Citation Nr: 21014493 Decision Date: 03/12/21 Archive Date: 03/12/21 DOCKET NO. 17-13 947A DATE: March 12, 2021 ORDER An initial rating in excess of 70 percent for posttraumatic stress disorder (PTSD) with alcohol use disorder is denied. An initial rating in excess of 30 percent for bilateral plantar fasciitis and calcaneal bone spurs (hereinafter bilateral foot disability) is denied. FINDINGS OF FACT 1. The severity, frequency, and duration of the Veteran’s psychiatric symptoms do not more closely approximate total occupational and social impairment. 2. The Veteran’s bilateral foot disability is manifested by no more than by pain on use, interference with standing, and lack of endurance. CONCLUSIONS OF LAW 1. The criteria for an initial rating in excess of 70 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9411. 2. The criteria for an initial rating in excess of 30 percent for bilateral foot disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.59, 4.71a, Diagnostic Code 5276. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1986 to June 2006. The Veteran has been granted a total disability rating for compensation based upon individual unemployability due to service-connected disabilities, effective May 12, 2017. Also, he has been awarded special monthly compensation under 38 U.S.C. § 1114, subsection (s) and 38 C.F.R. § 3.350(i) on account of PTSD with alcohol use disorder rated 100 percent and additional service-connected disabilities of herpes, independently ratable at 60 percent or more from May 12, 2017. This appeal comes before the Board of Veterans’ Appeals (Board) from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Veteran testified before the undersigned Veterans Law Judge (VLJ). A hearing transcript is associated with the record. In July 2020, the Board remanded the claims for further development. The Board finds that there has been substantial compliance with its prior remand. See Stegall v. West, 11 Vet. App. 268 (1998). During remand status, an October 2020 rating decision awarded the Veteran (1) service connection for migraine headaches with a 50 percent disability rating, effective March 20, 2014, (2) service connection for obstructive sleep apnea with a 50 percent disability rating, effective March 20, 2014, (3) a 60 percent disability rating for herpes, effective March 20, 2014, and (4) a 20 percent disability rating for hemorrhoids, effective March 20, 2014. This is a full grant of the benefits sought on appeal with regard to those claims, other than as to PTSD and bilateral foot disability, and there remains no controversy for the Board to consider. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997) (noting that a grant of service connection extinguishes appeals before the Board). See also AB v. Brown, 6 Vet. App. 35 (1993) (holding that claimants are presumed to seek the maximum available benefit for a disability). Here, the Veteran and his representative were advised that such were full grants of the benefits sought as they are the maximum schedular evaluations available and neither disagreed with such determination. See Appellate Brief (January 2021). Further, neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record, with regard to such claims. 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). Therefore, the Board finds that the scope of the appeal before the board no longer includes those matters. Conversely, the October 2020 rating decision granted the Veteran service connection for PTSD with a 70 percent disability rating, effective March 20, 2014, and a 30 percent disability rating for bilateral foot disability, effective March 20, 2014. Because these awards do not constitute full grants of benefits sought on appeal, the matters remain before the Board. See AB, supra. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.800(c). 38 U.S.C. § 7107(b). 1. Entitlement to an initial rating in excess of 70 percent for PTSD. The Veteran, and his representative, contends that a higher rating for PTSD is warranted, noting that his symptoms are worse than rated. See generally Hearing Transcript (November 2019); see also Appellate Brief (January 2021). The issue in this appeal is whether the Veteran’s associated symptoms caused the level of impairment required for a disability rating of 100 percent. The Board concludes that the Veteran’s symptoms did not cause the level of impairment required for a disability rating of 100 percent. The Veteran’s symptoms more closely approximated the symptoms associated with a 70 percent rating, and resulted in a level of impairment that most closely approximated the level of impairment associated with a 70 percent rating. Under the General Formula for Mental Disorders (General Formula), the Board must conduct a “holistic analysis” that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). A noncompensable rating is assigned when a mental condition has been formally diagnosed, but symptoms are not severe enough to either require continuous medication, or to interfere with occupational and social functioning. A 10 percent rating is assigned when mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of occasional stress, or symptoms controlled by medication cause occupational and social impairment. A 30 percent rating is assigned when symptoms such as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, or recent events), cause occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and normal conversation). A 50 percent rating is assigned when symptoms such as flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity. A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. A 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name. VA and private treatment records, the February 2015 and August 2020 VA examination reports, and the Veteran’s lay statements show that his PTSD was manifested by symptoms associated with a 70 percent rating (e.g. difficulty in adapting to stressful circumstance, including work or a worklike setting). The evidence additionally shows that his PTSD was manifested by symptoms associated with a 30 percent rating (e.g. depressed mood, anxiety, and chronic sleep impairment) and with a 50 percent rating (e.g. panic attacks more than once a week, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships). He also had symptoms that are not listed with a specific rating, such as occasional thoughts of small arms fire, irregular unwarranted verbal outbursts towards others and objects, feeling startled when hearing loud noises, avoidance from small-large crowds, and isolation from friends and family. The Board finds the severity, frequency, and duration of the Veteran’s unlisted symptoms more closely approximate the symptoms contemplated by a 50 or 70 percent rating, which are less severe, less frequent, and shorter in duration than those contemplated by a 100 percent rating. See 38 C.F.R. § 4.126. In this regard, the Veteran reported that these symptoms were not present daily, but would increase in severity on occasion or during a stressful or startling event, such as when he hears an unexpected loud sound or goes near crowds. Further, the symptoms of occasional thoughts of small arms fire and irregular unwarranted verbal outbursts towards others and objects are similar to panic attacks more than once a week; and difficulty in establishing and maintaining effective work and social relationships, which are contemplated by a 50 percent rating. Also, the symptoms of feeling startled when hearing loud noises, avoidance from small-large crowds, and isolation from friends and family are similar to near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; difficulty in adapting to stressful circumstances (including work or a worklike setting); and inability to establish and maintain effective relationships, which are contemplated by the assigned 70 percent rating. As stated above, a 100 percent rating is assigned when there is total occupational and social impairment from symptoms such as: Gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name. Report of VA examination, dated in February 2015, reflects that the Veteran’s PTSD was productive of occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication. His symptoms were depressed mood, anxiety, chronic sleep impairment, and disturbances of motivation and mood. The Veteran reported feeling startled whenever someone makes a loud noise; loss of interest in many activities; remaining on alert; and limited sleep. He additionally reported being very attached to his grandchildren. The examiner noted that the Veteran was dressed and groomed appropriately; he was pleasant and cooperative; showed no signs of psychomotor agitation or retardation; his speech was normal in tone, rate, and content; his thoughts appeared organized and logical; and that he denied suicidal and homicidal thoughts. The examiner additionally noted no evidence of psychosis, and that the Veteran’s affect was restricted and mood as slightly anxious. Report of VA examination, dated in August 2020, reflects that the Veteran’s PTSD was productive of occupational and social impairment with reduced reliability and productivity. His symptoms were depressed mood, anxiety, panic attacks more than once a week, chronic sleep impairment, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty adapting to stressful circumstances, including work or a work like setting. The Veteran reported avoiding loud areas, crowded areas, and having his back towards others/doorways in public. He additionally reported verbal outbursts towards others (seven to 14 times a week), violent outbursts towards objects (two times a week), and panic attacks lasting three to four minutes (about three to four times a week). The Veteran also denied experiencing current thoughts of wanting to harm himself or others. The examiner noted that the Veteran was married with three children and that his mental health symptoms have strained his relationship with his spouse and other family members; he additionally noted that the Veteran does not have any close friends in the area, but reported having one close friend who lives elsewhere. The report additionally shows that the Veteran has been unemployed since 2017; and was fired from his last job due to recurrent behavioral difficulties in the workplace. Lastly, the examiner noted that the Veteran’s affect appeared congruent with the topic of discussion and that he described his mood as sad and nervous. The above VA examination reports do not show complaints or findings for symptoms of the severity, frequency, or duration to more nearly approximate the criteria for a 100 percent evaluation for PTSD. When determining the appropriate disability evaluation to assign, the Board’s primary consideration is a veteran’s symptoms, but it must also make findings as to how those symptoms impact a veteran’s occupational and social impairment. Vazquez-Claudio, 713 F.3d at 112; Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). In this case, the evidence does not more nearly reflect severity, frequency, and duration of symptoms contemplated by the next higher evaluation. The Veteran’s other remaining symptoms were either contemplated by or more consistent with a 50 or 70 percent rating. Although his social relationships are at times strained, the overall medical and lay evidence reflects the Veteran as maintaining a relationship with his spouse, children, and grandchildren. The evidence additionally reveals the Veteran as being fully oriented and cooperative with his examinations; and as having a normal rate, rhythm and tone of speech. The Veteran, additionally, as evidenced in the VA examination reports, has not reported suicidal or homicidal ideation. As such, the medical and lay evidence of record does not reflect: A preclusion of functioning both mentally and behaviorally on a daily basis, causing total occupational and social impairment; psychiatric symptoms productive of a danger of physical harm to the Veteran or others; gross impairment of the Veteran’s cognitive functions and behavior; the preclusion of simple activities of daily living (such as maintaining minimal personal hygiene); or a level of symptoms that reflect an increased loss of touch with reality. The Board has considered a November 2019 private examination report (Disability Benefits Questionnaire on PTSD), which reflects that the Veteran’s symptoms were productive of occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking and/or mood. It lists the Veteran symptoms to include those encompassed by the 100 percent schedular rating criteria: Gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, persistent danger of hurting self or others, intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene), memory loss for names of close relatives, own occupation, or own name. Additionally, the report notes suicidal ideation, which is similar to persistent danger of self-harm, which is contemplated by the 100 percent criteria. Bankhead, 29 Vet. App. at 19. However, as noted in the July 2020 Board remand, the examination report is inadequate because it is not shown to be based on an accurate factual premise with consideration of the Veteran’s prior medical history. Ardison v. Brown, 6 Vet. App. 405, 407 (1994). Nevertheless, even if the Board was to find the examination report adequate, the Board still finds the report less than credible as it is inconsistent with the other evidence of record. See Pond v. West, 12 Vet. App. 341 (1999). For instance, an October 2019 treatment record, contemporaneous with the private examination report, reveals that the Veteran reported that he is able to take care of himself, no difficulty concentrating, remembering, or making decisions; the examiner found him to have good judgment, normal mood and affect. Additionally, the treatment record shows that the Veteran was assessed as alert and oriented x 3 – which is medical shorthand for finding the patient as responsive to his environment (i.e. alert), and knows who he is, where he is, and the approximate time. Lastly, the treatment record notes that the Veteran was found to have normal recent and remote memory. Moreover, in October 2019, the Veteran filled out a mental health questionnaire, in which, he did not report any of the above symptoms found in the private examination report. Additionally, the mental health questionnaire reveals that the Veteran reported not feeling sad, empty, or depressed. The private examination report, however, does not show a discussion or clarification on the contrary findings in the Veteran’s treatment records. Therefore, in consideration of the above, coupled with the report’s inconsistent and uncorroborated findings when compared to the Veteran’s treatment records and VA examination reports, the Board finds the November 2019 private examination report less than credible. See Fed. R. Evid. 803(7) (indicating that the absence of an entry in a record may be evidence against the existence of a fact if such a fact would ordinarily be recorded). The Board accepts that the Veteran believes his symptoms warrant a rating in excess of 70 percent. However, whether a disability meets the schedular criteria for the assignment of a higher evaluation is a factual determination by the Board based on the Veteran’s complaints coupled with the medical evidence. Both the lay and medical evidence are probative in this case. Although the Veteran may believe that he meets the criteria for the next higher disability rating, his complaints along with the medical findings do not meet the schedular requirements for higher evaluations than now assigned, as explained and discussed above. The Board assigns greater probative value to the competent, credible medical evidence, to include the February 2015 and August 2020 PTSD examination reports, as they were prepared by skilled, neutral medical professionals after evaluating the Veteran and review of the record. In summary, the severity, frequency, and/or duration of symptoms, individually or collectively, shown by the record do not more nearly reflect the type contemplated by the schedular criteria for an evaluation in excess of 70 percent for PTSD. Staging of the PTSD rating is not warranted as the factual findings show no distinct period where the disability exhibited symptoms that would warrant higher evaluations than assigned. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). Accordingly, the claim is denied. As the evidence of record is not roughly in equipoise, there is no doubt to resolve. 38 U.S.C. § 5107(b). 2. Entitlement to an initial rating in excess of 30 percent for bilateral foot disability. The Veteran, and his representative, contends that a higher rating for bilateral foot disability is warranted. In this regard, the Veteran testified that his foot disability has limited his ability to stand for prolonged periods of times. See generally Hearing Transcript (November 2019); see also Appellate Brief (January 2021). Throughout the appeal period, the Veteran’s bilateral foot disability has been rated pursuant to 38 C.F.R. § 4.71a, Diagnostic Code 5276. Prior to February 7, 2021, the Veteran’s disability was not specifically listed in the VA Schedule for Rating Disabilities (hereinafter Rating Schedule); therefore, it was rated analogous to a disability in which not only the functions affected, but anatomical localization and symptoms, are closely related. However, during the pendency of the appeal, the rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. § 4.71a were amended, effective February 7, 2021. 85 Fed. Reg. 230 (Nov. 30, 2020). These amendments revised select diagnostic codes “to ensure that this portion of the rating schedule uses current medical terminology and provides detailed and updated criteria for the evaluation of musculoskeletal disabilities.” Id. If 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. 38 U.S.C. § 5110(g). If the revised version of the regulation is more favorable, the implementation of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. If the former version is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. 38 U.S.C. § 5110. In this instance, the amendments added Diagnostic Code 5269 (plantar fasciitis), which is the Veteran’s specific disability. See C&P Exam (October 2020). Therefore, the Board will consider the Veteran's claim under the old criteria prior to February 7, 2021, and both the old and new rating criteria from February 7, 2021. The criteria that is more favorable to the Veteran will be applied. Pursuant to Diagnostic Code 5269, for plantar fasciitis, the highest schedular rating available is 30 percent. 38 C.F.R. § 4.71a, Diagnostic Code 5269. Thus, the Veteran cannot receive a higher rating than his currently assigned 30 percent rating under Diagnostic Code 5276, and this Diagnostic Code consequently will not be discussed further in this decision. Next, pursuant to Diagnostic Code 5276, for acquired flatfoot, a noncompensable rating is warranted for mild acquired flatfoot; symptoms relieved by built-up shoe or arch support. A 10 percent rating is warranted for moderate acquired flat foot; weight-bearing line over or medial to great toe, inward bowing of the tendo achillis, pain on manipulation and use of the feet, bilateral or unilateral. A 20 percent rating is assigned for severe unilateral acquired flat foot; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 30 percent rating is warranted for severe bilateral acquired flat foot; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 30 percent rating is also warranted for pronounced unilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. A maximum 50 percent rating is warranted for bilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, Diagnostic Code 5276. The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, even in the absence of arthritis, to include in situations where the disability at issue is not evaluated based on range of motion measurements. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011); Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). The Board finds that the preponderance of the evidence is against a rating in excess of 30 percent for bilateral foot disability. The Board acknowledges the Veteran’s lay reports of symptoms and that there was functional loss due to pain, pain during flare-ups, and pain during repetitive use over time. However, even considering the Veteran’s lay reports of symptoms and functional loss, the degree of additional limitation reflected by the statements that his feet swell, and pain intensifies, weekly, would not result in symptoms more nearly approximating pronounced bilateral acquired flatfoot. A February 2015 VA examination report reflects that the Veteran described his foot pain as “throbbing pain in soles of feet.” He did not report flare-ups that impact the function of the feet. The report of examination reveals no evidence of marked pronation of one foot or both feet; extreme tenderness of plantar surfaces on one or both feet; or marked inward displacement and severe spasm of the Achilles’ tendon (rigid hindfoot) on manipulation of one or both feet. The report of examination additionally notes that bilateral foot x-ray reports ruled out degenerative joint disease. VA examination report, dated in October 2020, likewise, shows that the Veteran reported bilateral foot pain, which he described as a “steady burning pain in the bottom of both feet.” The Veteran reported flares, which he described as pain intensifying and feet swelling. He additionally stated that this occurred weekly, lasting one to two days, and rated the pain as 10/10. The report of examination also shows that the Veteran reported difficulty with prolonged standing and walking; and difficulty wearing particular types of footwear, such as dress shoes or sandals. On examination, the report reveals no evidence of: Marked pronation of one foot or both feet, extreme tenderness of plantar surfaces on one or both feet, or marked inward displacement and severe spasm of the Achilles’ tendon (rigid hindfoot) on manipulation of one or both feet. The Board notes a November 2019 private examination report, in which, the Veteran reported, among other things, not being able to walk, run, or stand for long periods of time due to bilateral foot symptomology. The report, nevertheless, does not show evidence of marked pronation of one foot or both feet, extreme tenderness of plantar surfaces on one or both feet, or marked inward displacement and severe spasm of the Achilles’ tendon (rigid hindfoot) on manipulation of one or both feet. The evidence of record, overall, does not reflect that the Veteran’s bilateral foot disability symptomatology more nearly approximated bilateral pronounced flatfoot manifested by marked pronation, extreme tenderness of plantar surfaces of the feet, and marked inward displacement and severe spasm of the tendo achillis on manipulation, and where the condition is not improved by orthopedic shoes or appliances. Indeed, the examination reports, private and VA, reveal no evidence of marked deformity, marked pronation, “inward bowing,” marked inward displacement, or severe spasm. The Veteran’s reported use of night splints indicate that he remained symptomatic with their use, but also reported no extreme tenderness of the plantar surfaces of either foot. The preponderance of the evidence thus reflects that the Veteran’s service-connected bilateral foot disability does not more nearly approximate the criteria for a higher, 50 percent rating under Diagnostic Code 5276. Both the lay and medical evidence are probative here. However, whether a disability has worsened sufficiently to meet the schedular criteria for the assignment of a higher evaluation is a factual determination by the Board based on the Veteran’s complaints coupled with the medical evidence. Although the Veteran believes he meets the criteria for a higher disability rating, his complaints and the medical findings do not meet the schedular requirements for a higher evaluation, as explained and discussed above. It is noted that there is no contention of limited motion of either foot, or medical evidence of arthritis, but rather pain and swelling associated with the plantar fasciitis—the functional effect being limited walking and standing. Hence, as the rating is not based on limitation of motion, 38 C.F.R. § 4.40 and 38 C.F.R. § 4.45 are not for application. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Further, although under 38 C.F.R. § 4.59, painful motion is a factor to be considered, the current disability rating contemplates the associated pain and swelling symptoms. See Burton, 25 Vet. App. 1. Absent competent, credible evidence showing marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances, the Board finds that the evidence does not more nearly reflect the functional equivalent of bilateral pronounced flatfoot. The Board has considered whether a higher disability evaluation is available under any other potentially applicable provision of the Rating Schedule. However, as of February 7, 2021, the Veteran’s disability is specifically listed under the Rating Schedule and therefore cannot be rated under a different Diagnostic Code. Additionally, the evidence of record does not reflect that the Veteran has any other service-connected foot disabilities that would warrant a separate rating under a different Diagnostic Code. For instance, a higher rating is not warranted under Diagnostic Code 5278, as the medical evidence does not demonstrate that the service-connected disability is manifested by claw foot (pes cavus). See 38 C.F.R. § 4.71a, Diagnostic Code 5278. It noted that neither the Veteran, nor his representative, have contended that the VA foot examinations are inadequate to evaluate the Veteran’s foot disability because they did not comply with range of motion testing requirements outlined in 38 C.F.R. § 4.59 and Correia v. McDonald, 28 Vet. App. 158, 169-70 (2016). See Southhall-Norman v. McDonald, 28 Vet. App. 346, 354 (2016) (an adequate examination requires range of motion testing for any disability involving painful joints, even when the evaluation is not predicated on range of motion measurements). Further, remand for compliance is not warranted because neither the lay nor the medical evidence indicates that the Veteran’s foot condition involved two or more joints or that there is arthritis of either foot. Also, as to the bones and ligaments, because the competent medical evidence of record shows that the Veteran’s foot disorder was not manifested by marked deformity of one or both feet (pronation, abduction, etc.), and because the lay evidence is negative for complaints of functional impairment due to limitation of motion, remand would serve no useful purpose. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991). As the evidence of record shows no distinct period where the disability exhibited symptoms that would warrant higher evaluations than assigned, there is no basis to stage the rating. See Hart, 21 Vet. App. 505. See Fenderson, 12 Vet. App. at 126. Accordingly, the claim is denied. There is no doubt to resolve. 38 U.S.C. § 51074(b). C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Griffey, 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.