Citation Nr: 21005720 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 14-38 306 DATE: February 2, 2021 ORDER Entitlement to an initial disability rating in excess of 30 percent prior to October 11, 2019 for posttraumatic stress disorder (PTSD) is denied. Entitlement to a disability rating in excess of 10 percent for degenerative disc disease of the lumbar spine, to include on an extraschedular basis is denied. Entitlement to a separate 10 percent disability rating for right lower extremity radiculopathy, secondary to service-connected degenerative disc disease of the lumbar spine, from May 28, 2011 is granted. Entitlement to an initial disability rating in excess of 10 percent for radiculopathy of the left lower extremity prior to October 9, 2019 is granted. Entitlement to a disability in excess of 20 percent for radiculopathy of the left lower extremity from October 9, 2019 is denied. REMANDED Entitlement to a disability rating in excess of 10 percent for degenerative joint disease of the left ankle, to include on an extraschedular basis is remanded. Entitlement to a total disability rating for individual unemployability due to service-connected disability (TDIU) is remanded. FINDINGS OF FACT 1. For the period prior to October 11, 2019, the preponderance of the evidence shows that the symptomatology of the Veteran’s PTSD more nearly approximated occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal. 2. The preponderance of the evidence weighs against finding that the Veteran’s degenerative disc disease of the lumbar spine manifests in forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees, combined range of motion of the thoracolumbar spine not greater than 120 degrees, or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. 3. Resolving reasonable doubt in favor of the Veteran, the evidence reflects that the Veteran suffers from mild incomplete paralysis of the right lower extremity, secondary to his service-connected lumbar spine disability. 4. Resolving reasonable doubt in favor of the Veteran, the evidence reflects that the Veteran suffers from moderate incomplete paralysis of the left lower extremity for the entire period on appeal. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 30 percent for PTSD have not been met for the period prior to October 11, 2019. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.130, Diagnostic Code 9411. 2. The criteria for a disability rating in excess of 10 percent for degenerative disc disease of the lumbar spine have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.71a, Diagnostic Code 5242. 3. The criteria for a 10 percent disability rating for radiculopathy of the right lower extremity have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.124A, Diagnostic Code 8520. 4. For the period prior to October 9, 2019, the criteria for a 20 percent disability rating for radiculopathy of the left lower extremity have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.124A, Diagnostic Code 8520. 5. For the period from October 9, 2019, the criteria for disability rating in excess of 20 percent for radiculopathy of the left lower extremity have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.124A, Diagnostic Code 8520. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1985 to November 1996, from November 2001 to November 2003, and from October 2005 to Aril 2006. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board previously remanded the case in May 2018 for further development. The requested development as to the claims adjudicated below has been completed to the extent possible, and no further action is necessary to comply with the Board’s remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Increased Rating A disability rating is determined by the application of VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. VA has a duty to acknowledge and consider all regulations that are potentially applicable through the assertions and issues raised in the record, and to explain the reasons and bases for its conclusions. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as “staged ratings,” whether it is an initial rating case or not. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 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). An extraschedular disability rating is warranted if the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization that application of the regular schedular standards would be impracticable. 38 C.F.R. § 3.321(b)(1). In Thun v. Peake, the United States Court of Appeals for Veterans Claims (Court) explained how the provisions of 38 C.F.R. § 3.321 are applied. Thun v. Peake, 22 Vet. App. 111, 11516 (2008). Specifically, the Court stated the determination of whether a veteran is entitled to an extraschedular rating under § 3.321 is a three-step inquiry. First it must be determined whether the evidence presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate. In this regard, the Court indicated there must be a comparison between the level of severity and the symptomatology of the veteran’s service-connected disability with the established criteria found in the rating schedule for that disability. Under the approach prescribed by VA, if the criteria reasonably describe the veteran’s disability level and symptomatology, the veteran’s disability picture is contemplated by the rating schedule, the assigned schedular evaluation is, therefore, adequate, and no referral is required. Second, if the schedular evaluation does not contemplate the veteran’s level of disability and symptomatology and is found inadequate, the RO or Board must determine whether the veteran’s exceptional disability picture exhibits other related factors such as “marked interference with employment” and “frequent periods of hospitalization.” Third, when an analysis of the first two steps reveals that the rating schedule is inadequate to evaluate a veteran’s disability picture and that picture has attendant thereto related factors, such as marked interference with employment or frequent periods of hospitalization, then the case must be referred to the Under Secretary for Benefits or the Director of Compensation Service to determine whether, to accord justice, the veteran’s disability picture requires the assignment of an extraschedular rating. 1. Entitlement to an initial disability rating in excess of 30 percent prior to October 11, 2019 for PTSD is denied. The Veteran is seeking a disability rating in excess of 30 percent prior to October 11, 2019 for his PTSD. He contends his PTSD is more severe than reflected by his assigned disability rating for this period. As the Veteran was granted a 100 percent disability rating for his PTSD from October 11, 2019, the Board will only consider the period prior to October 11, 2019. The regulations for mental disorders are found in 38 C.F.R. §§ 4.125-4.130. The Board notes that the Veteran’s diagnosis of PTSD is evaluated under Diagnostic Code 9411 and is rated according to the General Rating Formula for Mental Disorders. Pursuant to the rating formula, a 50 percent disability rating is warranted for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; and difficulty in establishing and maintaining effective work and social relationships. A 70 percent disability rating is warranted for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near- continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); and inability to establish and maintain effective relationships. A 100 percent disability rating is warranted for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of close relatives, own occupation, or own name. When determining the appropriate disability evaluation to assign, the Board’s primary consideration is the veteran’s symptoms, but it must also make findings as to how those symptoms impact the veteran’s occupational and social impairment. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013); Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). Because the use of the term “such as” in the rating criteria demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, the Board need not find the presence of all, most, or even some, of the enumerated symptoms to award a specific rating. Mauerhan, 16 Vet. App. at 442; see also Sellers v. Principi, 372 F.3d 1318, 1326-27 (Fed. Cir. 2004). Nevertheless, all ratings in the general rating formula are also associated with objectively observable symptomatology and the plain language of the regulation makes it clear that the veteran’s impairment must be “due to” those symptoms, a veteran may only qualify for a given disability by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration. Vazquez-Claudio, 713 F.3d at 118. A July 2010 treatment record noted that the Veteran was well-appearing and fully oriented with normal mood and affect. In a February 2011 treatment record, the Veteran noted he had looked up generalized anxiety disorder on the internet and believed he had symptoms consistent with the disorder, such as irritability and poor focus. He noted he teared up easily and was not sleeping well. The Veteran was noted as appearing well and in no distress. He was fully oriented with intact recent and remote memory, intact judgement and insight, and normal mood and affect. In March 2011, the Veteran reported his medication for anxiety was helping. In a May 2011 treatment record, the Veteran reported that he was employed and currently lived with his wife and resided in a stable nuclear family. The Veteran reported difficulty with concentration but had some improvement with focus. He was now sleeping through the night. A June 2011 treatment record noted that the Veteran was well-appearing and in no distress. He was fully oriented with intact recent and remote memory. Judgement and insight were intact, and mood and affect were normal. In August 2011, the Veteran reported his PTSD was about usual. He was staying active with work and working out. The Veteran was well-appearing and fully oriented. His recent and remote memory were intact, as was his judgement and insight. He had normal mood and affect. A September 2011 treatment record noted that the Veteran was fully oriented with normal mood and affect. In September 2011, the Veteran reported an increase in stress and that his anxiety had returned. An October 2011 treatment record noted that the Veteran’s mood was better modulated but his anxiety remained below the surface. He appeared to be oriented with intact judgement. In October 2011, the Veteran was visibly upset and animated. He had violated some policies at work, was in trouble, and was to have a meeting with his bosses on Monday. The Veteran reported nightmares most nights but that he was feeling pretty good. In an October 2011 treatment record, regarding his PTSD, the Veteran reported he was feeling pretty good. He had nightmares most nights and still had stress at work. A November 2011 treatment record noted that the Veteran’s mood appeared euthymic with full affect. He appeared to be oriented with intact judgement. The Veteran reported difficulty with concentration and some improvement with focus. A January 2012 treatment record noted that the Veteran still experienced anxiety from time to time. In a February 2012 statement, the Veteran reported suffering from insomnia, anxiety, panic attacks, memory issues, and difficulty with concentration. He noted he was moody, irritable, and short-tempered. He stuttered when he was stressed. A February 2012 treatment record indicated that the Veteran was vomiting in the morning, which was notes as possibly related to his anxiety. In a February 2012 statement, the Veteran’s wife, Mrs. G. K., described symptoms of the Veteran’s PTSD. She noted that the Veteran experienced nightmares that caused him to talk, yell, and sweat in his sleep. He would sometimes kick in his sleep, causing her to sleep in a separate room. Mrs. G. K. noted that the Veteran’s anxiety made it difficult for him to lay in bed. He was unable to be in small spaces with her and loud noises made him jumpy. Mrs. G. K. reported that the Veteran was “ultra-protective” of her, fearing for her safety. Since a fire in the home during his deployment, the Veteran displayed obsessive behavior, making sure all the lights were off, plugs were unplugged, dials on the stove were turned off, and doors were locked. He purchased an alarm system for the house. Mrs. G. K. noted that she was still trying to adjust to the Veteran’s anxiety, panic attacks, compulsive behavior, and mood swings since his return from service. In a February 2012 statement, Mr. M. B., a colleague, noted that the Veteran was often worried and stressed at work. He would become anxious and not be able to focus if his wife did not arrive at work on time. Mr. M. B. described their work environment as a confined space that was very loud, which he believed aggravated the Veteran’s nerves, causing him to mentally and physically shut down. Mr. M. B. noted that the Veteran had social anxiety issues and did not allow himself to become close to people. He did not get along with other colleagues because of their actions and was not able to trust them. In April 2012, the Veteran reported experiencing stress at home due to his wife’s medical issues and stress at work because of his supervisor. An October 2012 treatment record noted that the Veteran appeared well and in no distress. Memory was intact, as was judgement and insight. The Veteran’s speech, mood, and affect were normal. An October 2012 treatment record noted that the Veteran was well-appearing and in no distress. His memory, judgement, and insight were intact. He had normal speech, mood, and affect. In a December 2012 VA examination, a VA examiner diagnosed the Veteran with PTSD and noted related symptoms of anxiety, panic attacks that occurred weekly or less often, chronic sleep impairment, mild memory loss, and occasional stuttering. The examiner determined that the Veteran experienced occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily with normal routine behavior, self-care, and conversation. A July 2013 treatment record noted that although the Veteran was seeing an outside provider for antidepressants, he was struggling with PTSD symptoms and really needed counseling. The clinician noted he disagreed with the Veteran’s mild diagnosis of PTSD; however, a rationale for this opinion was not included. In November 2014, the Veteran reported continued anxiety and insomnia. In February 2015, a history of complex PTSD was noted. The Veteran reported symptoms of insomnia, nocturnal hypervigilance, and feelings of anger. He noted that the stress was extreme at his workplace and that he was finding an increase in his symptoms. The Veteran reported sleep disturbances and was constantly fatigued. He flailed in his sleep and had exaggerated startle response. The clinician noted that the Veteran was nervous and anxious, with dysphoric mood and agitation. An April 2015 treatment record noted sleep disturbances and insomnia. The Veteran was nervous and anxious with dysphoric mood. His concentration was decreased. The Veteran reported triggering events throughout the day and night that elicited dissociative episodes. He was employed and worked with his bomb-snigging dog securing premises. A May 2015 treatment record noted that the Veteran’s PTSD and depression were stable. A June 2015 treatment record noted that the Veteran was currently employed as a police officer and was facing stress at work due to acting as a whistleblower. He reported harassment and retaliation and had legal issues pending. Medical issues impacted his job and his doctor had suggested that he stop working there. A March 2016 treatment record noted the Veteran was nervous and anxious. He was fully oriented with normal judgement and thought content. A May 2016 treatment record noted the Veteran was medically retired and was preparing for a career in the cybersecurity field. He reported low mood and was experiencing marital stresses. The Veteran was fully oriented with dysphoric mood and normal affect. He experienced sleep disturbances and fatigue. In September 2016, the Veteran reported lack of focus, distraction, and an inability to stay on track. He was in school now and was unable to stay focused or address his assignments properly. The Veteran was fully oriented with normal mood and affect. A December 2016 treatment record indicated that the Veteran reported flashbacks and nightmares related to his experiences in service. He denied paranoia but felt uncomfortable in crowds and hypervigilant in restaurants. He denied any mania or audio or visual hallucinations. The Veteran reported decreased sleep, appetite, self-esteem, motivation, and energy. He noted that his anxiety was more social anxiety than generalized. The Veteran indicated he was not currently working but was in school for cybersecurity. The Veteran presented with normal appearance and was pleasant and polite with a cooperative attitude. His mood was fluent and coherent, and his affect was euthymic, appropriate, and congruent. The Veteran’s thought flow was spontaneous, linear, logical, and goal directed. He was alert and fully oriented with fair attention. The Veteran denied delusions, hallucinations, and suicidal or homicidal ideation. A March 2017 treatment record indicated that the Veteran’s appearance and attitude were good. He was alert and fully oriented with normal speech. His mood was euthymic and congruent with mood. Thought processes were logical and goal directed. Insight and judgement were fair. Delusions were not evident, and the Veteran denied hallucinations, and suicidal and homicidal ideation. An April 2017 treatment record noted the Veteran was alert with dysphoric mood. He was fully oriented. The Veteran’s mood was low due to the recent death of his two brothers. An October 2017 treatment record noted that the Veteran reported anxiety. He had a busy week with school and yardwork but had a good time at a World of Warcraft event at the sportsplex. In November 2017, the Veteran reported he was fine and had enjoyed Thanksgiving dinner with his wife. He noted his medications continued to work fine. The Veteran presented with good appearance and good attitude. He was alert and fully oriented. His speech was normal, and his mood was euthymic and congruent with mood. Thought processes were logical and goal directed and no delusions were evident. The Veteran denied hallucinations and suicidal and homicidal ideations. In January 2018, the Veteran reported good holiday time with the family. His appearance and attitude were good. The Veteran was noted as alert and fully oriented with normal speech. His mood was euthymic with congruent mood. Thought processes were logical and goal directed and there was no evidence of delusions or hallucinations. Suicidal and homicidal ideation was denied. In March 2018, the Veteran reported fatigue, low mood, and insomnia for several months. In May 2018, the Veteran reported that his current medication doses and regimen were working fine but he still had some issues with school and his marriage that were making him intermittently depressed. In September 2018, the Veteran reported he had his anxiety under control. A December 2018 treatment record noted that the Veteran continued to struggle with sleep, depression, and anxiety. He reported anhedonia, lack of motivation, psychomotor retardation and fatigue, and issues with concentration. The Veteran noted he had thoughts of suicide three weeks ago without plan or intent to act. He denied suicidal thoughts today. The Veteran reported continued flashbacks and nightmares a few times a week. He avoided places, startled easy, and felt a sense of hyperarousal daily. The Veteran noted a great sense of tension and would release it by destroying things in his house or punch holes in the wall. He would stop short of harming anyone. The Veteran reported seeing images of a man he saw die in the military, a figure in clothing with a blurred face, or his wife; the images only lasted seconds and did not speak to him. He sometimes thought he heard background noise or someone calling his name. The hallucinations were not happening regularly and were not causing great distress. The clinician noted that the Veteran reported some audio and visual hallucinations that sounded consistent with PTSD and/or sleep deprivation. There was no paranoia or evidence of a thought disorder. The Veteran reported he was medically retired from the police force as a canine handler when he could no longer handle the necessary equipment after his hip replacement did not fuse correctly. He was currently in school working on obtaining a degree in cybersecurity. A subsequent December 2018 treatment record noted that the Veteran was feeling better, but his nightmares had worsened. He still had anhedonia and irritability. The Veteran reported some fleeting thoughts of suicide with no intent or plant. He continued to hear things at night, seemingly related to his hypervigilance. The Veteran was noted as future oriented and lacked current thoughts of suicide. A January 2019 correspondence indicated that the Veteran had recently completed a two-year degree program and was ready to begin his four-year degree program. In January 2019, the Veteran reported he was still depressed and anxious with ongoing irritability. He continued to have trouble sleeping and nightmares. He noted he yelled in his sleep a lot and sweated. The Veteran denied thoughts of suicide but felt his mood was still in a very tenuous place. He still experienced irritability but had stopped punching the wall. The Veteran described episodes of intense irritable mood and increased energy accompanied by an inability to sleep. A March 2019 treatment record noted the Veteran was depressed and irritable. He felt overwhelmed and felt like he needed to escape. The Veteran would pace around the house when irritable and punch an inflatable punching bag. He was sleeping better and without nightmares. The Veteran noted that he was working on his degree for cybersecurity and his grades had recently gone down from 98 to 93. Depression, irritability, insomnia, flashbacks, and anxiety were noted. An April 2019 treatment record noted that the Veteran’s mood was more level but still a little flat. The Veteran noted he was sleeping more but it was still intermittent. He denied irritability and nightmares. The Veteran reported his mood felt more “level,” and he was not depressed, agitated, or hypomanic, although he felt flat. He noted he kept busy in the house, exercised in the mornings and then took care of housework during the day while his wife was at work. The Veteran reported stress in his marriage. He noted that they did not go out with his military friends or work friends because of his wife’s headaches, and he believed his wife felt left out when he was with his friends. In May 2019, the Veteran reported ongoing anxiety and dysthymic mood. He noted he still had anger but felt more in control. The Veteran’s mood remained flat and he was not excited about much. He noted he was without nightmares but still was not sleeping well. A June 2019 treatment record noted the Veteran’s mood as usually dysthymic with some anxiety and some episodes of anger and irritability that did not seem warranted to the situation. The Veteran noted he was without nightmares, but still struggled with lack of emotion, not having fun with much, low energy, and depressed mood. In a July 2019 treatment record, the Veteran was noted to be depressed and anxious. He had trouble focusing in the day to get things done and then stayed up late at night to do them. Marital conflicts added to his depression, anxiety, and insomnia. Mental status examinations from September 2018 to July 2019 reflect that the Veteran was found to be appropriately dressed, with adequate hygiene. He was cooperative with normal and coherent speech. The Veteran’s mood was anxious, depressed, or level overall with some anxiety and grief and his affect was congruent with mood, stable, and in full range. His thought processes were linear, logical, and goal directed, and he was future oriented. The Veteran denied audio and visual hallucinations and was noted as alert and fully oriented. No overt deficiencies in attention, memory, or concentration were noted. The Veteran’s judgement and insight were intact. He denied suicidal and homicidal ideation. In weighing the evidence, the Board finds that prior to October 11, 2019, the symptomatology associated with the Veteran’s PTSD more closely approximated occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks which is consistent with a 30 percent disability rating. In this regard, the evidence of record reflects that the Veteran’s disability during this period on appeal was predominately manifested by symptoms such as depression, anxiety, insomnia and nightmares, hypervigilance, exaggerated startle response, occasional panic attacks, and decreased concentration and focus. Prior to October 11, 2019, the Veteran did not exhibit flattened affect; circumstantial, circumlocutory, or stereotyped speech; impaired abstract thinking; or impaired judgement. In fact, the evidence of record indicates that the Veteran consistently displayed normal speech with linear, logical, and goal-directed thought processes. His judgement was consistently intact. He was noted as fully oriented and often with affect in full range and congruent to mood. While the Veteran was noted to suffer from panic attacks, the February 2012 VA examination indicated they occurred weekly or less. Evidence does not reflect that the Veteran suffered from panic attacks more than once a week. Additionally, although the Veteran complained of memory loss intermittently, he was consistently found to have intact memory and at worst, the December 2012 VA examination noted mild memory loss. Treatment records do not show that the Veteran had difficulty in understanding complex commands or experienced disturbances in mood or motivation. To the contrary, academic transcripts show that the Veteran made it onto the Dean’s List multiple times and was able to complete his two-year degree in cybersecurity with a 3.25 GPA. He exercised and did yardwork and housework. The Veteran was preparing to enter a program for a four-year degree. Finally, although the February 2012 statement from Mr. M. B. indicated that the Veteran did not let himself get close to people and did not get along with his colleagues, the record reflects that the Veteran had formed a positive relationship with Mr. M. B. and did have military friends and colleagues as noted in the April 2019 treatment record. The Board acknowledges that the record also reflects obsessional rituals, suicidal ideation, impaired impulse control, and audio and visual hallucinations. However, the Board does not find that these impairments were of a sufficient severity, frequency, and duration to merit an increased disability rating. Mrs. G. K. noted in her February 2012 statement that the Veteran displayed obsessive behavior, making sure all the lights were off, plugs were unplugged, dials on the stove were turned off, doors were locked, and purchasing an alarm system for the house. However, there is no indication that these obsessional rituals interfered with routine activities. The Veteran consistently denied audio and visual hallucinations except in December 2018, when he noted seeing figures and hearing things. His clinician noted that the hallucinations were not happening regularly and were not causing great distress. A December 2018 treatment record noted that the Veteran was destroying things in the house and punching the wall to release his tension. He stopped short of harming anyone else. By January 2019, a month later, the Veteran had stopped punching the wall and redirected his energy to a punching bag. Finally, in December 2018, the Veteran reported he had experienced fleeting thoughts of suicide with no plan or action in the last three weeks. He denied suicidal ideation on examination and continued to deny suicidal ideation during subsequent treatment. The Board finds that each of these symptoms did not cause occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgement, thinking, or mood, or even occupational and social impairment with reduced reliability and productivity. In sum, as detailed above, the Board finds that the Veteran’s service-connected PTSD is best reflected by the criteria for a 30 percent disability rating under Diagnostic Code 9411 for the period prior to October 11, 2019. Accordingly, the Veteran’s claim for an initial disability rating in excess of 30 percent prior to October 11, 2019 is denied. 2. Entitlement to a disability rating in excess of 10 percent for degenerative disc disease of the lumbar spine, to include on an extraschedular basis is denied. 3. Entitlement to a separate 10 percent disability rating for right lower extremity radiculopathy, secondary to service-connected degenerative disc disease of the lumbar spine, from May 28, 2011 is granted. The Veteran is seeking a disability rating in excess of 10 percent for his degenerative disc disease of the lumbar spine. He contends his lumbar spine disability is more severe than reflected by his assigned disability rating. The Veteran’s degenerative disc disease of the lumbar spine is rated under Diagnostic Code 5242, which pertains to degenerative arthritis of the spine. Disabilities of the spine are rated under the General Rating Formula for Diseases or Injuries of the Spine (General Formula) for Diagnostic Codes 5235 to 5243, unless 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based (IVDS) on Incapacitating Episodes (IVDS Rating Formula); whichever method results in the higher evaluation when all disabilities are combined will be used. As relevant in this case, under the General Formula, 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 rating is warranted for unfavorable ankylosis of the entire 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. Ankylosis is defined as “immobility and consolidation of a joint due to disease, injury, or surgical procedure.” Dorland’s Illustrated Medical Dictionary, 94 (32nd ed. 2012). Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Id. at Note 5. Under the IVDS Rating Formula, a 10 percent disability rating is assigned when IVDS causes incapacitating episodes having a total duration of at least one week but less than two weeks during a 12-month period on appeal. A 20 percent disability rating is assigned when IVDS causes incapacitating episodes having a total duration of at least two weeks but less than four weeks during a 12-month period on appeal. A 40 percent disability rating is assigned when IVDS causes incapacitating episodes having a total duration of at least four weeks but less than six weeks during a 12-month period on appeal. A 60 percent disability rating is assigned when IVDS causes incapacitating episodes having a total duration of at least six weeks during a 12-month period on appeal. 38 C.F.R. § 4.71a, Diagnostic Code 5243. An incapacitating episode is a period of acute signs and symptoms due to IVDS that requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, Diagnostic Code 5243, Note 1. Based on a review of the record, the Board finds that the evidence does not support a disability rating in excess of 10 percent for the Veteran’s service-connected degenerative disc disease of the lumbar spine. The Veteran was afforded a VA examination for the thoracolumbar spine in January 2013. The Veteran reported that he continued to have low back pain after service that was sharp, stabbing, and burning. He would experience numbness in the low back after standing too long. The Veteran was treated by a chiropractor and saw other doctors for pain management. He reported he was a police officer canine handler and had gotten special permission to wear suspenders to alleviate some of the weight off his hips and back while having to wear a 20 to 30-pound duty belt and a 70-pound active duty gear bag. The Veteran noted that he experienced flare-ups of the thoracolumbar spine which would affect his driving as he could not sit for more than 30 minutes. He had to lift his leg into the car. The Veteran further noted his back affected his sex life, and he could not mow the lawn, exercise, lift, or stand to do the dishes. On examination, range of motion testing revealed forward flexion to 90 degrees or greater with objective evidence of pain beginning at 90 degrees or greater; extension to 30 degrees or greater with objective evidence of painful motion beginning at 30 degrees or greater; right lateral flexion to 30 degrees or greater with objective evidence of painful motion beginning at 30 degrees or greater; left lateral flexion to 30 degrees or greater with objective evidence of painful motion beginning at 30 degrees or greater; right lateral rotation to 30 degrees or greater with objective evidence of painful motion beginning at 30 degrees or greater; and left lateral rotation to 30 degrees or greater with objective evidence of painful motion beginning at 30 degrees or greater. The Veteran was able to perform repetitive use testing resulting in forward flexion to 90 degrees or greater; extension to 15 degrees; right lateral flexion to 30 degrees or greater; left lateral flexion to 30 degrees or greater; right lateral rotation to 30 degrees or greater; and left lateral rotation to 25 degrees. The examiner indicated that the Veteran had additional limitation in range of motion and functional loss/impairment of the thoracolumbar spine following repetitive use testing. Functional loss/impairment included less movement than normal, weakened movement, pain on movement, and interference with sitting, standing, and/or weightbearing. The Veteran had tenderness on palpation over the lower lumbar spine. He had guarding and/or muscle spasms that did not result in abnormal gait or spinal contour. Muscle strength testing was normal except for active movement against some resistance of the bilateral great toes. No muscle atrophy was noted. Deep tendon reflexes were normal at the bilateral knees and hypoactive at the bilateral ankles. Sensory examination was normal but for decreased sensation in the left thigh/knee, bilateral lower leg/ankle, and bilateral foot/toes. Straight leg testing was negative bilaterally. The examiner indicated that the Veteran had radicular pain and/or signs and symptoms due to radiculopathy, to include moderate intermittent pain in the left lower extremity, moderate numbness in the left lower extremity, and mild numbness in the right lower extremity. The examiner noted radiculopathy affected the sciatic nerve on the left side. No other neurologic abnormalities or findings related to the thoracolumbar spine were noted. The examiner indicated that the Veteran had IVDS of the spine without any incapacitating episodes over the past 12 months. The Veteran did not use assistive devices to ambulate. The examiner indicated that the Veteran’s thoracolumbar spine disability impacted his ability to work, noting that the Veteran reported he could not sit or stand for long periods and had to change positions after 30 minutes. The Veteran was afforded a VA examination for the thoracolumbar spine in October 2019. The Veteran reported a worsening of his low back pain since his last VA examination. He noted low back pain with intermittent numbness and pain radiating to the left lower extremity. The Veteran’s back pain was worse with prolonged sitting and weightbearing activities. He took Aleve and Skelaxin as needed. The Veteran reported that his back would get stiff if he was on his feet too long and it would become difficult to move and would affect his walking. The VA examiner confirmed a diagnosis of degenerative disc disease of the lumbar spine. On examination, range of motion testing revealed forward flexion to 65 degrees, extension to 20 degrees, right lateral flexion to 25 degrees, left lateral flexion to 20 degrees, right lateral rotation to 25 degrees, and left lateral rotation to 25 degrees. Range of motion and pain noted on examination did not contribute to functional loss. There was no evidence of pain with weightbearing or non-weightbearing. Passive range of motion of the spine was not performed as it was not feasible to perform the test in a safe and reasonable manner. Objective evidence of localized moderate tenderness on palpation was noted. The Veteran was able to perform repetitive use testing with no additional loss of function or range of motion. Pain, weakness, fatigability or incoordination did not significantly limit functional ability with repeated use over a period of time. The examiner noted that using his medical knowledge and expertise, and following physical examination of the Veteran, his reported history and subjective complaints, and review of the record, there was no basis of offer additional losses of function or motion after repeated use over a period of time. The Veteran denied flare-us of the thoracolumbar spine. The Veteran did not have guarding or muscle spasm of the thoracolumbar spine. Additional factors contributing to disability included disturbance of locomotion, interference with sitting, and interference with standing, all resulting in increased low back pain and left lower extremity pain. Muscle strength testing was normal, and no muscle atrophy was noted. Reflex examination reflected normal deep tendon reflexes and sensory examination was normal, except for decreased sensation of the left lower left/ankle and left foot/toes. Radiculopathy was noted in the left lower extremity. No ankylosis was indicated. The examiner noted that the Veteran did not have IVDS of the thoracolumbar spine. The Veteran used a cane regularly to ambulate. The examiner indicated that the Veteran’s thoracolumbar spine disability impacted his ability to work, noting that the Veteran reported losing up to one week of work in the last 12 months. The Veteran’s thoracolumbar spine disability affected his bending, lifting, wearing a duty belt, wearing Kevlar explosive protective gear, prolonged sitting, and weightbearing activities. The Board finds that a disability rating in excess of 10 percent for the Veteran’s degenerative disc disease of the lumbar spine is not warranted, as there is no evidence demonstrating that the Veteran suffers from forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees, combined range of motion of the thoracolumbar spine not greater than 120 degrees, or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. Specifically, the January 2013 VA examination noted forward flexion of the thoracolumbar spine to 90 degrees or greater and with evidence of pain at 90 degrees or greater. Forward flexion of the thoracolumbar spine remained at 90 degrees or greater following repetitive use testing. Similarly, the October 2019 VA examination reflected forward flexion of the thoracolumbar spine to 65 degrees with no loss of range of motion or functional loss following repetitive use testing. The Board has considered whether the Veteran is entitled to a higher rating for his degenerative disc disease of the lumbar spine based on the IVDS Rating Formula. While the January 2013 VA examination endorsed IVDS of the spine, the examiner indicated there were no incapacitating episodes over the past 12 months. The October 2019 VA examination indicated that the Veteran did not have IVDS of the spine. Further, the record provides no evidence of incapacitating episodes requiring bed rest prescribed by a physician due to the Veteran’s lumbar spine condition. As such, a disability rating under the IVDS Rating Formula would not result in the assignment of a higher disability rating. The Board has also considered whether a higher disability rating is warranted on the basis of functional loss due to pain or due to weakness, fatigability, incoordination, or pain on movement of a joint under 38 C.F.R. §§ 4.40 and 4.45. On the January 2013 VA examination, pain was noted on forward flexion at 90 degrees or greater and the Veteran was able to perform repetitive use testing resulting in flexion to 90 degrees or greater. While the examiner noted additional limitation in range of motion and functional loss/impairment of the thoracolumbar spine following repetitive use testing, specifically extension to 15 degrees and left lateral rotation to 25 degrees, the combined range of motion of the thoracolumbar spine was still greater than 120 degrees. Similarly, on the October 2019 VA examination, the VA examiner noted that pain on examination did not contribute to functional loss. The Veteran was able to perform repetitive use testing with no additional loss of function or range of motion and pain, weakness, fatigability, or incoordination did not significantly limit functional ability with repeated use over a period of time. Exhibiting forward flexion of the thoracolumbar spine 60 degrees or less or a combined range of motion of the thoracolumbar spine not greater than 120 degrees is required for a higher rating under the general rating formula for spine disabilities evaluated under Diagnostic Codes 5235 to 5243. The Board further notes that the Veteran’s treatment records for the period on appeal do not demonstrate forward flexion of the Veteran’s thoracolumbar spine 60 degrees or less, or a 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. The Board acknowledges October 2014 and May 2017 assertions from the Veteran’s attorney that he is entitled to a higher disability rating due to evidence of abnormal kyphosis, as noted on an August 2011 treatment record. The Board disagrees. While the August 2011 treatment record notes “T5-9 SRRL with flattened kyphosis,” there is no indication that the flattened kyphosis was attributed to severe muscle spasms or guarding. In fact, with the exception of the August 2011 treatment record, there is no other indication in the record that the Veteran has abnormal kyphosis. Further, the evidence of record does not reflect that the Veteran experiences muscle spasm or guarding severe enough to result in abnormal kyphosis, as is required for a higher rating. To the contrary, the January 2013 VA examination specifically indicated that guarding and/or muscle spasms did not result in abnormal gait or spinal contour and the October 2019 examination reflected no guarding or muscle spasm of the thoracolumbar spine. The Board also acknowledges October 2014 and May 2017 assertions from the Veteran’s attorney that the Veteran is entitled to a separate disability rating for radiculopathy of the right lower extremity as reflected by the January 2013 VA examination. While the January 2013 VA examiner indicated that only the Veteran’s left side was affected by radiculopathy of the sciatic nerve, the examiner also indicated earlier in the examination that the Veteran experienced radicular pain or signs and symptoms due to radiculopathy such as mild numbness in the right lower extremity. Further, reflex examination noted hypoactive reflexes in the right ankle and sensory examination revealed decreased sensation in the right lower leg/ankle and right foot/toes. Therefore, the Board resolves reasonable doubt in favor of the Veteran and finds that a separate 10 percent disability rating for radiculopathy of the right lower extremity, manifesting in mild incomplete paralysis of the sciatic nerve (discussed further below), is warranted. Finally, the Board had also considered whether an extraschedular rating is warranted for the Veteran’s service-connected degenerative disc disease of the lumbar spine, as advanced by the Veteran’s attorney. Specifically, the Veteran’s attorney asserted that referral for extraschedular consideration is warranted to address the marked interference with employment and additional functional limitations as a result of the Veteran’s back pain. The Board finds the first element of Thun has not been met, as the Veteran’s lumbar spine disability is specifically contemplated by the schedular rating criteria, and no referral for extraschedular consideration is required. The Veteran’s degenerative disc disease of the lumbar spine has manifested in painful movement, pain with prolonged sitting or standing, muscle spasms or guarding; limitation of motion due to pain, and functional limitations. The schedular criteria for rating the lumbar spine disability specifically provide for ratings based on the presence of painful motion, as noted above, whether or not such pain radiates; limitations of motion of the spine including due to pain and other orthopedic factors that result in functional impairment (38 C.F.R. §§ 4.40, 4.45, 4.59, DeLuca, Mitchell); and other clinical findings such as muscle spasm, guarding, abnormal gait, and abnormal spinal contours; and on the basis of incapacitating episodes. See Schafrath v. Derwinski, 1 Vet. App. 589, 592 (1991) (read together with schedular rating criteria, 38 C.F.R. §§ 4.40 and 4.45 recognize functional loss due to pain); Deluca v. Brown, 8 Vet. App. 202, 206-07 (1995) (functional limitations are applied to the schedular rating criteria to ascertain whether a higher schedular rating can be assigned based on limitation of motion due to pain and during flare-ups, and should be expressed in schedular rating terms of degree of range-of-motion loss); Burton v. Shinseki, 25 Vet. App. 1, 4 (2011) (the majority of 38 C.F.R. § 4.59, which is a schedular consideration rather than an extraschedular consideration, provides guidance for noting, evaluating, and rating joint pain); Sowers v. McDonald, 27 Vet. App. 472 (2016) (38 C.F.R. § 4.59 is limited by the diagnostic code applicable to the claimant’s disability, and is read in conjunction with, and subject to, the relevant diagnostic code); Mitchell v. Shinseki, 25 Vet. App. 32, 33-36 (2011) (pain alone does not constitute functional impairment under VA regulations, and the rating schedule contains several provisions, such as 38 C.F.R. §§ 4.40, 4.45, 4.59, that address functional loss in the musculoskeletal system as a result of pain and other orthopedic factors when applied to schedular rating criteria). All the symptomatology and functional impairment described above result from the limitation of motion of the lumbar spine, to include as due to pain, stiffness, muscle spasm, and all the symptoms described by the Veteran are contemplated in the schedular rating assigned under the General Rating Formula either directly as limitation of motion or muscle spasm, or indirectly as orthopedic factors that limit motion and function. See 38 C.F.R. §§ 4.40, 4.45, 4.59 4.71a; DeLuca, 8 Vet. App. at 206-07. Therefore, the Board finds that the record does not reflect that the Veteran’s service-connected degenerative disc disease of the lumbar spine is so exceptional or unusual as to warrant referral for consideration of the assignment of a higher disability rating on an extraschedular basis. Accordingly, the Veteran’s claim for a disability rating in excess of 10 percent for his degenerative disc disease of the lumbar spine, to include on an extraschedular basis, must be denied. A separate 10 percent disability rating for radiculopathy of the right lower extremity, effective May 28, 2011 is warranted. 4. Entitlement to an initial disability rating in excess of 10 percent for radiculopathy of the left lower extremity prior to October 9, 2019 is granted. 5. Entitlement to a disability in excess of 20 percent for radiculopathy of the left lower extremity from October 9, 2019 is denied. The Veteran is seeking a disability rating in excess of 10 percent for radiculopathy of the left lower extremity prior to October 9, 2019 and in excess of 20 percent thereafter. He contends his radiculopathy is more severe than reflected by his assigned disability ratings. The Veteran’s radiculopathy of the left lower extremity is evaluated under Diagnostic Code 8520. Diagnostic Code 8520 provides the rating criteria for paralysis of the sciatic nerve, and therefore, neuritis and neuralgia of that nerve. 38 U.S.C. § 4.124a, Diagnostic Code 8520. Disability ratings of 10 percent, 20 percent and 40 percent are assignable for incomplete paralysis which is mild, moderate, or moderately severe in degree, respectively. A 60 percent rating is warranted for severe incomplete paralysis with marked muscular atrophy. Complete paralysis of the sciatic nerve, which is rated as 80 percent disabling, contemplates foot dangling and dropping, no active movement possible of muscles below the knee, and flexion of the knee weakened or (very rarely) lost. Words such as “mild,” “moderate,” and “severe” are not defined in the Rating Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decisions are “equitable and just.” 38 C.F.R. § 4.6. Additionally, the term “incomplete paralysis,” with this and other peripheral nerve injuries, indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. 38 C.F.R. § 4.124a, Note at Diseases of the Peripheral Nerves. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. Id. The ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. Id. In a January 2013 VA examination for the thoracolumbar spine, deep tendon reflexes were normal at the bilateral knees and hypoactive at the bilateral ankles. Muscle strength testing was normal except for the Veteran’s great toes which exhibited active movement against some resistance. No atrophy was noted. Sensory examination revealed normal sensation at the bilateral upper anterior thigh, normal sensation at the right thigh/knee and decreased sensation at the left thigh/knee, decreased sensation at the bilateral lower leg/ankle, and decreased sensation at the bilateral foot/toes. Straight leg test was negative bilaterally. The examiner indicated the Veteran experienced symptoms of radiculopathy, noting the absence of constant pain and paresthesias and/or dysesthesias of the bilateral lower extremities, no intermittent pain of the right lower extremity and moderate intermittent pain of the left lower extremity, and mild numbness of the right lower extremity and moderate numbness of the left lower extremity. The examiner determined that the Veteran suffered from mild radiculopathy of the sciatic nerve affecting the left side. The examiner indicated the Veteran’s right side was not affected. The Veteran was afforded a VA examination for peripheral nerves conditions in October 2019. The VA examiner indicated the Veteran had symptoms attributable to a peripheral nerve condition, noting the absence of constant pain and paresthesias and/or dysesthesias of the bilateral lower extremities, no intermittent pain of the right lower extremity and moderate pain of the left lower extremity, and no numbness of the right lower extremity and moderate numbness of the left lower extremity. Muscle strength testing was normal at the knees and ankles. No muscle atrophy was noted. Reflex examination was normal bilaterally. Sensory examination revealed normal sensation at the bilateral thigh/knee, normal sensation at the right lower leg/ankle and decreased sensation at the left lower leg/ankle, and normal sensation at the right foot/toes and decreased sensation at the left foot/toes. No trophic changes were noted. The examiner indicated that the Veteran suffered from moderate incomplete paralysis of the sciatic nerve on the left. The right was noted as normal. Reviewing the evidence in the most favorable light, the Board finds that the Veteran’s radiculopathy of the left lower extremity is best characterized as moderate incomplete paralysis for the entire period on appeal. The January 2013 VA examination indicated that the Veteran suffered from a moderate level of intermittent pain and numbness of the left lower extremity, hypoactive deep tendon reflexes at the bilateral ankles, reduced strength at the Veteran’s toes, and decreased sensation at the left thigh/knee, bilateral lower leg/ankle, and bilateral foot/toes. Therefore, an initial 20 percent disability rating for radiculopathy of the left lower extremity prior to October 9, 2019 is granted. 38 C.F.R. § 4.7. However, a 40 percent disability rating is not warranted for the entire period on appeal, as the Veteran’s radiculopathy of the left lower extremity is not more accurately described by moderately severe incomplete paralysis. As discussed, the January 2013 VA examination noted a moderate level of intermittent pain and numbness of the left lower extremity, hypoactive deep tendon reflexes at the bilateral ankles, reduced strength at the Veteran’s toes, and decreased sensation at the left thigh/knee, bilateral lower leg/ankle, and bilateral foot/toes. Further, the October 2019 VA examination reflected no increase in the Veteran’s subjective symptoms, specifically moderate intermittent pain and numbness of the left lower extremity, normal muscle strength bilaterally with no muscle atrophy, normal deep tendon reflexes bilaterally, and decreased sensation at the left foot/toes. Neither medical or lay evidence during the period on appeal reflects that the Veteran’s left lower extremity radiculopathy affected his strength, reflexes, motor function, or sensation in such a way as to warrant an evaluation for moderately severe radiculopathy. The Board finds that the overall disability picture for radiculopathy of the left lower extremity does not more closely approximate a 40 percent rating under Diagnostic Code 8520. 38 C.F.R. §§ 4.7, 4.124a. With regard to the Veteran’s radiculopathy of the right lower extremity herein granted service connection, the Board finds that the evidence does not demonstrate any more than mild incomplete paralysis warranting a disability rating in excess of 10 percent. While the January 2013 VA examination noted only mild numbness in the right lower extremity, slightly reduced strength in the great right toe, hypoactive deep tendon reflexes in the right ankle, and decreased sensation in the right lower leg/ankle and foot/toes, the October 2019 VA examination reflected the absence of a sciatic nerve issue of the right lower extremity. The Veteran did not endorse constant pain, intermittent pain, paresthesias and/or dysesthesias, or numbness of the right lower extremity. Muscle strength was normal, as was reflex examination and sensory examination for the right lower extremity. As such, the Board finds that the severity of the Veteran’s radiculopathy of the right lower extremity is best reflected by a 10 percent disability rating. In sum, the Board finds that the evidence supports a 20 percent disability rating, but no higher, for the Veteran’s service-connected radiculopathy of the left lower extremity for the entire appeal period, and a 10 percent disability rating for the Veteran’s radiculopathy of the right lower extremity for the entire appeal period. REASONS FOR REMAND 1. Entitlement to a disability rating in excess of 10 percent for degenerative joint disease of the left ankle, to include on an extraschedular basis is remanded. In October 2014 and May 2017 statements, the Veteran’s attorney asserted that the Veteran was entitled to additional compensation under other applicable diagnostic codes related to his left ankle disability. Although the Veteran is currently evaluated under Diagnostic Code 5010 for degenerative joint disease of the left ankle, the Veteran’s attorney contends that diagnostic codes pertaining to Muscle Group IX and the tibia and fibula should be considered. Treatment records reflect a diagnosis of nontraumatic tear of the tibialis posterior tendon and a floating exostosis of the distal tibia. It is unclear from treatment records and the VA examinations of record whether the Veteran has additional ankle conditions related to his service-connected degenerative joint disease of the left ankle that would warrant evaluation under other diagnostic codes. As such, the Board finds that remand for an addendum opinion is necessary to determine whether the Veteran has additional findings or disability related to his service-connected degenerative joint disease of the left ankle. 2. Entitlement to TDIU is remanded. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the Court held that a claim for a TDIU is part of an increased or initial rating claim when such claim is expressly raised by the veteran or reasonably raised by the record. Here, the reflects that the Veteran was employed as a police officer canine handler. A June 2015 treatment record noted that the Veteran suffered from medical issues that impacted his job and it was suggested by his physician that he stop working there. In an April 2016 treatment record, the Veteran reported he was being medically retired due to hip replacement surgery that did not fuse correctly. The Board notes that following his retirement, the Veteran enrolled in school through the VA’s vocational rehabilitation and employment (VRE); however, enrollment alone does not reflect employability. Entitlement to TDIU benefits and participation in a VRE program are not necessarily mutually exclusive. See 38 C.F.R. §§ 3.341(c), 3.343(c). While the Veteran and his attorney did not raise entitlement to TDIU, the Board finds that it had been reasonably raised by the record. On remand, the Veteran should be forwarded the formal claim for TDIU, which he can return if he chooses. If the Veteran does not wish to pursue a claim for TDIU, then he should provide a statement as such. Finally, the Board finds that the issue of TDIU is inextricably intertwined with the Veteran’s left ankle disability remanded above. See Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Provide the Veteran with VA Form 21-8940 and request he provide details regarding his employment and educational history. The Veteran should be informed that if he does not wish to pursue a claim for TDIU, he should provide VA with a statement that he is not seeking TDIU. 2. Obtain an addendum opinion from an appropriate clinician regarding the Veteran’s degenerative joint disease of the left ankle. The claims file and a copy of this remand must be made available to the examiner. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. The examiner should respond to the following: Does the Veteran suffer from additional ankle disabilities or conditions that are related to his service-connected degenerative joint disease of the left ankle? Diagnoses of nontraumatic tear of the tibialis posterior tendon and a floating exostosis of the distal tibia should be addressed. The examination report must include a complete rationale for all opinions expressed. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge (Continued on the next page)   3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran’s claims should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, furnish the Veteran and his attorney a supplemental statement of the case (SSOC) and return the case to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Silverblatt, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.