Citation Nr: 21008711 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 15-44 142 DATE: February 17, 2021 ORDER 1. Entitlement to a rating in excess of 10 percent for spondylosis of L4 vertebra with chronic low back pain and degenerative disc disease (DDD) (lumbar spine spondylosis) prior to February 24, 2015 is denied. 2. Entitlement to a rating in excess of 20 percent for spondylosis of L4 vertebra with chronic low back pain and DDD from February 24, 2015 to November 5, 2019 is denied. 3. Entitlement to a rating in excess of 40 percent for spondylosis of L4 vertebra with chronic low back pain and DDD from November 5, 2019 is denied. 4. Entitlement to an initial rating in excess of 10 percent for sciatic nerve radiculopathy of the right lower extremity prior to February 24, 2015 is denied. 5. Entitlement to an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the right lower extremity from February 24, 2015 is denied. 6. Entitlement to an initial compensable rating for sciatic nerve radiculopathy of the left lower extremity prior to November 5, 2019 is denied. 7. Entitlement to an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the left lower extremity from November 5, 2019 is denied. REMANDED 8. Entitlement to a total disability rating for compensation based on individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDINGS OF FACT 1. Prior to February 24, 2015, lumbar spine spondylosis was not manifested by 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. 2. From February 24, 2015 to November 5, 2019, lumbar spine spondylosis has not been manifested by forward flexion of the thoracolumbar spine to 30 degrees or less or favorable ankylosis of the entire thoracolumbar spine. 3. From November 5, 2019, lumbar spine spondylosis was not manifested by unfavorable ankylosis of the entire thoracolumbar spine. 4. Prior to February 24, 2015, sciatic nerve radiculopathy of the right lower extremity was not manifested by moderate incomplete paralysis of the sciatic nerve. 5. From February 24, 2015, sciatic nerve radiculopathy of the right lower extremity was not manifested by moderately severe incomplete paralysis of the sciatic nerve. 6. Prior to November 5, 2019, sciatic nerve radiculopathy of the left lower extremity was not manifested by mild incomplete paralysis of the sciatic nerve. 7. From November 5, 2019, sciatic nerve radiculopathy of the left lower extremity was not manifested by moderately severe incomplete paralysis of the sciatic nerve. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for lumbar spine spondylosis prior to February 24, 2015 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.14, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5239. 2. The criteria for a rating in excess of 20 percent for lumbar spine spondylosis from February 24, 2015 to November 5, 2019 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.14, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5239. 3. The criteria for a rating in excess of 40 percent for lumbar spine spondylosis from November 5, 2019 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.14, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5239. 4. The criteria for an initial rating in excess of 10 percent for sciatic nerve radiculopathy of the right lower extremity prior to February 24, 2015 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 5. The criteria for an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the right lower extremity from February 24, 2015 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 6. The criteria for an initial compensable rating for sciatic nerve radiculopathy of the left lower extremity prior to November 5, 2019 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 7. The criteria for an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the left lower extremity from November 5, 2019 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1979 to November 1983. In November 2018, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In August 2019, the Board remanded the claims for increased ratings for updated private and VA treatment records and for a new VA examination. The Board finds there was substantial compliance with this development. Increased Ratings Disability evaluations are determined by evaluating the extent to which a Veteran's service-connected disability adversely affects the Veteran's ability to function under the ordinary conditions of daily life, including employment, by comparing the Veteran's symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 C.F.R. § Part 4. 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. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. 1. Entitlement to a rating in excess of 10 percent for lumbar spine spondylosis prior to February 24, 2015. The Veteran testified that his back condition has worsened since his VA examinations in 2014 and 2015. The Board notes the Veteran was granted a temporary 100 percent rating under 38 C.F.R. § 4.30 from February 18, 2014 to March 31, 2014, so this time period is not on appeal as he has the maximum schedular rating available during this time. Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance. It is essential that the examination upon which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to all these elements. The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervations, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. A little used part of the musculoskeletal system may be expected to show evidence of disuse, either through atrophy, the condition of the skin, absence of normal callosity or the like. 38 C.F.R. § 4.40. Evidence of pain, weakened movement, excess fatigability, or incoordination must be considered in determining the level of associated functional loss, taking into account any part of the musculoskeletal system that becomes painful on use. The provisions regarding the avoidance of pyramiding, see 38 C.F.R. § 4.14, do not forbid consideration of a higher rating based on greater limitation of motion due to pain on use, including flare ups. However, those provisions should only be considered in conjunction with the DCs predicated on limitation of motion. 38 C.F.R. §§ 4.40, 4.45. The intent of the rating schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. Painful motion is an important factor of joint disability, which is entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. However, the evaluation of painful motion as limited motion applies only when the limitation of motion is noncompensable under the applicable DC. The Veteran’s service-connected spondylosis of L4 vertebra with chronic low back pain and DDD is evaluated under the General Rating Formula for rating diseases and injuries of the spine. 38 C.F.R. § 4.71a, Diagnostic Code 5239. Under this formula, a 10 percent disability rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but less than 85 degrees; or, the combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent of more of the height. A 20 percent disability 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 disability 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 evaluation is assigned for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent evaluation is assigned for unfavorable ankylosis of the entire spine. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of a rating in excess of 10 percent for spondylosis of L4 vertebra with chronic low back pain and DDD prior to February 24, 2015. Specifically, the evidence shows that the Veteran’s lumbar spine disability did not result in 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. For example, a May 2014 VA examination report shows the Veteran had 70 degrees of flexion and a combined range of motion greater than 120 degrees. The examiner documented there was no muscle spasm, guarding, or ankylosis of the thoracolumbar spine. The examiner documented there was no objective evidence of painful motion. The examiner marked yes for the Veteran having intervertebral disc syndrome (IVDS), but noted that the Veteran did not have any incapacitating episodes in the prior 12 months. Incapacitating episodes are required for consideration of a rating for IVDS under Diagnostic Code 5239. The Board has considered whether a higher rating should be assigned pursuant to 38 C.F.R. §§ 4.40, 4.45, 4.59, DeLuca, and Mitchell criteria, but a higher rating is not warranted for the Veteran's disability picture. See DeLuca v. Brown, 8 Vet. App. 202, 206-07 (1995); Mitchell v. Shinseki, 25 Vet. App. 32, 42-43 (2011). VA treatment records submitted by the Veteran do not show functional loss from pain, weakness, or fatigability that is not contemplated by the current 10 percent rating. The VA treatment records are similarly silent for any showing of 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, to include functional impairment that resembles that level of severity. The May 2014 VA examiner noted there was no additional limitation of range of motion after three repetitions. VA treatment records show the Veteran has a ginger gait on ambulation and uses a cane and walker, but his gait is not shown to be the result of muscle spasm or guarding. The Board finds that the 10 percent rating contemplates pain and how it affects the Veteran, such as difficulty sitting or standing for prolonged periods of time because of pain. Although the Board is required to consider the effect of pain when making a rating determination, it is important to emphasize that the rating schedule does not provide a separate rating for pain. See Spurgeon v. Brown, 10 Vet. App. 194 (1997). Additionally, the rating criteria for evaluating the spine specifically contemplate pain with the assigned evaluations. After considering the effects of pain and functional loss, forward flexion has not limited to 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, favorable or unfavorable ankylosis of the entire thoracolumbar spine is not shown, and unfavorable ankylosis of the entire spine is not shown to warrant an increased rating. In sum, the evidence does not show that a disability rating in excess of 10 percent for spondylosis of L4 vertebra with chronic low back pain and DDD, is warranted. As the preponderance of the evidence is against the claim for a higher rating, the benefit of the doubt doctrine is not applicable, and the Veteran's claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. 2. Entitlement to a rating in excess of 20 percent for lumbar spine spondylosis from February 24, 2015 to November 5, 2019. The Veteran testified that his back condition has gotten worse. Roughly two years before his hearing, a spinal stimulator was installed to help with pain. The batteries were expected to last eight to 10 years, but they required changing after two years. He is not allowed to drive with the spinal stimulator, so he needs people to drive him around. The Veteran testified that he has to lay down at least three times a week for approximately four hours because of the pain. His physical therapist referred him to the pain clinic after he was unable to assist the Veteran further. The Board notes the Veteran was granted a temporary 100 percent rating under 38 C.F.R. § 4.30 from February 10, 2017 to March 31, 2017, so this time period is not on appeal as he has the maximum schedular rating available during this time. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of a rating in excess of 20 percent for spondylosis of L4 vertebra with chronic low back pain and DDD. Specifically, the evidence shows that from February 24, 2015 to November 5, 2019, the Veteran’s lumbar spine disability did not result in forward flexion of the thoracolumbar spine to 30 degrees or less or favorable ankylosis of the entire thoracolumbar spine. For example, the March 2015 VA examination documented 75 degrees of flexion. The examiner marked no for the Veteran having ankylosis of the spine. Although flexion demonstrated pain, pain is specifically contemplated by the rating criteria. The examiner marked yes for the Veteran having IVDS, but noted that the Veteran did not have any incapacitating episodes in the prior 12 months. Although the Veteran testified that he must lay down at least three times a week for approximately four hours each time due to pain, an incapacitating episode is defined as bed rest prescribed by a physician and treatment by a physician in the past 12 months. The Veteran has not presented any evidence that a physician has prescribed bed rest; therefore, there is no evidence of an incapacitating episode. Incapacitating episodes are required for consideration of a rating for IVDS under Diagnostic Code 5239. On the October 2015 VA Form 9, the Veteran contends that the March 2015 VA examination was not complete, and as a result, the rating is in error. At the November 2018 hearing, the Veteran testified that he felt the examination was inadequate because the Veteran did not remember seeing the examiner document his ranges of motion during the examination. The Board notes the Veteran did not state what part(s) of the examination were incomplete. The Veteran also testified that he may have been taking medication and/or a shot in his spine during the examination. However, the examination showed muscle spasm resulting in abnormal gait or spinal contour to warrant an increase to 20 percent. The March 2015 VA examination also documents similar ranges of motion as the May 2014 VA examination, and the Veteran has not alleged he was taking medication during the May 2014 examination, so the Board finds that the values shown are an accurate picture of the Veteran’s lumbar spine disability in March 2015. The Board has considered whether a higher rating should be assigned pursuant to 38 C.F.R. §§ 4.40, 4.45, 4.59, DeLuca, and Mitchell criteria, but a higher rating is not warranted for the Veteran's disability picture. See DeLuca v. Brown, 8 Vet. App. 202, 206-07 (1995); Mitchell v. Shinseki, 25 Vet. App. 32, 42-43 (2011). VA treatment records submitted by the Veteran do not show functional loss from pain, weakness, or fatigability that is not contemplated by the current 20 percent rating. The VA treatment records are similarly silent for any showing of forward flexion of the thoracolumbar spine to 30 degrees or less or favorable ankylosis of the entire thoracolumbar spine, to include functional impairment that resembles that level of severity. The March 2015 VA examiner noted there was no additional limitation of range of motion after three repetitions. The Board finds that the 20 percent rating contemplates pain and how it affects the Veteran, such as difficulty lifting, walking, sitting, or standing for prolonged periods of time because of pain. Although the Board is required to consider the effect of pain when making a rating determination, it is important to emphasize that the rating schedule does not provide a separate rating for pain. See Spurgeon v. Brown, 10 Vet. App. 194 (1997). Additionally, the rating criteria for evaluating the spine specifically contemplate pain with the assigned evaluations. After considering the effects of pain and functional loss, forward flexion of the thoracolumbar spine to 30 degrees or less, favorable or unfavorable ankylosis of the entire thoracolumbar spine is not shown, and unfavorable ankylosis of the entire spine is not shown to warrant an increased rating. In sum, the evidence does not show that a disability rating in excess of 20 percent for spondylosis of L4 vertebra with chronic low back pain and DDD, is warranted. As the preponderance of the evidence is against the claim for a higher rating, the benefit of the doubt doctrine is not applicable, and the Veteran's claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. 3. Entitlement to a rating in excess of 40 percent for lumbar spine spondylosis from November 5, 2019. The Veteran contends his lumbar spine disability is worse than the 40 percent rating assigned from November 5, 2019. He testified that a ramp was installed at his home because he was unable to navigate the stairs. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of a rating in excess of 40 percent for spondylosis of L4 vertebra with chronic low back pain and DDD. Specifically, the evidence shows that from November 5, 2019, the Veteran’s lumbar spine disability did not result in unfavorable ankylosis of the entire thoracolumbar spine. For example, the November 2019 VA examiner did not document ankylosis of the spine. Although the Veteran was only able to perform forward flexion to 20 degrees because of significant pain, pain is specifically contemplated by the rating criteria. The examiner marked yes for the Veteran having IVDS, and noted that the Veteran did not have any incapacitating episodes in the prior 12 months. Incapacitating episodes are required for consideration of a rating for IVDS under Diagnostic Code 5239. VA treatment records also failed to document the Veteran had ankylosis of the spine. The Board has considered whether a higher rating should be assigned pursuant to 38 C.F.R. §§ 4.40, 4.45, 4.59, DeLuca, and Mitchell criteria, but a higher rating is not warranted for the Veteran's disability picture. See DeLuca v. Brown, 8 Vet. App. 202, 206-07 (1995); Mitchell v. Shinseki, 25 Vet. App. 32, 42-43 (2011). VA treatment records submitted by the Veteran do not show functional loss from pain, weakness, or fatigability that is not contemplated by the current 40 percent rating. The VA treatment records are similarly silent for a showing of unfavorable ankylosis of the entire thoracolumbar spine, to include functional impairment that resembles that level of severity. The Board finds that the 40 percent rating contemplates pain and how it affects the Veteran, such as difficulty sitting or standing for prolonged periods of time and difficulty lifting objects, bending, and navigating stairs because of pain. Although the Board is required to consider the effect of pain when making a rating determination, it is important to emphasize that the rating schedule does not provide a separate rating for pain. See Spurgeon v. Brown, 10 Vet. App. 194 (1997). Additionally, the rating criteria for evaluating the spine specifically contemplate pain with the assigned evaluations. After considering the effects of pain and functional loss, unfavorable ankylosis of the entire thoracolumbar spine is not shown and unfavorable ankylosis of the entire spine is not shown to warrant an increased rating. In sum, the evidence does not show that a disability rating in excess of 40 percent for spondylosis of L4 vertebra with chronic low back pain and DDD, is warranted. As the preponderance of the evidence is against the claim for a higher rating, the benefit of the doubt doctrine is not applicable, and the Veteran's claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. 4. Entitlement to an initial rating in excess of 10 percent for sciatic nerve radiculopathy of the right lower extremity prior to February 24, 2015. The Veteran contends his sciatic nerve radiculopathy of the right lower extremity should be rated higher than 10 percent prior to February 24, 2015. In the May 2014 rating decision, the Veteran was granted service connection for sciatic nerve radiculopathy of the right lower extremity, which is associated with the service-connected lumbar spine disability and assigned a 10 percent rating effective June 13, 2013. Paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, DC 8520. (Neuritis and neuralgia of that group are evaluated under DCs 8620 and 8720.) Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R. § 4.124a. The words "mild," "moderate," and "severe" as used in the various DCs are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. 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 is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against an award of an initial rating in excess of 10 percent for sciatic nerve radiculopathy of the right lower extremity prior to February 24, 2015. Specifically, the evidence shows that prior to February 24, 2015, the Veteran’s sciatic nerve radiculopathy of the right lower extremity did not result in moderate incomplete paralysis of the right lower extremity. For example, the May 2014 VA examiner documented that the severity of Veteran’s sciatic nerve radiculopathy of the right lower extremity was mild. The Veteran had no muscle atrophy. Muscle strength testing was normal at hip flexion, knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension. Deep tendon reflexes were noted to be normal. Sensation to light touch testing of the upper anterior thigh, thigh/knee, lower leg/ankle, and foot/toes were all normal. The examiner noted that the Veteran had no constant pain, no intermittent pain, mild paresthesias and/or dysesthesias, and mild numbness, which the Board finds is indicative of no more than mild incomplete paralysis. VA treatment records do not otherwise support that the Veteran either complained of or was found to have moderate incomplete paralysis of the right lower extremity during the period on appeal. In sum, the preponderance of the evidence is against an initial disability rating in excess of 10 percent for sciatic nerve radiculopathy of the right lower extremity prior to February 24, 2015. As the preponderance of the evidence is against the claim for a disability rating in excess of 10 percent, the benefit of the doubt doctrine is not for application, and the Veteran's claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. 5. Entitlement to an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the right lower extremity from February 24, 2015. The Veteran testified that he has pain and weakness in the bilateral lower extremities. He testified that his foot drops causing him to stumble all the time. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against an award of an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the right lower extremity from February 24, 2015. Specifically, the evidence shows that from February 24, 2015, the Veteran’s sciatic nerve radiculopathy of the right lower extremity did not result in moderately severe incomplete paralysis of the sciatic nerve. For example, the March 2015 VA examiner documented that the severity of Veteran’s sciatic nerve radiculopathy of the right lower extremity was moderate. The Veteran had no muscle atrophy. Muscle strength testing was normal at hip flexion, knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension. Deep tendon reflexes were noted to be hypoactive. Sensation to light touch testing of the upper anterior thigh, thigh/knee, and lower leg/ankle were normal, and light touch testing of the foot/toes was decreased. The examiner noted that the Veteran had severe constant pain, severe intermittent pain, moderate paresthesias and/or dysesthesias, and moderate numbness, which the Board finds is indicative of no more than moderate incomplete paralysis. The November 2019 VA examiner documented that the severity of Veteran’s sciatic nerve radiculopathy of the right lower extremity was moderate. The Veteran had no muscle atrophy. Muscle strength testing was four out of five at hip flexion, knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension. Deep tendon reflexes were noted to be absent. Sensation to light touch testing of the upper anterior thigh and thigh/knee was normal, lower leg/ankle were decreased, and foot/toes was absent. The examiner noted that the Veteran had moderate constant pain, no intermittent pain, moderate paresthesias and/or dysesthesias, and moderate numbness, which the Board finds is indicative of no more than moderate incomplete paralysis. Although the Veteran testified that his foot drops causing him to stumble, the Board does not find this is indicative of worse than moderate incomplete paralysis when considered with the evidence of record. The November 2019 examiner noted that deep tendon reflexes of the right knee and ankle and sensation to light touch testing of the foot/toes were absent, and the examiner rated the Veteran’s sciatic nerve radiculopathy of the right lower extremity as moderate. The Veteran testified and the record shows he is able to walk with a walker or cane/walking stick which is evidence against an 80 percent rating where there is complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost. VA treatment records do not otherwise support that the Veteran either complained of or was found to have moderately severe incomplete paralysis of the right lower extremity during the period on appeal. For example, a June 2018 VA treatment showed a complaint of intense leg pain; however, this record alone does not endorse more than moderate incomplete paralysis of the right sciatic nerve. A November 2019 VA treatment record documents the Veteran stated neuropathic pain in his feet and legs has been better since optimizing pregabalin within the study. The examiner noted that the Veteran stated “that medicine has helped my feet a good deal. It helps me walk better." He was able to walk two to three miles most days. In sum, the preponderance of the evidence is against a disability rating in excess of 20 percent for sciatic nerve radiculopathy of the right lower extremity from February 24, 2015. As the preponderance of the evidence is against the claim for a disability rating in excess of 20 percent, the benefit of the doubt doctrine is not for application, and the Veteran's claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. 6. Entitlement to an initial compensable rating for sciatic nerve radiculopathy of the left lower extremity prior to November 5, 2019. The Veteran contends his sciatic nerve radiculopathy of the left lower extremity warrants a compensable rating because pain and numbness has gotten worse. In the May 2014 rating decision, the Veteran was granted service connection for sciatic nerve radiculopathy of the left lower extremity, which is associated with the service-connected lumbar spine disability and assigned a noncompensable rating effective June 13, 2013. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against an award of an initial compensable rating for sciatic nerve radiculopathy of the left lower extremity prior to November 5, 2019. Specifically, the evidence shows that prior to November 5, 2019, the Veteran’s sciatic nerve radiculopathy of the left lower extremity did not result in mild incomplete paralysis of the sciatic nerve. For example, the May 2014 VA examiner documented the Veteran did not have left lower extremity radiculopathy. The Veteran had no muscle atrophy. Muscle strength testing was normal at hip flexion, knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension. Deep tendon reflexes were noted to be normal. Sensation to light touch testing of the upper anterior thigh, thigh/knee, lower leg/ankle, and foot/toes were all normal. The examiner noted that the Veteran had no constant pain, no intermittent pain, no paresthesias and/or dysesthesias, and no numbness, which the Board finds is indicative of no mild incomplete paralysis of the left lower extremity. The March 2015 VA examiner documented the Veteran did not have left lower extremity radiculopathy. The Veteran had no muscle atrophy. Muscle strength testing was normal at hip flexion, knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension. Deep tendon reflexes were noted to be hypoactive. Sensation to light touch testing of the upper anterior thigh, thigh/knee, lower leg/ankle, and foot/toes were all normal. The examiner noted that the Veteran had no constant pain, no intermittent pain, no paresthesias and/or dysesthesias, and no numbness, which the Board finds is indicative of no mild incomplete paralysis of the left lower extremity. VA treatment records show that the Veteran was diagnosed with left lower extremity radiculopathy; however, he has repeatedly denied symptoms such as weakness and numbness. For example, an October 2012 VA treatment record documents a complaint of pain in the bilateral lower extremities, but only right lower extremity weakness was noted. A December 2014 VA treatment record documented the Veteran did not have leg weakness or numbness or loss of bowel/bladder control. An October 2015 VA treatment record documented complaints of legs hurting with walking and stabbing. Pain was described as sharp and stabbing at times all down the bilateral lower extremities. The Veteran denied any weakness or loss of feeling and bowel/bladder incontinence. An October 2016 VA treatment record documents back pain radiating into the bilateral buttocks, feet, and toes. The pain was noted as intermittent and at times sharp or burning. The Veteran denied any new weakness, loss of sensation, or bowel/bladder incontinence. While records show the Veteran complained of left leg pain throughout the appeal period, there was no showing of weakness or numbness to support a finding of mild incomplete paralysis of the left lower extremity to warrant a compensable rating. In sum, the preponderance of the evidence is against an initial compensable rating for radiculopathy of the left lower extremity prior to November 5, 2019. As the preponderance of the evidence is against the claim for a compensable disability rating, the benefit of the doubt doctrine is not for application, and the Veteran's claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3 7. Entitlement to an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the left lower extremity from November 5, 2019. The Veteran contends his sciatic nerve radiculopathy of the left lower extremity has worsened to warrant a higher rating than 20 percent from November 5, 2019. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against an award of an initial rating in excess of 20 percent for sciatic nerve radiculopathy of the left lower extremity from November 5, 2019. Specifically, the evidence shows that from November 5, 2019, the Veteran’s sciatic nerve radiculopathy of the left lower extremity did not result in moderately severe incomplete paralysis of the sciatic nerve. For example, the November 2019 VA examiner documented that the severity of Veteran’s sciatic nerve radiculopathy of the left lower extremity was moderate. The Veteran had no muscle atrophy. Muscle strength testing was four out of five at hip flexion, knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension. Deep tendon reflexes were noted to be normal. Sensation to light touch testing of the upper anterior thigh and thigh/knee were normal, lower leg/ankle was decreased, and the foot/toes was absent. The examiner noted that the Veteran had moderate constant pain, no intermittent pain, moderate paresthesias and/or dysesthesias, and moderate numbness, which the Board finds is indicative of no more than moderate incomplete paralysis. VA treatment records do not otherwise support that the Veteran either complained of or was found to have moderately severe incomplete paralysis of the right lower extremity during the period on appeal. For example, a June 2018 VA treatment showed a complaint of intense leg pain; however, this record alone does not endorse more than moderate incomplete paralysis of the right sciatic nerve. In sum, the preponderance of the evidence is against a rating in excess of 20 percent for sciatic nerve radiculopathy of the left lower extremity from November 5, 2019. As the preponderance of the evidence is against the claim for a rating in excess of 20 percent, the benefit of the doubt doctrine is not for application, and the Veteran's claim for an increased rating is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3 REASONS FOR REMAND 8. Entitlement to a TDIU rating is remanded. An August 2014 VA treatment record documents that the Veteran owned a convenience store and is on disability. This statement implies the Veteran is receiving Social Security Administration (SSA) disability payments. In November 2018, the Veteran testified that he stopped working because of his back. The Board finds this statement is the Veteran raising the issue of entitlement to a TDIU rating. The Board finds additional development is necessary to assist the Veteran with this claim. Additionally, the Veteran will be requested to complete a VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability. While such form is not required, it assists VA with making a determination of entitlement to a TDIU rating when the past work history and educational history are all located in the form. VA will also need to verify the Veteran’s employment. Thus, the Veteran will be asked to complete the form to assist VA with developing and adjudicating this claim. The matters are REMANDED for the following action: 1. Provide the Veteran with a VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability, and request that he complete the form in its entirety. 2. Obtain SSA records if the Veteran applied for and/or is receiving SSA disability payments. A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. McDaniels, 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.