Citation Nr: 21005557 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 16-00 226A DATE: February 2, 2021 ORDER The appeal seeking an initial rating in excess of 10 percent for arthritis of the left thumb is dismissed. The appeal seeking an initial rating in excess of 40 percent from March 6, 2020, for degenerative disc disease (DDD) of the lumbar spine is dismissed. The appeal seeking an initial rating in excess of 50 percent from March 6, 2020, for plantar fasciitis of the bilateral feet is dismissed. The appeal seeking an initial rating in excess of 30 percent from March 6, 2020, for migraine headaches is dismissed. An initial rating in excess of 10 percent prior to February 5, 2020, for DDD of the lumbar spine is denied. An initial rating of 40 percent from February 5, 2020 to March 6, 2020, for DDD of the lumbar spine is granted, subject to the rules and regulations governing the payment of monetary awards. An initial compensable rating prior to February 5, 2020, for plantar fasciitis of the bilateral feet is denied. An initial rating of 50 percent from February 5, 2020 to March 6, 2020, for plantar fasciitis of the bilateral feet is granted, subject to the rules and regulations governing the payment of monetary awards. An initial rating of 30 percent from October 1, 2011 to March 6, 2020, for migraine headaches is granted, subject to the rules and regulations governing the payment of monetary awards. FINDINGS OF FACT 1. On August 20, 2020, prior to the promulgation of a decision in the appeal, the Veteran stated she was satisfied with the rating assigned for her arthritis of the left thumb as well as the ratings currently assigned from March 6, 2020, for her DDD of the lumbar spine, plantar fasciitis of the bilateral feet, and migraine headaches, essentially requesting withdrawal of the appeals regarding these issues. 2. Prior to February 5, 2020, the Veteran’s DDD of the lumbar spine was manifested by pain on range of motion of the spine, without muscle spasm, guarding or incapacitating episodes of IVDS. 3. From February 5, 2020 to March 6, 2020, the Veteran’s DDD of the lumbar spine was reasonably shown to have been manifested by 30 degrees or less forward flexion of the thoracolumbar spine. 4. Prior to February 5, 2020, the Veteran’s plantar fasciitis of the bilateral feet was not manifested by moderate symptoms of foot disability and was shown to be alleviated by shoe inserts. 5. From February 5, 2020 to March 6, 2020, the Veteran’s plantar fasciitis of the bilateral feet was reasonably shown to have been manifested by extreme tenderness of the plantar surfaces of the feet with symptoms not improved by orthopedic shoe or appliance. 6. From the effective date of service connection in October 2011, the Veteran has experienced migraines with characteristic prostrating attacks occurring on average once a month over the last several months. CONCLUSIONS OF LAW 1. The criteria for dismissal of the issue of an increased rating for arthritis of the left thumb have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 2. The criteria for dismissal of the issue of an increased rating for DDD of the lumbar spine from March 6, 2020, have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 3. The criteria for dismissal of the issue of an increased rating for plantar fasciitis of the bilateral feet from March 6, 2020, have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 4. The criteria for dismissal of the issue of an increased rating for migraine headaches from March 6, 2020, have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 5. The criteria for a rating in excess of 10 percent for DDD of the lumbar spine prior to February 5, 2020, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5237. 6. From February 5, 2020 to March 6, 2020, the criteria for a rating of 40 percent, but no higher, for DDD of the lumbar spine have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5237. 7. The criteria for a compensable rating for plantar fasciitis of the bilateral feet prior to February 5, 2020, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5276, 5284. 8. From February 5, 2020 to March 6, 2020, the criteria for a rating of 50 percent, but no higher, for plantar fasciitis of the bilateral feet have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5276, 5284. 9. From October 1, 2011, the effective date of service connection, to March 6, 2020, the criteria for a rating of 30 percent, but no higher, for migraine headaches have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8100. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1977 to February 1985, from March 2006 to July 2006, from February 2008 to May 2008, and from October 2008 to September 2011. In addition, she had many years of service with the Naval Reserves. In February 2020, the Veteran testified at a Travel Board hearing before the undersigned Veteran’s Law Judge. A transcript of the hearing has been associated with the claims folder. At the hearing, the Veteran was not assisted by a representative. She was, however, advised of her right to have representation at the hearing and, as indicated on the record, it was her desire to proceed without her representative being present. The case was remanded by the Board in February 2020 for further development. After development, the Veteran was issued a July 2020 rating decision that, in pertinent part, granted an increased rating of 40 percent for her DDD of the lumbar spine, of 50 percent for her plantar fasciitis of the bilateral feet, and of 30 percent for her migraine headaches, all effective March 6, 2020; and an increased rating of 10 percent for arthritis of the left thumb, effective October 1, 2011. Entitlement to an increased initial rating for arthritis of the left thumb and entitlement to increased initial ratings from March 6, 2020, for DDD of the lumbar spine, for plantar fasciitis of the bilateral feet, and for migraine headaches. The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 19.55. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 19.55 (legacy appeals), § 20.205 (Appeals Modernization Act appeals). As noted above, in a July 2020 rating decision, the Veteran was awarded a 10 percent disability rating for her arthritis of the left thumb, effective from October 1, 2011; and a 40 percent rating for her DDD of the lumbar spine, a 50 percent rating for her plantar fasciitis of the bilateral feet; and a 30 percent rating for her migraine headaches, all effective from March 6, 2020. In an August 2020 statement, the Veteran stated she “agree[d] with the decisions, as to the levels of disability now assigned” for her service-connected disabilities but not their effective dates. In particular, she felt the increased disability ratings should have been assigned from the date of her separation from service. As the Veteran has indicated satisfaction with the 10 percent initial rating now assigned for her arthritis of the left thumb, and as it has been assigned from October 1, 2011, the day after her separation from service, the Board finds this issue has been withdrawn in its entirety and there remains no allegation of error of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeal and it is dismissed. As for the Veteran’s DDD of the lumbar spine, plantar fasciitis of the bilateral feet, and migraine headaches, the Veteran has indicated satisfaction with the 40 percent, 50 percent, and 30 percent disability ratings now assigned, respectively, from March 6, 2020. Accordingly, the Board finds that the issues of entitlement to an initial rating in excess of 40 percent from March 6, 2020, for DDD of the lumbar spine; entitlement to an initial rating in excess of 50 percent from March 6, 2020, for plantar fasciitis of the bilateral feet; and entitlement to an initial rating in excess of 30 percent from March 6, 2020, for migraine headaches have also been withdrawn in their entirety and there remains no allegations of error of fact or law for appellate consideration. Accordingly, the Board also does not have jurisdiction to review these appeals and they are dismissed. [The propriety of the disability ratings assigned prior to March 6, 2020, for the Veteran’s DDD of the lumbar spine, plantar fasciitis of the bilateral feet, and migraine headaches remains on appeal and is addressed below.] Increased Rating Entitlement to an initial rating in excess of 10 percent for DDD of the lumbar spine prior to March 6, 2020. The Veteran contends that the initial evaluation awarded for the DDD of her lumbar spine is inadequate to fully compensate her. She states she has had numerous treatments for the low back pain including massages, a type of “traction” and steroid injections. She also has asserted that the initial VA examination, conducted in 2012, was inadequate and incomplete as the examiner hardly touched her. Review of the record shows that service connection was granted by a rating decision dated in November 2012. A 10 percent rating was assigned initially. This rating was increased to 40 percent, effective March 6, 2020, by a rating decision dated in July 2020. As noted above, the Veteran has expressed satisfaction with the 40 percent rating assigned from March 6, 2020, but feels a rating higher than the 10 percent initial rating currently assigned prior to that date is warranted. The Board notes initially that the increased 40 percent disability rating was awarded from March 6, 2020, as that was the date of her most recent VA examination. However, the Veteran was afforded the VA examination based on the testimony she provided at a hearing conducted before the Board on February 5, 2020. Specifically, at the hearing, the Veteran testified to having chronic sciatic pain and low back pain on the left side, predominantly. She indicated that there were times when the pain was worse, such as after she had been sitting for long periods of time and/or on hard surfaces. She also noted that she continued to take medication to relieve pain and spasms. As a result of this testimony, her claim was remanded for a VA examination that was conducted in March 2020. During the March 2020 VA examination, the Veteran reiterated many of the complaints she shared during the Board hearing. On physical examination, range of motion testing showed she had 45 degrees of forward flexion that was estimated to be reduced to 30 degrees during periods of flare-ups. She was also found to have lumbar radiculopathy, and it was based on these findings that the Veteran was awarded an increased disability rating of 40 percent for her DDD of the lumbar spine, effective from the date of the VA examination. She was also awarded service connection for the right femoral nerve and right leg sciatic nerve, both rated 10 percent, effective March 6, 2020 (date of VA examination). The Veteran does not dispute the ratings assigned for her right femoral nerve and right leg sciatic nerve; however, she has argued that service connection for those disabilities should have been awarded from an earlier date. See August 2020 Correspondence. As the March 2020 VA examination was conducted as a result of the Veteran’s hearing testimony, the Board finds it is reasonably shown that her increased level of disability was factually ascertainable from that date. Therefore, the Board finds that the increased disability rating of 40 percent is warranted from February 5, 2020 to March 6, 2020, for the Veteran’s DDD of the lumbar spine. A rating in excess of 40 percent is not warranted, however, as it is not shown that the Veteran had unfavorable ankylosis of the entire thoracolumbar spine. Moreover, as addressed above, the Veteran has expressed satisfaction with the 40 percent rating assigned from March 6, 2020, which suggests she also does not feel a higher rating is warranted. To this extent, the Veteran’s appeal is granted. The Board acknowledges that in the July 2020 rating decision, the Veteran was also awarded service connection for a right femoral nerve and a right leg sciatic nerve, effective the date of the VA examination. The Board does not find, however, that these separate awards of service connection should also be made effective from the date of the February 2020 Board hearing (or earlier). In particular, at the hearing, the Veteran reported having left side sciatic pain and did not describe similar symptoms for the right side. At the March 2020 VA examination, the Veteran similarly described having current symptoms that included intermittent pain in the back that radiated to her left lower extremity. Despite complaints regarding her left lower extremity, on physical examination, she was only found to have radiculopathy on the right side. Therefore, the record does not show that the Veteran’s right femoral nerve and right leg sciatic nerve involvement were factually ascertainable until the VA examination conducted on March 6, 2020. Having determined that the Veteran’s DDD of the lumbar spine warrants a 40 percent initial rating from February 5, 2020, the Board now turns to consideration of whether a higher rating (in excess of 10 percent) is warranted for the disability prior to that date. Private treatment records dated from 2004 to 2006 show that the Veteran was treated with epidural steroid injections of the lumbar spine. These records, which date prior to the effective date of service connection in 2011, also show positive straight leg raising, but full range of motion of the thoracolumbar spine. An examination was conducted by VA in September 2012. At that time, the examiner reviewed the Veteran’s history of back pain since being in a “survival camp” where she was carrying heavy packs. The Veteran stated that the back pain would “come and go” depending on her activities such as prolonged sitting in planes or heavy lifting. She also reported that she had started experiencing more frequent episodes of back symptoms for which she had been treated with epidural steroid injections, that helped. She reported having constant dull back pain that worsened at times when she experienced spasms in the left lumbar paraspinal area. Stretching, chiropractic care and swimming helped. She reported having no flareups that impacted function of the thoracolumbar spine. On physical examination, range of motion testing demonstrated was forward flexion to 90 degrees or greater, extension to 30 degrees or greater, right and left lateral flexion to 30 degrees or greater, and right and left lateral rotation to 30 degrees or greater. There was no objective evidence of pain in any plane of motion. The Veteran was able to perform repetitive use testing without additional limitation of motion; however, functional loss after repetitive use testing was noted in that the Veteran had pain on movement. There was no muscle spasm, guarding or localized tenderness. Muscle strength testing was normal without muscle atrophy. Deep tendon reflexes were normal at both knees and ankles. Sensory examination was normal. Straight leg raising was negative. There were no signs or symptoms of radiculopathy. The Veteran did have intervertebral disc syndrome (IVDS), but there were no reported incapacitating episodes of IVDS over the past 12 months. The Veteran’s lumbar DDD is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5237. Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent rating is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (“[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran’s disability, after which a rating is determined based on the § 4.71a criteria.”). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia v. McDonald, 28 Vet. App. 158 (2016), the United States Court of Appeals for Veterans Claims (Court) held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing “for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint.” The spine has no opposite joint. In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination. The Board finds that the preponderance of the evidence is against a rating in excess of 10 percent for her lumbar spine disability prior to February 5, 2020. The Board acknowledges the Veteran’s lay reports of symptoms and that there was functional loss due to pain on motion. However, considering these lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements would not result in limitation of motion more nearly approximating forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees or the combined range of motion of the thoracolumbar spine not greater than 120 degrees. Additionally, the Veteran has not had muscle spasm or guarding that is severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. While the Veteran has objected to the adequacy of the 2012 VA examination, the report contains all the elements necessary to properly evaluate her spine disorder and there is no indication in the record that the examination was otherwise incomplete. During the 2012 VA examination, the Veteran had full range of motion, without objective evidence of pain. There was also no muscle spasm or guarding. As such there is no basis for a rating in excess of the 10 percent initial rating that is assigned prior to February 5, 2020. Consideration has also been given to assigning a rating under the Formula for Rating IVDS Based on Incapacitating Episodes. While the Veteran was noted to have IVDS, she did not have any episodes of incapacity as the evidence of record does not show findings that the Veteran was ever prescribed bed rest by a physician for a duration that meets the criteria for a higher rating. See 38 C.F.R. § 4.71a, Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes. Regarding neurological impairment, the lay and medical evidence of record is against a finding that the Veteran has had any other neurological abnormality associated with her spine disability during the time between the establishment of service connection and the examination report dated in March 6, 2020. As was addressed earlier, the earliest reports of radicular symptoms in the record are from the February 2020 Board hearing where the Veteran testified to having left sciatica pain. However, when the Veteran was examined in March 2020, and she made similar reports of low back pain that radiated into the left lower extremity, she was only found to have right lumbar radiculopathy. She has been granted service connection for those separate disabilities (right femoral nerve and right leg sciatic nerve) from the date of the March 2020 VA examination. Finally, while the Veteran was afforded steroid injections and other treatment for low back pain, this was prior to the establishment of service connection and is not pertinent to the current appeal. For the foregoing reasons, the preponderance of the evidence is against the Veteran’s claim for a rating in excess of 10 percent prior to February 5, 2020, for DDD of the lumbar spine. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Entitlement to a compensable rating for plantar fasciitis of the bilateral feet prior to March 6, 2020 The Veteran contends that she is entitled to a higher initial rating for her service-connected plantar fasciitis. Review of the record shows that service connection was granted by a rating decision dated in November 2012, and a noncompensable (0 percent) rating was assigned at that time. During the Veteran’s hearing testimony before the Board, she stated that she often had spasms in her feet for which had to massage herself. In a July 2020 rating decision, the disability rating for the Veteran’s plantar fasciitis was increased to 50 percent, effective March 6, 2020, under the provisions of 38 C.F.R. § 4.71a, Diagnostic Code 5276. Although the Veteran does not disagree with the 50 percent rating now assigned for her disability, she has disagreed with the effective date assigned. As with the Veteran’s DDD of the lumbar spine, the increased rating of 50 percent for her plantar fasciitis of the bilateral feet was assigned effective March 6, 2020, as that was the date of her VA examination. However, the VA examination was conducted because of the testimony she provided at a February 5, 2020 Board hearing. Accordingly, resolving all reasonable doubt in the Veteran’s favor, the Board finds that the 50 percent rating should have been assigned from February 5, 2020, as that was the earliest date it was factually ascertainable that an increase in her disability had occurred. As the Veteran does not disagree with the assignment of a 50 percent rating for her plantar fasciitis, to that extent, her appeal is granted. As for the period prior to February 5, 2020, the Veteran’s plantar fasciitis was initially rated under 38 C.F.R. § 4.71a, Diagnostic Code 5284, for other foot injuries. Under Diagnostic Code 5284, a 10 percent rating is warranted for moderate other foot injuries. A 20 percent rating is warranted for moderately severe other foot injuries. A 30 percent rating is warranted for severe other foot injuries. A Note to Diagnostic Code 5284 instructs that with actual loss of use of the foot rate as a maximum 40 percent. 38 C.F.R. § 4.71a, Diagnostic Code 5284. According to MERRIAM WEBSTER, “moderate” means “tending toward the mean or average amount or dimension”. See www.merriam-webster.com/dictionary/moderate. “Severe” means “of a great degree”. See www.merriam-webster.com/dictionary/severe. In every instance where the minimum schedular evaluation requires residuals and the schedule does not provide a no percent evaluation, a no percent evaluation will be assigned when the required residuals are not shown. 38 C.F.R. § 4.31. Under Diagnostic Code 5276, a noncompensable rating is warranted for mild acquired flatfoot; symptoms relieved by built-up shoe or arch support. A 10 percent rating is warranted for moderate acquired flat foot; weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet, bilateral or unilateral. A 20 percent rating is assigned for severe unilateral acquired flat foot; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 30 percent rating is warranted for severe bilateral acquired flat foot; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 30 percent rating is also warranted for pronounced unilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. A maximum 50 percent rating is warranted for bilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, Diagnostic Code 5276. An examination was conducted by VA in October 2012. At that time, the examiner noted that the Veteran had foot disability, but was not noted to have pes planus (flat feet). On examination, the Veteran had decreased sensation on the arch of each foot. She wore inserts to alleviate plantar fasciitis. In light of the foregoing, the Board finds that the preponderance of the evidence is against a compensable for plantar fasciitis prior to March 6, 2020. The Board acknowledges the Veteran’s lay reports of symptoms and that there was functional loss due to pain, but even considering these lay reports of symptoms and functional loss, the degree of additional limitation reflected by the statements that would not result in symptoms more nearly approximating moderate other foot injuries for either foot. The VA examination in 2012 shows only some decrease in sensation of the arch of the feet and that her symptoms were alleviated by shoe inserts. The Board has also considered the other Diagnostic Codes pertaining to the foot. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); see also Lyles v. Shulkin, 29 Vet. App. 107 (2017). In Scott v. Wilkie, the Federal Circuit expressly adopted the Court’s holding that disabilities specifically listed in the rating schedule may only be rated under Diagnostic Codes which specifically pertain to them. Scott v. Wilkie, 920 F.3d 1375 (Fed. Cir. 2019) (citing Copeland v. McDonald, 27 Vet. App. 333, 336 (2015)). The Federal Circuit also expressly adopted the Court’s holding that unlisted conditions may be rated by analogy to Diagnostic Codes that may not describe the unlisted disability but addresses disabilities that may be productive of similar symptoms. Scott, 920 F.3d 1375 (citing Yancy v. McDonald, 27 Vet. App. 484, 493 (2016). Finally, the Federal Circuit concluded that the Board must also consider assigning separate ratings under analogous Diagnostic Codes, when rating an unlisted service-connected foot disability exhibiting distinct manifestations, even when service connection has also been granted for one of the eight conditions listed in the rating schedule. Id. Here, the Veteran’s disability is unlisted and rated by analogy. In this regard, Diagnostic Codes 5277 through 5283 are not applicable. The Veteran has not been diagnosed or shown to exhibit symptoms of weak foot, claw foot, metatarsalgia, hallux valgus or rigidus, hammer toe, or malunion of the tarsal or metatarsal bones. While, as has been noted, she is now rated under the criteria for pes planus, the criteria for rating this is rated noncompensable for mild symptoms that are relieved by built-up shoes or arch support. As noted, the Veteran’s symptoms were shown to be alleviated by shoe inserts at the time of the VA examination in 2012. As such a compensable rating under 38 C.F.R. § 4.71a, Diagnostic Code 5276, for acquired flatfoot is not shown to be warranted. In conclusion, the Board finds that the preponderance of the evidence is against a compensable rating for plantar fasciitis prior to the February 5, 2020 Board hearing and the March 6, 2020 VA examination upon which the increased rating of the Veteran’s foot disabilities is now rated. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Entitlement to an initial rating in excess of 10 percent for migraine headaches prior to March 6, 2020 The Veteran contends that her migraine headaches have been more disabling than initially evaluated. During the February 2020 Board hearing, she indicated that she had frequent headaches, approximately three times per week, mostly at night, or with changes in barometric pressure. Review of the record shows that service connection was awarded for migraine headaches, rated 10 percent under Diagnostic Code 8100, in a December 2012 rating decision, effective October 1, 2011. The rating was increased to 30 percent, effective March 6, 2020. Migraine headaches are rated pursuant to 38 C.F.R. § 4.124a, Diagnostic Code (DC) 8100, for migraine. Under DC 8100, a noncompensable rating is warranted for migraines with less frequent attacks. A 10 percent rating is warranted for migraines with characteristic prostrating attacks averaging one in 2 months over the last several months. A 30 percent rating is warranted for migraines with characteristic prostrating attacks occurring on an average once a month over the last several months. A 50 percent (maximum) rating is warranted for migraines with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. The rating criteria of DC 8100 are considered successive, meaning that a claimant cannot fulfill the criteria of the higher rating without fulfilling those of the next lower rating. Johnson v. Wilkie, 30 Vet. App. 245, 252 (2018). This renders 38 C.F.R. §§ 4.7 and 4.21 inapplicable. Johnson, 30 Vet. App. at 252. The phrase “characteristic prostrating attacks” is used in the criteria corresponding to 10 percent and 30 percent ratings under DC 8100 to describe the nature and severity of migraines, but it is not defined in the regulation. Pursuant to Dorland’s Illustrated Medical Dictionary 1531 (32d ed. 2012), prostration is defined as “extreme exhaustion or powerlessness.” Thus, the phrase “characteristic prostrating attacks” is understood to describe migraine attacks that typically produce extreme exhaustion or powerlessness. The rating criteria for a 50 percent rating contains several undefined phrases. The descriptive phrase “very frequent” connotes a frequency at least greater than once a month, as is required by the rating criteria corresponding to a lesser 30 percent rating. Johnson, 30 Vet. App. at 253. The phrase “completely prostrating” generally means that the migraines attack must render the veteran entirely powerless. Id. The completely prostrating attacks must also be “prolonged,” which is defined as “to lengthen in time: extend duration: draw out: continue, protract.” Id. (internal citation omitted). Lastly, the 50 percent rating criteria requires that the very frequent completely prostrating and prolonged attacks be “productive of severe economic inadaptability.” Productive can be read as having either the meaning of “producing” or “capable of producing,” and, with regard to severe economic inadaptability, nothing in DC 8100 requires that the claimant be completely unable to work in order to qualify for a 50 percent rating. Pierce v. Principi, 18 Vet. App. 440, 445-46 (2004). An examination was conducted by VA in December 2012. At that time, the examiner indicated that the Veteran had not been diagnosed with a headache condition. She currently complained of having headaches several times per week, typically on awaking, but sometimes during the day or throughout the day into the evening. These were described as tension type headaches, but turned into migraine type about once monthly. She treated this with ibuprofen. The headaches were typically sharp, pulsating and throbbing in nature. They were exacerbated during meetings and while reading mail. The pain was on both sides of the head and radiated behind the eyes into the scalp. They were accompanied by nausea, vomiting, and sensitivity to light. The headaches typically lasted one to two days and, less commonly, could last at least three days. The Veteran stated she had characteristic prostrating attacks once every month. She described very frequent prostrating and prolonged attacks and non-migraine headaches more frequently than once per month. These were not considered prostrating or prolonged. The Veteran’s headache condition was stated to impact her ability to work. After reviewing the relevant evidence prior to March 6, 2020, the Board concludes that the Veteran has had migraines with characteristic prostrating attacks occurring on average once a month over the last several months throughout the appeal period, corresponding to the criteria for a 30 percent rating under DC 8100. The Veteran is competent to report her readily observable symptoms. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Veteran’s credibility during the 2012 VA examination, that she has monthly prostrating attacks is found to be sufficient to establish that the 30 percent rating should have been awarded from the initial date of service connection on October 1, 2011. Accordingly, the Board concludes that the Veteran has had migraines with characteristic prostrating attacks occurring on average once a month over the last several months throughout the appeal period, corresponding to the criteria for a 30 percent rating under DC 8100. To this extent, the Veteran’s appeal is granted. As for whether a rating higher than 30 percent is warranted prior to March 6, 2020, a 50 percent rating under DC 8100 requires migraines with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. This has not been demonstrated in the record. It is further noted that in an August 2020 statement, the Veteran expressed satisfaction with the 30 percent rating assigned from March 6, 2020, for her migraine headaches, which suggests that she also does not feel her disability warrants a higher. Thus, the Board concludes that prior to March 6, 2020, the Veteran did not have migraines with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability at any time during the appeal period, and a higher 50 percent rating is not warranted under DC 8100. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joseph P. Gervasio 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.