions. The September 2017 examiner also stated that although the Veteran reported that he had functional loss/impairment due to pain which limited his ability to walk for a long time and walking upstairs, lift and bend, the Veteran could perform any type of occupational task without significant restrictions. Additionally, even though pain prevented him from engaging in any prolonged physical activity, and he could only tolerate standing and movement for short intervals, he engaged in regular activities and reported engaging in sedentary hobbies at home such as genealogy research. In sum, the Board finds that considering the Veteran's college education and his previous employment as an IT specialist and as union president for the San Francisco VA, the records do not demonstrate that the Veteran's service-connected disabilities, alone, precluded him from performing all types of gainful employment. Therefore, the Board finds, for the period on appeal, TDIU is not warranted. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not applicable, and the claim is denied. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). MICHAEL LANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Tara-Deen 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.