Citation Nr: 21009285 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 18-32 996 DATE: February 22, 2021 ORDER A rating in excess of 10 percent for left wrist osteoarthritis is denied. FINDING OF FACT The weight of the competent and probative evidence is against finding ankylosis of the left wrist. CONCLUSION OF LAW The criteria for a rating in excess of 10 percent for left wrist osteoarthritis are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.71a, Diagnostic Code (DC) 5003-5215. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1980 to August 2005. This case is before the Board of Veterans’ Appeals (Board) on appeal from a June 2016 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared at a videoconference Board hearing in September 2020. The transcript of the hearing has been associated with the record. The Veteran contends that he is entitled to a rating in excess of 10 percent for the left wrist disability, evaluated under DC 5003-5215. Disability evaluations are determined by the application of a schedule of ratings, which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations shall be applied, VA will assign the higher evaluation if the disability picture more nearly approximates the criteria required for that rating. Otherwise, it will assign the lower rating. 38 C.F.R. § 4.7. VA resolves any reasonable doubt regarding the degree of disability in favor of the Veteran. 38 C.F.R. § 4.3. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires an additional diagnostic code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27. Where a claimant appeals the denial of a claim for an increased disability rating for a disability for which service connection was in effect before he filed the claim for increase, the present level of disability is the primary concern, and past medical reports should not be given precedence over current medical findings. Francisco v. Brown, 7 Vet. App. 55, 57-58 (1994). In evaluating a disability, the current examination reports in light of the whole recorded history are considered to ensure that the current rating accurately reflects the disorder’s severity. The medical, as well as industrial history, is to be considered, and a full description of the effects of the disability upon ordinary activity is also required. 38 C.F.R. §§ 4.1, 4.2, 4.10. The evaluation of the same disability under several diagnostic codes, known as pyramiding, must be avoided; however, separate ratings may be assigned for distinct disabilities resulting from the same injury so long as the symptomatology for one disorder is not duplicative of the symptomatology of the other disorder. 38 C.F.R. § 4.14; Esteban v. Brown, 6 Vet. App. 259, 262 (1994). The higher evaluation will be assigned when two disability evaluations are potentially applicable, and the disability picture more nearly approximates the criteria for the higher rating. 38 C.F.R. § 4.7. VA has an independent obligation to consider all potentially applicable provisions of law and regulation and to apply the diagnostic criteria in a manner that maximizes benefits. Schafrath v. Derwinski, 1 Vet. App. 589 (1991); Bradley v. Peake, 22 Vet. App. 280 (2008). Veterans are competent to report observable symptoms in the realm of their personal knowledge. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The standard of proof to be applied in decisions on claims for VA benefits is set forth in 38 U.S.C. § 5107(b). Under that provision, VA shall consider all information, including lay and medical evidence of record, in a case before the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be given to the claimant. 38 U.S.C. § 5107(b); see also Gilbert v. Derwinski, 1 Vet. App. 49, 57-58 (1990). DC 5003 provides that degenerative arthritis will be rated based on limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. 38 C.F.R. § 4.71a, DC 5003. A rating of 10 percent is applicable, to be combined, not added under DC 5003, for each major joint or group of minor joints limitation of motion effects when it is noncompensable under the appropriate diagnostic codes. Findings such as swelling, muscle spasm, or satisfactory evidence of painful motion must objectively confirm the limitation of motion. DC 5215 addresses wrist joint motion and allows for a single 10 percent rating if dorsiflexion is less than 15 degrees, or palmar flexion is limited in line with the forearm. 38 C.F.R. § 4.71a, DC 5215. The Veteran has already been awarded a 10 percent rating under this diagnostic code. This rating compensates for any and all limitations of motion in the wrist, including pain and other symptoms that affect function. As the maximum scheduler evaluation is in effect, no additional schedular discussion is necessary, and discussion of 38 C.F.R. §§ 4.40 and 4.45 and the DeLuca and Mitchell factors is moot. Johnston v. Brown, 10 Vet. App. 80, 85 (1995). DC 5214 allows for higher ratings for wrist limitation where ankylosis is shown. The June 2016 VA examination notes ankylosis of the left wrist is not present. The record is absent for any evidence of ankylosis during the appeal period; accordingly, the weight of the competent and probative evidence is against finding ankylosis of the left wrist. As such, DC 5214 is not applicable, and the Veteran cannot receive a rating in excess of 10 percent for left wrist limitation of motion. See 38 C.F.R. § 4.71a. There is no basis for a rating in excess of 10 percent for left wrist osteoarthritis under any applicable criteria. The Veteran was last provided a VA examination in October 2016; however, in this case, the 2016 VA examination and testing is adequate and provides an accurate picture of the Veteran’s disability picture from his left wrist osteoarthritis and enables the Board to rate the disability. Notably, neither the Veteran nor the representative argues that the Veteran’s left wrist osteoarthritis has increased in severity since the last examination; therefore, a new examination is not warranted at this time. See 09/03/2020, Hearing Transcript. The Veteran’s honorable service to our country is acknowledged, and the Board is sympathetic to the difficulties he endures with his left wrist disability; however, the law must be applied as it exists. See Owings v. Brown, 8 Vet. App. 17, 23 (1995). All diagnostic codes pertaining to the wrist have been considered. Schafrath, 1 Vet. App. at 593. The preponderance of the evidence is against the Veteran’s claim for a rating in excess of 10 percent for left wrist osteoarthritis; thus, the benefit-of- (Continued on next page) the-doubt doctrine is not applicable, and the increased rating for the period on appeal must be denied. See 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7; 4.71a. JAMES L. MARCH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Costa, 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.