Citation Nr: 21027562 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 13-31 761 DATE: May 6, 2021 ORDER Entitlement to a separate compensable rating for a right knee limitation of motion due to scar is denied. FINDING OF FACT Throughout the period of appeal, the Veteran's right knee scar has not been shown to result in any functional limitations of the right knee. CONCLUSION OF LAW The criteria for a separate disability rating for right knee scars based upon limitation of motion have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.71a, Diagnostic Codes 5260 and 5261, 4.118, DC 7805. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1968 to March 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a video conference hearing in April 2017. A copy of the transcript has been associated with the claims file and reviewed accordingly. This claim was previously before the Board in January 2019, at which time it was remanded for additional development. That development having been completed; this claim is once again before the Board. 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 appellant working or seeking work. 38 C.F.R. § 4.2. 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. The regulations require review of the recorded history of a disability by the adjudicator to ensure an accurate evaluation, however, the regulations do not give past medical reports precedence over the current medical findings. Where an increase in the disability rating is at issue, the present level of the Veteran's disability is the primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). It is also noted that staged ratings are appropriate for an increased rating claim whenever the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). As the issue of entitlement to an increased rating for the Veteran's scars based upon DCs 7800 to 7804 has previously been adjudicated by the Board, and shall not be the subject of the current inquiry. The scope of the current adjudication is limited to a discussion of DC 7805. Diagnostic Code 7805 instructs that any disabling effects not considered in a rating provided under Diagnostic Codes 7800-04 be rated under an appropriate Diagnostic Code. 38 C.F.R. § 4.118, DC 7805. It is contended the scar affects the functioning of flexion and extension of the knee particularly. As such 38 C.F.R. § 4.71a, DCs 5260 and 5261 are applicable. DC 5260 provides ratings based on limitation of flexion of the leg. Flexion of the leg limited to 45 degrees is rated 10 percent disabling; flexion of the leg limited to 30 degrees is rated 20 percent disabling; and flexion of the leg limited to 15 degrees is rated 30 percent disabling. 38 C.F.R. § 4.71a. DC 5261 provides ratings based on limitation of extension of the leg. Extension of the leg limited to 10 degrees is rated 10 percent disabling; extension of the leg limited to 15 degrees is rated 20 percent disabling; extension of the leg limited to 20 degrees is rated 30 percent disabling; extension of the leg limited to 30 degrees is rated 40 percent disabling; and extension of the leg limited to 45 degrees is rated 50 percent disabling. 38 C.F.R. § 4.71a. Normal range of motion of the knee is from 0 degrees extension to 140 degrees flexion. 38 C.F.R. § 4.71a. The Veteran contends that he is entitled to a higher rating because his right knee scar is so painful as to cause functional limitations, such as limitation of motion. The Veteran contends that his scars, during a flare up, prevent the full flexion or extension of his knee. At a VA examination in November 2012, it was noted that the Veteran did not have a painful or unstable scar. The November 2012 VA examiner did not indicate if the Veteran had any flare ups or discuss how flare ups would impact the Veteran's scars. In his October 2013 VA Form 9, the Veteran stated that during a flare up, his right knee scars were painful. The Veteran elaborated on this pain during his April 2017 Board hearing, indicating additional functional limitation of knee flexion and extension. The Veteran is competent to describe his symptoms, such as pain. The Veteran was provided an additional VA examination in May 2019. Although the May 2019 VA examiner indicated that there were three painful scars of the lower extremities, the Veteran is only noted as having two scars of the right lower extremity. Thus, the Board concludes that the examiner checked the incorrect box, indicating three painful scars, when in actuality only two scars are painful. Throughout the pendency of the appeal, the Veteran has only been shown to have two scars of the right lower extremity. The May 2019 VA examiner did not address the Veteran's lay statements that during a flare up, his scar prevented him full range of motion. The Veteran was provided with an additional VA examination in February 2021. At the examination, it was determined that the Veteran did not have any functional limitations of the right knee at all. Rather, flexion and extension were normal (140 degrees and 0 degrees respectively) on passive and active ranges of motion, after repetition, and taking pain and flare-ups into account. Additionally, the examiner found that the Veteran's scars of the right knee were no longer visible so as to provide a diagnosis. The examiner indicated that the Veteran may be experiencing subjective pain due to the scars, but essentially found there was no plausible relationship between any scar and knee functional limitations. Here, the Board finds that the Veteran's scar disability does not warrant a separate evaluation based upon functional loss. The most probative medical evidence of record has shown that the Veteran's ranges of motion for his right knee are wholly unaffected by his scars, which are well-healed. The Board acknowledges that the Veteran believes that the disability on appeal has been more severe than the assigned disability rating reflects. Moreover, the Veteran is competent to report observable symptoms, to include pain. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, the Board finds that the most probative evidence of record, via the February 2021 VA examination findings, do not show that there has been any evidence of the functional limitations so described by the Veteran. Likewise, the Veteran is not shown competent to ascribe any knee limitation of motion to a particular cause. In conclusion, the Board finds that the preponderance of the evidence is not in favor of the Veteran's claim for a separate disability rating for functional impairment of the right knee due to scars. In denying such, 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. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Dodd, Ryan 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.