Citation Nr: 21010701 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 14-36 449 DATE: February 25, 2021 ORDER A compensable rating for bilateral hearing loss prior to June 24, 2019, is denied. A rating in excess of 10 percent for bilateral hearing loss since June 24, 2019, is denied. A rating in excess of 10 percent for a cervical strain prior to July 3, 2019, is denied. A rating in excess of 30 percent for a cervical strain since July 3, 2019, is denied. A rating in excess of 10 percent for a right elbow strain prior to July 3, 2019, is denied. A 20 percent, but no more, for a right elbow strain since July 3, 2019, is granted, subject to the laws and regulations governing the payment of benefits. Service connection for residuals of a bilateral inguinal hernia repair is denied. Service connection for radiculopathy of the left upper extremity (LUE) is denied. Service connection for radiculopathy of the right upper extremity (RUE) is denied. Service connection for residuals of left thumb reconstruction with a metal hardware implant is granted. FINDINGS OF FACT 1. The Veteran had active duty between October 1983 and October 1986 and multiple periods of active duty as part of Reserve service; he has been 100 percent disabled since September 2011, in addition to receipt of special monthly compensation. 2. Prior to June 24, 2019, audiometric testing revealed, at worst, an average puretone threshold of 26.25 decibels (dBs) and 80 percent speech recognition in the right ear and an average puretone threshold of 31.25 dBs and 76 percent speech recognition in the left ear. 3. Since June 24, 2019, audiometric testing has revealed, at worst, an average puretone threshold of 35 dBs and 80 percent speech recognition in the right ear and an average puretone threshold of 43.75 dBs and 74 percent speech recognition in the left ear. 4. Prior to July 3, 2019, a cervical spine disability was characterized by subjective complaints of worsening symptoms and difficulty turning and performing physical activities; objective findings included forward flexion of the cervical spine to 45 degrees, a combined range of motion of the cervical spine to 225 degrees, and no guarding, muscle spasms, or intervertebral disc syndrome (IVDS). 5. Since July 3, 2019, a cervical spine disability has been characterized by subjective complaints of neck pain; objective findings include no ankylosis or IVDS. 6. Prior to July 3, 2019, a right elbow disability was characterized by subjective complaints of stiffness, soreness, and pain; objective findings included flexion to 125 degrees and pain on movement. 7. Since July 3, 2019, a right elbow disability has been characterized by subjective complaints of worsening symptoms and severe flare-ups; objective findings include flexion, at worst, to 90 degrees. 8. An inguinal hernia injury or inguinal hernial repair procedure did not occur during a period of active duty, or during a period of active duty training (ACDUTRA) or inactive duty training (INACDUTRA). 9. LUE radiculopathy and RUE radiculopathy have not been shown. 10. The Veteran underwent left thumb surgery during a period of active duty; ongoing left thumb pain has been attributed to the inservice surgery. CONCLUSIONS OF LAW 1. The criteria for a compensable rating for bilateral hearing loss prior to June 24, 2019, have not been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code (DC) 6100 (2020). 2. The criteria for a rating in excess of 10 percent for bilateral hearing loss since June 24, 2019, have not been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.85, 4.86, DC 6100 (2020). 3. The criteria for a rating in excess of 10 percent for a cervical strain prior to July 3, 2019, have not been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.71a, DCs 5237, 5243 (2020). 4. The criteria for a rating in excess of 30 percent for a cervical strain since July 3, 2019, have not been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.59, 4.71a, DCs 5237, 5243 (2020). 5. The criteria for a rating in excess of 10 percent for a right elbow strain prior to July 3, 2019, have not been met. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.59, 4.71a, DCs 5206-5208 (2020). 6. The criteria for a 20 percent, but no more, for a right elbow strain have been met since July 3, 2019. 38 U.S.C. §§ 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.3, 4.7, 4.59, 4.71a, DCs 5206-5208 (2020). 7. Residuals of a bilateral inguinal hernia repair procedure were not incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.309, 3.310 (2020). 8. LUE radiculopathy was not incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.309, 3.310 (2020). 9. RUE radiculopathy was not incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.309, 3.310 (2020). 10. Residuals of left thumb reconstruction with a metal hardware implant was incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.309, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS As a procedural matter, the claims on appeal were remanded by the Board in December 2019 for additional development. The case has now been returned to the Board for further adjudicative actions. Further, on February 7, 2021, the Secretary amended 38 C.F.R. § 4.71a, which covers diagnostic codes for musculoskeletal system disorders; however, the February 2021 amendments did not alter the diagnostic codes for cervical and right elbow strains or the criteria therefor. Therefore, the Board will consider the rating criteria under the previously and currently applicable versions of 38 C.F.R. § 4.71a at the same time in adjudicating the Veteran’s increased rating claims. Increased Rating Claims Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Bilateral Hearing Loss In addition to the above, the Rating Schedule provides rating tables for the evaluation of hearing impairment. Table VI assigns a Roman numeral designation (I through XI) for hearing impairment based on a combination of percent speech discrimination and the puretone threshold average (the sum of the puretone thresholds at 1000, 2000, 3000, and 4000 Hertz (Hz), divided by four). 38 C.F.R. § 4.85. Table VII is used to determine the percentage evaluation by combining the Table VI Roman numeral designations for hearing impairment in each ear. When evaluating service-connected hearing impairment, ratings are derived by a mechanical application of the rating schedule to the numeric designations assigned in audiometric evaluations. Lendenmann v. Principi, 3 Vet. App. 345 (1992). 38 C.F.R. § 4.86 provides for exceptional patterns of hearing impairment. When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hz) is 55 dBs or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. 38 C.F.R. § 4.86(a). Each ear is evaluated separately. Prior to June 24, 2019. Turning to the medical evidence, in an August 2012 VA examination, the Veteran reported that he had difficulty hearing in noisy environments and required visual cues in order to understand conversations. An audiological examination reflected puretone thresholds, in dBs, as follows:       HERTZ     1000 2000 3000 4000 RIGHT 30 25 25 25 LEFT 30 30 35 30 The average puretone thresholds were 26.25 dBs in the right ear and 31.25 dBs in the left ear. Word recognition scores were 80 percent in the right ear and 76 percent in the left ear. Applying the August 2012 findings to Table VI reveals numeric designations of Level III in both the right and left ears. The numeric designation in the right ear (Level III) along with the numeric designation for the left ear (Level III) reflect a noncompensable rating. In a subsequent January 2014 medical treatment note, a clinician further assessed the Veteran’s hearing loss. The Veteran described experiencing continued hearing loss, as well as tinnitus and dizziness. An audiological examination revealed puretone thresholds, in dBs, were follows:       HERTZ     1000 2000 3000 4000 RIGHT 30 35 30 35 LEFT 35 30 35 30 The average puretone thresholds were 32.50 dBs in both the right and left ears. Similarly, word recognition scores were 88 percent in both the right and left ears. Applying the January 2014 findings to Table VI reveals numeric designations of Level II in both the right and left ears. The numeric designation in the right ear (Level II) along with the numeric designation for the left ear (Level II) continue to reflect a noncompensable rating. In February 2016, the Veteran reported that he continued to have difficulty hearing and said that his symptoms had gradually worsened. The examiner indicated that the Veteran was expected to have limited difficulty with communication and diagnosed bilateral sensorineural hearing loss. An audiological examination revealed puretone thresholds, in dBs, as follows:       HERTZ     1000 2000 3000 4000 RIGHT 30 25 30 30 LEFT 30 30 40 35 The average puretone thresholds were 28.75 dBs in the right ear and 33.75 dBs in the left ear. Word recognition scores were 100 percent in the right ear and 92 percent in the left ear. Applying the August 2012 findings to Table VI reveals numeric designations of Level I in both the right and left ears. The numeric designation in the right ear (Level I) along with the numeric designation for the left ear (Level I) again reflect a noncompensable rating loss. Of note, the January 2014 and February 2016 clinicians both noted that their examinations were not adequate for rating purposes. As such, the January 2014 and February 2016 findings are afforded lesser probative value. Thus, the Board must predicate its determinations on the basis of the results of the audiology studies of record. Based on the results from the examination and evidence discussed above, the criteria for a compensable rating prior to June 24, 2019 for bilateral hearing loss have not been met. Therefore, the medical evidence does not support a compensable rating prior to June 24, 2019. Since June 24, 2019. In a June 24, 2019, VA audiological examination, the Veteran reported that he continued to have difficulty understanding conversation in noisy environments and that, as a result, he had trouble performing his job as a bus driver. Upon examination, the puretone thresholds in dBs were as follows:       HERTZ     1000 2000 3000 4000 RIGHT 30 35 35 40 LEFT 40 45 45 45 The average puretone thresholds were 35 dBs in the right ear and 43.75 dBs in the left ear. Word recognition scores were, at worst, 80 percent in the right ear and 74 percent in the left ear. Applying the June 2019 findings to Table VI reveals numeric designations of Level III in the right ear and Level IV in the left ear. The numeric designation in the right ear (Level III) along with the numeric designation for the left ear (Level IV) reflect a 10 percent rating. Therefore, the medical evidence does not support a higher rating for this period. The Board has considered lay statements. Lay witnesses, including the Veteran, are competent to describe hearing difficulty; however, their description of his service-connected disability must be considered in conjunction with the clinical evidence of record, as well as the pertinent rating criteria. In this regard, ratings are derived by a mechanical application of the rating schedule. Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). Thus, the Board must predicate its determinations on the basis of the results of the audiology studies of record. Based on the results from the examination and evidence discussed above, the criteria for higher ratings have not been met. The Board has considered whether referral for extra-schedular consideration is warranted. In exceptional cases where schedular ratings are found to be inadequate, consideration of an extraschedular evaluation is made. 38 C.F.R. § 3.321(b)(1); Thun v. Peake, 22 Vet. App. 111 (2008). In this case, the record does not establish that the rating criteria are inadequate. To the contrary, the very symptoms that the Veteran describes and the findings made by the various medical professionals, such as difficulty hearing, are “like or similar to” those explicitly listed in the rating criteria, which considers the level of hearing loss as tested in audiometric evaluations. Mauerhan, 16 Vet. App. at 443. Specifically, in the audiological examinations, the Veteran reported difficulty understanding conversations in noisy environments. In this regard, the rating criteria for hearing loss were last revised, effective June 10, 1999. See 64 Fed. Reg. 25,200 (May 11, 1999). In forming these revisions, VA sought the assistance of the Veteran’s Health Administration (VHA) in developing criteria that contemplated situations in which a veteran’s hearing loss was of such a type that speech discrimination tests may not reflect the severity of communicative functioning these veterans experienced or that was otherwise an extreme handicap in the presence of any environmental noise, even with the use of hearing aids. VHA had found through clinical studies of veterans with hearing loss that when certain patterns of impairment are present, a speech discrimination test conducted in a quiet room with amplification of the sounds did not always reflect the extent of impairment experienced in the ordinary environment. The decibel threshold requirements for application of Table VIA were based on the findings and recommendations of VHA. The intended effect of the revision was to fairly and accurately assess the hearing disabilities of veterans as reflected in a real life industrial setting. 59 Fed. Reg. 17,295 (April 12, 1994). Accordingly, the functional impairment due to hearing loss that is compounded by background or environmental noise is a disability picture that is considered in the current schedular rating criteria. Therefore, the Veteran’s struggle to understand conversations in noisy environments is a factor contemplated in the regulations and rating criteria as defined, and ratings are based on the overall severity and frequency of the disability, to include subjective complaints. Additionally, there is no indication that the average industrial impairment from his disability would be to such a degree as to warrant the assignment of higher ratings. Accordingly, referral for extra-schedular consideration is not in order. Cervical Strain The Veteran’s cervical spine strain has been rated under DC 5237. The Board will consider all relevant diagnostic codes. In order to warrant a higher rating, the evidence must show: • forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees (20 percent under DC 5237); • combined range of motion of the cervical spine not greater than 170 degrees (20 percent under DC 5237); • muscle spasms or guarding of the cervical spine severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis (20 percent under DC 5237); • intervertebral disc syndrome (IVDS) with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the 12 months prior to examination (20 percent under DC 5243); • unfavorable ankylosis of the entire cervical spine (40 percent under DC 5237); or • IVDS with incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the 12 months prior to examination (40 percent under DC 5243). Prior to July 3, 2019. In a June 2012 VA examination, the Veteran reported experiencing a cervical strain that began as a result of lifting objects and subsequently worsened. He described flare-ups of his cervical conditions that resulted in difficulty turning and said that his cervical disorder resulted in difficulty engaging in physical activities. Upon examination, the range of motion of the cervical spine was forward flexion to 45 degrees, extension to 30 degrees, right and left lateral flexion to 25 degrees each, and right and left lateral rotation to 50 degrees each. The combined range of his motion was 225 degrees. The examiner found that he did not have guarding, muscle spasms, or IVDS, and diagnosed a cervical strain. Based on the above, a rating in excess of 10 percent prior to July 3, 2019, is not warranted. In this regard, the forward flexion and combined range of motion of the cervical spine were measured at 45 and 225 degrees, respectively. Moreover, the June 2012 VA examination revealed that he did not have cervical IVDS or guarding or muscle spasms of his cervical spine. The clinical records were reviewed but do not reflect evidence inconsistent with the VA examination. As such, the medical evidence does not support a rating in excess of 10 percent for a cervical strain prior to July 3, 2019. Since July 3. 2019. In a July 3, 2019 VA examination, the Veteran reported that the symptoms of his cervical strain had gotten worse. He described severe, daily flare-ups of his neck that lasted all day, were precipitated by normal everyday activities, and were alleviated by rest. He said that his cervical spine disorder resulted in difficulty lifting heavy objects, difficulty with repetitive movement, and limited range of motion. Upon examination, the examiner diagnosed a cervical strain that prevented him from lifting more than 25 lbs. and found that he had no ankylosis or IVDS. In a subsequent June 2020 VA examination, the Veteran said that his neck always hurt and that turning his head from side to side and looking up were especially painful. While he denied radicular-type symptoms, he reported flare-ups. Upon examination, pain was noted on forward flexion, extension, left lateral flexion, and right lateral flexion that caused functional loss. Moreover, there was evidence of pain on weight-bearing. However, there was no evidence of pain on passive motion or in nonweight-bearing and his range of motion was normal. The examiner diagnosed a cervical strain with no ankylosis or IVDS. Based on the above, a rating in excess of 30 percent is not warranted for a cervical strain since July 3, 2019. To that end, the July 2019 and June 2020 examiners found that the Veteran had neither cervical ankylosis nor IVDS. The clinical records were reviewed and do not reflect evidence inconsistent with the VA examinations. As such, the medical evidence does not support a rating in excess of 30 percent for a cervical strain since July 3, 2019. Right Elbow Strain The Veteran’s right elbow strain has been rated under DC 5206 for limitation of flexion of the forearm. The Board will consider all relevant diagnostic codes. In order to warrant a higher rating, the evidence must show: • flexion of the forearm greater than 70 degrees, but not greater than 90 degrees (20 percent under DC 5206); • extension of the forearm greater than 60 degrees but not greater than 75 degrees (20 percent under DC 5207); or • forearm with flexion limited to 100 degrees and extension limited to 45 degrees (20 percent under DC 5208). The medical evidence revealed that the Veteran has not demonstrated ankylosis, a flail joint, joint fracture, malaligned fracture, impairment of supination or pronation, or a radial or ulnar impairment throughout the entire period on appeal. Accordingly, DCs 5205, 5209, 5210, 5211, 5212, and 5213 will not be considered. Prior to July 3, 2019. In an August 2012 VA examination, the Veteran reported experiencing a right elbow disorder originally characterized by stiffness and soreness that did not improve. He noted experiencing flare-ups of the elbow and forearm that were characterized by painful motion. Upon examination, the range of motion of the right elbow was flexion to 125 degrees and no limitation of extension. The examiner found that the Veteran experienced no additional loss of range of motion after repetitive use testing and that he had functional loss or impairment of his right elbow characterized by less movement than normal and pain on movement. The examiner noted that there was no ankylosis, a flail joint, joint fracture, or impairment of supination or pronation of his right elbow. The examiner diagnosed a right elbow strain, observing that right elbow supination ended at 85 degrees and pronation ended at 80 degrees. Based on the above, a rating in excess of 10 percent for a right elbow strain is not warranted prior to July 3, 2019. In this regard, the August 2012 VA examiner observed that the right elbow strain resulted in painful motion; however, the range of motion of the right elbow, at worst, included flexion to 125 degrees and no limitation of extension. The clinical records were reviewed but do not show any findings inconsistent with the VA examination. Accordingly, the medical evidence does not support a rating in excess of 10 degrees prior to July 3, 2019. Since July 3, 2019. In a July 3, 2019 VA examination, the Veteran reported that his right elbow disorder had worsened. He described severe daily flare-ups that were precipitated by normal everyday activities and alleviated by rest. He noted that his right elbow condition resulted in functional impairment or loss, to include difficulty lifting heavy objects and limited range of motion. Upon examination, the examiner observed that the Veteran had additional limitation of range of motion after repetitive use testing, repeated use over time, and with flare-ups that could all be measured in terms of range of motion. The examiner found that the range of motion of his right elbow was measured, at worst, as flexion to 90 degrees, extension ranging from 90 to 0 degrees, and forearm supination and pronation to 45 degrees each. The examiner offered that the range of motion did not contribute directly to functional loss and found evidence of pain that caused functional loss on extension, flexion, supination, and pronation. The examiner found no ankylosis, flail joint, joint fracture, or impairment of supination or pronation of his right elbow. The diagnosis was right elbow strain and noted that it impacted his ability to work as he had difficulty lifting more than 25 pounds. In a subsequent June 2020 VA examination, the Veteran described constant, worsening pain in his right elbow that he attributed to “getting older.” While he did not report experiencing flare-ups, he noted that his right elbow condition resulted in functional loss or impairment as it inhibited his ability to perform activities requiring heavy lifting. Upon examination, the examiner found that the range of motion of the Veteran’s right elbow was all normal. The examiner observed pain on flexion that caused functional loss and pain with weight-bearing. However, the examiner found that he had no crepitus and no pain on passive range of motion and while nonweight-bearing. The diagnosis was right elbow strain with no ankylosis, flail joint, joint fracture, ununited fracture, malaligned fracture, impairment of supination or pronation, or ulnar or radial impairment. Based on the above, the record supports a 20 percent rating, but no more, since July 3, 2019. In this regard, the flexion of the Veteran’s right wrist was measured, at worst, at no greater than 90 degrees. Accordingly, the evidence supports a 20 percent rating as of July 3, 2019. Nevertheless, a rating in excess of 20 percent is not warranted. In order to support a rating in excess of 20 percent, the evidence must show either flexion of the forearm limited to no greater than 70 degrees or extension of the forearm limited to 90 degrees at a minimum. The record reflects that the flexion of the Veteran’s elbow was greater than 70 degrees for the entire period on appeal. Further, the evidence does not show that the extension of the elbow was limited to no less than 90 degrees. Therefore, the evidence does not support a higher rating for the Veteran’s right elbow strain. Consideration has been given to assigning staged ratings for the disabilities discussed above. However, at no time during the periods in question have his disabilities warranted higher schedular ratings than those now assigned. Hart v. Mansfield, 21 Vet. App. 505 (2007). Service Connection Claims Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Finally, service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). Bilateral Inguinal Hernia Repair As an initial matter, the Veteran has been diagnosed with a disability stemming from his bilateral inguinal hernia repair. Specifically, an August 2012 VA examination diagnosed residuals of a bilateral inguinal hernia repair procedure. Therefore, a current diagnosis has been shown and the first element of service connection has been met. As to an in-service incurrence, the military personnel records establish that the Veteran had active service between October 1983 and October 1986 and multiple additional periods of active service since November 2001. The records reflect that between October 1986 and November 2001, he had further service in the Army and Air Force Reserves. His medical records reveal that on January 4, 1993, he underwent a bilateral inguinal hernia repair; however, the procedure did not occur during active duty. Moreover, personnel records do not establish that the procedure or the precipitating injury occurred during a period of ACDUTRA or INACDUTRA. To that end, his procedure took place in 1993. In the July 1986 separation examination, the period of active duty closest to his procedure, his abdomen and viscera were found to be clinically normal. He further reported in an associated July 1986 Report of Medical History that he did not then-presently or previously have a rupture or hernia. The record fails to otherwise document that an inguinal hernia or inguinal hernia procedure occurred during either active duty or a period of ACDUTRA or INACDUTRA. Accordingly, the second element of service connection – an in-service incurrence – has not been met and the medical evidence does not support service connection for the residuals of the Veteran’s bilateral inguinal hernia repair. LUE and RUE Radiculopathy In addition to the above, for a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during or contemporary to the pendency of the appeal. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). The record does not show that the Veteran had confirmed diagnoses of either LUE radiculopathy or RUE radiculopathy at any time during or contemporary to the pendency of the claim. To that end, August 2012 and July 2019 VA examiners diagnosed the Veteran with a cervical strain; however, neither examiner identified signs or symptoms of either LUE or RUE radiculopathy. Subsequently, a June 2020 VA examination again diagnosed a cervical strain and noted that the Veteran denied experiencing radicular-type symptoms. Ultimately, the medical evidence does not reflect a diagnosis of either LUE or RUE radiculopathy at any time during or contemporaneous to the pendency of his claims. Service connection may only be granted for a current disability. Brammer v. Derwinski, 3 Vet. App. 223 (1992). As there is no confirmed current diagnosis of either LUE or RUE radiculopathy at any time during the pendency of the appeal, service connection is not warranted, and the appeals are denied. Left Thumb A review of the record reveals that the Veteran fractured his left thumb in December 2001 while he was not on active duty; however, he underwent a surgical repair of the thumb in May 2002 during a period when he was on active duty. He now seeks compensation for ongoing pain as a result of the surgery. In an August 2012 VA examination, the Veteran was diagnosed with status/post left thumb reconstruction with residual pain. Therefore, a current diagnosis is shown. As to an in-service incurrence, the STRs reflect that he underwent surgical repair of the left thumb in May 2002. Therefore, an in-service incurrence has also been shown. As to a medical nexus, a reasonable reading of the medical evidence supports a finding that the left thumb surgery has caused residual pain but no functional limitation of motion. As noted, the August 2012 examiner diagnosed status/post left thumb reconstruction with pain suggesting that the pain was due to the reconstruction surgery. While the in-service surgery was meant to be ameliorative, it is apparent that the surgery has resulted in ongoing pain. Therefore, service connection is warranted and the appeal is granted. The Board has considered the Veteran’s lay statements regarding the etiology and current severity of the disorders addressed above. He is competent to report symptoms and describe his observations because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer opinions as to the etiology or identify a specific level of disability according to the appropriate diagnostic codes of any current disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the medical personnel who have examined the Veteran during his current appeal and who have rendered pertinent medical opinions in conjunction with the evaluations. The medical findings (as provided in the medical examinations and treatment notes) directly address the criteria under which his disabilities are evaluated. Moreover, as the clinicians have the requisite medical expertise to render medical opinions regarding the degree of impairment caused by the disabilities and had sufficient facts and data on which to base the conclusions, the Board affords the medical opinions great probative value. As such, these records are more probative than the lay statements that have been submitted. Based on the above, a rating of 20 percent, but no more, is granted as of July 3, 2019, for a right elbow strain and the appeals are otherwise denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Spigelman, 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.