DISEASE AND INJURIES OF THE SPINE

NEIL T. WERNER · 2026 · Case ID: 26001528

DENIED

Summary

The veteran, who served in the United States Air Force across multiple periods between November 1990 and January 2017, appeals the denial of increased disability ratings for his neck, back, and right wrist conditions. The Board reviewed the evidence, including multiple VA examinations conducted in July 2017, September 2023, and May 2025, in light of relevant legal precedents concerning musculoskeletal disabilities, pain, and medication effects. For the neck disability, rated at 10 percent, the Board found that the veteran's range of motion and absence of ankylosis or severe guarding did not meet the criteria for a higher rating. Similarly, for the back disability, rated at 20 percent, the Board determined that the veteran's range of motion and lack of incapacitating episodes did not meet the criteria for a higher rating. The right wrist disability, rated at 10 percent under a hyphenated diagnostic code for limitation of motion, was also found not to warrant an increased rating, as the veteran did not meet the criteria for ankylosis or other severe functional loss. The Board concluded that the most probative evidence, primarily from VA examinations, did not support the veteran's claims for increased ratings for any of the three conditions.

Rationale

Forward flexion of cervical spine always greater than 30 degrees.; Combined range of motion of cervical spine always greater than 170 degrees.; No ankylosis or adverse symptomatology equating to ankylosis documented.; No guarding severe enough for abnormal gait or spinal contour.

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

5242

Docket No.

18-00 324

Full Decision Text

Citation Nr: 26001528
Decision Date: 02/03/26 Archive Date: 02/03/26

DOCKET NO. 18-00 324
DATE: February 3, 2026

ORDER

Entitlement to an initial rating in excess of 10 percent for a neck disability is denied.

Entitlement to an initial rating in excess of 20 percent for a back disability is denied.

Entitlement to an initial rating in excess of 10 percent disabling for a right wrist disability is denied.

FINDINGS OF FACT

1. The most probative evidence of record shows that even when discounting beneficial medication effects when evaluating the baseline severity of the disability the Veteran's neck disability did not manifest by adverse symptomatology that equates to at least forward flexion of the cervical spine not greater than 30 degrees, have a combined range of motion of the cervical spine limited to 170 degrees or less, ankylosis, or lost range of motion that equates to ankylosis even when considering his complaints of pain with and without weight bearing and resistance in passive and active range of motion as well as during flare-ups, muscle spasm, guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis, nor intervertebral disc syndrome causing incapacitating episodes that required bed rest prescribed by a physician and treatment by a physician having a total duration of at least 2 weeks during a 12-month period.

2. The most probative evidence of record shows that even when discounting beneficial medication effects when evaluating the baseline severity of the disability the Veteran's back disability is not manifested by adverse symptomatology that equates to at least forward flexion of the thoracolumbar spine to 30 degrees or less, ankylosis, or lost range of motion that equates to ankylosis even when considering his complaints of pain with and without weight bearing and resistance in passive and active range of motion as well as during flare-ups and it is not manifested by intervertebral disc syndrome causing incapacitating episodes that required bed rest prescribed by a physician and treatment by a physician having a total duration of at least 4 weeks during a 12-month period.

3. The most probative evidence of record shows that even when discounting beneficial medication effects when evaluating the baseline severity of the disability the Veteran's right wrist disability is already in receipt of the maximum rating for lost motion and it is not manifested by adverse symptomatology that equates to at least ankylosis or lost range of motion that equates to ankylosis even when considering his complaints of pain with and without weight bearing and resistance in passive and active range of motion as well as during flare-ups.

CONCLUSIONS OF LAW

1. The criteria for entitlement to a rating in excess of 10 percent for a neck disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, Diagnostic Codes 5235 to 5243 (2020); 38 C.F.R. §§ 4.21, 4.3, 4.40, 4.45, 4.7, 4.71a, Diagnostic Codes 5235 to 5243 (2025).

2. The criteria for a rating in excess of 20 percent for a back disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, Diagnostic Codes 5235 to 5243 (2020); 38 C.F.R. §§ 3.102, 4.1, 4.14, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5235 to 5243 (2025).

3. The criteria for a rating in excess of 10 percent for a right wrist disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5024, 5214, 5215.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service with the United States Air Force from November 1990 to December 2000, October 2001 to March 2002, May 2004 to September 2004, October 2004 to September 2009, and August 2010 to January 2017.

These matters come before the Board of Veterans'
7; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5024, 5214, 5215.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2017 rating decision issued by a Department of Veterans Affairs (VA), Regional Office (RO).

In March 2021 the Veteran testified at a hearing before the undersigned. A transcript of the hearing has been associated with the claims file.

In February 2023 and March 2025, the Board Remanded to above claims for further development.

In this regard, the Board finds that while the appeal was in Remand status the RO substantially complied with that Remand. See 38 U.S.C. § 5103A(d); Stegall v. West, 11 Vet. App. 268, 271 (1998); D'Aries v. Peake, 22 Vet. App. 97 (2008) (holding that only substantial, and not strict compliance with the terms of a remand request, is required). The Board has reached this conclusion because while the appeal was in remand status it provided the claimant the curriculum vitae (CV) of the September 2023 (Dr. R.W.) and March 2024 (Dr. R.W.) VA examiners as well as the examiner that provided the June 2024 VA medical opinion (Dr. B.R.) because these CVs were associated with the claims file in July 2025, provided the appellant with new VA examinations in September 2023 and May 2025, associated with the claims file all identified and available treatment records, and issued a supplemental statement of the case in August 2025 that considered all the evidence added to the file since the November 2017 statement of the case.

Next, and notwithstanding the United States Court of Appeals for Veterans Claims (Court) holding in Rice v. Shinseki, 22 Vet. App. 447 (2009), the Board finds that the record does not raise a claim for a total rating based on individual unemployability because the Veteran does not claim he is unable to maintain gainful employment due to his service connected disability and, in fact, at the March 2021 Board hearing, he testified he was employed full time.

Lastly, the Board notes that while the appeal was in Remand status the RO in a September 2025 rating decision granted the Veteran service connection for right and left lower extremity radiculopathy. Moreover, the Veteran's representative appears to have since requested an increased rating for these newly service-connected disabilities. However, the request was not made on a form proscribed by VA. Therefore, when the file is again before the RO it should take appropriate steps to help the Veteran and his representative file this claim.

The Increased Rating Claims

The Veteran claims, in substance, that he is entitled to increased ratings for his neck, back, and right wrist disabilities.

Disability evaluations are determined by the application of a schedule of ratings which is based, as far as can practically be determined, on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Each service-connected disability is rated on the basis of specific criteria identified by a Diagnostic Code. 38 C.F.R. § 4.27. When rating the Veteran's service-connected disability, the entire medical history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Separate higher or lower compensable evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as "staged" ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999).

Regulations require that where there is a question as to which of two evaluations is to be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R
. App. 589 (1991). Separate higher or lower compensable evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as "staged" ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999).

The assignment of a particular diagnostic code is "completely dependent on the facts of a particular case." See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual's relevant medical history, the current diagnosis and demonstrated symptomatology. Any change in a diagnostic code by VA must be specifically explained. See Pernorio v. Derwinski, 2 Vet. App. 625 (1992).

In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. See Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. See Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. See Owens v. Brown, 7 Vet. App. 429, 433 (1995).

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. 38 U.S.C. § 5107(a). VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

Next, the Board notes that when evaluating joint disabilities rated on the basis of limitation of motion, VA must consider granting a higher rating in cases in which functional loss due to pain, weakness, excess fatigability, or incoordination is demonstrated, and those factors are not contemplated in the relevant rating criteria. See 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202 (1995). The Court has clarified that although pain may be a cause or manifestation of functional loss, limitation of motion due to pain is not necessarily rated at the same level as functional loss where motion is impeded. See Mitchell v. Shinseki, 25 Vet. App. 32 (2011); cf. Powell v. West, 13 Vet. App. 31, 34 (1999); Hicks v. Brown, 8 Vet. App. 417, 421 (1995); Schafrath v. Derwinski, 1 Vet. App. 589, 592 (1991).

Instead, the Mitchell Court explained that pursuant to 38 C.F.R. §§ 4.40 and 4.45, the possible manifestations of functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance, as well as less or more movement than is normal, weakened movement, excess fatigability, and pain on movement (as well as swelling, deformity, and atrophy) that effects stability, standing, and weight-bearing. See 38 C.F.R. §§ 4.40, 4.45. Thus, functional loss caused by pain must be rated at the same level as if the functional loss were caused by any of the other factors cited above. Thus, in evaluating the severity of a joint disability, VA must determine the overall functional impairment due to these factors.

The provisions of 38 C.F.R. § 4.
functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance, as well as less or more movement than is normal, weakened movement, excess fatigability, and pain on movement (as well as swelling, deformity, and atrophy) that effects stability, standing, and weight-bearing. See 38 C.F.R. §§ 4.40, 4.45. Thus, functional loss caused by pain must be rated at the same level as if the functional loss were caused by any of the other factors cited above. Thus, in evaluating the severity of a joint disability, VA must determine the overall functional impairment due to these factors.

The provisions of 38 C.F.R. § 4.59, which relate to painful motion, are not limited to arthritis, and must be considered when raised by the claimant or when reasonably raised by the record. See Burton v. Shinseki, 25 Vet. App. 1 (2011).

Moreover, the Court in Southall-Norman v. McDonald, 28 Vet. App. 346, 352 (2016) held that the provisions of 38 C.F.R. § 4.59, which relate to painful motion, are not limited to the evaluation of musculoskeletal disabilities under Diagnostic Codes predicated on range of motion measurements.

In Correia v. McDonald, 28 Vet. App. 158 (2016) and Sharp v. Shulkin, 29 Vet. App. 26 (2017) the Court held, in substance, that when rating a joint the Board needs to consider its' range of motion taking into account the appellant's complaints of pain as well as with and without weight bearing and resistance in passive and active range of motion as well as during flare-ups.

In Chavis v. McDonough, 34 Vet. App. 1 (2021) the Court held that ankylosis of the spine may be shown based on symptoms of fixation of the joint equivalent to ankylosis.

Furthermore, in Jones v. Shinseki, 26 Vet. App. 56, 61-63 (2012) the Court held that the Board may not deny entitlement to an increased rating on the basis of relief provided by medication when those effects are specifically contemplated by the rating criteria.

Subsequently, the Court in Ingram v. Collins, No. 23-1798 (March 12, 2025) held that the holding of Jones applies when evaluating musculoskeletal disabilities if the relevant Diagnostic Code does not reference medication use. The Court held that to comply with Jones, when evaluating musculoskeletal disabilities where the relevant Diagnostic Code does not reference medication use, the Board must discount beneficial medication effects and evaluate the baseline severity of each disability.

Correia, Sharp, and Ingram Compliance

Iin adjudicating below whether the Veteran meets the criteria for a higher evaluation for his neck, back, and right wrist disabilities, the Board has not overlooked the Court's holdings in Sharp, supra, Correia, supra, and Ingram, supra.

However, the Board finds that the record is adequate to adjudicate these issues because the May 2025 VA examiners provided the range of motion of neck, back, and right wrist that considered his complaints of pain as well as with and without weight bearing and resistance in passive and active range of motion, and as to the back, during flare-ups, which range of motion studies allows the Board to rate the disabilities including when discounting the beneficial medication effects; which in this Veteran's case he reported as none. As to range of motion of the neck and right wrist during flare-ups, because the Veteran told the March 2025 VA examiner that he did not have them, the Board finds that it may adjudicate these claims without this range of motion finding. See Owens, supra.

Entitlement to an initial rating in excess of 10 percent for a neck disability and in excess of 20 percent for a back disability.

The Veteran's neck disability is rated at 10 percent disabling and his back disability is rated as 20 percent disabling both under 38 C.F.R. § 4.71a, Diagnostic Code 5242.

The Old and New Rating Codes

Initially, the Board notes that VA amended some of its criteria for rating musculoskeletal disabilities effective February 7, 2021. See 85 Fed Reg 76453 (November 30, 2020); 85 Fed Reg 85523 (December 29, 2020); 86 Fed Reg 8142 (February 4, 2021). However, the new regulation does not provide for retroactive application. 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020) (to be
20 percent disabling both under 38 C.F.R. § 4.71a, Diagnostic Code 5242.

The Old and New Rating Codes

Initially, the Board notes that VA amended some of its criteria for rating musculoskeletal disabilities effective February 7, 2021. See 85 Fed Reg 76453 (November 30, 2020); 85 Fed Reg 85523 (December 29, 2020); 86 Fed Reg 8142 (February 4, 2021). However, the new regulation does not provide for retroactive application. 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020) (to be codified at 38 C.F.R. §?4.71a). Therefore, the Board finds that they are not applicable to the pre-February 7, 2021, time-period. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003).

As to rating the neck and back, the only amendment effective February 7, 2021, under 38 C.F.R. § 4.71a, Diagnostic Codes 5243 was a notation to Diagnostic Code 5243 stating that it should be assigned only when there is disc herniation with compression and/or irritation of the adjacent nerve root.

In this regard, the General Rating Formula for Disease and Injuries of the Spine provides that with or without such symptoms as pain (whether or not it radiates), stiffness, or aching in the area of the spine effected by residuals of injury or disease, provides a 10 percent rating if forward flexion of the thoracolumbar spine is greater than 60 degrees but not greater than 85 degrees, if forward flexion of the cervical spine is greater than 30 degrees but not greater than 40 degrees, the combined range of motion of the thoracolumbar spine is greater than 120 degrees but not greater than 235 degrees, the combined range of motion of the cervical spine is greater than 170 degrees but not greater than 335 degrees, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour, or a vertebral body fracture with loss of 50 percent or more of the height; a 20 percent rating if forward flexion of the thoracolumbar spine is greater than 30 degrees but not greater than 60 degrees, if forward flexion of the cervical spine is greater than 15 degrees but not greater than 30 degrees, if the combined range of motion of the thoracolumbar spine is not greater than 120 degrees, if the combined range of motion of the cervical spine is not greater than 170 degrees, or guarding severe enough to result in an abnormal gait, or abnormal spinal contour such as scoliosis, reversed lordosis or abnormal kyphosis; a 30 percent rating if forward flexion of the cervical spine is 15 degrees or less or there is favorable ankylosis of the entire cervical spine; a 40 percent rating if there is unfavorable ankylosis of the entire cervical spine, forward flexion of the thoracolumbar spine being 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine; a 50 percent rating if there is unfavorable ankylosis of the entire thoracolumbar spine; and 100 percent rating if there is unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, Diagnostic Code 5235-5242. Note(1) also articulates that neurologic abnormalities, including, but not limited to, bowel or bladder impairment, should be evaluated separately, under an appropriate diagnostic code. Id.

Normal neck motion is flexion to 45 degrees, extension to 45 degrees, right and left rotation to 80 degrees. 38 C.F.R. § 4.71a, Plate V.

Normal back motion is flexion to 90 degrees, extension to 30 degrees, right and left lateral flexion to 30 degrees, and right and left rotation to 30 degrees. 38 C.F.R. § 4.71a, Plate V.

Moreover, the Formula for Rating Intervertebral Disc Syndrome provides a 10 percent rating if the adverse symptomatology includes incapacitating episodes having a total duration of at least 1 week during the past 12 months, a 20 percent rating if the adverse symptomatology includes incapacitating episodes having a total duration of at least 2 weeks during the past 12 months, a 40 percent rating if the adverse symptomatology includes incapacitating episodes having a total duration of at least 4 weeks during the past 12 months,
extension to 30 degrees, right and left lateral flexion to 30 degrees, and right and left rotation to 30 degrees. 38 C.F.R. § 4.71a, Plate V.

Moreover, the Formula for Rating Intervertebral Disc Syndrome provides a 10 percent rating if the adverse symptomatology includes incapacitating episodes having a total duration of at least 1 week during the past 12 months, a 20 percent rating if the adverse symptomatology includes incapacitating episodes having a total duration of at least 2 weeks during the past 12 months, a 40 percent rating if the adverse symptomatology includes incapacitating episodes having a total duration of at least 4 weeks during the past 12 months, and a 60 percent rating if the adverse symptomatology includes incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. 38 C.F.R. § 4.71a. Diagnostic Code 5243 defines an incapacitating episode as one where the Veteran has physician prescribed bed rest.

The merits of the neck disability claim.

Initially, under the General Rating Formula for Disease and Injuries of the Spine the Board finds that even when considering the Veteran's complaints of pain as per 38 C.F.R. §§ 4.40, 4.45, 4.59 and the Court's holding in Correia, Sharp, Mitchell, Burton, Southall-Norman, DeLuca, Jones, and Chavis as well as when considering his competent reports of observable adverse symptomatology (see Davidson, supra) and when discounting the beneficial medication effects' when evaluating the baseline severity of the disability as per Ingram, the neck disability does not meet the criteria for at least the next higher, 20 percent, rating at any time during the appeal. See Owens, supra; Fenderson, supra; Hart, supra.

The Board has reached this conclusion because the most probative evidence of record in the form of the Veteran's VA examinations shows that forward flexion of the cervical spine was always greater than 30 degrees or the combined range of motion of the cervical spine was always greater than 170 degrees because, at its worst, flexion was 35 degrees and the combined range of motion was 185 degrees (see July 2017 VA examination-flexion to 45 degrees and combined range of motion of 340 degrees; September 2023 VA examination-flexion to 35 degrees and combined range of motion of 185 degrees; and May 2025 VA examination-flexion to 40 degrees and combined range of motion of 270 degrees). See 38 C.F.R. § 4.71a; Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions).

The Board also notes that the treatment records do not document lost neck motion being materially worse than what was reported by the above VA examiners because they do not show that forward flexion of the cervical spine was less than 30 degrees or the combined range of motion of the cervical spine was less than 170 degrees even when discounting beneficial medication effects. Id. The Board also finds that while the Veteran has not provided VA with competing range of motion studies. See Davidson, supra. Moreover, even if the Veteran provided his own range of motion findings, which he did not, the Board finds the VA examiners' opinions as to the degree of lost flexion and the combined range of motion more probative because the examiners have greater medical training. See Black v. Brown, 10 Vet. App. 297, 284 (1997) (in evaluating the probative value of medical statements, the Board looks at factors such as the individual knowledge and skill in analyzing the medical data).

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected neck disability under the General Rating Formula for Disease and Injuries of the Spine due to limitation of motion even when discounting the beneficial medication effects when evaluating the baseline severity of the disability at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Similarly, the Board finds that even when considering the Veteran's complaints of pain as per 38 C.F.R. §§ 4.40, 4.45, 4.59 and the Court's holding in Correia, Sharp, Mitchell, Burton, Southall-Norman, DeLuca, Jones, and Chavis as well as when considering his competent reports of observable adverse symptomatology (see Davidson, supra) and when discounting the beneficial medication effects when evaluating the baseline severity of the
even when discounting the beneficial medication effects when evaluating the baseline severity of the disability at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Similarly, the Board finds that even when considering the Veteran's complaints of pain as per 38 C.F.R. §§ 4.40, 4.45, 4.59 and the Court's holding in Correia, Sharp, Mitchell, Burton, Southall-Norman, DeLuca, Jones, and Chavis as well as when considering his competent reports of observable adverse symptomatology (see Davidson, supra) and when discounting the beneficial medication effects when evaluating the baseline severity of the disability as per Ingram, he does not meet the criteria for a higher rating under the General Rating Formula for Disease and Injuries of the Spine due to ankylosis or adverse symptomatology that equates to ankylosis at any time during the appeal.

The Board has reached this conclusion because the record, including the July 2017, September 2023, and May 2025 VA examinations, is uniform in documenting at least some neck motion and ankylosis is defined as immobility and consolidation of a joint due to disease, injury, or surgical procedure as well as lost motion that does not equate to ankylosis. See Lewis v. Derwinski, 3 Vet. App. 259 (1992).

In fact, the VA examiners specifically opined that the neck was not ankylosed and the Board finds that these medical opinions are not contradicted by any other medical evidence of record. See Colvin, supra. Moreover, the Board finds as the VA examiners must have found that the Veteran's neck range of motion (i.e., July 2017-forward flexion to 45 degrees, extension to 45 degrees, right and left lateral flexion to 35 degrees, right and left lateral rotation to 80 degrees; September 2023- forward flexion to 35 degrees, extension to 30 degrees, right and left lateral flexion to 25 degrees, right and left lateral rotation to 35 degrees; and May 2025- forward flexion to 40 degrees, extension to 40 degrees, right lateral flexion to 30 degrees, left lateral flexion to 25 degrees, right and left lateral rotation to 65 degrees), even at its worst, does not equate to ankylosis. See Owens, supra.

The Board also notes that the treatment records do not document adverse neck symptomatology being materially worse than what was reported by the above VA examiners because they do not show ankylosis or lost motion that equates to ankylosis even when discounting beneficial medication effects. Id. The Board also finds that the Veteran has not provided VA with a diagnosis of ankylosis and/or competing range of motion studies. See Davidson, supra. Moreover, even if the Veteran provided his own diagnosis of ankylosis or range of motion findings, which he did not, the Board finds the VA examiners' opinions as to the severity of his adverse symptomatology more probative because the examiners have greater musculoskeletal medical training. See Black, supra.

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected neck disability under the General Rating Formula for Disease and Injuries of the Spine due to ankylosis or adverse symptomatology that equates to ankylosis even when discounting the beneficial medication effects when evaluating the baseline severity of the disability at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Next, under the General Rating Formula for Disease and Injuries of the Spine, the Board finds that the most probative evidence of record shows that the Veteran's neck disability was not manifested by guarding severe enough to result in an abnormal gait, or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. See Owens, supra.

The Board has reached this conclusion because the record, including the July 2017, September 2023, and May 2025 VA examinations, is uniform in being negative for guarding severe enough to result in an abnormal gait, or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. See Colvin, supra.

In fact, the July 2017, September 2023, and May 2025 VA examiners specifically opined that the neck did not have a problem with guarding severe enough to result in an abnormal gait, or abnormal spinal contour such as scoliosis, and/or reversed lordosis and
, or abnormal kyphosis. See Owens, supra.

The Board also notes that the treatment records do not document adverse neck symptomatology being materially worse than what was reported by the above VA examiners because they do not show guarding severe enough to result in an abnormal gait, or abnormal spinal contour such as scoliosis, reversed lordosis and/or abnormal kyphosis even when discounting beneficial medication effects. Id. The Board also finds that the Veteran has not provided VA with these diagnoses and, even if he did, these are not competent diagnoses because these are complicated medical opinions. See Davidson, supra. Likewise, even if the Veteran provided his own diagnoses, the Board finds the VA examiners' opinions as to the severity of his adverse symptomatology more probative because the examiners have greater musculoskeletal medical training. See Black, supra.

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected neck disability under the General Rating Formula for Disease and Injuries of the Spine due to guarding severe enough to result in an abnormal gait, or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis even when discounting the beneficial medication effects when evaluating the baseline severity of the disability at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Similarly, the Board finds that the Veteran does not meet the criteria for a rating in excess of 10 percent for his neck disability under the Formula Rating for Intervertebral Disc Syndrome at any time during the appeal period. See Owens, supra.

The Board has reached this conclusion because the record, including the July 2017, September 2023, and May 2025 VA examinations, are negative for the Veteran having a diagnosis of intervertebral disc syndrome with at least 2 weeks of incapacitating episodes during any 12-month period during the pendency of the appeal and, in the absence of the above, the rating criteria does not allow the Board to grant an increased rating his disability under 38 C.F.R. § 4.71a, Diagnostic Code 5243, See Colvin, supra.

In fact, while the July 2017 VA examiner reported that the Veteran had intervertebral disc syndrome, the subsequent May 2025 VA examiner reported that the earlier diagnosis was an error and that examiner as well as the September 2023 examiner opined that he did not have intervertebral disc syndrome and the Board finds that these medical opinions are not contradicted by any other medical evidence of record. Id. Moreover, none of the VA examiners opined that the Veteran's neck disability caused at least 2 weeks of bedrest in any 12-months during the pendency of the appeal. Id.

The Board also finds that the Veteran has not provided VA with a diagnosis of intervertebral disc syndrome or an opinion as to the number of weeks he had of bed rest and, even if he did, these are not competent diagnoses because these are complicated medical opinions. See Davidson, supra. Moreover, even if the Veteran provided his own diagnosis, which he did not, the Board finds the VA examiners' opinions as to his diagnosis more probative because the examiners have greater musculoskeletal medical training. See Black, supra.

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected neck disability under the Formula for Rating Intervertebral Disc Syndrome at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Given the above, the Board also finds that the criteria for a rating in excess of 10 percent for the Veteran's neck disability is not met at any time during the appeal under 38 C.F.R. § 4.71a and an increased rating greater is not warranted.

Accordingly, entitlement to a rating in excess of 10 percent disabling
iners have greater musculoskeletal medical training. See Black, supra.

Accordingly, entitlement to a rating in excess of 10 percent disabling for a neck disability is denied.

The merits of the back disability claim.

Initially, under the General Rating Formula for Disease and Injuries of the Spine the Board finds that even when considering the Veteran's complaints of pain as per 38 C.F.R. §§ 4.40, 4.45, 4.59 and the Court's holding in Correia, Sharp, Mitchell, Burton, Southall-Norman, DeLuca, Jones, and Chavis as well as when considering his competent reports of observable adverse symptomatology (see Davidson, supra) and when discounting the beneficial medication effects when evaluating the baseline severity of the disability as per Ingram, the back disability does not meet the criteria for at least the next higher, 40 percent, rating at any time during the appeal. See Owens, supra; Fenderson, supra; Hart, supra.

The Board has reached this conclusion because the most probative evidence of record in the form of the Veteran's VA examinations shows that forward flexion of the thoracolumbar spine was never 30 degrees or less because, at its worst, it was 60 degrees at the September 2023 VA examination. See 38 C.F.R. § 4.71a; Colvin, supra.

The Board also notes that the treatment records do not document lost back motion being materially worse than what was reported by the above VA examiners because they do not show that forward flexion of the thoracolumbar spine was 30 degrees or less even when discounting beneficial medication effects. Id. The Board also finds that while the Veteran has not provided VA with competing range of motion studies and, even if he did, these are not competent because this is a complicated medical finding. See Davidson, supra. Moreover, even if the Veteran provided his own range of motion findings, which he did not, the Board finds the VA examiners' opinions as to the degree of lost flexion more probative because the examiners have greater medical training. See Black, supra.

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected back disability under the General Rating Formula for Disease and Injuries of the Spine due to limitation of motion even when discounting the beneficial medication effects when evaluating the baseline severity of the disability at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Similarly, the Board finds that even when considering the Veteran's complaints of pain as per 38 C.F.R. §§ 4.40, 4.45, 4.59 and the Court's holding in Correia, Sharp, Mitchell, Burton, Southall-Norman, DeLuca, Jones, and Chavis as well as when considering his competent reports of observable adverse symptomatology (see Davidson, supra) and when discounting the beneficial medication effects when evaluating the baseline severity of the disability as per Ingram, he does not meet the criteria for at least the next higher, 40 percent, rating under the General Rating Formula for Disease and Injuries of the Spine due to ankylosis or adverse symptomatology that equates to ankylosis at any time during the appeal.

The Board has reached this conclusion because the record, including the July 2017, September 2023 VA examinations and the post-remand May 2025 VA examination, is uniform in documenting at least some back motion and ankylosis is defined as immobility and consolidation of a joint due to disease, injury, or surgical procedure as well as lost motion that does not equate to ankylosis. See Lewis v. Derwinski, 3 Vet. App. 259 (1992).

In fact, the VA examiners specifically opined that the back was not ankylosed and the Board finds that these medical opinions are not contradicted by any other medical evidence of record. See Colvin, supra. Moreover, the Board finds as the VA examiners must have found that the Veteran's back range of motion (i.e., July 2017-forward flexion to 70 degrees, extension to 25 degrees, right lateral flexion to 30 degrees, left lateral flexion to 30 degrees, and right and left lateral rotation to 30 degrees; September 2023-forward flexion to 70 degrees, extension to 30 degrees, right lateral flexion to 30 degrees, left lateral flexion to 25 degrees, right lateral rotation to 25, and left lateral rotation to 20 degrees; and May 2025-forward flexion to 90 degrees, extension to 30 degrees, right and left lateral flexion to 25 degrees, right lateral rotation to 20 degrees, and left lateral rotation to 25 degrees), even at its worst, does not equate to ankylosis. See Owens, supra.

The Board also notes that the treatment records do not document adverse back symptomatology being materially worse than what was reported by the above VA examiners because they do not show ankylosis or lost motion that equates to ankylosis even when discounting beneficial medication effects. Id. The Board also finds that the Veteran has not provided VA with a diagnosis of ankylosis and/or competing range of motion studies and, even if he did, these are not competent findings because these are complicated medical opinions. See Davidson, supra. Moreover, even if the Veteran provided his own diagnosis of ankylosis or range of motion findings, which he did not, the Board finds the VA examiners' opinions as to the severity of his adverse symptomatology more probative because the examiners have greater musculoskeletal medical training. See Black, supra.

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected back disability under the General Rating Formula for Disease and Injuries of the Spine due to ankylosis or adverse symptomatology that equates to ankylosis even when discounting the beneficial medication effects when evaluating the baseline severity of the disability at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Similarly, the Board finds that the Veteran does not meet the criteria for a rating in excess of 20 percent for his back disability under the Formula Rating for Intervertebral Disc Syndrome at any time during the appeal period. See Owens, supra.

The Board has reached this conclusion because the record, including the July 2017, September 2023, and May 2025 VA examinations, are negative for the Veteran having a diagnosis of intervertebral disc syndrome with at least 4 weeks of incapacitating episodes during any 12-month period during the pendency of the appeal and, in the absence of such, the rating criteria does not allow the Board to rate his disability under 38 C.F.R. § 4.71a, Diagnostic Code 5243, See Colvin, supra.

In fact, while the July 2017 VA examiner reported that the Veteran had intervertebral disc syndrome, the subsequent May 2025 VA examiner reported that the earlier diagnosis was an error and that examiner as well as the September 2023 examiner opined that he did not have intervertebral disc syndrome and the Board finds that these medical opinions are not contradicted by any other medical evidence of record. Id. Moreover, none of the VA examiners opined that the Veteran's neck disability caused at least 4 weeks of bedrest in any 12-months during the pendency of the appeal. Id.

The Board also finds that the Veteran has not provided VA with a diagnosis of intervertebral disc syndrome with at least 4 weeks of bedrest in any 12-months during the pendency of the appeal. See Davidson, supra. Moreover, even if the Veteran provided his own diagnosis, which he did not, this is not a competent finding because this is a complicated medical opinion. See Davidson, supra. Moreover, the Board finds the VA examiners' opinions as to his diagnosis with week of bedrest more
Moreover, none of the VA examiners opined that the Veteran's neck disability caused at least 4 weeks of bedrest in any 12-months during the pendency of the appeal. Id.

The Board also finds that the Veteran has not provided VA with a diagnosis of intervertebral disc syndrome with at least 4 weeks of bedrest in any 12-months during the pendency of the appeal. See Davidson, supra. Moreover, even if the Veteran provided his own diagnosis, which he did not, this is not a competent finding because this is a complicated medical opinion. See Davidson, supra. Moreover, the Board finds the VA examiners' opinions as to his diagnosis with week of bedrest more probative because the examiners have greater musculoskeletal medical training. See Black, supra.

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected back disability under the Formula for Rating Intervertebral Disc Syndrome at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

Given the above, the Board also finds that the criteria for a rating in excess of 20 percent for the Veteran's back disability is not met at any time during the appeal under 38 C.F.R. § 4.71a and an increased rating is not warranted.

Accordingly, entitlement to a rating in excess of 20 percent disabling for a back disability is denied.

The right wrist disability claim.

The Veteran's right wrist disability is rated as 10 percent disabling under Diagnostic Codes 5024 (tendonitis)-5215 (wrist limitation of motion).

This is a hyphenated Diagnostic Code. When assigning Codes for service-connected disabilities, VA must give "preference . . . to the number assigned to the disease itself." 38 C.F.R. § 4.27. If that Code evaluates the disease based on residual conditions, VA adds a hyphen to the Code, followed by the Code associated with the residual. Id. Restated, with hyphenated Codes, the service-connected disability is the number before the hyphen, while the number following the hyphen represents the criteria applied. Id.

At all times during the pendency of the appeal, Diagnostic Code 5215 provides a maximum 10 percent rating for lost wrist motion in the major and minor extremity. 38 C.F.R. § 4.71a.

The 10 percent rating is the maximum rating possible under Diagnostic Code 5215 for limitation of motion of the right wrist. Therefore, the Board finds that the claim for an increased rating for the right wrist is denied at all times during the appeal under Diagnostic Code 5215. See 38 C.F.R. § 4.71a.

As to an increased rating for the right wrist disorder under another Diagnostic Code to rate the wrist, the Board notes that the Veteran would only be entitled to a higher rating if his disability is manifested by ankylosis. See 38 C.F.R. § 4.71a, Diagnostic Code 5214; Butts v. Brown, 5 Vet. App. 532, 539 (1993) (holding that the Board's choice of diagnostic code should be upheld so long as it is supported by explanation and evidence).

In this regard, the Veteran's dominant hand is his right hand. See VA examinations dated in July 2017, September 2023, and May 2025.

Moreover, Diagnostic Code 5214 provides, for the dominant/major wrist, a 30 percent rating warranted for favorable ankylosis in 20 to 30 degrees dorsiflexion. A 40 percent rating is warranted for ankylosis in any other position, except favorable. A maximum 50 percent rating is assigned for unfavorable ankylosis, in any degree of palmar flexion, or with ulnar or radial deviation. Extremely unfavorable ankylosis will be rated as loss of use of hands under Diagnostic Code 5125. 38 C.F.R. § 4.71a.

However, the Board finds that even when considering the Veteran's complaints of pain as per 38 C.F.R. §§ 4.40, 4.45, 4.59 and the Court's holding in Correia, Sharp, Mitchell, Burton, Southall-Norman, DeLuca, Jones, and Chavis as well as when considering his competent reports of observable adverse symptomatology (see Davidson, supra) and when discounting the beneficial medication effects when evaluating the baseline severity of the disability as per Ingram, he does not meet the criteria for an increased rating due to ankylosis or adverse symptomatology that equ
under Diagnostic Code 5125. 38 C.F.R. § 4.71a.

The Board has reached this conclusion because the record, including the July 2017, September 2023, and May 2025 VA examinations, is uniform in documenting at least some right wrist and ankylosis is defined as immobility and consolidation of a joint due to disease, injury, or surgical procedure as well as lost motion that does not equate to ankylosis. See Lewis, supra.

In fact, the September 2023 and May 2025 VA examiners specifically opined that the right wrist was not ankylosed and the Board finds that these medical opinions are not contradicted by any other medical evidence of record. See Colvin, supra. Moreover, the Board finds as the VA examiners must have found that the Veteran's right wrist range of motion (i.e., July 2017-palmar flexion to 80 degrees, dorsiflexion to 70 degrees, ulnar deviation to 45 degrees, and radial deviation to 20 degrees; September 2023-palmar flexion to 20 degrees, dorsiflexion to 15 degrees, ulnar deviation to 20 degrees, and radial deviation to 15 degrees; and May 2025-palmar flexion to 70 degrees, dorsiflexion to 60 degrees, ulnar deviation to 45 degrees, and radial deviation to 20 degrees), even at its worst, does not equate to ankylosis. See Owens, supra.

The Board also notes that the treatment records do not document adverse right wrist symptomatology being materially worse than what was reported by the above VA examiners because they do not show ankylosis or lost motion that equates to ankylosis even when discounting beneficial medication effects. Id. The Board also finds that the Veteran has not provided VA with a diagnosis of ankylosis and/or competing range of motion studies and, even if he did, these are not competent findings because these are complicated medical opinions. See Davidson, supra. Moreover, even if the Veteran provided his own diagnosis of ankylosis or range of motion findings, which he did not, the Board finds the VA examiners' opinions as to the severity of his adverse symptomatology more probative because the examiners have greater musculoskeletal medical training. See Black, supra.

Consequently, the Board finds that a higher evaluation is not warranted for the Veteran's service-connected right wrist disability under Diagnostic Code 5214 due to ankylosis or adverse symptomatology that equates to ankylosis even when discounting the beneficial medication effects when evaluating the baseline severity of the disability at all times during the appeal. See 38 C.F.R. § 4.71a; Fenderson, supra; Hart, supra.

III. Conclusion

In reaching the above conclusions, the Board considered the doctrine of reasonable doubt. See 38 U.S.C. § 5107(b). However, as the most probative evidence of record is against the claims to the extent outlined above (i.e., the evidence for and again the claims is not approximately in balance), the Board finds that the doctrine is not for application. See also, e.g., Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001); Lynch, supra.

NEIL T. WERNER

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Raborn, S.

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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