Citation Nr: 21009032 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 10-22 885 DATE: February 18, 2021 ORDER Entitlement to an initial rating in excess of 10 percent for right thigh impairment (previously rated as right hip chronic strain) is denied. Entitlement to an initial compensable rating for right thigh limitation of rotation under Diagnostic Code 5252 is denied. FINDINGS OF FACT 1. Impairment of the right thigh does not more nearly approximate limitation of abduction, motion lost beyond 10 degrees. 2. The Veteran’s right hip disability has not been manifested by limited range of motion in flexion of the right thigh to 45 degrees or less. CONCLUSIONS OF LAW 1. The criteria for an initial rating in excess of 10 percent for impairment of the right thigh have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5253. 2. The criteria for an initial compensable rating for right thigh limitation of rotation under Diagnostic Code 5252 have not been met. 38 U.S.C. § §§ 5107, 5110; 38 C.F.R. §§ 3.102, 3.156, 3.159, 3.400, Diagnostic Code 5252. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1995 to July 2008. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a June 2008 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A copy of the proceeding is associated with the electronic claims file. Subsequently, the Board remanded the case for further development in May 2018. Furthermore, in a May 2019 rating decision, the AOJ continued a 10 percent rating for right thigh impairment under DC 5253 effective from October 31, 2018, that had previously been rated as 10 percent under DC 5255 from August 1, 2008, and also granted a noncompensable rating for right thigh limitation of rotation, effective October 31, 2018. Subsequently, the Board remanded the case for further development in October 2019. Increased Rating Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned specific diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In a claim for a greater original rating after an initial award of service connection, all of the evidence submitted in support of the veteran’s claim is to be considered. See Fenderson v. West, 12 Vet. App. 119 (1999); 38 C.F.R. § 4.2. Separate ratings can be assigned for separate periods of time based on the facts found, a practice known as “staged” ratings. See 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.”). Once the evidence is assembled, the Secretary is responsible for determining whether the preponderance of the evidence is against the claim. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). If so, the claim is denied; if the evidence is in support of the claim or is in equal balance, the claim is allowed. Id. 1. Entitlement to an initial rating in excess of 10 percent for right thigh impairment (previously rated as right hip chronic strain) is denied. The Veteran contends that she is entitled to a higher rating because she has functional loss or functional impairment of the hip. Her right hip feels like it will give out at least 1-2 times a month when going up/ down the steps. She asserts that her disorder has gotten worse. She cannot walk/ sit for more than 30 minutes worsening right hip/ thigh pain. The Veteran’s impairment of the right thigh is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5253, a 10 percent rating for right thigh impairment under DC 5253 effective from October 31, 2018, that had previously been rated as 10 percent under DC 5255 from August 1, 2008. Under Diagnostic Code 5253, a 10 percent rating is warranted for limitation of rotation of affected leg, cannot toe out more than 15 degrees. A 10 percent rating is also warranted for limitation of adduction, cannot cross legs. A maximum 20 percent rating is warranted for limitation of abduction, motion lost beyond 10 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5253. 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). In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing “for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint.” In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the Veterans themselves, when a flare-up is not observable at the time of examination. The preponderance of the evidence is against a rating in excess of 10 percent for right thigh impairment under Diagnostic Code 5253. The Board acknowledges the Veteran’s credible lay reports of symptoms and that there was functional loss. However, even considering the Veteran’s lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements would not result in symptoms more nearly approximating limitation of abduction, motion lost beyond 10 degrees. The February 2020 contract VA examination was provided in compliance with the Board remand in October 2019. The examiner reviewed the evidence of record and considered the Veteran’s history and statements. The examiner described the disability in sufficient detail to enable a fully informed rating. With respect to estimating the loss of range of motion during repeated use over time and flare-ups, the examiner stated that after review of the Veteran’s records including the order request, disability benefits questionnaire, physical examination, reported history and subjective complaints, relevant evidence of record and using the examiner’s medical knowledge and expertise, the examiner had no basis to offer additional losses of function or motion with repeated use over time or during flare-ups. This is an adequate explanation for the inability to estimate the loss of range of motion in terms of degrees. Sharp, 29 Vet. App. 26. The Veteran has been provided an adequate medical examination in conjunction with her claim. See Barr, 21 Vet. App. at 311. Thus, there was substantial compliance with the remand directives. Stegall, 11 Vet. App. at 271. The February 2020 contract VA examination showed symptoms of right hip pain that is constant rates it as 2-9 with popping sounds of right hip. Aggravated prolonged walking more than 30 minutes / sitting not more than 1 hour. Intermittent feeling of right hip wants to give out. Functional impairment was described as can’t walk/ sit for more than 30 minutes worsening right hip/ thigh pain. Range of motion clinical testing showed right hip flexion was to 120 degrees, with normal being 125 degrees. Extension was to 30 degrees with normal being 30 degrees. Abduction was to 45 degrees with normal being 45 degrees. Adduction was to 25 degrees, with normal being 25 degrees. External rotation was to 35 degrees, with normal being 60 degrees. Internal rotation was 40 degrees with normal being 40 degrees. The examiner did not find that adduction was limited such that the Veteran cannot cross her legs. Functional loss was described as inability to do extended walking. Pain was noted on the examination and causes functional loss. The October 2018 VA contract examination showed current symptoms of constant aching/throbbing right hip pain that gets worse with prolonged walking and sitting. Alleviated with pressure/stretching/medication. Functional impairment was described as difficulty running due to hip pain. Range of motion clinical testing showed right hip flexion was to 120 degrees, with normal being 125 degrees. Extension was to 30 degrees with normal being 30 degrees. Abduction was to 45 degrees with normal being 45 degrees. Adduction was to 25 degrees, with normal being 25 degrees. External rotation was to 50 degrees, with normal being 60 degrees. Internal rotation was 40 degrees with normal being 40 degrees. The examiner did not find that adduction was limited such that the Veteran cannot cross her legs. Functional loss was described as inability to do extended walking. Pain was noted on the examination and causes functional loss. During the October 2018 VA examination, the Veteran reported functional loss or functional impairment of the hip. The examiner indicated that the examination of the Veteran’s right hip was neither medically consistent or inconsistent with the Veteran’s statements describing functional loss during flare-ups. The examiner opined that she was unable to say without mere speculation as to whether pain, weakness, fatigability or incoordination significantly limit functional ability with flare-ups. She explained that there was no conceptual or empirical basis for making such a determination without directly observing function under these conditions. The examiner further noted that she was not able to describe the functional loss in terms of range of motion, as it is not possible to determine, without resorting to mere speculation, loss of range of motion, because there is no conceptual or empirical basis for making such a determination without directly observing function under these conditions. Identical responses were provided for repetitive use over time. The Board finds the reports of the October 2018 VA examination problematic because the examination is contemporaneous to the September 2017 decision of the United States Court of Appeals for Veterans Claims (Court) in Sharp v. Shulkin, 29 Vet. App. 26, 35 (2017) and uses language criticized in that opinion. In Sharp, the Court spoke to the nature of the evidence at the disposal of most examiners such that estimates of functional loss during flare-ups and repetitive use over time can be made without resorting to speculation. To make such estimates, the examiner must “obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves.” Id. In other words, it is anticipated “that examiners will offer flare opinions based on estimates derived from information procured from relevant sources, including the lay statements of veterans.” Id. The May 2015 private medical record notes lower extremity muscles have normal tone bilaterally. The lower extremity motor strength is 5/5 bilaterally. The strength of hip muscle is 5/5 bilaterally. The strength of muscle quadriceps is 5/5 bilaterally. The muscle strength during hamstrings is 5/5 bilaterally. The muscle strength during adduction is 5/5 bilaterally. The muscle strength of the tibialis anterior muscle is 5/5 bilaterally. The strength of anterior muscle is 5/5 bilaterally. EHL is 5/5 bilaterally. The strength of gastroc muscle 5/5 bilaterally. The muscle strength of the Extensor Hallucis is 5/5 bilaterally. The strength of hallucis muscle is 5/5 bilaterally. There is no muscle atrophy noted. No significant fasciculations was noted. There is normal strength in the lower extremities. There is no bradykinesia, dyskinesia or myoclonus noted. No tremor noted. The June 2008 VA examination the Veteran notes a 10-year history of right hip/groin and lateral thigh pain. The pain is always in the right hip/groin area, but sometimes it radiates in the lateral thigh and buttocks region, or into the right anterior knee. Veteran’s pain is intermittent and associated with almost any position that is held too long such as sitting on a plane. Her pain is worse with strenuous workout. Active ROM of hip to 105 degrees, with some pain along posterior lateral aspect of greater trochanteric region, and she denied groin pain. The January 2008 VA examination, the examiner reported the Veteran has limitations as far as needing to change her position frequently, because of hip pain. She has increased pain with sitting for longer than one hour and she has a limp. The January 2008 VA joints examination for right hip impairment revealed symptoms chronic right hip pain going to the right knee for the last 12 years. Veteran said that she started having pain in the right hip in officer candidate school training 12 years ago, and she was initially thought to have stress fracture which was not confirmed but she was treated empirically for a stress fracture with crutch walking for two months. The Veteran reported having tenderness in right buttock and right groin area. She reported having limitation in prolonged standing, running, and squatting due to discomfort in right hip. Range of motion clinical testing showed right hip forward flexion was 110 degrees, abduction was 45 degrees, external rotation was 45, internal rotation was 30 degrees. She complained of pain during all range of motion of right hip. There was no loss of motion. The examinations show that, at worst, abduction was to 45 degrees. As noted above, the February 2020 VA examination fully contemplates functional impairment and is adequate for adjudication. The Board finds that, even considering the flare-ups and limitation of function after repeated use over time, the criteria for a higher evaluation are not more nearly approximated. For this to occur, the additional loss of function would need to reduce the function by more than half. The Veteran has not described additional loss of function that would correlate to such loss. Finally, treatment records do not provide evidence supporting the loss of abduction beyond 10 degrees. The Board has also considered the other Diagnostic Codes pertaining to the hip and thigh but finds that no other code is applicable. Neither the medical or lay evidence indicates ankylosis; that there is a flail joint; or nonunion, false joint, or malunion of the femur. See Diagnostic Codes 5250, 5254-5255. There is also not evince of extension limited to 5 degrees or less. See Diagnostic Code 5251. Accordingly, the claims for higher ratings for impairment of the right thigh is denied. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 2. Entitlement to an initial compensable rating for right thigh limitation of rotation under Diagnostic Code 5252 is denied. The Veteran seeks entitlement to higher ratings for her right hip disabilities. She contends that her right hip disabilities are more severe than reflected by the current assigned ratings. The Veteran reports that her right hip disabilities are manifested by decreased movement and painful movement, and she suffers from limitation of flexion, extension, adduction, and abduction. The Veteran is currently rated at 0 percent for right thigh limitation of rotation under Diagnostic Code 5252, effective October 31, 2018, and she has not demonstrated flexion limited to 45 degrees, required for a 10 percent rating. Instead, her most reduced flexion was 120 degrees. Although granted currently from October 2018, the question before the Board is whether this separate service connection has led to a compensable loss, that is functional impairment, at any time since August 2008, as this is the appellate period for the question of higher ratings for the right hip. The Veteran has sought review of the initial ratings for the right hip, and the initial rating is effective August 2008. Although the RO noted this as limitation in rotation of the thigh, it has been rated under the DC that provides ratings for limitation of flexion. The Board finds that this is the most analogous code. 38 C.F.R. §§ 4.40 Under Diagnostic Code 5252, limitation of flexion of the thigh to 45 degrees warrants a 10 percent rating; flexion limited to 30 degrees warrants a 20 percent rating; flexion limited to 20 degrees warrants a 30 percent rating; and flexion limited to 10 degrees warrants a 40 percent rating. 38 C.F.R. § 4.71a. Normal range of motion (ROM) of the hip and thigh is flexion from 0 to 125 degrees and abduction from 0 to 45 degrees. 38 C.F.R. § 4.71a, Plate II. When evaluating joint disabilities rated on the basis of limitation of motion, VA must consider granting a higher rating in cases in which functional loss due to pain, weakness, excess fatigability, or incoordination is demonstrated, and those factors are not contemplated in the relevant rating criteria. See 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202 (1995). The Court of Appeals of Veterans Claim (Court) clarified that although pain may be a cause or manifestation of functional loss, limitation of motion due to pain is not necessarily rated at the same level as functional loss where motion is impeded. See Mitchell v. Shinseki, 25 Vet. App. 32 (2011); cf. Powell v. West, 13 Vet. App. 31, 34 (1999); Hicks v. Brown, 8 Vet. App. 417, 421 (1995); Schafrath v. Derwinski, 1 Vet. App. 589, 592 (1991). Instead, the Mitchell Court explained that pursuant to 38 C.F.R. §§ 4.40 and 4.45, the possible manifestations of functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance, as well as less or more movement than is normal, weakened movement, excess fatigability, and pain on movement (as well as swelling, deformity, and atrophy) that affects stability, standing, and weight-bearing. See 38 C.F.R. §§ 4.40, 4.45. Thus, functional loss caused by pain must be rated at the same level as if the functional loss were caused by any of the other factors cited above. In evaluating the severity of a joint disability, VA must determine the overall functional impairment due to these factors. The intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. The provisions of 38 C.F.R. § 4.59 cited above are not limited to arthritis and must be considered when raised by the claimant or when reasonably raised by the record. Burton v. Shinseki, 25 Vet. App. 1 (2011). The Veteran was afforded a Hip and Thigh Conditions VA contract examination in February 2020. The Veteran complained of hip joint pain which limits her ability for high impact physical activities. The Veteran described the hip pain as constant rates it as 2-9 with popping sounds of right hip, and she experienced flare-ups of hip pain, manifested by my right hip feels like it will give out at least 1-2 times a month when going up/ down the steps. Upon examination, range of motion testing of the Veteran’s right hip revealed flexion limited to 120 degrees, extension limited to 30 degrees, abduction limited to 45 degrees, adduction limited to 25 degrees, external rotation to 35 degrees, and internal rotation to 40 degrees. Adduction was not so limited as to prevent Veteran from crossing legs. Pain was observed on clinical examination, but the VA examiner did not find that it caused the Veteran any functional loss. The Veteran was able to perform repetitive use testing and it did not result in additional limitation of motion. The VA examiner found that the clinical examination was neither medically consistent or inconsistent with the Veteran’s statements describing functional loss with repetitive use over time and due to flare-ups. There was no evidence of reduced muscle strength and, muscle atrophy. The VA examiner noted that the Veteran right hip disabilities impacts her ability to sit more than 30 minutes/ difficulty going up/ down the steps due to right hip discomfort. The October 2018 VA contract examination showed current symptoms of constant aching/throbbing right hip pain that gets worse with prolonged walking and sitting. Alleviated with pressure/stretching/medication. Functional impairment was described as difficulty running due to hip pain. Range of motion clinical testing showed right hip flexion was to 120 degrees, with normal being 125 degrees. Extension was to 30 degrees with normal being 30 degrees. Abduction was to 45 degrees with normal being 45 degrees. Adduction was to 25 degrees, with normal being 25 degrees. External rotation was to 50 degrees, with normal being 60 degrees. Internal rotation was 40 degrees with normal being 40 degrees. The examiner did not find that adduction was limited such that the Veteran cannot cross her legs. Functional loss was described as inability to do extended walking. Pain was noted on the examination and causes functional loss. During the October 2018 VA examination, the Veteran reported functional loss or functional impairment of the hip. The examiner indicated that the examination of the Veteran’s right hip was neither medically consistent or inconsistent with the Veteran’s statements describing functional loss during flare-ups. The examiner opined that she was unable to say without mere speculation as to whether pain, weakness, fatigability or incoordination significantly limit functional ability with flare-ups. She explained that there was no conceptual or empirical basis for making such a determination without directly observing function under these conditions. The examiner further noted that she was not able to describe the functional loss in terms of range of motion, as it is not possible to determine, without resorting to mere speculation, loss of range of motion, because there is no conceptual or empirical basis for making such a determination without directly observing function under these conditions. Identical responses were provided for repetitive use over time. The Board finds the reports of the October 2018 VA examination problematic because the examination is contemporaneous to the September 2017 decision of the United States Court of Appeals for Veterans Claims (Court) in Sharp v. Shulkin, 29 Vet. App. 26, 35 (2017) and uses language criticized in that opinion. In Sharp, the Court spoke to the nature of the evidence at the disposal of most examiners such that estimates of functional loss during flare-ups and repetitive use over time can be made without resorting to speculation. To make such estimates, the examiner must “obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves.” Id. In other words, it is anticipated “that examiners will offer flare opinions based on estimates derived from information procured from relevant sources, including the lay statements of veterans.” Id. The May 2015 private medical record notes lower extremity muscles have normal tone bilaterally. The lower extremity motor strength is 5/5 bilaterally. The strength of hip muscle is 5/5 bilaterally. The strength of muscle quadriceps is 5/5 bilaterally. The muscle strength during hamstrings is 5/5 bilaterally. The muscle strength during adduction is 5/5 bilaterally. The muscle strength of the tibialis anterior muscle is 5/5 bilaterally. The strength of anterior muscle is 5/5 bilaterally. EHL is 5/5 bilaterally. The strength of gastroc muscle 5/5 bilaterally. The muscle strength of the Extensor Hallucis is 5/5 bilaterally. The strength of hallucis muscle is 5/5 bilaterally. There is no muscle atrophy noted. No significant fasciculations was noted. There is normal strength in the lower extremities. There is no bradykinesia, dyskinesia or myoclonus noted. No tremor noted. The June 2008 VA examination the Veteran notes a 10-year history of right hip/groin and lateral thigh pain. The pain is always in the right hip/groin area, but sometimes it radiates in the lateral thigh and buttocks region, or into the right anterior knee. Veteran’s pain is intermittent and associated with almost any position that is held too long such as sitting on a plane. Her pain is worse with strenuous workout. Active ROM of hip to 105 degrees, with some pain along posterior lateral aspect of greater trochanteric region, and she denied groin pain. The January 2008 VA examination, the examiner reported the Veteran has limitations as far as needing to change her position frequently, because of hip pain. She has increased pain with sitting for longer than one hour and she has a limp. The January 2008 VA joints examination for right hip impairment revealed symptoms chronic right hip pain going to the right knee for the last 12 years. Veteran said that she started having pain in the right hip in officer candidate school training 12 years ago, and she was initially thought to have stress fracture which was not confirmed but she was treated empirically for a stress fracture with crutch walking for two months. The Veteran reported having tenderness in right buttock and right groin area. She reported having limitation in prolonged standing, running, and squatting due to discomfort in right hip. Range of motion clinical testing showed right hip forward flexion was 110 degrees, abduction was 45 degrees, external rotation was 45, internal rotation was 30 degrees. She complained of pain during all range of motion of right hip. There was no loss of motion. The Board finds that the February 2020 VA contract examination was adequate upon which to consider functional impairment, to include whether pain or flare-ups, cause a loss of range in motion. Considering this evidence, the Board finds that the evidence does not reflect a compensable loss of range of motion. The painful motion is contemplated by the 10 percent rating provided under DC 5253. In addition, the record contains the Veteran’s VA treatment records dated through the appeal period. These records show that she has received treatment for her complaints of right hip pain. VA treatment records show findings of painful motion and tenderness, but do not result in any right thigh limitation of rotation to 45 degrees. Likewise, there is no finding of ankylosis in the right hip joint. The Board has also considered the other Diagnostic Codes pertaining to the hip and thigh. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); Lyles v. Shulkin, 29 Vet. App. 107 (2017) (holding that 38 C.F.R. § 4.14 prohibits paying compensation twice for the same symptoms or functional impairment). The Board finds that no other code is applicable. Neither the medical or lay evidence indicates ankylosis; that there is a flail joint; or nonunion, false joint, or malunion of the femur. See Diagnostic Codes 5250, 5254-5255. There is also not evince of extension limited to 5 degrees or less. See Diagnostic Code 5251. In conclusion, the Board finds that the preponderance of the evidence against the Veteran’s claim for a compensable rating for right thigh limitation of rotation. The Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Ottley III 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.