Citation Nr: 21032367 Decision Date: 05/26/21 Archive Date: 05/26/21 DOCKET NO. 16-53 772A DATE: May 26, 2021 ORDER Entitlement to an initial disability rating in excess of 10 percent from July 21, 2003 to July 9, 2010, excluding September 12, 2005 to November 1, 2005, for degenerative disc disease (DDD) of the cervical spine with spinal fusion is denied. Entitlement to a disability rating in excess of 20 percent from July 9, 2010 to August 31, 2011, for DDD of the cervical spine with spinal fusion is denied. Entitlement to a disability rating in excess of 30 percent from September 1, 2011 to February 6, 2014, for DDD of the cervical spine with spinal fusion is denied. Entitlement to a disability rating in excess of 10 percent as of February 7, 2014 for DDD of the cervical spine with spinal fusion is denied. A 20 percent disability rating for DDD of the cervical spine with spinal fusion is granted effective March 5, 2021. An effective date prior to July 21, 2003 for the grant of service connection for DDD of the cervical spine with spinal fusion is denied. FINDINGS OF FACT 1. From July 21, 2003 to July 9, 2010, the Veteran's DDD of the cervical spine manifested, at worst, in forward flexion to 45 degrees, with no neurological abnormalities. 2. From July 9, 2010 to August 31, 2011, the Veteran's DDD of the cervical spine manifested, at worst, in forward flexion to 25 degrees, with no ankylosis present. 3. From September 1, 2011 to February 6, 2014, the Veteran's DDD of the cervical spine does not manifest in unfavorable ankylosis. 4. From February 7, 2014, the Veteran's DDD of the cervical spine manifests, at worst, in forward flexion to 40 degrees, with no ankylosis present. 5. From March 5, 2021, the Veteran's combined range of motion of the cervical spine was 155 degrees. 6. The Veteran's claim for entitlement to service connection for DDD of the cervical spine was received July 21, 2003. CONCLUSIONS OF LAW 1. From July 21, 2003 to July 9, 2010, the criteria for an initial disability rating in excess of 10 percent for the Veteran's service-connected DDD of the cervical spine were not met or approximated. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1-4.14, 4.71a, Diagnostic Code 5242. 2. From July 9, 2010 to August 31, 2011, the criteria for a disability rating in excess of 20 percent for the Veteran's service-connected DDD of the cervical spine were not met or approximated. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 4.1-4.14, 4.71a, Diagnostic Code 5242 (2018). 3. From August 31, 2011 to February 6, 2014, the criteria for a disability rating in excess of 30 percent for the Veteran's service-connected DDD of the cervical spine were not met or approximated. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1-4.14, 4.71a, Diagnostic Code 5242. 4. From February 7, 2014, the criteria for a disability rating in excess of 10 percent for the Veteran's service-connected DDD of the cervical spine were not met or approximated. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1-4.14, 4.71a, Diagnostic Code 5242. 5. From March 5, 2021, the criteria for a 20 percent rating for the Veteran's service-connected DDD of the cervical spine were met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1-4.14, 4.71a, Diagnostic Code 5242. 6. The criteria for an effective date prior to July 21, 2003 for the grant of service connection for DDD of the cervical spine with spinal fusion have not been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty with the United States Army from November 1969 to December 1975, to include service in the Republic of Vietnam. The Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). The evaluation of evidence generally involves a three-step inquiry. First, the Board must determine whether the evidence comes from a "competent" source. The Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). The third step of this inquiry requires the Board to weigh the probative value of the evidence in light of the entirety of the record. Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board . . . to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Increased Ratings Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Ratings are assigned based on the average impairment of earning capacity resulting from a service-connected disability. 38 C.F.R. § 4.1. Where two disability ratings are potentially applicable, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. In deciding this appeal, the Board has considered whether separate ratings for different periods of time, based on the facts found, are warranted, a practice of assigning ratings referred to as "staging the ratings." See Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2008). The Veteran's DDD was given an initial disability rating of 10 percent. From September 12, 2005, to November 1, 2005, the Veteran was assigned a total temporary disability rating of 100 percent following surgery for cervical fusion. The Veteran's DDD of the cervical spine was rated 10 percent disabling under Diagnostic Code 5242, using the General Rating Formula for Diseases and Injuries of the Spine. 38 C.F.R. § 4.71a, Diagnostic Code 5242. Under the General Rating Formula for Diseases and Injuries of the Spine, a 10 percent rating is assigned for forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 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 cervical spine greater than 15 degrees less but not greater than 30 degrees; or, the combined range of motion of the cervical spine not greater than 170 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 rating of 30 percent is awarded for forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine. A rating of 40 percent is awarded for unfavorable ankylosis of the entire cervical spine. The normal combined range of motion of the cervical spine is 340 degrees. Normal forward flexion of the cervical spine is 0 to 45 degrees, extension is from 0 to 45 degrees, left and right lateral flexion are 0 to 45 degrees, and left and right lateral rotation are from 0 to 80 degrees. 38 C.F.R. § 4.71a. 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. 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 (musculoskeletal system) or § 4.73 (muscle injury); 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."). 1. Entitlement to an initial disability rating in excess of 10 percent from July 21, 2003 to July 9, 2010, excluding September 12, 2005, to November 1, 2005, for DDD of the cervical spine with spinal fusion. The preponderance of the evidence is against a finding for an initial disability rating in excess of 10 percent for the Veteran's cervical spine disability. The Veteran's VA treatment records during this period note complaints of and treatment for chronic neck pain. A September 2003 treatment records states the Veteran complains chronic pain and tingling in left upper extremity. The record notes a normal range of motion on extension to -60 degrees but abnormal rotation to -10 on the left side. A January 2005 VA treatment record notes that he had forward flexion to 45 degrees, extension to 60 degrees, lateral flexion to 45 degrees, and rotation to 80 degrees. Additionally, in October 2003, the Veteran completed a VA spine examination. At examination, the Veteran reported pain in his middle and lower back that increased with prolonged sitting or standing. The Veteran reported some diminishment in his ability to lift objects. The Veteran did not require the use of external supports for ambulation. He noted some symptoms of radiculopathy but denied changes in bowel or bladder habits. Although cervical spine range of motion measurements were not obtained, the VA examiner noted that the Veteran demonstrated increased range of motion when not under direct observation. The October 2003 VA orthopedic examiner indicated there was no objective evidence that function was additionally limited by pain, fatigue, weakness, incoordination or lack of endurance, with exam compromised by significant functional overlay. Thus, any additional limitation due to pain did not more nearly approximate forward flexion of the cervical spine greater than 15 degrees less but not greater than 30 degrees; or, the combined range of motion of the cervical spine not greater than 170 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. At a March 2010 VA Spine examination, the Veteran reported pain in his neck that radiated to his head and ears. He also reported daily numbness in varying areas. The Veteran used a scooter to assist with ambulation outside his home, and only had limited ambulation within his home. The VA examiner noted that the Veteran's range of motion was limited but also found that the Veteran was entirely uncooperative with the examination and stated that he had "voluntary restriction of range of motion." The VA examiner noted that any range of motion findings were likely inaccurate based on the Veteran's lack of cooperation. The VA examiner also noted there was no ankylosis of the cervical spine. There is no basis for an increased rating due to pain, weakness, fatigability, weakness, or incoordination because even with consideration of these factors, the 20 percent criteria are not met. The initial 10 percent rating prior to from July 21, 2003, to July 9, 2010, contemplated functional loss due to pain, excess fatigability, and less movement. He was compensated for his painful motion. 38 C.F.R. § 4.59. Note (1) under the General Rating Formula for Diseases and Injuries of the Spine directs evaluation of any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate Diagnostic Code. A March 2003 VA multiple examination noted that the Veteran did not have any current bladder or bowel impairments. A March 2005 electromyography notes some neurologic abnormality in the upper extremities but determines the neuropathy to be consistent with bilateral carpal tunnel syndrome, and not associated with the cervical spine. February 2005 and July 2005 VA treatment records noted that he did not have bowl or bladder incontinence. A September 2005 VA treatment record details that the Veteran denied radiculopathy. Another September 2005 record noted that the Veteran did not have problems emptying his bladder. A March 2010 cervical spine examination noted the Veteran did not experience numbness and was silent for bowel or bladder problems. A July 2010 electromyography showed no evidence of peripheral neuropathy. A December 2010 VA treatment record noted that the Veteran did not have problems with urinary elimination. The probative evidence of record does not establish neurologic abnormalities associated with the Veteran's DDD of the Veteran's cervical spine during this appeal period. From July 21, 2003 to July 9, 2010, excluding the Veteran's temporary total disability rating, the probative medical evidence of record does not establish that the Veteran's degenerative disc disease of the cervical spine manifested to the level necessary to support an increase to 20 percent disabling. See Fenderson, 12 Vet. App. 114. The evidence of record does not establish forward flexion of the cervical spine greater than 15 degrees less but not greater than 30 degrees; or, the combined range of motion of the cervical spine not greater than 170 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. See 38 C.F.R. § 4.45, 4.71a, Diagnostic Code 5242. The preponderance of the evidence is against his claim for an increased rating. Consequently, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 55. 2. Entitlement to a disability rating in excess of 20 percent from July 9, 2010, to August 31, 2011, for DDD of the cervical spine with spinal fusion From July 9, 2010 to August 31, 2011, the Veteran's DDD of the cervical spine is rated 20 percent disabling under Diagnostic Code 5242, which pertains to cervical strain, using the General Rating Formula for Diseases and Injuries of the Spine. 38 C.F.R. § 4.71a, Diagnostic Code 5242. The preponderance of the evidence is against a finding for a rating in excess of 20 percent for the Veteran's cervical spine disability. An October 2010 VA treatment record reports that the Veteran's forward flexion of his cervical spine was 25 degrees. His extension was 10 degrees. His lateral flexion was 30 degrees bilaterally. His lateral rotation was 40 degrees bilaterally. His combined range of motion was 175 degrees. The range of motion was described as "mildly decreased" and that he had "mildly painful motion." The October 2010 VA treatment records notes that the Veteran complained of chronic neck pain, that was worse when provoked through bending, twisting, flexing, extending, walking, running, or lifting heavy objects. His sensory examination was normal. The 20 percent rating from July 9, 2010, to September 1, 2011, contemplated functional loss due to pain, excess fatigability, and less movement. See 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca, 8 Vet. App. at 206-07. Additionally, the record does not contain probative evidence that the Veteran experienced neurological complications from his cervical spine disability during this period. The Board finds, from July 9, 2010 to September 1, 2011, the probative evidence of record does not establish that the Veteran's degenerative disc disease of the cervical spine manifested to the level necessary to support an increase to 30 percent disabling. The preponderance of the evidence is against his claim for an increased rating. The probative medical evidence of record does not establish forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine. Consequently, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 55. 3. Entitlement to a disability rating in excess of 30 percent from September 1, 2011, to February 6, 2014, for DDD of the cervical spine with spinal fusion From September 1, 2011 to February 6, 2014, the Veteran's cervical spine disability has been rated 30 percent disabling under Diagnostic Code 5242, which pertains to cervical strain, using the General Rating Formula for Diseases and Injuries of the Spine. 38 C.F.R. § 4.71a, Diagnostic Code 5242. A review of the probative record of evidence does not establish that the Veteran experienced unfavorable ankylosis of the entire cervical spine. At a September 2011 VA examination, the Veteran reported chronic neck and back pain since a Vietnam injury in 1968. The Veteran wore supportive braces on both knees but stated he was largely confined to a scooter for ambulation. The Veteran stated he felt unstable while standing or walking. He reported pain that sometimes radiated to his right hip and buttocks. The Veteran had forward flexion to 5 degrees, extension to 15 degrees, lateral flexion to 20 degrees bilaterally, right lateral rotation to 25 degrees, and left lateral rotation to 35 degrees. There was objective evidence of pain on motion. Repeated testing did not increase range of motion limitations. The VA examiner noted that the Veteran's cervical spine disability resulted in less movement than normal, weakened movement, excess fatigability, pain on movement, disturbance of locomotion, interference with sitting and standing. However, the September 2011 examination of the Veteran's cervical spine indicates that unfavorable ankylosis of the entire cervical spine was not present, as the Veteran was able to move his joint at the time of examination. "Ankylosis" is defined as "immobility and consolidation of a joint due to disease, injury, or surgical procedure." Dorland's Illustrated Medical Dictionary, 94 (32nd ed. 2012). Additionally, unfavorable ankylosis is defined by VA regulation. "Unfavorable ankylosis" is defined as "a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching." 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine, Note (5). Additionally, fixation of a spinal segment in neutral position (zero degrees) is "always" considered favorable ankylosis. Id. The record does not show, nor does the Veteran assert, that he has unfavorable ankylosis of the entire cervical spine as evidenced by the conditions listed in Note (5). Therefore, the Veteran's cervical spine disability does not meet the requirements for a 40 percent rating, and is more closely approximated by a 30 percent disability rating. The VA examiner noted no symptoms of radicular pain or other signs of radiculopathy. The Veteran reported additional dribbling and fecal soiling. However, the evidence of record does not establish bowel or bladder problems. Conversely, a November 2013 VA nursing note states that the Veteran reported expected bowel and bladder function. His VA treatment records do not reflect subjective complaints of bowel or bladder problems and no bowel or bladder problems were diagnosed. The Board finds the years of VA treatment records from September 2011 to February 2014 to be more probative than the Veteran's assertion, which is not consistent with the contemporaneous medical records. The Board finds, from September 1, 2011 to February 7, 2014, the probative evidence of record does not establish that the Veteran's degenerative disc disease of the cervical spine manifested to the level necessary to support an increase to 40 percent disabling. See Fenderson, 12 Vet. App. 114. The preponderance of the evidence is against his claim for an increased rating. Consequently, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 55. 4. Entitlement to a disability rating in excess of 10 percent from February 7, 2014, to March 4, 2021 for DDD of the cervical spine with spinal fusion As of February 7, 2014, the Veteran's DDD of the cervical spine is rated 10 percent disabling under Diagnostic Code 5242, which pertains to cervical strain, using the General Rating Formula for Diseases and Injuries of the Spine. 38 C.F.R. § 4.71a, Diagnostic Code 5242. After review of the evidence, in consideration of the above criteria, the Board finds that the preponderance of the evidence is against a finding for a rating in excess of 10 percent for the Veteran's cervical spine disability. A February 2014 VA examination of the Veteran notes his cervical spine range of motion measurements showed flexion to 40 degrees, extension to 30 degrees, right and left lateral flexion to 25 degrees, right lateral rotation to 50 degrees, and left rotation to 45 degrees, with pain at the end points of the motions. His combined range of motion was 215 degrees. After repetitive use testing, there were no additional degrees of limitation. He denied experiencing flare-ups. The Veteran did not have muscle spasm or guarding of the cervical spine resulting in an abnormal gait. The VA examiner also noted there was no ankylosis of the cervical spine. The examiner further noted that the Veteran's cervical spine disability resulted in limited cervical spine range of motion, limited bending and twisting of the cervical spine, limited lifting to 25 pounds occasionally and 10 pounds frequently throughout the work-day. As noted above, a 20 percent disability rating is not warranted unless the probative medical evidence of record establishes forward flexion of the cervical spine greater than 15 degrees less but not greater than 30 degrees; or, the combined range of motion of the cervical spine not greater than 170 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. 38 C.F.R. § 4.71a, Diagnostic Code 5242. The Board has considered whether a disability rating higher than 10 percent is warranted for this period of appeal based on functional loss due to pain or weakness, fatigability, incoordination, or pain on movement of a joint. There is no basis for the assignment of additional disability due to pain, weakness, fatigability, weakness, or incoordination. The provisions for evaluating intervertebral disc syndrome (IVDS) are also not for application for the Veteran's service-connected cervical spine disability as the February 2014 VA examiner noted the Veteran does not have IVDS. See 38 C.F.R. § 4.71a, Diagnostic Code 5242. At the February 7, 2014 VA examination, the Veteran indicated intermittent urinary and bladder incontinence. However, the VA examiner noted, "there is no mention of the subjective complaints or objective medical findings within the medical record (particularly with urology and neurosurgery notes)." The Veteran did not have symptoms of radicular pain or other signs of radiculopathy. In a December 2018 VA treatment record, the Veteran specifically denied bowel and bladder incontinence. That the Veteran did not report bowel or bladder problems during urology and neurosurgery treatment is especially probative. If he was experiencing urinary symptoms, it is reasonable to conclude that he was would have reported this at a urology appointment. Additionally, the remaining VA treatment records do not reflect subjective complaints of urinary or bowel symptoms. The probative evidence of record does not support a finding that the Veteran has bladder or bowel symptoms due to his neck disability. The 10 percent rating as of February 7, 2014, contemplated functional loss due to pain, excess fatigability, and less movement. There is no basis for the assignment of additional disability due to pain, weakness, fatigability, weakness or incoordination during this period of appeal. See 38 C.F.R. §§ 4.40, 4.45; DeLuca, 8 Vet. App. at 206-07. The preponderance of the evidence is against his claim for an increased rating. Consequently, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); Gilbert, 1 Vet. App. at 55. 5. Entitlement to a 20 percent rating for DDD of the cervical spine is granted beginning March 5, 2021. The Veteran underwent a VA examination on March 5, 2021. He reported neck pain, especially with motion. He denied having flare-ups. His forward flexion was 30 degrees, his extension was 40 degrees, his right lateral flexion was 10 degrees, his left lateral flexion was 15 degrees, his lateral rotation was 30 degrees bilaterally. His combined range of motion of the cervical spine was 155 degrees. He had pain during all range of motion testing. This meets the criteria for a 20 percent rating. For this reason, a 20 percent rating is granted, effective March 5, 2021, the date of his examination. Prior to that date, the record does not show an increase in severity from the February 2014 examination, and the information contained in the March 5, 2021 examination report does not support a finding that the 20 percent rating should be assigned prior to that date. Passive range of motion was also tested at his March 2021 examination, and it was the same as active motion, with pain. After repetitive motion there was no change in range of motion and no additional loss of function. He was examined immediately after repetitive use over time and there was no additional functional loss. There was no localized tenderness, guarding, or muscle spasm. His strength and reflexes were normal. There was no muscle atrophy. His sensory examination was normal. The examiner stated that he did not have radiculopathy or other neurological abnormalities such as bowel or bladder problems. The March 2021 examination report supports a 20 percent rating, but not a 30 percent rating. The Veteran's forward flexion was not 15 degrees or less. Additionally, he was able to move his neck and therefore by definition he did not have ankylosis. Further, he denied experiencing flare ups and did not describe the functional equivalent of ankylosis. The preponderance of the evidence supports a 20 percent rating beginning March 5, 2021. 6. Effective date prior to July 21, 2003 for the grant of service connection for DDD of the cervical spine with spinal fusion Except as otherwise provided, the effective date for a grant of compensation will be the day following separation from active service or the date entitlement arose, if a claim is received within one year of separation. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400. Otherwise, the effective date of the award of an evaluation based on an original claim, a claim reopened after a final disallowance, or a claim for an increase will be the date of receipt of the claim or the date entitlement arose, whichever is later. Id. The Veteran filed his initial claim for service connection for DDD of the cervical spine on July 21, 2003. An August 2016 rating decision granted the Veteran's claim for service connection and assigned a 10 percent disability rating. The August 2016 rating decision assigned an effective date of July 21, 2003, the date of the Veteran's claim for service connection for DDD of the cervical spine. As noted above, unless the Veteran's claim is submitted within one year of his completion of active service, the effective date of a grant for compensation is the date of the receipt of the claim or the date the entitlement arose, whichever is later. 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. The Board notes that the Veteran's claim was not submitted within one year of his completion of active service in December 1975. The Veteran has not asserted that he previously filed a claim for service connection for DDD of the cervical spine. The evidence does not show an earlier claim for DDD of cervical spine. Hence, this is an original claim for compensation. As the Veteran's DDD of the cervical spine was already present when the Veteran filed his claim, the earliest possible effective date of the claim for service connection for DDD of the cervical spine is the date the claim was filed, July 21, 2003. See 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. Other Considerations The record shows that the Veteran is not employed. However, he has a 100 percent schedular disability rating for his posttraumatic stress disorder and traumatic brain injury (TBI) since January 2001, and special monthly compensation (SMC) under 38 U.S.C. § 1114(s) for a disability with a schedular 100 percent rating and other disabilities independently ratable at 60 percent or more beginning July 21, 2003, which convers the entire appeal period. Therefore, discussion of a entitlement to a total rating based upon individual unemployability (TDIU) due to service-connected disabilities is not necessary. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Riordan, 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.