Citation Nr: 21027745 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 16-43 298 DATE: May 6, 2021 ORDER Entitlement to an effective date of January 1, 1996 for entitlement to service connection for right ankle strain at a noncompensable disability rating; is granted. Entitlement to service connection for lateral collateral ligament strain of the left ankle is dismissed. Entitlement to service connection for achilles tendonitis of the left heel associated with left ankle disability is denied. Entitlement to an initial disability rating in excess of 10 percent for chronic lumbar strain and degenerative disc disease prior to October 8, 2020; is denied. Entitlement to a disability rating in excess of 20 percent for chronic lumbar strain and degenerative disc disease from October 8, 2020; is denied. Entitlement to an initial disability rating in excess of 10 percent for right ankle strain with achilles tendonitis of the right heel is denied. Entitlement to a compensable disability rating for lipoma of the lower back is denied. Entitlement to a disability rating in excess of 10 percent for chondromalacia of the right knee associated with right ankle strain with achilles tendonitis of the right heel is denied. Entitlement to an initial disability rating in excess of 10 percent for chondromalacia of the left knee associated with right ankle strain with achilles tendonitis of the right heel is denied. Entitlement to an initial compensable disability rating for corneal scar and endothelial pigmentation of the right eye is denied. FINDINGS OF FACT 1. The RO granted entitlement to service connection for right ankle strain in the August 2016 rating decision, effective January 1, 1996 at a noncompensable disability rating. 2. On January 13, 2021, prior to the promulgation of a decision in the appeal, the RO granted the Veteran's claim for entitlement to service connection for lateral collateral ligament strain of the left ankle associated with right ankle strain with achilles tendonitis of the right heel, effective August 12, 2010. 3. The preponderance of the evidence of record is against finding that the Veteran has had achilles tendonitis of the left heel at any time during or approximate to the pendency of the claim. 4. Prior to October 8, 2020; the Veteran's chronic lumbar strain and degenerative disc disease is manifest by forward flexion of 0 to 80 degrees, extension of 0 to 15 degrees, lateral flexion of 0 to 25 degrees bilaterally, rotation of 0 to 25 degrees bilaterally, and combined range of motion of 195 degrees; with no pain in range of motion, no loss of motion on repeated use, no sensory deficit in lower extremities; and no localized tenderness, spasm, deformity, atrophy, or weakness. 5. From October 8, 2020; the Veteran's chronic lumbar strain and degenerative disc disease is manifest by forward flexion from 0 to 60 degrees, extension of 0 to 15 degrees, lateral flexion of 0 to 20 degrees bilaterally, and lateral rotation of 0 to 20 degrees bilaterally without additional loss of function after three repetitions; with a combined range of motion of 155 degrees. 6. The Veteran's right ankle strain with achilles tendonitis of the right heel is manifested by no more than moderate limited motion of the ankle. 7. The Veteran's lipoma of the lower back has manifested as raised and discolored skin. 8. The Veteran's chondromalacia of the right knee associated with right ankle strain with achilles tendonitis of the right heel produced no worse than 0 to 70 degrees flexion. 9. The Veteran's chondromalacia of the left knee associated with right ankle strain with achilles tendonitis of the right heel produced no worse than 0 to 70 degrees flexion. 10. The Veteran's corneal scar and endothelial pigmentation manifests as impaired visual acuity to no worse than 20/20 bilaterally. CONCLUSIONS OF LAW 1. The criteria for an effective date of January 1, 1996 for entitlement to service connection for right ankle strain have been met. 38 U.S.C. §§ 5110, 5107; 38 C.F.R. § 3.400. 2. The criteria for dismissal of an appeal for entitlement to service connection for lateral collateral ligament strain of the left knee have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 3. The criteria for service connection for achilles tendonitis of the left heel associated with left ankle disability are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for a rating in excess of 10 percent for chronic lumbar strain and degenerative disc disease prior to October 8, 2020; have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5237. 5. The criteria for a rating in excess of 20 percent for chronic lumbar strain and degenerative disc disease from October 8, 2020; have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5237. 6. The criteria for a rating in excess of 10 percent for right ankle strain with achilles tendonitis of the right heel have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5003, Diagnostic Code 5271. 7. The criteria for a compensable disability rating for lipoma of the lower back has not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.118, Diagnostic Code 7804, Diagnostic Code 7819. 8. The criteria for a rating in excess of 10 percent for chondromalacia of the right knee associated with right ankle strain with achilles tendonitis of the right heel have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5003, Diagnostic Code 5260. 9. The criteria for a rating in excess of 10 percent for chondromalacia of the left knee associated with right ankle strain with achilles tendonitis of the right heel have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5003, Diagnostic Code 5260. 10. The criteria for a compensable disability rating percent for corneal scar and endothelial pigmentation of the right eye have not been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.75-4.79 Diagnostic Code 6015, Diagnostic Code 6011. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Air Force from October 1983 until his honorable release in December 1995. These matters come before the Board of Veterans' Appeals (Board) on appeal from the July 2012, June 2013, August 2016, and January 2021 rating decision by the Baltimore, Maryland Regional Office (RO) and Buffalo, New York RO of the United States Department of Veterans Affairs (VA). In February 2019, the Board remanded the case to the RO for further development. Earlier Effective Date Generally, the effective date of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be on the date of receipt of the claim or the date entitlement arose, whichever is the later. 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. Under 38 U.S.C. § 5110(a), the effective date of an increase in a Veteran's disability compensation shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C. § 5110(b)(2) provides an exception to this general rule: "The effective date of an award of increased compensation shall be the earliest date as of which it is ascertainable that an increase in disability had occurred, if application is received within one year from such date." Thus, "the plain language of [section] 5110(b)(2)...only permits an earlier effective date for an increased disability compensation if that disability increased during the one-year period before the filing of the claim." Thus, three possible dates may be assigned depending on the facts of an increased rating earlier effective date case: (1) If an increase in disability occurs after the claim is filed, the date that the increase is shown to have occurred (date entitlement arose) (38 C.F.R. § 3.400 (o)(1)); (2) If an increase in disability precedes the claim by a year or less, the date that the increase is shown to have occurred (factually ascertainable) (38 C.F.R. § 3.400 (o)(2)); or (3) If an increase in disability precedes the claim by more than a year, the date that the claim is received (date of claim) (38 C.F.R. § 3.400(o)(2)). See Gaston v. Shinseki, 605 F.3d 979, 982-84 (Fed. Cir. 2010); Harper v. Brown, 10 Vet. App. 125, 126 (1997). Prior to March 24, 2015, when VA amended its rules as to what constitutes a claim, a claim was a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 U.S.C. § 101 (30); 38 C.F.R. § 3.1 (p). The date of receipt shall be the date on which a claim, information or evidence was received by VA. 38 U.S.C. § 101 (30); 38 C.F.R. § 3.1 (r). Any communication or action, indicating intent to apply for one or more benefits under the laws administered by VA, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claims must identify the benefit sought. 38 C.F.R. § 3.155. 1. Entitlement to an effective date prior to August 12, 2010 for right ankle strain with achilles tendonitis of the right heel The Veteran asserts that he is entitled to an effective date prior to August 12, 2010 for entitlement to service connection for right ankle strain with achilles tendonitis of the right heel because he originally applied for service connection in January 1996. The question for the Board is whether VA received an informal or formal claim for compensation for this disability prior to August 12, 2010; that was not finally adjudicated. In an August 2016 rating decision, the RO found that the June 24, 1996 rating decision that denied the Veteran's claim for entitlement to service connection for right ankle strain was CUE and granted the Veteran's right ankle strain disability at a non-compensable disability rating effective January 1, 1996. Although the record reflects that the RO granted the Veteran's claim in the August 2016 rating decision, it does not appear to have been effective. The record does not reflect a right ankle strain disability listed from January 1, 1996 to August 11, 2010. To that extent, the Veteran's claim is granted because the RO has already found CUE and has granted a noncompensable disability rating from January 1, 1996 to August 11, 2010. The Board notes from August 12, 2010 to present, the Veteran has been service connected for right ankle strain with achilles tendonitis of the right heel at a 10 percent disability rating. Although the issue of severity of the Veteran's disability is also on appeal, it will be addressed later in this decision. Accordingly, the claim for an earlier effective date of January 1, 1996 is granted. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran 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 - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability; compensation may be provided for the degree of the disability (but only that degree) over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b) (2017); Allen v. Brown, 8 Vet. App. 374 (1995). 2. Entitlement to service connection for lateral collateral ligament strain of the left ankle The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed or there remain no allegations of errors of fact or law for appellate consideration. 38 U.S.C. § 7105. In the present case, the RO granted the Veteran's claim in the January 2021 rating decision. Therefore, the Veteran's claim is dismissed as moot. 3. Entitlement to service connection for achilles tendonitis of the left heel associated with left ankle disability The Veteran asserts that he is entitled to service connection for achilles tendonitis of the left heel associated with left ankle disability. The Board finds that there is not evidence of a current disability of achilles tendonitis of the left heel. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen v. Brown, 8 Vet. App. 374 (1995). The Veteran was afforded a VA examination in November 2020. The November 2020 VA examiner diagnosed the Veteran with lateral collateral ligament sprain (chronic or recurrent) of the left side; however, the November 2020 VA examiner did not diagnose the Veteran with achilles tendonitis of the left heel. See November 2020 VA examination, p. 2. The Board notes that the Veteran is already service connected for his diagnosed disability of lateral collateral ligament sprain (chronic or recurrent) of the left side, which will be addressed later in this decision. In the absence of a disability during the pendency of the claim, service connection cannot be established. See Brammer v. Derwinski, 2 Vet. App. 223 (1992). There is also insufficient evidence of a disability at any point during the claim period or shortly before. See McClain v. Nicholson, 21 Vet. App. 219 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Accordingly, entitlement to service connection is denied. At the core of service connection is functional impairment, which can be a disability even if there is no underlying diagnosis. Consideration should be given to the impact of functional limitation. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir., 2018). Here there is no assertion of functional limitation due to achilles tendonitis of the left heel. Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Schedule), found in 38 C.F.R. Part 4. The Schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation 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. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in the Veteran's favor. 38 C.F.R. § 4.3. In considering the severity of a disability, it is essential to trace the medical history of the Veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41. Consideration of the whole-recorded history is necessary so that a rating may accurately reflect the elements of any disability present. 38 C.F.R. § 4.2; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Although the regulations do not give past medical reports precedence over current findings, the Board is to consider the Veteran's medical history in determining the applicability of a higher rating for the entire period in which the appeal has been pending. Powell v. West, 13 Vet. App. 31, 34 (1999). Where entitlement to compensation has been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Where an appeal is based on an initial rating for a disability, however, evidence contemporaneous with the claim and the initial rating decision are most probative of the degree of disability existing when the initial rating was assigned and should be the evidence "used to decide whether an original rating on appeal was erroneous." Fenderson v. West, 12 Vet. App. 119, 126 (1999). In either case, if later evidence indicates that the degree of disability increased or decreased following the assignment of the initial rating, staged ratings may be assigned for separate periods of time. Fenderson, 12 Vet. App. at 126; Hart v. Mansfield, 21 Vet. App. 505 (2007) (noting that staged ratings are appropriate whenever the factual findings show distinct time periods in which a disability exhibits symptoms that warrant different ratings). When adjudicating a claim for an increased initial evaluation, the relevant time period is from the date of the claim. Moore v. Nicholson, 21 Vet. App. 211, 215 (2007), rev'd in irrelevant part, Moore v. Shinseki, 555 F.3d 1369 (2009). When adjudicating an increased rating claim, the relevant time period for consideration is the time period one year before the claim was filed. Hart, 21 Vet. App. at 509. Generally, the effective date of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be on the date of receipt of the claim or the date entitlement arose, whichever is the later. 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. Under 38 U.S.C. § 5110(a), the effective date of an increase in a Veteran's disability compensation shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C. § 5110(b)(2) provides an exception to this general rule: "The effective date of an award of increased compensation shall be the earliest date as of which it is ascertainable that an increase in disability had occurred, if application is received within one year from such date." Thus, "the plain language of [section] 5110(b)(2)...only permits an earlier effective date for an increased disability compensation if that disability increased during the one-year period before the filing of the claim." Thus, three possible dates may be assigned depending on the facts of an increased rating earlier effective date case: (1) If an increase in disability occurs after the claim is filed, the date that the increase is shown to have occurred (date entitlement arose) (38 C.F.R. § 3.400 (o)(1)); (2) If an increase in disability precedes the claim by a year or less, the date that the increase is shown to have occurred (factually ascertainable) (38 C.F.R. § 3.400 (o)(2)); or (3) If an increase in disability precedes the claim by more than a year, the date that the claim is received (date of claim) (38 C.F.R. § 3.400(o)(2)). See Gaston v. Shinseki, 605 F.3d 979, 982-84 (Fed. Cir. 2010); Harper v. Brown, 10 Vet. App. 125, 126 (1997). Prior to March 24, 2015, when VA amended its rules as to what constitutes a claim, a claim was a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 U.S.C. § 101 (30); 38 C.F.R. § 3.1 (p). The date of receipt shall be the date on which a claim, information or evidence was received by VA. 38 U.S.C. § 101 (30); 38 C.F.R. § 3.1 (r). Any communication or action, indicating intent to apply for one or more benefits under the laws administered by VA, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claims must identify the benefit sought. 38 C.F.R. § 3.155. 4. Entitlement to an initial disability rating in excess of 10 percent for chronic lumbar strain and degenerative disc disease prior to October 8, 2020 5. Entitlement to a disability rating in excess of 20 percent for chronic lumbar strain and degenerative disc disease from October 8, 2020 Due to the similar dispositions for the above claims on appeal, the Board will address them in a common discussion below. As a preliminary matter, the Board notes that in February 2021, the Veteran filed a Decision Review Request: Supplemental Claim (VA Form 20-0995) appealing the January 15, 2021 rating decision that granted him an increased disability rating to 20 percent disabled for chronic lumbar strain and degenerative disc disease from October 8, 2020 because it has been continuously prosecuted since August 12, 2010. Although the RO denied the Veteran's claims in the February 2021 rating decision, this issue is still before the Board and shall be addressed in the decision below. Furthermore, the Board notes that in correspondence received in October 2010, the Veteran filed a claim for clear and unmistakable error (CUE) for the June 1996 rating decision that denied entitlement to service connection for chronic lumbar strain. The CUE claim was decided in the August 2016 rating decision, denying the Veteran's claim for CUE. The Veteran did not appeal the August 2016 rating decision pertaining to the CUE claim, and that decision became final in September 2016. Furthermore, the Board notes that in the August 2016 Statement of the Case (SOC), the RO also clearly explained that the February 2013 Notice of Disagreement (NOD) that the Veteran filed pertaining to the July 19, 2012 rating decision included a statement that the Veteran asserted his service connection should be retroactive because he filed his original claim for the disabilities on January 16, 1996. However, the RO noted that the Veteran filed the CUE claim in October 2010 had not previously been adjudicated and found that the February 2013 NOD pertaining to the earlier effective date based on CUE was premature because the issue had not previously been adjudicated. The Veteran asserts that he is entitled to a higher disability rating because his disabilities are expected to worsen over time. The Veteran's chronic lumbar strain and degenerative disc disease is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5237. Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent rating is warranted for forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent evaluation is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. Id. at Note 1. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria."). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint." The spine has no opposite joint. In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination.] Prior to October 8, 2020 The Board finds that the preponderance of the evidence is against a rating in excess of 10 percent for chronic lumbar strain and degenerative disc disease. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to chronic low back discomfort and stiffness starting in 1992 without specific trauma. The Veteran was afforded a VA examination in July 2011. During the July 2011 VA examination, the Veteran reported that he had not sought evaluation or treatment (including prescribed medication) for spine impairment since he left service; denied any radiation; no episodes of total physical incapacitation due to spine impairment in the last 12 months; no associated bowel, bladder, constitutional symptoms; and does not use an assistive device. The July 2011 VA examiner found that the Veteran was walking briskly in the hallway without assistive devices, with normal gait and posture; the Veteran was able to dress and undress without difficulty; was able to walk on heels and toes and squat and could duck walk; there was no localized tenderness, spasm, deformity, atrophy, or weakness; and the Veteran's range of motion was forward flexion of 80 degrees, extension was 15 degrees, lateral flexion was 25 degrees bilaterally, rotation was 25 degrees bilaterally without pain in range of motion and no loss of range of motion on repeated maneuvers (three times); with a combined range of motion of 195 degrees. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements that the Veteran reported would not result in limitation of motion more nearly approximating 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. Additionally, the Veteran did not have muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. Consideration has also been given to assigning a rating under the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes. However, the Veteran does not have IVDS and the evidence of record is against a finding that the Veteran was ever prescribed bed rest by a physician for a duration that meets the criteria for a higher rating. See 38 C.F.R. § 4.71a, Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes. Regarding neurological impairment, the Veteran has already been granted service connection for impingement syndrome of the bilateral shoulders and the lay and medical evidence of record is against a finding that the Veteran has any other neurological abnormality associated with his spine disability. For the foregoing reasons, the preponderance of the evidence is against the Veteran's claim for a rating in excess of 10 percent for chronic lumbar strain and degenerative disc disease prior to October 8, 2020. 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. From October 8, 2020 The Veteran was afforded a VA examination on October 29, 2020. The October 2020 VA examiner noted that the Veteran did not report flare-ups but did report difficulty in sitting for long periods of time. The October 2020 VA examiner found that the Veteran had forward flexion from 0 to 60 degrees, extension of 0 to 15 degrees, lateral flexion of 0 to 20 degrees bilaterally, and lateral rotation of 0 to 20 degrees bilaterally without additional loss of function after three repetitions; with a combined range of motion of 155 degrees. The Board finds that the preponderance of the evidence is against a rating in excess of 20 percent for chronic lumbar strain and degenerative disc disease. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to sitting for long periods of time causes pain. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements that he had difficulty sitting for long periods of time would not result in limitation of motion more nearly approximating forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. Consideration has also been given to assigning a rating under the Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes. However, the Veteran does not have IVDS and the evidence of record is against a finding that the Veteran was ever prescribed bed rest by a physician for a duration that meets the criteria for a higher rating. See 38 C.F.R. § 4.71a, Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes. As noted above, regarding neurological impairment, the Veteran has already been granted service connection for impingement syndrome of the bilateral shoulders and the lay and medical evidence of record is against a finding that the Veteran has any other neurological abnormality associated with his spine disability. Considering the effective date of the Veteran's increased disability rating to 20 percent, the Board notes that the RO increased the Veteran's disability rating effective October 8, 2020. According to the January 2021 rating decision, the basis of the October 8, 2020 effective date was on the date of the VA examination. As noted above, if an increase in disability occurs after the claim is filed, the date that the increase is shown to have occurred (date entitlement arose). 38 C.F.R. § 3.400 (o)(1). As noted above the date of the VA examination was October 29, 2020 and not October 8, 2020. See October 2020 VA Back (Thoracolumbar Spine) conditions Disability Benefits Questionnaire (DBQ) examination, pp. 1-10 lower right of each page. Therefore, the Board finds that the appropriate effective date for the Veteran's increased disability rating under 38 C.F.R. § 3.400 (o)(1) is October 29, 2020. However, the Board will not disrupt the RO's decision that erroneously granted the increased disability rating three weeks prior to the October 2020 VA examination. Based on the foregoing, the preponderance of the evidence is against the Veteran's claim for a rating in excess of 20 percent for chronic lumbar strain and degenerative disc disease from October 8, 2020. 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. 6. Entitlement to an initial disability rating in excess of 10 percent for right ankle strain with achilles tendonitis of the right heel The Veteran asserts that he is entitled to a higher disability rating for his right ankle strain with achilles tendonitis of the right heel. The Veteran's right ankle strain with achilles tendonitis of the right heel is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5003-5271, for limitation of motion of the ankle. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the specific basis for the evaluation assigned; the additional code is shown as a hyphen. 38 C.F.R. § 4.27. Degenerative arthritis is rated under DC 5003, which provides ratings for degenerative arthritis. Degenerative arthritis (osteoarthritis or hypertrophic) established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. When, however, the limitation of motion of the specific joint or joints involved is noncompensably disabling under the appropriate diagnostic codes, a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under DC 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. 38 C.F.R. § 4.71a. In the absence of limitation of motion, a 10 percent rating is warranted where there is X-ray evidence of involvement of two or more major joints or two or more minor joint groups. A 20 percent rating is warranted where there is X-ray evidence of involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations. In Notes (1) and (2) in DC 5003, it is indicated these 20 and 10 percent ratings based on X-ray findings will not be combined with ratings based on limitation of motion. 38 C.F.R. § 4.71a, DC 5003. Under Diagnostic Code 5271, a 10 percent rating is warranted for moderate limited motion of the ankle. A maximum 20 percent rating is warranted for marked limited motion of the ankle. 38 C.F.R. § 4.71a, Diagnostic Code 5271. According to MERRIAM WEBSTER, "moderate" means "tending toward the mean or average amount or dimension". See www.merriam-webster.com/dictionary/moderate. "Marked" means "having a distinctive or emphasized character". See www.merriam-webster.com/dictionary/marked. 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 factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria."). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint." In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination. The Veteran was afforded a VA examination in April 2013. The April 2013 VA examiner determined that the Veteran had less movement than normal in the right ankle, pain on movement, and swelling with localized tenderness with x-ray evidence showing mild to moderate osteoarthritis. The Veteran had plantar flexion of 40 degrees with objective evidence of painful motion beginning at 35 degrees, right ankle dorsiflexion (extension) of 10 degrees with painful motion beginning at 5 degrees, with additional limitations of range of motion to 35 degrees for plantar flexion and 5 degrees for dorsiflexion (extension) after repeated use over time. The April 2013 VA examiner concluded that the Veteran had stable minimal irregularity at the tibiofibular syndesmosis and stable minimal degenerative change at the posterior aspect of the tibiotalar joint. The Veteran was afforded a second VA examination in October 2020. The October 2020 VA examiner determined that the Veteran had osteoarthritis of the right ankle and right ankle strain with achilles tendonitis of the right heel. The Veteran did not report flare-ups but did report difficulty walking and standing for long periods of time. The October 2020 VA examiner found that the Veteran had abnormal range of motion of 0 to 10 degrees dorsiflexion of 0 to 10 degrees and plantar flexion of 0 to 35 degrees with no additional loss of function after three repetitions. The Board finds that the preponderance of the evidence is against a rating in excess of 10 percent for right ankle strain with achilles tendonitis of the right heel. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to standing or walking for long periods of time. However, even considering the Veteran's lay reports of symptoms and functional loss, the degree of additional limitation reflected by the statements that he is unable to stand or walk for long periods of time would not result in symptoms more nearly approximating marked limited motion or limitation so distinctive or emphasized that it would approximate marked limited motion. The Board has considered whether any other Diagnostic Codes related to disabilities of the ankle 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. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran's appeal for a rating in excess of 10 percent for right ankle strain with achilles tendonitis of the right heel. 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. 7. Entitlement to a compensable disability rating for lipoma of the lower back The Veteran asserts that he is entitled to a higher disability rating for his lipoma of the lower back. The Veteran's lipoma of the lower back is rated under Diagnostic Code 7805-7819. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the specific basis for the evaluation assigned; the additional code is shown as a hyphen. 38 C.F.R. § 4.27. The Board notes that VA amended the criteria for rating skin disabilities effective from August 13, 2018. However, Diagnostic Code 7805 was not changed by the August 13, 2018, amendments. Diagnostic Code 7805 instructs that any disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04 under an appropriate Diagnostic Code. Diagnostic Code 7819 instructs that benign skin neoplasms are rated under disfigurement of the head, face, or neck (under Diagnostic Code 7800), scars (Diagnostic Codes 7801-7805), or impairment of function. The Veteran was afforded a VA examination in September 2010. The September 2010 VA examiner found that the Veteran had a lump or a mass in the middle lower to middle of the back of the right side that has remained constant with no treatment and no side effect(s) beyond abnormal appearance of the area which he reported a history of occasional pain or discomfort without any specified timeframe. The Veteran was afforded a second VA examination in October 2020. The October 2020 VA examiner found that the Veteran had a lump on his right lower back with no current symptom or treatment beyond raised and discolored skin that encompasses less than 5 percent of his total body and none of his exposed area. The Board finds that the preponderance of the evidence is against the assignment of a compensable disability rating for the Veteran's lipoma of the lower back under Diagnostic Code 7805 as there are no other disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04. The Veteran reports no disabling effects beyond the raised and discolored skin. The Board has also considered the other Diagnostic Codes pertaining to scars. However, the Veteran's lipoma of the lower back is not of the head, face, or neck, is not deep and nonlinear, and is not associated with underlying soft tissue damage. Although it is superficial and not associated with underlying soft tissue damage, it does not cover an area or areas of 144 square inches or greater. Moreover, the Veteran's lipoma of the lower back is not unstable or painful. Therefore, Diagnostic Codes 7800, 7801, 7802, and 7804, both prior to and from August 13, 2018, are inapplicable. 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 raised and discolored skin, and his reports are credible. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, he does not assert, and medical records do not show, that the Veteran's lipoma of the lower back is manifest by any disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran's claim for a compensable rating for lipoma of the lower back. 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. 8. Entitlement to a disability rating in excess of 10 percent for chondromalacia of the right knee associated with right ankle strain with achilles tendonitis of the right heel 9. Entitlement to a disability rating in excess of 10 percent for chondromalacia of the left knee associated with right ankle strain with achilles tendonitis of the right heel Due to the similar dispositions for the above claims on appeal, the Board will address them in a common discussion below. The Veteran asserts that he is entitled to a higher disability rating for chondromalacia of the bilateral knees. The assigned Diagnostic Code 5260 suggests that the Veteran's chondromalacia of the bilateral knees associated with right ankle strain with achilles tendonitis of the right heel are rated based on compensable limitation of flexion and extension. 38 C.F.R. § 4.71a. The Board notes that Diagnostic Code 5260 provides a compensable disability rating for limitation of flexion of 45 degrees or less and that the Veteran's limitation of range of motion has been no less than 70 degrees throughout the period on appeal. As noted above, a review of the evidence reflects that the chondromalacia of the bilateral knees associated with right ankle strain with achilles tendonitis of the right heel has manifested as osteoarthritis and been rated based on painful noncompensable limitation of motion, and that the chondromalacia of the bilateral knees associated with right ankle strain with achilles tendonitis of the right heel has not had compensable limitation of motion (i.e. limitation of flexion or extension) at any time during the relevant rating period. Therefore, the Diagnostic Code assigned should have been Diagnostic Code 5003, to show that the chondromalacia of the bilateral knees associated with right ankle strain with achilles tendonitis of the right heel is being rated based on noncompensable limitation of motion that is painful. 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). The Board finds that a change in the Veteran's assigned Diagnostic Code is warranted. The Board notes that the Court has held that the selection of a particular Diagnostic Code "is a determination that is completely dependent upon the facts of a particular case," and the Board has discretion in determining the appropriate Diagnostic Code. Butts v. Brown, 5 Vet. App. 532, 538 (1993) (applying the more deferential "arbitrary, capricious" standard, rather than de novo review, to the Board's determination of the appropriate Diagnostic Code). Therefore, the Board finds that a rating under Diagnostic Code 5260 is not the appropriate Diagnostic Code to rate the Veteran's disability. The evidence does not show a compensable limitation to range of motion. As such, the Board finds that a rating under Diagnostic Code 5003 for painful motion is the more appropriate Diagnostic Code. Accordingly, the Board finds that the appropriate Diagnostic Code for the Veteran's disability is Diagnostic Code 5003. The Board further notes that the Veteran's current disability has been rated under Diagnostic Code 5060 for over 10 years and is afforded protection under 38 U.S.C. § 1195; 38 C.F.R. § 3.95. However, the Board finds that a change in the Diagnostic Code will not result in a reduction of the current disability rating or severance of service connection. Therefore, the Board finds that a change in the Diagnostic Code does not violate the Veteran's rights under 38 U.S.C. § 1159. In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint." In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination. Degenerative arthritis is rated under DC 5003, which provides ratings for degenerative arthritis. Degenerative arthritis (osteoarthritis or hypertrophic) established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. When, however, the limitation of motion of the specific joint or joints involved is noncompensably disabling under the appropriate diagnostic codes, a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under DC 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. 38 C.F.R. § 4.71a. In the absence of limitation of motion, a 10 percent rating is warranted where there is X-ray evidence of involvement of two or more major joints or two or more minor joint groups. A 20 percent rating is warranted where there is X-ray evidence of involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations. In Notes (1) and (2) in DC 5003, it is indicated these 20 and 10 percent ratings based on X-ray findings will not be combined with ratings based on limitation of motion. 38 C.F.R. § 4.71a, DC 5003. The Veteran was afforded a VA examination in April 2013. The April 2013 VA examiner determined that Veteran's chondromalacia of the right knee produced flexion of 0 to 120 degrees with objective evidence of painful motion beginning at 110 degrees. The Veteran's chondromalacia of the left knee produced flexion of 0 to 110 degrees with objective evidence of painful motion beginning at 100 degrees. The Veteran's chondromalacia did not produce hyperextension of either knee. Results after repetitive use produced limited range of motion of 0 to 110 degrees in the right knee and 0 to 100 degrees in the left knee. The Veteran was afforded a second VA examination in October 2020. The October 2020 VA examiner determined that the Veteran's bilateral knee joint osteoarthritis that did not produce flare-ups but did produce abnormal range of motion of 0 to 70 degrees flexion and 70 to 0 degrees extension without additional functional loss after repetitive use, bilaterally. In conclusion, the Board finds that the preponderance of the evidence is against the Veteran's claim for a rating in excess of 10 percent for chondromalacia of the bilateral knees. 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. 10. Entitlement to a compensable disability rating for corneal scar and endothelial pigmentation of the right eye The Veteran asserts that he is entitled to a higher disability rating. During the pendency of the Veteran's appeal, VA issued a final rule revising the portion of the VA Schedule for Rating Disabilities that address the organics of special sense and schedule of ratings-eye. 83 Fed. Reg. 15316 (April 10, 2018). The final rule went into effect May 13, 2018. Where there is a change in the rating criteria during the appeal period, the Board will consider the claim in light of both the former and revised schedular rating criteria, although an increased evaluation based on the revised criteria cannot predate the effective date of the amendments. Under both the former and revised criteria, a 10 percent disability rating is warranted for localized scars, atrophy, or irregularities of the retina, unilateral or bilateral, that are centrally located and that result in an irregular, duplicated, enlarged, or diminished image. Both versions of the criteria also provide for an alternative basis for the evaluation if it results in a higher disability rating. Under the former criteria, the alternative evaluation is based on the General Rating Formula for Diseases of the Eye. The General Rating Formula for Diseases of the Eye instructs to evaluate the disability based on visual impairment or its rating criteria for incapacitating episodes. Thus, the primary difference between the former and revised criteria is consideration of incapacitating episodes. The Board also notes that in the May 2018 changes also included a change to the Note(s) under General Rating Formula for Diagnostic Codes 6000 through 6009. Specifically, prior to the May 2018 changes, the Note provided "For VA purposes, an incapacitating episode is a period of acute symptoms severe enough to require prescribed bed rest and treatment by a physician or other healthcare provider." However, subsequent to the May 2018 changes, there are now three notes under General Rating Formula for Diagnostic Codes 6000 through 6009. Note: (1) provides "For the purposes of evaluation under 38 C.F.R. § 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. Note: (2) provides "examples of treatment may include but are not limited to: systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions." Note: (3) provides for the purposes of evaluating visual impairment due to the particular condition, refer to 38 C.F.R. §§ 4.75 through 4.78 and 4.79, Diagnostic Codes 6061-6091. The Board notes that the Veteran does not have a history of incapacitating episodes under either the former and revised criteria. Evaluations of defective vision from noncompensable to 100 percent based on organic impairment of visual acuity (excluding developmental errors of refraction), visual field, and muscle function. 38 C.F.R. §§ 4.76(a), 4.79. The examination for visual impairment must be conducted by a licensed optometrist or by a licensed ophthalmologist and the examiner must identify the disease, injury, or any other pathologic found. 38 C.F.R. § 4.76(b). Examination of visual fields or muscle function will be conducted only when there is a medical indication of disease or injury that may be associated with visual field defect or impaired muscle function. Id. Unless medically contraindicated, the fundus must be examined with the Veteran's pupils dilated. Id. Unless otherwise directed, evaluate diseases of the eye under the General Rating Formula for Diseases of the Eye. 38 C.F.R. § 4.79, Diagnostic Codes 6000 through 6009. Impairment of Visual Acuity is rated under Diagnostic Codes 6061 through 6066. The Veteran is rated under Diagnostic Code 6015-6011. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the specific basis for the evaluation assigned; the additional code is shown as a hyphen. 38 C.F.R. § 4.27. Diagnostic Code 6011 provides that localized scars, atrophy, or irregularities of the retina, unilateral or bilateral, that are centrally located and that result in an irregular, duplicated, enlarged, or diminished image are to be evaluated at 10 percent disabling or alternatively evaluated under the General Rating Formula for Disease of the Eye. 38 C.F.R. § 4.79, Diagnostic Code 6011. Diagnostic Code 6015 provides that benign neoplasms of the eye, orbit, and adnexa (excluding skin) are to be separately evaluated for visual and nonvisual impairment, e.g. disfigurement (diagnostic code 7800), and to combine the evaluations. The Board notes that there is no evidence nor assertion of disfigurement and no evidence of incapacitating episodes. Therefore, the Board shall rate the Veteran's disability under the General Rating Formula for Disease of the Eye in accordance with Diagnostic Code 6011. Examinations of visual acuity must include the central uncorrected and corrected visual acuity for distance and near vision using Snellen's test type or its equivalent. 38 C.F.R. § 4.76(a). Evaluation of central visual acuity on the basis of corrected distance vision with central fixation, even if a central scotoma is present. 38 C.F.R. § 4.76(b). However, when the lens required to correct distance vision in the poorer eye differs by more than three diopters from the lens required to correct distance vision in the better eye (and the difference is not due to congenital or developmental refractive error), and either the poorer eye or both eyes are service connected, evaluate the visual acuity of the poorer eye using either its uncorrected or corrected visual acuity, whichever results in better combined visual acuity. Id. A July 2011 VA examination reveals that the Veteran had no generalized symptoms, no pain, no redness, no swelling, no discharge, nor visual symptoms. 07.12.2011 Uncorrected Distance Corrected Distance Uncorrected Near Corrected Near RIGHT Unknown 20/20 Unknown 20/20 LEFT Unknown 20/20 Unknown 20/20 Based on the evidence above, a compensable disability rating for the Veteran's loss of visual acuity (no loss of visual acuity) is not warranted. The Veteran's visual acuity of 20/20 corrected distance bilaterally warrants a noncompensable disability rating. The Veteran was afforded a second VA examination in October 2020. The October 2020 VA examination reveals that the Veteran had a mark on the cornea of his right eye. 10.08.2020 Uncorrected Distance Corrected Distance Uncorrected Near Corrected Near RIGHT 20/50 20/20 or better 20/200 20/20 or better LEFT 20/40 20/20 or better 20/200 20/20 or better Based on the evidence above, a compensable disability rating for the Veteran's loss of visual acuity is not warranted. The Veteran's visual acuity of 20/20 corrected distance bilaterally warrants a noncompensable disability rating. (CONTINUED ON THE NEXT PAGE) Accordingly, the preponderance of the most probative evidence is against the claim of entitlement to a compensable disability rating for a loss of visual acuity. In reaching the conclusion above, the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against the Veteran's claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Deemer, 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.