14-43 761

CourtBoard of Veterans' Appeals
DecidedJune 4, 2018
Docket14-43 761
StatusUnpublished

This text of 14-43 761 (14-43 761) is published on Counsel Stack Legal Research, covering Board of Veterans' Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
14-43 761, (bva 2018).

Opinion

Citation Nr: 18107546 Decision Date: 06/04/18 Archive Date: 06/02/18

DOCKET NO. 14-43 761 DATE: June 4, 2018 ORDER A 20 percent rating for a lumbar spine disability is granted, subject to the laws and regulations governing the award of monetary benefits. Entitlement to an initial rating in excess of 10 percent for a left hip disability is denied. Entitlement to an initial rating in excess of 10 percent for a right hip disability is denied.

REMANDED Entitlement to total disability rating based on individual unemployability (TDIU). FINDINGS OF FACT 1. Range of motion testing of the Veteran’s lumbar spine has shown forward flexion functionally limited to between 31 and 60 degrees; and ankylosis of the spine was not shown. The Veteran has not been shown to have been prescribed bed rest to treat his service connected back disability during the course of his appeal. 2. The Veteran’s left hip disability results in extension limited to 5 degrees or less. It does not result in any ankylosis, hip flail joint, impairment of the femur, limitation of rotation to 15 degrees, adduction so limited as to prevent the Veteran from crossing his legs, limitation of abduction beyond 10 degrees, or flexion limited to 45 degrees or less. 3. The Veteran’s right hip disability results in extension limited to 5 degrees or less. It does not result in any ankylosis, hip flail joint, impairment of the femur, limitation of rotation to 15 degrees, adduction so limited to prevent the Veteran from crossing his legs, limitation of abduction beyond 10 degrees, or flexion limited to 45 degrees or less. CONCLUSIONS OF LAW 1. The criteria for a 20 percent rating for the Veteran’s lumbar spine disability, but no higher, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5237, 5243. 2. The criteria for an initial rating in excess of 10 percent for a left hip disability have not been satisfied. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5003, 5019, 5250-5255. 3. The criteria for an initial rating in excess of 10 percent for a left hip disability have not been satisfied. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5003, 5019, 5250-5255. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from July 1979 to May 1986. In October 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is of record. At that examination, the Veteran waived AOJ consideration of the Social Security Administration (SSA) records and VA examinations that were being sought. In determining claims for increased ratings, disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the Veteran working or seeking work. 38 C.F.R. § 4.2. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. The Veteran was granted service connection for his low back disability in a February 2011 rating decision. The Regional Office (RO) assigned a 10 percent rating effective October 5, 2010, the date the Veteran’s claim for service connection was filed. The same rating decision also denied service connection for the Veteran’s right and left hips. The Veteran appealed both the initial back rating and the denial of service connection for his hips. The RO subsequently granted service connection for each of the Veteran’s hips, and assigned each a 10 percent rating for each, also effective October 5, 2010. The Veteran perfected appeals on the initial ratings of his back and each hip. He asserts that he is entitled to ratings in excess of 10 percent for each of these disabilities. Entitlement to an initial disability rating in excess of 10 percent for a lumbar spine disability VA regulations dictate that a back disability is to be rated under either the General Rating Formula for Diseases and Injuries of the Spine or the Formula for Rating Intervertebral Disc Syndrome (IVDS) based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined. 38 C.F.R. § 4.71a, Diagnostic Code 5243. Under the current Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, a 10 percent rating is assigned when IVDS causes incapacitating episodes having a total duration of at least one week, but less than two weeks, during a 12-month period on appeal. A 20 percent rating is assigned when IVDS causes incapacitating episodes having a total duration of at least two weeks, but less than four weeks, during a 12-month period on appeal. A 40 percent rating is assigned when IVDS causes incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during a 12-month period on appeal. A 60 percent rating is assigned when IVDS causes incapacitating episodes having a total duration of at least six weeks during a 12-month period on appeal. Id. An incapacitating episode is a period of acute signs and symptoms due to IVDS that requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, Diagnostic Code 5243, Note (1) (emphasis added). The evidence of record does not show that the Veteran has, or has ever had, a diagnosis of IVDS. Moreover, there is no suggestion he has ever been prescribed bed rest. As such, a rating in excess of 10 percent is not warranted under this Formula, and the General Rating Formula for Diseases and Injuries of the Spine will be used to determine whether an increased rating for the Veteran low back disability is appropriate. Under the General Rating Formula for Diseases and Injuries of the Spine, a 20 percent evaluation is warranted if forward flexion of the thoracolumbar spine is greater than 30 degrees, but not greater than 60 degrees; when the combined range of motion of the thoracolumbar spine is not greater than 120 degrees; or when muscle spasm or guarding is severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis.

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Bluebook (online)
14-43 761, Counsel Stack Legal Research, https://law.counselstack.com/opinion/14-43-761-bva-2018.