12-25 574
12-25 574
| Board of Vet. App. | Apr 26, 2017Background
- Veteran served on active duty 1989–1992 and appealed an RO March 2011 rating decision awarding service connection ratings for lumbar spine and bilateral lower‑extremity radiculopathy.
- Claim for increased lumbar rating filed July 14, 2010; appeal remanded April 2015 for new VA exam and further development; adequate VA exams obtained (notably Nov 2010, May 25, 2012, Aug 2015).
- Pre‑May 25, 2012 examinations showed forward flexion ~80°, combined ROM ~216°, no abnormal gait/contour, normal motor/reflex/sensation — consistent with 10% spine and 10% radiculopathy ratings.
- May 25, 2012 exam demonstrated more severe spine flare‑ups (bed‑bound during flares) and moderate radiculopathy (intermittent pain, paresthesias, numbness) prompting upstaging.
- August 2015 exam showed continued limited ROM and moderate radiculopathy but no ankylosis, abnormal spinal posture, or incapacitating episodes sufficient to warrant ratings above the applicable schedular maxima.
- Veteran asserted exams under‑represented flare‑ups and functional loss; VA considered functional loss and found it adequately reflected in ROM and neurologic findings.
Issues
| Issue | Veteran's Argument | VA/RO Argument | Held |
|---|---|---|---|
| Entitlement to >10% for lumbar spine prior to May 25, 2012 | May 2012 and earlier symptoms worse than recorded; flare‑ups cause more functional loss | Objective ROM and exam findings (Nov 2010) show ROM and no incapacitating episodes or ankylosis | Denied — 10% correct for period prior to May 25, 2012 |
| Entitlement to 40% for lumbar spine from May 25, 2012 to Aug 24, 2015 | May 25, 2012 exam and veteran statements show bed‑bound flare‑ups and worsened ROM/function | May 2012 exam shows objective decline and flare‑ups; supports higher rating but no ankylosis/incapacitating episodes of ≥4 weeks | Granted — 40% from May 25, 2012 to Aug 24, 2015 |
| Entitlement to >40% for lumbar spine since Aug 24, 2015 | Continued severe functional loss and flare‑ups warrant >40% | Aug 2015 exam shows limited ROM but no ankylosis or requisite incapacitating episodes | Denied — >40% not shown since Aug 24, 2015 |
| Entitlement to >10% (pre‑May 25, 2012) and >20% (post‑May 25, 2012) for bilateral lower‑extremity radiculopathy | Symptoms (radiating pain, numbness, functional loss) are more severe than current ratings | Examinations document mild symptoms pre‑May 2012 and moderate symptoms from May 25, 2012 onward, but not "moderately severe" or motor loss/atrophy | Denied >10% pre‑May 25, 2012; Granted 20% for each leg from May 25, 2012–Aug 24, 2015; Denied >20% thereafter |
Key Cases Cited
- Bernard v. Brown, 4 Vet. App. 384 (procedural standard for appellate review)
- Nieves‑Rodriguez v. Peake, 22 Vet. App. 295 (examiner must review claims file and provide rationale)
- Correia v. McDonald, 28 Vet. App. 158 (weight‑bearing ROM considerations)
- Stegall v. West, 11 Vet. App. 268 (substantial compliance with remand directives)
- Dyment v. West, 13 Vet. App. 141 (remand compliance standard)
- Mauerhan v. Principi, 16 Vet. App. 436 (consider non‑rating factors when appropriate)
- Massey v. Brown, 7 Vet. App. 204 (consideration of factors outside rating criteria)
- Fenderson v. West, 12 Vet. App. 119 (staged ratings for changed symptoms)
- DeLuca v. Brown, 8 Vet. App. 202 (functional loss considerations in musculoskeletal ratings)
- Mitchell v. Shinseki, 25 Vet. App. 32 (pain effects on functional movement and ROM measurements)
- Rucker v. Brown, 10 Vet. App. 67 (lay evidence competency limits for medical conclusions)
- Gabrielson v. Brown, 7 Vet. App. 36 (credibility/probative value analysis required)
- Gilbert v. Derwinski, 1 Vet. App. 49 (VA must explain acceptance/rejection of evidence)
- Thun v. Peake, 22 Vet. App. 111 (extraschedular referral framework)
- Bagwell v. Brown, 9 Vet. App. 337 (extraschedular standards)
- Mittleider v. West, 11 Vet. App. 181 (applicability of schedular criteria)
- Rice v. Shinseki, 22 Vet. App. 447 (TDIU evidentiary requirements)
- Roberson v. Principi, 251 F.3d 1378 (TDIU and employment evidence)
