Citation Nr: 21005920 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 13-24 495 DATE: February 2, 2021 ORDER Entitlement to an increased rating for a chronic left shoulder strain, rated as 10 percent rating prior to November 7, 2019 and 20 percent thereafter, is denied. Entitlement to a rating in excess of 10 percent for a stress fracture left symphysis is denied. Entitlement to a separate 10 percent rating for right obturator nerve neuropathy is granted. FINDINGS OF FACT 1. For the appeal period prior to November 7, 2019, the Veteran’s chronic left shoulder strain manifested as forward flexion and abduction to 180 degrees, at worst, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups without limitation of motion at shoulder level, ankylosis of scapulohumeral articulation, impairment of the humerus, or impairment of the clavicle or scapula. 2. For the appeal period beginning on November 7, 2019, the Veteran’s chronic left shoulder stain manifested as forward flexion to 150 degrees and abduction to 110 degrees at worst, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups without limitation of motion from midway between the side and shoulder level, ankylosis of scapulohumeral articulation, impairment of the humerus, or impairment of the clavicle or scapula. 3. Throughout the period on appeal, the Veteran’s stress fracture of the left symphysis manifested as painful and flexion limited to 125 degrees, at worst, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups, but without limitation of extension to 5 degrees, limitation of flexion to 45 degrees, limitation of abduction to 10 degrees, limitation of adduction precluding crossing her legs, or limitation of rotation, ankylosis, fail joint, or impairment of the femur. 4. Throughout the period on appeal, the Veteran’s right obturator nerve neuropathy manifested as severe incomplete paralysis. CONCLUSIONS OF LAW 1. The criteria for entitlement for an increased rating for a chronic left shoulder strain, rated as 10 percent rating prior to November 7, 2019 and 20 percent thereafter, not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1—4.14, 4.20, 4.40, 4.45, 4.71a, Diagnostic Codes 5201. 2. The criteria for entitlement to a rating in excess of 10 percent for stress fracture left symphysis have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1—4.14, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5252. 3. The criteria for a separate 10 percent rating for right obturator nerve neuropathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1—4.14, 4.124a, Diagnostic Code 8528. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from January 2011 to July 2011 and from October 2017 to January 2018. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a January 2012 rating decision issued by a Department of Veterans Affairs Regional Office (RO). The matter subsequently came before the Board in December 2018, whereupon the matter was remanded for additional development, to include obtaining outstanding treatment records and an updated examination that noted the Veteran’s current symptomatology and functional loss. Updated VA treatment records have been associated with the record and updated VA examinations were conducted in November 2019. The Board therefore determines that there has been substantial compliance with the previous remand. Stegall v. West, 11 Vet. App. 268 (1998). In an August 2020 rating decision, the agency of original jurisdiction (AOJ) granted a 20 percent rating for a chronic left shoulder strain, effective November 7, 2019. However, a higher rating is available for a shoulder disorder. The Veteran is presumed to seek the maximum available benefit for a disability. As such, this claim is still considered to be on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Increased Rating Disability evaluations are determined by evaluating the extent to which a veteran’s service connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Pyramiding, that is the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when evaluating a Veteran's service-connected disability. 38 C.F.R. § 4.14. However, it is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes; the critical element in permitting the assignment of several evaluations under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. See Esteban v. Brown, 6 Vet. App. 259, 261- 62 (1994). Where there is a question as to which of two evaluations (ratings) shall be applied, the higher rating 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. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 4.3, 4.7. VA should interpret reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability. 38 C.F.R. § 4.2. Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Nevertheless, where the evidence contains factual findings that show a change in the severity of symptoms during the course of the rating period on appeal, assignment of staged ratings would be permissible. Hart v. Mansfield, 21 Vet. App. 505 (2007). In order to evaluate the level of disability and any changes in condition, it is necessary to consider the complete medical history of the Veteran's condition. Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). When evaluating disabilities of the musculoskeletal system, functional loss due to pain and weakness causing additional disability beyond that reflected on range of motion measurements must be considered. See 38 C.F.R. § 4.40; DeLuca v. Brown, 8 Vet. App. 202 (1995). Consideration must also be given to weakened movement, excess fatigability, and incoordination. 38 C.F.R. § 4.45. The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, even in the absence of arthritis. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). In this regard, 38 C.F.R. § 4.59 requires that "[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint." Correia v. McDonald, 28 Vet. App. 158 (2016). Further, 38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the Diagnostic Code under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 1. Entitlement to an increased rating or a chronic left shoulder strain, rated as 10 percent disabling prior to November 7, 2019 and 20 percent thereafter, is denied. The Veteran asserts that he is entitled to an increased rating for his left shoulder condition, specifically because his symptoms are more severe than contemplated by the currently assigned ratings. Specific argument in support of this appeal has not been submitted. Diagnostic Code 5201 contemplates a 20 percent rating for limitation of motion of the arm at shoulder level. Limitation of motion of the arm from midway between the side and shoulder level for a major extremity is rated at 30 percent for a major extremity and 20 percent for a minor extremity. Limitation of motion to 25 degrees from the side is rated at 40 percent for a major extremity and 30 percent for a minor extremity. 38 C.F.R. § 4.71a. The normal range of motion of the shoulder is from 0 degrees of flexion (forward elevation) to 180 degrees of flexion, from 0 degrees of abduction to 180 degrees of abduction, from 0 degrees of external rotation to 90 degrees of external rotation, and from 0 degrees of internal rotation to 90 degrees of internal rotation. 38 C.F.R. § 4.71, Plate I. The rating criteria for evaluating disabilities of the shoulder, distinguish between the major (dominant) extremity and the minor (non-dominant) extremity. See 38 C.F.R. § 4.69. As the record establishes that the Veteran's left shoulder is dominant, the criteria for rating disabilities of the major extremity are for application. The Veteran has been afforded several VA examinations during the appeal period. The Board will summarize the results of the Veteran’s various VA examinations and other medical and lay evidence, focusing primarily on the Veteran’s limitation on range of motion as well as the pain level in his left shoulder. The Veteran was provided a VA examination for his left shoulder in November 2011. The examination, including range of motion testing, revealed pain upon movement of the left shoulder joint. Forward flexion was measured to 150 degrees, with pain beginning at 100 degrees. Abduction was to 150 degrees, with pain at 100 degrees. The Veteran was also demonstrated to be able to repetitive use testing with three repetitions. Functional loss was also noted and recorded as “shoulder pain while abducting”. The Veteran was provided another VA examination for his left shoulder in April 2015, at which the Veteran reported ongoing tension in his left shoulder with tenderness and soreness upon changes in the weather. Range of motion testing revealed normal findings of forward flexion 180 degrees, and abduction at 180 degrees, without limitation due to pain. Strength in the affected extremity was at 5 out of 5. The examiner opined that the findings revealed essentially normal orthopedic presentation of the left shoulder with no significant objective or radiographic findings to warrant further diagnosis. The examination showed slight improvement over the previous examination, however sustained improvement was not demonstrated. The Veteran’s VA examination of November 2019 documents the Veteran suffering from intermittent pain in the posterior aspect of his left shoulder and pain flareups two to three times per week, especially upon over-exertion. The examiner also conducted range of motion testing which revealed forward flexion to 160 degrees; abduction to 120 degrees; external rotation to 90 degrees; and internal rotation to 90 degrees. Objective evidence of pain upon flexion and abduction was noted. The examiner also noted evidence of localized tenderness with palpation of the posterior aspect of the left shoulder. There was no additional limitation of motion, or other additional functional limitation following repetitive use over time, and no additional limitation of motion would be expected following repetitive use over time. However, flexion is expected to be additionally limited to 150 degrees, and extension is expected to be limited to 110 degrees, during flare-ups. Based on the foregoing, the Board finds that at no point during the appeal period prior to November 7, 2019 has the Veteran's chronic left shoulder strain resulted in limitation of motion of the arm to shoulder level, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups. In this regard, even when considering DeLuca factors, the Veteran's left shoulder motion was, at its worst, manifested by forward flexion to 180 degrees and abduction to 180 degrees. Furthermore, while the Board acknowledges that the Veteran has limitation of motion of his left shoulder that increases during a flare-up and results in an inability to raise his arm overhead and over his back, and symptoms of pain, burning and tingling sensations, stiffness, and weakness, such is not shown by the medical evidence of record, or the Veteran's own statements, to result in a limitation of motion of the arm to shoulder level. 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, supra. As such, a rating in excess of 10 percent for the Veteran's chronic left shoulder strain for the appeal period prior to November 7, 2019 under Diagnostic Code 5201 is not warranted. For the appeal period beginning on November 7, 2019, the Board finds that at no point during the appeal period has the Veteran's chronic left shoulder strain resulted in limitation of motion of the arm midway between side and shoulder level, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups. The Veteran’s left shoulder motion was, at its worst, manifested by forward flexion to 150 degrees and abduction to 110 degrees at the November 2019 VA examination. The Veteran reported flare-ups of pain after overuse or lifting heavy objects with the left arm that occurred about two to three times per week and the examiner determined that the Veteran’s flexion would be limited to 150 degrees and abduction was limited to 120 degrees during such flare-ups. C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, supra. As such, a rating in excess of 20 percent for the Veteran's chronic left shoulder strain for the appeal period beginning on November 7, 2019 under Diagnostic Code 5201 is not warranted. The Board further finds that a separate or higher rating is not warranted under any other potentially applicable Diagnostic Code related to the shoulder. In this regard, the evidence, to include VA examination reports and treatment records, does not show, nor does the Veteran contend, that he has ankylosis of the scapulohumeral articulation, impairment of the humerus, or impairment of the clavicle or scapula. Consequently, separate or higher ratings are not warranted under Diagnostic Codes 5200, 5202 and 5203, respectively. The Board has considered the effects of repeated use over time and flare-ups along with the adequacy of the VA examination in light of the Court’s holdings in Correia and Sharp. See Correia v. McDonald, 28 Vet. App. 158, 168 (2016), and Sharp v. Shulkin, 29 Vet. App. 26 (2017). In this case, the VA November 2019 examiner tested the opposite joint and conducted repetitive-use testing and concluded that there was no additional limitation in range of motion. Regarding flare-ups, the Board acknowledges that the November 2019 VA examiner was not able to provide an opinion regarding additional functional impairment during flare-ups, however, the Veteran was able to describe his symptoms during a flare-up and the impact of such. The April 2015 VA examiner tested the opposite joint and conducted repetitive-use testing and concluded that there was no additional limitation in range of motion. Although the April 2015 VA examiner did not conducted range of motion testing with regards to flare-ups, the Veteran did not report flare-ups of the shoulder or arm. Therefore, the Board finds that all information required for rating purposes has been provided. See Correia v. McDonald, supra; see also Sharp v. Shulkin, supra. In assessing the severity of the Veteran’s left shoulder condition, the Board has given due consideration to the competent lay assertions regarding symptoms experienced and observed. See, e.g., Layno v. Brown, 6 Vet. App. 465, 470 (1994) and Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). However, the criteria needed to support higher ratings involve medical findings that are within the province and purview of trained medical professionals. See Jones v. Brown, 7 Vet. App. 134, 137-138 (1994). As such, the Veteran’s lay assertions are not considered more persuasive than the objective medical findings which, as indicated above, do not support assignment of any higher rating pursuant to any applicable criteria at any point pertinent to this appeal. While the Veteran is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of his bilateral plantar fasciitis according to the appropriate diagnostic codes. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); The Board has considered whether a staged rating under Hart, supra, is appropriate for the Veteran's service-connected chronic left shoulder strain; however, the Board finds that his symptomatology has been stable throughout each period on appeal. Therefore, assigning a further staged rating for such disability is not warranted. The Veteran and his representative has not raised any other issues, and no other issues have been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). The Board has considered whether an inferred claim for a total disability based upon individual unemployability has been raised pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009). Neither the Veteran nor his representative allege that he is unable to secure and maintain substantially gainful employment. Indeed, the record shows he has been employed as a kennel handler during the appeal period. The issue of a TDIU does not arise in the context of an increased rating claim when there is no allegation or evidence of unemployability. Jackson v. Shinseki, 587 F.3d 1106 (Fed. Cir. 2009) (finding that where there was no evidence indicating unemployability, and with the record suggesting the opposite, i.e. that the Veteran was employed, a TDIU claim was not raised.) As such, a Rice claim is not raised. Accordingly, the Board finds that the preponderance of the evidence is against the Veteran’s claim for increased rating for a chronic left shoulder strain for any period during the pendency of this appeal. Given that the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. 2. Entitlement to an increased rating in excess of 10 percent for thigh stress fracture is denied. The Veteran asserts that he is entitled to an increased rating for his thigh stress fracture condition, specifically because his symptoms are more severe than contemplated by the currently assigned ratings. Specific argument in support of this appeal has not been submitted. The Veteran was granted service connection for his thigh stress fracture in a January 2012 rating decision by RO. The RO assigned a 10 percent rating under Diagnostic Code 5252, effective July 15, 2011. Diagnostic Code 5252 provides for a 10 percent rating when flexion of the thigh is limited to 45 degrees. A 20 percent rating is assigned where flexion is limited to 30 degrees; a 30 percent rating is assigned where flexion is limited to 20 degrees; and a 40 percent rating is assigned where flexion is limited to 10 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5252. Diagnostic Code 5251 provides that limitation of extension of the thigh to 5 degrees warrants a 10 percent rating. 38 C.F.R. § 4.71a, Diagnostic Code 5251. Diagnostic Code 5253 provides that impairment of the thigh resulting in limitation of rotation of the affected leg such that the Veteran cannot toe-out more than 15 degrees warrants a 10 percent rating. Impairment of the thigh resulting in limitation of adduction and an inability to cross legs warrants a 10 percent rating. Impairment of the thigh resulting in limitation of abduction and motion lost beyond 10 degrees warrants a 20 percent rating. 38 C.F.R. § 4.71a, Diagnostic Code 5253. Normal range of hip motion is 125 degrees of flexion, zero degrees of extension, and 45 degrees of abduction. 38 C.F.R. § 4.71, Plate II. Diagnostic Code 8528, provide ratings for paralysis, neuritis, and neuralgia of the obturator nerve. Neuritis and neuralgia are rated as incomplete paralysis. A maximum 10 percent rating is warranted for severe incomplete paralysis or paralysis of the respective nerve. Mild or moderate impairment of the nerve warrants noncompensable rating. 38 C.F.R. § 4.124a, Diagnostic Codes 8528. Words such as "severe," "moderate," and "mild" are not defined in the Rating Schedule. Rather than applying a mechanical formula, VA must evaluate all evidence, to the end that decisions will be equitable and just. 38 C.F.R. § 4.6. Although the use of similar terminology by medical professionals should be considered, that is not dispositive of an issue. Instead, all evidence must be evaluated in arriving at a decision regarding a request for a higher rating. 38 U.S.C. § 7104; 38 C.F.R. §§ 4.2, 4.6. In rating diseases of the nerves, the term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. 38 C.F.R. § 4.124a. Neither the Rating Schedule nor the regulations provide definitions for words such as "moderately severe." Service treatment records from April 2011 contain a Magnetic Resonance Imaging (MRI) scan conducted on the Veteran which revealed stress reactive changes in the pubic region without evidence of pelvic or femoral stress injury or fracture. The Veteran also complained of joint pain at the time. The Veteran was afforded a VA examination for his thigh condition in April 2015. The Veteran reported that he had initially injured his right thigh and pelvis area while engaging in hand to hand combat training during his time in-service. The Veteran went on to state that he had been diagnosed while in-service with bursitis with residuals of bone fragments in his right thigh. At the time of the examination, the Veteran complained of a burning sensation, akin to being poked with a hot needle into his right upper thigh which sometimes caused spasms. The Veteran also complained of increased soreness in the affected area upon cold weather. The examiner conducted range of motion testing on the right hip which measured flexion to 115 degrees, extension to 30 degrees, abduction to 45 degrees, and adduction to 25 degrees. The Veteran’s magnetic resonance imaging (MRI) scan conducted on April 15, 2019 revealed mild (grade 1) stress reactive changes of the left symphysis pubis. The Veteran was then provided another VA examination in November 2019, which noted a progressive worsening of the Veteran’s symptoms, with increase in pain in the right upper thigh area along with weakness. The Veteran reported that he suffered from a painful chronic “burning” sensation in the right upper right thigh with pain at 5-6 out of 10, and increasing to 8-10 out of 10 upon prolonged walking or climbing stairs. The Veteran also reported of weakness upon standing or walking. Further, the Veteran reported that he had difficulty in engaging in sports activities and that his hip pain also negatively affected his sexual activity. Range of motion testing was conducted which measured right hip flexion to 100 degrees, extension to 30 degrees, abduction to 45 degrees, adduction to 10 degrees, external rotation to 30 degrees, and internal rotation to 30 degrees. The Veteran was afforded another VA examination in July 2020 which checked his peripheral nerves connected to his hip and pelvis. This examination diagnosed the Veteran with right obturator nerve neuropathy. Throughout the period on appeal, the Board finds that at no point during the appeal period has the Veteran's stress fracture left symphysis manifested as flexion that was limited to 125 degrees, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups. In this regard, even when considering DeLuca factors, the Veteran's left hip motion was, at its worst, manifested by forward flexion to 125 degrees during the November 2019 VA examination. Furthermore, while the Board acknowledges that the Veteran’s reports of increase of pain in the right hip and upper thigh area and difficulty in movement that occur two to three times per week and usually after prolonged walking or standing; however, the Veteran is service connected a left hip disorder. Moreover, limitation of flexion to 30 degrees is not shown by the medical evidence of record, or the Veteran's own statements. 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, supra. As such, a rating in excess of 10 percent for the Veteran's stress fracture left symphysis for the period on appeal under Diagnostic Code 5252 is not warranted. Furthermore, while the Veteran exhibited limitation of extension, adduction, abduction, and rotation, such did not rise to the level necessary for a compensable rating under Diagnostic Code 5251 or 5253. Specifically, at no point pertinent to the appeal period was the Veteran's extension limited to 5 degrees or less, he could not cross her legs, he lost motion beyond 10 degrees of abduction, or he could not toe-out more than 15 degrees, even in contemplation of functional loss due to symptoms such as pain, fatigue, weakness, lack of endurance, or incoordination, or as a result of repetitive motion and/or flare-ups. Finally, at no point did the Veteran show ankylosis of her hip, a flail joint, or any impairment of her femur. Moreover, the Veteran’s left hip is not ankylosed and a higher or separate rating under Diagnostic Code 5250 is not warranted. Therefore, a higher or separate rating for the Veteran's stress fracture of the left symphysis are not warranted under the orthopedic diagnostic codes. The November 2019 and July 2020 VA examination reports note diagnoses of right obturator nerve neuropathy. A November 2019 VA examiner opined that a diagnosis of right obturator nerve neuropathy was added to the residuals of a pelvis fracture based on the symptoms and current examination and that the right obturator nerve neuropathy is likely a result of the Veteran's pelvis injury and fracture. The November 2019 VA examiner further opined that this diagnosis is new and related to the Veteran's service connected condition. The August 2020 VA examiner further noted that a current review of Musculoskeletal Medicine, 2008, indicates that there are many entities that produce groin pain including tendonitis, bursitis, osteitis pubis, stress fracture, sports hernia or athletic pubalgia, or nerve entrapment. A July 2020 Peripheral Nerves Disability Benefits Questionnaire (DBQ) report found that the Veteran had severe incomplete paralysis of the right obturator nerve. Therefore, the Board finds that a separate rating of 10 percent is warranted for severe right obturator nerve neuropathy. This is the highest schedular rating available under Diagnostic Code 8528. The Board has considered the effects of repeated use over time and flare-ups along with the adequacy of the VA examination in light of the Court’s holdings in Correia and Sharp. See Correia v. McDonald, supra, and Sharp v. Shulkin, supra. In this case, the VA November 2019 examiner tested the opposite joint and conducted repetitive-use testing and concluded that there was no additional limitation in range of motion. Regarding flare-ups, the Board acknowledges that the November 2019 VA examiner was not able to provide an opinion regarding additional functional impairment during flare-ups, however, the Veteran was able to describe his symptoms during a flare-up and the impact of such. The April 2015 VA examiner tested the opposite joint and conducted repetitive-use testing and concluded that there was no additional limitation in range of motion. Although the April 2015 VA examiner did not conducted range of motion testing with regards to flare-ups, the Veteran did not report flare-ups of the hip or no response was provided about the presence of flare-ups. Therefore, the Board finds that all information required for rating purposes has been provided. See Correia v. McDonald, supra; see also Sharp v. Shulkin, supra. In assessing the severity of the Veteran’s hip condition, the Board has given due consideration to the competent lay assertions regarding symptoms experienced and observed. See, e.g., Layno v. Brown, supra and Grottveit v. Brown, supra. However, the criteria needed to support higher ratings involve medical findings that are within the province and purview of trained medical professionals. See Jones v. Brown, supra. As such, the Veteran’s lay assertions are not considered more persuasive than the objective medical findings which, as indicated above, do not support assignment of any higher rating pursuant to any applicable criteria at any point pertinent to this appeal. While the Veteran is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of his bilateral plantar fasciitis according to the appropriate diagnostic codes. Rucker v. Brown, supra; Layno v. Brown, supra. The Board has considered whether a staged rating under Hart, supra, is appropriate for the Veteran's service-connected stress fracture of the left symphysis; however, the Board finds that his symptomatology has been stable throughout each period on appeal. Therefore, assigning a further staged rating for such disability is not warranted. The Veteran and his representative has not raised any other issues, and no other issues have been reasonably raised by the record. See Doucette v. Shulkin, supra. The Board has considered whether an inferred claim for a total disability based upon individual unemployability has been raised pursuant to Rice v. Shinseki, supra. Neither the Veteran nor his representative allege that he is unable to secure and maintain substantially gainful employment. Indeed, the record shows he has been employed as a kennel handler during the appeal period. The issue of a TDIU does not arise in the context of an increased rating claim when there is no allegation or evidence of unemployability. Jackson v. Shinseki, supra. As such, a Rice claim is not raised. Accordingly, the Board finds that a separate 10 percent rating is warranted for right obturator nerve neuropathy. Otherwise, the preponderance of the evidence is against the Veteran’s claim for increased rating for any of the period during the pendency of this appeal. Given that the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. KRISTY L. ZADORA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kashif I. Ali, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.