Citation Nr: 22015481 Decision Date: 03/17/22 Archive Date: 03/17/22 DOCKET NO. 17-33 947 DATE: March 17, 2022 ORDER Entitlement to an evaluation in excess of 10 percent for left knee traumatic arthritis with internal derangement, limitation of flexion, is denied. Entitlement to an initial compensable evaluation for left knee traumatic arthritis with internal derangement, limitation of extension, is denied. Entitlement to an evaluation in excess of 10 percent for right knee degenerative arthritis with internal derangement, limitation of flexion, is denied. Entitlement to an initial compensable evaluation for right knee degenerative arthritis with internal derangement, limitation of extension, is denied. FINDINGS OF FACT 1. The Veteran's left knee traumatic arthritis with internal derangement, limitation of flexion, is manifested by an active and passive range of motion in flexion to no less than 70 degrees; 4/5 muscle strength; no muscle atrophy; no crepitus; pain on motion, manipulation, and weight bearing; complaints of pain, with difficulty standing, walking, sitting, squatting, kneeling, and climbing stairs; and X-ray evidence of knee joint osteoarthritis. 2. The Veteran's left knee traumatic arthritis with internal derangement, limitation of extension, is manifested by an active and passive range of motion in extension to no less than 5 degrees, with pain on motion, manipulation, and weight bearing. 3. The Veteran's right knee degenerative arthritis with internal derangement, limitation of flexion, is manifested by an active and passive range of motion in flexion to no less than 70 degrees; 4/5 muscle strength; no muscle atrophy; no crepitus; pain on motion, manipulation, and weight bearing; complaints of pain, difficulty standing, walking, sitting, squatting, kneeling, and climbing stairs; and X-ray evidence of knee joint osteoarthritis. 4. The Veteran's right knee degenerative arthritis with internal derangement, limitation of extension, is manifested by an active and passive range of motion in extension to no less than 5 degrees, with pain on motion, manipulation, and weight bearing. CONCLUSIONS OF LAW 1. The criteria for an evaluation in excess of 10 percent for left knee traumatic arthritis with internal derangement, limitation of flexion, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Codes 5003, 5260. 2. The criteria for an initial compensable evaluation for left knee traumatic arthritis with internal derangement, limitation of extension, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Codes 5003, 5261. 3. The criteria for an evaluation in excess of 10 percent for right knee degenerative arthritis with internal derangement, limitation of flexion, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Codes 5003, 5260. 4. The criteria for an initial compensable evaluation for right knee degenerative arthritis with internal derangement, limitation of extension, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Codes 5003, 5261. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from January 1964 to March 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared at a hearing before the undersigned Veterans Law Judge in November 2019. A transcript of the hearing is in the Veteran's file. In January 2020, the Board remanded this matter for additional evidentiary development. In December 2020, the Board issued a decision which, in pertinent part, denied the Veteran's claims seeking increased evaluations for the Veteran's left knee traumatic arthritis with internal derangement, limitation of flexion; left knee traumatic arthritis with internal derangement, limitation of extension; right knee degenerative arthritis with internal derangement, limitation of flexion; and right knee degenerative arthritis with internal derangement, limitation of extension. The Veteran appealed the denial of these issues to the United States Court of Appeals for Veterans Claims (Court). In July 2021, the Court granted a Joint Motion for Remand (Joint Motion), which set aside this portion of the December 2020 Board decision and remanded these issues for further adjudication consistent with the Joint Motion. Notably, the Veteran did not appeal the portion of the Board's December 2020 decision which denied increased evaluations in excess of 10 percent for the Veteran's instability in the left and right knees. As noted in the Joint Motion, the Veteran requested that the Board's decision as to these issues should not be disturbed and that the appeal with respect to these issues should be dismissed. In November 2021, the Board remanded this matter for additional evidentiary development. The RO subsequently obtained a November 2021 VA examination of the knees to determine the severity of the Veteran's bilateral knee disabilities. As reflected in the subsequent discussion section, the Board finds this action to be in substantial compliance with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that a remand confers on the claimant, as a matter of law, the right to compliance with the remand order); Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (holding that substantial, rather than strict, compliance with remand directives is required). Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule of Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Disabilities must be reviewed in relation to their history. 38 C.F.R. § 4.1. Other applicable, general policy considerations are: interpreting reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating many accurately reflect the elements of disability, 38 C.F.R. § 4.2; resolving any reasonable doubt regarding the degree of disability in favor of the claimant, 38 C.F.R. § 4.3; where there is a questions as to which of two evaluations apply, assigning a higher of the two where the disability pictures more nearly approximates the criteria for the next higher rating, 38 C.F.R. § 4.7; and, evaluating functional impairment on the basis of lack of usefulness, and the effects of the disability upon the person's ordinary activity, 38 C.F.R. § 4.10. See Schafrath v. Derwinski, 1 Vet. App. 589 (1991). A claimant may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Thus, separate ratings can be assigned for separate periods of time based on the facts found - a practice known as "staged" ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). 1. Entitlement to an evaluation in excess of 10 percent for left knee traumatic arthritis with internal derangement, limitation of flexion. The Veteran contends that an evaluation in excess of 10 percent is warranted for his left knee traumatic arthritis with internal derangement, limitation of flexion. A review of the evidence reflects that the Veteran's left knee traumatic arthritis with internal derangement, limitation of flexion, is manifested as osteoarthritis and has been rated based on painful noncompensable limitation of motion. 38 C.F.R. § 4.71a, Diagnostic Codes 5003-5260. 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. The evidence of record indicates that the Veteran's left knee traumatic arthritis with internal derangement has not exhibited a compensable limitation of motion at any time during the relevant rating period. Thus, the assigned diagnostic codes are correct. 38 C.F.R. § 4.71a. Diagnostic Code 5010 provides that traumatic arthritis shall be rated under Diagnostic Code 5003, the code for degenerative arthritis. 38 C.F.R. § 4.71(a). VA regulations provided that degenerative arthritis, established by X-ray findings, will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. See 38 C.F.R. § 4.71a, Diagnostic Code 5003. When there is arthritis with at least some limitation of motion, but to a degree which would be noncompensable under a limitation-of-motion code, a 10 percent rating will be assigned for each affected major joint or group of minor joints. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, a 10 percent evaluation is warranted if there is X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups and a 20 percent evaluation is authorized if there is X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups and there are occasional incapacitating exacerbations. 38 C.F.R. § 4.71(a), Diagnostic Code 5003. Under 38 C.F.R. § 4.71a, Diagnostic Code 5260, used in rating limitation of flexion of the leg, a noncompensable rating is warranted for flexion limited to 60 degrees. A 10 percent rating is warranted for flexion limited to 45 degrees. A 20 percent rating is warranted for flexion limited to 30 degrees. A 30 percent rating is warranted for flexion limited to 15 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5260. 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 that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 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; 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."). Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint." The Board finds that the persuasive evidence of record is against a rating in excess of 10 percent for left knee traumatic arthritis with internal derangement, limitation of flexion. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain on movement, pain on weight bearing, pain on repetitive movement, and weakened movement. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the Veteran's statements and testimony that he has weakness, pain, reduced motion, difficulty standing, walking, sitting, squatting, kneeling, and climbing stairs, would not result in limitation of motion more nearly approximating flexion limited to 30 degrees. The Veteran's left knee exhibited flexion to no less than 70 degrees on his VA examinations in April 2014, April 2017, March 2020, and November 2021. On his most recent VA examination of the knee, performed in November 2021, the Veteran's left knee flexion was to 90 degrees on active and passive motion. The report noted that an additional loss of motion was anticipated during periods of repeated use over time. Nevertheless, the estimated left knee flexion during such periods of time remained at 80 degrees, although functional loss was present due to pain and fatigue. Thus, a noncompensable evaluation was exhibited, with a higher compensable evaluation having been assigned based upon full consideration of the functional loss exhibited by the Veteran's left knee. The Veteran's March 2020 VA examination noted that his left knee exhibited flexion to 70 degrees on both active and passive motion. His early examinations reflected an even greater range of motion for flexion in his left knee. For this claim, and for each successive issue, the Board finds the examinations of record to be adequate for evaluating the Veteran's claims. While the examinations performed prior to November 2021 were not as complete and did not contain all necessary elements for the Board to rely on them solely, when read in concert with the November 2021 examination, they do provide sufficient information for the Board to make an informed decision. Further, the November 2021 examination contained all pertinent and required information for the Board to make an informed decision, including testing and opinions that directly addressed the concerns raised in the Joint Motion and by the Board in its remand directives. Considering the Veteran's contentions regarding his worsening symptoms, the Board views the November 2021 examination to be the best evidence of the Veteran's current symptoms, and this examination may also be used to draw conclusions about the historical severity of the Veteran's disabilities. The Board has also considered the other Diagnostic Codes pertaining to the knee and leg. On this point, the Board notes that the Veteran has previously been granted separate disability evaluations for limitation of extension and instability in the left knee. 38 C.F.R. § 4.71a, Diagnostic Codes 5257, 5261. The limitation of extension evaluation is addressed below, and the Veteran indicated in his July 2021 Joint Motion for Remand that he was satisfied with the 10 percent evaluation assigned to his left knee instability. There does not appear to be any additional left knee symptomatology warranting assignment of an additional separate disability rating. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); Lyles v. Shulkin, 9 Vet. App. 107 (2017). In conclusion, the Board finds that the persuasive evidence of record is against the Veteran's claim for an evaluation in excess of 10 percent for left knee traumatic arthritis with internal derangement, limitation of flexion; the evidence is not in approximate balance. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 2. Entitlement to an initial compensable evaluation for left knee traumatic arthritis with internal derangement, limitation of extension. The Veteran contends that his left knee traumatic arthritis with internal derangement, limitation of extension, warrants a compensable initial evaluation. The Veteran's left knee traumatic arthritis with internal derangement, limitation of extension, is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5261, for limitation of extension of the leg. Under Diagnostic Code 5261, a noncompensable rating is warranted for extension limited to 5 degrees. A 10 percent rating is warranted for extension limited to 10 degrees. A 20 percent rating is warranted for extension limited to 15 degrees. A 30 percent rating is warranted for extension limited to 20 degrees. A 40 percent rating is warranted for extension limited to 30 degrees. A 50 percent rating is warranted for extension limited to 45 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5261. 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 that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 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, 8 Vet. App. at 202; see also Mitchell, 25 Vet. App. at 44. 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; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson, 815 F.3d at 785. Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). In Correia, 28 Vet. App. at 158, the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint." Based upon a longitudinal review of the evidence of record, the Board finds that the persuasive evidence of record is against assignment of an initial compensable evaluation for the Veteran's left knee limitation of extension. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain on movement, pain on weight bearing, pain on repetitive movement and weakened movement. Nevertheless, the degree of additional limitation reflected by the Veteran's statements and testimony would not result in limitation of motion more nearly approximating extension limited to 10 degrees. The Veteran's left knee exhibited extension to 0 degrees on his VA examinations of the knee in April 2014, April 2017, and March 2020. On his March 2020 VA examination of the knee, the Veteran's left knee extension was 0 degrees on active and passive motion. The report also noted that no additional loss of motion was anticipated during repeated use over time, although functional loss is present due to pain and fatigue. On his most recent VA examination of the knee, performed in November 2021, the Veteran's left knee extension was to 0 degrees on active and passive motion. The report also noted, however, that an additional loss of motion was anticipated during repeated use over time, due to symptoms including pain, fatigability, weakness, and lack of endurance. The estimated range of motion in degrees for the left knee during this time frame consisted of extension to 5 degrees. Thus, giving full consideration of the functional loss based upon repeated use over time, the anticipated range of motion in extension by the Veteran's left knee remains at a noncompensable level. The Board has previously explained why the examinations of record especially the November 2021 examination are a sufficient and adequate basis on which to evaluate the Veteran, and no further discussion of those examinations is warranted. In conclusion, the Board finds that the weight of the persuasive evidence is against the Veteran's claim for a compensable evaluation for left knee traumatic arthritis with internal derangement, limitation of extension; the evidence for a higher rating is not in approximate balance with that of the evidence against the Veteran's claim. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 3. Entitlement to an evaluation in excess of 10 percent for right knee degenerative arthritis with internal derangement, limitation of flexion. The Veteran contends that an evaluation in excess of 10 percent is warranted for his right knee degenerative arthritis with internal derangement, limitation of flexion. A review of the evidence reflects that the Veteran's right knee degenerative arthritis with internal derangement, limitation of flexion, has manifested as osteoarthritis and been rated based on painful noncompensable limitation of motion. 38 C.F.R. § 4.71a, Diagnostic Codes 5003-5260. 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. The evidence of record indicates that the Veteran's right knee degenerative arthritis has not exhibited a compensable limitation of motion at any time during the relevant rating period. Thus, the assigned diagnostic codes are correct. 38 C.F.R. § 4.71a. Under Diagnostic Code 5003, degenerative arthritis, established by X-ray findings, will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved. See 38 C.F.R. § 4.71a, Diagnostic Code 5003. When there is arthritis with at least some limitation of motion, but to a degree which would be noncompensable under a limitation-of-motion code, a 10 percent rating will be assigned for each affected major joint or group of minor joints. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, a 10 percent evaluation is warranted if there is X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups and a 20 percent evaluation is authorized if there is X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups and there are occasional incapacitating exacerbations. 38 C.F.R. § 4.71(a), Diagnostic Code 5003. Under 38 C.F.R. § 4.71a, Diagnostic Code 5260, used in rating limitation of flexion of the leg, a noncompensable rating is warranted for flexion limited to 60 degrees. A 10 percent rating is warranted for flexion limited to 45 degrees. A 20 percent rating is warranted for flexion limited to 30 degrees. A 30 percent rating is warranted for flexion limited to 15 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5260. The Board finds that the persuasive evidence of record is against a rating in excess of 10 percent for right knee degenerative arthritis with internal derangement, limitation of flexion. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain on movement, pain on weight bearing, pain on repetitive movement, and weakened movement. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements that he has weakness, pain, reduced motion, difficulty standing, walking, sitting, squatting, kneeling, and climbing stairs, would not result in limitation of motion more nearly approximating flexion limited to 30 degrees. The Veteran's right knee exhibited flexion to no less than 70 degrees on his VA examinations in April 2014, April 2017, March 2020, and November 2021. On his most recent VA examination of the knee, performed in November 2021, the Veteran's right knee flexion was to 100 degrees on active and passive motion. The report also noted that an additional loss of motion was anticipated during repeated use over time, which the examination report still estimated right knee flexion to remain at 90 degrees, although functional loss was present due to pain and fatigue. The Veteran's March 2020 VA examination noted that his right knee exhibited flexion to 70 degrees on both active and passive motion. His earlier VA examinations reflected an even greater range of motion for flexion in the Veteran's right knee. The Board has also considered the other Diagnostic Codes pertaining to the knee and leg. On this point, the Board notes that the Veteran has previously been granted separate disability evaluations for limitation of extension and instability in the right knee. 38 C.F.R. § 4.71a, Diagnostic Codes 5257, 5261. The limitation of extension evaluation is addressed below, and the Veteran indicated in his July 2021 Joint Motion for Remand that he was satisfied with the 10 percent evaluation assigned to his right knee instability. There does not appear to be any additional right knee symptomatology warranting assignment of an additional separate disability rating. See Esteban, 6 Vet. App. at 261-62. In conclusion, the Board finds that the persuasive evidence of record is against the Veteran's claim for an evaluation in excess of 10 percent for right knee degenerative arthritis with internal derangement, limitation of flexion; the evidence is not in approximate balance. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. 4. Entitlement to an initial compensable evaluation for right knee degenerative arthritis with internal derangement, limitation of extension. The Veteran contends that his right knee degenerative arthritis with internal derangement, limitation of extension, warrants an initial compensable evaluation. The Veteran's right knee degenerative arthritis with internal derangement, limitation of extension, is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5261, for limitation of extension of the leg. Under Diagnostic Code 5261, a noncompensable rating is warranted for extension limited to 5 degrees. A 10 percent rating is warranted for extension limited to 10 degrees. A 20 percent rating is warranted for extension limited to 15 degrees. A 30 percent rating is warranted for extension limited to 20 degrees. A 40 percent rating is warranted for extension limited to 30 degrees. A 50 percent rating is warranted for extension limited to 45 degrees. 38 C.F.R. § 4.71a, Diagnostic Code 5261. Based upon a longitudinal review of the evidence of record, the Board finds that the persuasive evidence of record is against assignment of an initial compensable evaluation for the Veteran's right knee limitation of extension. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain on movement, pain on weight bearing, pain on repetitive movement and weakened movement. Nevertheless, the degree of additional limitation reflected by the statements would not result in limitation of motion more nearly approximating extension limited to 10 degrees. The Veteran's right knee exhibited extension to 0 degrees on his VA examinations of the knee in April 2014, April 2017, and March 2020. On his March 2020 VA examination of the knee, the Veteran's right knee extension to 0 degrees on active and passive motion. The report also noted that no additional loss of motion was anticipated during repeated use over time, although functional loss is present due to pain and fatigue. On his most recent VA examination of the knee, performed in November 2021, right knee extension to 0 degrees was found on both active and passive motion. The report noted an additional loss of motion was anticipated during repeated use of the right knee over time, duty to symptoms including pain, fatigability, weakness, and lack of endurance. The estimated range of motion in degrees for the right knee consisted of extension to 5 degrees. Thus, even with full consideration of the functional loss based upon repeated use over time, the anticipated range of motion in extension by the Veteran's right knee remains at a noncompensable level. In conclusion, the Board finds that the persuasive evidence of record is against the Veteran's claim for a compensable evaluation for right knee degenerative arthritis with internal derangement, limitation of extension; the evidence is not in approximate balance. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board W. Yates, 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.