Citation Nr: 21015758 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 15-42 743A DATE: March 18, 2021 ORDER Entitlement to an evaluation in excess of 20 percent for degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis is denied. Entitlement to an evaluation in excess of 10 percent prior to September 23, 2019 for right lumbar radiculopathy of the sciatic nerve is denied. Entitlement to an evaluation in excess of 20 percent from September 23, 2019 for right lumbar radiculopathy of the sciatic nerve is denied. Entitlement to an initial evaluation in excess of 20 percent for right lumbar radiculopathy of the femoral nerve is denied. REMANDED Entitlement to a total disability rating based on individual unemployability due to service-connected disability (TDIU) is remanded. FINDINGS OF FACT 1. Throughout the appeal period, the most probative evidence of record reflects, the Veteran’s degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis was manifested by pain and other symptoms productive of limitation of forward flexion of the thoracolumbar spine, at worst, to 35 degrees and combined range of motion of 90 degrees. 2. For the appeal period prior to September 23, 2019, the most probative evidence of record reflects, the Veteran’s right lumbar radiculopathy of the sciatic nerve was manifested by symptoms productive of no more than mild incomplete nerve paralysis. 3. For the appeal period from September 23, 2019, the most probative evidence of record reflects, the Veteran’s right lumbar radiculopathy of the sciatic nerve was manifested by symptoms productive of no more than moderate incomplete nerve paralysis. 4. Throughout the initial appeal period, the most probative evidence of record reflects, the Veteran’s right lumbar radiculopathy of the femoral nerve was manifested by symptoms productive of no more than moderate incomplete nerve paralysis. CONCLUSIONS OF LAW 1. Throughout the appeal period, the criteria for a rating in excess of 20 percent for degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.71a, DC 5242. 2. For the appeal period prior to September 23, 2019, the criteria for a rating in excess of 10 percent for right lumbar radiculopathy of the sciatic nerve have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 3. For the appeal period from September 23, 2019, the criteria for a rating in excess of 20 percent for right lumbar radiculopathy of the sciatic nerve have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520. 4. Throughout the initial appeal period, the criteria for a rating in excess of 20 percent for right lumbar radiculopathy of the femoral nerve have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8526. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from January 1978 to August 1978. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a March 2015 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). Further, the Board recognizes, that the Veteran, in his March 2015 notice of disagreement (NOD) as to the March 2015 rating decision, checked the boxes indicating disagreement with the awards of service connection for his degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis and right lumbar radiculopathy of the sciatic nerve, rather than disagreement with the evaluations assigned for these disabilities. However, he also specifically stated a 40 percent rating was sought for his degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis and 30 percent rating was sought for right lumbar radiculopathy of the sciatic nerve, and as the evidence of record shows VA liberally construed his disagreement with the evaluations assigned for these disabilities and performed subsequent actions addressing the appeals as such, the Board will recognize these issues as on appeal. Percy v. Shinseki, 23 Vet. App. 37, 46 (2009). This case previously before the Board in January 2019. In January 2019, the Board remanded the Veteran’s claims increased ratings for degenerative arthritis of the lumbar spine with L5/S1spondylolisthesis and right lower extremity lumbar radiculopathy for further development. They now return for appellate review. During the pendency of the appeal for a higher rating for the Veteran’s right lower extremity lumbar radiculopathy of the sciatic nerve, a May 2020 rating decision granted a 20 percent evaluation effective September 23, 2019. Because this higher evaluation does not represent a grant of the maximum benefits allowable under the VA Schedule for Rating Disabilities, the Veteran’s appeal as to this issue remains in appellate status. AB v. Brown, 6 Vet. App. 35, 38 (1993) (holding that a grant of a higher rating during the course of an appeal, but less than the maximum benefits allowable, does not abrogate the appeal). The May 2020 rating decision also, in pertinent part, assigned a separate 20 percent evaluation right lumbar radiculopathy of the femoral nerve, effective September 23, 2019. The Board notes that the Veteran did not appeal the propriety of the assigned effective date or rating for this disability. However, the issue of an increased initial rating for this disability was included in the August 2020 supplemental statement of the case, as part and parcel of the Veteran’s claim for a higher rating for his service-connected back, and thus, has been included on the title page of this decision. In December 2018, the Veteran presented testimony at a video conference hearing before the undersigned Veterans Law Judge. A transcript of this hearings is associated with the claims file. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the United States Court of Appeals for Veterans Claims (Court) held that a TDIU claim is part of an increased rating claim when such claim is raised by the record. During the pendency of the Veteran’s claim for increased ratings for his back and right lower extremity disabilities, specifically in an October 2020 post remand brief, the Veteran’s representative reported the Veteran believed he was unable to work due to his disabilities at issue herein. Thus, the Board concludes that the Court’s holding in Rice is applicable, and the TDIU claim is properly before the Board. Increased Rating Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. VA must consider whether to “stage” the rating, meaning assign different ratings at different times during the rating period to compensate the Veteran for times when the disability may have been more severe than at others. Consideration of the appropriateness of a staged rating is required for increased rating claims, irrespective of whether it is an initial rating at issue or instead an established rating. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2008). 1. Entitlement to an evaluation in excess of 20 percent for degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis The Veteran contends that he is entitled to higher rating for his degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis. Specifically, in December 2018 testimony, the Veteran reported, as to his back disability, he had a limited range of motion with turning and bending, and that that with sitting, squatting, or rising from a lying prone position, he took longer to complete these actions. He also testified he had daily chronic pain, that he could not walk further than a block or less than a quarter of a mile, and could stand 10 to 15 minutes. He further testified he had issues with weight-bearing and with stiffness, especially during cold weather. In order to determine the appeal period for consideration, a discussion of the procedural history this claim is necessary. On October 18, 2013, VA received an application from the Veteran with a claim for an increased rating for his service-connected back disability. A March 2014 rating decision, in pertinent part, continued a 20 percent rating for the Veteran’s degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis. No new and material evidence was received within a year of that decision that suggested higher ratings were warranted, so it is final. On February 10, 2015, the Veteran requested filed another claim for an increased rating. A March 2015 rating decision, in pertinent part, readjudicated the claim and continued a 20 percent rating for the Veteran’s degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis. The Veteran expressly appealed the March 2015 rating decision later in March 2015. Following issuance of a statement in November 2015, a substantive appeal was timely received within 60 days thereafter. Thus, the rating period for consideration on appeal with respect degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis, pursuant to the re-adjudication, is from the date of the Veteran’s increased rating claim received on February 10, 2015. Thus, the rating period for consideration on appeal is from one year prior to the date of receipt of the February 10, 2015 claim for increase, if it is factually ascertainable that an increase occurred during that period. The Veteran’s degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis is rated under 38 C.F.R. § 4.71a, DC 5242. Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or the combined range of motion 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 rating is warranted for forward flexion of the thoracolumbar spine to 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. A 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. Additionally, during the pendency of the appeal, VA revised the portion of the VA Schedule for Rating Disabilities that addresses the musculoskeletal system. Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020) (to be codified at 38 C.F.R. § 4.71a). The final rule went into effect February 7, 2021; however, the rating criteria for DC 5242, and under which the Veteran’s degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis disability is rated was unchanged by the amendments. However, DC 5242 was characterized as degenerative arthritis of the spine under the old regulation, and was changed to degenerative arthritis, degenerative disc disease other than Intervertebral Disc Syndrome (IVDS), under the new regulation, nonetheless, as discussed, this is rated under the same unchanged criteria. Further, to the extent the Veteran may have had other lumbar spine diagnoses at any point during the appeal period, the Board will consider all findings of non-distinct symptomology as attributed to the Veteran’s service-connected degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis. Mittleider v. West, 11 Vet. App. 181, 182 (1998). Also, any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1. Ankylosis is defined as “immobility and consolidation of a joint due to disease, injury, or surgical procedure.” Dorland’s Illustrated Medical Dictionary, 94 (32nd ed. 2012). Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Id. at Note 5. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (“[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran’s disability, after which a rating is determined based on the § 4.71a criteria.”). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia v. McDonald, 28 Vet. App. 158 (2016), the United States Court of Appeals for Veterans Claims (Court) held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing “for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint.” The spine has no opposite joint. In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination. After careful review of the evidence, the Board finds the symptoms of the Veteran’s service-connected back disability are insufficient to support a rating in excess of 20 percent at any point during the appeal period. A March 2014 VA examiner found the Veteran had thoracolumbar spine flexion to 65 degrees, reduced to 50 degrees with pain, and combined range of motion of 190 degrees, reduced to 170 degrees with pain, and with no additional loss of range of motion with repetitive motion. The Veteran also submitted an October 2017 examination report from a VA medical provider, which also noted, in part, that the Veteran had very limited range of motion but did not provide range motion finding in degrees and further noted he was not assessed with a goniometer. A September 2019 VA examiner found the Veteran had thoracolumbar spine flexion to 35 degrees, and combined range of motion of 90 degrees, and with no additional loss of range of motion with repetitive motion. These findings do not satisfy the rating criteria for the next higher evaluation of forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. Additionally, the Veteran’s medical records do not demonstrate symptomology productive of a higher evaluation. A February 2014 VA treatment record noted the Veteran had chronic low back pain, had received a new back brace and was to continue medication. A December 2016 VA treatment record documented the Veteran had a history of chronic low back pain for many years and left knee pain for a year and that that he reported adequate pain control on the current regimen. A February 2017 VA treatment record documented the Veteran reported pain in his low back, right leg and left knee described achy, dull, sharp, and stiff, which was worsened by sitting for a long time and improved by medications, walking, and a home exercise program. Also, an October 2017 VA treatment record documented, in part, the Veteran very limited thoracolumbar spine range of motion due to pain, but did not provide any findings in degrees. Additionally, more recently, an April 2019 VA treatment record documented, in part, the Veteran complained low back pain and stiffness was affecting his daily function. A May 2019 VA treatment record documented the Veteran reported low back pain, which he described as aching and throbbing. Another May 2019 VA treatment record documented the Veteran reported he had low back pain shooting down his leg. A July 2019 VA treatment record, documenting a group therapy session, titled Living Well with Chronic Pain Group, noted the Veteran shared that he loved to do yard work, but this sometimes contributed to pain flares. Another July 2019 VA treatment record documented, as to the Veteran’s musculoskeletal system, he had no muscle atrophy, no weakness, and good range of motion. Also, June 2017, October 2017, August 2019 and March 2020 VA treatment records also noted the Veteran had symptomatic lumbar degenerative disc disease and had some improvement with physical therapy but also noted other treatments were not successful. Accordingly, the Board finds that the preponderance of the evidence is against a rating in excess of 20 percent for the Veteran’s lumbar spine disability at any point during the appeal period. The Board acknowledges the Veteran’s lay reports of symptoms and that there was functional loss due to pain and other symptoms, to include pain walking about a city block and when rising from a prolonged seated position, intense and constant dull pain which progressed to a sharp pain, that his disability affected bending, stooping, squatting, twisting, that he had less movement than normal, pain on movement, disturbance of locomotion, interference with sitting, standing and/or weight bearing, and weakened movement due to muscle or of peripheral nerves, etc., that he had muscle spasm, was afraid of falling, that he could not sit up straight and had to sit on his left side, and that he had flares-up with bending, flare-ups which resulted in an inability to do certain things like bending and/or squatting, and that he flare-ups with tingling and numbness shooting down his right leg. However, even considering the Veteran’s lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the Veteran’s statements that would not result in limitation of motion more nearly approximating forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. In this regard, the March 2014 VA examiner found the Veteran reported constant pain but did not report flare-ups impacted the function of the thoracolumbar spine and the September 2019 VA examiner found the Veteran did not have additional loss of range of motion with repetitive motion. Further, while the September 2019 VA examiner found the Veteran had less movement than normal due to ankylosis, limitation or blocking, adhesions, etc., the examiner also further explained as to this finding (and as to the finding of weakened movement due to muscle or of peripheral nerves, etc.), that the Veteran had pain, weakness and loss of motion that contributed to disability, thus this finding is not inconsistent with the finding of no ankylosis. Thus, a higher rating based on the September 2019 VA examiner’s finding less movement than normal due to ankylosis, limitation or blocking, adhesions, etc., is not warranted. Moreover, the September 2019 found the Veteran’s pain and weakness significantly limited functional ability with repeated use over a period of time resulting thoracolumbar spine flexion to 35 degrees, and combined range of motion of 90 degrees. The September 2019 also found the Veteran’s pain and incoordination significantly limited functional ability with flare-ups resulting thoracolumbar spine flexion to 35 degrees, and combined range of motion of 90 degrees. Accordingly, a rating in excess of 20 percent is not warranted. Other considerations Concerning the range of motion findings of the Veteran’s lumbar spine disability throughout the appeal period, the Board notes that the September 2019 VA examiner found there was objective evidence of pain when the Veteran’s back was used in non-weight bearing but found range of motion could not be performed or was not medically appropriate. The September 2019 VA examiner also found there was no objective evidence of pain on passive range of motion testing. Moreover, in a June 2020 addendum opinion, the September 2019 VA examiner also estimated, based review of the March 2014 examination report, that at the time, as to active motion with pain on weight bearing, the Veteran would have had thoracolumbar spine flexion to 65 degrees, and combined range of motion of 190 degrees. Also, in the June 2020 addendum opinion, as to passive motion testing, the examiner was unable to provide an estimate, without resorting to mere speculation, as passive motion testing was not performed. Consideration has also been given to assigning a rating under DC 5243, defined as IVDS prior to the February 7, 2021 amendment, and as disc herniation with compression and/or irritation of the adjacent nerve root thereafter, under the formula for rating IVDS based on incapacitating episodes. However, the Veteran did not have IVDS prior to February 7, 2021, nor IVDS or disc herniation with compression and/or irritation of the adjacent nerve root thereafter, and the evidence of record is against a finding that the Veteran was ever prescribed bed rest by a physician for a duration that meets the criteria for a higher rating. See 38 C.F.R. § 4.71a. Specifically, June 2012, March 2014, and September 2019 VA examiners found the Veteran did not have IVDS of the thoracolumbar spine. Regarding neurological impairment, the Veteran has already been granted service connection for radiculopathy of the right lower extremity as to the femoral nerve and the sciatic nerve, and the lay and medical evidence of record is against a finding that the Veteran has any other neurological abnormality associated with his spine disability. Specifically, the June 2012, March 2014, October 2017, and September 2019 VA examiners found the Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy of the left lower extremity. Further, in December 2018 testimony, the Veteran described he had a left knee problem but that he not experience weakness, numbness, and tingling in his left leg coming from his back. Additionally, June 2012, March 2014, October 2017, and September 2019 VA examiners found the Veteran did not have any other neurologic abnormalities or finding related to a thoracolumbar spine condition (such as bowel or bladder problems/pathologic reflexes). An April 2019 VA treatment record noted the Veteran denied bowel or bladder dysfunction. Further, February 2017 and September 2019 VA treatments record also noted, in part, the Veteran denied incontinence of the bowel or bladder. Further, while the Veteran, as a layperson, is competent to report the symptoms he has experienced; however, he has not been shown to have the requisite knowledge or training to be deemed competent to identify a specific level of disability for his lumbar spine disability according to the rating criteria. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Such competent evidence concerning the nature and extent of the Veteran’s lumbar spine disability has been provided by the March 2014 and September 2019 VA examiners’ findings which directly address the criteria under which the Veteran’s spine disability is evaluated. The Board finds the March 2014 and September 2019 VA examiners’ findings to be competent, objective, and probative evidence of record, and are therefore accorded greater weight than the Veteran’s subjective complaints of symptomatology for his lumbar spine disability. Additionally, neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record with his respect to his lumbar spine disability. See Doucette v. Shulkin, 28 Vet. App. 366 (2017). Based on the foregoing, the preponderance of the evidence is against the Veteran’s claim for a rating in excess of 20 percent for degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis. In making this determination the Board considered the application of “staged” ratings, but found no additional distinctive periods where the Veteran’s service-connected back disability met or nearly approximated the criteria for a higher rating other than that already granted. In reaching this decision the Board considered the doctrine of reasonable doubt; however, to the extent the preponderance of the evidence is against a rating higher than, or separate from, that already assigned for the Veteran’s degenerative arthritis of the lumbar spine with L5/S1 spondylolisthesis, the doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 2. Entitlement to an evaluation in excess of 10 percent prior to September 23, 2019 for right lumbar radiculopathy of the sciatic nerve 3. Entitlement to an evaluation in excess of 20 percent from September 23, 2019 for right lumbar radiculopathy of the sciatic nerve 4. Entitlement to an initial evaluation in excess of 20 percent for right lumbar radiculopathy of the femoral nerve The Veteran contends he is entitled to higher ratings for his lumbar radiculopathy of the right sciatic nerve and right femoral nerve. Specifically, in December 2018 testimony, the Veteran described constant numbness and tingling in his right lower extremity. As discussed above, service connection for the Veteran’s right lumbar radiculopathy of the femoral nerve has been awarded effective from September 23, 2019 and his right lumbar radiculopathy of the sciatic nerve has been inferred as part of his increased rating claim for his service-connected back disability, which stemmed from an February 2015 claim for increase. As such the period for consideration for the Veteran’s right lumbar radiculopathy of the femoral nerve is from September 23, 2019 and his right lumbar radiculopathy of the sciatic nerve is from one year prior to the date of receipt of the February 2015 claim for increase, if it is factually ascertainable that an increase occurred during that period. Throughout the respective appeal periods, the Veteran’s right lumbar radiculopathy of the sciatic nerve has been rated under DC 8520 and right lumbar radiculopathy of the femoral nerve has been rated under DC 8526. Paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, DC 8520. (Neuritis and neuralgia of that group are evaluated under DCs 8620 and 8720). Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R. § 4.124a. Paralysis of the anterior crural nerve (femoral) is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, DC 8526. (Neuritis and neuralgia of that group are evaluated under DCs 8626 and 8726). Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Severe incomplete paralysis is rated as 30 percent disabling. Complete paralysis of the quadriceps extensor muscles is rated as 40 percent disabling. Id. The words “mild,” “moderate,” and “severe” as used in the various DCs are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. 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. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at “Diseases of the Peripheral Nerves.” The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). In rating peripheral nerve disability, neuritis, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete paralysis. The maximum rating to be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate incomplete paralysis, or with sciatic nerve involvement, for moderately severe incomplete paralysis. 38 C.F.R. § 4.123. Neuralgia, cranial or peripheral, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, can receive a maximum rating of moderate incomplete paralysis, except for tic douloureux or trifacial neuralgia, which may be rated up to complete paralysis. 38 C.F.R. § 4.124. Right sciatic nerve prior to September 23, 2019 Turning to the evidence of record for the appeal period prior to September 23, 2019, proximate to the appeal period, in a back conditions disability benefits questionnaire, a March 2014 VA examiner found the Veteran did have involvement of his right L4/L5/S1/S2/S3 nerve roots (sciatic nerve) but also indicated neither lower extremity had radiculopathy. However, the March 2014 VA examiner also completed a peripheral nerves conditions disability benefits questionnaire, with more specific findings. In peripheral nerves conditions disability benefits questionnaire, the March 2014 VA examiner found endorsed a diagnosis of sciatic neuropathy and found the Veteran, ast worst, did not have parenthesis and/or dysesthesias or numbness, but he did have mild constant pain (may be excruciating at times) and mild intermittent pain (usually dull). An October 2017 examiner, via an examination report submitted by the Veteran from a VA medical provider, found the Veteran had severe radiculopathy of the right lower extremity but did not provide any indication as to the specific nerve root that this finding applied to. Further, the October 2017 examiner’s finding of severe right lower extremity radiculopathy is inconsistent with the other findings endorsed by the examiner of moderate constant pain (may be excruciating at times), and no paresthesias and/or dysesthesias or numbness. Also, the October 2017 examiner did not provide any findings as to intermittent pain (usually dull) or dull pain (subjective symptoms). Further, the October 2017 VA examiner’s findings are inconsistent with the prior March 2014 VA examiner’s findings of mild symptomology and subsequent September 2019 VA examiner’s findings of moderate symptomology. Thus, as the October 2017 examiner’s findings are incomplete and inconsistent with internal findings and other examiners’ findings, the October 2017 examiner’s findings lack probative value. Additionally, the clinical treatment records prior to September 23, 2019 are largely consistent with the findings endorsed by the March 2014 VA examiner and do not demonstrate additional symptoms associated with the Veteran’s service-connected right lumbar radiculopathy of the sciatic nerve and applicable to the rating criteria that would warrant a higher evaluation. For example, a February 2017 VA treatment record described the Veteran reported pain in his right leg, starting in the lumbar area shooting down the leg to the ankle. Thus, weighing the evidence prior to September 23, 2019, the Board finds Veteran’s symptoms of right lumbar radiculopathy of the sciatic nerve more closely approximate the evaluation of 10 percent, for mild incomplete paralysis of the sciatic nerve, under DC 8520. In this regard, as discussed, the March 2014 VA examiner also found, as to the Veteran’s right lower extremity, he had, at worst, mild constant pain (may be excruciating at times) and mild intermittent pain (usually dull), which are consistent with a 10 percent rating under DC 8520. Right sciatic nerve and right femoral nerve from September 23, 2019 Turning to the evidence of record for the Veteran’s right lumbar radiculopathy of the sciatic nerve and his right lumbar radiculopathy of the femoral nerve, each for the appeal period from September 23, 2019, the evidence is limited in scope and is comprised of a September 2019 VA examination report. In this regard, the Veteran’s VA treatment records dated after September 23, 2019 do not address his disability of his right sciatic nerve or his right femoral nerve in the context of the rating criteria. The September 2019 VA examiner provided the first diagnosis as to the Veteran’s radiculopathy of the femoral nerve. Specifically, the September 2019 VA examiner documented the Veteran had, radiculopathy of the right lower extremity with involvement of L4/L5/S1/S2/S3 nerve root and involvement of L2/L3/L4 nerve roots (femoral nerve), each characterized as moderate. The September 2019 VA examiner also found, as to the Veteran’s right lower extremity, he had mild constant pain (may be excruciating at times), moderate mild intermittent pain (usually dull), moderate parenthesis and/or dysesthesias, and moderate numbness. These findings reflect the Veteran’s symptoms of right lumbar radiculopathy of the sciatic nerve and right lumbar radiculopathy of the femoral nerve do not more closely approximate the next higher evaluations for incomplete paralysis of the sciatic and femoral nerves, under DC 8520, and DC 8526 respectively, from September 23, 2019. Other considerations Additionally, review of the probative evidence throughout the appeal period, demonstrates the Veteran’s right lumbar radiculopathy of the sciatic nerve is a disability of the sciatic nerve, and his right lumbar radiculopathy of the femoral nerve is a disability of the femoral nerve, including from the findings of the June 2012, March 2014 and September 2019 VA examiners. Thus, the Board finds that DC 8520, for paralysis of the sciatic nerve, and DC 8526, for paralysis of the anterior crural nerve (femoral), are the most appropriate DCs, respectively, as to the nerves at issue. Copeland v. McDonald, 27 Vet. App. 333 (2015). The Board has also considered, throughout the appeal, whether higher ratings are available under the regulations pertaining to neuritis and neuralgia for the Veteran’s right sciatic nerve disability and right femoral nerve disability. In terms of neuritis. The June 2012 VA examiner found the Veteran’s deep tendon reflexes for the right knee and right ankle were normal. The March 2014 VA examiner found, at worst, the Veteran’s deep tendon reflexes as to the right knee and right ankle were hypoactive, and the September 2019 found his right knee was hypoactive and his right ankle was normal. Thus, these findings do not demonstrate a loss of reflexes. Further, the June 2012 and March 2014 VA examiners also documented, as to sensation to light touch (dermatome) testing, the Veteran’s upper anterior thigh (L2), thigh/knee (L3/4), lower leg/ankle (L4/L5/S1) and foot/toes (L5) were all normal on the right side. The September 2019 VA examiner found, as to sensation to light touch (dermatome) testing, the Veteran’s upper anterior thigh (L2) and foot/toes (L5) were normal and his thigh/knee (L3/4) and lower leg/ankle (L4/L5/S1) were decreased on the right side. However, the June 2012, March 2014 and September 2019 VA examiners each found the Veteran did not have muscle atrophy, thus a higher evaluation for the regulations pertaining to neuritis is not warranted for the Veteran’s right sciatic nerve disability or his femoral nerve disability. Similarly, in terms of neuralgia, while the March 2014 VA examiner found the Veteran had mild symptoms of intermittent pain and the September 2019 VA examiner found he had moderate symptoms of intermittent pain, these findings would not provide for a higher evaluation as the Veteran was already assigned an evaluation for mild symptoms prior to September 23, 2019 and moderate symptoms from September 23, 2019, thus higher evaluations are not warranted at any point during the appeal period. Further, moderate incomplete paralysis is the maximum rating provided for the sciatic nerve under DC 8720 or the femoral nerve under DC 8726. 38 C.F.R. § 4.124. Additionally, the clinical treatment records throughout the rating period for consideration are largely consistent with the findings in the March 2014 and September 2019 VA examination reports and do not demonstrate additional symptoms associated neuritis and/or neuralgia of the Veteran’s right lower extremity that would warrant higher evaluations at any point during the appeal period. For example, a February 2017 VA treatment record documented the Veteran reported pain in his low back, right leg and left knee describes achy, dull, sharp, and stiff, which was worsened by sitting for a long time and improved by medications, walking, and a home exercise program. Additionally, an October 2017 VA treatment record documented, in part, as to the Veteran’s right lower extremity, sensation to light touch was intact knee and ankle jerks were hypoactive and muscle strength was undiminished. More recently, an April 2019 VA treatment record documented, in part, the Veteran complained of right lower extremity pain described as throbbing in nature; however, he also denied numbness and paresthesia. Further, the Veteran, as a layperson, is competent to report the symptoms he has experienced, as to his right lower extremity; however, he has not been shown to have the requisite knowledge or training to be deemed competent to identify a specific level of disability for right sciatic nerve disability or right femoral nerve disability according to the rating criteria. See Jandreau, 492 F.3d at 1376-77. Such competent evidence concerning the nature and extent of the Veteran’s right sciatic nerve disability and right femoral nerve disability has been provided by the March 2014 and September 2019 VA examiners’ findings which directly address the criteria under which the Veteran’s these disabilities are evaluated. The Board finds the March 2014 and September 2019 VA examiners’ findings to be competent, objective, and probative evidence of record, and are therefore accorded greater weight than the Veteran’s subjective complaints of symptomatology as to his disabilities of his right lower extremity. Additionally, neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record with his respect to his right sciatic nerve disability and right femoral nerve disability. See Doucette, 28 Vet. App. at 369-70. Based on the foregoing, the preponderance of the evidence is against the Veteran’s claims for a rating in excess of 10 percent, prior to September 23, 2019, for right lumbar radiculopathy of the sciatic nerve, and in excess 20 percent thereafter, and for an initial evaluation in excess of 20 percent for right lumbar radiculopathy of the femoral nerve. In making these determinations the Board considered the application of “staged” ratings, but found no additional distinctive periods where the Veteran’s right sciatic nerve disability or right femoral nerve disability met or nearly approximated the criteria for higher ratings other than that already granted. In reaching these decisions the Board considered the doctrine of reasonable doubt, however, to the extent the preponderance of the evidence is against a rating higher than, or separate from, that already assigned for the Veteran’s right sciatic nerve disability and right femoral nerve disability, the doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3; Gilbert, 1 Vet. App.at 53. REASONS FOR REMAND 1. Entitlement to a TDIU is remanded. As noted above, the issue of entitlement to a TDIU has been raised by the record under Rice in conjunction with Veteran’s service-connected lumbar spine disability and his right lumbar radiculopathy of the sciatic nerve. In this regard, the record generally reflects the Veteran was determined to be disabled by the Social Security Administration as of November 1994; however, the record does not provide clear documentation regarding the Veteran’s recent employment history or education, if any. Thus, a remand is necessary for the Veteran to submit a VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability, or other evidence of his recent work history and education in order provide a complete and accurate recent history, and for the Agency of Original Jurisdiction to adjudicated in this matter in first instance, to avoid any prejudice to the Veteran. See Bernard v. Brown, 4 Vet. App. 384, 394 (1993). The matters are REMANDED for the following actions: 1. Request the Veteran to complete a VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability. Upon receipt of the form, complete any additional development necessary, to include sending a VA Form 21-4192, Request for Employment Information in Connection with Claim for Disability Benefits, to all employers identified by the Veteran. 2. Thereafter, adjudicate entitlement to a TDIU. If the benefit sought is not granted, furnish the Veteran and his representative with a supplemental statement of the case and afford them an opportunity to respond before the record is returned to the Board for further review. M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Espinoza, 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.