Citation Nr: A25035690 Decision Date: 04/17/25 Archive Date: 04/17/25 DOCKET NO. 241202-494034 DATE: April 17, 2025 ORDER Service connection for rhinitis is granted. Entitlement to an initial rating higher than 70 percent for service-connected PTSD is denied. Entitlement to an initial rating higher than 30 percent for service-connected coronary artery disease is denied. Entitlement to an initial rating higher than 20 percent for service-connected prostate cancer residuals is denied. Entitlement to an initial rating higher than 20 percent for service-connected bilateral hearing loss disability is denied. Entitlement to a compensable rating for service-connected scars of the chest and lower abdomen is denied. Entitlement to a compensable rating for service-connected erectile dysfunction is denied. FINDINGS OF FACT 1. The evidence is in equipoise as to whether the Veteran's rhinitis is proximately due to his TERA, to include exposure to asbestos and Agent Orange. 2. The Veteran's PTSD has not manifested total social and occupational impairment. 3. During the appeal period, MET testing shows that the Veteran's coronary artery disease resulted in symptoms of fatigue at a workload greater than 5.0 but not greater than 7.0 METs. There is no evidence of cardiac hypertrophy, dilatation, congestive heart failure, or left ventricular ejection fraction less than 50 percent. 4. During the appeal period, the Veteran's prostate cancer has been in remission; residuals of prostate cancer are manifested by voiding dysfunction requiring wearing absorbent materials that must be changed less than two times per day; renal function as defined by VA is not shown. 5. The Veteran's bilateral hearing loss disability has been manifested by hearing acuity of no worse than Level VI in the right ear and Level V in the left ear. 6. The Veteran's scars of the chest and abdomen were not painful or unstable, did not measure at least 144 square inches (929 square centimeters) or greater, and did not measure to at least 6 square inches (39 sq. cm.). 7. The Veteran's erectile dysfunction warrants a noncompensable rating. CONCLUSIONS OF LAW 1. Resolving all reasonable doubt in the Veteran's favor, the criteria for service connection for rhinitis have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 2. The criteria for a rating higher than 70 percent for service-connected PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.3, 4.7, 4.130, Diagnostic Code (DC) 9411. 3. The criteria for a rating higher than 30 percent for service-connected CAD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.100, 4.104, Diagnostic Code (DC) 7005. 4. The criteria for a rating higher than 20 percent for service-connected prostate cancer residuals have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, 4.115a, Diagnostic Code (DC) 7528. 5. The criteria for a rating higher than 20 percent for service-connected bilateral hearing loss disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, 4.115a, Diagnostic Code (DC) 6100. 6. The criteria for a compensable disability rating for scars of the chest and abdomen have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.118, Diagnostic Codes (DCs) 7801, 7802, and 7804. 7. The criteria for a compensable disability rating for erectile dysfunction have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, 4.115b, Diagnostic Code (DC) 7522. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from January 1969 to November 1970. This matter comes before the Board of Veterans' Appeals (Board) from a rating decisions dated September 2024 by the Department of Veterans Affairs (VA) Regional Office (RO). In December 2024, the Veteran timely appealed this rating decision to the Board and selected the evidence review lane. Under the evidence lane, the Board reviews the claims based on the evidence of record at the time of the September 2024 rating decision, and evidence received within 90 days following receipt of the NOD. 38 C.F.R. § 20.303. VA's Duties to Notify and Assist VA's duty to notify under the Veterans Claims Assistance Act of 2000 (VCAA) was satisfied by a duty to notify attachment to the November 9, 2021, Application for Compensation (VA Form 21-526EZ). See 38 U.S.C. §§ 5102, 5103, 5103A; 38 C.F.R. § 3.159. This notice letter and duty to notify attachment advised the Veteran of the information and evidence necessary to substantiate his service connection and increased rating claims on appeal. Under the AMA, the Board may still remand issues to the AOJ, but only to correct pre-decisional duty to assist errors it identifies (such as an inadequate VA examination or missing treatment records), OR any other AOJ error to satisfy a statutory or regulatory duty if correction of the error would have a reasonable possibility of aiding in substantiating the appellant's claim. 38 U.S.C. § 5103A(f)(2)(A); 38 C.F.R. §§ 3.159(c), 20.802(a). The Board notes that there was a prior remand by the Board on these issues in October 2023 for a pre-duty to assist error in not obtaining Social Security Administration Records for a disability determination reached prior to February 1975. In November 2023, SSA informed VA that no medical records from that determination exist. Otherwise, the Veteran has not raised any issues with the duty to notify or duty to assist for the increased rating issues on appeal being denied in the present Board decision. Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board...to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Importantly, a close review of the claims file reveals the Veteran has not proffered any substantive arguments regarding the duty to assist in the present case. On this point, the Court has reaffirmed that the duty to assist is not a one-way street. Martinez v. Wilkie, 31 Vet. App. 170, 178 (2019). The duty to assist "does not encompass 'a duty to prove a claim with the claimant only in a passive role.'" Hilkert v. West, 12 Vet. App. 145, 151 (1999) (en banc). A claimant cannot remain passive when he or she has relevant information to support the claim. Wamhoff v. Brown, 8 Vet. App. 517 (1996). That is, if a claimant wishes help, he or she cannot passively wait in those circumstances where his / her own actions are essential in obtaining the putative evidence. Hayes v. Brown, 5 Vet. App. 60, 68 (1993). In this vein, the Veteran has not questioned the adequacy of the pre-decisional VA examinations of record and has not alleged that additional development was necessary for any of the issues on appeal, for any error occurring prior to the September 12, 2024, AMA rating decision on appeal. 38 U.S.C. § 5103A; 38 C.F.R. §§ 3.159(c), 20.802(a). Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). Service connection may be granted on a secondary basis for a disability which is proximately due to or the result of an established service-connected disorder. 38 C.F.R. § 3.310. Similarly, any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, may be service connected on an aggravation basis. 38 C.F.R. § 3.310(b); Allen v. Brown, 7 Vet. App. 439 (1995). Lay persons are competent to provide opinions on some medical issues falling within the realm of common knowledge. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). VA is responsible for determining whether the evidence persuasively favors one side or another. 38 C.F.R. § 4.3. When there is an approximate or nearly equal balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the Veteran and the claim will be granted on the merits. 38 U.S.C. § 5107(b). When the evidence persuasively favors against the claims of the Veteran, the benefit of the doubt doctrine is inapplicable, and the claim will be denied on its merits. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021). The Veteran asserts service connection for sinusitis. As a preliminary matter, the Board notes that the Veteran has been diagnosed with both sinusitis and rhinitis. See Private Evaluation received November 3, 2021, and VA Examination February 2023. Therefore, the Board has recharacterized the claim to encompass conditions with similar sinus symptoms raised by the record, to include rhinitis. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Turning to the facts of the case, the Veteran's service treatment records document a diagnosis of a head and chest cold in June 1969. He manifested symptoms of shortness of breath and some congestion for two days. He was given over-the-counter medication for his symptoms. Upon discharge, the Veteran's relevant systems, to include his sinuses, were clinically normal. See Report of Medical Examination dated August 31, 1970. However, VA has conceded the Veteran's exposure to asbestos and Agent Orange. See January 2023 Rating Decision and VA Memorandum dated January 9, 2023. In a private medical opinion dated October 2021, the Veteran's private chiropractor, Dr. M.T., indicated that the Veteran had a respiratory deficiency to include congestion of the maxillary sinuses with difficulty breathing, drainage, and facial pressure, along with coughing. The clinician diagnosed chronic sinusitis and opined that it was at least as likely as not directly and causally related to the Veteran's service, to include his exposure to asbestos. In so finding, the examiner reasoned that the Veteran stated he sustained injury to his respiratory system while exposed to asbestos material from pipes and walls aboard ship. No other rationale was provided. The Veteran was afforded a VA examination in October 2022. At that time, the examiner noted that the Veteran was diagnosed with acute sinusitis in 1970. The Veteran reported that he previously underwent a uvulopalatopharyngoplasty (UPPP) procedure, which removed extra tissue in his throat, to open his airways and help with snoring. However, he had not received any treatment for any sinus issues since service. Upon review of the record and examination of the Veteran, the examiner provided a negative nexus between any current sinus condition and the Veteran's period of service. In so finding, the examiner found that any sinus issue the Veteran manifested during service was acute and resolved during military service. As there was no evidence of chronicity during or since service, the examiner reasoned that a post-service event was a more likely etiology. The Veteran underwent additional VA examination in February 2023. At that time, the examiner diagnosed the Veteran with non-allergic rhinitis, as evidenced by nasal turbinate hypertrophy absent an allergic component. The Veteran described experiencing nasal congestion and snoring in the 1970s. He again noted that he had surgery sometime after service, but his condition worsened. At the time of the examination, he was not on any medication for his condition. Diagnostic testing yielded normal results. Upon review of the record and examination of the Veteran, the examiner found that it was less likely than not that the Veteran's rhinitis was related to his period of service. In so finding, the examiner noted previous diagnoses of chronic sinusitis, but found that based on x-rays, the Veteran did not manifest sinusitis. As for rhinitis, the examiner noted that the Veteran's in-service respiratory infection was acute and resolved without residuals. The examiner further found that rhinitis was not presumptively caused by Agent Orange exposure. In an April 2023 addendum opinion, a VA examiner opined that the Veteran's rhinitis was at least as likely as not caused by his conceded toxic exposure risk activity during service. In so finding, the examiner noted that rhinitis could be a long-term problem with no clear cause. However, given the Veteran's conceded exposure to Agent Orange, and no risk factors outside of military service, it was likely that the Veteran's rhinitis was attributed to his toxic exposure. Finally, at the August 2024 VA examination, the examiner diagnosed the Veteran with allergic rhinitis. The examiner noted the private October 2021 diagnosis of chronic sinusitis but found that the diagnostic testing did not support this diagnosis. The examiner ultimately opined that the Veteran's rhinitis was less likely than not related to his period of service. In so finding, the examiner acknowledged the Veteran's lay statements of experiencing symptoms during service but found that medical literature did not support a link between exposure to either asbestos or Agent Orange and the development of rhinitis. Based on the above, the Board finds that the evidence for and against the claim is approximately balanced and, resolving all reasonable doubt in the Veteran's favor, service connection for rhinitis is warranted. In so finding, the Board acknowledges the October 2021 private opinion, which provides a positive nexus for chronic sinusitis. However, the Board assigns this opinion little probative value. It does not appear that the diagnosis was based on any objective diagnostic testing. Further, the examiner's nexus opinion appears to be primarily based on the Veteran's own lay statements without the benefit of any diagnostic testing or extensive evaluation. Moreover, the nexus opinion was couched in terms of the Veteran's own subjective observations rather than any objective medical principles. Similarly, the Board also assigns the October 2022 and February 2023 VA negative nexus opinions little probative value. The October 2022 negative nexus opinion appears to be primarily based on the lack of documented evidence of a chronic condition. While the examiner indicated that he "reviewed" the claims file, which includes the Veteran's lay statements, there was no discussion of the specifics of the Veteran's contentions documented in the examination report or previous medical records. At best, the opinion is conclusory and does not assist the Board in making a decision. Similarly, the February 2023 negative nexus opinion is based on the lack of a presumptive link between the Veteran's toxic exposure and his current rhinitis. The fact that a veteran cannot establish entitlement to service connection on a presumptive basis does not preclude him from establishing entitlement on a direct incurrence or other basis. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.304(d) (the availability of service connection on a presumptive basis does not preclude consideration of service connection on a direct basis); Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994) (Radiation Compensation Act does not preclude a veteran from establishing service connection with proof of actual direct causation). As the examiner did not address all theories of entitlement raised, this opinion is insufficient in assisting the Board in rendering a decision. The Board finds that the remaining evidence of record, specifically, the April 2023 positive and August 2024 negative nexus opinions, are at least in relative equipoise as to whether the Veteran's rhinitis is attributable to his service. To that end, the Board finds that the two opinions of record, while opposing in their conclusion, are equally probative in addressing the issue on appeal. Both opinions were rendered upon examination of the Veteran and review of the record. Although they arrive at different conclusions, the opinions do not directly contradict each other, as the positive nexus focused more on the synergistic effect of the Veteran's toxic exposure in light of his service and post-service history, while the negative nexus focused more on a direct link based on medical literature. As each opinion is adequately based on facts in the record, the Board cannot find that either opinion is more probative than the other. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303-304 (2008). In sum, resolving all reasonable doubt in favor of the Veteran, the Board is satisfied that the criteria for service connection for rhinitis have been met. The evidence, at a minimum, is in relative equipoise and service connection for rhinitis is granted. 38 U.S.C. 5107(b); 38 C.F.R. § 3.102; Wise v. Shinseki, 26 Vet. App. 517, 531 (2014); Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021). Increased Rating Disability evaluations are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing his symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10. If two evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation; otherwise, the lower evaluation will be assigned. 38 C.F.R. § 4.7. Staged ratings are appropriate for any rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). PTSD The Veteran's PTSD is currently rated 70 percent disabling under DC 9411. All psychiatric disorders are evaluated under a general rating formula for mental disorders. 38 C.F.R. § 4.130. Under the general rating formula, a 70 percent evaluation is warranted for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful situations (including work or a work-like setting); and inability to establish and maintain effective relationships. Finally, a total schedular rating of 100 percent is warranted when the disorder results in total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of mental and personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. The symptoms listed in the rating schedule are not intended to constitute an exhaustive list, but rather serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Nevertheless, all ratings in the general rating formula are associated with objectively observable symptomatology, and "a veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration." Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013). Further, "§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas." Thus, "[a]lthough the veteran's symptomatology is the primary consideration, the regulation also requires an ultimate factual conclusion as to the veteran's level of impairment in 'most areas.'" Id. at 118. As such, the Board will consider both the Veteran's specific symptomatology as well as the occupational and social impairment associated with the rating code to determine whether an increased evaluation is warranted. Turning to the facts of the case, the current appeal stems from a January 2021 service connection claim. In support of his claim, the Veteran submitted a private Disabilities Benefits Questionnaire (DBQ) and evaluation, dated October 2021. At that time, the Veteran was diagnosed with PTSD, other specified depressive disorder, and general anxiety disorder. The Veteran's symptoms included anxiety, suspiciousness, mild memory loss, flattened affect, impaired speech, and disturbances of motivation and mood, along with difficulty adapting to stressful circumstances. Socially, the Veteran maintained an "all right" relationship with his brother, "excellent relationships with his kids, and "awesome" relationships with his grandchildren. He worked as a charter boat captain and interacted with 20 to 30 individuals every day he worked. He did not go out much because of his wife's social avoidance. Prior to his retirement in 2020, the Veteran was confrontational with his supervisor, which resulted in difficulty at work. The Veteran described engaging in verbal outbursts when angry, both at home and while driving. The Veteran also described experiencing nightmares, flashbacks, and avoidance symptoms. Testing revealed the Veteran had minimal symptoms of depression and anxiety and he denied any suicidal or homicidal ideation. The examiner found that the Veteran's condition resulted in occupational and social impairment with deficiencies in most areas. At the February 2022 VA examination, the Veteran was diagnosed with PTSD. His symptoms included depressed mood, anxiety, chronic sleep impairment, mild memory loss, and flattened affect, along with disturbances of motivation and mood. Socially, the Veteran described maintaining good relationships with his family, boat mates, and friends. He endorsed restless sleep due to nightmares and anxious thoughts. He had mild problems with immediate and remote recall. Upon mental status examination, the Veteran was oriented on all spheres. He described his mood as irritable, and he presented with a flattened affect. His thoughts were logical, linear, clear, and direct. He denied suicidal and homicidal ideation and there was no evidence of hallucinations or delusions. Insight, judgment, and impulse control were intact. The examiner found that the Veteran's PTSD resulted in occupational and social impairment with reduced reliability and productivity. Based on this examination, the RO granted service connection for PTSD and assigned a 70 percent rating. See August 2022 Rating Decision. At the outset, the Board recognizes that the Veteran has been diagnosed with PTSD, depressive disorder, and anxiety disorder. VA rates mental disorders under the General Rating Formula and assigns one rating regardless if there is one or more diagnosed disorders. Here, the Board attributes all psychiatric symptoms and psychiatric impairment as being part of the service-connected PTSD. See Mittleider v. West, 11 Vet. App. 181 (1998) (prescribing that, under such circumstances, the reasonable doubt doctrine dictates that all psychiatric symptoms be attributed to the service-connected disability). Based on the above, the Board finds that a higher rating of 100 percent is not warranted for the Veteran's PTSD, as the frequency, duration, and severity of his symptoms does not more nearly approximate that which is contemplated by total occupational and social impairment. The Board notes that the words "total" and "persistent" are not specifically defined in the regulation. The word "total" is defined as "absolute, utter." https://merriam-webster.com/dictionary/total. The word "persistent" is defined as "continuing to exist despite interference or treatment." www.merriam-webster.com/dictionary/persistent. Throughout the appeal period, the Veteran's PTSD has been manifested by anxiety, depression, irritability, and verbal outbursts. Although he described some difficulty with previous supervisors prior to retirement, he maintained good relationships with his family and friends. His work as a charter boat captain led to many interactions with other people and the Veteran did not describe any issues. He remained oriented on all spheres. While the Veteran demonstrated some irritability at home and while driving, his behavior does not establish that he is a persistent danger to himself or others. He denied suicidal or homicidal ideations and did not endorse any delusions or hallucinations. His thought processes, judgment, communication, and insight have remained intact. Based on the above, the Board finds that the frequency, duration, and severity of the Veteran's PTSD symptoms are adequately contemplated by the currently assigned 70 percent rating. Entitlement to a 100 percent rating for PTSD is denied. Coronary Artery Disease (CAD) The Veteran seeks a rating higher than 30 percent for his service-connected CAD pursuant to 38 C.F.R. § 4.104, DC 7005, for heart conditions. Effective November 14, 2021, VA amended the rating criteria for arteriosclerotic heart disease (coronary artery disease) under 38 C.F.R. § 4.104, DC 7005. This amended regulation applies to all applications for benefits received by VA or that are pending before the agency of original jurisdiction on or after November 14, 2021. Claims pending prior to the effective date will be considered under both the pre- and post-amendment rating criteria. Whichever is more favorable to the Veteran will be applied. However, the Board may not apply the post-amendment rating criteria to a period prior to its effective date, unless the regulation explicitly provides otherwise. Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Conversely, the Board is not precluded from applying the pre-amendment rating criteria to a period on or after the effective date of the post-amendment rating criteria so long as it was in effect during the pendency of the appeal. Prior to November 14, 2021, under 38 C.F.R. § 4.104, DC 7005, for arteriosclerotic heart disease (coronary artery disease) a 30 percent rating is warranted where a workload of greater than 5.0 METs but not greater than 7.0 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; there is cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray. A 60 percent rating is warranted where there is more than one episode of acute congestive heart failure in the past year, or; a workload of greater than 3.0 METs but not greater than 5.0 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent. A 100 percent rating is warranted where there is chronic congestive heart failure, or; a workload of 3.0 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent. Under the pre-amendment rating criteria, one MET is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. 38 C.F.R. § 4.104, Note (2). When the level of METs at which dyspnea, fatigue, angina, dizziness, or syncope develops is required for evaluation and a laboratory determination of METs by exercise testing cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea, fatigue, angina, dizziness, or syncope may be used. Id. For the purposes of a 60 percent evaluation, the pre-amendment rating criteria do not require a separate showing of left ventricular dysfunction in addition to an ejection fraction of 30 to 50 percent. Otero-Castro v. Principi, 16 Vet. App. 375, 382 (2002). Additionally, the phrase "30 to 50 percent" means 30 percent through 50 percent. Id. at 380. For the purposes of a 100 percent evaluation, the pre-amendment rating criteria do not require a separate showing of left ventricular dysfunction in addition to an ejection fraction of less than 30 percent. Id. at 382. Effective November 14, 2021, under 38 C.F.R. § 4.104, DC 7005, arteriosclerotic heart disease (coronary artery disease) is rated in accordance with the General Rating Formula for Diseases of the Heart (General Rating Formula). Under DC 7005, a 30 percent evaluation is warranted where a workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope; or, where there is evidence of cardiac hypertrophy or dilation on electrocardiogram, echocardiogram or x-ray. 38 C.F.R. § 4.104. A 60 percent evaluation is warranted where there has been more than one episode of acute congestive heart failure in the past year; or, a workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope; or, where there a LVEF of 30 to 50 percent. Id. A 100 percent evaluation is warranted for chronic congestive heart failure; or, a workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope; or, where there is left ventricular dysfunction with an ejection fraction of less than 30 percent. Id. Under the post-amendment rating criteria, one MET is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. 38 C.F.R. § 4.104, Note (2). When the level of METs at which breathlessness, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination of METs by exercise testing cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in METs and supported by specific examples, such as slow stair climbing or shoveling snow) that results in those symptoms may be used. Id. For purposes of the General Rating Formula for Diseases of the Heart, heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope. 38 C.F.R. § 4.104, Note (3). Turning to the facts of the case, in a private medical evaluation dated October 2021, the Veteran's chiropractor indicated that the Veteran underwent triple bypass surgery in 2020. Since then, he manifested dyspnea, random vertigo, heavy legs, and fatigue. There was no mention of the frequency, duration or severity of these symptoms. There were also no objective diagnostic tests or evaluations conducted to evaluate the severity of the Veteran's heart condition. The Veteran was afforded a VA examination in February 2022. At that time, the Veteran was diagnosed with coronary artery disease status post coronary artery bypass graft (CABG). The Veteran denied experiencing any symptoms, to include shortness of breath, chest pain, and palpitations. He took medication for his condition. Upon interview-based METs testing, the examiner estimated that a METs level of 5-7 METs would cause fatigue. Based on the above, the Board finds that a higher rating is not warranted as the Veteran's CAD did not meet the criteria for a rating in excess of 30 percent. During the appeal period, the evidence does not otherwise show any cardiac hypertrophy, dilation, congestive heart failure, or left ventricular ejection fraction lower than 50 percent. The Veteran's workload capacity was not less than 5.0 METs and there were no episodes of acute congestive heart failure. As such, a higher 60 percent disability rating is not warranted at any time during the period on appeal. The Veteran is competent to report his readily observable symptoms, however he is not shown to be competent to provide a medical opinion on his condition. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The more probative evidence of record, to include medical testing and expertise, does not indicate that the assignment of an evaluation higher than 30 percent is warranted. In so finding, the Board acknowledges the October 2021 private evaluation. However, without any objective test results, the Veteran's reports of symptoms of dyspnea, heavy legs, and random vertigo are insufficient to establish that the criteria of a 60 percent rating have been met. The Veteran had the opportunity to report any limitations to the VA physician, and the examiner factored fatigue into the METs evaluation. In weighing the lay and medical evidence, the Board finds more probative the evaluation report rendered by the VA medical professional which involved physical examination and an interview of the Veteran directed towards estimating his METs level based on his capability to perform certain activities. As there is no contrary probative medical evidence favoring an increased disability rating CAD, the evidence is against increased ratings. As the evidence of record persuasively weighs the claim, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). Prostate Cancer The Veteran appeals for a rating higher than 30 percent for his service-connected prostate cancer residuals. The Veteran's prostate cancer is rated under DC 7528, covering malignant neoplasms of the genitourinary system. 38 C.F.R. § 4.115b, DC 7528. Under DC 7528, a rating of 100 percent is warranted for a malignant neoplasm. Following the cessation of surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure, the rating of 100 percent shall continue with a mandatory VA examination at the expiration of six months. 38 C.F.R. § 4.115b, DC 7528, Note. Any change in evaluation based upon that or any subsequent examination is then subject to the provisions governing a reduction in disability rating. If there is no local reoccurrence or metastasis, the disability should be rated on residuals as voiding or renal dysfunction, whichever is predominant. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 C.F.R. § 3.105(e). Id. The overwhelming competent evidence shows that the Veteran's prostate cancer has been in remission for the entire appeal period. The Veteran was service-connected for prostate cancer, effective January 23, 2021. Neither the lay nor medical evidence demonstrates any active prostate malignancy. As such, the criteria for a 100 percent rating, as well as the due process provisions of 38 C.F.R. § 3.105(e), are not applicable. As there is no local reoccurrence or metastasis of the prostate cancer, the Board will consider whether a higher rating is warranted based on the residuals of voiding or renal dysfunction pursuant to the provisions of 38 C.F.R. § 4.115a. Voiding dysfunction is rated under the three subcategories of urine leakage, urinary frequency, and obstructed voiding. 38 C.F.R. § 4.115a. Continual urine leakage, post-surgical urinary diversion, urinary incontinence, or stress incontinence which requires the wearing of absorbent materials which must be changed less than two times per day merits a 20 percent disability rating. For continual urine leakage, post-surgical urinary diversion, urinary incontinence, or stress incontinence, requiring the wearing of absorbent materials which must be changed 2 to 4 times per day, a 40 percent rating is warranted. The maximum rating of 60 percent is warranted when there is urinary leakage requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day. A higher rating may not be awarded for prostate cancer residuals unless there is evidence of significant renal dysfunction. 38 C.F.R. § 4.115a. Urinary frequency with a daytime voiding interval between two and three hours or awakening to void two times per night warrants a 10 percent rating. A daytime voiding interval between one and two hours or awakening to void three to four times per night warrants a 20 percent rating. A daytime voiding interval of less than one hour or awakening to void five or more times per night warrants a 40 percent rating. 38 C.F.R. § 4.115(a). Obstructive voiding symptomatology with marked obstructive symptomatology with any one or combination of: post-void residuals greater than 150 cc, a markedly diminished peak flow rate of less than 10 cc/sec, recurrent urinary tract infections secondary to obstruction, or stricture disease requiring periodic dilation every two to three months, warrants a 10 percent rating. Urinary retention requiring intermittent or continuous catheterization warrants a 30 percent rating. 38 C.F.R. § 4.115(a). Urinary tract infection where the evidence shows recurrent symptomatic infection requiring drainage and frequent hospitalization (greater than two times per year) and/or requiring continuous intensive management warrants a 30 percent rating. 38 C.F.R. § 4.115(a). Effective November 14, 2021, VA amended parts of 38 C.F.R. § 4.115a and 4.115b. Pertinent to the present appeal, the amendment included a revision of the introductory text in §4.115a and the table entries for "Renal dysfunction" and "Urinary tract infection", as well as other changes not pertinent to the Veteran's instant appeal. See Schedule for Rating Disabilities; The Genitourinary Diseases and Conditions, 86 Fed. Reg. 54081 (Sep. 30, 2021). Prior to November 2021, and pertinent to the present appeal, a 30 percent disability rating is warranted for albumin constant or recurring with hyaline and granular casts or red blood cells; or, transient or slight edema or hypertension at least 10 percent disabling under diagnostic code 7101. A 60 percent evaluation is warranted for constant albuminuria with some edema; or definite decrease in kidney function; or, hypertension at least 40 percent disabling under DC 7101. An 80 percent evaluation is warranted for persistent edema and albuminuria with blood urea nitrogen (BUN) 40 to 80mg%; or, creatinine 4 to 8mg%; or, generalized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion. The maximum evaluation of 100 percent is warranted for requiring regular dialysis, or precluding more than sedentary activity from one of the following: persistent edema and albuminuria; or, BUN more than 80mg%; or, creatinine more than 8mg%; or, markedly decreased function of kidney or other organ systems, especially cardiovascular. 38 C.F.R. § 4.115a (2020). Effective November 2021, the criteria to evaluate renal dysfunction considers the glomerular filtration rate (GFR). A noncompensable rating is warranted for renal dysfunction or chronic kidney disease presenting with a GFR from 60 to 89 mL/min/1.73m2 and either recurrent red blood cell (RBC) casts, white blood cell (WBC) casts, or granular casts for at least 3 consecutive months during the past 12 months; or structural kidney abnormalities (cystic, obstructive, or glomerular) for at least 3 consecutive months during the past 12 months; or albumin/creatinine ratio (ACR) 30 mg/g for at least 3 consecutive months during the past 12 months. A 30 percent rating is warranted when the condition manifests with a GFR from 45 to 59 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months. Higher disability ratings are provided for lower GFR values and/or renal dysfunction requiring dialysis or transplant. See 38 C.F.R. § 4.115a (2022). Under the previous version and the current version of 38 C.F.R. § 4.115a, voiding dysfunction may be rated as urine leakage, frequency, or obstructed voiding. The rating criteria for rating urinary frequency provides for consideration of the voiding interval (frequency) during the day and night. The rating criteria for urinary leakage or incontinence provides for consideration of the use of absorbent material and the frequency such material needs replacement. Finally, the rating criteria for obstructive voiding provides for consideration of obstructive symptomatology. 38 C.F.R. § 4.115a. Turning to the facts, the Veteran filed a service connection claim for prostate cancer in January 2021. At the February 2022 VA examination, the Veteran reported being diagnosed with prostate cancer in 2016. At that time, he underwent a laparoscopic radical prostatectomy. Since surgery, his cancer has been in remission; however, he experienced occasional urinary leakage, for which he wore absorbent materials as needed. The Veteran did not experience renal dysfunction, nor did he take medication for his condition. The Veteran's voiding dysfunction required absorbent material which had to be changed less than two times per day. While there was increased urinary frequency which caused daytime voiding interval between two and three hours and nighttime awakening to void two times, the Veteran did not require the use of an appliance nor were there any signs or symptoms of obstructed voiding. There was no evidence of a history of chronic prostatitis, urethritis, epididymitis, orchitis, or urinary tract infections. Subsequently, in August 2022, the Veteran presented to the hospital for choking. Diagnostic testing revealed a renal mass and the Veteran was diagnosed with renal cell cancer. Contemporaneous treatment records are silent for any elevated glomerular filtration rate (GFR), chronic kidney disease, albumin constant or recurring with hyaline and granular casts or red blood cells, transient or slight edema, or compensable hypertension pursuant to DC 7101. Based on a separate service connection claim for renal cell cancer, the Veteran was afforded a VA examination in January 2023. At that time, the examiner found that the Veteran did not endorse any renal dysfunction as defined by the VA. Based on the above, the Board finds that a rating higher than 20 percent for service-connected prostate cancer is not warranted. In order to warrant a higher rating, there must be evidence of either voiding dysfunction requiring the wearing of absorbent materials which must be changed 2 to 4 times per day or daytime voiding interval of less than one hour or night awakening to void five or more times per night; or renal dysfunction manifested by albumin constant or recurring with hyaline and granular casts or red blood cells, transient or slight edema, or compensable hypertension pursuant to DC 7101; or chronic kidney disease with GFR from 45 to 59 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months. As it pertains to the voiding dysfunction, the medical and lay evidence reflects that the Veteran needed to change absorbent materials up to 2 times per day. Voiding intervals during the daytime were between 2 and 3 hours, with nighttime awakening to void two times. These symptoms are adequately contemplated under the currently assigned 20 percent disability rating. In regard to renal dysfunction, the Board acknowledges the Veteran's recent diagnosis of renal cell cancer. Upon his diagnosis, the Veteran filed a separate service connection claim for renal cell cancer, which is addressed in a separate appeal stream. As it specifically pertains to the rating criteria pursuant to DC 7528, the Board finds that the evidence fails to establish that a higher rating for prostate cancer is warranted on the basis of renal dysfunction. Here, the rating criteria specifically defines renal dysfunction. The February 2022 VA examination indicates that the Veteran did not manifest any renal dysfunction. Treatment records and lay statements fail to indicate that the Veteran manifested renal dysfunction as defined by VA based on laboratory findings. The Board acknowledges the Veteran's assertions that his disability is more severe than evaluated to include his reports of voiding frequency and functional limitations. The Veteran is competent to report his symptoms and has presented credible testimony. Layno v. Brown, 6 Vet. App. 465, 469 (1994). The Board finds, however, that neither the lay or medical evidence demonstrates that the criteria for a higher rating have been met. Based on the above, the Board finds that a rating higher than 20 percent is not warranted for service-connected prostate cancer residuals under 38 C.F.R. § 4.115a. The Board has considered whether any other diagnostic codes would allow for a higher disability rating but has found none. Bilateral Hearing Loss The Veteran asserts a rating higher than 20 percent for his bilateral hearing loss disability. Hearing loss disability evaluations range from 0 percent to 100 percent based on organic impairment of hearing acuity, as measured by controlled speech discrimination tests in conjunction with the average hearing threshold, as measured by puretone audiometric tests in the frequencies 1000, 2000, 3000 and 4000 Hertz. The rating schedule establishes 11 auditory acuity levels designated from Level I for essentially normal hearing acuity, through Level XI for profound deafness. VA audiometric examinations are conducted using a controlled speech discrimination test together with the results of a puretone audiometry test. The vertical lines in Table VI represent nine categories of the percentage of discrimination based on the controlled speech discrimination test. 38 C.F.R. § 4.85. The horizontal columns in Table VI represent nine categories of decibel loss based on the pure tone 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 found from Table VII by intersecting the vertical column appropriate for the numeric designation for the ear having the better hearing acuity and the horizontal row appropriate to the numeric designation level for the ear having the poorer hearing acuity. For example, if the better ear has a numeric designation Level V and the poorer ear has a numeric designation Level VII, the percentage evaluation is 30 percent. 38 C.F.R. § 4.85. There is an alternative method of rating hearing loss in defined instances of exceptional hearing loss. Exceptional hearing exists when the pure tone threshold at the frequencies of 1000, 2000, 3000, and 4000 Hertz is 55 decibels or more; or where the pure tone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz. If the Veteran is found to have exceptional hearing, the Roman numeral designation for hearing impairment will be determined under either Table VI or Table VIa, whichever results in the higher numeral. See 38 C.F.R. § 4.86. Turning to the facts, at the February 2022 VA examination, the Veteran described having difficulty understanding speech. 38 C.F.R. § 4.10; Martinak v. Nicholson, 21 Vet. App. 447 (2007). Upon examination, the Veteran's Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: February 4, 2022 HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 40 70 75 75 65 64 LEFT 35 60 70 70 59 68 Applying the results to Table VI, the findings yield a numeric designation of Level VI in the right ear and Level V in the left ear. Entering the resulting bilateral numeric designation of Level VI for the right ear and Level V for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a 20 percent disability rating under DC 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown. Based on the evidence above, an initial rating in excess of 20 percent for the Veteran's bilateral hearing loss disability is not warranted. The Board expressly acknowledges its consideration of the lay evidence of record when adjudicating this claim, including the Veteran's statements describing difficulty hearing speech. The Veteran is competent to report difficulty hearing; however, disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. Lendenmann v. Principi, 3 Vet. App. 345 (1992). Similarly, a private medical opinion referred to a 40 percent loss of hearing acuity, but this estimation was not based on using VA criteria. As such, there is no probative value as it pertains to the extent of hearing loss per VA criteria. 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 contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Veteran's main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned. Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). Accordingly, the most probative evidence of record persuasively weighs against the claim of entitlement to an initial rating in excess of 20 percent for the bilateral hearing loss disability. As the most probative evidence of record persuasively weighs against a rating in excess of 20 percent, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). Scars of the Chest and Lower Abdomen The Veteran is seeking a compensable rating for his service-connected scars related to his CABG and radical prostatectomy. The Veteran's scars are rated under 38 C.F.R. § 4.188, DC 7802. DC 7802 is for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are not associated with underlying soft tissue damage. Under DC 7802, a 10 percent rating is warranted if the area or areas affected is/are at least 144 square inches (929 square centimeters) or greater. A superficial scar is one not associated with underlying soft tissue damage. If multiple qualifying scars are present, a separate evaluation is assigned for each affected extremity based on the total area of the qualifying scars that affect that extremity. 38 C.F.R. § 4.118. Also relevant to the appeal, under DC 7801 (scars other than those of the head, face, or neck that are deep and nonlinear), a 10 percent rating is warranted if the area or areas affected is/are at least 6 square inches (39 sq. cm), but less than 12 square inches (77 sq. cm), in size. Higher ratings of 20, 30, and 40 percent are warranted if the affected area or areas exceed 12 square inches (77 sq. cm), 72 square inches (465 sq. cm), and 144 square inches (929 sq. cm), respectively. A deep scar is one associated with underlying soft tissue damage. Under DC 7804 (scars, unstable or painful), a 10 percent rating is warranted for one or two scars that are unstable or painful. Three or four scars that are unstable or painful warrant a 20 percent evaluation, and five or more scars that are unstable or painful warrant a 30 percent evaluation. An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. If one or more scars are both unstable and painful, 10 percent is added to the evaluation that is based on the total number of unstable or painful scars. 38 C.F.R. § 4.118, DC 7804. Under DC 7805, scars and other effects of scars not considered in a rating provided under DCs 7800-04 should be evaluated under an appropriate diagnostic code. The Veteran's scars were first evaluated at a February 2022 VA examination. At that time, the Veteran was assessed with a vertical mid sternal linear scar due to CABG surgery, and a linear scar at umbilicus, a linear scar at the left mid abdomen, and a linear scar at the right mid abdomen both due to laparoscopic radial prostatectomy surgery. The Veteran's scars were not unstable or painful. The mid sternal scar was 15 cm x 0.3 cm. The umbilicus was 1 cm x 0.5 cm. The right mid abdomen scar was 1 cm x 0.5 cm. The left mid abdomen scar was 1 cm. x. 0.5 cm. Together, all anterior trunk scars covered approximately 6 cm2 and none of the scars had underlying tissue damage. The scars did not result in limitation of function or limitation of motion and there were no additional physical findings, complications, conditions, signs, or symptoms related to the Veteran's scars. In a January 2023 VA examination, the Veteran continued to endorse four scars on his trunk. None of the scars were painful or unstable. The midline abdomen scar measured at 7 x 0.5 cm; the right abdomen scar measured at 1 x 1 cm; the left abdomen scar measured at 1 x 1 cm; the final scar measured at 1 x 1 cm. The approximate total area of the anterior trunk affected by the scars measured at 6.5 cm2. The scars did not result in any limitation of function or limitation of motion and there were no other physical findings, complications, conditions, signs, or symptoms associated with any of the scars. Based on the above, the Board finds that the evidence of record persuasively weighs against the assignment of a compensable evaluation under DC 7802 because the Veteran's anterior trunk scars are not manifest by an area or areas of 144 square inches (929 sq. cm.) or greater. The Board has also considered the other DCs pertaining to scars but finds that a compensable rating is not warranted under any of the other potentially applicable rating criteria. The Veteran's anterior trunk scars are not deep and non-linear and are not associated with underlying soft tissue damage. Further, the Veteran's anterior trunk scars are not unstable or painful. Therefore, DCs 7801 and 7804 are inapplicable. Finally, the evidence of record shows there are no other disabling effect(s) not considered in a rating provided under DCs 7800-04 as contemplated under DC 7805. The Board acknowledges that the Veteran asserts a higher rating for his scars; however, he has not presented any specific theory of entitlement to a higher rating. While the Veteran is competent to report observable symptoms, the Veteran does not assert, and the medical records do not show, that the Veteran's scars are manifested by an area or areas of 144 square inches (929 sq. cm.) or greater, nor is there any evidence that the scars are painful or unstable, deep and non-linear, or have underlying soft tissue damage. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's claim for a compensable rating for the four anterior trunk scars. As the evidence of record persuasively weighs against a compensable rating, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). Erectile Dysfunction The Veteran is seeking a compensable rating for erectile dysfunction, which has been service-connected effective January 23, 2021. During the appeal period, the criteria for erectile dysfunction was amended. Prior to November 14, 2021, the rating criteria specified that deformity of the penis with loss of erectile power was rated as either 20 percent disabling, or noncompensable, depending upon the extent of the deformity. 38 C.F.R. § 4.115b, DC 7522. There is no indication whatsoever that the Veteran has any penile deformity to support a higher disability rating. Effective November 14, 2021, the rating schedule was revised to remove the deformity aspect of the criteria. 86 Fed Reg 54081 (September 30, 2021). Erectile dysfunction, with or without penile deformity, is rated under the provisions of 38 C.F.R. § 4.115b, DC 7522. A noncompensable disability rating is the only rating provided under the newer version. Thus, a noncompensable disability rating is provided for the Veteran's situation under the older criteria and the newer rating criteria. A noncompensable disability rating is currently the only schedular rating provided for erectile dysfunction; however, a note appended to 38 C.F.R. § 4.115b instructs adjudicators to review for entitlement to SMC. This is exactly what occurred in this case. The noncompensable disability rating was assigned according to the regulatory rating schedule, but adjudicators concurrently granted SMC for the Veteran's erectile dysfunction. These grants have remained in effect since the inception of the appeal period. In short, the Veteran's award of SMC for loss of use of a creative organ compensates his complained loss of reproductive function throughout the duration of the appeal. Moreover, the amount of special monthly compensation for loss of use of a creative organ is a non-variable amount and is set by statute. 38 U.S.C. § 1114(k). Accordingly, there is no legal basis for the Veteran to obtain increased compensation for this disability, to include additional special monthly compensation. The claim is denied. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Orie, Chinyere 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.