Citation Nr: 21032892 Decision Date: 05/28/21 Archive Date: 05/28/21 DOCKET NO. 14-02 656 DATE: May 28, 2021 ORDER Restoration of the Veteran's 10 percent rating under Diagnostic Code 5099-5024 for limitation of flexion is granted from January 7, 2011 to October 5, 2015. Entitlement to an initial evaluation in excess of 10 percent for a chronic right knee strain with limitation of extension is denied. Entitlement to a disability rating in excess of 10 percent for a chronic right knee strain with limitation of flexion is denied. Entitlement to a compensable evaluation for chronic rhinitis is denied. FINDINGS OF FACT 1. The reduction of the Veteran's disability rating for limitation of right knee flexion from 10 percent to noncompensable, effective January 7, 2011, failed to comply with applicable law. 2. For the period on appeal, the Veteran's right knee chronic strain was manifested as painful motion, but not ankylosis, limitation of flexion to 45 degrees, or limitation of extension to 10 degrees. 3. For the period on appeal, while the Veteran's chronic rhinitis has been characterized by congestion, it has not been manifested by nasal polyps or without polyps but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side. CONCLUSIONS OF LAW 1. The reduction of the rating for right knee chronic strain from 10 percent to noncompensable effective January 7, 2011, was not proper. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.344, 4.1, 4.2, 4.7, 4.71a. 2. For the period on appeal, the criteria for an initial evaluation in excess of 10 percent for a chronic right knee strain with limitation of extension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.14, 4.21, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5003-5261. 3. For the period on appeal, the criteria for a disability evaluation in excess of 10 percent for right knee limitation of flexion have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.14, 4.21, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5260. 4. For the period on appeal, the criteria for a compensable evaluation for the Veteran's chronic rhinitis has not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1-4.16; 4.97, Diagnostic Code 6522. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from April 1976 to April 1980 and from July 1981 ot August 1997. This case comes before the Board of Veterans' Appeals (Board) on appeal of December 2011 and April 2012 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). The claim was previously before the Board in July 2015, at which time the Board remanded it for additional development. The issues were again before the Board in January 2020 so that the Veteran could be afforded new VA examinations. The Veteran was afforded VA examinations to determine the current severity of his service-connected right knee condition and his rhinitis. The February 2020 VA examination included passive and active range of motion testing. In its remand, the Board also directed the examiner to discuss functional impairment during flare-ups. However, at the examination, the Veteran denied experiencing flare-ups. The February 2020 knee and sinusitis examinations describe the Veteran's disabilities in detail sufficient to allow the Board to make a fully informed determination. Therefore, there was substantial compliance with the remand directives. Stegall v. West, 11 Vet. App. 268 (1998). As a procedural matter, entitlement to an initial compensable evaluation for left ear hearing loss was in front of the Board in January 2020. The Board denied this claim, and therefore this issue is no longer before the Board. Reduction of Disability Rating and Change in Diagnostic Code As a preliminary matter, the Board will restore the Veteran's 10 percent rating under Diagnostic Code 5099-5024 for the period from January 7, 2011 to October 5, 2015 for the reasons discussed below. In the December 2011 rating decision on appeal, the RO granted a 10 percent rating for right knee strain with limitation of extension under Diagnostic Code 5261, and continued an already existing 10 percent rating under Diagnostic Code 5099-2024. During the appeal period, in an April 2012 rating decision, the RO found clear and unmistakable error in the December 2011 rating decision and assigned a temporary 100 percent rating beginning January 31, 2007 and a 10 percent rating beginning March 1, 2007, but reduced the rating to noncompensable beginning January 1, 2011. Because the overall combined evaluation was not impacted, the notice provisions set forth in 38 C.F.R. § 3.105(e) do not apply. In an October 2015 rating decision, the RO granted service connection for limitation of flexion of the right knee, and assigned a 10 precent rating under Diagnostic Code 5260. The question before the Board is whether the reduction in rating from 10 percent to noncompensable from January 7, 2011 to October 5, 2015 was proper. At the time of the April 2012 rating decision, the 10 percent rating had been effective for five years, as it began March 1, 2007. 38 C.F.R. § 3.344 (a) (b) provide greater protection to recipients of disability ratings that have continued for five years or more. 38 C.F.R. § 3.344 (c). Prior to reducing a long term disability rating, the RO must find: (1) based on a review of the entire record, the examination forming the basis for the reduction is full and complete, and at least as full and complete as the examination upon which the rating was originally based; (2) the record clearly shows a finding of material improvement; and (3) it is reasonably certain that the material improvement found will be maintained under the ordinary conditions of life. 38 C.F.R. § 3.344 (a),(b); Brown v. Brown, 5 Vet. App. 413 (1993). Furthermore, in any reduction case, it must be determined that an improvement in a disability has actually occurred but also that the improvement actually reflects an improvement in the Veteran's ability to function under the ordinary conditions of life and work. Brown, 5 Vet. App. at 421. The Veteran was not provided with a new VA examination prior to the reduction. Additionally, the RO did not address whether an improvement reflected an improvement in the Veteran's ability to function under the ordinary conditions of life and work. Because the RO did not do this, restoration of the rating is appropriate. Therefore, the 10 percent rating under Diagnostic Code 5099-5024 is restored from January 7, 2011 to October 5, 2015. In an October 2015 rating decision, the RO granted a 10 percent rating under Diagnostic Code 5003-5260 for limitation of flexion of the right knee. The Board finds that it is appropriate to switch the Diagnostic Code for the Veteran's 10 percent rating for limitation of flexion of the right knee from Diagnostic Code 5099-5024 to Diagnostic Code 5003-5260 beginning October 5, 2015. The 10 percent rating has been in effect for less than 20 years and service connection is not severed in this case because the code is changed to more accurately determine the benefit. Read v. Shinseki, 651 F.3d 1296, 1302 (Fed. Cir. 2011). Diagnostic Code 5024 contemplates tenosynovitis, and the rater is instructed to rate the disability on limitation of motion of affected parts, as degenerative arthritis, except for gout which is rated under Diagnostic Code 5002. 38 C.F.R. § 4.71a, Diagnostic Code 5024. The Veteran does not have gout. Limitation of motion of the knee is rated under Diagnostic Code 5260 for flexion and 5261 for extension. Rating a disability using Diagnostic Code 5024 involves using Diagnostic Codes 5260 and/or 5261, or the criteria for rating arthritis in Diagnostic Code 5003. Therefore, Diagnostic Code 5003-5260 more accurately describes the Veteran's disability. Increased Rating Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate Diagnostic Codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. "Staged" ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 5050 (2007). Given the nature of the present claims for higher initial evaluations, the Board has considered all evidence of severity since the effective dates for the awards of service connection. Fenderson v. West, 12 Vet. App. 119 (1999). Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. 1. Entitlement to an initial evaluation in excess of 10 percent for a chronic right knee strain with limitation of extension under Diagnostic Code 5261 2. Entitlement to a disability rating in excess of 10 percent for right knee limitation of flexion under Diagnostic Code 5099-5024 prior to October 5, 2015, and under Diagnostic Code 5003-5260 thereafter. The right knee is currently rated under 38 C.F.R. § 4.71a, Diagnostic Code 5261, for limitation of extension, with a 10 percent rating on and after October 10, 2010. As a result of the restoration of his 10 percent rating for limitation of flexion, the Veteran's right knee is also rated under 38 C.F.R. § 4.71a, Diagnostic Codes 5099-5024 and 5003-5260, for limitation of flexion (previously rated as chronic strain, right knee with limitation of flexion). The Veteran's left knee is abnormal because he has arthritis, and has been assigned a 10 percent disability rating for it since August 2000. 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."). Hyphenated Diagnostic Codes are used when a rating under one Diagnostic Code requires use of an additional Diagnostic Code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27. 38 C.F.R. § 4.71a, Diagnostic Code 5003 pertains to degenerative arthritis and Diagnostic Code 5024 pertains to tenosynovitis. Diagnostic Code 5003 provides, when limitation of motion is noncompensable under the appropriate Diagnostic Code, for a 10 percent rating for each major joint or group of minor joints affected by limitation of motion. Id. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Id. For rating purposes, the knee is considered a major joint. 38 C.F.R. § 4.45. As noted above, Diagnostic Code 5024 instructs the rater to evaluate based on limitation of motion or arthritis. Limitation of flexion of the leg is evaluated as follows: flexion limited to 15 degrees (30 percent); flexion limited to 30 degrees (20 percent); flexion limited to 45 degrees (10 percent); and flexion limited to 60 degrees (noncompensable). 38 C.F.R. § 4.71a, Diagnostic Code 5260. Limitation of extension of the leg is evaluated as follows: extension limited to 45 degrees (50 percent); extension limited to 30 degrees (40 percent); extension limited to 20 degrees (30 percent); extension limited to 15 degrees (20 percent); extension limited to 10 degrees (10 percent); and extension limited to 5 degrees (noncompensable). 38 C.F.R. § 4.71a, Diagnostic Code 5261. For VA purposes, a normal range of knee motion is from 0 degrees of extension to 140 degrees of flexion. 38 C.F.R. § 4.71, Plate II. At a December 2010 VA Surgery History and Physical Examination, the Veteran reported that he has had bilateral knee pain since approximately 1995. The Veteran underwent a right knee arthroscopy surgery in 2007. At this time, the Veteran reported chronic pain, locking, stabbing and difficulty with any knee rotation. The Veteran rated his pain at an eight out of 10. The Veteran was first afforded a VA examination for his right knee in January 2011. At this examination, the Veteran reported having constant pain while walking, which limited his mobility. The Veteran reported he was unable to walk more than a few yards because his knees will begin hurting. The examiner found bony joint enlargement, crepitus, edema, and tenderness. The examiner also noted pain at rest and guarding of movement, as well as grinding. The examiner noted that the Veteran's range of motion (ROM) measurements for his right knee were as follows, flexion: 10 to 95 degrees; extension was limited by 10 degrees. While there was objective evidence of pain on repetitive motion, there was no additional loss of ROM with repetition. The Veteran attended another VA examination in June 2013. The examiner diagnosed arthritis. At this time, the Veteran reported having two right knee arthroscopies done with no improvement. The Veteran also stated he had sleepless nights because of the pain. The Veteran reported flare-ups 4-5 times a week. The Veteran's flexion was recorded as 90 degrees with pain beginning at 90 degrees, and the Veteran displayed full extension of 0 degrees with no pain. There was no change after repetitive testing. His strength was normal and the joint was stable to all testing. The examiner found that there was no history of recurrent subluxation or dislocation. He did not have a meniscal condition. The Veteran was afforded another VA examination in October 2015. The examiner diagnosed arthritis. The Veteran stated that his knee pain resulted in functional loss, including self-limits on riding and sexual relationships, not being able to walk more than 75 yards, not being able to climb or engage in high impact sporting activities. The Veteran reported having flare-ups on average of 4 times per month which he described as a sharp, knife-like pain. His flexion was 131 degrees and extension was normal at 0 degrees. The examiner noted that the abnormal ROM did not contribute to functional loss. There was objective evidence of pain on weight bearing and localized tenderness or pain on palpation of the joint. There was no objective evidence of crepitus. There was no additional functional loss or range of motion after repetitive testing. His strength was normal at 5/5. There was no history of recurrent subluxation or instability. His right knee joint was stable on testing. He had a meniscal tear with frequent episodes of joint pain. with repetitive use and during flare-ups would be speculative because the Veteran was not examined during one. The Veteran was afforded another VA examination in July 2018. The examiner diagnosed a meniscal tear and arthritis. He stated that he had been falling more, but that this was because his left knee gave way. He did not report that his right knee gave way. He reported an increase in pain since his October 2015 examination. He described flare ups 4-5 times per month with knife-like pain. He stated that because of his knee pain he could not dance or walk more than 10 minutes without sitting down. He also had difficulty doing yardwork and vacuuming. His right knee flexion was 120 degrees and his extension was normal at 0 degrees. He had pain during flexion. There was no tenderness or pain on palpation of the joint or associated soft tissue. There was pain on weight bearing. There was no additional functional loss or range of motion after repetitive testing. Although the Veteran was not examined immediately after repetitive use over time, the examiner noted that the examination was medically consistent with the Veteran's statements describing functional loss with repetitive use over time. The examiner stated that the examination was also medically consistent with the Veteran's description of flare ups, but would not estimate the ROM in degrees because the examination was not conducted during a flare up. His right knee strength was normal. There was no history of recurrent subluxation or instability of the right knee, and the joint was stable on testing. He had a meniscus condition with frequent episodes of joint pain. There was pain on passive range of motion testing. Both the October 2015 and July 2018 examiners stated that they would not be able to provide estimates of the Veteran's ROM during a flare-up because the examination was not conducted during one, which is not adequate. In the January 2020 remand, the Board directed that the Veteran be provided with a VA examination to address his flare-ups. The Veteran was afforded a VA examination in February 2020. At this examination, he reported that over the last 18 months, his symptoms have worsened, and he was experiencing increased pain. Specifically, the Veteran reported having chronic daily pain, and stated that "if I move wrong, it's like a stab. Otherwise, it's a constant pressure like pain in my knees that is sharp and throbbing." The Veteran also stated that his knees "pop and crack" and occasionally "give out." The Veteran denied having flare-ups at this VA examination. Because he denied flare-ups, and did not describe them, the examiner did not address flare-ups. Since the Veteran denied having flare-ups at the examination, an estimate of range of motion during a flare-up was not necessary and the examination report is adequate. In February 2020, the Veteran reported having functional loss due to his knee pain, including not being able to walk long distances or for extended periods of time. The Veteran also reported difficulty negotiating steps, stairs, or inclines due to increased pain. The Veteran stated he is unable to stand for prolonged periods of time and reported being unable to kneel down at all. The Veteran's flexion was 90 degrees and his extension was normal at 0 degrees. The examiner found that this contributed to a functional loss as pain and decreased ROM will affect ability to walk, stand, kneel, or negotiate stairs. Pain was noted on the exam and caused functional loss at both flexion and extension. There was evidence of pain on weight bearing, and objective evidence of crepitus. The Veteran was able to perform repetitive-use testing with at least three repetitions, and there was no additional loss of function or ROM after three repetitions. Further, pain, weakness, fatigability, or incoordination did not significantly limit functional ability with repeated use over a period of time. Additionally, pain, weakness, fatigability, or incoordination did not significantly limit functional ability with flare ups. Although the Veteran was not examined immediately after repetitive use over time, the examiner stated that the examination was medically consistent with the Veteran's statements about his functional loss after repetitive use over time, and that there would not be additional functional limitation after repeated use over time. The Veteran's muscle strength testing showed normal strength on both flexion and extension. The Veteran does not have muscle atrophy or ankylosis. The examiner noted that the Veteran's gait does have a mild limp and is antalgic in nature. The examiner also observed that there is no history of recurrent subluxation, lateral instability, or recurrent effusion. Joint stability testing was performed and was normal. The examiner also noted that there is objective evidence of pain on passive range of motion testing, and there is objective evidence of pain when the joint is used in non-weight bearing. The examiner stated that the Veteran had a meniscal tear with frequent episodes of joint pain. VA treatment records consistently note complains of chronic knee pain, including during walking and standing. His VA treatment records do not document range of motion testing. In January 2019, he reported knee pain and when examined, his right knee did not have swelling. His knee was diffusely tender and his muscle strength was 4/5, and his pulse was 1+. The preponderance of the evidence described above shows that the Veteran is not entitled to a rating in excess of 10 percent under Diagnostic Code 5261 for his limitation of extension. The medical evidence of record throughout the appeal period does not support a finding that the Veteran's right knee extension is limited to 15 degrees, which is required for a 20 percent rating. The Board considers the Veteran's credible report of increased knee pain and issues with prolonged standing, walking, and climbing; however, his limitation of extension of his right knee is still not contemplated by a 20 percent rating, which requires that his extension would be limited to 15 degrees. As discussed above, the 10 percent rating for limitation of flexion has been restored because the RO's reduction of his rating did not comply with applicable law. The preponderance of the evidence does not show that the Veteran is entitled to a rating greater than 10 percent for his limitation of flexion because it is not limited to 30 degrees. The Board has considered the Veteran's lay statements. The Veteran is competent to report his own observations in regard to the symptoms of his knee disabilities and his descriptions are credible. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Nothing in the Veteran's lay statements provide a basis for assigning higher ratings than those assigned herein under any Diagnostic Code pertaining to musculoskeletal disabilities of the knee. Multiple VA examiners have diagnosed a meniscal tear in the Veteran's right knee. He has had an arthroscopy but has not had any portion of his meniscus removed. Therefore a separate rating under Diagnostic Code 5259 is not warranted. The Veteran is also not entitled to a separate rating for his meniscus condition under Diagnostic Code 5258. Assignment of a separate rating under Diagnostic Code 5258 is not precluded by law when a knee is already rated under other codes for limitation of motion. Lyles v. Shulkin, 29 Vet. App. 107 (2017). Under Diagnostic Code 5258, a 20 percent rating is warranted for dislocated semilunar cartilage with frequent episodes of "locking," pain, and effusion into the joint. This is the only evaluation available under Diagnostic Code 5258. In this case, the symptom associated with the Veteran's meniscus condition is frequent episodes of joint pain. The Veteran is being compensated for joint pain by his ratings under Diagnostic Codes 5260 and 5261. The evidence does not show that the Veteran experiences non-joint pain in his right knee that would require a separate rating. To assign a separate rating under Diagnostic Code 5258 to compensate him for joint pain would constitute pyramiding. 38 C.F.R. § 4.14. Lastly, the Veteran is not entitled to a separate rating for instability of the right knee. Under Diagnostic Code 5257, a 10 percent evaluation is warranted when there is slight recurrent subluxation or lateral instability. A 20 percent evaluation is warranted when there is moderate recurrent subluxation or lateral instability. A 30 percent evaluation is warranted for severe recurrent subluxation or lateral instability. 38 C.F.R. § 4.71a. Diagnostic Code 5257 is based upon instability and subluxation, not limitation of motion, as a result, the criteria set forth in DeLuca do not apply. DeLuca, 8 Vet. App. 202. "Recurrent" is defined as, "returning or happening time after time." Merriam-Webster's Collegiate Dictionary 1041 (11th ed. 2012). With the exception of his February 2020 VA examination, the examiners found that there was no history of instability or subluxation, and the joint was also found normal during stability testing. At the February 2020 examination, he stated that his "knees" will "give out" but did not state how frequently this occurred in his right knee. A VA treatment record from January 2019 shows that the Veteran was prescribed a brace for stability of the left knee, but not his right. The Veteran's statement that his knees will give out does not rise to the level of frequency that could be described as "recurrent." Additionally, the record shows that he does not have subluxation. A separate rating under Diagnostic Code 5257 is not warranted. Effective February 7, 2021, VA amended the rating criteria for the musculoskeletal system. 85 FR 76453, 76460. Diagnostic Codes 5260 and 5261 were not changed. Diagnostic Code 5003 was changed to state that the code was for degenerative arthritis "other than post-traumatic," but the criteria themselves did not change. Diagnostic Code 5257 was revised. Effective February 7, 2021, Diagnostic Code 5257 contemplates recurrent subluxation or instability and patellar instability. Patellar instability warrants a 10 percent rating when there is a diagnosed condition involving the patellofemoral complex with recurrent instability (with or without history of surgical repair) that does not require a prescription from a medical provider for a brace, cane, or walker. Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453 (Nov. 30, 2020) (to be codified at 38 CFR 4.71a, Diagnostic Code 5257). The patellofemoral complex consists of the quadriceps tendon, the patella, and the patellar tendon. Id. A 20 percent rating is warranted when there is a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for one of the following: a brace, cane, or walker. A 30 percent rating is warranted when there is a diagnosed condition involving the patellofemoral complex with recurrent instability after surgical repair that requires a prescription by a medical provider for a brace and either a cane or a walker. A surgical procedure that does not involve repair of one or more patellofemoral components that contribute to the underlying instability shall not qualify as surgical repair for patellar instability (including, but not limited to, arthroscopy to remove loose bodies and joint aspiration). Id. For recurrent subluxation or instability, a 10 percent rating is warranted for sprain, incomplete ligament tear, or complete ligament tear (repaired, unrepaired, or failed repair) causing persistent instability, without a prescription from a medical provider for an assistive device (e.g. cane(s), crutch(es), walker) or bracing for ambulation. A 20 percent rating is warranted for one of the following: (a) sprain, incomplete ligament tear, or repaired complete ligament tear causing persistent instability, and a medical provider prescribes a brace and/or assistive device (e.g. cane(s), crutch(es), walker) for ambulation or (b) unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes either an assistive device (e.g. cane(s), crutch(es), walker) or bracing for ambulation. A 30 percent rating is warranted for unrepaired or failed repair of complete ligament tear causing persistent instability, and a medical provider prescribes both an assistive device (e.g. cane(s), crutch(es), walker) and bracing for ambulation. These criteria are not more favorable to the Veteran because the evidence does not show that he has recurrent instability or subluxation, as discussed above. 3. Entitlement to a compensable evaluation for chronic rhinitis The Veteran contends that he is entitled to a higher evaluation for his chronic rhinitis. The Veteran's allergic rhinitis is rated under 38 C.F.R. § 4.97, Diagnostic Code 6522. Under Diagnostic Code 6522, a 10 percent rating is warranted for allergic rhinitis without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side. A 30 percent evaluation is warranted for allergic rhinitis with polyps. The Veteran was afforded an examination in January 2012. At this examination, the examiner acknowledged the Veteran's diagnosis of chronic rhinitis. The examiner observed that there is not greater than 50 percent obstruction of the nasal passage on both sides due to rhinitis, and there is not complete obstruction on one side due to rhinitis. The examiner also noted that the Veteran did not have permanent hypertrophy of the nasal turbinates, and the Veteran did not have nasal polyps. The Veteran also did not have any granulomatous conditions. The Veteran was afforded another VA examination for his chronic rhinitis in June 2013. Again, the examiner noted that the Veteran has a diagnosis of rhinitis but found that the Veteran did not have greater than 50 percent obstruction of the nasal passage on both sides due to this diagnosis. Further, the Veteran did not have complete obstruction of one side due to rhinitis. The examiner also observed that the Veteran did not have permanent hypertrophy of the nasal turbinates and did not have nasal polyps. The examiner also found that the Veteran did not have any granulomatous conditions. The issue was remanded by the Board in a July 2015 decision so that the Veteran could be afforded a new VA examination. The Veteran attended a new VA examination in October 2015, but the examiner did not acknowledge the diagnosis of rhinitis. The examiner instead noted that rhinitis and sinusitis are easily confused and can be similar. The issue was again remanded by the Board in January 2020 since the October 2015 exam was not clear on whether there was a review on rhinitis related symptoms. The Veteran was subsequently afforded a VA examination in February 2020. The examiner noted the Veteran's diagnosis of chronic rhinitis. In February 2020, the Veteran reported that his symptoms had worsened in the past 18 months. Specifically, the Veteran reported having more episodes where he is symptomatic with rhinitis. The Veteran stated that he develops symptoms five to six times a year and each episode lasts 5-7 days on average. During these times, the Veteran reports that he experiences a runny/stuffy nose, head and ear congestion, and sneezing. The examiner noted that the Veteran does not have greater than 50 percent obstruction of the nasal passage on both sides due to his rhinitis. Additionally, the examiner observed that the Veteran does not have complete obstruction of either side due to his rhinitis. The examiner also found that the Veteran does not have permanent hypertrophy of the nasal turbinates, and the Veteran does not have nasal polyps. Additionally, the Veteran did not have any granulomatous conditions. The Board finds that a compensable rating for allergic rhinitis is not warranted. The evidence does not show that the Veteran has 50 percent obstruction on both sides of his nasal passages, or complete obstruction of one side of his nasal passages. The Veteran is competent to state the symptoms he experiences, and his description of his symptoms are credible. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, nothing in these statements constitutes a contention that the symptoms of the Veteran's allergic rhinitis have included nasal polyps at any point during the period on appeal. Further, his statements do not provide competent evidence that he has either 50 percent obstruction on both sides of his nasal passages or complete obstruction on either side. Determining what percentage of obstruction is present is accomplished by a nasal examination. Viewing the inside of a nasal passage and determining how much of it is obstructed is not readily observable to a layperson and requires specialized knowledge of the respiratory system. Accordingly, the Board finds that the Veteran's disability picture is best captured by a noncompensable rating. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. DeVerter, 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.