Citation Nr: 21009804 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-35 343A DATE: February 23, 2021 ORDER For the appeal period prior to August 7, 2014, a rating of 40 percent, but not higher, for lumbar spine degenerative arthritis and intervertebral disc disease, postoperative, is granted. For the appeal period beginning August 7, 2014, a rating in excess of 40 percent for lumbar spine degenerative arthritis and intervertebral disc disease, postoperative, is denied. For the appeal period prior to August 7, 2014, a rating of 10 percent, but not higher, for right lower extremity radiculopathy, is granted. For the appeal period beginning August 7, 2014, a rating in excess of 20 percent for right lower extremity radiculopathy, is denied. For the appeal period prior to August 27, 2020, a rating of 10 percent, but not higher, for left lower extremity radiculopathy (sciatic nerve), is granted. For the appeal period beginning August 27, 2020, a rating in excess of 20 percent for left lower extremity radiculopathy (sciatic nerve), is denied. For the rating period prior to August 27, 2020, a compensable rating for left lower extremity radiculopathy (femoral nerve) is denied. For the rating period beginning August 27, 2020, a rating in excess of 20 percent for left lower extremity radiculopathy (femoral nerve) is denied. FINDINGS OF FACT 1. For the appeal period prior to August 7, 2014, the Veteran’s lumbar spine disability was characterized by, at worst, forward flexion of the thoracolumbar spine 30 degrees or less. 2. For the appeal period beginning August 7, 2014, the Veteran’s lumbar spine disability was not manifested by unfavorable ankylosis or incapacitating episodes of intervertebral disc syndrome. 3. For the appeal period prior to August 7, 2014, the Veteran’s right lower extremity radiculopathy more nearly approximated mild incomplete paralysis of the sciatic nerve. 4. For the appeal period beginning August 7, 2014, the Veteran’s right lower extremity radiculopathy was manifested by, no worse, than moderate incomplete paralysis of the sciatic nerve. 5. For the appeal period prior to August 27, 2020, the Veteran’s left lower extremity radiculopathy approximated mild incomplete paralysis of the sciatic nerve. 6. For the appeal period beginning August 27, 2020, the Veteran’s left lower extremity radiculopathy manifested as no worse than moderate incomplete paralysis of the sciatic nerve. 7. The Veteran was first diagnosed with moderate left lower extremity radiculopathy associated with the femoral nerve on August 27, 2020. CONCLUSIONS OF LAW 1. For the appeal period prior to August 7, 2014, the criteria for a rating of 40 percent, but not higher, for lumbar spine degenerative arthritis and intervertebral disc disease, postoperative, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Codes 5242, 5243. 2. Beginning August 7, 2014, the criteria for a rating in excess of 40 percent for lumbar spine degenerative arthritis and intervertebral disc disease, postoperative, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Codes 5242, 5243. 3. For the appeal period prior to August 7, 2014, the criteria for a rating of 10 percent, but not higher, for right lower extremity radiculopathy, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520. 4. Beginning August 7, 2014, the criteria for a rating in excess of 20 percent for right lower extremity radiculopathy, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520. 5. For appeal period prior to August 27, 2020, the criteria for a rating of 10 percent, but not higher, for left lower extremity radiculopathy (sciatic nerve), have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520. 6. Beginning August 27, 2020, the criteria for a rating in excess of 20 percent for left lower extremity radiculopathy (sciatic nerve) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520. 7. For the rating period prior to August 27, 2020, the criteria for a compensable rating for left lower extremity radiculopathy (femoral nerve) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8526. 8. For the rating period beginning August 27, 2020, the criteria for a rating in excess of 20 percent for left lower extremity radiculopathy (femoral nerve) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8526. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1989 to August 2010. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from the September 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In that decision, the RO granted service connection for a lumbar spine disability and assigned a non-compensable rating, effective September 1, 2010, the day following the Veteran’s discharge from military service. In September 2014, the RO increased the rating for the lumbar spine disability to 40 percent, effective August 7, 2014. In October 2014, the Veteran filed VA Form 9, expressing dissatisfaction with the effective date of his increased rating. In November 2018, the Board remanded the claim to obtain a new VA examination to determine the severity of the Veteran’s lumbar spine disability. Subsequent to the VA examination, but before assigning the claim back to the Board, the RO increased the rating for the lumbar spine disability for the period prior to August 7, 2014, from non-compensable to 10 percent. Accordingly, the issue remains in appellate status. See A.B. v. Brown, 6 Vet. App. 35, 38 (1993). Furthermore, the Board finds substantial compliance with its February 2019 remand directives. See D’Aries v. Peake, 22 Vet. App. 97, 105 (2008) (holding that there must be substantial compliance with the terms of a Court or Board remand). Increased Ratings - Applicable Laws and Regulations The Veteran was rated at 10 percent under 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5242 from September 1, 2010, and 40 percent under DC 5243 from August 7, 2014. Effective February 7, 2021, VA’s Schedule, 38 C.F.R. Part 4, was amended with regard to rating musculoskeletal disorders. Fed. Reg. 76453 (November 30, 2020) (codified at 38 C.F.R. § 4.71a). When a law or regulation changes during the course of a claim or an appeal, the version more favorable to the veteran will apply, to the extent permitted by any stated effective date in the amendment in question. VAOPGCPREC 3-2000; Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). The revised musculoskeletal regulations do not provide for retroactive application; thus, the amendments may be applied as of, but not prior to, February 7, 2021.  Hence, VA has made clear that its intent is that the claims pending prior to the effective date will be considered under both old and new rating criteria, and whatever criteria is more favorable to the Veteran will be applied.   For applications filed on or after the effective date, only the new criteria will be applied.  As the Veteran’s claim was pending prior to February 7, 2021, the Board will consider entitlement under the prior regulations as well as the updated regulations from February 7, 2021 forward, applying the most favorable criteria for the Veteran. The changes effective February 7, 2021 under 38 C.F.R. § 4.71a, DC 5242 and 5243 were not to the rating schedule itself but added instruction to classify disabilities associated with IVDS under DC 5243 and all other intervertebral disc disabilities under 5242. As such, DC 5242 now reflects “Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)”; DC 5243 now reflects “Intervertebral disc syndrome: Assign this diagnostic code only when there is disc herniation with compression and/or irritation of the adjacent nerve route; assign diagnostic code 5242 for all other disc diagnoses.” As such, the changes do not impact the general rating formula and evaluation of the disability under the pre- and post-February 7, 2021 regulations is not required. 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 (musculoskeletal system) or § 4.73 (muscle injury); 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 [or 4.73] criteria.”). Disabilities of the spine are rated under the General Rating Formula for Diseases and Injuries of the Spine (for DCs 5235 to 5243, unless DC 5243 is evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes). 38 C.F.R. § 4.71a. The General Rating Formula specifies that the criteria and ratings apply with or without symptoms such as pain, whether or not it radiates, stiffness, or aching in the area affected by residuals of injury or disease. Id. The General Rating Formula for Diseases and Injuries of the Spine provides a 20 percent rating for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion (ROM) 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 provided for forward flexion of the thoracolumbar spine 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine, and a 100 percent rating may be assigned due to unfavorable ankylosis of the entire spine. See 38 C.F.R. § 4.71a. General Rating Formula. Ankylosis is defined, for VA compensation purposes, as a condition in which all or part of the spine is fixed in flexion or extension. 38 C.F.R. § 4.71a, General Rating Formula, Note (5). Alternatively, under the Intervertebral Disc Syndrome (IVDS) Formula, incapacitating episodes having a total duration of at least six weeks during the past 12 months warrants a 60 percent rating. For incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months, a 40 percent rating is warranted. With incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months, a 20 percent rating is warranted. With incapacitating episodes having a total duration of at least one week but less than two weeks during the past 12 months, a 10 percent rating is warranted. 38 C.F.R. § 4.71a, DC 5243. An incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome which requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, DC 5243. Any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately, under an appropriate DC. 38 C.F.R. § 4.71a, General Rating Formula, Note (1). For VA compensation purposes, normal forward flexion of the thoracolumbar spine is 0 to 90 degrees, extension is 0 to 30 degrees, right and left lateral extension are 0 to 30 degrees, and right and left lateral rotation are 0 to 30 degrees. The combined ROM refers to the sum of the range of forward flexion, extension, right and left lateral flexion, and left and right rotation. The normal combined ROM for the thoracolumbar spine is 240 degrees. 38 C.F.R. § 4.71a, General Rating Formula, Note (2). Each ROM measurement is to be rounded to the nearest five degrees. 38 C.F.R. § 4.71a, General Rating Formula, Note (4). Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) found in 38 C.F.R. Part 4. 38 U.S.C. § 1155. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. Where there is a question as to which of two disability ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the low rating will be assigned. 38 C.F.R. § 4.7. It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the rating of the same disability, or the same manifestation of a disability, under different diagnostic codes (DC or DCs), is to be avoided when rating a veteran’s service-connected disabilities. 38 C.F.R. § 4.14. It is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several DC; however, the critical element in doing so is that none of the symptomatology is duplicative or overlapping with the symptomatology of the other condition. Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). The assignment of a particular DC is “completely dependent on the facts of a particular case.” See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One DC may be more appropriate than another based on such factors as an individual’s relevant medical history, the DC, and the demonstrated symptomatology. Any change in a DC by VA must be specifically explained. See Pernorio v. Derwinski, 2 Vet. App. 625 (1992). Where the veteran is appealing the rating for an already established service-connected condition, his or her present level of disability is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Staged ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). A veteran is competent to report symptoms because this requires only personal knowledge, not medical expertise, as it comes to him or her through their senses. See Layno v. Brown, 6 Vet. App. 465 (1994). Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303 (2007). In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Lumbar Spine Disability The Veteran contends that the 40 percent disability rating should have been effective in September 1, 2010, and not August 7, 2014. The RO assigned a 10 percent disability rating for the appeal period to August 6, 2014 for the Veteran’s lumbar spine disability on the basis 38 C.F.R. § 4.59, which allows consideration of functional loss due to painful motion to be rated to at least the minimum compensable rating for a particular joint. In support, the RO referenced the painful motion of the thoracolumbar spine reported in the April 2010 VA compensation examination. See 38 C.F.R. § 4.59. The RO has assigned a 40 percent disability rating for the Veteran’s lumbar spine disability under DC 5242, effective August 7, 2014, based on forward flexion of the thoracolumbar spine 30 degrees or less; guarding and muscle spasm severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis; and combined range of motion of the thoracolumbar spine not greater than 120 degrees, as reported in the August 2014 VA compensation examination. See 38 C.F.R. § 4.71a, DC 5242. In light of the evidence, lay and medical, and providing the Veteran the benefit of the doubt, the Board finds that for the rating period on appeal to August 6, 2014, a 40 percent rating, but not higher, for the lumbar spine disability is approximated. Turning to the evidence, the Veteran’s service treatment records (STRs) note that he complained of lumbar spine pain since October 1999. See e.g. December 1999 Physical Therapy Consultation. In the Veteran’s STRs, a March 2007 physical therapy evaluation noted his lumbar flexion was approximately 25 degrees with pain; gait and stance were antalgic because of pain; and the lumbosacral spine exhibited spasm that moved up throughout the lumbar paravertebral muscles. See March 2007 Physical Therapy Evaluation. Follow up physical therapy visits reported forward flexion to 25 degrees; 65 degrees; and 70 degrees. See April 2007 Physical Therapy Treatments. In April 2008, the STRs note the Veteran was seen for lumbar spine pain and reported that he participated in a run the previous day and developed left sided sciatica with tingling down to his foot, but denied muscle weakness, and bowel or bladder problems. See April 2008 Chronological Record of Medical Care. Magnetic resonance imaging (MRI) of the lumbar spine was completed in July 2008 which found generalized minimal loss of disc height at L5-S1 and impingement of the traversing bilateral S1 nerve roots, left much greater than right, as well as potential impingement of multiple traversing bilateral lower nerve roots. See July 2008 Private MRI. A private electromyography (EMG) study and a nerve conduction velocity (NCV) test were completed in August 2008. The report noted the lumbar spine pain radiated down the left lower extremity with numbness over the left calf region. The findings were consistent with L5-S1 involvement (radiculopathy) on the left. See August 2008 Private EMG and NCV. In October 2008, the Veteran underwent a lumbar spine laminectomy due to his diagnosed lumbar stenosis. See October 2008 Medical Prescription Note. In May 2010, the Veteran was provided a VA compensation examination for his lumbar spine disability. He reported he could walk without limitation; did not experience fatigue, spasms, paresthesia, numbness, or weakness; the pain was localized in the right shoulder and occurred .25 times per month and lasted one week; pain level was moderate and was exacerbated by physical activity and relieved by rest; and during flare ups he experienced limitation of motion of the joint where he could not lift his right arm above shoulder without pain. Due to the surgery in October 2008, the Veteran reported he had residuals of stiffness and loss of movement but had no incapacitation in the past 12 months. The examiner noted the Veteran walked with a normal gait and had no indication of radiating pain on movement. Further, the examiner noted absent muscle spasm, tenderness, guarding or weakness, atrophy, or ankylosis. The examiner did not provide range of motion (ROM) measurements but indicated it was within normal limits. Finally, the examiner found no signs of lumbar intervertebral disc syndrome with chronic and permanent nerve root involvement. See April 2010 VA compensation examination and report. In October 2013, the Veteran reported in a VA treatment record that he had begun to experience pain and radicular symptoms down his right leg. See October 2013 VA Treatment Record. Another VA compensation examiner was conducted in August 2014. The Veteran reported increased lumbar spine pain associated with posterolateral gluteal and thigh pain and dysesthesias, which at times could descend to the lateral right foot, and more loss of active painless motion at the lumbar spine especially with stooping and forward bending and squatting. He also stated prolonged sitting had become more uncomfortable and he had increased problems with lumbar spasms during flare ups, though his back always feels tight. The examiner noted initial forward flexion ROM to 30 degrees, with pain at 25 degrees, but no ankylosis. The examiner estimated that during flare ups, the ROM forward flexion was to 25 degrees. The examiner indicated IVDS was present but there were no incapacitating episodes in the last 12 months. The examiner noted radiculopathy was present on the right, manifesting as moderate intermittent pain, moderate paresthesia and/or dysesthesias, and mild numbness, with moderate incomplete paralysis of the sciatic nerve. See August 2014 VA compensation examination and report. In September 2014, the Veteran reported to a private physician, Dr. H.K.D, that his pain radiated to his left hip, thigh, and left calf, and that the pain was continuous. On examination, Dr. H.K.D. found ROM of all major joints were grossly within normal limits, with tenderness at L5-S1 on the left side, a negative straight leg test on the right but positive on the left, and normal gait. See September 2014 Private Treatment Record. In October 2014, Dr. H.K.D. diagnosed left L5-S1 radiculopathy. See October 2014 Private Treatment Record. In January 2017, the Veteran had spinal cord stimulator implant surgery by private doctor, Dr. C.A.E. The preoperative diagnosis was failed back syndrome, lumbar radiculopathy. See January 2017 Private Procedure Report. In an accompanying medical record, Dr. C.A.E. noted the Veteran’s report of dull and aching pain in the low back, greater on the left than right, with burning, stabbing, and shooting pain radiating down the left lower extremity on the lateral portion of the foot. See January 2017 Private Treatment Record. In conjunction with the Board remand, the Veteran was provided another VA compensation examination in August 2020. The Veteran reported his symptoms had worsened since 2014 and his average pain was 6 to 7/10, constant and aching, with intermittent sharp pain and numbness down left leg. His flare ups occurred 2-3 times per week with 10/10 pain, which lasted from 12 hours to 1 day, and that were severe to the point the Veteran could not move and would lay down until it went away. Initial forward flexion ROM was to 30 degrees; no repetitive use testing was completed for fear of pain; and forward flexion was estimated to 25 degrees, with similar findings for flare ups. No ankylosis was present. The Veteran was positive for IVDS but no episodes of acute signs and symptoms where bed rest was prescribed in previous 12 months; however, under remarks the examiner noted 2-4 weeks work time lost in last 12 months. The examiner diagnosed lower extremity radiculopathy impacting the femoral and sciatic nerve, bilaterally, but noted no symptoms were reported or observed in the examination of right lower extremity. In the left lower extremity, the examiner indicated moderate radiculopathy, with involvement of the femoral and sciatic nerves, manifesting as moderate constant pain and mild numbness. See August 2020 VA examination and report. On review of the evidence of record, both lay and medical, the Board finds that a rating of 40 percent, but not higher, is warranted for the period on appeal to August 6, 2014. The May 2010 VA compensation examination and report on which the 10 percent rating is based is inadequate for rating purposes. As noted above, the rating system for lumbar spine disability is based, in part, on the limitation of range of motion. The May 2010 VA examination report contained no measurements of range of motion for the lumbar spine and only indicated the ROM was within normal limits. Further, the examiner indicated he reviewed the Veteran’s claim file, but made no mention of his previous complaints of left lower extremity radiculopathy. As such, the Board provides the May 2010 VA examination no probative weight. Green v. Derwinski, 1 Vet. App. 121, 124 (1991) (a thorough and contemporaneous medical examination is one which takes into account the records of prior medical treatment, so that the evaluation of the claimed disability will be a fully informed one). Conversely, the Board finds that the Veteran’s STRs provide competent, credible, and probative evidence of the severity of his lumbar spine disability. The STRs indicate that prior to his lumbar laminectomy, the Veteran’s lumbar spine forward flexion was limited to, at worst, 25 degrees due to pain in March and April 2007 during physical therapy, accompanied by an antalgic gait and muscle spasm. As such, the Board affords significant probative weight to the Veteran’s STRs. See Harvey v. Brown, 6 Vet. App. 390, 394 (1994). The Board notes that the evidence predates the effective date of his award. However, the Board is instructed to view the appellant’s disability in terms of its overall history and context. See 38 C.F.R. §§ 4.1, 4.2. Furthermore, the Board cannot find that the Veteran’s lay statements that his lumbar spine disability was severe during and since service lacks credibility based on the lack of contemporaneous medical records. See Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Additionally, while a lengthy period of absence of medical complaints for condition can be considered as one factor in resolving claim, the Board finds the balance of the competent and credible evidence supports the conclusion that the disability approximated a 40 percent rating since service. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) As such, the Board finds a 40 percent rating, but no higher, is approximated for the period on appeal to August 6, 2014. A rating in excess of 40 percent is not approximated for the entirety of the period on appeal as there is absent reports of ankylosis of the spine, favorable or unfavorable. See 38 C.F.R. § 4.71a, DC 5242. A higher rating is not warranted under the IVDS Formula. While there is evidence of IVDS, there is no evidence of incapacitating episodes which by regulation requires prescribed bed rest by a physician. 38 C.F.R. § 4.71a, IVDS Formula, Note (1). Therefore, a higher rating based on the IVDS Formula is not warranted. Lower Extremity Radiculopathy In a September 2014 rating decision, the RO granted service connection for right lower extremity radiculopathy and assigned an initial rating of 20 percent effective August 7, 2014 based on the August 2014 VA compensation examination. See September 2014 Rating Decision. In a September 2020 rating decision, the RO granted service connection for left lower extremity radiculopathy with involvement of the sciatic nerve and assigned an initial rating of 20 percent effective August 27, 2020 based on the August 2020 VA compensation examination. See September 2020 Rating Decision. Under Diagnostic Code 8520, a 10 percent rating is warranted for mild incomplete paralysis of the sciatic nerve; 20 percent for moderate incomplete paralysis; 40 percent for moderately severe incomplete paralysis; 60 percent for severe incomplete paralysis with marked muscular atrophy; and 80 percent for complete paralysis of the sciatic nerve. 38 C.F.R. § 4.124a, Diagnostic Code 8520. 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. 38 C.F.R. § 4.124a. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. Id. Neither the Rating Schedule nor the regulations provide definitions for descriptive words such as “mild,” “moderate,” “moderately severe,” and “severe.” Spellers v. Wilkie, 30 Vet. App. 2011 (2018) (“DC 8520 does not define ‘mild,’ ‘moderate,’ ‘moderately severe,’ or ‘severe,’ or generally associate those terms with specific symptoms”). Rather than applying a mechanical formula, the Board must instead evaluate all the evidence to the end that its decisions are “equitable and just.” 38 C.F.R. § 4.6. Right Lower Extremity In consideration of the evidence, the Board finds that for the rating period prior to August 7, 2014, a 10 percent rating, but not higher, for right lower extremity radiculopathy is warranted. In an October 2013 VA treatment record, the Veteran complained of experiencing pain and radicular symptoms down his right leg “again.” See October 2013 VA Treatment Record. Additionally, the August 2014 VA examination noted his right lower extremity radicular symptoms had been ongoing for the past several years, associated with lumbar spine pain. See August 2014 VA Examination and Report. As such, and resolving reasonable doubt in the Veteran’s favor, the Board finds that a rating of 10 percent is warranted for the rating period prior to August 7, 2014. A rating in excess of 10 percent is not warranted. The Veteran’s VA compensation examinations and private treatment records indicated his radiculopathy waxed and waned. Further, the report does indicate the symptoms as more than pain down the leg. As such, a rating in excess of 10 percent for right lower extremity radiculopathy is not warranted for the appeal period prior to August 7, 2014. As it pertains to the rating period beginning August 7, 2014, a rating in excess of 20 percent is not approximated. The August 2014 VA examination and report indicated the Veteran suffered moderate intermittent pain and paresthesia or dysesthesias, mild numbness, but no constant pain and the examiner found there was “moderate” involvement of the sciatic nerve. As such, the preponderance of the evidence is against a finding that a rating in excess of 20 percent is warranted. Left Lower Extremity In consideration of the evidence, the Board finds that for the period on appeal to August 26, 2020, a 10 percent rating, but not higher, for left lower extremity radiculopathy with involvement of the sciatic nerve is warranted. It is evident from the Veteran’s STRs as early as April 2008 the Veteran complained of sciatic pain, and a private August 2008 EMG study and NCV test found left L5-S1 radiculopathy. See October 2014 Private Treatment Records. Furthermore, private treatment records from Dr. H.K.D. indicated he complained of left sided low back pain that radiated down the left leg, and Dr. H.K.D. diagnosed left lower extremity radiculopathy. A rating in excess of 10 percent is not warranted. The Veteran’s STRs, VA compensation examinations, and private treatment records indicate his radiculopathy waxed in waned, as the STRs identified only left lower extremity radiculopathy, the August 2014 VA compensation examination found only right lower extremity radiculopathy, and the August 2020 VA compensation found only left lower extremity radiculopathy. Further, the reports indicate the radiculopathy was wholly sensory. As such, a rating in excess of 10 percent for left lower extremity radiculopathy impacting the sciatic nerve is not warranted for the period on appeal to August 27, 2020. For the period on appeal from August 27, 2020, a rating in excess of 20 percent is not approximated. The August 2020 VA examination and report indicated the Veteran suffered from moderate constant pain and mild numbness, but no intermittent pain or paresthesia or dysesthesias, and the examiner indicated there was moderate involvement of the sciatic nerve. Furthermore, the evidence does not demonstrate that the symptoms are anything but sensory. As such, the preponderance of the evidence is against a finding that a rating in excess of 20 percent is warranted. The Board further notes that the Veteran was awarded a 20 percent rating for left lower extremity radiculopathy associated with femoral nerve involvement effective August 27, 2020. Notably, the August 2020 VA examination is the first evidence of record distinguishing the Veteran’s radiculopathy as femoral versus sciatic and noting moderate severity. As such, the Board finds that a compensable rating for femoral nerve left lower extremity radiculopathy is not warranted prior to August 27, 2020. A rating in excess of 20 percent is also not warranted for the appeal period beginning August 27, 2020 as the VA examiner specifically indicated that the Veteran’s radiculopathy was moderate. Other Considerations The Board also considered whether an inferred claim for a total disability rating based on individual unemployability (TDIU) under Rice v. Shinseki, 22 Vet. App. 447 (2009) has been raised. Here however, the Veteran reported during his August 2020 VA examination that he was gainfully employed and does not assert the inability to maintain his current job due to his service-connected disabilities. The Board, therefore, finds that Rice is inapplicable, and a TDIU request has not been inferred. Finally, the Board notes that neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record.  See Doucette v. Shulkin, 28 Vet. App. 366, 369-70 (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). Romina A. Casadei Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Moldawer, 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.