Citation Nr: 21039917 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 16-42 564 DATE: July 1, 2021 ORDER As of August 1, 2014, a 40 percent rating but no higher is warranted for lumbosacral strain and degenerative arthritis with intervertebral disc syndrome (IVDS). Entitlement to a rating in excess of 10 percent prior to April 16, 2020, is denied; a rating of 20 percent thereafter for right lower extremity radiculopathy, but no higher, is granted. Entitlement to a rating in excess of 10 percent prior to August 11, 2016, is denied; a rating of 20 percent thereafter for left lower extremity radiculopathy, but no higher, is granted. FINDINGS OF FACT 1. The Veteran's lumbosacral strain and degenerative arthritis with IVDS has manifested by forward flexion limited to 30 degree or less for the entire period on appeal. 2. From May 22, 2017 to April 16, 2020, the Veteran's right lower extremity radiculopathy manifested by no more than mild incomplete paralysis. As of April 16, 2020, the Veteran's right lower extremity radiculopathy has manifested by no more than moderate incomplete paralysis. 3. From August 1, 2014 to August 11, 2016, the Veteran's left lower extremity radiculopathy manifested by no more than mild incomplete paralysis. As of August 11, 2016, the Veteran's left lower extremity radiculopathy has manifested by no more than moderate incomplete paralysis. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 40 percent for lumbosacral strain and degenerative arthritis with IVDS but no higher have been met as of August 1, 2014. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5242, 5243. 2. The criteria for a disability rating in excess of 10 percent from May 22, 2017 to April 16, 2020, and in excess of 20 percent as of April 16, 2020 for right lower extremity radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520. 3. The criteria for a disability rating in excess of 10 percent from August 1, 2014 to August 11, 2016, has not been met, and a rating of 20 percent but no higher as of August 11, 2016, for left lower extremity radiculopathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from January 1975 to January 1980, and from December 1990 to August 1991. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). Increased Ratings-Spine and associated Radiculopathy The Veteran's lumbar spine disability is currently rated under Diagnostic Code 5243 for intervertebral disc syndrome (IVDS). Diagnostic Code 5243 provides that IVDS is to be rated either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating IVDS Based on Incapacitating Episodes, whichever method results in the higher rating when all disabilities are combined under 38 C.F.R. § 4.25. Any associated objective neurologic abnormalities, including but not limited to bowel and bladder impairment, are to be evaluated separately under an appropriate diagnostic code. 38 C.F.R. § 4.71a, Note(1). General Rating Formula for Diseases and Injuries of the Spine. For disabilities evaluated on the basis of limitation of motion, VA is required to apply the provisions of 38 C.F.R. §§ 4.40, 4.45, pertaining to functional impairment. The Court has instructed that in applying these regulations VA should obtain examinations in which the examiner determined whether the disability was manifested by weakened movement, excess fatigability, incoordination, or pain. Such inquiry is not to be limited to muscles or nerves. However, as will be seen, the Veteran's disability is already in receipt of the highest rating it can receive based on limitation of motion since this appeal was initiated. To receive a higher rating, some form of ankylosis is required, meaning that the spine is fixed in one position. The rating criteria for intervertebral disc disease state that this disability is to be evaluated under either the General Rating Formula for Diseases and Injuries of the Spine or the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever is most favorable to the Veteran. Under the General Rating Formula for the Spine, a 40 percent rating is warranted for forward flexion of the thoracolumbar spine limited to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. The criteria for a 50 percent rating are unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent rating requires unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a. Associated objective neurological abnormalities are rated separately under the appropriate diagnostic code. Id., Note(1). Alternatively, a back disorder can be rated as Intervertebral Disc Syndrome (IVDS) based on incapacitating episodes. Under those criteria, found at Diagnostic Code 5243, a ten percent evaluation requires incapacitating episodes having a total duration of at least one week, but less than 2 weeks during the past 12 months, and 20 percent evaluating requires incapacitating episodes having a total duration of at least 2 weeks, but less than 4 weeks during the past 12 months. Id. DC 5243. A 40 percent rating is warranted for incapacitating episodes having a total duration of less than six weeks, but more than four weeks and a 60 percent rating is warranted if incapacitating episodes have a total duration of at least six weeks during the past 12 months. There is no corresponding note allowing for the separate For purposes of evaluation under this formula, an incapacitating episode is a period of acute signs and symptoms due to IVDS that requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, Code 5243, Note 1. During the pendency of the appeal, the rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. § 4.71a were amended effective February 7, 2021. 85 Fed. Reg. 230 (Nov. 30, 2020). These amendments do not change the necessary criteria. However, Diagnostic Code 5243, which relates to IVDS states: "assign this diagnostic code only when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign diagnostic code 5242 for all other disc diagnoses." Therefore, assignment of the Veteran's lumbar spine disability under Diagnostic Code 5243 is proper for the entire appeal period. To summarize, in order for the Veteran to receive a rating in excess of 40 percent for his back disability, the rating criteria requires that there be a showing of unfavorable ankylosis of either the entire thoracolumbar spine or the entire spine. See 38 C.F.R. § 4.71a, Code 5242. In the alternative, there must be a showing of incapacitating episodes having a total duration of at least six weeks during the past 12 months. 38 C.F.R. § 4.71a, Code 5243. It is also worth noting that the Court recently held that when evaluating a disability under VA's General Rating Formula for Diseases and Injuries of the Spine (General Rating Formula), the criteria for a rating based on ankylosis may be met by evidence demonstrating the functional equivalent of ankylosisi.e., functional loss consistent with that contemplated by ankylosis. See Chavis v. McDonough, No. 18-2928 (April 2021); 38 C.F.R. §§ 4.40, 4.45; Mitchell v. Shinseki, 25 Vet. App. 32 (2011); DeLuca v. Brown, 8 Vet. App. 202 (1995). Entitlement to a disability rating in excess of 10 percent for lumbosacral strain and degenerative arthritis with intervertebral disc syndrome (IVDS) prior to May 22, 2017; entitlement to a disability rating in excess of 20 percent for lumbosacral strain and degenerative arthritis with intervertebral disc syndrome (IVDS) from May 22, 2017 to February 11, 2021; entitlement to a disability rating in excess of 40 percent for lumbosacral strain and degenerative arthritis with intervertebral disc syndrome (IVDS) from as of February 11, 2021. A December 2014 private treatment record shows that the Veteran's lumbar spine range of motion was limited to forward flexion to 10 degrees. Extension was noted to 10 degrees, and bilateral flexion was noted to 10 degrees. A January 2015 VA back condition disability benefits questionnaire (DBQ) shows that the Veteran was diagnosed with lumbar spine degenerative joint disease and degenerative disc disease. He reported constant lower back pain that was worse when he was trying to sleep. Pain as reported as severe when he would get up to use the bathroom at night. The Veteran reported putting himself on bedrest frequently because of extreme pain. He reported he was had balance problems and pain into his legs. The examiner noted that the Veteran was clearly uncomfortable sitting in the exam room due to pain. Flare-ups were reported and functional loss was reported by the Veteran. The examiner noted that range of motion testing was unable to be conducted due to pain experienced by the Veteran. Guarding and muscle spasms were not assessed. The examiner did not provide any diagnosis or mention of IVDS. A May 2015 VA back DBQ, shows that the Veteran reported low back pain that had worsened in the prior 3 to 4 months on the right side mostly. The Veteran reported pain radiating into the right posterior thigh. He denied buttock pain that improved with walking which he did all day working as a maintenance custodian. He did not report flare-ups affecting the thoracolumbar spine. Functional impairment of the spine was not reported by the Veteran. Range of motion testing showed forward flexion to 70 degrees; extension to 5 degrees; right and left lateral flexion to 15 degrees; right and left lateral rotation to 20 degrees. Pain was noted on the examination that did not result in functional loss. Pain with weight bearing was not assessed. Objective evidence of localized tenderness or pain to palpation was not assessed. Repetitive use testing was conducted with no additional loss of range of motion. The examiner noted that the Veteran was examined after repetitive use over time with no limited functional ability. Guarding or muscle spasms were not assessed. Ankylosis was not diagnosed. IVDS was not diagnosed. The Veteran was noted to use a cane constantly for assistance with walking. The examiner noted that the Veteran's back disabilty did not impact his ability to work. A September 2017 VA back condition DBQ shows that the Veteran had experienced enduring back pain for a year but pain has gotten worse in the prior 12 months. He could not sit for long periods of time and could not bend or do activities due to pain. Symptoms at the time of examination were pain, stiffness, muscle spasms, and an inability to ambulate secondary to pain. Treatment was noted as physical therapy once or twice per week as well as medication for pain. Flare-ups were reported; the Veteran was unable to bend to tie shoes, dress himself, or perform sexual actives during these episodes. Range of motion testing could not be conducted due to pain. Objective evidence of localized tenderness or pain on palpation of the joint of the thoracolumbar spine was not observed. Pain was noted on rest and non-movement. The examiner reported that it was not possible to determine without resorting to mere speculation, loss of motion during flares-ups or repetitive use, because there was no conceptual or empirical basis for making such a determination without directly observing function under these conditions or flare ups or after repetitive use over time. Guarding and muscle spasms were assessed resulting in abnormal gait or abnormal spine contour. Ankylosis was not assessed. No other neurological symptoms were assessed. IVDS was diagnosed with no incapacitating episodes requiring bed rest assessed. The Veteran was also noted to use a cane due to his back pain. The examiner noted that the Veteran was working in maintenance at the time of examination and missed 1 to 2 weeks of work during the prior 12 months. He was also noted to be unable to sit or stand for long periods of time and unable to bend. The Veteran reported that he was on light duties regarding his work. An April 2020 VA back DBQ shows that the Veteran reported chronic pain that radiated down into his legs. He reported avoiding prolonged sitting and standing, avoiding bending down to tie his shoes, and his spouse had to help with shoes and socks. He did not do any lifting or carrying of heavy items. The Veteran also reported that he had balance issues due to bilateral radiculopathy, and used a cane for walking. He endorsed flare-ups that caused increased pain and functional loss. Range of motion testing showed forward flexion to 30 degrees; extension to 10 degrees; right and left lateral flexion to 15 degrees, and right and left lateral rotation to 15 degrees. Pain with weight bearing was assessed. Objective evidence of localized tenderness was assessed. Repetitive use testing was conducted with no additional loss of range of motion. The examiner noted that the examination was not conducted during a flare-up but the examination was medically consistent with Veteran's statements describing functional loss during flare-ups. Pain, weakness, fatigability, or incoordination were noted not to significantly limit functional ability during flare -ups. Guarding or muscle spasms were not assessed. Ankylosis was not assessed. IVDS was assessed with no incapacitating episodes requiring bedrest. Pain on passive range of motion testing and non-weight bearing was assessed. A February 2021 VA back DBQ shows that the Veteran reported chronic pain radiating to his legs bilaterally. He reported that his wife did all his chores and helped with dressing and chores. He reported using a cane. Flare-ups were reported with increased pain. After repetitive use functional loss was reported. Range of motion testing was noted as forward flexion to 20 degrees; extension to 5 degrees; right and left lateral flexion to 10 degrees; and right and left lateral rotation to 30 degrees, all noted with pain. Passive range of motion testing showed decreased right and left lateral flexion to 10 degrees and right and left lateral rotation to 10 degrees. Pain was noted on all planes of motion. Pain was also noted on weight bearing, non-weight bearing, active motion, passive motion, rest/non-movement. Pain to palpation was noted. Repetitive use testing was conducted with no additional loss of range of motion. The examiner noted that the evaluation was not conducted during a flare-up but from procured evidence, such a statements from the Veteran, suggested pain, fatiguability, weakness, and lack of endurance would not cause additional functional ability. Tenderness was noted not to caused abnormal gait or spinal contour. Additional symptoms were noted as interference with sitting and standing, disturbance of locomotion, and less movement than normal. Ankylosis was not diagnosed. IVDS was diagnosed with IVDS with no incapacitating episodes. The Veteran was noted to use a walker to help with ambulating. Pain on passive range of motion and non-weight bearing were noted. After a review of the evidence of record and resolving reasonable doubt in favor of the Veteran, the Board finds that a rating of 40 percent but no higher is warranted from August 1, 2014, which is the date of the Veteran's claim for an increased rating for his service connected lumbar spine disability. The Board finds it significant that probative evidence shows that in December 2014, the Veteran's forward flexion was limited to 10 degrees, and during VA examinations conducted in January 2015 and September 2017, he was unable to complete range of motion testing due to pain. Moreover, VA examinations conducted in April 2020 showed forward flexion of the thoracolumbar spine limited to 30 degrees and in February 2021 limited 20 degrees, which meet the criteria for a rating of 40 percent but no higher. The Board acknowledges that during the May 2015 VA examination, the Veteran was able to achieve forward flexion greater than 30 degrees. However, it is clear that his was an isolated range of motion result and the overall weight of the evidence both before and after the May 2015 VA examination, shows that forward flexion the thoracolumbar spine was limited to 30 degrees or less. The Board resolves doubt in the Veteran's favor on this material issue and finds that a rating of 40 percent, but no higher, is warranted. 38 U.S.C. § 5107(b). The Board finds that a rating in excess of 40 percent for the lumbar spine disabilty is not warranted as the Veteran does not have unfavorable ankylosis as shown in medical evidence of record. In this regard, the examinations and DBQs show that while the Veteran has pain and functional impairment because of his limited range of motion, he is able to perform some range of motion which demonstrates that he does not have ankylosis. See 38 C.F.R. § 4.71a, Note(5) ("unfavorable ankylosis is a condition in which . . . the entire thoracolumbar spine . . . is fixed in flexion or extension"). Additionally, the has reported that while limited he retains some range of motion. A higher rating of 60 percent for IVDS is not warranted as he had not had incapacitating episodes with total duration of at least six weeks during the past 12 months. The Veteran has not had IVDS that required bed rest per the controlling regulation. The Veteran's erectile dysfunction does not warrant assignment of a separate rating as his disorder does not meet the minimum requirement for a compensable rating. 38 C.F.R. § 4.31, 4.115b, Diagnostic Code 7522. SMC for loss of use of a creative organ has been awarded. Regarding other neurological impairment, the Veteran has not reported bowel problems and he is already service connected for urinary incontinence which he has not communicated disagreement with any ratings assigned. Radiculopathy of the lower extremities will be evaluated below. Increased Ratings- Bilateral Lower Extremity Radiculopathy Entitlement to service connection for radiculopathy affecting the sciatic nerve of the right lower extremity was granted in a November 2017 rating decision and assigned an effective date of May 22, 2017. An initial rating of 10 percent was assigned prior to February 12, 2021, and 20 percent thereafter. Entitlement to service connection for radiculopathy affecting the sciatic nerve of the left lower extremity has been in effect since October 2012. The Veteran filed a claim for an increased rating for left lower extremity radiculopathy on August 1, 2014. The RO has assigned a 10 percent rating prior to August 11, 2016. From August 11, 2016, to September 24, 2017, the RO assigned a 20 percent rating. From September 24, 2017 to February 12, 2021, the RO assigned a 10 percent rating, and as of February 12, 2021, the RO has assigned a 20 percent rating. The Veteran's service-connected peripheral neuropathy has been rated by the RO under the provisions of Diagnostic Code 8520. Under this regulatory provision, an 80 percent rating is warranted for complete paralysis of the sciatic nerve in which the foot dangles and drops; there is no active movement possible of the muscles below the knee; and flexion of the knee is weakened or lost. A 60 percent rating is warranted for severe incomplete paralysis of the sciatic nerve, with marked muscular atrophy. A 40 percent rating is warranted for moderately severe incomplete paralysis of the sciatic nerve. A 20 percent rating is warranted for moderate incomplete paralysis of the sciatic nerve. A 10 percent rating is warranted for mild incomplete paralysis of the sciatic nerve. The term "incomplete paralysis" indicates a degree of impaired function substantially less than the type of picture for "complete paralysis" given for each nerve, whether due to varied level of the nerve lesion or to partial regeneration. 38 C.F.R. § 4.124a, Diseases of the Peripheral Nerves, Note. When the involvement is wholly sensory, the rating for incomplete paralysis should be for the mild, or, at most, the moderate degree. Id. VA guidance states that moderate incomplete paralysis will likely be described by the Veteran and medically graded as significantly disabling and may be demonstrated by combinations of significant sensory changes and reflex or motor changes of a lower degree, or motor and/or reflex impairment such as weakness or diminished or hyperactive reflexes (with or without sensory impairment) graded as medically moderate. For severe incomplete paralysis, in general, expect motor and/or reflex impairment (for example, atrophy, weakness, or diminished or hyperactive reflexes) at a grade reflecting a very high level of limitation or disability. Trophic changes may be seen in severe longstanding neuropathy cases. Even though severe incomplete paralysis cases should show findings substantially less than representative findings for complete impairment of the nerve, the disability picture for severe incomplete paralysis may contain signs/symptoms resembling some of those expected in cases of complete paralysis of the nerve. The Court held in Miller v. Shulkin that, "[a]lthough the note preceding § 4.124a directs the claims adjudicator to award no more than a 20% disability rating for incomplete paralysis of a peripheral nerve where the condition is productive of wholly sensory manifestations, it does not logically follow that any claimant who also exhibits non-sensory manifestations must necessarily be rated at a higher level." 28 Vet. App. 376, 380 (2017). 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. 38 C.F.R. § 4.123. The maximum rating which may be assigned for neuritis not characterized by such organic changes will be that for moderate, or with sciatic nerve involvement, for moderately severe, incomplete paralysis. Id. Words such as "moderate," "moderately severe," and "severe" are not defined in the Rating Schedule. Rather than applying a mechanical formula, VA must evaluate all evidence, to the end that decisions will be equitable and just. 38 C.F.R. § 4.6. The Board turns to a dictionary to define these terms. In this regard, moderate is generally defined as "tending toward the mean or average amount." MERRIAM-WEBSTER'S COLLEGIATE DICTIONARY 798 (11th ed. 2003). Severe is generally defined as "of a great degree" or "serious." Id. at 1140. Moderately severe, therefore, could be construed as falling beyond or above the mean or average amount while falling short of being a great degree or serious. The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). A May 2015 VA back DBQ, shows that the Veteran's muscle strength testing for the lower extremities were normal. Reflex examination for the knees and ankles were 1+. Sensory examination was normal for the lower extremities. Straight leg testing was negative. Radiculopathy was not assessed. The examiner noted that the Veteran had peripheral neuropathy due to diabetes mellitus and not due to the lumbar spine. A December 2016 peripheral nerve condition DBQ shows that the Veteran was diagnosed with bilateral lower extremity radiculopathy. Symptoms were noted as bilateral lower extremity moderate intermittent pain, moderate paresthesias, and moderate numbness. Muscle strength testing for knee extension, ankle plantar flexion, and ankle dorsiflexion were assessed as 4/5. Muscle atrophy was not assessed. Reflex examination shows 1+ for the knees and ankles. Sensory examination was decreased for the knees and feet. Trophic changes were not assessed. His gait was noted as normal. The examiner assessed the right and left sciatic nerves with moderate incomplete paralysis. Functional impairment was noted to be limited in repetitive use and prolonged weightbearing. Bilateral lower extremity radiculopathy was assessed to be due to his service connected back condition. The examiner assessed the radiculopathy of the lower extremity as mild. A September 2017 VA back DBQ shows that lower extremity muscle strength testing was normal for the lower extremities. Muscle atrophy was not assessed. Reflex and sensory examination was normal for the lower extremities. Positive straight leg testing was noted. Radiculopathy of the lower extremities was assessed. Symptoms were noted as moderate constant pain for the right lower extremity and mild constant pain for the left lower extremity. Mild intermittent pain, paresthesias, and numbness of the bilateral lower extremities was assessed. An addendum from October 2017 identified the sciatic nerves as the nerve group affected with radiculopathy. The examiner noted that this disability was a progression of the Veteran's service connection lumbar spine disability. An April 2020 VA back DBQ shows that the Veteran's lower extremities has normal muscle strength. Muscle atrophy was not assessed. Reflex examinations were normal. Sensory examination of the lower extremities were normal. The examiner noted symptoms of radiculopathy affecting the bilateral lower extremities as moderate intermittent pain, severe paresthesias, and moderate numbness. The examiner also assessed the Veteran with incontinence and erectile dysfunction due to the radiculopathy. The examiner assed the bilateral sciatic nerves as being affected described as severe. A February 2021 VA back DBQ shows that the Veteran's lower extremities had normal muscle strength for the lower extremities. Muscle atrophy was not assessed. Reflex examination was 2+ for the lower extremities. Sensory examination was normal for the lower extremities. Symptoms of radiculopathy were noted as mild constant pain for the right lower extremity. Moderate intermittent pain for the lower extremities. Severe paresthesias for the lower extremities. Moderate numbness for the lower extremities. Incontinence was also assessed as caused by the service-connected radiculopathy. The examiner noted symptoms of radiculopathy affecting the bilateral lower extremities as moderate intermittent pain, severe paresthesias, and moderate numbness. The examiner also assessed the Veteran with incontinence (which has been deemed service connected) and erectile dysfunction due to the radiculopathy. 1. Entitlement to a rating in excess of 10 percent prior to February 12, 2021 and in excess of 20 percent thereafter for right lower extremity radiculopathy. For the period from May 22, 2017 to April 16, 2020, the evidence shows that the Veteran underwent a VA examination in September 2017. Symptoms were noted as moderate constant pain for the right lower extremity and mild constant pain for the left lower extremity. Mild intermittent pain, paresthesias, and numbness of the bilateral lower extremities were assessed. The examination showed that the Veteran had symptoms, such as mild constant pain, paresthesias/dysesthesias, and numbness in his right lower extremity. The objective examination indicates that the symptoms were wholly sensory. Further, the Veteran had no atrophy. After review of the competent and probative evidence, the Board finds that for the period from May 22, 2017 to April 16, 2020, a rating in excess of 10 percent for right lower extremity radiculopathy is not warranted. During this period, the Veteran's radiculopathy manifested by no worse than mild intermittent pain, paresthesias/dysesthesias, and numbness. From the period after April 16, 2020, the evidence noted above shows that the Veteran underwent VA examinations in April 2020 and February 2021. Symptoms of right lower extremity radiculopathy were noted as mild constant pain, moderate intermittent pain, severe paresthesias, and moderate numbness. After review of the competent and probative evidence, the Board finds as of April 16, 2020, a rating of 20 percent but no higher is warranted for right lower extremity radiculopathy due to severe sensory symptoms. A rating in excess of 20 percent is not warranted as the Veteran has had no worse than severe sensory during the period on appeal. From April 2020, his symptoms were wholly sensory and did not manifest in muscle atrophy and he generally had normal strength, gait, reflexes, and sensation. 2. Entitlement to a rating in excess of 10 percent prior to August 11, 2016, in excess of 20 percent from August 11, 2016 to September 29, 2017, in excess of 10 percent from September 29, 2017 to February 12, 2017, and in excess of 20 percent thereafter for left lower extremity radiculopathy. Entitlement to service connection for radiculopathy affecting the sciatic nerve of the left lower extremity has been in effect since October 2012. The Veteran filed a claim for an increased rating for left lower extremity radiculopathy on August 1, 2014. The RO has assigned a 10 percent rating prior to August 11, 2016. From August 11, 2016 to September 24, 2017, the RO assigned a 20 percent rating. From September 24, 2017 to February 12, 2021, the RO assigned a 10 percent rating, and as of February 12, 2021, the RO has assigned a 20 percent rating. For the period from August 1, 2014 to August 11, 2016, the evidence shows that the Veteran reported buttock and hamstring radiating pain. See December 2014 Private Treatment Record. Additionally, a May 2015 VA DBQ shows that radiculopathy was assessed. As the symptoms noted during this period shows that the only symptom experience was pain and there is no evidence that shows the pain was of a moderate severity, the Board finds that for the period from August 1, 2014 to August 11, 2016, a rating in excess of 10 percent for left lower extremity radiculopathy is not warranted. For the appeal period after August 11, 2016, the Board finds that at 20 percent rating but no higher is warranted for left lower extremity radiculopathy as symptoms evaluated and reported by the Veteran most closely approximated moderate incomplete paralysis of the right sciatic nerve. During this period, the symptoms noted in VA examination reports and lay statements were moderate. There were objective findings of moderate pain and numbness, decreased sensation, severe paresthesias in the left lower extremity. The Veteran is not entitled to a rating higher than 20 percent because there was no evidence of trophic changes, muscle atrophy, absent reflexes, or absent sensation indicative of incomplete paralysis of greater severity. Thus, prior to August 11, 2016, a rating higher than 10 percent is denied. For the period from August 11, 2016 to September 29, 2017, a rating higher than 20 percent is not warranted. From September 29, 2017, to February 12, 2017, the Veteran's radiculopathy most nearly approximated mild incomplete paralysis such that a rating higher than 10 percent is not warranted. Further, from February 12, 2017, the Veteran's disability picture has most nearly approximately moderate incomplete paralysis; a rating higher than 20 percent is not warranted. MARTHA R. LUBOCH Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Dworkin, 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.