Citation Nr: 25014792 Decision Date: 12/10/25 Archive Date: 12/10/25 DOCKET NO. 19-16 288 DATE: December 10, 2025 ORDER Prior to July 9, 2024, entitlement to a compensable rating for the Veteran's service-connected bilateral hearing loss is denied. From July 9, 2024, to September 18, 2024, entitlement to a rating in excess of 10 percent for the Veteran's service-connected bilateral hearing loss is denied. Since September 18, 2024, entitlement to a rating in excess of 40 percent for the Veteran's service-connected bilateral hearing loss is denied. For the appellate period prior to June 3, 2024, an initial evaluation of 40 percent, but no higher, is granted for the Veteran's service-connected right lower extremity radiculopathy. Since June 3, 2024, entitlement to a rating in excess of 40 percent for the Veteran's service-connected right lower extremity radiculopathy is denied. REMANDED Entitlement to an increased evaluation for the service-connected facial scars, status post excision of cyst of left and right jaw, evaluated as 0 percent disabling (noncompensable) prior to June 3, 2024, 10 percent disabling from June 3, 2024, to June 16, 2025, and noncompensable from June 17, 2025, forward, is remanded. FINDINGS OF FACT 1. Prior to July 9, 2024, the Veteran's bilateral hearing loss was manifested by hearing acuity of no worse than Level II in the right ear and Level II in the left ear. 2. From July 9, 2024, to September 18, 2024, the Veteran's bilateral hearing loss was manifested by hearing acuity of no worse than Level IV in the right ear and Level IV in the left ear. 3. Since September 18, 2024, the Veteran's bilateral hearing loss has been manifested by hearing acuity of no worse than Level VII in the right ear and Level VIII in the left ear. 4. For the entire period on appeal, the Veteran's right lower extremity radiculopathy has been productive of, at worst, moderate symptoms. CONCLUSIONS OF LAW 1. Prior to July 9, 2024, the criteria for compensable rating for the Veteran's service-connected bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 2. From July 9, 2024, to September 18, 2024, the criteria for a disability rating in excess of 10 percent for the Veteran's service-connected bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 3. Since September 18, 2024, the criteria for a disability rating in excess of 40 percent for the Veteran's service-connected bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. 4. Prior to June 3, 2024, the criteria for an initial rating of 40 percent, but no higher, for the Veteran's service-connected right lower extremity radiculopathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.123, 4.124a, Diagnostic Code 8520. 5. Since June 3, 2024, the criteria for a disability rating in excess of 40 percent for the Veteran's service-connected right lower extremity radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.123, 4.124a, Diagnostic Code 8520. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active in the U.S. Air Force from March 1974 to April 1996. This matter comes before the Board on appeal from an October 2017 rating decision of the Department of Veterans Affairs (VA) regional office, which, in pertinent part, denied increased evaluations for the Veteran's service-connected sinusitis, bilateral hearing loss, lumbar spine disorder, and status post excision of a cyst of the left and right jaw. See October 2017 Rating Decision. In April 2021, the Veteran testified before the undersigned Veterans Law Judge in a videoconference hearing. A copy of the hearing transcript is of record. Thereafter, in a September 2022 decision, the Board, in pertinent part, granted an increased 30 percent evaluation for the sinusitis effective from April 5, 2021, but denied a rating in excess of 10 percent prior to that date. See September 2022 Board Decision. That decision also awarded a 50 percent disability rating for the Veteran's service-connected tension headaches, dismissed the claims for increased ratings for the service-connected hemorrhoids, prostatitis, and status post fracture of the fifth finger of the right hand, and remanded the issues of entitlement to higher ratings for the service-connected right lower extremity radiculopathy, bilateral hearing loss, lumbar spine disorder, and status post excision of a cyst of the left and right jaw. Id. Further, regarding the claims for increased evaluations for the service-connected bilateral hearing loss, lumbar spine disorder, and status post excision of a cyst of the left and right jaw, the September 2022 Board decision found that, although the Veteran submitted a timely notice of disagreement (NOD) regarding the agency of original jurisdiction's (AOJ's) October 2017 denial of these issues, a Statement of the Case (SOC) had not yet been issued. See id. As such, the Board remanded the claims pursuant to Manlincon v. West, 12 Vet. App. 238, 240 (1999). An SOC was subsequently issued in October 2022 continuing to deny the claims. The Veteran perfected an appeal, and the issues were merged into his pending appeal for purposes of judicial economy and efficiency. See December 2022 Substantive Appeal (VA Form 9); see also 38 C.F.R. §§ 19.20, 19.21, 19.22, 19.52, 20.200, 20.201, 20.202, 20.203 (setting forth requirements and timeframe for initiating and perfecting an appeal under VA's legacy system). Meanwhile, the Veteran appealed the Board's September 2022 decision to the U.S. Court of Appeals for Veterans Claims (Court/CAVC). Pursuant to a May 2023 Joint Motion for Partial Remand (JMPR) filed by the parties, the Court vacated the portion of the Board's September 2022 decision denying a rating in excess of 10 percent for the sinusitis prior to April 5, 2021, and remanded the claim back to the Board for additional development and adjudication consistent with the terms of the JMPR. See May 2023 JMPR; May 2023 CAVC Order. The portions of the Board's September 2022 decision dismissing the claims for higher ratings for the prostatitis, hemorrhoids, and status post fracture of the fifth finger of the right hand, and denying entitlement to a rating in excess of 50 percent for tension headaches and 30 percent for sinusitis from April 5, 2021, forward, remained undisturbed. See id. The appeal returned to the Board in November 2023, at which time the Board remanded the claims for an evaluation in excess of 10 percent for the service-connected sinusitis prior to April 5, 2021, a compensable evaluation for the service-connected bilateral hearing loss, a compensable evaluation for the service-connected status post excision of cyst of left and right jaw, and an evaluation in excess of 40 percent for the service-connected lumbar spine disorder to the AOJ for additional development. See November 2023 Board Decision. In that decision, the Board also noted that, the AOJ had not yet completed the development for the claim of entitlement to a disability rating in excess of 20 percent for radiculopathy of the right lower extremity requested by the Board in the September 2022 remand. See id. As such, the Veteran's appeal of that claim had not yet returned to the Board. The AOJ undertook the requested development, and the Veteran was provided VA examinations to determine the current nature and severity of his service-connected conditions in June, July and September 2024, with accompanying retrospective medical opinions regarding the severity of the claimed conditions throughout the relevant appellate periods in September 2024. See June 2024 VA Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx Disability Benefits Questionnaire (DBQ); June 2024 VA Scars/Disfigurement DBQ; June 2024 VA Back Conditions DBQ; July 2024 VA Hearing Loss and Tinnitus DBQ; September 2024 VA Sinusitis/Rhinitis and Other Conditions of the Nose, Throat, Larynx and Pharynx DBQ; September 2024 VA Hearing Loss and Tinnitus DBQ; September 2024 VA Scars/Disfigurement DBQ; September 2024 VA Back Conditions DBQ; September 2024 VA Medical Opinion DBQs. Based upon the results of those VA examinations, the AOJ increased the evaluation assigned the service-connected bilateral hearing loss from 0 percent (noncompensable) to 10 percent, effective from July 9, 2024, and to 20 percent, effective from September 18, 2024. See October and December 2024 Rating Decisions. A December 2024 supplemental statement of the case (SSOC) denied entitlement to an evaluation in excess of 10 percent for the service-connected sinusitis prior to April 5, 2021; entitlement to a compensable evaluation prior to July 9, 2024, an evaluation in excess of 10 percent from July 9, 2024, to September 17, 2024, and an evaluation in excess of 20 percent from September 18, 2024, forward for the service-connected bilateral hearing loss; entitlement to a compensable evaluation for the service-connected status post excision of cyst of left and right jaw; and entitlement to an evaluation in excess of 40 percent for the service-connected lumbar spine disorder. See December 2024 SSOC. The appeal returned to the Board in April 2025, at which time the Board granted an increased 30 percent evaluation for the service-connected sinusitis effective for the entire appellate period prior to April 5, 2021, but denied a rating in excess of 40 percent for the service-connected lumbar spine disorder. See April 2025 Board Decision. Additionally, the Board remanded the claims for an increased rating for the service-connected bilateral hearing loss (evaluated as 0 percent disabling (noncompensable) prior to July 9, 2024, 10 percent disabling from July 9, 2024, to September 18, 2024, and 20 percent disabling from September 18, 2024, forward) and for a compensable evaluation for the service-connected facial scars, status post excision of cyst of left and right jaw to the AOJ for additional evidentiary development. See id. (finding that remand was necessary to provide the Veteran with adequate VA examinations for his service-connected auditory and skin conditions). Finally, given the AOJ's continued failure to take any action on the claim of entitlement to a disability rating in excess of 20 percent for radiculopathy of the right lower extremity, which was remanded by the Board in September 2022, as noted above, the Board added the issue to the appeal and remanded the claim for the issuance of an SSOC. See id. The AOJ undertook the requested development, and the Veteran was provided VA examinations to determine the current nature and severity of his service-connected bilateral hearing loss and facial scars. See June 2025 VA Hearing Loss and Tinnitus DBQ; June 2025 VA Scars/Disfigurement DBQ. The AOJ subsequently granted an increased 10 percent evaluation for the service-connected facial scars, status post excision of cyst of left and right jaw, effective from June 3, 2024, to June 17, 2025, but continued the noncompensable evaluation prior to June 3, 2024, and from June 17, 2025, forward. The AOJ also granted an increased 40 percent evaluation for the service-connected right lower extremity radiculopathy, effective from June 3, 2024, forward. See July 2025 Rating Decision. The AOJ also awarded an increased 40 percent evaluation for the service-connected bilateral hearing loss effective from September 18, 2024, forward. See August 2025 Rating Decision. Subsequent SSOCs denied entitlement to a compensable evaluation prior to July 9, 2024, an evaluation in excess of 10 percent from July 9, 2024, to September 18, 2024, and an evaluation in excess of 40 percent from September 18, 2024, forward for the service-connected bilateral hearing loss; entitlement to a compensable evaluation prior to June 3, 2024, an evaluation in excess of 10 percent from June 3, 2024, to June 17, 2025, and a compensable evaluation from June 17, 2025, forward for the service-connected facial scars, status post excision of cyst of left and right jaw; and entitlement to an evaluation in excess of 20 percent prior to June 3, 2024, and an evaluation in excess of 40 percent from June 3, 2024, forward, for the service-connected right lower extremity radiculopathy. See August 2024 SSOC; September 2024 SSOC. As such, those claims have returned to the Board. INCREASED RATINGS VA has adopted a Schedule for Rating Disabilities to evaluate service-connected disabilities. See 38 U.S.C. § 1155; 38 C.F.R., Part IV. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life, including employment. 38 C.F.R. § 4.10. The percentage ratings in the Schedule for Rating Disabilities represent, as far as practicably can be determined, the average impairment in earning capacity resulting from service-connected diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities and the criteria for specific ratings. If two disability evaluations are potentially applicable, the higher evaluation will be assigned to the disability picture that more nearly approximates the criteria required for that rating. 38 C.F.R. § 4.7. Otherwise, the lower rating will be assigned. Id. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. The schedule recognizes that disability from distinct injuries or diseases may overlap. See 38 C.F.R. § 4.14. However, the evaluation of the same disability or its manifestation under various diagnoses, which is known as pyramiding, is to be avoided. Id. Because the level of disability may have varied over the course of the claim, the rating may be "staged" higher or lower for segments of time during the period under review in accordance with such variations, to the extent the evidence shows distinct time periods where the service-connected disability has exhibited signs or symptoms that would warrant different ratings under the rating criteria. Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). In initial-rating cases, where the appeal stems from a granted claim of service connection with respect to the initial evaluation assigned, VA assesses the level of disability from the effective date of service connection. See Fenderson, 12 Vet. App. at 126. In increased-rating claims, where a claimant seeks a higher evaluation for a previously service-connected disability, it is the present level of disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). In such claims, VA considers the level of disability for the period beginning one year prior to the claim for a higher rating. 38 U.S.C. § 5110(b)(2); 38 C.F.R. § 3.400 (o)(2); Hart, 21 Vet. App. at 509. A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 1. Prior to July 9, 2024, entitlement to a compensable rating for the Veteran's service-connected bilateral hearing loss is denied. 2. From July 9, 2024, to September 18, 2024, entitlement to a rating in excess of 10 percent for the Veteran's service-connected bilateral hearing loss is denied. 3. Since September 18, 2024, entitlement to a rating in excess of 40 percent for the Veteran's service-connected bilateral hearing loss is denied. The Veteran asserts entitlement to a compensable evaluation prior to July 9, 2024, an evaluation in excess of 10 percent from July 9, 2024, to September 18, 2024, and to an evaluation in excess of 40 percent since September 18, 2024, for bilateral hearing loss. Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz). 38 C.F.R. § 4.85, Diagnostic Code 6100. See also Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992) (reflecting that, in evaluating service-connected hearing loss, disability ratings are derived from a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are performed). The rating schedule establishes 11 auditory acuity levels, designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. The vertical lines in Table VI (in 38 C.F.R. § 4.85) represent nine categories of the percentage of discrimination based on the controlled speech discrimination test (Maryland CNC). The horizontal columns in Table VI represent nine categories of decibel loss based on the puretone threshold average derived from the audiometry test. The numeric designation of impaired hearing (Levels I through XI) is determined for each ear by intersecting the vertical row appropriate for the percentage of discrimination and the horizontal column appropriate to the puretone decibel loss. The percentage evaluation is derived from Table VII in 38 C.F.R. § 4.85 by intersecting the vertical column corresponding to the numeric designation for the ear having the better hearing acuity (as determined by Table VI) and the horizontal row corresponding to the numeric designation level for the ear having the poorer hearing acuity (as determined by Table VI). For example, if the better ear has a numeric designation Level of "V" and the poorer ear has a numeric designation Level of "VII," the percentage evaluation is 30 percent. See id. An exceptional pattern of hearing impairment occurs when the pure tone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more. 38 C.F.R. § 4.86(a). In that situation, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. Further, when the average pure tone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral, and that numeral will then be elevated to the next higher numeral. 38 C.F.R. § 4.86(b). Turning to the evidence of record, the August 2017 VA audiological evaluation shows a puretone threshold average of 50 decibels (dB) in the right ear and 51 dB in the left ear. See August 2017 VA Hearing Loss and Tinnitus DBQ (reflecting puretone thresholds of 40 dB at 1000 Hertz, 45 dB at 2000 Hertz, 55 dB at 3000 Hertz, and 60 dB at 4000 Hertz in the right ear; and 35 dB at 1000 Hertz, 50 dB at 2000 Hertz, 60 dB at 3000 Hertz, and 60 dB at 4000 Hertz in the left ear). Speech discrimination scores using the Maryland CNC word list were 86 percent in the right ear and 84 percent in the left ear. Id. Additionally, the Veteran reported experiencing "problems communicating with people, [his] wife especially." See id. See also 38 C.F.R. § 4.10; Martinak v. Nicholson, 21 Vet. App. 447 (2007). The July 2024 VA audiological examination reflects a puretone threshold average of 58.75 dB in the right ear and 55 dB in the left ear. See July 2024 VA Hearing Loss and Tinnitus DBQ (reflecting puretone thresholds of 60 dB at 1000 Hertz, 55 dB at 2000 Hertz, 60 dB at 3000 Hertz, and 60 dB at 4000 Hertz in the right ear; and 50 dB at 1000 Hertz, 55 dB at 2000 Hertz, 55 dB at 3000 Hertz, and 60 dB at 4000 Hertz in the left ear). Speech discrimination scores using the Maryland CNC word list were 80 percent in the right ear and 78 percent in the left ear. Id. The Veteran reported the functional impact of his hearing loss included difficulty hearing and understanding conversational speech and "have[ing] to use subtitles on [the] TV." See id. See also 38 C.F.R. § 4.10; Martinak, 21 Vet. App. 447. As discussed above and as detailed in the prior April 2025 Board decision, the September 2024 VA audiological evaluation was inadequate for rating purposes because "a full audiometric evaluation of the Veteran could not be completed due to several factors, including the examiner's inability to maintain a seal during acoustic immittance (tympanometry) testing and the discontinuance of the examination during speech discrimination testing for the left ear 'because [the] Veteran began to experience a migraine... [and] was in significant pain.'" See April 2025 Board Decision (quoting the September 2024 VA Hearing Loss and Tinnitus DBQ). The June 2025 VA audiological examination reflects a puretone threshold average of 62.50 dB in the right ear and 63.75 dB in the left ear. See June 2025 VA Hearing Loss and Tinnitus DBQ (reflecting puretone thresholds of 60 dB at 1000 Hertz, 60 dB at 2000 Hertz, 65 dB at 3000 Hertz, and 65 dB at 4000 Hertz in the right ear; and 55 dB at 1000 Hertz, 70 dB at 2000 Hertz, 65 dB at 3000 Hertz, and 65 dB at 4000 Hertz in the left ear). Speech discrimination scores using the Maryland CNC word list were 54 percent in the right ear and 50 percent in the left ear. Id. The Veteran reported the functional impact of his difficulty hearing as "aggravating" and further noted that he had difficulty hearing the television. See id. See also 38 C.F.R. § 4.10; Martinak, 21 Vet. App. 447. Regarding the August 2017 audiometric findings, with respect to the right ear, the point where a puretone threshold average of 50 dB intersects with a speech discrimination score of 86 percent yields a numeric designation of II. With respect to the left ear, the point where a puretone threshold average of 51 dB intersects with a speech discrimination score of 84 percent also yields a numeric designation of II. The point where designations II and II (as derived from Table VI) intersect on Table VII yields a 0 percent (noncompensable) rating under DC 6100. See 38 C.F.R. § 4.85. Therefore, prior to July 9, 2024, a compensable rating is not warranted for bilateral hearing loss. Regarding the July 2024 audiometric findings, with respect to the right ear, the point where a puretone threshold average of 58.75 dB intersects with a speech discrimination score of 80 percent yields a numeric designation of IV. With respect to the left ear, the point where a puretone threshold average of 55 dB intersects with a speech discrimination score of 78 percent (the lowest of record) also yields a numeric designation of IV. The point where designations IV and IV (as derived from Table VI) intersect on Table VII yields a 10 percent rating under DC 6100. See 38 C.F.R. § 4.85. The Board also notes that the July 2024 VA audiological examination showed an exceptional pattern of hearing loss in the right ear. See July 2024 VA Hearing Loss and Tinnitus DBQ; However, in applying Table VIA (Numeric designation of hearing impairment based only on puretone threshold average) to the July 2024 audiometric results, a numeric designation of IV is still provided for the right ear. See 38 C.F.R. §§ 4.85, 4.86. As such, application of Table VIA does not result in a higher numeric designation and is thus not more beneficial to the Veteran. Therefore, prior to September 18, 2024, a rating higher than 10 percent is not warranted for bilateral hearing loss. Regarding the June 2025 audiometric findings, with respect to the right ear, the point where a puretone threshold average of 62.50 dB intersects with a speech discrimination score of 54 percent yields a numeric designation of VII. With respect to the left ear, the point where a puretone threshold average of 63.75 dB intersects with a speech discrimination score of 50 percent yields a numeric designation of VIII. The point where designations VII and VIII (as derived from Table VI) intersect on Table VII yields a 40 percent rating under DC 6100. See 38 C.F.R. § 4.85. The Board also notes that the June 2025 VA audiological examination showed an exceptional pattern of hearing loss in both ears. See June 2025 VA Hearing Loss and Tinnitus DBQ; However, applying Table VIA (Numeric designation of hearing impairment based only on puretone threshold average) to the June 2025 audiometric results yields lower numeric designations of V for both ears. See 38 C.F.R. §§ 4.85, 4.86. As such, application of Table VIA does not result in a higher numeric designation for either ear and is thus not more beneficial to the Veteran. Therefore, for the appellate period from September 18, 2024, forward, a rating higher than 40 percent is not warranted for bilateral hearing loss. The Board has considered the functional impairment caused by the Veteran's hearing loss disability. In this regard, the Veteran has asserted that his hearing loss results in difficulty hearing and understanding speech, affecting his quality of life, including his ability to engage in conversation and watch television. See August 2017, July 2024, September 2024, and June 2025 VA Hearing Loss and Tinnitus DBQs. The Veteran is competent to report difficulty with his hearing; however, as noted, disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenmann, 3 Vet. App. 345. The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran describes is therefore contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). Because the Veteran's main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned, see Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017), the functional impairment he has described does not establish entitlement to ratings higher than those currently assigned, absent audiometric and speech discrimination scores showing that his hearing loss has met the schedular criteria for a greater level of compensation. See 38 C.F.R. § 4.85; Lendenmann, 3 Vet. App. at 349. While the Board empathizes with the Veteran's impairment and does not dispute the fact that he has a bilateral hearing loss disability, the Board must conclude, based on the results of mandatory auditory tests and the mechanical application of relevant regulations by which the Board is bound, that the level of his disability does not rise to a compensable evaluation for the appellate period prior to July 9, 2024, a rating higher than 10 percent for the period from July 9, 2024 to September 18, 2024, and a rating higher than 40 percent for the period from September 18, 2024, forward. See 38 C.F.R. § 4.85(b); see also 38 U.S.C. § 7104; 38 C.F.R. § 20.101(a). In sum, the Board finds that the most probative evidence of record persuasively weighs against the assignment of a compensable evaluation prior to July 9, 2024, an evaluation in excess of 10 percent from July 9, 2024, to September 18, 2024, and an evaluation in excess of 40 percent from September 18, 2024, forward. As such, the benefit-of-the-doubt rule does not apply, and the claims for a compensable rating prior to July 9, 2024, a rating higher than 10 percent from July 9, 2024, to September 18, 2024, and a rating higher than 40 percent from September 18, 2024, forward, are denied. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3, 4.7; Lynch, 21 F.4th 776. 4. For the appellate period prior to June 3, 2024, an initial evaluation of 40 percent, but no higher, is granted for the Veteran's service-connected right lower extremity radiculopathy. 5. Since June 3, 2024, entitlement to a rating in excess of 40 percent for the Veteran's service-connected right lower extremity radiculopathy is denied. The Veteran also seeks an initial evaluation in excess of 20 percent prior to June 3, 2024, and in excess of 40 percent since, for the service-connected right lower extremity radiculopathy, characterized as "right lower radiculopathy with trophic changes associated with herniated L5 - S1 nucleus pulposus." See, e.g., June 2018 Notice of Disagreement (NOD) (VA Form 21-0958); April 2021 Board Hearing Transcript. In this regard, paralysis of the sciatic nerve is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8520. (Neuritis and neuralgia of that group are evaluated under Diagnostic Codes 8620 and 8720.). Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R. § 4.124a. The words "mild," "moderate," and "severe" as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based on the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. See 38 C.F.R. §§ 4.123, 4.124. The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type of picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017). Initially, the Board notes that the AOJ based the July 2025 rating decision that awarded an increased 40 percent rating effective from June 3, 2024, for the right lower extremity radiculopathy on VA examinations dated in June and September 2024, which documented findings and manifestations of the right lower extremity radiculopathy including "abnormal muscle strength testing"; "reduced/hypoactive deep tendon reflexes & sensory exam at the knee, ankle, and foot"; "positive straight leg raising test"; "trophic changes of the bilateral lower extremities with loss of extremity hair"; "pain with tingling and numbness radiating from the lower back into [the right lower extremity]"; and "difficulty with prolonged sitting, standing and walking and doing and daily physical activity," and for which the Veteran was prescribed "Gabapentin 800 mg daily." See July 2025 Rating Decision (summarizing the results of the June and September 2024 VA examinations). See also June 2024 VA Peripheral Nerves Conditions DBQ; September 2024 VA Back (Thoracolumbar Spine) Conditions DBQ. Prior to June 2024, the Veteran had not been afforded a VA peripheral nerves examination to evaluate the nature and severity of his service-connected right lower extremity radiculopathy. Instead, the Veteran's neuropathic manifestations were clinically evaluated as part of VA compensations and pension (C&P) examinations of his thoracolumbar spine. See August 2017, April 2019, and December 2019 VA Back Conditions DBQs. Additionally, in September 2020, the Veteran submitted a Back Conditions DBQ completed by his private treating physician. See May 2019 Back (Thoracolumbar Spine) Conditions DBQ from C.B.C., M.D., M.S. (received by VA in September 2020). These reports reflect findings that are generally consistent with those documented in the June and September 2024 examination reports. See August 2017 VA Back (Thoracolumbar Spine) Conditions DBQ (reflecting findings and manifestations of right lower extremity radiculopathy including reduced muscle strength testing (3/5 on hip flexion and ankle plantar flexion, and 4/5 on knee extension, ankle dorsiflexion, and great toe extension); reduced/hypoactive deep tendon reflexes at the right knee and ankle; positive straight leg raising test; and moderate constant pain, and characterizing the severity of the Veteran's right lower extremity sciatic radiculopathy as "Moderate"); April 2019 VA Back Conditions DBQ (noting findings and manifestations of right lower extremity radiculopathy including reduced muscle strength testing (3/5 on hip flexion and 4/5 on knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension); reduced/hypoactive deep tendon reflexes at the right knee and ankle; and moderate constant pain, and characterizing the severity of the Veteran's right lower extremity radiculopathy as "Moderate"); December 2019 VA Back (Thoracolumbar Spine) Conditions DBQ (reporting findings and manifestations of right lower extremity radiculopathy including reduced muscle strength testing (4/5 on knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension); decreased sensation to light touch at the right thigh/knee, lower leg/ankle, and foot/toes; positive straight leg raising test; and "mild" intermittent pain, numbness, and paresthesias and/or dysesthesias); May 2019 Back (Thoracolumbar Spine) Conditions DBQ from C.B.C., M.D., M.S. (documenting findings and manifestations of right lower extremity radiculopathy including reduced muscle strength testing (3/5 on hip flexion, knee flexion, ankle dorsiflexion, foot adduction, and great toe extension; and 4/5 on knee extension, ankle plantar flexion, and foot abduction); absent deep tendon reflexes at the right ankle; reduced/hypoactive deep tendon reflexes at the right knee; decreased sensation to light touch at the right thigh; positive straight leg raising test; and moderate constant pain, mild numbness and mild paresthesias and/or dysesthesias, and characterizing the severity of the Veteran's right lower extremity radiculopathy as "Moderate"). As such, given the consistency of the examination reports dated throughout the relevant appellate period, the Board finds that the probative evidence of record, including the June 2024 VA Peripheral Nerves Conditions DBQ, the May 2019 Back Conditions DBQ completed by Dr. C.B.C., and the August 2017, April 2019, December 2019, and September 2024 VA Back Conditions DBQs, reflects symptoms and manifestations of the Veteran's service-connected right lower extremity radiculopathy that most closely approximate moderately severe incomplete paralysis of the sciatic nerve throughout the entirety of the relevant appellate period. See 38 C.F.R. § 4.124a, Diagnostic Code 8520 (reflecting that a 40 percent rating is warranted for moderately severe incomplete paralysis). Thus, in light of the foregoing, and applying the doctrine of the benefit of the doubt, the Board finds the Veteran is entitled to an increased initial evaluation of 40 percent for his service-connected right lower extremity radiculopathy for the appellate period prior to June 3, 2024. See id. A rating in excess of 40 percent is not warranted for the entire appeal period, however, as the evidence of record does not show that the Veteran's overall disability picture for his right lower extremity radiculopathy is more than moderately severe. Rather, there is neither evidence nor assertion that the Veteran's symptoms have in any way manifested in severe incomplete paralysis with marked muscle atrophy of the right lower extremity, or complete paralysis of the right lower extremity with foot dangling and/or dropping, no active movement possible of muscles below the knee, or flexion of knee weakened or (very rarely) lost. See id. The Board has also considered other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected. Therefore, a separate or higher rating under a different Diagnostic Code is not warranted. As such, the claim for a rating in excess of 40 percent for the right lower extremity radiculopathy from June 3, 2024, forward, is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3, 4.7; Lynch, 21 F.4th 776. REASONS FOR REMAND Unfortunately, yet another remand is required for the remaining issue of entitlement to higher evaluations for the service-connected facial scarring. Although the Board sincerely regrets further delay, it is necessary because the record does not reflect that there has been substantial compliance with the Board's prior remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that a remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with its remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008) (holding that only substantial rather than strict compliance with the Board's remand directives is required under Stegall); accord Dyment v. West, 13 Vet. App. 141, 146-47 (1999). 1. Entitlement to an increased evaluation for the service-connected facial scars, status post excision of cyst of left and right jaw, evaluated as noncompensable prior to June 3, 2024, 10 percent disabling from June 3, 2024, to June 17, 2025, and noncompensable from June 17, 2025, forward, is remanded. As noted in the introduction above, the Board remanded the claim in April 2025 for additional evidentiary development, finding that the prior June and September 2024 VA examinations were inadequate to decide the claim. See April 2025 Board Decision. In particular, the Board noted that the June and September 2024 VA examiners did not take any pictures of the Veteran's service-connected facial scars, despite the fact that the Veteran's condition is evaluated under 38 C.F.R. § 4.118, Diagnostic Code 7800, for "Burn scar(s) of the head, face, or neck; scar(s) of the head, face, or neck due to other causes; or other disfigurement of the head, face, or neck," which requires that evaluations of a disability rating for scars must take into consideration unretouched color photographs. See id. (citing 38 C.F.R. § 4.118, Diagnostic Code 7800, at Note (3)). The Board thus concluded that, "because the relevant rating criteria require that unretouched color photographs be taken into consideration in the evaluation of the condition, the June 2024 and September 2024 examination reports are not sufficient to support a decision on the claim, and remand for a new VA examination in required." See id. Further, the Board specifically instructed that the examination report obtained on remand "must include consideration of unretouched color photographs of the affected area(s), and the photographs should be appended to the examination report for inclusion in the claims file." See id. The AOJ obtained a VA examination of the service-connected facial scars, status post excision of cyst of left and right jaw, in June 2025; however, the examiner did not take photographs of the Veteran's skin condition. See June 2025 VA Scars/Disfigurement DBQ. As such, there has not been substantial compliance with the April 2025 remand directives, and a remand is required. See Stegall, 11 Vet. App. at 271; Dyment, 13Vet. App. at 146 47. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records, to include any outstanding records of VA authorized, non-VA treatment (e.g., VHA Choice and/or Community Care Programs), and associate them with the Veteran's claims file. 2. Contact the Veteran and request that he identify any relevant outstanding private treatment records. He should be invited to submit this evidence himself or to request VA to obtain it on his behalf. Authorized release forms (VA Form 21-4142) should be provided for this purpose. 3. Thereafter, upon receipt of all additional records, and any additional notification and/or development deemed warranted, schedule the Veteran for an appropriate VA examination(s) to determine the current nature and severity of his service-connected facial scars, status post excision of cyst of left and right jaw. The examination(s) should be scheduled with an examiner who has not yet conducted an examination or provided medical opinion in this case, if possible, and may be conducted via telehealth or similar service if deemed necessary. The entire claims file and a copy of this REMAND must be made available to the examiner prior to the examination(s). The examiner must note in the examination report that the evidence in the claims file, including complete copies of this REMAND and all prior REMANDS, has been reviewed. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. THE EXAMINATION(S) MUST INCLUDE CONSIDERATION OF UNRETOUCHED COLOR PHOTOGRAPHS OF THE AFFECTED AREA(S), AND THE PHOTOGRAPHS SHOULD BE APPENDED TO THE EXAMINATION REPORT(s) FOR INCLUSION IN THE CLAIMS FILE. The examiner must also provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's condition under the rating criteria, including specifically the size (in inches) and location of the affected area(s), identification and description of any related scarring, the types of therapy and treatment required, a description of any functional impairment caused, and findings addressing the surface contour, underlying tissue, pigmentation, and flexibility/induration of the affected area(s). If possible, the appropriate Disability Benefits Questionnaires (DBQs) (e.g., VA Skin Diseases DBQ, VA Scars/Disfigurement DBQ) should be filled out for this purpose. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. In this regard, the Board emphasizes that the Veteran is competent to report his symptoms and history, and such statements by the Veteran regarding symptomatology and medical history must be specifically acknowledged and considered in formulating any opinions concerning the onset and severity of his disability. If such reports are rejected by the examiner, a reason for doing so must be provided. All examination findings, along with the complete explanation for all opinions expressed, must be set forth in the examination report(s). If the examiner is unable to answer any question without a resort to speculation, then he or she should so indicate and provide a rationale for why an answer could not be provided. 4. Following completion of the above directives, review the claims file to ensure compliance with this remand. If any examination report does not include adequate responses to the specific opinions requested, it must be returned to the examiner for corrective action. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. McCabe, 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.