KNEE IMPAIRMENT OF

PAUL R. CASEY · 2025 · Case ID: A25110554

MIXED

Summary

The veteran, who served from March 1968 to April 1971, appeals decisions denying increased ratings for his right ankle fracture, arteriosclerotic heart disease, and surgical scar, and also appeals the denial of service connection for PTSD. The Board granted service connection for left knee strain, right knee strain, lumbosacral strain, and right lower extremity sciatic radiculopathy, finding these conditions secondary to existing service-connected musculoskeletal and peripheral nerve issues. The Board applied the benefit of the doubt doctrine, finding the evidence in equipoise for these grants. For the right ankle residuals, the Board denied an increased rating, finding the veteran's range of motion measurements did not meet the criteria for a higher evaluation, despite acknowledging lay reports of pain and functional loss. The Board granted a 60 percent rating for the service-connected heart condition, finding the veteran's symptoms manifested at a METs level of 3.1-5.0, aligning with the criteria for that rating, but denied a higher rating as the evidence did not support symptoms at 3.0 METs or less. The claim for the surgical scar was denied as it did not meet the criteria for a compensable rating. The Board remanded the PTSD claim due to incomplete development of the claimed stressor, noting inconsistencies in the veteran's identification of a fellow service member involved in the incident. The claim for an increased rating for right lower extremity peripheral neuropathy was also remanded, as it was inextricably intertwined with the development needed for the newly granted sciatic radiculopathy.

Rationale

Evidence in equipoise; Benefit of the doubt applied; Secondary to service-connected conditions

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250320-529249

Full Decision Text

Citation Nr: A25110554
Decision Date: 12/29/25 Archive Date: 12/29/25

DOCKET NO. 250320-529249
DATE: December 29, 2025

ORDER

Entitlement to service connection for left knee strain is granted.

Entitlement to service connection for right knee strain is granted.

Entitlement to service connection for lumbosacral strain is granted.

Entitlement to service connection for right lower extremity sciatic radiculopathy is granted.

Entitlement to a disability rating in excess of 10 percent for residuals of right ankle fracture is denied.

Entitlement to a disability rating in excess of 60 percent for arteriosclerotic heart disease (coronary artery disease), with coronary artery bypass, and valvular disease (heart condition) is denied.

Entitlement to a compensable disability rating for residual scar of the anterior trunk mid sternum status post coronary artery bypass graft associated with the service-connected heart condition is denied.

REMANDED

Entitlement to service connection for posttraumatic stress disorder (PTSD) is remanded.

Entitlement to a disability rating in excess of 20 percent for peripheral neuropathy of the right lower extremity is remanded.

FINDINGS OF FACT

1. The Veteran's left knee strain is due to service-connected residuals of right ankle fracture, right lower extremity peripheral neuropathy, and loss of use of the left foot.

2. The Veteran's right knee strain is due to service-connected residuals of right ankle fracture, right lower extremity peripheral neuropathy, and loss of use of the left foot.

3. The Veteran's lumbosacral strain is due to service-connected residuals of right ankle fracture, right lower extremity peripheral neuropathy, and loss of use of the left foot.

4. The Veteran's right lower extremity radiculopathy sciatic radiculopathy is due to service-connected lumbosacral strain.

5. The Veteran's right ankle is manifested by limitation of motion still permitting 30 degrees of plantar flexion and 10 degrees of dorsiflexion.

6. Metabolic equivalent (MET) testing shows that at a workload of 3.1-5.0 METs the Veteran's service-connected heart condition results in heart failure symptoms, but no such symptoms at a workload of 3.0 METs or less.

7. The Veteran's anterior trunk mid sternum coronary artery bypass surgical scar measures 23 cm by 0.5 cm, an area of less than 12 square cm.

CONCLUSIONS OF LAW

1. The criteria for service connection for left knee strain as secondary to service-connected residuals of right ankle fracture, loss of use of the left foot, and peripheral neuropathy of the right lower extremity are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

2. The criteria for service connection for right knee strain as secondary to service-connected residuals of right ankle fracture, loss of use of the left foot, and peripheral neuropathy of the right lower extremity are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

3. The criteria for service connection for lumbosacral strain as secondary to service-connected residuals of right ankle fracture, loss of use of the left foot, and peripheral neuropathy of the right lower extremity are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

4. The criteria for service connection for right lower extremity sciatic radiculopathy as secondary to service-connected lumbosacral strain have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

5. The criteria for a rating in excess of 10 percent for residuals of a right ankle fracture have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5271.

6. The criteria for a rating in excess of 60 percent for the service-connected heart condition have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.100
for a rating in excess of 10 percent for residuals of a right ankle fracture have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5271.

6. The criteria for a rating in excess of 60 percent for the service-connected heart condition 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 7005.

7. The criteria for a compensable disability rating for residual scar of the anterior trunk mid sternum status post coronary artery bypass graft have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7802.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from March 1968 to April 1971.

These matters come before the Board of Veterans' Appeals (Board) on appeal from four separate rating decisions.

On March 20, 2025, the Veteran submitted four VA Forms 10182, Decision Review Request: Board Appeal (Notice of Disagreement), electing the Evidence Submission docket as to all of the issues in the four decisions identified.

Therefore, with regard to the issues of (1) Entitlement to service connection for a left knee strain; (2) Entitlement to service connection for a right knee strain; (3) Entitlement to service connection for a lumbosacral strain; (4) Entitlement to service connection for right lower extremity sciatic radiculopathy; and (5) Entitlement to a disability rating in excess of 10 percent for residuals of right ankle fracture, the Board may only consider the evidence of record at the time of the October 1, 2024, agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

With regard to the issue of entitlement to a disability rating in excess of 20 percent for right lower extremity peripheral neuropathy, the Board may only consider the evidence of record at the time of the October 21, 2024, AOJ decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

With regard to the issue of entitlement to service connection for PTSD, the Board may only consider the evidence of record at the time of the November 19, 2024, AOJ decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

With regard to the issues of (1) Entitlement to a disability rating in excess of 60 percent for the service-connected heart condition; and (2) Entitlement to a disability rating in excess of 10 percent for the residual
82. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

With regard to the issues of (1) Entitlement to a disability rating in excess of 60 percent for the service-connected heart condition; and (2) Entitlement to a disability rating in excess of 10 percent for the residual scar of the anterior trunk and mid sternum, the Board may only consider the evidence of record at the time of the December 18, 2024, AOJ decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the decided claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claims of entitlement to service connection for PTSD and entitlement to an increased rating for the right lower extremity peripheral neuropathy claims, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

In this case evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is deciding the claims of entitlement to service connection for a left knee strain, a right knee strain, a lumbosacral strain, and a right lower extremity sciatic radiculopathy, as well as for increased ratings for the right ankle, heart, and surgical scar conditions, it may not consider this evidence in its decision. 38 C.F.R. § 20.300. The Veteran may file a Supplemental Claim and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

As the Board is remanding the claims of entitlement to service connection for PTSD and entitlement to an increased rating for right lower extremity peripheral neuropathy for further development, this additional evidence will be considered by the RO in the adjudication of those claims.

When claimants begin their appeals to the Board, VA regulations permit them to elect one of three methods of review. 38 U.S.C. § 7105; 38 C.F.R. § 20.202(b). As discussed above, in this instance, the Veteran has elected the evidence review docket with respect to all the issues from each of the four decisions on appeal. VA regulations also provide claimants with up to one year following the decision on appeal or 60 days following the submission of the VA Form 10182 to change the method of review they initially selected. 38 U.S.C. § 7105; 38 C.F.R. § 20.202(c). In this case, the relevant time limits have expired as to all issues addressed in the decisions from October and November 2024. The December 2024 decision addresses the issues of the heart condition and its associated scar. At the time of writing, there remain a few days prior to the expiration of the one-year period following the decision on appeal. However, despite this, the issues are ready for adjudication because the Veteran has elected the evidence review docket, submitted evidence, and the regulatory opinion for submitting evidence under that docket has expired.

Service Connection

1. The matters of (1) Entitlement to service connection for a left knee condition;
§ 7105; 38 C.F.R. § 20.202(c). In this case, the relevant time limits have expired as to all issues addressed in the decisions from October and November 2024. The December 2024 decision addresses the issues of the heart condition and its associated scar. At the time of writing, there remain a few days prior to the expiration of the one-year period following the decision on appeal. However, despite this, the issues are ready for adjudication because the Veteran has elected the evidence review docket, submitted evidence, and the regulatory opinion for submitting evidence under that docket has expired.

Service Connection

1. The matters of (1) Entitlement to service connection for a left knee condition; (2) Entitlement to service connection for a right knee condition; and (3) Entitlement to service connection for a lumbosacral strain.

These matters arise from the same or similar legal and factual circumstances. Consequently, the Board finds that they can be adequately and efficiently be addressed together.

The Veteran contends that his left knee, right knee, and lumbosacral spine conditions are related to his service-connected musculoskeletal and peripheral nerve conditions.

The Veteran submitted an examination report dated May 2024 along with his claim in June 2024 that diagnosed the Veteran with left knee pain, right knee pain, and low back pain. Subsequent compensation and pension (C&P) examinations from July 2024 document diagnoses of left knee strain, right knee strain, and lumbosacral strain.

The June 2024 non-VA examination report included opinions that the left knee strain, right knee strain, and lumbosacral strain conditions are the result of the Veteran compensating for his service-connected ankle, left foot, and right lower extremity peripheral nerve conditions

The July 2024 C&P examiner reached a contrary conclusion. However, the rationale provided appears to have focused on the anatomical distinctness of the claimed joints from the service-connected joints. It does not appear to have considered the Veteran's compensation for his service-connected musculoskeletal and peripheral nerve conditions.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current left knee strain, right knee strain, and lumbosacral strain conditions are due to the service-connected musculoskeletal and peripheral nerve conditions. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a left knee strain, a right knee strain, and lumbosacral strain is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

2. Entitlement to service connection for right lower extremity sciatic radiculopathy

The May 2024 examination report provided by the Veteran indicates that the Veteran has right sciatic pain and paresthesia of the right leg. This examiner opined that the condition was directly and causally related to the low back condition.

Similarly, the July 2024 C&P examination regarding the Veteran's back documents right sciatic radiculopathy and relates it to the Veteran's service-connected back condition.

The examination also indicates that the symptoms are essentially indistinguishable from the already service-connected right lower extremity peripheral neuropathy. That evidence is relevant to a decision regarding the propriety of a separate or higher rating, but at the level of service connection the question is whether the Veteran has the condition that is due to or aggravated by a service-connected condition. In this case, all examiners appear to agree that the Veteran does.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current right lower extremity sciatic radiculopathy is due to the service-connected lumbosacral strain. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for right lower extremity sciatic radiculopathy is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

Increased Rating

1. Entitlement to a disability rating in excess of 10 percent for residuals of right ankle fracture.

The Veteran is seeking a higher rating for his right ankle disability.

The Veteran's residuals of the right ankle fracture are rated under 38 C.F.R. § 4.71a, Diagnostic Code 5271, for limitation of motion of the ankle. Under Diagnostic Code 5271, a 10 percent rating is warranted for moderate limited motion of the ankle (less than 15 degrees dorsiflexion or less than 30 degrees plantar flexion). A 20 percent rating is warranted for marked limited motion of the ankle (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion).

When evaluating mus
to a disability rating in excess of 10 percent for residuals of right ankle fracture.

The Veteran is seeking a higher rating for his right ankle disability.

When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also to be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a; a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria.").

Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011).

In Correia v. McDonald, 28 Vet. App. 158 (2016), the Court held that the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of range of motion testing "for pain on both active and passive motion [and] in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint."

In Sharp v. Shulkin, 29 Vet. App. 26 (2017), the Court held that VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination.

The Board finds that the evidence of record persuasively weighs against a rating in excess of 10 percent for residuals of right ankle fracture because dorsiflexion measured 10 degrees and plantar flexion measured 30 degrees upon examination in July 2024. Thus, these measurements did not meet the criteria corresponding to a higher, 20 percent rating. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain and limited movement. However, even considering the Veteran's lay reports of symptoms and functional loss, the degree of additional limitation reflected by the statements would not result in symptoms more nearly approximating marked limited motion of the ankle (less than 5 degrees dorsiflexion or less than 10 degrees plantar flexion).

The Board acknowledges that the private examination the Veteran submitted along with his claim in June 2024 indicates "severe decreased range of motion." However, this evidence is unpersuasive as it provides no details or actual measurements regarding the range of motion. The Board notes that this same examiner provided range of motion measurements with regard to other claims (particularly the back and knee conditions). Thus, the Board infers that these measurements were either not conducted, or the measurements were withheld because they would have been similar to the measurements obtained at the subsequent C&P examination in July and would have weighed against the Veteran's claim.

The Board has considered whether any other Diagnostic Codes related to disabilities of the ankle would provide for a higher disability rating. However, the evidence does not reflect that the symptoms would warrant a higher or separate rating under a different Diagnostic Code.
indicates "severe decreased range of motion." However, this evidence is unpersuasive as it provides no details or actual measurements regarding the range of motion. The Board notes that this same examiner provided range of motion measurements with regard to other claims (particularly the back and knee conditions). Thus, the Board infers that these measurements were either not conducted, or the measurements were withheld because they would have been similar to the measurements obtained at the subsequent C&P examination in July and would have weighed against the Veteran's claim.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's appeal for a rating in excess of 10 percent for residuals of right ankle fracture. As the evidence of record persuasively weighs against a rating in excess of 10 percent, the benefit-of-the-doubt rule does not provide an independent basis for granting the requested relief. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. Entitlement to a disability rating in excess of 60 percent for the service-connected heart condition.

The Veteran is seeking a higher rating for the service-connected heart condition, recounting his history of surgical procedures for this condition, the inability to have further surgical treatments, and the fact that his heart condition required him to cease driving a truck.

The Veteran's service-connected heart condition is rated pursuant to the criteria set forth in 38 C.F.R. § 4.104, DC 7005. Pursuant to these criteria, a 10 percent rating is warranted where a workload of 7.1-10.0 METs results in heart failure symptoms, or continuous medication is required for control. A 30 percent rating is warranted where a workload of 5.1-7.0 METs results in heart failure symptoms, or where there is cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent (e.g., multi gated acquisition scan or magnetic resonance imaging). A 60 percent rating is warranted where a workload of 3.1-5.0 METs results in heart failure symptoms. A 100 percent rating is warranted where a workload of 3.0 METs or less results in heart failure symptoms.

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).

At the October 2024 C&P examination, the Veteran reported experiencing chest pain, light headedness, shortness of breath, and fatigue. The examiner documented that these symptoms manifested at a METs level between 3.1 and 5.0 METs. These symptoms were not present at a level of 3.0 METs or fewer.

The METs are not recorded or estimated elsewhere in the record, and the Veteran's statements, as described above, focus on the history and the effects of his surgical procedures which occurred long before this claim began in 2024.

Considering all relevant evidence of record, the Board finds that the heart failure symptoms the Veteran describes occur upon a workload from 3.1 through 5.0 METs. Accordingly, the Board concludes that the Veteran's service-connected heart condition warrants a 60 percent rating under DC 7005.

A higher 100 percent rating under DC 7005 is not warranted unless a workload of 3.0 METs or less results in heart failure symptoms. As discussed above, there is no evidence of
fewer.

A higher 100 percent rating under DC 7005 is not warranted unless a workload of 3.0 METs or less results in heart failure symptoms. As discussed above, there is no evidence of record suggesting that the Veteran's service-connected heart condition results in hearth failure symptoms at 3.0 METs or below. Thus, the Board concludes that the Veteran's service-connected heart condition did not meet the criteria corresponding to a higher 100 percent rating under DC 7005.

The Board has also considered whether to infer a claim for a total disability rating due to individual unemployability (TDIU) rating based on the Veteran's description of having to give up his license to drive a truck. Rice v. Shinseki, 22 Vet. App. 447 (2009). However, in the context of the wider record, the Board notes that this does not appear to have resulted in the Veteran's inability to obtain or maintain a substantially gainful course of employment, at least not by itself or in combination with the Veteran's current service-connected disabilities. The record reflects that the Veteran's surgical procedures and the necessity to give up his license to drive a truck occurred decades ago. Following that, the Veteran developed his own business which he passed down to two of his sons and retired. He attributes his need to retire elsewhere to the stress of dealing with others, a symptom that appears to be associated with his psychiatric condition. Other examinations appear to concur that the Veteran is no longer employable, but to attribute it to the combination of his heart, physical, and mental health symptoms. Consequently, the Board finds that a claim for TDIU is not inferred at this time.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's appeal for a rating in excess of 60 percent for the service-connected heart condition. As the evidence of record persuasively weighs against a rating in excess of 60 percent, the benefit-of-the-doubt rule does not provide an independent basis for granting the requested relief. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

3. Entitlement to a compensable disability rating for surgical scars of the anterior trunk mid sternum status post coronary artery bypass graft

The Veteran is seeking a higher rating for his surgical scar.

The Veteran's surgical scar caused by his heart surgical procedures is rated under Diagnostic Code 7802.

Diagnostic Code 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. 38 C.F.R. § 4.118. Pursuant to these criteria a 10 percent disability rating is assigned for a scar with an area of 144 square inches (929 square centimeters). Id.

In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 U.S.C. § 501; 38 C.F.R. § 4.31.

The Board finds that the evidence of record persuasively weighs against the assignment of a compensable evaluation under Diagnostic Code 7802 because the Veteran's scar measures 23 cm by .5 cm, an area of 11.5 square centimeters. It is therefore not manifested by an area or areas of 144 square inches (929 sq. cm.) or greater according to the October 2024 C&P examination.

The Board has also considered the other Diagnostic Codes pertaining to scars. However, the Veteran's scar is not of the head, face, or neck, is not deep and non-linear, and is not associated with underlying soft tissue damage. Moreover, the Veteran's scar is not unstable or painful. Therefore, Diagnostic Codes 7800, 7801, and 7804 are inapplicable to this claim. Finally, the evidence of record shows there are no other disabling effects not considered in a rating provided under Diagnostic Codes 7800-04 as contemplated under Diagnostic Code 7805. The Veteran has merely asserted entitlement to an increased rating but has not alleged specific symptoms
cm.) or greater according to the October 2024 C&P examination.

The Board acknowledges that the Veteran believes that the disability on appeal has been more severe than the assigned disability rating reflects. Moreover, the Veteran is competent to report observable symptoms. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, the Veteran does not assert, and the medical treatment records do not show, that the Veteran's heart surgery scar is manifest by an area or areas of 144 square inches (929 sq. cm.) or greater.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's claim for a compensable rating for the heart surgical scar. As the evidence of record persuasively weighs against a compensable rating, the benefit-of-the-doubt rule does not provide an independent basis for granting the requested relief. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

REASONS FOR REMAND

1. Entitlement to service connection for PTSD is remanded.

Under the AMA, the Board must remand a claim to correct an error by the AOJ to satisfy its duty to assist the Veteran under 38 U.S.C. § 5103A, if the error occurred prior to the AOJ decision on appeal. 38 U.S.C. § 5103A?(f)(2)(A); 38 C.F.R. § 20.802(a). The Board may also remand a claim to correct any other AOJ error "in satisfying a regulatory or statutory duty, if correction of the error would have a reasonable possibility of aiding in substantiating" the claim. 38 C.F.R. § 20.802(a).

Here, the Board finds that VA did not comply with its duty to assist prior to the decision on appeal in this case. Specifically, VA's attempts to substantiate the Veteran's claimed stressor are incomplete. The Veteran related that his claimed PTSD arises out of a stressful occurrence where his friend, who he asserted was named "Joe Gordon" was thrown from a tank and died during the Veteran's service between September 1, 1969, and December 1, 1969. However, in other parts of the record, the Veteran gives his individual's first name not as "Joe" but as "Jeff." Consequently, the Board finds that this matter must be remanded in an attempt to substantiate his claimed stressor pursuing the relevant records under both first names given by the Veteran and conduct an appropriate examination in the event that the claimed stressor can be verified.

2. Entitlement to a disability rating in excess of 20 percent for right lower extremity peripheral neuropathy is remanded.

As discussed in the section regarding the matter of entitlement to service connection for right lower extremity sciatic radiculopathy, there is significant overlap between the Veteran's right lower extremity radiculopathy and right lower extremity peripheral neuropathy condition. Consequently, the resolution of the increased rating claim for this condition is inextricably intertwined with the development required to implement the grant regarding the right lower extremity sciatic radiculopathy. Therefore, the Board finds that this matter must be remanded, pending the implementation of the grant for right lower extremity sciatic radiculopathy and readjudicated alongside that issue.

The matters are REMANDED for the following actions:

1. Make the necessary efforts to substantiate the Veteran's stressor. These efforts should include searching for the appropriate records regarding the incident the Veteran claims resulted in the accidental death of his fellow service-member who served with him between September 1, 1969 and December 1, 1969, who has been variously identified as Joe Gordon or Jeff Gordon.

After the Veteran's reported stressors have been developed, schedule the Veteran for a psychiatric examination to determine the nature and etiology of any posttraumatic stress disorder (PTSD). If the Veteran is diagnosed with PTSD
of the grant for right lower extremity sciatic radiculopathy and readjudicated alongside that issue.

The matters are REMANDED for the following actions:

After the Veteran's reported stressors have been developed, schedule the Veteran for a psychiatric examination to determine the nature and etiology of any posttraumatic stress disorder (PTSD). If the Veteran is diagnosed with PTSD, the examiner must explain how the diagnostic criteria are met and opine whether it is at least as likely as not related to a verified in-service stressor.

If any other acquired psychiatric disorders are diagnosed, the examiner must opine whether each diagnosed disorder is at least as likely as not related to an in-service injury, event, or disease.

2. Conduct any development that is necessary or appropriate to implement the grant of entitlement to service connection for right lower extremity sciatic radiculopathy and adjudicate in the first instance whether a rating separate from the right lower extremity peripheral neuropathy condition is warranted or whether the condition should be combined with the extant right lower extremity peripheral neuropathy condition.

3. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined issue of entitlement to an increased rating for right lower extremity peripheral neuropathy.

Paul R. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Steven H. Johnston, 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.

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