Citation Nr: 21025479 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 17-48 367 DATE: April 28, 2021 ORDER Entitlement to a compensable evaluation for right lower extremity compartment syndrome is denied. Entitlement to a compensable evaluation for left lower extremity compartment syndrome is denied. Entitlement to an evaluation in excess of 10 percent for bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis for the period on appeal prior to September 21, 2019 is denied. Entitlement to an evaluation of 50 percent but no higher, for bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis for the period on appeal between September 21, 2019 and December 21, 2020 is granted. Entitlement to an evaluation in excess of 50 percent for bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis for the period on appeal beginning December 21, 2020 is denied. Entitlement to an evaluation of 10 percent, but no higher, for bilateral plantar fasciitis for the period beginning on February 7, 2021, is granted. FINDINGS OF FACT 1. During the period on appeal, the Veteran’s right lower extremity compartment syndrome has exhibited a mild severity; the Veteran’s right lower extremity compartment syndrome has not been shown to be moderate, moderately severe, or severe; the Veteran did not exhibit any cardinal signs or symptoms. 2. During the period on appeal, the Veteran’s left lower extremity compartment syndrome has exhibited a mild severity; the Veteran’s left lower extremity compartment syndrome has not been shown to be moderate, moderately severe, or severe; the Veteran did not exhibit any cardinal signs or symptoms. 3. During the period on appeal prior to September 21, 2019, the Veteran’s bilateral pes planus exhibited pain on use of the feet bilaterally; there was no objective evidence of marked deformity, characteristic callouses, marked pronation, extreme tenderness of the plantar surfaces of the feet, or marked inward displacement and severe spams of the Achilles tendon on manipulation. 4. During the period on appeal beginning September 21, 2019, the Veteran’s bilateral pes planus exhibited pain on use of the feet bilaterally and pain on manipulation of the feet bilaterally, and the pain was accentuated on use and manipulation bilaterally; the Veteran’s bilateral pes planus also exhibited extreme tenderness of plantar surfaces of both feet. 5. The Veteran has bilateral plantar fasciitis; he has not undergone foot surgery. CONCLUSIONS OF LAW 1. The criteria for a compensable evaluation for right lower extremity compartment syndrome have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.73, Diagnostic Code (DC) 5312. 2. The criteria for a compensable evaluation for left lower extremity compartment syndrome have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.73, DC 5312. 3. The criteria for an evaluation in excess of 10 percent for bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis for the period on appeal prior to September 21, 2019 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71a, DC 5276. 4. The criteria for an evaluation of 50 percent, but no higher, for bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis for the period on appeal between September 21, 2019 and December 21, 2020 have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71a, DC 5276. 5. The criteria for an evaluation in excess of 50 percent for bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis for the period on appeal beginning December 21, 2020 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71a, DCs 5276. 6. The revised criteria for an evaluation of 10 percent, but no higher for bilateral plantar fasciitis for the period beginning February 7, 2021 have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71a, DC 5269. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1990 to June 2011. The Veteran contends that he is entitled to increased ratings for right lower extremity compartment syndrome and left lower extremity compartment syndrome. He also contends that he is entitled to increased ratings for bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The case was first before the Board in April 2019. In the April 2019 Board decision, the Board denied increased ratings for pes planus and remanded the issues of increased ratings for right lower extremity compartment syndrome and left lower extremity compartment syndrome. The Veteran appealed the April 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). In February 2020, the Court granted a Joint Motion for Partial Remand (JMPR) of the Veteran and the Secretary of Veterans Affairs (the Parties). The Parties remanded the case back to the Board. The issue of increased ratings for bilateral pes planus returned to the Board in May 2020, at which time the Board remanded the case for additional development. The case returns to the Board at this time for further appellate review. Increased Ratings The Veteran contends that he is entitled to a compensable evaluation for right lower extremity compartment syndrome and a compensable evaluation for left lower extremity compartment syndrome. For the Veteran’s bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis, the Veteran contends that he is entitled to an evaluation in excess of 10 percent for the period on appeal prior to December 21, 2020, as well as an evaluation in excess of 50 percent for the period beginning December 21, 2020. The Veteran first filed claims of service connection for a bilateral pes planus and bilateral compartment syndrome on February 3, 2011. In a January 25, 2011 rating decision, the RO granted the Veteran service connection for bilateral pes planus with a noncompensable (0 percent) evaluation under 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5276. The RO also granted service connection for right shin splints and service connection for left shin splints, each with a noncompensable evaluation under DC 5262. On July 22, 2013, the Veteran filed a claim of increased ratings for bilateral pes planus, right shin splints, and left shin splints. The RO denied the Veteran’s claims for increased ratings in an August 2013 rating decision. In that rating decision, the RO also recharacterized the Veteran’s right shin splints and left shin splints as right lower extremity compartment syndrome and left lower extremity compartment syndrome. Then in a May 2017 rating decision, the RO granted an increased rating of 10 percent for bilateral pes planus, effective March 2, 2016. In a July 2017 rating decision, the RO changed the effective date of the 10 percent rating for bilateral pes planus to July 1, 2011, the date after the Veteran’s discharge from active service, because they found that the medical evidence showed findings consistent with the evaluation assigned from this date after review of the evidence and liberal interpretation of the law resolved in the Veteran’s favor. In a December 2019 rating decision, the RO recharacterized the Veteran’s bilateral pes planus as bilateral pes planus with bilateral plantar fasciitis and left foot degenerative arthritis, and the RO denied the Veteran’s claim of increased rating. In a January 2021 rating decision, the RO granted an increased rating of 50 percent for bilateral pes planus, effective December 21, 2020. Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant’s favor. 38 C.F.R. § 4.3. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. Separate ratings can be assigned for separate periods based on the facts found - a practice known as “staged” ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The basis of disability evaluation 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. Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. Functional loss may be due to the absence or deformity of structures or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior in undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. § 4.40. In Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011), the United States Court of Appeals for Veterans Claims (Court) held that, although pain may cause a functional loss, “pain itself does not rise to the level of functional loss as contemplated by VA regulations applicable to the musculoskeletal system.” Rather, pain may result in functional loss, but only if it limits the ability “to perform the normal working movements of the body with normal excursion, strength, speed, coordination, or endurance.” Id., quoting 38 C.F.R. § 4.40. With respect to joints, in particular, the factors of disability reside in reductions of normal excursion of movements in different planes. Inquiry will be directed to more or less than normal movement, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity or atrophy of disuse. 38 C.F.R. § 4.45; DeLuca v. Brown, 8 Vet. App. 202 (1995). 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. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). In this regard, 38 C.F.R. § 4.59 requires that “[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.” Correia v. McDonald, 28 Vet. App. 158 (2016). Further, 38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the DC under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). 1. Entitlement to Increased Ratings for Right Lower Extremity Compartment Syndrome 2. Entitlement to Increased Ratings for Left Lower Extremity Compartment Syndrome The Veteran’s right lower extremity compartment syndrome and left lower extremity compartment syndrome have each been rated as noncompensable under 38 C.F.R. § 4.71a, DC 5262, which pertains to impairment of the tibia and fibula. Under DC 5262, malunion of the tibia and fibula of a leg warrants a 10 percent rating when it results in slight knee or ankle disability. A 20 percent rating requires that malunion results in moderate knee or ankle disability. A 30 percent rating requires that malunion results in marked knee or ankle disability. Nonunion of the tibia and fibula warrants a 40 percent rating if there is loose motion requiring a brace. 38 C.F.R. § 4.71a, DC 5262. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 CFR §4.31. The Board has also considered whether the Veteran’s right and left compartment syndrome should be rated under 38 C.F.R. § 4.73, DC 5312, which concern muscle injuries of the leg affecting Muscle Group XII. Such muscle group affects the dorsiflexion, extension of the toes, and stabilization of the arch, and it includes the anterior muscles of the leg. These muscles include the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and peroneus tertius. Under DC 5311, a noncompensable rating is provided for a slight disability, a 10 percent rating is provided for a moderate disability, a 20 percent rating is provided for a moderately severe disability, and a 30 percent rating is provided for a severe disability. 38 C.F.R. § 4.73. The words slight, moderate, and severe are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are equitable and just. 38 C.F.R. § 4.6. It should also be noted that use of terminology such as severe by VA examiners and others, although an element to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. In a March 2013 VA Primary Care Telephone Encounter Note, the Veteran stated that he has been dealing with shin pain for about 10 years. He reported that he was diagnosed with compartment syndrome, and he was told to basically stop the activity he is doing until the pain goes away. In a June 2014 VA Primary Care Physician Note, he said that his chronic pain from compartmental syndrome mainly happens when he walks too much. At a July 2013 VA examination for the knee and lower leg, the Veteran reported a history of pain in both lower legs associated with running and prolonged walking. He stated that he underwent evaluation on numerous occasions and was diagnosed as having shin splints, even though previous bone scans were negative for increased uptake of the tibias. Subsequent evaluations by a private medical provider revealed a diagnosis of bilateral lower leg compartment syndrome. At the time of the July 2013 examination, the Veteran complained of recurrent pain in both lower legs associated with prolonged standing, brisk walking, and running. The Veteran reported flare ups with pain in both lower legs with prolonged standing, walking, and running. The July 2013 VA examiner reported that the Veteran had a diagnosis of bilateral compartment syndrome in the lower legs. The VA examiner also named the Veteran’s condition as bilateral chronic exertional compartment syndrome. The VA examiner observed that the Veteran had pain in both lower legs with running, and the condition was previously erroneously diagnosed as shin splints. The VA examiner noted that no specific treatment was required for this condition other than rest and activity modifications as needed. In a July 2013 statement, the Veteran reported that he cannot run or job a quarter of a mile without pain in both his shins and his right hip becoming unbearable. He cannot fast walk half a mile before the pain in his shins becomes unbearable. He stated that he has a low threshold for fatigue and fatigue-pain in his shins during and after activities. He reported experiencing pain in his lower extremities during physical activities such as walking, jogging, jumping, and running. At a March 2016 VA examination for the knee and lower leg, the examiner noted that the Veteran continued to experience similar symptoms to those reported in the July 2013 VA examination, but the Veteran no longer sought medical care for shin pain. The Veteran reported that the flares of his shins are triggered by activity. He stated that he cannot run anymore. Prolonged walking caused pain, and he has to stop and rest. In a May 2017 addendum medical opinion, the March 2016 VA examiner noted that the Veteran had been initially diagnosed with bilateral shin splints, but later a competent authority more specifically found the diagnosis to be chronic exertional compartment syndrome. The VA examiner noted that symptoms of the two entities are similar, and for purposes of rating the Veteran, the correct diagnosis is chronic exertional compartment syndrome. The VA examiner stated that the shin splints should have resolved after the Veteran was no longer required to run and engage in the rigors of military exercise, but he still has complaints of pain in the lower legs. In an October 2019 VA addendum medical opinion, the March 2016 VA examiner was asked whether the Veteran’s service-connected bilateral lower extremity compartment syndrome is most analogous to a tibia / fibula impairment or to a lower leg muscle impairment. The VA examiner stated that medical literature indicates that chronic exertional compartment syndrome is a condition that typically affects young endurance athletes, especially those who run extensively. It is thought to result from increased pressure within a muscle compartment. The VA examiner reported that the condition occurs primarily in the lower leg, and it is analogous to a lower leg muscle impairment. At an August 2020 VA examination for muscle injuries, the VA examiner reported that the Veteran had diagnoses of right lower extremity compartment syndrome and left lower extremity compartment syndrome. The VA examiner noted that the Veteran was asymptomatic for these conditions, and he stated that the Veteran has no issues at this time unless he walks a lot or runs. The examiner stated that the Veteran has had an injury to the muscles in Group XII in both legs; but there were no cardinal signs or symptoms of muscle disability. The Veteran did not have muscle atrophy, scars, fascial defects, or impairment of muscle tonus. The VA examiner stated that there was no change in the service-connected diagnosis, and no additional diagnoses had been rendered. In a related medical opinion, the August 2020 VA examiner stated that the Veteran does not have a severe disability related to the service-connected bilateral lower extremity compartment syndrome. He is only symptomatic if he runs or walks a lot. In an August 2020 VA Primary Care Physician Note, the Veteran reported that he cannot run, jump, jog, or do a treadmill because his legs start hurting. He noted that walking is not a problem. He stated that the condition prevents him from doing sports such as basketball. The Board has additionally reviewed the balance of the Veteran’s other medical treatment records from the period on appeal. The findings in the other medical treatment records are substantially similar to those noted in the VA examinations and treatment records described above. Based on the evidence described above, the Board finds that, as the Veteran’s right lower extremity compartment syndrome and left lower extremity compartment syndrome are more analogous to a lower leg muscle impairment, these disabilities should be rated under 38 C.F.R. § 4.73, DCs 5312, which concern muscle injuries of the leg. However, the Veteran’s bilateral compartment syndrome is asymptomatic, and he only has issues such as pain when he performs activities such as prolonged walking or running. The Veteran did not exhibit any cardinal signs or symptoms or any other impairment of the knee such that his disability could be evaluated as moderate, moderately severe, or severe. During the period on appeal, the Veteran’s bilateral compartment syndrome has not been shown to have more than mild severity. The severity of his disability has not been shown to be moderate, moderately severe, or severe, as would be required for a compensable evaluation under DC 5312. Thus, an evaluation of 10 percent or greater under DC 5312 would not be warranted in this case. As such, the Board finds that the a noncompensable (0 percent) evaluation under DC 5312 is warranted for the entire period on appeal. The Board acknowledges the Veteran’s assertions that his right lower extremity compartment syndrome and left lower extremity compartment syndrome are of a sufficient severity so as to warrant higher disability ratings. However, the competent medical evidence offering specific determinations pertinent to the rating criteria are the most probative evidence with regard to evaluating the pertinent symptoms for the disability on appeal. Thus, the Veteran’s own assessment as to the severity of the symptoms and their relationship to the rating criteria are less probative than the opinions of medical practitioners who have specialized knowledge and skill in excess of him. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); Woehlaert, supra. Moreover, the Board finds the reports of the medical examiners from July 2013, March 2016, and August 2020 VA examinations to be the more probative evidence of record concerning whether the Veteran’s right and left compartment syndrome have been severe enough to warrant higher disability ratings. The July 2013, March 2016, and August 2020 VA examiners’ rationales were logical and well-reasoned and based on consideration of the Veteran’s claims file, medical records, and post-service history, as well as relevant medical literature. Thus, the Board is satisfied that the July 2013, March 2016, and August 2020 VA examiners’ opinions are competent, credible, persuasive, and probative for deciding this appeal. As a final matter, the Board recognizes that the regulations containing the rating criteria for musculoskeletal disorders were revised during the pendency of this appeal. In situations such as this, the Board considers both the former and the current schedular criteria; although if an increased rating is warranted under the revised criteria, that award may not be made effective before the effective date of the change, even though there is no prohibition against assigning a rating under the older criteria for the entire period on appeal. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003) (overruling Karnas v. Derwinski, 1 Vet. App. 308, 312-13 (1991), to the extent it held that, where a law or regulation changes after a claim has been filed or reopened but before the administrative or judicial appeal process has been concluded, the version more favorable to appellant should apply). In this case, the criteria that were in place when the Veteran filed his claim that led to the August 2013 rating decision under this appeal are not more or less favorable to the Veteran than the revised criteria. See 83 Fed. Reg. 32592 (Jul. 13, 2018). The change in the law does not impact the evaluation of the Veteran’s right lower extremity compartment syndrome or left lower extremity compartment syndrome in this case. In sum, the Veteran’s right lower extremity compartment syndrome and left lower extremity compartment syndrome should each be rated as noncompensable under 38 C.F.R. § 4.73, DCs 5312, which concern muscle injuries of the leg. However, the preponderance of the evidence is against the assignment of a compensable evaluation under DC 5312 for both the right lower extremity compartment syndrome and the left lower extremity compartment syndrome. In reaching the above conclusions, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claims, that doctrine is not applicable in the instant appeal, and his claims must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 3. Entitlement to Increased Ratings for Bilateral Pes Planus The Veteran’s bilateral pes planus with plantar fasciitis and left foot degenerative arthritis has been rated under 38 C.F.R. § 4.71a, DC 5276. The Veteran is currently assigned a 10 percent evaluation for the period on appeal prior to December 21, 2020 and a 50 percent evaluation for the period after December 21, 2020. Under DC 5276, which concerns acquired flatfoot (pes planus), a noncompensable rating is assigned for mild flatfoot with symptoms relieved by built-up shoe or arch support. A 10 percent rating is warranted where there is moderate bilateral or unilateral flatfoot, with weight-bearing line over or medial to great toe, inward bowing of the tendo Achillis, and pain on manipulation and use of the feet. A 30 percent rating is assigned for severe bilateral flatfoot with objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. A 50 percent rating is assigned for pronounced bilateral flatfoot with marked pronation, extreme tenderness of plantar surfaces of the feet, and marked inward displacement and severe spasm of the tendo Achilles on manipulation, not improved by orthopedic shoes or appliance. 38 C.F.R. § 4.71a, Diagnostic Code 5276. At a July 2013 VA examination, the VA examiner diagnosed the Veteran with bilateral pes planus, osteoarthritis of the toes, and hallux valgus. The Veteran reported a history of pain in both feet associated with prolonged standing, walking, and running. Treatment included arch supports, activity modifications, and the use of various non-steroidal medications. This provided some relief, but he continued to experience pain in both feet with prolonged standing, walking and running. The Veteran had pain on use of the feet bilaterally, and pain was accentuated on use. The Veteran did not have pain on manipulation of the feet, and there was no indication of swelling on use. The Veteran did not have characteristic calluses, and he did not have extreme tenderness of plantar surfaces on the feet. The Veteran had decreased longitudinal arch height on weight-bearing bilaterally. There was no objective evidence of marked deformity of the foot (pronation, abduction, etc.). There was no marked pronation of the foot. The weight-bearing line did not fall over or medial to the great toe. There was no lower extremity deformity other than pes planus causing alteration of the weight-bearing line. The Veteran did not have inward bowing of the Achilles tendon, and he did not have marked inward displacement and severe spasm of the Achilles tendon on manipulation. At a March 2016 VA examination, the VA examiner noted that the Veteran wears shoe inserts but still develops pain when he is active, whether prolonged walking, jogging, or running. The Veteran reported having a dull pain in his arches. The Veteran reported flare-ups that were triggered by activity. During flare-ups, even walking is painful. He stated that he cannot walk more than half a mile because of pain. The Veteran reported pain on use of the feet bilaterally, and the pain was accentuated on use bilaterally. The Veteran did not have pain on manipulation of the feet, and there was no indication of swelling on use. The Veteran did not have characteristic callouses. The Veteran had tried arch supports, but he remained symptomatic bilaterally. He did not have extreme tenderness of plantar surfaces on the feet. He had decreased longitudinal arch height of both feet on weight-bearing. There was no objective evidence of marked deformity on the feet, and there was no marked pronation of the feet. The weight bearing line did not fall over or medial to the great toe. There was no lower extremity deformity other than pes planus causing alteration of the weight-bearing line. He did not have inward bowing of the Achilles tendon, and he did not have marked inward displacement and severe spasm of the Achilles tendon on manipulation of the feet. Contributing factors of disability included pain on weight-bearing bilaterally. There was pain, weakness, fatigability or incoordination that significantly limited functional ability during flare-ups or when the foot was used repeatedly over a period of time bilaterally. At a September 21, 2019 VA examination, the Veteran was diagnosed with bilateral flatfoot, bilateral plantar fasciitis, bilateral degenerative joint disease, and right foot hallux valgus. The Veteran reported toe joint pain and stiffness that tends to be worse when he gets up in the morning and improves as the day progresses. The Veteran reported pain in the bottom of his feet with weight bearing. The Veteran did not report flare-ups that impact the function of the feet. The Veteran reported pain on use of the feet bilaterally, and the pain was accentuated on use bilaterally. The Veteran had pain on manipulation of the feet, and the pain was accentuated on manipulation bilaterally. The Veteran had extreme tenderness of the plantar surfaces of both feet, and the tenderness was improved by orthopedic shoes or appliances. The Veteran used arch supports that effected relief of symptoms bilaterally. The Veteran had decreased longitudinal arch height of both feet on weight-bearing. There was no indication of swelling on use, and the Veteran did not have characteristic callouses. There was no evidence of marked deformity of the feet, and there was no marked pronation of the feet. The weight-bearing line of the feet did not fall over or medial to the great toe. There was not a lower extremity deformity other than pes planus that caused alteration of the weight-bearing line. The Veteran did not have inward bowing of the Achilles tendon, and he did not have marked inward placement and severe spasm of the Achilles tendon on manipulation of the feet. There was pain on physical examination bilaterally, but the pain did not contribute to functional loss. The pain was not enough to induce functional loss or limitations. There was not pain, weakness, fatigability, or incoordination that significantly limited functional ability during flare-ups or when the foot was used repeatedly over a period of time. There was not any other functional loss during flare-ups or when the foot was used repeatedly over a period of time. The examiner noted that the pes planus with chronic exertion could result in plantar fasciitis. At a December 21, 2020 VA examination, the Veteran was diagnosed with bilateral flatfoot, bilateral plantar fasciitis, and right foot hallux valgus, as well as left foot hallux valgus with degenerative arthritis. The Veteran reported recurrent pain and weakness in both feet that had worsened since his last VA examination; and the pain caused him to have difficulty standing, running, and walking for extended periods. The Veteran reported dull aching pain in the heels that radiated to the arch and forefoot. The Veteran reported flare-ups that impacted the function of the foot. The flare-ups of the feet were moderate to severe with sharp stabbing pain in the heels that radiated to the arches; the flare-ups occurred three to four times a week and lasted four to 12 hours. The flare-ups were precipitated by running, standing, or walking for long periods. The Veteran had pain on use of the feet bilaterally, and pain was accentuated on use bilaterally. The Veteran had pain on manipulation of the feet bilaterally, and pain was accentuated on manipulation bilaterally. The Veteran had characteristic callouses bilaterally. He had extreme tenderness of plantar surfaces of both feet, and he had decreased longitudinal arch height of both feet on weight bearing. The Veteran had tried orthotics, but he remained symptomatic. The weight bearing line fell over or medial to the great toe on the right foot. There was no indication of swelling on use. There was no objective evidence of marked deformity of the feet, and there was no marked pronation of the feet. There was not a lower extremity deformity other than pes planus causing alteration of the weight-bearing line. The Veteran did not have inward bowing of the Achilles tendon, and he did not have marked inward displacement and severe spasms of the Achilles tendon. There was pain on physical examination, and the pain contributed to functional loss. Contributing factors of disability included less movement than normal, weakened movement, pain on movement, pain on weight-bearing, pain on non-weight-bearing, disturbance of locomotion, and interference with standing. There was pain, weakness, fatigability or incoordination that significantly limited functional ability during flare-ups or when the foot was used repeatedly over a period of time. The foot pain and weakness cause him to have difficulty walking, running, and standing for long periods. There was objective evidence of pain on passive range of motion testing, weight bearing, and non-weightbearing testing of both feet. The Veteran regularly used bilateral orthotic inserts for his bilateral pes planus, plantar fasciitis, hallux valgus, and degenerative arthritis. The Board has additionally reviewed the balance of the Veteran’s other medical treatment records from the period on appeal. The findings in the medical treatment records are substantially similar to those noted in the VA examinations described above. During the period prior to September 21, 2019, the Veteran’s pes planus exhibited pain on use of the feet bilaterally. There was no objective evidence of marked deformity, characteristic callouses, marked pronation, extreme tenderness of the plantar surfaces of the feet, or marked inward displacement and severe spams of the Achilles tendon on manipulation, as would be required for an evaluation in excess of 10 percent under DC 5276. Thus, prior to September 21, 2019, an evaluation in excess of 10 percent is not warranted in this case. As such, the Board finds that the Veteran has been appropriately assigned a 10 percent evaluation under DC 5276 for the period on appeal prior to September 21, 2019. At the September 21, 2019 VA examination, the Veteran’s pes planus exhibited pain on use of the feet bilaterally and pain on manipulation of the feet bilaterally; and the pain was accentuated on use and manipulation bilaterally. The Veteran also had extreme tenderness of plantar surfaces of both feet. At the December 21, 2020 VA examination, the Veteran had characteristic callouses bilaterally, and the weight bearing line fell over or medial to the great toe on the right foot. Thus, the Veteran is entitled to a 50 percent evaluation under DC 5276 for the period on appeal beginning September 21, 2019. The Board notes that 50 percent is the highest evaluation allowed under DC 5276. The Board acknowledges the Veteran’s assertions that his bilateral pes planus was of a sufficient severity so as to warrant higher disability ratings than those described above. However, the competent medical evidence offering specific determinations pertinent to the rating criteria are the most probative evidence with regard to evaluating the pertinent symptoms for the disability on appeal. Thus, the Veteran’s own assessment as to the severity of the symptoms and their relationship to the rating criteria are less probative than the opinions of medical practitioners who have specialized knowledge and skill in excess of him. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); Woehlaert, supra. Moreover, the Board finds the reports of the medical examiners from July 2013, March 2016, September 2019, and December 2020 VA examinations to be the more probative evidence of record concerning whether the Veteran’s right and left compartment syndrome have been severe enough to warrant higher disability ratings. The July 2013, March 2016, September 2019, and December 2020 VA examiners’ rationales were logical and well-reasoned and based on consideration of the Veteran’s claims file, medical records, and post-service history. Thus, the Board is satisfied that the July 2013, March 2016, September 2019, and December 2020 VA examiners’ opinions are competent, credible, persuasive, and probative for deciding this appeal. As a final matter, the Board recognizes that the regulations containing the rating criteria for musculoskeletal disorders were revised during the pendency of this appeal. In situations such as this, the Board considers both the former and the current schedular criteria; although if an increased rating is warranted under the revised criteria, that award may not be made effective before the effective date of the change, even though there is no prohibition against assigning a rating under the older criteria for the entire period on appeal. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003) (overruling Karnas v. Derwinski, 1 Vet. App. 308, 312-13 (1991), to the extent it held that, where a law or regulation changes after a claim has been filed or reopened but before the administrative or judicial appeal process has been concluded, the version more favorable to appellant should apply). In this case, the revised criteria are more favorable to the Veteran in that they provide a new alternative diagnostic code for plantar fasciitis. Under DC 5269 in the revised criteria, a 30 percent evaluation is warranted where there is no relief from both non-surgical and surgical treatment bilaterally, and a 20 percent evaluation is warranted where there is no relief from both non-surgical and surgical treatment unilaterally. A 10 percent evaluation is warranted where there is otherwise unilateral or bilateral plantar fasciitis. See 83 Fed. Reg. 32592 (Jul. 13, 2018). In this case, the Veteran has not undergone any surgical treatment of his feet. Thus, beginning February 7, 2021, the date the revised criteria became effective, the Veteran is entitled to an additional 10 percent evaluation for bilateral plantar fasciitis. In sum, for the period on appeal prior to September 21, 2019, the preponderance of the evidence is against the assignment of an evaluation in excess of 10 percent for bilateral pes planus under DC 5276. However, for the period on appeal between September 21, 2019, and December 21, 2020, the Veteran is entitled to an evaluation of 50 percent, but no higher, for bilateral pes planus under DC 5276. For the period on appeal beginning December 21, 2020, the preponderance of the evidence is against the assignment of an evaluation in excess of 50 percent for bilateral pes planus; a 50 percent evaluation is the highest evaluation allowed under DC 5276. Additionally, beginning on February 7, 2021, the Veteran is entitled to an additional 10 percent evaluation for bilateral plantar fasciitis. In reaching the foregoing determinations, the Board has applied the benefit of the doubt doctrine and resolved all doubt in the Veteran’s favor, which has resulted in the additional increased ratings described above. However, insofar as the Board has denied increased ratings for bilateral pes planus, the preponderance of the evidence is against such aspects of the Veteran’s claim. Therefore, the benefit of the doubt doctrine is not applicable in such regard, and the claim must otherwise be denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Z. SAHRAIE Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dawn A. Leung, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.