Citation Nr: 21022128 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 17-14 170A DATE: April 14, 2021 ORDER Entitlement to service connection for right ear hearing loss is denied. Entitlement to an initial compensable disability rating for left ear hearing loss is denied. Entitlement to an initial disability rating in excess of 20 percent for right shoulder rotator cuff tendonitis with degenerative arthritis prior to November 25, 2020 is denied. Entitlement to a disability rating in excess of 30 percent for right shoulder rotator cuff tendonitis with degenerative arthritis from November 25, 2020 is denied. Entitlement to an initial disability rating in excess of 10 percent for right knee chondromalacia with degenerative arthritis is denied. Entitlement to an initial disability rating in excess of 10 percent for left knee strain is denied. Entitlement to an initial disability rating in excess of 10 percent for degenerative arthritis of the lumbar spine prior to November 25, 2020 is denied. Entitlement to a disability rating in excess of 20 percent for degenerative arthritis of the lumbar spine from November 25, 2020 is denied. Entitlement to an initial disability rating in excess of 10 percent for left lower extremity radiculopathy is denied. Entitlement to an initial disability rating in excess of 10 percent for right ankle strain is denied. Entitlement to an initial disability rating in excess of 20 percent for residuals of left remote navicular bone fracture with left ankle disability is denied. Entitlement to an initial disability rating in excess of 10 percent for bilateral plantar fasciitis with bilateral pes cavus prior to November 25, 2020 is denied. Entitlement to a disability rating in excess of 50 percent for bilateral plantar fasciitis with bilateral pes cavus from November 25, 2020 is denied. Entitlement to an initial disability rating in excess of 10 percent for right elbow tricep tendonitis is denied. Entitlement to an initial disability rating in excess of 10 percent for left hip trochanteric pain syndrome with bursitis is denied. Entitlement to an initial compensable disability rating for left anterior costochondral separation cage is denied. REMANDED Entitlement to an initial compensable rating for left eye corneal opacity, residual of injury, status post cataract removal with replacement lens is remanded. FINDINGS OF FACT 1. The evidence of record does not reflect a diagnosis of right ear hearing loss under VA regulations during the period on appeal. 2. Throughout the period on appeal, the Veteran’s left ear hearing loss is manifested by hearing impairment corresponding to no higher than an auditory acuity of Level III. 3. Prior to November 25, 2020, the Veteran’s right shoulder rotator cuff tendonitis with degenerative arthritis is manifested by limitation of motion of the right arm at shoulder level. 4. From November 25, 2020, the Veteran’s right shoulder rotator cuff tendonitis with degenerative arthritis is manifested by limitation of motion of the right arm to midway between the side and shoulder level. 5. Throughout the period on appeal, the Veteran’s right knee chondromalacia with degenerative arthritis is manifested by painful range of motion to, at worst, 100 degrees in flexion, with normal extension to zero degrees, but not by flexion limited to between 16 to 30 degrees, extension limited to between 15 to 19 degrees, recurrent subluxation or lateral instability, or ankylosis. 6. Throughout the period on appeal, the Veteran’s left knee strain is manifested by painful range of motion to, at worst, 110 degrees in flexion, with normal extension to zero degrees, but not by flexion limited to between 16 to 30 degrees, extension limited to between 15 to 19 degrees, recurrent subluxation or lateral instability, or ankylosis. 7. Prior to November 25, 2020, the Veteran’s degenerative arthritis of the lumbar spine is manifested by forward flexion of the thoracolumbar spine to, at worst, 80 degrees and combined range of motion of the thoracolumbar spine to, at worst, 230 degrees, but not by muscle spasms or guarding severe enough to result in abnormal gait or abnormal spinal contour. 8. From November 25, 2020, the Veteran’s degenerative arthritis of the lumbar spine is manifested by forward flexion of the thoracolumbar spine to, at worst, 50 degrees and combined range of motion of the thoracolumbar spine to, at worst, 155 degrees, but not by favorable ankylosis of the entire thoracolumbar spine. 9. Throughout the period on appeal, the Veteran’s left lower extremity radiculopathy most nearly approximates mild incomplete paralysis of the sciatic nerve. 10. Throughout the period on appeal, the Veteran’s right ankle strain is manifested by range of motion between 5 to 15 degrees in dorsiflexion and 15 to 45 degrees in plantar flexion, which contributes to functional loss and more closely approximates moderate limitation of motion of the right ankle, but without evidence of malunion or ankylosis. 11. Throughout the period on appeal, the Veteran’s residuals of left foot remote navicular bone fracture with left ankle disability is manifested by range of motion between zero to 10 degrees in dorsiflexion and 10 to 45 degrees in plantar flexion, which contributes to functional loss and more closely approximates marked limitation of motion of the left ankle, but without evidence of malunion or ankylosis. 12. Prior to November 25, 2020, the Veteran’s bilateral plantar fasciitis with bilateral pes cavus is manifested as bilateral acquired flatfoot that is moderate in nature, due to pain on weight-bearing, but not by severe acquired flatfoot with objective evidence of marked deformity. 13. From November 25, 2020, the Veteran’s bilateral plantar fasciitis with bilateral pes cavus is manifested as bilateral acquired flatfoot with marked pronation that is not improved by orthopedic shoes or appliances, and the Veteran is in receipt of the maximum schedular rating. 14. Throughout the period on appeal, the Veteran’s right elbow tricep tendonitis is manifested by painful range of motion to, at worst, 135 degrees in flexion, with normal extension to zero degrees, but not by flexion limited to between 71 to 90 degrees, extension limited to between 75 to 89 degrees, or ankylosis. 15. Throughout the period on appeal, the Veteran’s left hip trochanteric pain syndrome with bursitis is manifested by painful range of motion to, at worst, 105 degrees in flexion, with extension to 20 degrees, but not by flexion limited to between 21 to 30 degrees or ankylosis. 16. Throughout the period on appeal, the Veteran’s left anterior costochondral separation cage disability manifests as a slight Group XXI muscle injury with subjective evidence of pain that results in no evidence of fascial defect, atrophy, impaired tonus, impairment of function or metallic fragments retained in muscle tissue. CONCLUSIONS OF LAW 1. The criteria for service connection for right ear hearing loss are not met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. § 3.303 (2019). 2. The criteria for an initial compensable disability rating for left ear hearing loss are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.85, 4.86, Diagnostic Code 6100 (2019). 3. Prior to November 25, 2020, the criteria for an initial disability rating in excess of 20 percent for right shoulder rotator cuff tendonitis with degenerative arthritis are not met.  38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5003-5201 (2019).  4. From November 25, 2020, the criteria for a rating in excess of 30 percent for right shoulder rotator cuff tendonitis with degenerative arthritis are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5003-5201 (2019). 5. The criteria for an initial disability rating in excess of 10 percent for right knee chondromalacia with degenerative arthritis are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5003-5260 (2019). 6. The criteria for an initial disability rating in excess of 10 percent for left knee strain are not met.  38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5260 (2019). 7. Prior to November 25, 2020, the criteria for an initial disability rating in excess of 10 percent for degenerative arthritis of the lumbar spine are not met.  38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5242 (2019). 8. From November 25, 2020, the criteria for a disability rating in excess of 20 percent for degenerative arthritis of the lumbar spine are not met.  38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5242 (2019). 9. The criteria for an initial disability rating in excess of 10 percent for left lower extremity radiculopathy are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.124a, Diagnostic Code 8520 (2019). 10. The criteria for an initial disability rating in excess of 10 percent for right ankle strain are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5271 (2019). 11. The criteria for an initial disability rating in excess of 20 percent for residuals of left foot fracture with left ankle disability are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5271 (2019). 12. Prior to November 25, 2020, the criteria for an initial disability rating in excess of 10 percent for bilateral plantar fasciitis with bilateral pes cavus are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5276 (2019). 13. From November 25, 2020, the criteria for a disability rating in excess of 20 percent for bilateral plantar fasciitis with bilateral pes cavus are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.71a, Diagnostic Code 5276 (2019). 14. The criteria for an initial disability rating in excess of 10 percent for right elbow tricep tendonitis are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5206 (2019). 15. The criteria for an initial disability rating in excess of 10 percent for left hip trochanteric pain syndrome with bursitis are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5019-5252 (2019). 16. The criteria for an initial compensable disability rating for left anterior costochondral separation cage are not met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 4.1-4.3, 4.7, 4.73, Diagnostic Code 5321 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from March 2005 to January 2014. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). A January 2017 rating decision, assigned a 20 percent disability rating for residuals of left foot remote navicular bone fracture, effective January 25, 2014. Thereafter, a November 2020 rating decision assigned a 50 percent disability rating for bilateral plantar fasciitis with bilateral pes cavus effective November 25, 2020; a 30 percent disability rating for right shoulder rotator cuff tendonitis with degenerative arthritis effective November 25, 2020; a 20 percent disability rating for degenerative arthritis of the lumbar spine effective November 25, 2020; and a separate 10 percent disability rating for left lower extremity radiculopathy, secondary to the Veteran’s service-connected lumbar spine disability. As the rating periods regarding the issues of bilateral foot disability, right shoulder disability, and lumbar spine disability prior to November 25, 2020 and from November 25, 2020 are not the maximum allowable, the issues remain on appeal. AB. v. Brown, 6 Vet. App. 35 (1993). Further, as the separate 10 percent disability rating for left lower extremity radiculopathy was established during the pendency of the increased rating appeal as to the Veteran’s lumbar spine disability, and this rating is not the maximum allowable, the issue also remains on appeal. Id. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Generally, the evidence must show: (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 or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may also be granted for chronic disabilities, such as organic diseases of the neurologic system, if such are shown to have been manifested to a compensable degree within one year after the veteran was separated from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. As an alternative to the nexus requirement, service connection for these chronic disabilities may be established through a showing of continuity of symptomatology since service. 38 C.F.R. § 3.303(b). The option of establishing service connection through a demonstration of continuity of symptomatology rather than through a finding of nexus is specifically limited to the chronic disabilities listed in 38 C.F.R. § 3.309(a). See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Entitlement to service connection for right ear hearing loss The Veteran seeks service connection for right ear hearing loss, which he contends is due to exposure from acoustic trauma during his active military service. Service connection for impaired hearing shall only be established when hearing status as determined by audiometric testing meets specified pure tone and speech recognition criteria. Audiometric testing measures puretone threshold hearing levels (in decibels) over a range of frequencies (in hertz). Hensley v. Brown, 5 Vet. App. 155, 158 (1993). For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels (dB) or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hz are 26 dB or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385 (2019). Upon review of the relevant evidence, the Board finds that service connection for right ear hearing loss is not warranted. A necessary element for establishing entitlement to service connection is the existence of a current disability; it is the cornerstone of a claim for VA disability compensation. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Degmetich v. Brown, 104 F.3d 1328, 1332 (Fed. Cir. 1997). For VA purposes, a current disability exists when a claimant has a disability at the time a claim is filed or at some point during the pendency of that claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). While the Veteran asserts that he has hearing loss as a result of noise exposure during service, the multiple audiograms within his service treatment records do not reflect hearing loss for VA purposes. All audiogram readings for the right ear are below 26 dB for frequencies between 500 and 4000 Hz. Additionally, the October 2014 and October 2020 VA examinations and July 2014 and May 2015 private audiological examinations fail to show impaired hearing under VA regulations, as the examination reports do not reflect an auditory threshold of 40 dB or greater for any of the frequencies between 500 and 4000 Hz, nor do they show a threshold of 26 dB or greater for at least three frequencies between 500 and 4000 Hz. On the contrary, the Veteran had an average puretone threshold of 18 dB (July 2014), 24 dB (October 2014), 18 dB (May 2015), and 14 dB (October 2020) in his right ear. His speech recognition ability under the Maryland CNC Test during his October 2014 and October 2020 VA examinations was 96 percent and 94 percent, respectively, in the right ear. Here, there is simply no indication in the record that the Veteran has a current diagnosis of right ear hearing loss under VA regulations, or that he has had any such diagnosis at any time during the appeal period. A threshold requirement for the granting of service connection is evidence of a current disability. In the absence of evidence of a current disability there can be no valid claim. See Brammer, 3 Vet. App. 223, 225 (1992). Taking into account all the relevant evidence of record, the Board finds that the weight of the evidence is against the Veteran’s claim of service connection for right ear hearing loss. Although the Veteran is entitled to the benefit of the doubt where the evidence is in approximate balance, the benefit of the doubt doctrine is inapplicable where, as here, the preponderance of the evidence is against the claim. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Increased Ratings Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.1 (2019). The basis of disability ratings is the ability of the body as a whole, or of the psyche, or of a system or organ of the body, to function under the ordinary conditions of daily life, including employment. 38 C.F.R. § 4.10 (2019). The determination of whether an increased rating is warranted is based on review of the entire evidence of record and the application of all pertinent regulations. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (2019). However, the evaluation of the same disability under various diagnoses, known as pyramiding, is to be avoided. 38 C.F.R. § 4.14 (2019). While the Veteran’s entire history is reviewed when making a disability determination, where service connection has already been established and increase in the disability rating is at issue, it is the present level of the disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55 (1994). However, staged ratings are appropriate for an increase rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 1. Entitlement to an initial compensable disability rating for left ear hearing loss The Veteran seeks a higher disability rating for his service-connected left ear hearing loss, which is currently rated as noncompensable under Diagnostic Code 6100. 38 C.F.R. § 4.85. Disability ratings for service-connected hearing impairments are determined through a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are made. Bruce v. West, 11 Vet. App. 405 (1998); Lendenmann v. Principi, 3 Vet. App. 345 (1992). The regulations set forth eleven auditory acuity levels, designated from Roman numerals I to XI, in escalating order of hearing impairment. 38 C.F.R. § 4.85. The appropriate auditory level is identified as the point where the percentage of speech discrimination and puretone threshold average intersect. Id. The regulations also provide that in cases of exceptional hearing loss, i.e., when the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the Roman numeral designation will be determined from either Table VI or Table VIA, whichever results in the higher numeral. 38 C.F.R. § 4.86(a). Likewise, a Roman numeral designation will be determined from either Table VI or Table VIA, whichever results in the higher numeral, when the puretone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz. That numeral will then be elevated to the next higher Roman numeral. 38 C.F.R. § 4.86(b). In support of his claim, the Veteran submitted a July 2014 private audiological evaluation. The puretone thresholds, in decibels, were as follows:        HERTZ       500 1000 2000 3000 4000 RIGHT 10  5  15 25  25  LEFT 10 5  5 10  25  Those results show an average puretone threshold of 11 decibels in the Veteran’s left ear. The private hearing evaluation did not include speech recognition testing using the Maryland CNC Test. This audiometry test result equates to Level I hearing impairment in the Veteran’s left ear, using Table VIA. 38 C.F.R. § 4.85. In support of his claim, the Veteran submitted a May 2015 private audiological evaluation. The puretone thresholds, in decibels, were as follows:        HERTZ       500 1000 2000 3000 4000 RIGHT 5  0  15 30  25  LEFT 5 0  0 10  40  Those results show an average puretone threshold of 13 decibels in the Veteran’s left ear. The private hearing evaluation did not include speech recognition testing using the Maryland CNC Test. This audiometry test result equates to Level I hearing impairment in the Veteran’s left ear, using Table VIA. 38 C.F.R. § 4.85. In October 2014, the Veteran underwent a VA audiological examination. During the audiological evaluation, the puretone thresholds, in decibels, were as follows:        HERTZ       500 1000 2000 3000 4000 RIGHT 10  15  25 25  30  LEFT 10 5  10 15  40  Those results show an average puretone threshold of 18 decibels in the Veteran's left ear. Speech recognition ability using the Maryland CNC Test was 100 percent in the Veteran's left ear. These audiometry test results equate to Level I hearing impairment in the Veteran's left ear, using Table VI. 38 C.F.R. § 4.85. In October 2020, the Veteran underwent another VA audiological examination. During the audiological evaluation, the puretone thresholds, in decibels, were as follows:        HERTZ       500 1000 2000 3000 4000 RIGHT 15  10  15 15  15  LEFT 15 15  20 25  40  Those results show an average puretone threshold of 25 decibels in the Veteran's left ear. Speech recognition ability using the Maryland CNC Test was 82 percent in the Veteran's left ear. These audiometry test results equate to Level III hearing impairment in the Veteran's left ear, using Table VI. 38 C.F.R. § 4.85. The Veteran's post-service treatment records are silent for any further audiological examinations. Upon further review of the evidence of record, the Board finds that an initial compensable disability rating for the Veteran's service-connected left ear hearing loss is not warranted. The Board notes that the Veteran is not service-connected for his right ear. As such, the right ear is assigned a Roman numeral designation of I, in order to determine the percentage evaluation from Table VII. See 38 C.F.R. § 4.85(f). Applying the clinical findings of the July 2014, October 2014, May 2015, and October 2020 VA and private examinations to Table VII, a noncompensable evaluation is assigned in all instances. Specifically, the point where the Roman numeral designations for each ear intersect indicates a zero percent evaluation. The Veteran's left ear hearing impairment corresponds to no higher than an auditory acuity of Level III, and, when coupled with his non-service-connected right ear auditory acuity of Level I, does not warrant an initial compensable disability rating. The Board has considered the various lay statements from the Veteran attesting to the impact of his hearing loss. However, the Veteran, while competent to report symptoms associated with hearing loss, is not competent to report that his hearing acuity is of sufficient severity to warrant a higher evaluation under Diagnostic Code 6100 because such an opinion requires medical expertise, i.e., training in evaluating hearing impairment, which he has not shown to have. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Charles v. Principi, 16 Vet. App. 370 (2002). As such, the Board finds the medical evidence of record to be more probative. The Board is sympathetic to the Veteran's position that a higher (e.g., compensable) rating is warranted for his service-connected left ear hearing loss. However, the audiometric examination results, as compared to the rating criteria, do not warrant an initial compensable disability rating at any time during the appeal period. Accordingly, the Board finds that the preponderance of the evidence is against the claim for an initial compensable disability rating for left ear hearing loss; and therefore, the claim must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Entitlement to an initial disability rating in excess of 20 percent for right shoulder rotator cuff tendonitis with degenerative arthritis prior to November 25, 2020 3. Entitlement to a disability rating in excess of 30 percent for right shoulder rotator cuff tendonitis with degenerative arthritis from November 25, 2020 The Veteran seeks higher ratings for his service-connected right shoulder rotator cuff tendonitis with degenerative arthritis, which is currently rated as 20 percent disabling prior to November 25, 2020 under 38 C.F.R. § 4.71a, Diagnostic Code 5010-5201, and as 30 percent disabling from November 25, 2020 under Diagnostic Code 5010-5201.  See 38 C.F.R. § 4.27 (hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen).  Here, the Veteran’s right shoulder disability is rated analogous to post-traumatic arthritis (Diagnostic Code 5010) under the criteria for limitation of motion of the arm (Diagnostic Code 5201). Diagnostic Code 5010 suggests that the Veteran’s right shoulder arthritis is post-traumatic in nature. A review of the evidence reflects that the Veteran’s right shoulder arthritis is degenerative in nature. Therefore, the diagnostic code assigned should have been Diagnostic Code 5003 which corresponds to degenerative arthritis. For this reason, the Board is changing the diagnostic code for right shoulder rotator cuff tendonitis with degenerative arthritis to Diagnostic Code 5003-5201 to reflect the more closely analogous criteria under that code. 38 C.F.R. § 4.71a. Ratings based on function impairment of the upper extremities are predicated upon which extremity is the major extremity, with only one extremity being considered major.  38 C.F.R. § 4.69. The medical evidence in this case reflects that the Veteran is right-hand dominant. Therefore, his right upper extremity will be considered as the major extremity. 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. 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. Under the prior criteria for Diagnostic Code 5201, a 20 percent rating is assigned for limitation of motion of the arm at shoulder level for the major joint. 38 C.F.R. § 4.71a.  A 30 percent rating is assigned for limitation of motion of the arm midway between the side and shoulder level for the major joint. Id.  A 40 percent rating, the highest schedular rating allowed, is assigned for limitation of motion of the arm to 25 degrees from the side for the major joint.  Id.  Under the revised criteria for Diagnostic Code 5201, a 20 percent rating is assigned for limitation of motion of the arm at shoulder level (flexion and/or abduction limited to 90 degrees) for both major and minor joints.  38 C.F.R. § 4.71a.  A 30 percent rating is assigned for limitation of motion of the arm midway between the side and shoulder level (flexion and/or abduction limited to 45 degrees) for the major joint.  Id.  A 40 percent rating, the highest schedular rating allowed, is assigned for limitation of motion of the arm with flexion and/or abduction limited to 25 degrees from the side for the major joint.  Id.  Normal ranges of motion of the shoulder are flexion (forward elevation) from zero to 180 degrees, abduction from zero to 180 degrees, and both internal and external rotation from zero to 90 degrees.  38 C.F.R. § 4.71, Plate I. In determining whether the Veteran has limitation of motion to shoulder level, it is necessary to consider forward flexion and abduction. See Mariano v. Principi, 17 Vet. App. 305, 314-16 (2003). In addition, separate ratings may be assigned for ankylosis of scapulohumeral articulation (Diagnostic Code 5200), impairment of the humerus (Diagnostic Code 5202), or impairment of the clavicle or scapula (Diagnostic Code 5303). However, as the medical evidence of record is silent for ankylosis of the right shoulder; impairment of the right humerus, to include nonunion, malunion, or episodes of guarding; or impairment of the right clavicle or scapula, to include dislocation, nonunion, or malunion, these separate diagnostic codes are not for application. 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). Period on appeal prior to November 25, 2020 Upon review of the relevant evidence, the Board finds that, prior to November 25, 2020, an initial disability rating in excess of 20 percent for the Veteran’s right shoulder rotator cuff tendonitis with degenerative arthritis is not warranted. As the period on appeal is prior to the February 7, 2021 rating amendment, the Board will consider only the former criteria under Diagnostic Code 5003-5201. Here, the medical evidence of record for the period on appeal reflects that the Veteran’s right shoulder limitation of motion is at shoulder level or greater. Specifically, the November 2014 VA examination shows right shoulder flexion to, at worst, 115 degrees and right shoulder abduction to, at worst, 90 degrees. The Veteran did not report right shoulder flare-ups or pain with motion during examination. The 2014 VA examiner also found no evidence of right shoulder ankylosis or guarding, nor was there any dislocation, malunion, or nonunion of the right clavicle, scapula, or humerus. As the Veteran is already in receipt of a 20 percent rating under Diagnostic Code 5003-5201 for right shoulder limitation of motion at shoulder level, for a higher 30 percent rating to be warranted, the evidence must show limitation of motion in flexion or abduction to midway between the side and shoulder level, which is between 45 degrees and 89 degrees. Here, the medical evidence, to include the 2014 VA examination and post-service treatment records, fails to show that, prior to November 25, 2020, the Veteran’s right shoulder was limited in motion to midway between the side and shoulder level, as limitation of right arm motion was to 115 degrees flexion and 90 degrees abduction. Therefore, prior to November 25, 2020, the currently assigned 20 percent rating for the Veteran’s right shoulder rotator cuff tendonitis with degenerative arthritis under Diagnostic Code 5003-5201 is appropriate and a higher rating is not warranted.  Period on appeal from November 25, 2020 Upon review of the relevant evidence, the Board finds that, from November 25, 2020, a disability rating in excess of 30 percent for the Veteran’s right shoulder rotator cuff tendonitis with degenerative arthritis is not warranted. As the record is silent for relevant medical evidence pertaining to the Veteran’s right shoulder from February 7, 2021 onward, the Board will consider only the former criteria under Diagnostic Code 5003-5201. Here, the medical evidence of record for the period on appeal reflects that the Veteran’s right shoulder limitation of motion is midway between side and shoulder level. Specifically, the November 2020 VA examination shows right shoulder flexion to, at worst, 100 degrees and right shoulder abduction to, at worst, 30 degrees, to include reported pain and right shoulder flare-ups. The 2020 VA examiner also found no evidence of right shoulder ankylosis or guarding, nor was there any dislocation, malunion, or nonunion of the right clavicle, scapula, or humerus. As the Veteran is already in receipt of a 30 percent rating under Diagnostic Code 5003-5201 for right shoulder limitation of motion midway between side and shoulder level, for a higher 40 percent rating to be warranted, the evidence must show limitation of motion in flexion or abduction to 25 degrees or less. Here, the medical evidence, to include the 2020 VA examination and post-service treatment records, fails to show that, from November 25, 2020 onward, the Veteran’s right shoulder was limited in motion with flexion or abduction to 25 degrees or less, as right arm flexion was to 100 degrees and right arm abduction was to 30 degrees. Therefore, from November 25, 2020, the currently assigned 30 percent rating for the Veteran’s right shoulder rotator cuff tendonitis with degenerative arthritis under Diagnostic Code 5003-5201 is appropriate and a higher rating is not warranted.  In conclusion, as the Board finds that the preponderance of, the evidence is against the Veteran’s claim for a disability rating in excess of 20 percent for right shoulder rotator cuff tendonitis with degenerative arthritis prior to November 25, 2020 under Diagnostic Code 5003-5201 and a disability rating in excess of 30 percent for right shoulder rotator cuff tendonitis with degenerative arthritis from November 25, 2020 under Diagnostic Code 5003-5201, the claims must be denied.  In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable.  38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.  4. Entitlement to an initial disability rating in excess of 10 percent for right knee chondromalacia with degenerative arthritis 5. Entitlement to an initial disability rating in excess of 10 percent for left knee strain The Veteran seeks higher ratings for his service-connected right knee chondromalacia with degenerative arthritis and left knee strain. The Veteran’s right knee disability is currently rated as 10 percent disabling under Diagnostic Code 5003-5260. See 38 C.F.R. § 4.27. Here, the Veteran’s right knee disability is rated analogous to degenerative arthritis, other than post-traumatic (Diagnostic Code 5003) under the criteria for limitation of flexion of the leg (Diagnostic Code 5260). The Veteran’s left knee disability is rated as 10 percent disabling under Diagnostic Code 5260. 38 C.F.R. § 4.71a, Schedule of ratings – musculoskeletal system. While portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, the rating criteria for Diagnostic Code 5260 was not changed. Under Diagnostic Code 5260, a 20 percent rating is assigned for knee flexion limited to 30 degrees.  C.F.R. § 4.71a.  Under Diagnostic Code 5261, a 20 percent rating is assigned for knee extension limited to 15 degrees. 38 C.F.R. § 4.71a.  Normal range of motion of the knee is to zero degrees extension and to 140 degrees flexion.  38 C.F.R. § 4.71a, Plate II.  Separate ratings may be assigned for compensable limitation of both flexion (Diagnostic Code 5260) and extension (Diagnostic Code 5261), or for limitation of motion and instability or subluxation of the knee (Diagnostic Code 5257), or meniscal pathology.  However, a separate rating can only be assigned where additional compensable symptomatology is shown that is not duplicative of that used to assign another rating.  38 C.F.R. § 4.14; VAOPGCPREC 09-04 (2004), 69 Fed. Reg. 59990 (2004); VAOPGCPREC 23-97 (1997), 62 Fed. Reg. 63604 (1997); VAOPGCPREC 9-98 (1998), 63 Fed. Reg. 56704 (1998); Lichtenfels v. Derwinski, 1 Vet. App. 484 (1991).  Upon review of the relevant evidence, the Board finds that an initial disability rating in excess of 10 percent for right knee chondromalacia with degenerative arthritis and an initial disability rating in excess of 10 percent for left knee strain is not warranted. Specifically, the medical evidence of record, to include the November 2014 and November 2020 VA examinations and post-service treatment records, reflect that the only manifestation of the Veteran’s right and left knee disabilities is limitation of motion due to pain. During the November 2014 VA examination, initial range of motion in flexion was to 130 degrees in the right knee and 130 degrees in the left knee, with normal extension to zero degrees for both knees. No additional range of motion loss was found during repeated use testing, and the Veteran did not report experiencing any knee flare-ups. Bilateral knee pain was noted throughout range of motion testing. Moreover, the VA examiner found no evidence of ankylosis, instability, or subluxation in either knee. As to the November 2020 VA examination, initial range of motion in flexion was to 110 degrees in the right knee and 120 degrees in the left knee, with normal extension to zero degrees in both knees. Repeated use testing showed that flexion was to 105 degrees in the right knee and 110 degrees in the left knee, with normal extension to zero degrees in both knees. Range of motion as to reported flare-ups in both knees showed that flexion was to 100 degrees in the right knee and 110 degrees in the left knee, with normal extension to zero degrees in both knees. Bilateral knee pain was noted throughout range of motion testing. The examiner found no evidence of ankylosis, instability, or subluxation in either knee. In evaluating disabilities of the musculoskeletal system, painful motion is an important factor of disability.  See 38 C.F.R. § 4.59.  The intent of the schedule is to recognize painful motion with joint or particular pathology as productive of disability.  Id.  Joints that are actually painful, unstable, or malaligned, due to healed injury, should be entitled to at least the minimum compensable rating for the joint.  Id. Here, the February 2015 rating decision assigned a 10 percent rating for the Veteran’s right knee disability and a 10 percent rating for the Veteran’s left knee disability based on painful right knee and left knee flexion, as this is the minimum compensable rating for flexion of the right and left knees under Diagnostic Code 5260. See 38 C.F.R. §§ 4.59, 4.71a; Burton v. Shinseki, 25 Vet. App. 1 (2011). For a higher 20 percent rating to be warranted, the evidence must show limitation of flexion between 16 to 30 degrees or limitation of extension between 15 to 19 degrees. Here, the medical evidence, to include the 2014 and 2020 VA examinations and post-service treatment records, fails to show these criteria, as the Veteran’s right knee flexion was to, at worst, 100 degrees, and his left knee flexion was to, at worst 110 degrees, with normal extension to zero degrees as to both knees throughout the period on appeal. In other words, the Veteran’s right knee and left knee disabilities have not had compensable limitation of motion (i.e. limitation of flexion or extension) at any time during the relevant rating period. Therefore, the currently assigned 10 percent initial disability rating for right knee chondromalacia with degenerative arthritis under Diagnostic Code 5003-5260 and 10 percent initial disability rating for left knee strain under Diagnostic Code 5260, based on painful limitation of motion of the right and left knees, are appropriate and higher ratings are not warranted. The Board has also considered whether ratings under Diagnostic Codes 5256, 5262, and 5263 for ankylosis, impairment of tibia and fibula, and genu recurvatum are warranted, respectively.  However, as the medical evidence shows that such impairments are absent, and the Veteran does not contend otherwise, higher ratings are not available under those Diagnostic Codes. In conclusion, as the Board finds that the preponderance of, the evidence is against the Veteran’s claims for an initial disability rating in excess of 10 percent for right knee chondromalacia with degenerative arthritis under Diagnostic Code 5003-5260 and an initial disability rating in excess of 10 percent for left knee strain under Diagnostic Code 5260, the claims must be denied.  In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable.  38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.  6. Entitlement to an initial disability rating in excess of 10 percent for degenerative arthritis of the lumbar spine prior to November 25, 2020 7. Entitlement to a disability rating in excess of 20 percent for degenerative arthritis of the lumbar spine from November 25, 2020 The Veteran seeks higher ratings for his service-connected degenerative arthritis of the lumbar spine, which is currently rated as 10 percent disabling under Diagnostic Code 5242 (General Rating Formula for Diseases and Injuries of the Spine – Degenerative arthritis) prior to November 25, 2020 and as 20 percent disabling under Diagnostic Code 5242 from November 25, 2020. 38 C.F.R. § 4.71a, Schedule of ratings – musculoskeletal system. While portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, the rating criteria for Diagnostic Code 5242 was not changed. Under Diagnostic Code 5242, a 10 percent rating is assigned 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. 38 C.F.R. § 4.71a. A 20 percent rating is assigned 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. Id. A 40 percent rating is assigned for forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. Id. A 50 percent rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine.  Id.  A 100 percent rating is assigned for unfavorable ankylosis of the entire spine.  Id.  Normal thoracolumbar spine motion includes forward flexion from 0 to 90 degrees and normal combined range of motion of the thoracolumbar spine is 240 degrees.  38 C.F.R. § 4.71a, Plate V.  Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. 38 C.F.R. § 4.71a, Diagnostic Code 5242 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).  Unfavorable ankylosis is defined as “a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching.”  38 C.F.R. § 4.71a, Diagnostic Code 5242 at Note 5. Additionally, fixation of a spinal segment in neutral position (zero degrees) is “always” considered favorable ankylosis.  Id.   Period prior to November 25, 2020 Upon review of the relevant evidence, the Board finds that, prior to November 25, 2020, a disability rating in excess of 10 percent for the Veteran’s degenerative arthritis of the lumbar spine is not warranted. Specifically, the medical evidence of record, to include the November 2014 VA examination and post-service treatment records, does not support a finding of forward flexion of the thoracolumbar spine to greater than 30 degrees but not greater than 60 degrees, combined range of motion of the thoracolumbar spine to no greater than 120 degrees, or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour. During the November 2014 VA examination, initial range of motion was to 80 degrees in forward flexion, with combined range of motion of the lumbar spine to 230 degrees, even with pain noted. The examiner found there to be no additional range of motion loss with repetitive use or during a flare-up, nor was there evidence of abnormal gait or abnormal spinal contour, ankylosis, or intervertebral disc syndrome (IVDS). As the Veteran is already in receipt of a 10 percent disability rating under Diagnostic Code 5242 for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees, for a higher 20 percent rating to be warranted, the evidence must show either forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; combined range of motion of the thoracolumbar spine to no greater than 120 degrees, or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour. Here, the medical evidence prior to November 25, 2020, to include the November 2014 VA examination, and post-service treatment records, only reflects forward flexion of the lumbar spine to, at worst, 80 degrees and combined range of motion of the lumbar spine to, at worst, 230 degrees, and it fails to show that there are muscle spasms or guarding severe enough to result in abnormal gait or abnormal spinal contour. Regarding neurological impairment, the lay and medical evidence of record prior to November 25, 2020 is against a finding that the Veteran has any other neurological abnormality associated with his lumbar spine disability. Therefore, the currently assigned 10 percent initial disability rating for the Veteran’s degenerative arthritis of the lumbar spine prior to November 25, 2020 under Diagnostic Code 5242 is appropriate and a higher rating is not warranted.  Period on appeal from November 25, 2020 Upon review of the relevant evidence, the Board finds that, from November 25, 2020, a disability rating in excess of 20 percent for the Veteran’s degenerative arthritis of the lumbar spine is not warranted. Specifically, the medical evidence of record, to include the November 2020 VA examination and post-service treatment records, does not support a finding of forward flexion of the thoracolumbar spine to 30 degrees or less, ankylosis of the entire thoracolumbar spine, or IVDS. During the November 2020 VA examination, initial range of motion was to 55 degrees in forward flexion, with combined range of motion of the lumbar spine to 180 degrees, even with pain noted. Repeated range of motion testing, to include pain noted, revealed forward flexion to 55 degrees, with combined range of motion of the lumbar spine to 160 degrees, even with pain noted. Range of motion loss during a flare-up, to include pain noted, was estimated to be to 50 degrees in forward flexion, with combined range of motion of the lumbar spine to 155 degrees. The examiner found no evidence of abnormal gait or abnormal spinal contour, ankylosis, or IVDS. As the Veteran is already in receipt of a 20 percent disability rating under Diagnostic Code 5242 for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees, for a higher 40 percent disability rating to be warranted, the evidence must show either forward flexion of the thoracolumbar spine to 30 degrees or less or favorable ankylosis of the entire thoracolumbar spine. Here, the medical evidence from November 25, 2020, to include the November 2020 VA examination and post-service treatment records, only reflects forward flexion of the lumbar spine to, at worst, 50 degrees and combined range of motion of the lumbar spine to, at worst, 155 degrees, and it fails to show favorable ankylosis of the entire thoracolumbar spine. Regarding neurological impairment, the Veteran has already been granted service connection left lower extremity radiculopathy based on the November 25, 2020 VA examination findings, and the lay and medical evidence of record from November 25, 2020 onward is against a finding that the Veteran has any other neurological abnormality associated with his lumbar spine disability. Therefore, the currently assigned 20 percent disability rating for the Veteran’s degenerative arthritis of the lumbar spine from November 25, 2020 under Diagnostic Code 5242 is appropriate and a higher rating is not warranted.  In conclusion, as the Board finds that the preponderance of, the evidence is against the Veteran’s claims for an initial disability rating in excess of 10 percent for degenerative arthritis of the lumbar spine prior to November 25, 2020 under Diagnostic Code 5242 and a disability rating in excess of 20 percent for degenerative arthritis of the lumbar spine from November 25, 2020 under Diagnostic Code 5242, the claims must be denied.  In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable.  38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.   8. Entitlement to an initial disability rating in excess of 10 percent for left lower extremity radiculopathy The Veteran seeks a higher disability rating for his service-connected left lower extremity radiculopathy, which is currently rated as 10 percent disabling under Diagnostic Code 8620 (Neuritis). 38 C.F.R. § 4.124a, Diseases of the Peripheral Nerves. As an initial matter, Diagnostic Code 8620 suggests that the Veteran’s left lower extremity radiculopathy is rated based on neuritis. A review of the evidence reflects that the Veteran’s left lower extremity radiculopathy has manifested as mild incomplete paralysis of the sciatic nerve. Therefore, the diagnostic code assigned should have been Diagnostic Code 8520 which corresponds to paralysis of the sciatic nerve. For this reason, the Board is changing the diagnostic code for left lower extremity radiculopathy to Diagnostic Code 8520 to reflect the more closely analogous criteria under that code. 38 C.F.R. § 4.71a. Under Diagnostic Code 8520, a 10 percent rating is assigned for mild incomplete paralysis of the sciatic nerve. 38 C.F.R. § 4.71a. A 20 percent rating is assigned for moderate incomplete paralysis of the sciatic nerve. Id. A 40 percent rating is assigned for moderately severe incomplete paralysis of the sciatic nerve. Id. A 60 percent rating is assigned for severe incomplete paralysis of the sciatic nerve with marked muscular atrophy. Id. A maximum rating of 80 percent is assigned for complete paralysis of the sciatic nerve, where the foot dangles and drops, there is no active movement possible of muscles below the knee, and flexion of the knee is weakened or (very rarely) lost. Id. The term “incomplete paralysis” indicates a degree of impaired function substantially less than the type of picture for “complete paralysis” given for each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating should be for the mild, or at most, the moderate degree. 38 C.F.R. § 4.71a. The terms “mild,” “moderate,” “moderately-severe,” and “severe” as used under Diagnostic Code 8520 are not defined in the Schedule. Rather than applying a mechanical formula to determine when symptomatology is “mild” or “moderate” etc., the Board must evaluate all of the evidence to ensure an “equitable and just” decision. 38 C.F.R. § 4.6. The maximum rating which may be assigned for neuritis not characterized by organic changes will be moderately severe incomplete paralysis for sciatic nerve involvement. See 38 C.F.R. § 4.123. Upon review of the relevant evidence, the Board finds that an initial rating in excess of 10 percent for left leg radiculopathy is not warranted. The November 2020 VA examination report revealed normal sensory test results of the lower left extremity with regard to light touch and deep tendon reflex, and no muscle atrophy was found. The examiner indicated that the Veteran’s radicular symptoms of his left lower extremity were mild as to constant pain, paresthesias, and numbness, stating that the severity of the Veteran’s left lower extremity radiculopathy was, overall, mild in nature. The Board finds that the Veteran’s symptoms are primarily sensory with no corresponding loss of muscle strength or function. Here, the probative evidence of record, to include post-service treatment records, does not demonstrative that the Veteran’s left lower extremity radiculopathy is manifested by moderate incomplete paralysis. Accordingly, the Board finds that the currently assigned 10 percent initial disability rating for left lower extremity radiculopathy of the sciatic nerve is appropriate, and a higher rating is not warranted. The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. In conclusion, as the Board finds that the preponderance of the evidence is against the Veteran’s claim for an initial disability rating in excess of 10 percent for left lower extremity radiculopathy under Diagnostic Code 8520, the claim must be denied. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38U.S.C. §5107 ; 38C.F.R. §§4.3, 4.7. 9. Entitlement to an initial disability rating in excess of 10 percent for right ankle strain 10. Entitlement to an initial disability rating in excess of 20 percent for residuals of left foot remote navicular bone fracture with left ankle disability The Veteran seeks higher ratings for his service-connected right ankle strain and residuals of left foot remote navicular bone fracture with left ankle disability. The Veteran’s right ankle disability is currently rated as 10 percent disabling under Diagnostic Code 5271 (Limited motion of the ankle), and his left foot disability is currently rated as 20 percent disabling under Diagnostic Code 5271. 38 C.F.R. § 4.71a, Schedule of ratings – musculoskeletal system. As previously discussed, during 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). The Board will consider the Veteran's claims 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. Under the prior criteria for Diagnostic Code 5271, a 10 percent rating is assigned for moderate limited motion of the ankle. 38 C.F.R. § 4.71a. A 20 percent rating, the maximum schedular rating allowed, is assigned for marked limitation of motion of the ankle. Id. Under the revised criteria for Diagnostic Code 5271, a 10 percent rating is assigned for moderate (less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion) limited motion of the ankle. 38 C.F.R. § 4.71a. A 20 percent rating, the highest schedular rating allowed, is assigned for marked (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion) limited motion of the ankle. Id. Full ankle motion includes dorsiflexion from zero to 20 degrees and plantar flexion from zero to 45 degrees. 38C.F.R. §4.71a, Plate II. As the word “marked” is not defined in the VA Schedule for Rating Disabilities, the Board must evaluate all of the evidence, to the end that its decisions are “equitable and just.” 38C.F.R. §4.6 (2019). In addition, separate ratings may be assigned for ankylosis of the ankle (Diagnostic Code 5270), ankylosis of the subastragalar or tarsal joint (Diagnostic Code 5272), malunion of the os calcis or astragalus (Diagnostic Code 5273), or astragalectomy (Diagnostic Code 5274). However, as the medical evidence of record is silent for ankylosis of the right of left ankle, ankylosis of the right or left foot subastragalar or tarsal joint, malunion of the right or left foot os calcis or astragalus, or astragalectomy, these separate diagnostic codes are not for application. Upon review of the relevant evidence, the Board finds that an initial disability rating in excess of 10 percent for right ankle strain and an initial disability rating in excess of 20 percent for residuals of left foot remote navicular bone fracture with left ankle disability are not warranted. As the record is silent for relevant medical evidence pertaining to the Veteran’s right ankle and left ankle from February 7, 2021 onward, the Board will consider only the former criteria under Diagnostic Code 5271. The evidence of record supports a finding of moderate limitation of motion in the Veteran’s right ankle and marked limitation of motion in the Veteran’s left ankle. During the November 2014 VA examination, initial range of motion testing showed right ankle dorsiflexion to 5 degrees and plantar flexion to 45 degrees, with pain noted. Left ankle initial range of motion testing reflected dorsiflexion to zero degrees and plantar flexion to 45 degrees, with pain noted. The VA examiner found no range of motion loss for either ankle during repetitive use testing, nor any evidence of right or left ankle ankylosis or malunion, and the Veteran did not report experiencing right or left ankle flare-ups. During the November 2020 VA examination, initial range of motion testing showed right ankle dorsiflexion to 15 degrees and plantar flexion to 35 degrees, with pain noted. Right ankle repetitive use testing reflected dorsiflexion to 10 degrees and plantar flexion to 30 degrees, with pain noted. The Veteran did not report experiencing right ankle flare-ups. As to the left ankle, initial range of motion testing showed dorsiflexion to 10 degrees and plantar flexion to 20 degrees, with pain noted. Repetitive use testing reflected dorsiflexion to 10 degrees and plantar flexion to 15 degrees, with pain noted. Regarding the Veteran’s reported left ankle flare-ups, estimated range of motion loss was to 5 degrees in dorsiflexion and to 10 degrees in plantar flexion. The VA examiner also found no evidence of right or left ankle ankylosis or malunion. As the Veteran’s right ankle disability is currently evaluated as 10 percent disabling, for a 20 percent rating to be warranted, the evidence must show marked limited motion in the right ankle, which would be less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion. As the Veteran’s left ankle disability is currently evaluated as 20 percent disabling, for a 30 percent rating to be warranted, the evidence must show left ankle ankylosis in plantar flexion between 30 to 40 degrees or left ankle ankylosis in dorsiflexion between 0 to 10 degrees. Here, the medical evidence, to include the 2014 and 2020 VA examinations and post-service treatment records, fails to show marked limited motion of the right ankle, as the Veteran’s right ankle dorsiflexion is between 5 to 15 degrees, and his plantar flexion is between 30 to 45 degrees. Moreover, the medical evidence also fails to show left ankle ankylosis. Therefore, the currently assigned 10 percent initial disability rating for right ankle strain under Diagnostic Code 5271 and 20 percent initial disability rating for residuals of left foot remote navicular bone fracture with left ankle disability under Diagnostic Code 5271 are appropriate and higher ratings are not warranted. In conclusion, as the Board finds that the preponderance of the evidence is against the Veteran’s claims for an initial disability rating in excess of 10 percent for right ankle strain under Diagnostic Code 5271 and an initial disability rating in excess of 20 percent for residuals of left foot remote navicular bone fracture with left ankle disability under Diagnostic Code 5271, the claims must be denied. In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable. 38U.S.C. §5107 ; 38C.F.R. §§4.3, 4.7. 11. Entitlement to an initial disability rating in excess of 10 percent for bilateral plantar fasciitis with bilateral pes cavus prior to November 25, 2020 12. Entitlement to a disability rating in excess of 50 percent for bilateral plantar fasciitis with bilateral pes cavus from November 25, 2020 The Veteran seeks higher ratings for his service-connected bilateral plantar fasciitis with bilateral pes cavus, which is currently rated as 10 percent disabling prior to November 25, 2020, under 38 C.F.R. § 4.71a, Diagnostic Code 5276 (Acquired flatfoot), and as 50 percent disabling from November 25, 2020 under Diagnostic Code 5276. While portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, the rating criteria for Diagnostic Code 5276 was not changed. Under Diagnostic Code 5276, a 10 percent rating is assigned 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. 38 C.F.R. § 4.71a. 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. Id. A 30 percent rating is assigned 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. Id. A 30 percent rating is also assigned 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. Id. A 50 percent rating, the highest schedular rating allowed, is assigned 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. Id. 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). Period on appeal prior to November 25, 2020 Upon review of the relevant evidence, the Board finds that an initial disability rating in excess of 10 percent for bilateral plantar fasciitis with bilateral pes cavus is not warranted. Here, the medical evidence of record for the period on appeal reflects that the Veteran’s bilateral plantar fasciitis with bilateral pes cavus is moderate in nature. Specifically, the November 2014 VA examination shows bilateral foot pain on weight-bearing, which contributes to functional loss in terms of pain with walking. The Veteran did not report bilateral foot flare-ups. The examiner found no effect on the Veteran’s toes due to his bilateral pes cavus. No evidence of marked deformity, swelling on use, or characteristic callosities was found. As the Veteran is already in receipt of a 10 percent rating under Diagnostic Code 5276 for bilateral plantar fasciitis with bilateral pes cavus, for a higher 30 percent rating to be warranted, the evidence must show bilateral acquired flatfoot that is severe in nature, with objective evidence of marked deformity. Here, the medical evidence, to include the 2014 VA examination and post-service treatment records, fails to show that, prior to November 25, 2020, the Veteran’s bilateral plantar fasciitis and bilateral pes planus was severe in nature, as symptoms of marked deformity are not present. Therefore, prior to November 25, 2020, the currently assigned 10 percent initial disability rating for the Veteran’s bilateral plantar fasciitis with bilateral pes cavus under Diagnostic Code 5276 is appropriate and a higher rating is not warranted.  The Board has also considered the other Diagnostic Codes pertaining to the foot. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); see also Lyles v. Shulkin, 29 Vet. App. 107 (2017). In Scott v. Wilkie, the Federal Circuit expressly adopted the Court’s holding that disabilities specifically listed in the rating schedule may only be rated under Diagnostic Codes which specifically pertain to them. Scott v. Wilkie, 920 F.3d 1375 (Fed. Cir. 2019) (citing Copeland v. McDonald, 27 Vet. App. 333, 336 (2015)). The Federal Circuit also expressly adopted the Court’s holding that unlisted conditions may be rated by analogy to Diagnostic Codes that may not describe the unlisted disability but addresses disabilities that may be productive of similar symptoms. Scott, 920 F.3d 1375 (citing Yancy v. McDonald, 27 Vet. App. 484, 493 (2016). Finally, the Federal Circuit concluded that the Board must also consider assigning separate ratings under analogous Diagnostic Codes, when rating an unlisted service-connected foot disability exhibiting distinct manifestations, even when service connection has also been granted for one of the eight conditions listed in the rating schedule. Id. Here, the Veteran’s bilateral plantar fasciitis is specifically listed under the rating schedule and therefore cannot be rated under a different Diagnostic Code. Additionally, while the Board notes that the Veteran’s bilateral pes cavus is rated together with his service-connected bilateral plantar fasciitis, the evidence of record is against a finding that his bilateral pes cavus has distinct manifestations from those that are already being compensated. See 38 C.F.R. § 4.14. Specifically, the November 2014 VA examination reflects no pain or tenderness, effects on the Veteran’s toes, or dorsiflexion or varus deformity due to bilateral pes cavus. As such a separate rating is not warranted. Period on appeal from November 25, 2020 Upon review of the relevant evidence, the Board finds that a disability rating in excess of 50 percent for bilateral plantar fasciitis with bilateral pes cavus is not warranted. Here, the Veteran is in receipt of the highest schedular rating for acquired flat foot, based on evidence during the November 2020 VA examination of bilateral flatfoot with marked pronation that is not improved with use of orthopedic shoes or appliances. As the Veteran is in receipt of the maximum schedular rating, the Board finds that there is no legal basis upon which to award a higher schedular evaluation for bilateral plantar fasciitis with bilateral pes cavus. Therefore, from November 25, 2020, the currently assigned 50 percent disability rating for the Veteran’s bilateral plantar fasciitis with bilateral pes cavus under Diagnostic Code 5276 is appropriate and a higher rating is not warranted.  The Board has also considered the other Diagnostic Codes pertaining to the foot. Here, the Veteran’s bilateral plantar fasciitis is specifically listed under the rating schedule and therefore cannot be rated under a different Diagnostic Code. Additionally, while the Board notes that the Veteran’s bilateral pes cavus is rated together with his service-connected bilateral plantar fasciitis, the evidence of record is against a finding that his bilateral pes cavus has distinct manifestations from those that are already being compensated. See 38 C.F.R. § 4.14. Specifically, the November 2020 VA examination reflects no pain or tenderness, effects on the Veteran’s toes, or dorsiflexion or varus deformity due to bilateral pes cavus. As such a separate rating is not warranted. In conclusion, as the Board finds that the preponderance of the evidence is against the Veteran’s claims for an initial disability rating in excess of 10 percent for bilateral plantar fasciitis with bilateral pes cavus prior to November 25, 2020 under Diagnostic Code 5276 and a disability rating in excess of 50 for bilateral plantar fasciitis with bilateral pes cavus from November 25, 2020 under Diagnostic Code 5276, the claims must be denied. In denying such ratings, the Board finds the benefit of the doubt doctrine is not applicable. 38U.S.C. §5107 ; 38C.F.R. §§4.3, 4.7. 13. Entitlement to an initial rating in excess of 10 percent for right elbow tricep tendonitis The Veteran seeks a higher rating for his service-connected right elbow tricep tendonitis, which is currently rated as 10 percent disabling under Diagnostic Code 5206 (Limitation of flexion of the forearm). 38 C.F.R. § 4.71a, Schedule of ratings – musculoskeletal system. While portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, the rating criteria for Diagnostic Code 5206 was not changed. As previously discussed, the medical evidence in this case reflects that the Veteran is right-hand dominant. Therefore, his right upper extremity will be considered as the major extremity. 38 C.F.R. § 4.69. Under Diagnostic Code 5206, a 10 percent rating is assigned for flexion of the major forearm limited to 100 degrees. C.F.R. § 4.71a.  A 20 percent rating is assigned for flexion of the major forearm limited to 90 degrees. Id. A 30 percent rating is assigned for flexion of the major forearm limited to 70 degrees. Id. A 40 percent rating is assigned for flexion of the major forearm limited to 55 degrees. Id. A 50 percent rating, the highest schedular rating allowed, is assigned for flexion of the major forearm limited to 45 degrees. Id. Pursuant to VA regulations, normal range of motion for elbow flexion is 0 to 145 degrees, extension is 145 to zero degrees, forearm supination is zero to 85 degrees, and forearm pronation is zero to 80 degrees. 38 C.F.R. § 4.71, Plate I. Upon review of the relevant evidence, the Board finds that an initial disability rating in excess of 10 percent for right elbow tricep tendonitis is not warranted. Specifically, the medical evidence of record, to include the November 2014 and November 2020 VA examinations and post-service treatment records, reflect that the only manifestation of the Veteran’s right elbow disability is limitation of motion due to pain. During the November 2014 VA examination, right elbow initial range of motion in flexion was normal to 145 degrees, with normal extension to zero degrees, with pain noted. No additional range of motion loss was found during repeated use testing, and the Veteran did not report experiencing right elbow flare-ups. Moreover, the VA examiner found no evidence of right elbow ankylosis, impairment of flail joint, impairment of ulna, impairment of radius, nonunion of radius and ulna, or impairment of supination and pronation. As to the November 2020 VA examination, right elbow initial range of motion in flexion was to 135 degrees, with normal extension to zero degrees, with pain noted. No additional range of motion loss was found during repeated use testing, and the Veteran did not report experiencing right elbow flare-ups. Moreover, the VA examiner found no evidence of right elbow ankylosis, impairment of flail joint, impairment of ulna, impairment of radius, nonunion of radius and ulna, or impairment of supination and pronation. In evaluating disabilities of the musculoskeletal system, painful motion is an important factor of disability.  See 38 C.F.R. § 4.59.  The intent of the schedule is to recognize painful motion with joint or particular pathology as productive of disability.  Id.  Joints that are actually painful, unstable, or malaligned, due to healed injury, should be entitled to at least the minimum compensable rating for the joint.  Id. Here, the February 2015 rating decision assigned a 10 percent rating for the Veteran’s right elbow disability based on painful right elbow flexion, as this is the minimum compensable rating for flexion of the right elbow under Diagnostic Code 5206. See 38 C.F.R. §§ 4.59, 4.71a; Burton v. Shinseki, 25 Vet. App. 1 (2011). For a higher 20 percent rating to be warranted, the evidence must show right elbow limitation of flexion between 71 to 90 degrees or limitation of extension between 75 to 89 degrees. Here, the medical evidence, to include the 2014 and 2020 VA examinations and post-service treatment records, fails to show these criteria, as the Veteran’s right elbow flexion was to, at worst, 135 degrees, with normal flexion to zero degrees throughout the period on appeal. In other words, the Veteran’s right elbow disability has not had compensable limitation of motion (i.e. limitation of flexion or extension) at any time during the relevant rating period. Therefore, the currently assigned 10 percent initial disability rating for right elbow tricep tendonitis Diagnostic Code 5206, based on painful limitation of motion of the right elbow, is appropriate a higher rating is not warranted. The Board has considered whether any other Diagnostic Codes related to disabilities of the right elbow would provide for a higher disability rating. However, the evidence does not reflect that the symptoms would warrant a higher rating under a different Diagnostic Code. See 38 C.F.R. § 4.71a. Specifically, the record is silent for evidence of right elbow ankylosis, impairment of flail joint, impairment of ulna, impairment of radius, nonunion of radius and ulna, or impairment of supination and pronation. As such, a higher rating under another Diagnostic Code is not warranted. In conclusion, as the Board finds that the preponderance of, the evidence is against the Veteran’s claim for an initial disability rating in excess of 10 percent for right elbow tricep tendonitis under Diagnostic Code 5206, the claim must be denied.  In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable.  38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.  14. Entitlement to an initial rating in excess of 10 percent for left hip trochanteric pain syndrome with bursitis The Veteran seeks a higher rating for his service-connected left hip trochanteric pain syndrome with bursitis, which is currently rated as 10 percent disabling under Diagnostic Code 5019-5252. See 38 C.F.R. § 4.27 (hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen).  Here, the Veteran’s left hip disability is rated analogous to bursitis (Diagnostic Code 5019) under the criteria for limitation of extension of the thigh (Diagnostic Code 5252). While portions of the rating schedule addressing the musculoskeletal system were revised effective February 7, 2021, the rating criteria for Diagnostic Code 5019-5252 was not changed. Under Diagnostic Code 5252, a 10 percent rating is assigned for hip flexion limited to 45 degrees. 38 C.F.R. § 4.71a. A 20 percent rating is assigned for hip flexion limited to 30 degrees. Id. A 30 percent rating is assigned for hip flexion limited to 20 degrees. Id. A maximum 40 percent rating is assigned for hip flexion limited to 10 degrees. Id. Normal range of motion for the hip is flexion from zero degrees to 125 degrees and abduction from zero degrees to 45 degrees. 38 C.F.R. § 4.71, Plate II. Upon review of the relevant evidence, the Board finds that an initial disability rating in excess of 10 percent for left hip trochanteric pain syndrome with bursitis is not warranted. Specifically, the medical evidence of record, to include the November 2014 and November 2020 VA examinations and post-service treatment records, reflect that the only manifestation of the Veteran’s left hip disability is limitation of motion due to pain. During the November 2014 VA examination, left hip initial range of motion in flexion was to 90 degrees, with normal extension to zero degrees, with pain noted. No additional range of motion loss was found during repeated use testing, and the Veteran did not report experiencing left hip flare-ups. Moreover, the VA examiner found no evidence of left hip ankylosis. As to the November 2020 VA examination, left hip initial range of motion reflected flexion to 115 degrees and extension to 20 degrees, with pain noted. Repeated use testing showed flexion to 110 degrees and extension to 20 degrees, with pain noted. Estimated range of motion loss due to reported left hip flare-ups was found to be to 105 degrees in flexion and to 20 degrees in extension, with pain noted. Moreover, the VA examiner found no evidence of left hip ankylosis. In evaluating disabilities of the musculoskeletal system, painful motion is an important factor of disability.  See 38 C.F.R. § 4.59.  The intent of the schedule is to recognize painful motion with joint or particular pathology as productive of disability.  Id.  Joints that are actually painful, unstable, or malaligned, due to healed injury, should be entitled to at least the minimum compensable rating for the joint.  Id. Here, the February 2015 rating decision assigned a 10 percent rating for the Veteran’s left hip disability based on painful left hip flexion, as this is the minimum compensable rating for flexion of the left hip under Diagnostic Code 5252. See 38 C.F.R. §§ 4.59, 4.71a; Burton v. Shinseki, 25 Vet. App. 1 (2011). For a higher 20 percent rating to be warranted, the evidence must show left hip flexion between 21 to 30 degrees. Here, the medical evidence, to include the 2014 and 2020 VA examinations and post-service treatment records, fails to show this criterion, as the Veteran’s left hip flexion was to, at worst, 105 degrees. In other words, the Veteran’s left hip disability has not had compensable limitation of motion (i.e. limitation of flexion or extension) at any time during the relevant rating period. Therefore, the currently assigned 10 percent initial disability rating for left hip trochanteric pain syndrome with bursitis under Diagnostic Code 5019-5252, based on painful limitation of motion of the left hip, is appropriate a higher rating is not warranted. The Board has considered whether any other Diagnostic Codes related to disabilities of the left hip would provide for a higher disability rating. However, the evidence does not reflect that the symptoms would warrant a higher rating under a different Diagnostic Code. See 38 C.F.R. § 4.71a. Specifically, the record is silent for evidence of left hip ankylosis, left hip abduction with motion lost beyond 10 degrees, left hip flail joint, and left femur impairment. As such, a higher rating under another Diagnostic Code is not warranted. In conclusion, as the Board finds that the preponderance of, the evidence is against the Veteran’s claim for an initial disability rating in excess of 10 percent for left hip trochanteric pain syndrome with bursitis under Diagnostic Code 5019-5252, the claim must be denied.  In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable.  38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.   15. Entitlement to an initial compensable rating for left anterior costochondral separation cage The Veteran seeks a higher rating for his service-connected left anterior costochondral separation cage, which is currently rated as noncompensable under Diagnostic Code 5297 (Removal of ribs). 38 C.F.R. § 4.71a, Schedule of ratings – musculoskeletal system. The assigned Diagnostic Code 5297 suggests that the Veteran’s left rib cage disability is rated based on removal of one or more ribs or the resection of two or more ribs without regeneration. 38 C.F.R. § 4.71a. The rating criteria do not mention chest pain. Id. Review of the evidence reflects continued reports of left chest area pain around the left ribcage and muscle area. Diagnostic Code 5321 addresses injury to muscle group XXI, muscles of the respiration and the thoracic muscle group. Factors for consideration in the rating of muscle disabilities are set forth in 38 C.F.R. § 4.56, which provides guidance for the evaluation of muscle disabilities as slight, moderate, moderately severe, or severe. The cardinal signs and symptoms of muscle disability are loss of power, weakness, lowered threshold of fatigue, fatigue-pain, impairment of coordination, and uncertainty of movement. 38 C.F.R. § 4.56(c). A slight muscle injury results in no evidence of fascial defect, atrophy, impaired tonus, impairment of function or metallic fragments retained in muscle tissue. Id. A moderate muscle injury results in some loss of deep fascia or muscle substance or impairment of muscle tonus and loss of power or lower threshold of fatigue when compared to the sound side. Id. A moderately-severe muscle injury contemplates palpation of loss of deep fascia, muscle substance or normal firm resistance of muscles compared with the sound side. Id. Tests of strength and endurance demonstrate positive evidence of impairment. Id. Finally, a severe muscle injury contemplates swollen and hardened muscles in contraction with severe impairment of muscle strength, endurance or coordinated movements. Id. The Veteran’s left anterior costochondral separation cage related chest pain is equally anatomically localized to the area of muscle group XXI, and Diagnostic Code 5321 (Group XXI, Function: Respiration, Muscles of respiration: Thoracic muscle group) explicitly considers “fatigue-pain” as a criterion for rating. For these reasons, the Board is changing the diagnostic code for left anterior costochondral separation cage to Diagnostic Code 5321 to reflect the more closely analogous criteria under that code. 38 C.F.R. §§ 4.20, 4.73. Under Diagnostic Code 5321, a noncompensable rating is assigned for a slight disability of muscle group XXI. 38 C.F.R. § 4.73. A 10 percent rating is assigned for a moderate disability of muscle group XXI. Id. A 20 percent rating, the highest schedular rating allowed, is assigned for severe or moderately severe disability of muscle group XXI. Id. Upon review of the relevant evidence, the Board finds that an initial compensable disability rating for left anterior costochondral separation cage is not warranted. Specifically, the evidence of record, to include the November 2020 VA examinations and post-service treatment records, as well as the Veteran’s lay statements, reflect subjective complaints of left chest muscle pain without any identified functional impairment or objective manifestations. The November 2020 VA examination reflects a diagnosis of a non-penetrating muscle injury to the lower left rib area. The Veteran reported left chest area pain and discomfort when taking a deep breath. As to the cardinal signs and symptoms of a muscle disability, the examiner found no objective evidence of loss of power, weakness, fatigue and/or pain, impairment of coordination, or uncertainty of movement. No functional impairment or functional impact as to the Veteran’s muscle injury was found. For a higher 10 percent rating to be warranted, the evidence must show moderate injury to the Group XXI muscle, which would require evidence of some loss of deep fascia or muscle substance or impairment of muscle tonus and loss of power or lower threshold of fatigue when compared to the sound side. Here, the medical evidence, to include the 2020 VA examination and post-service treatment records, fails to show these criteria, as the Veteran’s Group XXI muscle injury to the left chest area is slight in nature and only productive of subjective complaints without any identified functional impairment or objective manifestations. Therefore, the currently assigned noncompensable initial disability rating for left anterior costochondral separation cage under Diagnostic Code 5321 is appropriate a higher rating is not warranted. In conclusion, as the Board finds that the preponderance of, the evidence is against the Veteran’s claim for an initial compensable disability rating for left anterior costochondral separation cage under Diagnostic Code 5321, the claim must be denied.  In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable.  38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.  REASONS FOR REMAND Entitlement to an initial compensable rating for left eye corneal opacity, residual of injury, status post cataract removal with replacement lens is remanded. Throughout the period on appeal, the Veteran has received private treatment from Dr. D. K. for his left eye disability. During the January 2017 private eye examination, Dr. D. K. indicated that the Veteran would undergo an additional eye examination within the next year, or sooner. The record is silent for any additional private treatment records from Dr. D. K. after January 2017. As it appears that the Veteran continues to seek private treatment for his left eye disability, a remand is necessary to obtain any outstanding private treatment records as to the Veteran’s vision. These records appear relevant to the Veteran’s claim as they may include further information pertaining to the Veteran’s history of symptoms. VA has a duty to seek these records. 38 U.S.C. § 5103A(b)(1). The matter is REMANDED for the following action: 1. With any necessary identification of sources and authorization by the Veteran, request all private treatment records for the Veteran not already associated with the file, to specifically include those from Dr. D. K. from 2017 to the present. Copies of any outstanding private treatment records should be added to the Veteran's electronic claims file. 2. After completing all indicated development, the Agency of Original Jurisdiction should readjudicate the Veteran’s claim. If the benefit sought on appeal remains denied, the Veteran should be furnished with a supplemental statement of the case, given the opportunity to respond, and the case should thereafter be returned to the Board for further appellate review, if warranted. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Houle, 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.