Citation Nr: 22008044 Decision Date: 02/11/22 Archive Date: 02/11/22 DOCKET NO. 15-44 450 DATE: February 11, 2022 ORDER Entitlement to an initial disability rating in excess of 20 percent prior to September 22, 2015 for lumbar spine disorder is denied. Entitlement to an initial disability rating in excess of 10 percent prior to September 22, 2015 for cervical spine disorder is denied. Entitlement to an initial compensable disability rating prior to June 24, 2015 for residuals of a right long finger fracture is denied. FINDINGS OF FACT 1. Prior to September 22, 2015, the Veteran's lumbar spine disorder did not more approximate forward flexion to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. 2. Prior to September 22, 2015, the Veteran's cervical spine disorder did not more approximate forward flexion greater than 15 degrees but not greater than 30 degrees, or combined ranges 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. 3. Prior to June 24, 2015, the Veteran's residuals of a right long finger fracture did not more nearly approximate limitation of motion of the long or index finger with a gap of less than one inch (2.5 cm.) between the fingertip and the proximal transverse crease of the palm, with the finger flexed to the extent possible, and; where extension is limited by no more than 30 degrees. CONCLUSIONS OF LAW 1. Prior to September 22. 2015, the criteria for a rating in excess of 20 percent for lumbar spine disorder have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.40, 4.45, 4.59. 4.71a, Diagnostic Code 5237-5242. 2. Prior to September 22. 2015, the criteria for a rating in excess of 10 percent for cervical spine disorder have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.40, 4.45, 4.59. 4.71a, Diagnostic 5243. 3. Prior to June 24, 2015, the criteria for a compensable rating for residuals of a right long finger fracture have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.7, 4.40, 4.45, 4.59. 4.71a, Diagnostic Code 5299-5229. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active-duty service in the United States Army from October 1989 to October 2009 with service in Bosnia and Southwest Asia. These matters come before the Board of Veterans' Appeals (Board) from a January 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office(RO). In November 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. The Veteran's claims file contains a transcript of that proceeding. INCREASED RATINGS The Veteran asserts that the severity of the respective disabilities articulated above warrant increased initial ratings prior to indicated dates. Ratings for service-connected disabilities are determined by comparing the Veteran's symptoms with criteria listed in VA's Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. Separate Diagnostic Codes identify the various disabilities. 38 C.F.R. Part 4. When rating a service-connected disability, the entire history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. 38 C.F.R. § 4.7. The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Hart v. Mansfield, 21 Vet. App. 505 (2007). The rating of the same disability under various diagnoses, known as pyramiding, is generally to be avoided. 38 C.F.R. § 4.14. The critical element in permitting the assignment of several ratings under various Diagnostic Codes is that none of the symptomatology for any one of the disabilities is duplicative or overlapping with the symptomatology of the other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). Where there is a question as to which of two ratings shall be applied, 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. Musculoskeletal Disabilities Disability of the musculoskeletal system is primarily the inability, due to damage or infection in the parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance. It is essential that the examination on which ratings are based adequately portray the anatomical damage and the functional loss with respect to all these elements. In evaluating disabilities of the musculoskeletal system, it is necessary to consider, along with the schedular criteria, functional loss due to flare-ups of pain, fatigability, incoordination, pain on movement, and weakness. Deluca v. Brown, 8 Vet. App. 202 (1995). Functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective enervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. §§ 4.10, 4.40, 4.45. The Court has held that VA must analyze the evidence of pain, weakened movement, excess fatigability, or incoordination and determine the level of associated functional loss under 38C.F.R. §4.40, which requires VA to regard as "seriously disabled" any part of the musculoskeletal system that becomes painful on use. See DeLuca v. Brown, 8 Vet. App. 202, 206-8 (1995). The intent of the rating schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. Painful motion is an important factor of joint disability, which is entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. However, the evaluation of painful motion as limited motion only applies when the limitation of motion is noncompensable under the applicable Diagnostic Code. Where pain alone results in functional impairment, even if there is no identified underlying diagnosis, it can constitute a disability. However, subjective pain and numbness in and of itself will not establish a current disability. Consideration should be given to the impact, or lack thereof, from pain, focusing on evidence of functional limitation caused by pain. See Saunders v. Wilkie, 886 F. 3d 1356 (Fed. Cir. 2018). Musculoskeletal VA examinations, to be adequate, must address particular issues when are where that are practicable and medically possible to include active and passive motion; weight bearing and non-weight bearing; range of motion of an opposing joint; and findings as to loss of motion during flare-ups. See Correia v. McDonald, 28 Vet. App. (2016); Sharp v. Shulkin, 29 Vet. App. 26 (2017). General Rating for Diseases and Injuries of the Spine The general rating formula is as follows: With or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease: Unfavorable ankylosis of the entire spine............................100 Unfavorable ankylosis of the entire thoracolumbar spine......50 Unfavorable ankylosis of the entire cervical spine; or forward flexion of the thoracolumbar spine 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine...............................................................40 Forward flexion of the cervical spine 15 degrees or less; or, favorable ankylosis of the entire cervical spine..........................................................30 Forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 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.................20 Forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 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..................................................10 Normal forward flexion of the thoracolumbar spine is 0 to 90 degrees, extension is 0 to 30 degrees, left and right lateral flexion are 0 to 30 degrees and left and right lateral rotation are 0 to 30 degrees. The normal combined range of motion for the thoracolumbar spine is 240 degrees. 38 C.F.R. § 4.71a. The U.S. Court of Appeals for Veterans Claims (Court) has defined ankylosis as follows. See, e.g., Dinsay v. Brown, 9 Vet. App. 79, 81 (1996) citing Dorland's Illustrated Medical Dictionary at 86 (27th ed. 1988) (Ankylosis is "immobility and consolidation of a joint due to disease, injury, or surgical procedure."); Chavis v. McDonough, No. 18-2928 (April 16, 2021) ("flare-ups resulting in symptoms more nearly approximating ankylosis can warrant a higher rating under the general rating formula"). An alternative method of evaluating spine disabilities is pursuant to Diagnostic Code 5243, which compensates based on incapacitating episodes due to intervertebral disc syndrome (IVDS). These ratings are not to be combined, and only the rating which results in a higher evaluation is to be granted. 38 C.F.R. § 4.71a, Diagnostic Code 5243. Under this Diagnostic Code, incapacitating episodes having a total duration of at least 6 weeks during the past 12 months warrants a 60 percent rating. Incapacitating episodes having a total duration of at least 4 weeks, but less than 6 weeks, during the past 12 months warrants a 40 percent rating. And, incapacitating episodes having a total duration of at least 2 weeks, but less than 4 weeks, during the past 12 months warrants a 20 percent rating. 38 C.F.R. § 4.71a, Diagnostic Code 5243. Note (1) following the IVDS section stipulates that an "incapacitating episode" is a period of acute signs and symptoms attributable to IVDS that requires physician-prescribed bed rest and treatment. Id. When considering disability of the musculoskeletal system, arthritis is considered. An evaluation of traumatic arthritis, Diagnostic Code 5010, is rated under the criteria for Diagnostic Code 5003, which in turn evaluates disabilities based on the degree of limitation of motion under the appropriate Diagnostic Codes. 38 C.F.R. § 4.71a. If the disability is noncompensable under the appropriate Diagnostic Code for the joint involved, a 10 percent rating will be for application for such major joint or group of minor joints affected by limitation of motion. 38 C.F.R. § 4.71a. The rating criteria pertaining to Diagnostic Code 5010 was revised effective February 7, 2021. Posttraumatic arthritis is rated as limitation of motion, dislocation, or other specified instability under an affected joint. If there are two or more joints affected, each rating shall be combined in accordance with 38 C.F.R. § 4.25. Evidence and Analysis As applicable to all claims, the Veteran reported and testified that he underwent a VA ordered examination that was performed at the U.S. Consulate in Naples, Italy in February 2012. He testified that the report was forwarded to the VA Regional Office of jurisdiction but was lost and not associated with the claims file. Efforts to recover the report have been unsuccessful. Lumbar spine disorder The RO has evaluated this disability under 38 C.F.R. § 4.71a, Diagnostic Code 5242-5237. 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 rating. 38 C.F.R. § 4.27; The additional code is shown after the hyphen. Id. In a September 2009 VA examination report (performed pre-discharge at a facility in Germany), a clinician diagnosed grade II retrolisthesis of L5-S1 with degenerative disc disease (DDD). The clinician indicated that the Veteran showed tenderness on palpation at L4-SI as well as reduced range of motion. Otherwise, the Veteran had a full range of motion in most joints. Specifically, the Veteran had forward flexion to 60 degrees; extension to 30 degrees; right lateral flexion to 30 degrees; left lateral flexion to 30 degrees; right lateral rotation to 30 degrees; and left lateral rotation to 30 degrees. The combined range of motion was 210 degrees.) Repetitive-use testing elicited reduced range of motion and pain. Specifically, the Veteran had forward flexion to 65 degrees; extension to 25 degrees; right lateral flexion to 30 degrees; left lateral flexion to 30 degrees; right lateral rotation to 30 degrees; and left lateral rotation to 30 degrees. Posture and gait were normal and there was no evidence of kyphosis, lordosis, ankylosis, or significant scoliosis. Likewise, there was no abnormal swelling, redness, or deformity of any joint with the exception of special claimed conditions (to include degenerative disc and joint disease, cervical spine, multilevel, as discussed in a separate section of the instant decision). The Veteran displayed abnormal straight left leg raises to 45 degrees. The clinician reported that the Veteran endorsed pain on flexion, extension, and left lateral rotation. The clinician did not report that pain, fatigue, lack of endurance or incoordination additionally limited the spine upon repetitive use or with flare-ups. Series of x-ray imaging studies showed lower back retrolisthesis L5-S1, central stenosis and spondylolysis L5 with right pars. Magnetic resonance imaging (MRI) disclosed degenerative anomalies L5 and S1 and severe discopathy L5-S1. Records of outpatient care at a military clinic in Livorno, Italy (Camp Darby) and at Landstuhl Regional Medical Center, Germany from January 2009 to October 2013 are associated with the claims file. Problem listings include lumbar disc degeneration and treatment for a variety of symptoms but without reported lumbar spine symptoms or detailed examination or treatment. A June 2011 consultation report showed "hot mud massage therapy" was provided for neck and back pain. Gait and stance were noted as normal on many occasions. A January 2012 record also showed a normal gait with no reported lumbar spine symptoms. In February 2013, there were notations of cervical pain as discussed below but not lumbar pain. In July 2013, the Veteran reported no back pain. In October 2013, the Veteran sought outpatient treatment for neck pain and a clinician also evaluated the lumbar spine. A clinician noted a normal appearance of the thoracolumbar spine with no tenderness, muscle spasms, or pain. Spine motion was "normal." Several tests for radiating pain were also normal. In a March 2014 letter, private nurse practitioner (NP) W. wrote that the Veteran sought treatment for his upper and lower spine. NP W. also reported that the Veteran complained of lower lumbar pain with radiculopathy and paraspinal muscle spasm. Likewise, NP W. indicated that the Veteran complained of cervical neck pain which caused guarded movements and often accelerated to a severe muscle tension headache or migraine. Treatment consisted of physical therapy (PT) and medication. The Veteran contends that his lumbar spine disorder was more severe than that contemplated by a 20 percent rating prior to September 22, 2015. The Veteran is competent to report discernable symptoms of pain and achiness. The Board has considered the Veteran lay statements. 38 C.F.R. § 3.159(a)(2). The Veteran's reporting of discernable symptoms is competent and assigned some probative weight, particularly those reported during medical examinations; however, upon review of the evidence of record the Veteran does not possess the specialized orthopedic education, training, or experience to offer medical diagnoses, statements, or opinions as to the clinical severity of a lumbar spine disorder. 38 C.F.R. § 3.159(a)(1). Prior to September 22. 2015, the RO assigned a 20 percent rating under Diagnostic Code 5242-5237. This 20 percent rating contemplated forward flexion of the thoracolumbar spine greater that 30 degrees but not greater than 120 degrees. For an increased rating prior to September 22. 2015, there would have had to be a showing of forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. As noted above, the VA clinician indicated that the Veteran has DDD (IVDS). However, no clinician indicated that DDD (IVDS) resulted in incapacitating episodes over the previous 12 months. As such, even a compensable rating for DDD (IVDS) is not warranted under 38 C.F.R. § 4.71a, Diagnostic Code 5243. The Board has summarized the pertinent evidence above. No VA or private clinician (NP W) found during the time frame under consideration forward flexion of the thoracolumbar spine to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. The Board acknowledges the Veteran's reports of a VA examination in February 2012 and that these records are missing. However, the outpatient records both before and after this date do not suggest a worsening of lumbar spine symptoms. The Board has considered whether a higher disability evaluation is warranted on the basis of functional loss due to pain or due to weakness, fatigability, incoordination, or pain on movement of a joint under 38 C.F.R. §§ 4.40 and 4.45; see also DeLuca, 8 Vet. App. 202. Functional loss contemplates the inability of the body to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance, and must manifest by adequate evidence of disabling pathology, especially when it is due to pain. 38 C.F.R. § 4.40. Painful motion is an important factor of disability; and joints that are actually painful, unstable, or malaligned, due to healed injury, should be entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. Analysis must turn to whether functional loss warranting a higher than 20 percent rating is reasonably shown. While the VA clinician and NP W noted that the Veteran's lumbar spine disorder elicited pain at indicated ranges of motion, these experts did not report that the lumbar spine disorder functionally impacted the Veteran's ability to work. Consequently, an increased rating based on functional limitations due to these factors is not warranted. In sum, the Board finds that the weight of evidence is against the claim for a rating in excess of 20 percent for the Veteran's lumbar spine disorder prior to September 22, 2015. Cervical spine disorder The RO hase evaluated this disability under 38 C.F.R. § 4.71a, Diagnostic Code 5243. Evidence and Analysis In a September 2009 VA examination report, the clinician diagnosed DDD and multilevel joint disease of the cervical spine. The Veteran had forward flexion to 38 degrees; extension to 36 degrees; right lateral flexion to 30 degrees; left lateral flexion to 20 degrees; right lateral rotation to 60 degrees; and left lateral rotation to 58 degrees. The combined range of motion was 245 degrees. The Veteran endorsed dull and aching pain throughout the paraspinal muscles. Upon repetitive-use testing, the Veteran had forward flexion to 40 degrees; extension to 36 degrees; right lateral flexion to 30 degrees; left lateral flexion to 20 degrees; right lateral rotation to 60 degrees; and left lateral rotation to 58 degrees, (Again, the combined range of motion was 245 degrees.) The clinician indicated that there was no evidence of radiating pain, tenderness (at the joint line or associated soft tissues), muscle spasms, or ankylosis. The clinician reported that the Veteran endorsed pain on extension and left lateral rotation. The clinician did not report that pain, fatigue, lack of endurance or incoordination additionally limited the spine upon repetitive use or with flare-ups. X-ray imaging and MRI disclosed degenerative changes of the cervical spine as well as degenerative anomalies of C3-6 with bulging and narrowing of the cervical channel. Records of outpatient care at a military clinic in Livorno, Italy (Camp Darby) and at Landstuhl Regional Medical Center, Germany from January 2009 to October 2013 are associated with the claims file. Problem listings include cervical disc degeneration and treatment for a variety of symptoms but without reported cervical spine symptoms or detailed examination or treatment. A June 2011 consultation report showed "hot mud massage therapy" was provided for neck and back pain. Gait and stance were noted as normal on many occasions. In February 2013, there were notations of cervical pain; however in August 2013, the neck was noted as normal. In October 2013, the Veteran sought treatment for neck stiffness. A clinician noted that the cervical spine was tender with abnormal flexion and rotation but normal motion in other directions. The clinician commented that the cervical dysfunction was mild and further intervention was not warranted. As noted above, NP W indicated that the Veteran complained of cervical neck pain which caused guarded movements and often accelerated to a severe muscle tension headache or migraine. The Veteran contends that his cervical spine disorder was more severe than that contemplated by a 10 percent rating prior to September 22, 2015. As already noted, the Veteran is competent to report discernable symptoms of pain and dull aching. The Board has considered the Veteran lay statements. 38 C.F.R. § 3.159(a)(2). And, again, the Veteran's reporting of discernable symptoms is competent and assigned some probative weight, particularly those reported during medical examinations; however, upon review of the evidence of record the Veteran does not possess the specialized orthopedic education, training, or experience to offer medical diagnoses or assessments of severity. 38 C.F.R. § 3.159(a)(1). Prior to September 22. 2015, the RO assigned a 10 percent rating under Diagnostic Code 5243. During the period under consideration, the Veteran had forward flexion to 38 degrees and combined ranges of motion to 245 degrees. For an increased rating prior to September 22, 2015, there would need to have been forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees, or combined ranges 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. As noted above, the VA clinician indicated that the Veteran has DDD (IVDS). However, no clinician indicated that DDD (IVDS) resulted in incapacitating episodes over the previous 12 months. As such, even a compensable rating for DDD (IVDS) is not warranted under 38 C.F.R. § 4.71a, Diagnostic Code 5243. The Board has summarized the pertinent evidence above. No VA or private clinician (NP W) found during the time frame under consideration forward flexion greater than 15 degrees but not greater than 30 degrees or combined ranges of motion not greater that 170 degrees. Likewise, no clinician reported muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. The Board acknowledges the Veteran's reports of a VA examination in February 2012 and that these records are missing. However, the outpatient records both before and after this date do not suggest a worsening of cervical spine symptoms. The Board has considered whether a higher disability evaluation is warranted on the basis of functional loss due to pain or due to weakness, fatigability, incoordination, or pain on movement of a joint under 38 C.F.R. §§ 4.40 and 4.45; see also DeLuca, 8 Vet. App. 202. Functional loss contemplates the inability of the body to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance, and must manifest by adequate evidence of disabling pathology, especially when it is due to pain. 38 C.F.R. § 4.40. Painful motion is an important factor of disability; and joints that are actually painful, unstable, or malaligned, due to healed injury, should be entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. Here, more than the minimal compensable rating for the cervical spine is already assigned, and analysis must turn to whether functional loss warranting a higher than 20 percent rating is reasonably shown. While the VA clinician and NP W noted that the Veteran's cervical spine disorder elicited pain at indicated ranges of motion, these experts did not report that the cervical spine disorder functionally impacted the Veteran's ability to work. Consequently, an increased rating based on functional limitations due to these factors is not warranted. In sum, the Board finds that the weight of evidence is against the claim for a rating in excess of 10 percent for the Veteran's cervical spine disorder prior to September 22, 2015. Residuals of a right long finger fracture The RO has evaluated this disability under 38 C.F.R. § 4.71a. Diagnostic Code 5299-5229. Diagnostic Code 5299 indicates that the disability is not listed in the Schedule for Rating Disabilities, and it has been rated by analogy under a closely related disease or injury. 38 C.F.R. §§ 4.20, 4.27. Diagnostic Code 5223 pertains to favorable ankylosis of two digits on one hand. However, the Veteran's finger disability was not characterized by ankylosis during the period under consideration. As such, Diagnostic Code 5299-5229 for limitation of motion of the index or long finger is appropriate. Diagnostic Code 5229, regardless of whether it affects the major or minor hand, assigns a noncompensable rating for limitation of motion of the long or index finger with a gap of less than one inch (2.5 cm.) between the fingertip and the proximal transverse crease of the palm, with the finger flexed to the extent possible, and; where extension is limited by no more than 30 degrees. A 10 percent disability rating is assigned for limitation of motion of the long or index finger with a gap of one inch (2.5 cm.) or more between the fingertip and the proximal transverse crease of the plan, with the finger flexed to the extent possible, or; with extension limited by more than 30 degrees. Id. Evidence and Analysis A July 1994 x-ray report was positive for a right ring/long finger at the distal phalanx. The September 2009 VA examination report includes normal x-ray imaging of the Veteran's bilateral pains and a notation concerning a chronic problem of pain in the finger joints. The clinician noted that the Veteran was right-hand dominant. The clinician also report that the Veteran had a strong hand grasp. While the clinician provided extensive fingers as to the status of residuals of a left middle finger fracture, the clinician provided little guidance as to the status of the residuals of the right long finger fracture. Records of outpatient care at a military clinic in Livorno, Italy (Camp Darby) and at Landstuhl Regional Medical Center, Germany from January 2009 to October 2013 are associated with the claims file. Problem listings include "hand pain" and "finger joint pain." In February 2012, the Veteran sought treatment for pain at the base of his first and fifth fingers after performing "dips." Examination of the right hand showed no abnormal motion and no loss of function. The Veteran contends that his residuals of a right long fracture were more severe than that contemplated by a noncompensable rating prior to June 24, 2015. As already noted, the Veteran is competent to report discernable symptoms. 38 C.F.R. § 3.159(a)(2). However, upon review of the evidence of record the Veteran does not possess the specialized orthopedic education, training, or experience to offer medical diagnoses or assessments of severity. 38 C.F.R. § 3.159(a)(1). Neither the Veteran nor his representative has submitted neither competent clinical nor medical evidence to support this contention. The Veteran that a claimant still ultimately bears some burden of production. 38 U.S.C. § 5107(a); Cromer v. Nicholson, 455 F. 3d 1346 (Fed. Cir. 2006). Prior to June 24, 2015, the RO assigned a noncompensable rating under Diagnostic Code 5299-5229. To receive a compensable rating, there would need to be showing of limitation of motion of the long or index finger with a gap of one inch (2.5 cm.) or more between the fingertip and the proximal transverse crease of the plan, with the finger flexed to the extent possible, or; with extension limited by more than 30 degrees. Such is not disclosed in the evidence of record. The Board has considered whether a compensable rating on the basis of functional loss due to pain or due to weakness, fatigability, incoordination, or pain on movement of a joint under 38 C.F.R. §§ 4.40 and 4.45, or as a result of repetitive motion and/or flare-ups. DeLuca, 8 Vet. App. 202. However, as reported above, the Veteran has offered no evidence to this effect. In sum, the Board finds that the weight of evidence is against the claim for a compensable rating in for the Veteran's residuals of a right long finger fracture prior to June 24, 2015. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. J. Komins, 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.