PARALYSIS OF THE SCIATIC NERVE

ERIC S. LEBOFF · 2026 · Case ID: 26001703

MIXED

Summary

The veteran, who served, appeals the Board of Veterans' Appeals' (BVA) decision regarding disability ratings for several conditions, primarily related to left lower extremity radiculopathy secondary to a service-connected lumbar spine disability, as well as bilateral hearing loss, urinary incontinence, fecal incontinence, erectile dysfunction, and eligibility for automobile adaptive equipment. The BVA granted a 60 percent rating for left lower extremity sciatic nerve radiculopathy, a 30 percent rating for left anterior crural (femoral) nerve radiculopathy, and a 30 percent rating for left external popliteal nerve radiculopathy, all associated with the lumbar spine condition. The Board denied higher ratings or separate ratings for other nerve manifestations of the lumbar spine disability and right lower extremity radiculopathy. The BVA granted a 20 percent rating for urinary incontinence and erectile dysfunction, along with special monthly compensation for loss of use of a creative organ, all associated with the lumbar spine disability. For bilateral hearing loss, the Board granted a 90 percent rating for the period of May 2011 to November 2016, but denied compensable ratings thereafter. The claim for automobile adaptive equipment was denied as the veteran's service-connected disabilities did not meet the criteria for loss of use of extremities or other qualifying conditions. The decision involved extensive review of audiological and neurological examinations to determine appropriate ratings and periods of entitlement.

Rationale

Evidence in approximate balance for severe incomplete paralysis; Weight of evidence against complete paralysis; Criteria for 60% rating met

Special Benefit

AUTO / ADAPTIVE EQUIPMENT; SMC

Docket No.

11-05 570A

Full Decision Text

Citation Nr: 26001703
Decision Date: 02/06/26 Archive Date: 02/06/26

DOCKET NO. 11-05 570A
DATE: February 6, 2026

ORDER

Entitlement to a 60 percent disability rating, but no higher, for left lower extremity radiculopathy, sciatic nerve associated with service connected lumbar spine disability for the period from October 2, 2018, to April 22, 2025, is granted.

Entitlement to a disability rating in excess of 60 for left lower extremity radiculopathy, sciatic nerve, associated with service connected lumbar spine disability for the period from October 2, 2018, onward is denied.

Entitlement to a separate 30 percent disability rating, but no higher, for left lower extremity radiculopathy, anterior crural nerve (femoral) associated with service connected lumbar spine disability for the period from October 2, 2018, onward is granted.

Entitlement to a separate disability rating for left lower extremity radiculopathy, external popliteal nerve, associated with service connected lumbar spine disability prior to January 31, 2020, is denied.

Entitlement to 30 percent disability rating, but no higher, for left lower extremity radiculopathy, external popliteal nerve, associated with service connected lumbar spine disability for the period from January 31, 2020, is granted.

Entitlement to a compensable disability rating for left lower extremity radiculopathy, external cutaneous nerve associated with service connected lumbar spine disability for the period from October 2, 2018, onward is denied.

Entitlement to a compensable disability rating for left lower extremity radiculopathy, ilioinguinal nerve associated with service connected lumbar spine disability for the period from October 2, 2018, onward is denied.

Entitlement to a separate disability rating for right lower extremity radiculopathy, associated with service connected lumbar spine disability prior to April 23, 2025, is denied.

Entitlement to a disability rating in excess of 20 percent for right lower extremity radiculopathy, associated with service connected lumbar spine disability sciatic nerve, is denied.

Entitlement to a separate disability rating of 20 percent for urinary incontinence prior for the period prior to April 23, 2025, is granted.

Entitlement to a disability rating in excess of 20 percent for urinary incontinence for the entire period on appeal is denied.

Entitlement to a separate disability rating for fecal incontinence with impairment of sphincter control prior to April 23, 2025, is denied.

Entitlement to a separate disability rating for erectile dysfunction prior to April 23, 2025, is granted.

Entitlement to special monthly compensation for loss of use of a creative organ prior to April 23, 2025, is granted.

Entitlement to a disability rating of 90 percent, but no higher, for bilateral hearing loss for the period from May 24, 2011, to November 22, 2016, is granted.

Entitlement to a compensable disability rating for bilateral hearing loss for the period from November 23, 2016, to February 9, 2025, and in excess of 50 percent from February 10, 2025, onward, are denied.

Eligibility for assistance for providing automobile and/or adaptive equipment is denied.

FINDINGS OF FACT

1. The evidence is in at least approximate balance as to whether the Veteran has experienced severe incomplete paralysis of the left femoral and sciatic nerves from October 2, 2018, onward (i.e., the entire period on appeal).

2. The evidence is in at least approximate balance as to whether the Veteran has experienced severe incomplete paralysis of the external popliteal nerve for the period from January 31, 2020, onward.

3. The weight of the evidence is persuasively against a finding that the Veteran has experienced complete paralysis of the left femoral nerve at any point during the period on appeal.

4. The weight of the evidence is persuasively against a finding that the Veteran has experienced complete paralysis of the left sciatic nerve at any point during the period on appeal.

5. The weight of the evidence is persuasively against a finding that the Veteran has experienced complete paralysis of the left external popliteal nerve at any point during the period on appeal.

6. The weight of the evidence is persuasively against a finding that the Veteran has experienced mild incomplete paralysis of the left external popliteal nerve prior to January 31, 2020.

7. The
the evidence is persuasively against a finding that the Veteran has experienced complete paralysis of the left femoral nerve at any point during the period on appeal.

4. The weight of the evidence is persuasively against a finding that the Veteran has experienced complete paralysis of the left sciatic nerve at any point during the period on appeal.

5. The weight of the evidence is persuasively against a finding that the Veteran has experienced complete paralysis of the left external popliteal nerve at any point during the period on appeal.

6. The weight of the evidence is persuasively against a finding that the Veteran has experienced mild incomplete paralysis of the left external popliteal nerve prior to January 31, 2020.

7. The weight of the evidence is persuasively against a finding that the Veteran has experienced severe to complete paralysis of the left external cutaneous nerve at any point during the period on appeal.

8. The weight of the evidence is persuasively against a finding that the Veteran has experienced severe to complete paralysis of the left ilioinguinal nerve at any point during the period on appeal.

9. The weight of the evidence is persuasively against a finding that the Veteran experienced right extremity radiculopathy attributable to his service connected lumbar spine disability prior to April 23, 2025.

10. The weight of the evidence is persuasively against a finding that the Veteran's right lower extremity radiculopathy has manifested as moderately severe incomplete paralysis; severe incomplete paralysis with marked muscular atrophy; or complete paralysis of the sciatic nerve at any point during the period on appeal.

11. The weight of the evidence is in at least approximate balance as to whether the Veteran has experienced urinary incontinence requiring the wear of absorbent materials changed less than 2 times per day prior to April 23, 2025.

12. The weight of the evidence is persuasively against the application of an evaluation in excess of 20 percent for the Veteran's urinary incontinence at any point during the period on appeal.

13. The evidence is in at least approximate balance as to whether the Veteran has experienced erectile dysfunction throughout the period on appeal.

14. The weight of the evidence is persuasively against the application of an evaluation in excess of 90 percent for the Veteran's bilateral hearing loss from May 24, 2011, to November 22, 2016; a 90 percent rating is supported by the record for this period.

15. The weight of the evidence is persuasively against the application of a compensable disability rating for bilateral hearing loss for the period from November 23, 2016, to February 9, 2025.

16. The weight of the evidence is persuasively against the application of an evaluation in excess of 50 percent from February 10, 2025, onward.

17. The weight of the evidence is persuasively against a finding that the Veteran has experienced functional impairment of his upper and/or lower extremities such that no effective functions remain other than that which would be equally well served by an amputation with prosthetic, or that there is "deprivation of [his] ability to avail [himself]" of any extremity at any point during the period on appeal.

CONCLUSIONS OF LAW

1. The criteria for entitlement to a disability rating of 60 percent for left lower extremity radiculopathy, sciatic nerve, but no higher, proximately due to service connected lumbar spine disability for the period from October 2, 2018, to April 22, 2025 are met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

2. The criteria for entitlement to a separate 30 percent disability rating, but no higher, for left lower extremity radiculopathy, anterior crural nerve (femoral) for the period from October 2, 2018, onward are met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

3. The criteria for entitlement to a separate disability rating of 30 percent, but no higher for left lower extremity radiculopathy, external popliteal nerve, for the period from January 31, 2020, onward are met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

4. The criteria for entitlement
.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

4. The criteria for entitlement to a separate disability rating for left lower extremity radiculopathy, external popliteal nerve, prior to January 31, 2020 are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

5. The criteria for entitlement to a compensable disability rating for left lower extremity radiculopathy, external cutaneous nerve for the period from October 2, 2018. Onward are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

6. The criteria for entitlement to a compensable disability rating for left lower extremity radiculopathy, ilioinguinal nerve for the period from October 2, 2018, onward, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

7. The criteria for entitlement to a separate disability rating for right lower extremity radiculopathy, associated with service connected lumbar spine disability prior to April 23, 2025, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a, 4.71a (2009), 4.124a, 4.124a (2009).

8. The criteria for entitlement to a disability rating in excess of 20 percent for right lower extremity radiculopathy, associated with service connected lumbar spine disability are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a, 4.71a (2009), 4.124a, 4.124a (2009).

9. The criteria for entitlement to a disability rating of 20 percent for urinary incontinence for the entire period on appeal prior to April 23, 2025, are met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.115a, 4.115a (2009).

10. The criteria for entitlement to a disability rating in excess of 20 percent for urinary incontinence for the entire period on appeal are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.115a, 4.115a (2009).

11. The criteria for entitlement to a separate disability rating for erectile dysfunction and special monthly compensation for loss of use of a creative organ for the entire period on appeal prior to April 23, 2025, are met. 38 U.S.C. §§ 1114, 1155, 5107(b); 38 C.F.R. §§ 3.350, 4.1, 4.7, 4.71a, 4.71a (2009).

12. The criteria for entitlement to a disability rating of 90 percent, but no higher, for bilateral hearing loss are met for the period from May 24, 2011, to November 22, 2016. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.85, 4.85 (2011), 4.86, 4.86 (2011).

5, 5107(b); 38 C.F.R. §§ 3.350, 4.1, 4.7, 4.71a, 4.71a (2009).

13. The criteria for entitlement to a compensable disability rating for bilateral hearing loss for the period from November 23, 2016, to February 9, 2025, and in excess of 50 percent from February 10, 2025, onward, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.85, 4.85 (2011), 4.86, 4.86 (2011).

14. The criteria for entitlement to assistance for providing automobile and/or adaptive equipment are not met. 38 U.S.C. § 3901 et. seq.

REASONS AND BASES FOR FINDING AND CONCLUSION

These matters originate from Department of Veterans Affairs (VA) Regional Office (RO) rating decisions issued in May 2010, March 2013, and August 2014. These rating decisions, in turn, arose from claims received in June 2009; May 2011; and March 2014, respectively.

In March 2024 the Board remanded the following claims: entitlement to a compensable rating for bilateral hearing loss; entitlement to an initial rating in excess of 40 percent for left lower extremity radiculopathy, secondary to a service connected lower back disability, from October 2, 2018 onward; entitlement to separate ratings for neurological manifestations of the Veteran's lower back disability, to include right lower extremity radiculopathy, bladder incontinence, and erectile dysfunction; and eligibility for automobile and/or adaptive equipment.

In May 2025 the RO granted the Veteran a disability rating of 50 percent for bilateral hearing loss, effective February 10, 2025; and entitlement to a separate disability rating of 20 percent for urinary incontinence, associated with the Veteran's lumbar spine disability, effective April 23, 2025. 05/23/2025, Rating Decision - Narrative.

In August 2025 the RO granted the Veteran a separate disability rating for fecal incontinence with impairment of sphincter control, associated with the lumbar spine disability, with a disability evaluation of 100 percent effective April 23, 2025; a separate disability rating for erectile dysfunction, effective April 23, 2025; special monthly compensation for loss of use of a creative organ, effective April 23, 2025; a disability rating of 20 percent for right lower extremity radiculopathy, sciatic nerve; and separate noncompensable disability ratings for left lower extremity radiculopathy of the external cutaneous and ilioinguinal nerves, both effective April 23, 2025. 08/14/2025, Rating Decision - Narrative; 08/29/2025, Rating Decision - Narrative.

In September 2025 the RO granted the Veteran an increase in disability rating to 60 percent for left lower extremity sciatic nerve radiculopathy, effective April 23, 2025. 09/19/2025, Rating Decision - Narrative.

As noted above, the claims on appeal were received in May 2010, March 2013, and August 2014. As the highest possible rating has not been assigned for the periods on appeal, the appeals continue. See AB v. Brown, 6 Vet. App. 35 (1993). The Board also remanded a claim of entitlement to service connection for bilateral carpal tunnel syndrome; that claim has been granted in full and is thus no longer on appeal before the Board.

Additionally, the Board notes that while the RO characterized its dispositions as to the Veteran's lower extremity radiculopathy as grants of service connection, these issues are properly understood as increased rating claims. The General Rating Formula for Diseases and Injuries of the Spine provides for separate evaluation of any associated neurologic abnormalities, including, but not limited, to, bowel or bladder impairment, under an appropriate diagnostic code. 38 C.F.R. § 4
. See AB v. Brown, 6 Vet. App. 35 (1993). The Board also remanded a claim of entitlement to service connection for bilateral carpal tunnel syndrome; that claim has been granted in full and is thus no longer on appeal before the Board.

A remand by the Board confers on the Veteran, as a matter of law, the right to substantial compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). In March 2024 the Board directed that the RO obtain outstanding VA treatment records and schedule the Veteran for VA examinations related to the above identified disabilities. Updated VA treatment records have been associated with the claims file. The Veteran was afforded a series of VA examinations. Accordingly, the Board finds that there has been substantial compliance with the prior remand directives and adjudication of the Veteran's claims on the merits is appropriate.

Disability ratings are determined by applying the criteria set forth in the VA Schedule of Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Disabilities must be reviewed in relation to their history. 38 C.F.R. § 4.1. Other applicable general policy considerations are: interpreting reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating many accurately reflect the elements of disability; resolving any reasonable doubt regarding the degree of disability in favor of the claimant; where there is a questions as to which of two evaluations apply, assigning a higher of the two where the disability pictures more nearly approximates the criteria for the next higher rating; and, evaluating functional impairment on the basis of lack of usefulness, and the effects of the disability upon the person's ordinary activity. See 38 C.F.R. §§ 4.2, 4.3, 4.7, 4.10; see also Schafrath v. Derwinski, 1 Vet. App. 589 (1991).

In adjudicating claims for VA benefits, the burden of proof only requires an "approximate balance" of the evidence for and against a claim. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1991). This low standard of proof is "unique" to the VA adjudicatory process, and "the nation, 'in recognition of our debt to our veterans,' has 'taken upon itself the risk of error' in awarding such benefits." Wise v. Shinseki, 26 Vet. App. 517, 531 (2014). In evaluating a claim for disability benefits, when 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. 38 U.S.C. § 5107.

1. Entitlement to a 60 percent disability rating, but no higher, for left lower extremity radiculopathy, sciatic nerve associated with service connected lumbar spine disability for the period from October 2, 2018, to April 22, 2025, is granted.

2. Entitlement to a disability rating in excess of 60 percent for left lower extremity radiculopathy, sciatic nerve, associated with service connected lumbar spine disability for the period from October 2, 2018, onward is denied.

3. Entitlement to a separate 30 percent disability rating, but no higher, for left lower extremity radiculopathy, anterior crural nerve (femoral) associated with service connected lumbar spine disability for the period from October 2, 2018, onward is granted.

4. Entitlement to a separate disability rating for left lower extremity radiculopathy, external popliteal nerve, associated with service connected lumbar spine disability prior to January 31, 2020, is denied.

5. Entitlement to 30 percent disability rating,
opathy, sciatic nerve, associated with service connected lumbar spine disability for the period from October 2, 2018, onward is denied.

5. Entitlement to 30 percent disability rating, but no higher, for left lower extremity radiculopathy, external popliteal nerve, associated with service connected lumbar spine disability for the period from January 31, 2020, is granted.

6. Entitlement to a compensable disability rating for left lower extremity radiculopathy, external cutaneous nerve associated with service connected lumbar spine disability for the period from October 2, 2018, onward is denied.

7. Entitlement to a compensable disability rating for left lower extremity radiculopathy, ilioinguinal nerve associated with service connected lumbar spine disability for the period from October 2, 2018, onward is denied.

At the time of the last Board remand, a single disability rating was in place for left lower extremity radiculopathy. As the RO has since assigned additional ratings for left lower extremity radiculopathy, the ratings have been separately characterized as attaching to the sciatic, external cutaneous, and ilioinguinal nerves. As discussed further below, the Board is granting additional ratings for the left anterior crural nerve (femoral) and externa popliteal nerves.

In a May 2023 decision, the Board decided the issue of an appropriate rating, or ratings, for the Veteran's lower extremity radiculopathy prior to October 2, 2018, while remanding the issue of entitlement to a disability rating in excess of 40 percent for left lower extremity radiculopathy from October 2, 2018 onward. All Board decisions are final on the date stamped on the face of the decision. 38 C.F.R. § 20.1100. The issue of an appropriate rating from October 2, 2018, onward returned to the Board and was remanded again in March 2024. Accordingly, the period on appeal presently before the Board with respect to the Veteran's left lower extremity radiculopathy (regardless of specific nerve involvement) begins October 2, 2018.

Under the rating criteria in effect at the time of the Veteran's 2009 claim, and presently, a 40 percent disability rating is warranted for paralysis of the sciatic nerve where there is moderately severe incomplete paralysis. The next higher rating of 60 percent is warranted where there is severe incomplete paralysis, with marked muscular atrophy. The highest schedular rating of 80 percent is warranted where there is complete paralysis of the sciatic nerve such that the foot dangles and drops, no active movement of muscles below the knee is possible, and flexion of the knee is weakened or lost. 38 C.F.R. § 4.124a; 38 C.F.R. § 4.124a (2009).

With respect to the external popliteal nerve, a 10 percent rating is warranted where there is mild incomplete paralysis; a 20 percent rating is warranted where there is moderate incomplete paralysis; and a 30 percent rating is warranted where there is severe incomplete paralysis. The highest schedular rating of 40 percent is warranted where there is complete paralysis such that there is foot drop and slight droop of first phalanges of all toes, no dorsiflexion of the foot, no extension (dorsal flexion) of proximal phalanges of toes, lost abduction of the foot, weakened adduction, and where anesthesia covers the entire dorsum of the foot and toes. 38 C.F.R. § 4.124a; 38 C.F.R. § 4.124a (2009).

With respect to the femoral nerve, a 10 percent rating is warranted where there is mild incomplete paralysis; a 20 percent rating is warranted where there is moderate incomplete paralysis; and a 30 percent rating is warranted where there is severe incomplete paralysis. The highest schedular rating of 40 percent is warranted where there is complete paralysis of the quadriceps extensor muscles. 38 C.F.R. § 4.124a; 38 C.F.R. § 4.124a (2009).

At present, noncomp
anesthesia covers the entire dorsum of the foot and toes. 38 C.F.R. § 4.124a; 38 C.F.R. § 4.124a (2009).

At present, noncompensable ratings are assigned for mild or moderate paralysis of the external cutaneous and/or ilioinguinal nerves; a compensable rating of 10 percent is warranted where there is severe to complete paralysis of the external cutaneous and/or ilioinguinal nerves. 38 C.F.R. § 4.124a; 38 C.F.R. § 4.124a (2009).

Turning to the evidence, in October 2018 a VA examiner documented the Veteran's report of increased pain and numbness down his left leg. On examination the Veteran demonstrated muscle strength of 2 out of 5 ("active movement against gravity eliminated") across all dimensions; symmetrical muscle atrophy across the entire left lower extremity; normal reflexes; and normal sensation to light touch. The examiner documented severe radiculopathy of the left femoral and sciatic nerves, with severe constant pain; severe intermittent pain; severe paresthesias and/or dysesthesias; and severe numbness.

In January 2020 a VA examiner documented the Veteran's report of constant severe pain with numbness of the left leg that caused difficulties walking and standing. On examination the Veteran demonstrated muscle strength of 4 out of 5 ("active movement against some resistance") across all measured dimensions; no muscle atrophy; hypoactive or normal reflexes; and decreased sensation to light touch. The examiner noted no trophic changes and documented moderately severe incomplete paralysis of the sciatic nerve and severe incomplete paralysis of the external popliteal nerve.

In September 2020 a VA examiner documented normal muscle strength across all measured dimensions; no muscle atrophy; normal reflexes; and normal sensation to light touch; the examiner documented no radicular pain or other signs or symptoms due to radiculopathy and indicated no nerve involvement.

In April 2025 a VA examiner documented the Veteran's report of lower limb weakness with radiating pain and paresthesias affecting the anterior and lateral aspects of the thigh. On examination the Veteran demonstrated muscle strength of 4 out of 5 ("active movement against some resistance") to 5 out of 5 across all measured dimensions; no muscle atrophy; and normal to hypoactive reflexes. The examiner noted trophic changes of loss of lower extremity hair at the bottom half of the leg. The examiner noted an unsteady and wide-based gait with reduced stride length, noticeable difficulty initiating movement, and occasional shuffling. The examiner documented normal to decreased sensation to light touch; severe constant pain; moderate intermittent pain; moderate paresthesias and/or dysesthesias; and severe numbness. The examiner documented severe incomplete paralysis of the sciatic nerve; and mild incomplete paralysis of the ilioinguinal nerve. The examiner also documented femoral nerve involvement; however, in a July 2025 addendum the examiner stated that the indication of femoral nerve involvement had been in error.

Given the above, the evidence is in at least approximate balance as to whether the Veteran has experienced severe incomplete paralysis of the left femoral and sciatic nerves from October 2, 2018, onward (i.e., the entire period on appeal). The evidence is in at least approximate balance as to whether the Veteran has experienced severe incomplete paralysis of the external popliteal nerve for the period from January 31, 2020, onward.

The criteria for entitlement to a disability rating of 60 percent for left lower extremity radiculopathy, sciatic nerve, but no higher, proximately due to service connected lumbar spine disability for the period from October 2, 2018, to April 22, 2025; a separate 30 percent disability rating, but no higher, for left lower extremity radiculopathy, anterior crural nerve (femoral) for the period from October 2, 2018, onward; and a separate disability rating of 30 percent, but no higher for left lower extremity radiculopathy, external popliteal nerve, for the period from January 31, 2020, onward are met. 38 U.S.C. §§ 1155,
for left lower extremity radiculopathy, sciatic nerve, but no higher, proximately due to service connected lumbar spine disability for the period from October 2, 2018, to April 22, 2025; a separate 30 percent disability rating, but no higher, for left lower extremity radiculopathy, anterior crural nerve (femoral) for the period from October 2, 2018, onward; and a separate disability rating of 30 percent, but no higher for left lower extremity radiculopathy, external popliteal nerve, for the period from January 31, 2020, onward are met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

The weight of the evidence is persuasively against a finding that the Veteran has experienced complete paralysis of the left femoral, sciatic, and/or external popliteal nerves at any point during the period on appeal; mild incomplete paralysis of the left external popliteal nerve prior to January 31, 2020; and severe to complete paralysis of either the left external cutaneous or ilioinguinal nerves at any point during the period on appeal. The criteria for entitlement to a disability rating in excess of 60 percent for left lower extremity radiculopathy, sciatic nerve, but no higher, proximately due to service connected lumbar spine disability from April 23, 2025, onward; entitlement to a separate disability rating for left lower extremity radiculopathy, external popliteal nerve, prior to January 31, 2020; a compensable disability rating for left lower extremity radiculopathy, external cutaneous nerve for the period from October 2, 2018. onward; and a compensable disability rating for left lower extremity radiculopathy, ilioinguinal nerve for the period from October 2, 2018, onward, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.124a, 4.124a (2009).

8. Entitlement to a separate disability rating for right lower extremity radiculopathy, associated with service connected lumbar spine disability prior to April 23, 2025, is denied.

9. Entitlement to a disability rating in excess of 20 percent for right lower extremity radiculopathy, associated with service connected lumbar spine disability sciatic nerve, is denied.

The Board has not before explicitly addressed the issue of entitlement to a separate compensable disability rating for right lower extremity radiculopathy associated with the Veteran's service connected lumbar spine disability. Accordingly, the Board construes the period on appeal as running from the date of the Veteran's 2009 claim to the present. A 20 percent rating for right lower extremity radiculopathy, sciatic nerve, is presently in effect from April 23, 2025, onward.

Under the rating criteria in effect at the time of the Veteran's 2009 claim, and presently, a 20 percent disability rating for paralysis of the sciatic nerve is warranted where there is moderate incomplete paralysis; a 40 percent disability rating is warranted where there is moderately severe incomplete paralysis; a 60 percent disability rating is warranted where there is severe incomplete paralysis, with marked muscular atrophy. The highest schedular rating of 80 percent is warranted where there is complete paralysis of the sciatic nerve such that the foot dangles and drops, no active movement of muscles below the knee is possible, and flexion of the knee is weakened or lost. 38 C.F.R. § 4.124a; 38 C.F.R. § 4.124a (2009).

A July 2009 report from a non-VA medical provider reflects the Veteran's report of symptoms of pain and weakness his left leg; the Veteran did not report any right leg symptoms. The provider documented a negative right leg straight leg raise test and documented sensory deficits in the left leg only.

In November 2012 a VA examiner documented muscle weakness in the right lower extremity, with normal reflexes and sensitivity to light touch and no symptoms of pain, numbness, or paresthesia and/or dysesthesias. The examiner documented no radiculopathy of the right lower extremity.

In November 2016 a VA examiner documented the Veteran's report of "needles" in the feet and intermittent numbness in his right leg. On examination, the Veteran demonstrated muscle strength of 4 out of 5 across all measured
weakness his left leg; the Veteran did not report any right leg symptoms. The provider documented a negative right leg straight leg raise test and documented sensory deficits in the left leg only.

In November 2016 a VA examiner documented the Veteran's report of "needles" in the feet and intermittent numbness in his right leg. On examination, the Veteran demonstrated muscle strength of 4 out of 5 across all measured dimensions, no muscle atrophy, and absent to hypoactive reflexes. The examiner documented decreased sensation to light touch at the foot and toes, with sensation otherwise recorded as normal. The examiner documented no constant or intermittent pain, but mild paresthesias/dysesthesias and numbness. The examiner did not characterize the Veteran's symptoms as constituting radiculopathy of any right lower extremity nerve and indicated that the Veteran had no radiculopathy of the right lower extremity.

In October 2018 a VA examiner documented the Veteran's report of pain radiating down his left leg; the examiner did not document any reports of pain or other symptoms associated with the right leg. The examiner documented muscle strength of 2 out of 5 across all measured dimensions, hypoactive reflexes, and decreased or absent sensation to light touch across all measured dimensions. The examiner documented no constant or intermittent pain, mild paresthesias/dysesthesias, or numbness. The examiner did not characterize the Veteran's symptoms as constituting radiculopathy of any right lower extremity nerve and indicated that the Veteran had no radiculopathy of the right lower extremity.

In January 2020 a VA examiner documented the Veteran's report of numbness of the right leg. The examiner documented muscle strength of between 4 out of 5 and 5 out of 5 across all measured dimensions, no muscle atrophy, and hypoactive to normal reflexes. The examiner documented no constant or intermittent pain and no paresthesias/dysesthesias. The examiner documented normal sensation to light touch and no trophic changes. The examiner did not characterize the Veteran's symptoms as constituting radiculopathy of any right lower extremity nerve and indicated that the Veteran had no radiculopathy of the right lower extremity.

In April 2025 a VA examiner documented the Veteran's report of radiating pain and paresthesias in the anterior and lateral aspects of the Veteran's right thigh, as well as lower extremity weakness. The examiner documented 4 out of 5 to 5 out of 5 muscle strength across all measured dimensions and no muscle atrophy. The examiner documented reflexes ranging from hyperactive without clonus to hyperactive with clonus and sensation to light touch ranging from normal to decreased. The examiner noted a trophic change of loss of lower extremity hair at the bottom half of the leg. The examiner characterized the Veteran as experiencing moderate incomplete paralysis of the right sciatic nerve. The examiner also documented femoral nerve involvement; however, in a July 2025 addendum the examiner stated that the indication of femoral nerve involvement had been in error.

As demonstrated by the above findings, the earliest medical opinion characterizing the Veteran's reported symptoms and clinical presentation as constituting radiculopathy of the right lower extremity is the April 2025 VA examination. The Board may not reach its own unsubstantiated medical conclusion to characterize earlier clinical observations or lay reports of symptoms as lower extremity radiculopathy attributable to the Veteran's service connected lumbar spine disability. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Therefore, the Board finds that the weight of the evidence is persuasively against a finding that the Veteran experienced right extremity radiculopathy attributable to his service connected lumbar spine disability prior to April 23, 2025. Further, the weight of the evidence is persuasively against a finding that the Veteran's right lower extremity radiculopathy has manifested as moderately severe incomplete paralysis; severe incomplete paralysis with marked muscular atrophy; or complete paralysis of the sciatic nerve at any point during the period on appeal.

Given the above, the criteria for entitlement to a separate disability rating for right lower extremity
Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Therefore, the Board finds that the weight of the evidence is persuasively against a finding that the Veteran experienced right extremity radiculopathy attributable to his service connected lumbar spine disability prior to April 23, 2025. Further, the weight of the evidence is persuasively against a finding that the Veteran's right lower extremity radiculopathy has manifested as moderately severe incomplete paralysis; severe incomplete paralysis with marked muscular atrophy; or complete paralysis of the sciatic nerve at any point during the period on appeal.

Given the above, the criteria for entitlement to a separate disability rating for right lower extremity radiculopathy, associated with service connected lumbar spine disability prior to April 23, 2025, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a, 4.71a (2009), 4.124a, 4.124a (2009). The criteria for entitlement to a disability rating in excess of 20 percent for right lower extremity radiculopathy, associated with service connected lumbar spine disability are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a, 4.71a (2009), 4.124a, 4.124a (2009).

10. Entitlement to a separate disability rating of 20 percent for urinary incontinence prior for the period prior to April 23, 2025, is granted.

11. Entitlement to a disability rating in excess of 20 percent for urinary incontinence for the entire period on appeal is denied.

The period on appeal with respect to the Veteran's urinary incontinence claim runs from the date of his June 2009 claim for an increased rating for his lumbar spine disability onward. A 20 percent rating is currently in effect from April 23, 2025, onward.

As noted above, the General Rating Formula for Diseases and Injuries of the Spine provides for separate evaluation of any associated neurologic abnormalities, including, but not limited, to, bowel or bladder impairment, under an appropriate diagnostic code. 38 C.F.R. § 4.71a; 38 C.F.R. § 4.71a (2009). Under the rating criteria in effect at the time of the Veteran's 2009 claim, as now, urinary incontinence is rated under 38 C.F.R. § 4.115a. A 20 percent rating is warranted where the Veteran is required to wear absorbent materials which must be changed less than 2 times per day; a 40 percent rating is warranted where the Veteran is required to wear absorbent materials which must be changed 2 to 4 times per day; and the highest schedular rating of 40 percent is warranted where the Veteran is required to use an appliance or to wear absorbent materials which must be changed more than 4 times per day. 38 C.F.R. § 4.115a; 38 C.F.R. § 4.15a (2009).

The Veteran has consistently reported symptoms of urinary incontinence to VA treating providers and VA examiners throughout the period on appeal. See e.g., 06/20/2012, CAPRI at 269, 516; 03/06/2013, CAPRI at 135; 07/23/2014, CAPRI at 273; 01/10/2017, CAPRI at 115; 11/18/2024, CAPRI at 4; 11/01/2012, VA Examination at 28.

In April 2025 a VA examiner documented that the Veteran required absorbent material that required changing less than 2 times per day. The examiner documented a daytime voiding interval of 2 - 3 hours, with nighttime awakening to void 3 - 4 times per night. 05/01/2025, C&P Exam.

The weight of the evidence is in at least approximate balance as to whether the Veteran has experienced urinary incontinence requiring the wear of absorbent materials changed less than 2 times per day prior to April 23, 2025. The Board has considered whether any other diagnostic codes would be appropriate to evaluate symptoms of the Veteran's disability. 38 C.F.R. §§ 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). Here, the Board finds that the weight of the evidence is persuasively against the application of an evaluation in excess of 20 percent for the Veteran's urinary incontinence at any point during the period on appeal; thus, there is no question to resolve and the lower rating is appropriate. Id. The criteria for entitlement to a disability rating of 20 percent for urinary incontinence prior to April 23, 2025, are met; however, the criteria for entitlement to a disability rating in excess of 20 percent for urinary incontinence are not met for the entire period on appeal. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.115a, 4.115a (2009).

12. Entitlement to a separate disability rating for fecal incontinence with impairment of sphincter control prior to April 23, 2025, is denied.

The period on appeal with respect to the Veteran's fecal incontinence claim runs from the date of his June 2009 claim for an increased rating for his lumbar spine disability onward. A 20 percent rating is currently in effect from April 23, 2025, onward.

No bowel or fecal incontinence is documented in the Veteran's VA treatment records prior to April 2025, as reflected either by the Veteran's own report or clinical observation. See e.g., 06/20/2012, CAPRI at 269, 605, 614, 629. 01/10/2017, CAPRI at 287, 299; 01/08/2020, CAPRI at 69; 01/11/2023, CAPRI at 19. No VA examination prior to April 2025 reflects either the Veteran's report or clinical observation of bowel or fecal incontinence. In those instances where the treatment records or examination reports are silent as to bowel incontinence, as opposed to affirmatively characterizing the Veteran as bowel continent, the Board notes that both the Veteran's VA treatment records and multiple VA examinations do reflect that the Veteran was experiencing urinary incontinence; thus, the Board finds the records' silence as to bowel incontinence to be probative as to whether or not the Veteran was experiencing same.

The Board finds that the weight of the evidence is persuasively against a finding that the Veteran experienced bowel incontinence associated with his service connected lumbar spine disability prior to April 23, 2025. The criteria for entitlement to a separate disability rating for fecal incontinence with impairment of sphincter control prior to April 23, 2025, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a, 4.71a (2009).

13. Entitlement to a separate disability rating for erectile dysfunction prior to April 23, 2025, is granted.

14. Entitlement to special monthly compensation for loss of use of a creative organ prior to April 23, 2025, is granted.

The period on appeal with respect to the Veteran's erectile dysfunction and special monthly compensation claim runs from the date of his June 2009 claim for an increased rating for his lumbar spine disability onward.

13. Entitlement to a separate disability rating for erectile dysfunction prior to April 23, 2025, is granted.

14. Entitlement to special monthly compensation for loss of use of a creative organ prior to April 23, 2025, is granted.

The Veteran's erectile dysfunction is currently rated as associated with his service connected lumbar spine disability. He reported erectile dysfunction to a VA examiner in November 2012. In April 2025 the Veteran reported to a VA examiner that he had been experiencing symptoms of erectile dysfunction for over thirty years. The Veteran is competent to report phenomena observable to his senses, such as erectile dysfunction. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a).

In light of the above, the evidence is in at least approximate balance as to whether the Veteran has experienced erectile dysfunction throughout the period on appeal.

Additionally, where a Veteran experiences loss of use of a creative organ as the result of service connected disability, they are entitled to special monthly compensation under 38 U.S.C. § 1114(k) and 38 C.F.R. § 3.350(a). Therefore, the criteria for entitlement to a separate disability rating for erectile dysfunction and special monthly compensation for loss of use of a creative organ for the entire period on appeal prior to April 23, 2025, are met. 38 U.S.C. §§ 1114, 1155, 5107(b); 38 C.F.R. §§ 3.350, 4.1, 4.7, 4.71a, 4.71a (2009).

15. Entitlement to a disability rating of 90 percent, but no higher, for bilateral hearing loss for the period from May 24, 2011, to November 22, 2016, is granted.

16. Entitlement to a compensable disability rating for bilateral hearing loss for the period from November 23, 2016, to February 9, 2025, and in excess of 50 percent from February 10, 2025, onward, are denied.

The Veteran's bilateral hearing loss claim comes before the Board on appeal of a March 2013 rating decision that denied entitlement to a compensable rating. The March 2013 rating decision itself reflects that VA received the Veteran's hearing loss claim in May 2011. Accordingly, the Board concludes that the period on appeal runs from May 2011, onward. The Board notes that the applicable rating criteria have not undergone substantive revision during the period on appeal. See 38 C.F.R. §§ 4.85 (2011), 4.86 (2011).

The rating criteria for hearing loss, unlike a majority of the conditions in VA's rating schedule, do not list any specific symptoms or functional effects. See 38 C.F.R. §§ 4.85, 4.86. Instead, VA evaluates service-connected hearing loss through the mechanical application of a veteran's audiometric testing results to a rating table. See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). Specifically, VA conducts two audiometric tests for compensation purposes: a puretone audiometry test, which measures puretone decibel thresholds at 1000, 2000, 3000, and 4000 Hertz, and a controlled speech discrimination test, the Maryland CNC. 38 C.F.R. § 4.85(a), (d). Based on the results of these tests, each ear is assigned an evaluation corresponding to the level of hearing impairment using either Table VI, which requires results from both tests, or, in certain circumstances, Table VIa, which requires only the puretone threshold results. 38 C.F.R. §§ 4.85(b), (c), (h), 4.86. The evaluations for each ear are combined using Table VII to determine the appropriate disability rating. 38 C.F.R. § 4.85(e), (h). Doucette v. Shulkin, 28 Vet. App. 366, 368 (2017). When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rater will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. Each ear will be evaluated
.R. §§ 4.85(b), (c), (h), 4.86. The evaluations for each ear are combined using Table VII to determine the appropriate disability rating. 38 C.F.R. § 4.85(e), (h). Doucette v. Shulkin, 28 Vet. App. 366, 368 (2017). When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rater will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. Each ear will be evaluated separately.

In August 2011 a VA examiner documented the following puretone threshold test results:

Hertz 500 1000 2000 3000 4000 Average (in decibels)

Right Ear Threshold (in decibels) 80 80 90 95 100 91.25

Left Ear Threshold (in decibels) 80 95 100 105 110 102.50

The examiner documented a right ear speech recognition score of 40 percent and a left ear speech recognition score of 32 percent.

The Veteran was afforded another VA examination in February 2012. The February 2012 VA examiner documented no puretone threshold test results, stating that the results which were obtained were not valid for testing purposes as they were indicative of non-organic hearing loss. Similarly, the examiner stated that the bilateral speech discrimination scores of 50 percent were not appropriate for the Veteran because of language difficulties, cognitive problems, and/or inconsistent speech discrimination scores. The February 2012 VA examiner went on to note that the Veteran presented wearing hearing aids, but that upon inspection the hearing aid batteries were nonfunctional and that the Veteran had been able to converse with the examiner, with and without the nonfunctional hearing aids, in a manner inconsistent with his puretone threshold test results. Similarly, the examiner stated that the Veteran's normal Acoustic Reflex Threshold test results were inconsistent with his puretone threshold test results.

The Veteran was afforded another examination in November 2016. The examiner documented the following puretone threshold test results:

Hertz 500 1000 2000 3000 4000 Average (in decibels)

Right Ear Threshold (in decibels) 30 35 45 45 50 43.75

Left Ear Threshold (in decibels) 30 35 45 55 55 47.50

The examiner documented a right ear speech recognition score of 96 percent and a left ear speech recognition score of 98 percent.

In December 2017 the Board remanded the Veteran's hearing loss claim to obtain a VA medical opinion as to whether the August 2011 VA examination test results reflected organic hearing loss or not.

In September 2020 a VA examiner again stated that test results were unreliable, noting that the Veteran's ability to respond to spoken instructions and to converse with a masked examiner was inconsistent with the obtained puretone threshold test results.

In December 2020 a VA examiner documented the following puretone threshold test results:

Hertz 500 1000 2000 3000 4000 Average (in decibels)

Right Ear Threshold (in decibels) 30 40 40 50 60 47.50

Left Ear Threshold (in decibels) 30 40 45 60 60 51.25

The examiner documented a right ear speech recognition score of 96 percent and a left ear speech recognition score of 90 percent.

The Veteran's hearing loss claim was remanded again in May 2023 and March 2024 for failure to comply with the December 2017 remand directives with respect to the medical opinion evaluating the validity of the 2011 test results.

An additional VA examination was obtained in February 2025. The February 2025 VA examiner documented the following puretone threshold test results:

Hertz 500 1000 2000 3000 4000 Average (in decibels)

Right Ear Threshold (in decibels) 40 45 55 65 70 58.75

Left Ear Threshold (in decibels) 45 50 50 60 70 57.50

The examiner documented a right ear speech recognition score of 50 percent and a left ear speech recognition score of 46 percent.

The examiner also reviewed the Veteran's complete audiological history, to include in-service records and hazardous noise exposure and past VA audiological evaluations. The examiner stated that the Veteran's August 2011 audiological test results likely provided a reasonable representation of the Veteran's hearing at that
500 1000 2000 3000 4000 Average (in decibels)

Right Ear Threshold (in decibels) 40 45 55 65 70 58.75

Left Ear Threshold (in decibels) 45 50 50 60 70 57.50

The examiner documented a right ear speech recognition score of 50 percent and a left ear speech recognition score of 46 percent.

In light of the February 2025 VA examiner's opinion that the August 2011 test results are valid for the purposes of rating organic hearing loss, the Board will rate the Veteran's hearing loss for the entire period on appeal using all completed audiological evaluations of record.

The August 2011 test results reflect puretone thresholds at each of the four specified frequencies of 55 decibels or more; accordingly, the criteria for rating exceptional patterns of hearing impairment will be applied. See 38 C.F.R. § 4.86. Based on the Veteran's average puretone thresholds of 91.25 (right) and 102.50 (left) and speech discrimination scores of 40 percent (right) and 32 percent (left) Table VI yields the higher numeral. Applying the results of Table VI to Table VII yields a disability rating of 90 percent. 38 C.F.R. §§ 4.85, 4.86.

From November 2016 onward, the application of exceptional patterns of hearing impairment are not satisfied. Based on the Veteran's November 2016 average puretone thresholds of 43.75 (right) and 47.50 (left) and speech discrimination scores of 96 percent (right) and 98 percent (left), Table VII yields a noncompensable disability rating.

Based on the Veteran's December 2020 average puretone thresholds of 47.50 (right) and 51.25 (left) and speech discrimination scores of 96 percent (right) and 90 percent (left), Table VII yields a noncompensable disability rating.

Based on the Veteran's February 2025 average puretone thresholds of 58.75 (right) and 57.50 (left) and speech discrimination scores of 50 percent and 46 percent, Table VII yields a disability rating of 50 percent.

Where there is a question as to which of two evaluations shall 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. § 4.7. The Board has considered whether any other diagnostic codes would be appropriate to evaluate symptoms of the Veteran's disability. 38 C.F.R. §§ 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991). Here, the Board finds that the weight of the evidence is against the application of an evaluation in excess of 90 percent for the Veteran's bilateral hearing loss from May 24, 2011, to November 22, 2016; is against the application of a compensable disability rating for bilateral hearing loss for the period from November 23, 2016, to February 9, 2025; and, is against the application of an evaluation in excess of 50 percent from February 10, 2025, onward; thus, there is no question to resolve and the lower rating is appropriate.

Based on the foregoing, the criteria for entitlement to a disability rating of 90 percent, but no higher, for bilateral hearing loss are met for the period from May 24, 2011, to November 22, 2016. The criteria for entitlement to a compensable disability rating for bilateral hearing loss for the period from November 23, 2016, to February 9, 2025, and in excess of 50 percent from February 10, 2025, onward, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.85, 4.85 (2011), 4.86, 4.86 (2011).

17. Eligibility for assistance for providing automobile and/or adaptive equipment is denied.

Financial assistance may be provided to an "eligible person" in acquiring an automobile or other conveyance and adaptive equipment, or adaptive equipment only. 38 U
the period from November 23, 2016, to February 9, 2025, and in excess of 50 percent from February 10, 2025, onward, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.85, 4.85 (2011), 4.86, 4.86 (2011).

17. Eligibility for assistance for providing automobile and/or adaptive equipment is denied.

Financial assistance may be provided to an "eligible person" in acquiring an automobile or other conveyance and adaptive equipment, or adaptive equipment only. 38 U.S.C. § 3902. Eligibility for assistance to purchase a vehicle and adaptive equipment is warranted where one of the following exists as the result of an injury or disease incurred or aggravated during active duty service: (1) loss or permanent loss of use of one or both feet; (2) loss or permanent loss of use of one or both hands; (3) permanent impairment of vision of both eyes, meaning central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20 degrees in the better eye; (4) severe burn injury precluding effective operation of an automobile; or (5) amyotrophic lateral sclerosis (ALS). 38 U.S.C. § 3901.

Although loss of use of the hand or foot is not defined under 38 C.F.R. § 3.808, under 38 C.F.R. § 3.350(a)(2), and for purposes of special monthly compensation under 38 C.F.R. § 4.63, loss of use of a hand or foot will be held to exist when no effective functions remain other than that which would be equally well served by an amputation with prosthetic. Additionally, in the context of a claim of eligibility for specially adapted housing, the Court of Appeals for Veterans Claims found that a "loss of use" exists when there is "deprivation of the ability to avail oneself" of that extremity. See Jensen v. Shulkin, 29 Vet. App. 66, 78-79 (2017).

Service connection is in effect for bilateral carpal tunnel syndrome; bilateral lower extremity radiculopathy; bilateral plantar fasciitis; a right shoulder disability; and residuals of a left humerus fracture. The record does not reflect that the Veteran has any burn injury, optical impairment, or ALS as a result of his period of active service. Accordingly, entitlement to assistance for providing automobile and/or adaptive equipment must be evaluated on the basis of loss or loss of use of one or both hands and/or feet.

Throughout the period on appeal the Veteran has been afforded a multiple of VA examinations in relation to his service connected lumbar spine (with bilateral lower extremity radiculopathy); bilateral plantar fasciitis; bilateral carpal tunnel syndrome; right shoulder; and left humerus fracture residual disabilities, to include in November 2012, July 2014, November 2016, October 2018, January 2020, September 2020, October 2022, and May 2025. VA examiners have consistently stated none of these disabilities have resulted in loss of effective functions other than that which would be equally well served by an amputation with prosthetic.

The record reflects that throughout the period on appeal the Veteran has alternated between use of a cane to walk and use of a wheelchair for mobility. See e.g., 06/16/2014, CAPRI at 9, 15; 09/15/2025, C&P Exam. In July 2020, the Veteran submitted a functional evaluation by a non-VA treating provider who stated that the Veteran was limited in his mobility and ability to bend and twist due to low back pain; however, the provider stated that the Veteran was able to move both arms bilaterally without restriction. In May 2024 the Veteran presented to VA treating providers walking independently "with a slight antalgic gait pattern." In April 2025 the Veteran reported to a VA examiner that he "preferred" using a wheelchair as it felt safer, but that he was able to stand and walk "with difficulty." 09/15/2025, C&P Exam.

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In light of the above, the weight of the evidence is persuasively against a finding that the Veteran has experienced functional impairment of his upper and/or lower extrem
mobility and ability to bend and twist due to low back pain; however, the provider stated that the Veteran was able to move both arms bilaterally without restriction. In May 2024 the Veteran presented to VA treating providers walking independently "with a slight antalgic gait pattern." In April 2025 the Veteran reported to a VA examiner that he "preferred" using a wheelchair as it felt safer, but that he was able to stand and walk "with difficulty." 09/15/2025, C&P Exam.

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In light of the above, the weight of the evidence is persuasively against a finding that the Veteran has experienced functional impairment of his upper and/or lower extremities such that no effective functions remain other than that which would be equally well served by an amputation with prosthetic, or that there is "deprivation of [his] ability to avail [himself]" of any extremity at any point during the period on appeal. The criteria for entitlement to assistance for providing automobile and/or adaptive equipment are not met. 38 U.S.C. § 3901 et. seq.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sametshaw, Eric C.

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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