Citation Nr: 21028458 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 04-37 906A DATE: May 11, 2021 ORDER Entitlement to service connection for otitis media, right ear is denied. Service connection for right ear hearing loss is denied. Entitlement to a disability rating in excess of 10 percent for the residuals of a right facial fracture from August 1, 2003, is denied. A disability rating in excess of 30 percent for post-traumatic headaches, to include photophobia, is denied. A disability rating in excess of 10 percent prior to July 29, 2020 and in excess of 20 percent thereafter for a low back disability is denied. A disability rating in excess of 20 percent for a right shoulder disability is denied. A disability rating in excess of 10 percent for a right ankle disability is denied. FINDINGS OF FACT 1. The Veteran's otitis media of the right ear was not shown in service or for many years thereafter and is not otherwise etiologically related to active duty service, and is not proximately due to or the result of his service-connected residuals of a right facial fracture. 2. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of right ear hearing loss. 3. The Veteran's residuals of a right facial fracture have been characterized by moderate incomplete paralysis of the fifth cranial nerve. 4. The Veteran's post-traumatic headaches have not been characterized by very frequent prostrating and prolonged attacks productive of severe economic inadaptability. 5. Prior to July 29, 2020, the Veteran's low back disability was characterized by pain with some limitation of motion; forward flexion of the thoracolumbar spine less than 60 degrees, a combined range of motion of the thoracolumbar spine of 120 degrees or less, or muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, revered lordosis, or abnormal kyphosis, intervertebral disc syndrome (IVDS) with incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months, and x-ray evidence of arthritis with the involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations were not been shown. 6. Since July 29, 2020, the Veteran's low back disability has been characterized by pain with some limitation of motion; forward flexion of the thoracolumbar spine to 30 degrees or less, favorable ankylosis of the entire thoracolumbar spine, and IVDS with incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during the past 12 months have not been shown. 7. Throughout the period on appeal, the Veteran's right shoulder disability has been characterized by pain with some limitation of motion; favorable ankylosis of the scapulohumeral articulation and limitation of motion to midway between the side and shoulder level have not been shown. 8. Throughout the period on appeal, the Veteran's right ankle disability has been characterized by pain with some limitation of motion; his right ankle disability has not been manifested by ankylosis of the ankle with plantar flexion less than 30 degrees, "marked" limitation of motion, ankylosis of the subastragalar or tarsal joint in poor weight-bearing position, or malunion of the Os calcis or astragalus with marked deformity, and he has not had an astragalectomy. CONCLUSIONS OF LAW 1. The criteria for service connection for otitis media, right ear have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310. 2. The criteria for service connection for right ear hearing loss have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.304, 3.307, 3.309, 3.385. 3. The criteria for a disability rating in excess of 10 percent for the residuals of a right facial fracture from August 1, 2003, have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.3, 4.7, 4.124a, Diagnostic Code (DC) 8205. 4. The criteria for a disability rating in excess of 30 percent for post-traumatic headaches, to include photophobia, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.124a, DC 8100. 5. The criteria for a disability rating in excess of 10 percent prior to July 29, 2020 and in excess of 20 percent thereafter for a low back disability have not been met. 38 U.S.C. § §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71, 4.71a, DC 5237. 6. The criteria for a disability rating in excess of 20 percent for a right shoulder disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71, 4.71a, DC 5003-5201. 7. The criteria for a disability rating in excess of 10 percent for a right ankle disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71, 4.71a, DC 5271-5010. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1982 to July 2003. This matter comes before the Board of Veterans' Appeals (Board) on appeal from rating decisions issued by a Department of Veterans Appeals (VA) Regional Office (RO). These matters previously came before the Board in April 2019, at which time they were remanded for further development At that time, the Board issued two separate decisions addressing the claims as the Veteran had a limited power of attorney agreement with a private attorney for only some of the issues on appeal with the remainder being pursued pro se. During the pendency of the ordered development, the Veteran withdrew his power of attorney over any and all issues in writing. To date he has not appointed a new power of attorney or representative. As the Veteran is now pursuing all claims pro se, they are combined in one decision. Service Connection The Veteran contends that service connection is warranted for otitis media of the right ear and right ear hearing loss. He principally contends that these disorders were caused by his service-connected right facial fracture. Under the relevant laws and regulations, 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. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). "In the absence of proof of a present disability there can be no valid claim." Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Moreover, evidence of continuous symptoms since active duty is a factor for consideration as to whether a causal relationship exists between an in-service injury or incident and the current disorder as is contemplated under 38 C.F.R. § 3.303(a). Certain chronic diseases may be presumed to have been incurred during service if they become manifested to a compensable degree within one year from separation from service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307(a)(3), 3.309(a). This presumption is rebuttable by affirmative evidence to the contrary. Id. Moreover, evidence of continuous symptoms since active duty is a factor for consideration as to whether a causal relationship exists between an in-service injury or incident and the current disorder as is contemplated under 38 C.F.R. § 3.303(a). Service connection is also warranted for a disability that is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether the additional impairment is itself a separate disease or injury caused by the service-connected condition, should also be compensated. Allen v. Brown, 7 Vet. App. 439 (1995). Accordingly, when service connection is established for a secondary condition, the secondary condition shall be considered a part of the original condition. Id. 1. Entitlement to service connection for otitis media, right ear The Veteran contends that service connection is warranted for his otitis media of the right ear. After a review of the evidence of record, the Board concludes that although he has a current diagnosis of otitis, the preponderance of the evidence weighs against finding that service connection is warranted. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Initially, the Board finds that the Veteran's service treatment records fail to establish that his otitis media was incurred in or is otherwise etiologically related to his active duty service. Here, his service treatment records do not reflect that he reported symptoms of, received treatment for, or was diagnosed with otitis media. In fact, the report from a March 2001 examination reflects that the examining physician determined that his ears were "normal," and his March 2001 report of medical history reflects that he denied ear trouble and reported that his present health was "outstanding." Thus, his service treatment records fail to show that his otitis was incurred in or is otherwise etiologically related to his active duty service. The post-service clinical evidence also fails to establish a relationship between the Veteran's right hip disorder and his active duty service. In this case, the objective medical evidence reflects that he first sought treatment for otitis in December 2011, more than eight years after his separation from service. Therefore, continuity of symptoms based upon the clinical evidence is not sufficient to support a direct nexus, including for purposes of the chronic disease presumption under 38 C.F.R. § § 3.307(a)(3). Indeed, the Veteran is not truly asserting that he has experienced continuous symptoms of otitis since service. Next, service connection may be granted when the evidence establishes a medical nexus between active duty service and the current diagnosis. However, the Board finds that the weight of the competent evidence does not attribute the Veteran's otitis to active duty service, including his service-connected right facial fracture. Here, the report from a June 2016 VA examination reflects that based upon an in-person examination and a review of the claims file, the examiner opined that the Veteran's otitis media of the right ear was less likely than not proximately due to or the result of his service-connected residuals of a right facial fracture. In support of that opinion, the examiner explained that there is not etiological relationship between otitis media and a right sided facial fracture of the zygoma and maxillary bones. In further support, the examiner explained that the Veteran contracted otitis media almost 20 years after he sustained a right facial fracture, and that the gap in time also showed no etiological relationship between his otitis media and facial fracture. Given the expertise of the June 2016 VA examiner and the persuasive rationale set forth in the examination the Board finds the opinion of the June 2016 VA examiner to be entitled to great probative weight. Accordingly, the Board concludes that the medical evidence does not support a nexus between the Veteran's right hip disorder and his service-connected right ankle disability. In arriving at its conclusion, the Board has also considered the statements made by the Veteran relating his otitis media of the right ear to his service-connected residuals of a right facial facture. The Federal Circuit has held that "[l]ay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional." Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009) (quoting Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007)). In this case, however, the Veteran is not competent to provide testimony regarding the etiology of his right hip disorder. See Jandreau, 492 F.3d at 1377, n.4. Although the Veteran can provide competent testimony regarding symptoms, otitis is not a disorder that can be diagnosed by its unique and identifiable features as it does not involve a simple identification that a layperson is competent to make. In any event, the diagnoses of dysfunctions and disorders, and their respective etiologies, are medical determinations and generally must be established by medical findings and opinion. See Jandreau, 492 F.3d at 1376-77. Thus, to the extent that the Veteran believes that his otitis media of the right ear is related to his service-connected residuals of a right facial fracture, he is a lay person without appropriate medical training and expertise to provide a medical diagnosis and etiological opinion. By virtue of the foregoing, service connection for otitis media of the right ear is denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet App. 49 (1990); 38 C.F.R. § 3.102. 2. Entitlement to service connection for right ear hearing loss With respect to the Veteran's claimed right ear hearing loss, the Board concludes that after a thorough review of the evidence of record, the evidence does not reflect that the Veteran has a current diagnosis of right hearing loss, and does not reflect that he has had a diagnosis of right ear hearing loss at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). The evidence of record does not show that he has a current diagnosis of right ear hearing loss for VA compensation purposes. Impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of the above frequencies are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. In this case, the report from the June 2016 VA examination documents the results of audiometric testing performed during the examination and shows that the auditory thresholds in his right ear were 10 decibels (dB) at 500 Hz, 15 dB at 1000 Hz, 15 dB at 2000 Hz, 25 dB at 3000 Hz, and 30 dB at 4000 Hz. With respect to his left ear, the examination report reflects that the auditory thresholds were 15 dB at 500 Hz, 15 dB at 1000 Hz, 15 dB at 2000 Hz, 20 dB at 3000 Hz, and 15 dB at 4000 Hz. The examination report also reflects that he had a speech discrimination score of 96 percent in his right ear. Because the report from the April 2015 VA examination does not show that the auditory threshold at 500, 1000, 2000, 3000, or 4000 Hz was 40 dB or greater, that the auditory thresholds for three of these frequencies was 26 dB or greater, or that speech recognition scores were less than 94 percent, the report from the June 2016 VA examination fails to show that he has right hearing loss for VA disability compensation purposes. Additionally, the record is devoid of any evidence controverting the results of the audiometric testing set forth in the June 2016 VA examination report or otherwise showing right ear hearing loss for VA disability compensation purposes. Accordingly, service connection for right ear hearing loss is not warranted because he does not have a current diagnosis under 38 C.F.R. § 3.385. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet App. 49 (1990); 38 C.F.R. § 3.102. Increased Ratings The Veteran is seeking increased disability ratings for his service-connected residuals of a right facial fracture, posttraumatic headaches, low back disability, right shoulder disability, and right ankle disability. Disability evaluations are determined by the application of a schedule of ratings that is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. See 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two separate evaluations shall be applied, the higher evaluation will be assigned if the disability more closely approximates the criteria required for that particular rating. 38 C.F.R. § 4.7. When a reasonable doubt arises regarding the degree of disability, such doubt will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. 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. It is essential that the examination on which ratings are based adequately portray the anatomical damage, and the functional loss, with respect to all these elements. The functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective enervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by visible behavior of the claimant 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. §§ 4.10, 4.40, 4.45; see also DeLuca v. Brown, 8 Vet. App. 202 (1995). The provisions of 38 C.F.R. § 4.14 (avoidance of pyramiding) do not forbid consideration of a higher rating based on greater limitation of motion due to pain on use, including during flare-ups. It should be noted that, during the course of this appeal, the schedular criteria for evaluating limitation of motion of the shoulder and the ankle have been amended. Specifically, the criteria pertaining to limitation of motion of the shoulder under 38 C.F.R. § 4.71a, DC 5271, was amended effective February 7, 2021. See 85 Fed. Reg. 76,453 (November 30, 2020). Where a law or regulation changes during the pendency of a claim for increased rating, the Board should first determine whether application of the revised version would produce retroactive results. In particular, a new rule may not extinguish any rights or benefits the claimant had prior to enactment of the new rule. VAOPGCPREC 07-03 (November 19, 2003). However, if the revised version of the regulation is more favorable, the implementation of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. If the former version is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. 38 U.S.C. § 5110; Karnas v. Derwinski, 1 Vet. App. 308, 313 (1991), overruled in part, Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). As the Veteran's claim seeking increased disability ratings for his right shoulder and right ankle disabilities was received prior to the effective date of the regulation changes, the Board must consider the Veteran's limitation of motion of right shoulder and the right ankle under both the old and the revised rating criteria and must apply the old rating criteria if the result is more favorable to the Veteran. Id. 3. Entitlement to a disability rating in excess of 10 percent for the residuals of a right facial fracture from August 1, 2003 The Veteran contends that a disability rating in excess of 10 percent is warranted for his service-connected residuals of a right facial fracture. Specifically, he asserts that an increased rating is warranted for his service-connected residuals of a right facial fracture because his symptoms include headaches, sensitivity to light, an inability to function during the day if he does not take pain medication, snoring, an inability to sleep for more than four hours per night, numbness on the right side of his face, pain on the right side of his face, pain with chewing on the right side of his mouth, and a partial loss of sensation near his right temple. He also asserts that to the extent that his right facial pain symptoms are separate and distinct from the symptoms that encompassed by the disability rating assigned under DC 8205, he should be assigned a separate 10 percent disability rating under DC 8405. The Veteran's right facial fracture has been assigned a 10 percent disability rating under DC 5296-8205. DC 5296 is applicable to loss of part of both inner and outer tables of the skull and DC 8205 is applicable a disability of the cranial nerve. Hyphenated DCs are used when a rating under one DC requires use of an additional DC to identify the specific basis for the evaluation assigned. The additional code is shown after a hyphen. 38 C.F.R. § 4.27. In order to warrant a disability rating in excess of 10 percent to be warranted for the Veteran's service-connected residuals of a right facial fracture, the evidence must show incomplete paralysis that is severe in nature. 38 C.F.R. § 4.124a, DC 8205. Terms such as "mild," "moderate," and "severe" are not defined by the rating schedule; rather than applying a mechanical formula, VA must evaluate all the evidence to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6. However, the Note to DC 8205 instructs that the degree of paralysis should be based upon the relative degree of sensory motor manifestation or motor loss. Id. Based upon the evidence of record, the Board concludes that a disability rating in excess of 10 percent for the Veteran's residuals of a right facial fracture is not warranted. Initially, the reports from the June 2012 and June 2016 VA examinations do not show that a disability rating in excess of 10 percent is warranted for the Veteran's residuals of a right facial fracture. The report from a June 2012 VA examination reflects that the Veteran reported that he had experienced numbness on the right side of his face. The examination report reflects that the examiner determined that the Veteran had moderate incomplete paralysis of the fifth cranial nerve that was characterized by mild numbness of the mid- and upper-face. The report from a June 2016 VA examination reflects that the Veteran reported that he had experienced constant numbness in the right side of his face. The examination report reflects that the examiner determined that the Veteran had moderate incomplete paralysis of the fifth cranial nerve that was characterized by mild numbness of the mid- and upper-face. Given the symptoms reported in the June 2012 and June 2016 VA examination, there is not sufficient evidence in the VA examinations to show that the Veteran's incomplete paralysis of the fifth cranial nerve has been "severe" in nature. Accordingly, the VA examinations do not establish that a disability rating in excess of 10 percent is warranted for his service-connected residuals of a right facial fracture. The Board also notes that the Veteran's treatment records do not reflect that the Veteran's incomplete paralysis of the fifth cranial nerve has been "severe" in nature. The Board acknowledges that various treatment records, including treatment records from September 2007, November 2009, February 2011, and February 2012, reflect that his residual of a right facial fracture have included pain, numbness, sensitivity to light, and pain after chewing. These symptoms were accounted for but the June 2012 and June 2016 VA examiners and do not establish that his incomplete paralysis of the fifth cranial nerve has been "severe" in nature. When looking at the Veteran's own statements regarding severity, and the findings of the various examiners, the evidence does not show that the relative degree of sensory manifestation or motor loss is severe in nature. Accordingly, the treatment records also do not establish that a disability rating in excess of 10 percent is warranted for the Veteran's service-connected residuals of a right facial fracture. In order to prevent any potential prejudice to the Veteran, the Board has also considered whether the Veteran could receive separate ratings for other sensory impairment related to his service-connected residuals of a right facial fracture, including a separate rating under DC 8405 for neuralgia of the fifth crania nerve. As an initial matter, neuralgia of the fifth cranial nerve under 8205 is rated using the same criteria as DC 8205. Moreover, there is no other evidence of any other sensory impairment that would warrant a separate rating. In sum, the Board finds that the Veteran's disability has not shown to result in incomplete paralysis of the trigeminal cranial nerve, and therefore, the claim is denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet App. 49 (1990); 38 C.F.R. § 3.102. 4. Entitlement to a disability rating in excess of 30 percent for posttraumatic headaches, to include photophobia The Veteran contends that a disability rating in excess of 30 percent is warranted for his service-connected posttraumatic headaches because he experiences "chronic" headaches on a daily basis, he takes pain medication in the morning and evening to relieve the pain caused by his headaches, and direct light causes him to contract a headache. The Veteran's service-connected posttraumatic headaches have been assigned a 30 percent disability rating under 38 C.F.R. § 4.124a, DC 8100 (addressing migraines). In order to warrant the maximum 50 percent rating under DC 8100, the evidence must show very frequent prostrating and prolonged attacks productive of severe economic inadaptability. Id. After a review of the evidence of record, the Board determines that a disability rating in excess of 30 percent for the Veteran's service-connected posttraumatic headaches is not warranted. In this case, the report from the June 2012 VA examination reflects that he did not have very frequent prostrating and prolonged attacks of migraine headache pain or very frequent prostrating and prolonged attacks of non-migraine headache pain. The report from the June 2016 VA examination reflects that he did not have characteristic prostrating attacks of migraine or non-migraine headache pain. The report form the October 2018 VA examination reflects that although the Veteran had characteristic prostrating attacks of migraine and/or non-migraine headache pain once every month, he did not have very prostrating and prolonged attacks of migraine and/or non-migraine headache pain productive of severe economic inadaptability. Given that the reports from the June 2012, June 2016, and October 2018 VA examinations do not show that the Veteran's headaches were manifested by very frequent prostrating and prolonged attacks productive of severe economic inadaptability, they fail to show that the maximum 50 percent disability rating should assigned to the Veteran's service-connected posttraumatic headaches. The Board also notes that the Veteran's treatment records do not reflect that the Veteran's headaches were characterized by very frequent prostrating and prolonged attacks productive of severe economic inadaptability during the period on appeal. Finally, the Board recognizes the Veteran's own lay statements that he is required to take medication daily to treat headache pain. While this evidence is certainly competent and credible of observable symptomatology, it does not imply that the frequent attacks of headache pain are completely prostrating in nature or prolonged (indeed, the fact that he successfully treats his headaches with medication speaks to the opposite). By virtue of the foregoing, a disability rating in excess of 30 percent is not warranted for the Veteran's service-connected posttraumatic headaches. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet App. 49 (1990); 38 C.F.R. § 3.102. 5. Entitlement to a disability rating in excess of 10 percent prior to July 29, 2020 and in excess of 20 percent thereafter for a low back disability The Veteran contends that a disability rating in excess of 10 percent prior to July 29, 2020, an in excess of 20 percent thereafter, is warranted for his low back disability because he cannot walk or stand for long periods of time, walking is becoming more difficult, and because he has received two injections to treat the pain caused by his low back disability. Prior to July 29, 2020 Prior to July 29, 2020, the Veteran's low back disability was assigned a 10 percent rating under 38 C.F.R. § 4.71a, DC 5237 (addressing lumbosacral or cervical strain). A rating in excess of 10 percent is warranted when the evidence demonstrates: Forward flexion of the thoracolumbar spine greater than 30 degrees, but not greater than 60 degrees (20 percent); A combined range of motion of the thoracolumbar spine not greater than 120 degrees (20 percent); Muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, revered lordosis, or abnormal kyphosis (20 percent); IVDS with incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months (20 percent under DC 5237); X-ray evidence of arthritis with the involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations (20 percent under DC 5003). 38 C.F.R. § 4.71a. After a review of the evidence of record, the Board determines that a disability rating in excess of 10 percent is not warranted prior to July 29, 2020. First, the reports from the VA examinations conducted prior to July 29, 2020 do not show that a disability rating in excess of 10 percent is warranted prior to July 29, 2020. The report from the August 2013 VA examination reflects that the Veteran reported that he experienced constant pain and stiffness, but that he denied flareups of his back disability. The examination report reflects that forward flexion ended at 70 degrees, with painful motion at 70 degrees, extension ended at 20 degrees, with painful motion at 20 degrees, and left lateral flexion, right lateral flexion, right lateral rotation, and left lateral rotation all ended at 30 degrees or greater, with no objective evidence of painful motion. The examination report further reflects that the Veteran was able to complete repetitive use testing without any additional loss of range of motion. Additionally, the examination report reflects that he did not have muscle spasm or guarding of the thoracolumbar spine or any incapacitating episodes of IVDS. Finally, the examination report does not show x-ray evidence of arthritis with the involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations. The report from the July 2017 VA examination reflects that the Veteran reported that he experienced constant back pain and that he experienced flareups, where if he sat for a significant amount of time, he would experience back pain. The examination report reflects that forward flexion ended at 70 degrees, extension ended at 20 degrees, right lateral flexion and left lateral flexion ended at 20 degrees, and right lateral rotation and left lateral rotation ended at 25 degrees. Although pain related to forward flexion, extension, right lateral flexion, left lateral flexion, right lateral rotation, and left lateral rotation was noted on examination, it did not result in or cause functional loss. The examination report also reflects that although he did not have guarding of the thoracolumbar spine and that although he had muscle spasm of the thoracolumbar spine, it did not result in an abnormal gait or abnormal spinal contour. Finally, the examination report reflects that he did not have IVDS and does not reflect that there was or x-ray evidence of arthritis with the involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations. Given that the reports from the August 2013 and July 2017 VA examinations do not show that forward flexion of his back ended at less than 60 degrees, a combined range of motion of 120 degrees or less, muscle spasm or guarding resulting in an abnormal gait, IVDS with incapacitating episodes having a total duration of at least two weeks, but less than four weeks, during the past 12 months, or x-ray evidence of arthritis with the involvement of two or more major joints or two or more minor joint groups, with occasional incapacitating exacerbations, they fail to establish that a disability rating in excess of 10 percent is warranted for the Veteran's low back disability prior to July 29, 2020. Additionally, the Veteran's VA treatment records are not sufficient to demonstrate a low back symptomatology to warrant a disability rating in excess of 10 percent prior to July 29, 2020. Although treatment records reflect that he experienced back pain and stiffness, they do not show a sufficient limitation of motion, muscle guarding or spasm with an abnormal gait, sufficient incapacitating episodes of IVDS, or incapacitating exacerbations related to arthritis for the assignment of a disability rating in excess of 10 percent prior to July 29, 2020. From July 29, 2020 Since July 29, 2020, the Veteran's low back disability has been assigned a 20 percent rating under 38 C.F.R. § 4.71a, DC 5237. A rating in excess of 20 percent is warranted when the evidence shows: Forward flexion of the thoracolumbar spine to 30 degrees or less (40 percent); Favorable ankylosis of the entire thoracolumbar spine (40 percent); or IVDS with incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during the past 12 months (40 percent). 38 C.F.R. § 4.71a, DC 5237. Based upon the evidence of record, the Board concludes that a disability rating in excess of 20 percent from July 29, 2020 is not warranted for the Veteran's low back disability. Here, the report from the July 2020 VA examination reflects that his forward flexion initially ended at 60 degrees, that there was no additional loss of function or range of motion after he completed repetitive use testing, and that forward flexion ended 50 degrees after repetitive use over time and during a flareup. Thus, the July 2020 VA examination fails to show that forward flexion of the thoracolumbar spine ended at 30 degrees or less as required for the assignment of an increased rating. Additionally, the July 2020 examination report reflects that he did not have ankylosis of the spine or IVDS, so an increased rating based on ankylosis or IVDS also is not warranted. The Veteran's VA treatment records are also not sufficient to demonstrate a low back symptomatology to warrant a disability rating in excess of 20 percent from July 29, 2020. Indeed, his treatment records do not show that forward flexion of the thoracolumbar spine ended at 30 degrees or less, ankylosis of the thoracolumbar spine, or IVDS with incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during the past 12 months. When evaluating the extent of the Veteran's low back disability, the Board is required to consider whether a separate evaluation is warranted for any associated neurological abnormality including, but not limited to, bowel or bladder impairment, neurological impairment in the extremities or other such disorders, which are to be evaluated under the appropriate DC. See 38 C.F.R. § 4.71(a). In this case, the medical evidence does not reveal evidence of any neurological abnormalities or associated neurological impairments related to his lumbar spine disability during the period on appeal. Specifically, the reports the August 2013, July 2017, and July 2020 VA examinations indicate that the Veteran did not have any neurological impairments, including radiculopathy and bowel or bladder impairments, related to his service-connected back disability that would warrant a separate rating, nor has the Veteran asserted otherwise. When considering the appropriate disability ratings for the Veteran's low back disability, the Board has considered the impact of functional loss in his back due to flare-ups of pain, fatigability, incoordination, pain on movement, and weakness. 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 206, 206-07 (1995). In this case, he has complained that he has experienced pain and difficulty walking. Although he experiences the aforementioned symptoms, overall, it does not appear that these symptoms result in additional and significant functional loss, and his complaints are adequately contemplated in the ratings he currently receives. See Sharp v. Shinseki, 29 Vet. App. 26 (2017); Mitchell v. Shinseki, 25 Vet. App. 32, 37-43 (2011) (pain must affect some aspect of the normal working movements of the body such as strength, speed, coordination or endurance). Here, the report from the August 2013 VA examination reflects that there was no additional loss of range of motion after repetitive use testing, the report from the July 2017 VA examination does not show that pain caused additional functional loss, and the report from the July 2020 VA examination reflects that he only lost 10 degrees of motion after repetitive use over time and during a flareup. Further, the VA examiners did not find any additional loss of motion or functioning after weight bearing that would warrant a higher rating. 6. Entitlement to a disability rating in excess of 20 percent for a right shoulder disability The Veteran contends that he is entitled to a disability rating in excess of 20 percent for a right shoulder disability because he has lost function in his right shoulder, cannot use his right shoulder as much as he desires, and because he has received numerous injections to treat the pain caused by his right shoulder disability. For the period on appeal, the Veteran's right shoulder disability has been assigned a 20 percent disability rating under 38 C.F.R. § 4.71a, DC 5003-5201. DC 5003-5201 is applicable to degenerative arthritis and limitation of motion of the shoulder. Under the old criteria, to warrant a disability rating in excess of 20 percent for a shoulder disability based on limitation of motion of the dominant shoulder, the evidence must show: Favorable ankylosis of the scapulohumeral articulation, abduction to 60 degrees, can reach mouth and head (30 percent under DC 5200); Limitation of motion to midway between the side and shoulder level (30 percent under DC 5201). 38 C.F.R. § 4.71a. The revised criteria did not change DC 5200. However, DC 5201 was amended by the revised criteria, and provides that a 30 percent disability rating is warranted where the evidence shows limitation of motion of the dominant shoulder to midway between the side and shoulder level (flexion and/or abduction limited to 45 degrees). Id. After a review of the evidence, the Board determines that a rating in excess of 20 percent is not warranted for the Veteran's right shoulder disability. First, the reports from the VA examinations from the period on appeal fail to show that a disability rating in excess of 20 percent is warranted based upon limitation of motion of his right shoulder. The report from the June 2012 VA examination reflects that he did not experience flareups of the right shoulder or arm, and that flexion of his right shoulder ended at 180 degrees, with no objective evidence of painful motion, and abduction of his right shoulder ended at 180 degrees, with painful motion at 180 degrees. He was able to perform repetitive use testing without any loss of flexion or abduction. Finally, the examination report reflects that he did not have ankylosis of the scapulohumeral articulation, impairment of the humerus, or impairment of the clavicle of scapula. The report form the August 2013 VA examination reflects that he did not experience flareups of the right shoulder or arm, and that flexion of his right shoulder ended at 90 degrees, with objective evidence of painful motion at 90 degrees, and abduction of his right shoulder ended at 90 degrees, with objective evidence of painful motion at 90 degrees. He was able to perform repetitive use testing without any additional loss of range of motion. Finally, the examination report reflect that he did not have ankylosis of the scapulohumeral articulation, impairment of humerus, or impairment of the clavicle of scapula. The report from the March 2016 VA examination reflects that the Veteran reported flareups of his right shoulder, where lifting and laying on his right side caused him to experience pain in his right shoulder and an inability to lift his arm over his head. The examination report reflects that flexion and abduction of his right shoulder ended at 90 degrees. He was able to perform repetitive use testing without any additional functional loss or loss of range of motion. Finally, the examination report reflects that the examiner did not determine that he had ankylosis of the scapulohumeral articulation or impairment of the humerus. The examination report reflects that he did have impairment of the clavicle or scapula to the extent that he had AC joint arthritis. The report from the July 2017 VA examination reflects that the Veteran reported flareups of his right shoulder, where if he moved a "certain way," he would experience "shocking pain." The examination report reflects that flexion and abduction of his right shoulder ended at 170 degrees, and that although pain was noted on examination, it did not result in or cause functional loss. He was able to perform repetitive use testing without any additional functional loss or loss of range of motion. Finally, the examination report reflects that he did not have ankylosis of the scapulohumeral articulation, impairment of the humerus, or impairment of the clavicle or scapula. The report from the July 2020 VA examination reflects that the Veteran reported flareups of his right shoulder any time he tried to use his right and shoulder, and that he avoided overhead work because of his right shoulder pain. The examination report reflects that flexion of his right shoulder ended at 115 degrees and abduction of his right shoulder ended at 70 degrees. The examination report further reflects that the examiner indicated that after repetitive use over time and during a flareup (although the examination was not conducted during a flareup), flexion of the Veteran's right shoulder would end at 110 degrees and abduction of his right shoulder would end at 65 degrees. Finally, the examination report reflects that he did not have ankylosis of the scapulohumeral articulation, impairment of the humerus, or impairment of the clavicle or scapula. The reports from the VA examination do not show that a disability rating in excess of 20 percent is warranted for the Veteran's right shoulder disability under DC 5200 is warranted because the reports from the June 2012, August 2013, March 2016, July 2017, and July 2020 VA examinations all reflect that he did not have ankylosis. The VA examination reports also do not show that a disability rating in excess of 20 percent is warranted for the Veteran's right shoulder disability under old criteria under DC 5201 or the revised criteria under DC 5201 because the reports from the June 2012, August 2013, March 2016, July 2017, and July 2020 VA examinations do not show limitation of motion of the dominant shoulder to midway between the side and shoulder level or flexion and/or abduction limited to 45 degrees. Thus, the reports from the VA examination fail to show that a disability rating in excess of 20 percent is warranted for the Veteran's right shoulder disability. Additionally, the Veteran's VA treatment records are not sufficient to demonstrate right shoulder symptomatology to warrant a higher rating based upon limitation of motion. Although treatment records reflect that he experienced right shoulder pain, they do not show a sufficient limitation of motion for an increased rating. His treatment records also do not show ankylosis of the right shoulder. Therefore, a rating in excess of 20 percent for his right shoulder disability is not warranted. The Board has also considered whether a separate rating may be warranted for any instability or deformity of the shoulder joint under 38 C.F.R. § 4.71a, DCs 5202 or 5203. However, the evidence of record does not indicate that a separate compensable rating for his right shoulder is warranted for any period on appeal. In this case, the reports from the June 2012, August 2013, March 2016, July 2017, and July 2020 VA examinations do not reflect that he had any impairment of the clavicle or scapula. Although the report from the March 2016 VA examination reflects that he had arthritis of the AC joint, no VA examination reflects that he had inability in his right shoulder and no other VA examination reflects that an examiner observed impairment of the humerus. Thus, while the Veteran had some impairment to his rotator cuff, his predominant symptoms are related to limitation of motion of the shoulder, and as such, these symptoms are addressed in his 20 percent rating under DC 5003-5201. Therefore, a separate rating based on any sort of instability or deformity of his right shoulder is not warranted. When considering the proper rating to be assigned to the Veteran's right shoulder disability, the Board has considered the impact of functional loss in the Veteran's right shoulder due to flareups of pain. 38 C.F.R. §§ 4.40, 4.45, 4.59; see Sharp, 29 Vet. App. 26; Correia, 28 Vet. App. 158; DeLuca, 8 Vet. App. 206. In this case, the Veteran states that he has lost function in his right shoulder and cannot use his right shoulder as much as he desires. Although the Veteran experiences the aforementioned symptoms, overall, it does not appear that these symptoms result in additional and significant functional loss, and his complaints are adequately contemplated in the ratings he currently receives. See Sharp, 29 Vet. App. 26; Mitchell, 25 Vet. App. 32, 37-43 (2011) (pain must affect some aspect of the normal working movements of the body such as strength, speed, coordination or endurance). Here, there is no evidence from the treatment records or the June 2012, August 2013, March 2016, July 2017, and July 2020 VA examination reports of any significant loss of motion or functioning after flare-ups, repetitive testing, or weight bearing that would warrant a higher rating during any period on appeal. Indeed, the July 2020 VA examination report shows that his right shoulder lost only 5 degrees of flexion and abduction during a flareup and after repetitive use over time. Additionally, the 20 percent rating that has been awarded specifically contemplated functional limitation. By virtue of the foregoing, a disability rating in excess of 20 percent for the Veteran's right shoulder disability is not warranted for the period on appeal. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet App. 49 (1990); 38 C.F.R. § 3.102. 7. Entitlement to a disability rating in excess of 10 percent for a right ankle disability The Veteran contends that a disability rating in excess of 10 percent for his right ankle disability is warranted because his right ankle swells when he attempts to walk long distances and because he experiences pain in his right ankle. The Veteran's right ankle disability has been assigned a 10 percent rating under 38 C.F.R. § 4.71a, DC 5271-5010. DC 5271-5010 is applicable to limitation of motion and traumatic arthritis of the ankle. Under the old criteria, DC 5010 directed the rater that arthritis was to be rated under DC 5003 (degenerative arthritis). 38 C.F.R. § 4.71a. Thus, in order for a disability rating in excess of 10 percent for the Veteran's right ankle disability under the old criteria, the evidence must show: Ankylosis of the ankle with plantar flexion less than 30 degrees (20 percent under DC 5270); "Marked" limitation of motion (20 percent DC 5271); Ankylosis of the subastragalar or tarsal joint in poor weight-bearing position (20 percent under DC 5272); Malunion of the Os calcis or astragalus with marked deformity (20 percent under DC 5273); Astragalectomy (20 percent under DC 5274); or X-ray evidence of involvement of two or more major joints or two or more minor joints, with occasional incapacitating exacerbations. Id. Under the old criteria, the terms "moderate" and "marked" were not defined in the Rating Schedule. Rather than applying a mechanical formula under the old criteria, the Board was directed to evaluate all of the evidence to the end that its decisions were "equitable and just." 38 C.F.R. § 4.6. Under the new criteria, DC 5010 provides that posttraumatic arthritis should be rated as limitation of motion, dislocation, or other specified instability under the affected joint, and that if there are two or more joints affected, each rating should be combined in accordance with 38 C.F.R. § 4.25. Thus, in order for a rating in excess of 10 percent to be warranted for the Veteran's right ankle disability under the revised criteria, the evidence must show: Ankylosis of the ankle with plantar flexion less than 30 degrees (20 percent under DC 5270); "Marked" limitation of motion, meaning less than 5 degrees of dorsiflexion or less than 10 degrees of plantar flexion (20 percent DC 5271); Ankylosis of the subastragalar or tarsal joint in poor weight-bearing position (20 percent under DC 5272); Malunion of the Os calcis or astragalus with marked deformity (20 percent under DC 5273); or Astragalectomy (20 percent under DC 5274). 38 C.F.R. § 4.71a. Based upon the evidence of record, an initial disability rating in excess of 10 percent is not warranted for the Veteran's right ankle disability. First, the reports from the VA examinations from the period on appeal fail to show that a disability rating in excess of 10 percent is warranted for the Veteran's right ankle disability. The report from the June 2012 VA examination reflects that the Veteran reported that he experienced flareups of his right ankle disability where he experienced pain. The examination report reflects that his right ankle plantar flexion ended at 25 degrees, with painful motion at 25 degrees, and his right ankle dorsiflexion ended at 15 degrees, with painful motion at 15 degrees. The examination report also reflects that he was able to perform repetitive use testing without any additional loss of range of motion of his right ankle. Additionally, the examination report reflects that he did not have ankylosis of the right ankle, he did not have Os calcis or astragalus, and that he had not had an astragalectomy. Finally, although arthritis was documented by imaging studies, no incapacitating exacerbations were noted in the examination report. The report from the August 2013 VA examination reflects that the Veteran reported constant pain and denied flareups of his right ankle disability. The examination report reflects that his right ankle plantar flexion ended at 35 degrees, with no objective evidence of painful motion, and his right ankle dorsiflexion ended at 15 degrees, with no objective evidence of painful motion. The examination report also reflects that he was able to perform repetitive use testing without any additional loss of range of motion of his right ankle. Additionally, the examination report reflects that he did not have ankylosis of the right ankle, he did not have Os calcis or astragalus, and that he had not had an astragalectomy. Finally, although arthritis was documented by imaging studies, no incapacitating exacerbations were noted in the examination report. The report from the September 2014 VA examination reflects that the Veteran denied flareups of his right ankle disability. The examination report reflects that he had normal plantar flexion and dorsiflexion, with no pain noted on examination. The examination report also reflects that he was able to perform repetitive use testing without any additional loss of range of motion of his right ankle. Additionally, the examination report reflects that he did not have ankylosis of the right ankle, he did not have Os calcis or astragalus, and that he had not had an astragalectomy. Finally, although arthritis was documented by imaging studies, no incapacitating exacerbations were noted in the examination report. The report from the July 2017 VA examination reflects that the Veteran reported that pain in his right ankle had worsened since he injured it during his active duty service, that he experienced swelling, that he was unable to stand or walk for prolonged periods of time, that he experienced numbness in his ankle, and that he experienced flareups, where if he walked or stood for a prolonged period of time, his ankle would swell. The examination report reflects that his right ankle plantar flexion ended at 40 degrees and his right ankle dorsiflexion ended at 15 degrees. Although pain was noted on examination, the examiner noted that it did not cause or result in functional loss. The examination report also reflects that he was able to perform repetitive use testing without any additional loss of range of motion of his right ankle. Additionally, the examination report reflects that he did not have ankylosis of the right ankle, he did not have Os calcis or astragalus, and that he had not had an astragalectomy. Finally, although arthritis was documented by imaging studies, no incapacitating exacerbations were noted in the examination report. The report from the July 2020 VA examination reflects that the Veteran reported that his right ankle pain had worsened since he injured it during his active duty service, that he was unable to stand for more than five minutes due to pain, that he experienced pain when running and playing sports, causing him to avoid those activities, that he experienced aching when standing, and that he experienced flareups after standing or walking for longer than five minutes. The examination report reflects that his right ankle plantar flexion ended at 25 degrees and his right ankle dorsiflexion ended at 15 degrees. Pain causing functional loss was noted in the examination report. The examination report also reflects that he was able to perform repetitive use testing without any additional loss of range of motion of his right ankle. With respect to repeated use over time and flareups, the examination report reflects that dorsiflexion would end at 10 degrees and plantar flexion would end at 15 degrees after repeated use over time and during flareups. Additionally, the examination report reflects that he did not have ankylosis of the right ankle, he did not have Os calcis or astragalus, and that he had not had an astragalectomy. Finally, although arthritis was documented by imaging studies, no incapacitating exacerbations were noted in the examination report, and his passive range of motion was the same as his active range of motion. In this case, the reports from the June 2012, August 2013, September 2014, July 2017 and July 2020 VA examinations do not show that initial disability rating in excess of 10 percent are warranted under DCs 5272, 5273, and 5274 because the examination reports reflect that he did not have ankylosis of the right ankle, he did not have malunion of the Os calcis or astragalus with marked deformity of the right ankle, and that he had not had an astragalectomy of the right ankle. With respect to limitation of motion under the old criteria of DC 5271, marked limitation of motion was not shown by the examinations because the examination reports fail to show marked limitation of motion because the examination report the July 2020 VA examination shows the most extensive limitation of motion with dorsiflexion ending at 10 degrees and plantar flexion ending at 15 degrees during a flareup or after repeated use over time. That range of motion, in conjunction with all of the examination reports reflecting that he had normal muscle strength in his right ankle, is not sufficient to show a marked limitation of motion to support the assignment of a 20 percent disability rating for the Veteran's right ankle disability. Thus, the assignment of an increased disability rating for his right ankle disability is not established by the June 2012, August 2013, September 2014, July 2017, and July 2020 VA examinations under the old criteria. With respect to limitation of motion under the revised criteria of DC 5271, the June 2012, August 2013, September 2014, July 2017 and July 2020 VA examinations VA examination reports also fail to show "marked" limitation of motion because they do not show less than 5 degrees of dorsiflexion or less than 10 degrees of plantar flexion. Next, the Veteran's treatment records do not controvert the findings of the VA examiners or reflect a sufficient limitation of motion or functional loss resulting from his right ankle disability that would warrant the assignment of a disability rating in excess of 10 percent for his right ankle disability. In order to prevent any potential prejudice to the Veteran, the Board has also considered whether the Veteran's right ankle disability may be better rated under 38 C.F.R. § 4.71a, DC 5284, which addresses non-specific foot injuries. When determining whether DC 5284 is "more appropriate," the Court has noted that a more specific statute should be "given precedence over a more general one." See Zimick v. West, 11 Vet. App. 45, 51 (1998); see also Tedeschi v. Brown, 7 Vet. App. 411, 414 (1995). In this case, the disabilities being considered are specific to arthritis and limitation of motion of the right ankle, and DC 5271 is deemed by the Board to be the most appropriate DC. Notably, this DC pertains specifically to the disability at issue (limitation on motion in the ankle), and also provides specific guidance as to how symptoms of this disability are to be evaluated. On the other hand, DC 5284 pertains only to "foot injuries," which the Board finds to be less specific and more general. Indeed, a reasonable reading of the relevant DCs suggests that DC 5284 is more applicable to injuries that may not have been contemplated by other DCs, which is not the case here. Therefore, because there are specific DCs to evaluate ankle limitation of motion, consideration of other DCs (particularly DC 5284) for evaluating the disability is not appropriate in this matter. See 38 C.F.R. § 4.20. When considering the proper rating to be assigned to the Veteran's right ankle disability, the Board has considered the impact of functional loss in the Veteran's right ankle due to flareups of pain. 38 C.F.R. §§ 4.40, 4.45, 4.59; see Sharp, 29 Vet. App. 26; Correia, 28 Vet. App. 158; DeLuca, 8 Vet. App. 206. In this case, the Veteran states that he has experienced pain and swelling in his right ankle, that he cannot exercise or play sports because of his ankle, and that he is unable to stand or walk for longer than five minutes because of his right ankle disability. Although the Veteran experiences the aforementioned symptoms, overall, it does not appear that these symptoms result in additional and significant functional loss, and his complaints are adequately contemplated in the ratings he currently receives. See Sharp, 29 Vet. App. 26; Mitchell, 25 Vet. App. 32, 37-43 (2011) (pain must affect some aspect of the normal working movements of the body such as strength, speed, coordination or endurance). Here, there is no evidence from the treatment records or the June 2012, August 2013, March 2016, July 2017, and July 2020 VA examination reports of any significant loss of motion or functioning after flare-ups, repetitive testing, or weight bearing that would warrant a higher rating during any period on appeal. Indeed, the July 2020 VA examination report shows that his right shoulder lost only 10 degrees of plantar flexion and 5 degrees of dorsiflexion after repeated use over time and during a flareup. Further, the July 2020 VA examination report reflects that his passive and active ranges of motion were the same. Moreover, although the examination reports reflect pain on weight bearing, the examination reports do not reflect any additional loss of range of motion or function as a result of such pain. Finally, the 10 percent rating that has been awarded specifically contemplated functional limitation of his right ankle. Additionally, the Board has considered the statements from the Veteran that his service-connected residuals of a right facial fracture, posttraumatic headaches, low back disability, right shoulder disability, and right ankle disability are worse than the disability ratings he currently receives. In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Although the Veteran is competent to report symptoms of these disabilities such as numbness, pain, and limitation of motion because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of his service-connected disabilities according to the appropriate DCs. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) ("although interest may affect the credibility of testimony, it does not affect competency to testify"). On the other hand, such competent evidence concerning the nature and extent of the Veteran's service-connected residuals of a right facial fracture, posttraumatic headaches, low back disability, right shoulder disability, and right ankle disability has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the VA examination reports) directly address the criteria under which these disabilities are evaluated. By virtue of the foregoing, service connection for otitis media of the right ear and right ear hearing loss is denied, a disability rating in excess of 10 percent for the residuals of a right facial fracture from August 1, 2003 is denied, a disability rating in excess of 30 percent for post-traumatic headaches, to include photophobia, is denied, a disability rating in excess of 10 percent prior to July 29, 2020 and in excess of 20 percent thereafter for a low back disability is denied, disability rating in excess of 20 percent for a right shoulder disability is denied, and a disability rating in excess of 10 percent for a right ankle disability is denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet App. 49 (1990); 38 C.F.R. § 3.102. M. Pryce Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Crosnicker, 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.