Citation Nr: 21029765 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 16-40 984 DATE: May 17, 2021 ORDER Entitlement to a rating of 40 percent, but no higher, for right ulnar neuropathy is granted. FINDING OF FACT The Veteran's right ulnar neuropathy is manifest by no more than severe incomplete paralysis of the major extremity. CONCLUSION OF LAW The criteria for a disability rating in excess of 40 percent for right ulnar neuropathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8516. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from May 1980 to July 1980. This appeal comes before the Board of Veterans' Appeals (Board) from an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded in March 2019 for further development. The Board finds there has been substantial compliance with its remand instructions. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to a rating of 40 percent, but no higher, for right ulnar neuropathy The Veteran contends that his dominant right ulnar neuropathy is more disabling that currently evaluated warranting an increased rating. The Veteran's right ulnar neuropathy is rated as 30 percent disabling under 38 C.F.R. § 4.124a, Diagnostic Code 8516. Diagnostic Code 8516 provides a 10 percent rating for mild incomplete paralysis of the ulnar nerve in the fingers of either hand. A 30 percent rating is warranted for moderate incomplete paralysis of the ulnar nerve in the fingers of the major hand and a 20 percent is warranted for moderate incomplete paralysis of the ulnar nerve in the fingers of the minor hand. A 40 percent rating is warranted for severe incomplete paralysis of the ulnar nerve in the fingers of the major hand and a 30 percent is warranted for severe incomplete paralysis of the ulnar nerve in the fingers of the minor hand. A 60 percent rating is warranted for complete paralysis of the ulnar nerve in the fingers of either hand. 38 C.F.R. § 4.123 provides that neuritis, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete, paralysis. The maximum rating which may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatic nerve involvement, for moderately severe, incomplete paralysis. 38 C.F.R. § 4.124 provides that neuralgia, characterized usually by a dull and intermittent pain, of typical distribution so as to identify the nerve, is to be rated on the same scale, with a maximum equal to moderate incomplete paralysis. Tic douloureux, or trifacial neuralgia, may be rated up to complete paralysis of the affected nerve. The words "slight," "moderate" and "severe" as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all the evidence, to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6. It should also be noted that use of terminology such as "severe" by VA examiners and others, although an element of evidence to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. Regulations also provide that a Veteran may only have one major upper and lower extremity. 38 C.F.R. § 4.124a Initially, the Board finds that the Veteran's major hand is his service-connected right hand. See September 2019 VA examination. Initially, the Board finds that while treatment records document the Veteran's complaints and treatment for right ulnar neuropathy, nothing in these records shows his adverse symptomatology to be worse than what was reported by the VA examiners. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). The Board notes that April 2015 VA examiner opined that the Veteran disability picture equated to moderate incomplete paralysis of the right ulnar nerve. The VA examiner noted the Veteran experienced moderate constant pain, moderate paresthesias and/or dysesthesias, and moderate numbness. At the subsequent September 2019 VA examination, the VA examiner thereafter opined that the Veteran's disability picture equated to moderate incomplete paralysis of the right ulnar nerve. However, the VA examiner also noted the Veteran experienced severe constant pain, severe paresthesias and/or dysesthesias, and severe numbness. The Board finds that based on the September 2019 VA examiner's finding that the Veteran experiences severe constant pain, severe paresthesias and/or dysesthesias, and severe numbness, the Veteran is entitled to a rating of 40 percent, but no higher, for his right ulnar neuropathy as he experiences incomplete paralysis that is severe. The Veteran is not entitled to a rating greater than 40 percent as none of the evidence of record shows the Veteran has complete paralysis of the ulnar nerve. Complete paralysis of the ulnar nerve in the fingers of either hand is simply not indicated in treatment records or within the examiantions. Therefore, the Board finds that the most probative evidence of record shows that the Veteran's disability equates to severe incomplete paralysis of the right ulnar under Diagnostic Code 8516, and the claim for entitlement to a rating of 40 percent, but no higher, for right ulnar neuropathy is granted. John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Holcombe, 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.