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12-25 574
12-25 574
| Board of Vet. App. | Apr 26, 2017
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Background

  • 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)
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Case Details

Case Name: 12-25 574
Court Name: Board of Veterans' Appeals
Date Published: Apr 26, 2017
Docket Number: 12-25 574
Court Abbreviation: Board of Vet. App.