ANKLE IMPAIRMENT OF

MICHAEL LANE · 2026 · Case ID: 26004344

MIXED

Summary

The veteran, who served in the Marine Corps from September 1989 to February 1990, appeals the denial of service connection for bilateral ankle disabilities and increased ratings for bilateral knee and foot disabilities. The veteran also appealed the denial of Total Disability based on Individual Unemployability (TDIU) from April 13, 2015, to May 25, 2016. The Board reviewed the evidence, including the veteran's service records and medical opinions. For the ankle claims, the Board found the evidence persuasively against a service connection, noting the lack of objective findings or nexus to service. For the knee and foot claims, the Board determined that the evidence did not meet the criteria for increased ratings, citing specific diagnostic codes and lack of objective evidence of marked deformity or pronounced symptoms. The Board granted entitlement to TDIU for the period of April 13, 2015, to May 25, 2016, resolving reasonable doubt in the veteran's favor, as the evidence showed the veteran was unable to secure or follow substantially gainful employment due to service-connected disabilities during that time. The Board also noted a previously remanded issue regarding groin pain, which was not perfected by the veteran and therefore not addressed. Service connection for bilateral ankle disabilities and increased ratings for bilateral knees and feet were denied. TDIU was granted for a specific period.

Rationale

Evidence persuasively against service connection; Lack of nexus to service-connected knee and feet disability

Service Branch

MARINE CORPS

Special Benefit

TDIU

Docket No.

17-13 270

Full Decision Text

Citation Nr: 26004344
Decision Date: 04/08/26 Archive Date: 04/08/26

DOCKET NO. 17-13 270
DATE: April 8, 2026

ORDER

Entitlement to service connection for a right ankle disability to include as secondary to a knee and feet disability is denied.

Entitlement to service connection for a left ankle disability to include as secondary to a knee and feet disability is denied.

Entitlement to an increased evaluation in excess of 10 percent for a right knee disability is denied.

Entitlement to an increased evaluation in excess of 10 percent for a left knee disability is denied.

Entitlement to an increased evaluation in excess of 20 percent for right foot flexible pes planovalgus stress fracture prior to January 25, 2016 is denied.

Entitlement to an increased evaluation in excess of 10 percent for left foot flexible pes planovalgus stress fracture prior to January 25, 2016 is denied.

Entitlement to an increased evaluation in excess of 30 percent for bilateral foot flexible pes planovalgus stress fracture since January 25, 2016 is denied.

Entitlement to a total disability rating based on individual unemployability (TDIU) from April 13, 2015 to May 25, 2016 is granted.

FINDINGS OF FACT

1. The evidence is persuasively against a finding that the Veteran's right ankle disability is related to the Veteran's active-duty service, caused by or aggravated by the Veteran's knee and feet disability.

2. The evidence is persuasively against a finding that the Veteran's left ankle disability is related to the Veteran's active-duty service, caused by or aggravated by the Veteran's knee and feet disability

3. The evidence of record does not show the Veteran's right knee disability manifested with ankylosis; flexion functionally limited to 30 degrees or less; extension functionally limited to 15 degrees or more; an impairment of the tibia and fibula; or genu recurvatum.

4. The evidence of record does not show the Veteran's left knee disability manifested with ankylosis; flexion functionally limited to 30 degrees or less; extension functionally limited to 15 degrees or more; an impairment of the tibia and fibula; or genu recurvatum.

5. The evidence of record prior to January 25, 2016 does not show the Veteran's left foot flexible pes planovalgus stress fracture manifested with objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities.

6. The evidence of record prior to January 25, 2016 does not show the Veteran's left foot flexible pes planovalgus stress fracture manifested with objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities.

7. Review of the medical treatment record since January 25, 2016, does not show the Veteran's bilateral flexible pes planovalgus stress fracture manifested with pronounced symptoms, including marked pronation, extreme tenderness of plantar surfaces of the feet, or marked inward displacement and severe spasm of the Achilles tendon on manipulation.

8. Resolving reasonable doubt, the evidence of record from April 13, 2015 to May 25, 2016 shows the Veteran was unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for right ankle disability have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a).

2. The criteria for entitlement to service connection for left ankle disability have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a).

3. The criteria for an increased evaluation in excess of 10 percent for a right knee disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, Diagnostic Code 5024, 5260.

4. The criteria for an increased evaluation in excess of 10 percent for a left knee disability have not been met.
3, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a).

4. The criteria for an increased evaluation in excess of 10 percent for a left knee disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, Diagnostic Code 5024, 5260

5. The criteria for an increased evaluation in excess of 20 percent for right foot flexible pes planovalgus stress fracture prior to January 25, 2016 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, Diagnostic Code 5262, 5299-5276.

6. The criteria for an increased evaluation in excess of 10 percent for left foot flexible pes planovalgus stress fracture prior to January 25, 2016 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, Diagnostic Code 5299-5276.

7. The criteria for an increased evaluation in excess of 30 percent for bilateral flexible pes planovalgus stress fracture since January 25, 2016 nerve have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.10, 4.124a, Diagnostic Code 5276.

8. The criteria for entitlement to TDIU from April 13, 2015 to May 25, 2016, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.340, 4.16, 4.19.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in active-duty service with the Marine Corp from September 1989 to February 1990.

This matter is on appeal from a June 2013 rating decision.

The Veteran was afforded a March 2020 hearing before the undersigned Judge; a transcript of the hearing has been associated with the claims record.

During the pendency of the appeal, a January 2021 Board decision found the issue of TDIU was raised by the Veteran during an appeal for an increased evaluation for the knees and feet. Rice v. Shinseki, 22 Vet. App. 447 (2009).

The Board has remanded this appeal in January 2021 and November 2024 for development.

The Board notes that one of the issues remanded by the November 2024 Board decision for development was entitlement to service connection for a disability manifested by extreme pain in the groin area.

The November 2024 Board decision found that the Veteran had not been issued a Statement of the Case (SOC) for this issue; and therefore requested an SOC be issued to give the Veteran and opportunity to complete the steps necessary to perfect the appeal of this issue by filing a timely substantive appeal. (VA Form 9 or equivalent statement). See Manlicon v. West, 12 Vet. App. 238 (1999).

However, the Veteran did not submit a VA Form 9 within 60 days of the February 2025 SOC addressing this issue. The evidence of record does not show that the SOC was returned as undeliverable.

As such, the Veteran has not perfected the appeal concerning entitlement to service connection for a disability manifested by extreme pain in the groin area; therefore, the issue is not before the Board and will not be addressed.

The Board notes that there were indications in the claims file that the Veteran received benefits from the Social Security Administration (SSA). Review of the record shows a November 2024 SSA profile documents the Veteran's
See Manlicon v. West, 12 Vet. App. 238 (1999).

However, the Veteran did not submit a VA Form 9 within 60 days of the February 2025 SOC addressing this issue. The evidence of record does not show that the SOC was returned as undeliverable.

Service Connection

Service connection is granted on a direct basis when there is competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a), (d).

The Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. See Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Board determinations with respect to the weight and credibility of evidence are factual determinations going to the probative value of the evidence. Layno v. Brown, 6 Vet. App. 465, 469 (1994).

In relevant part, 38 U.S.C. § 1154 (a) requires that the VA give "due consideration" to "all pertinent medical and lay evidence" in evaluating a claim to disability. Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional." Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). In fact, competent medical evidence is not necessarily required when the determinative issue involves either medical etiology or a medical diagnosis. Id. at 1376-77; see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. 38 U.S.C. § 5107 (b); see Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. § 3.102. The evidence must be persuasively against the claim for benefits to be denied. See Alemany v. Brown, 9 Vet. App. 518 (1996).

Right and Left ankle

Review of the Veteran's service treatment records (STRs) show in November 1989 the Veteran demonstrate full range of motion (ROM) of the ankles with no reported pain in the ankles.

A May 1990 X-ray of the feet were negative and unremarkable for any bone or soft tissue injury. The Veteran demonstrated full strength with some limitation to ROM.

In a January 2001 statement, the Veteran reported the loss of several jobs due to pain and swelling symptoms in the foot and knees.

In a February 2001 VA examination the Veteran reported pain in both ankles. In an August 2001 VA examination the examiner found no limitation to the Veteran's ankle joint ROM.

In a March 2006 VA examination the examiner noted that x-rays of the Veteran's right ankle showed evidence of a past dislocation but no evidence of current disability or disorder or recent fracture with normal bone density.

In a July 2007 VA examination the Veteran demonstrated full ROM; the examiner found no evidence of painful motion; instability; or loss of motion with repetition, pain, fatigue, or weakness.

In an October 2011 VA medical center (VAMC) visit, the Veteran reported bilateral ankle pain that they had been dealing with "for years" with no specific trauma. The Veteran demonstrated full
reported pain in both ankles. In an August 2001 VA examination the examiner found no limitation to the Veteran's ankle joint ROM.

In a July 2007 VA examination the Veteran demonstrated full ROM; the examiner found no evidence of painful motion; instability; or loss of motion with repetition, pain, fatigue, or weakness.

In November 2011 the Veteran reported ankle pain and continued to work while taking leave.

In February 2013 the Veteran was treated for an ankle sprain.

In a June 2013 VA examination, the examiner diagnosed the Veteran with bilateral ankle strain. The Veteran reported an onset of June 2011 relating to carrying mail for their job; the Veteran stated that they were currently doing minimal standing and walking for their job.

The examiner noted review of the Veteran's STRs noted on "entry...complaints relatable to ankles" but found no further details or findings of related diagnosis. The examiner noted the Veteran next complained of ankle pain in February 2001.

The examiner did not find the Veteran's right or left ankle to be related to service. The examiner noted the Veteran's complaint of ankle symptoms in 2001 was brief with no underlying pathology and the main onset of symptoms was not until June 2011, years after the Veteran's separation from service.

At the March 2020 hearing, the Veteran testified to the onset of symptoms relating to their ankles during service; the Veteran attributed these symptoms to running and marching during camp that caused stress fractures to the knee and tibia as well as affecting the ankles.

In June 2020, a private provider documented the Veteran's "long history of foot and knee pain since separation" to include reported symptoms of constant, progressive pain with the use of a cane or crutches for assistance and the referenced the Veteran's March 2020 testimony on the ankle in relation to service; however, the provider noted that they were unable to determine any service connected etiology and did not provide an etiology opinion.

In a September 2021 VA examination, the Veteran reported the onset in 1989 with bilateral ankle pain during basic training; the Veteran stated that they were later treated for stress fracture and received a medical discharge from service. The Veteran also reported using a cane for assistance.

The Veteran demonstrated full ROM. The examiner did not find the Veteran with a current diagnosed ankle disability. However, the examiner does not reconcile the previous diagnoses of record to include the June 2013 VA examination diagnosis for bilateral ankle strain.

In November 2023 and September 2025 the Veteran failed to appear for a scheduled VA examination.

In September 2025 the Veteran reported their intent to not participate in any examination relating to their ankle.

After review of the evidence, the Board finds the evidence is persuasively against a finding of service connection for the Veteran's claimed right and left ankle.

The record shows complaints, treatment, and diagnoses for a right and left ankle disability as documented in the June 2013 VA examination; as noted above, a September 2021 VA examiner did not diagnose the Veteran with a current disability but did not address or reconcile the June 2013 VA diagnosis. Therefore, the Board resolves reasonable doubt and find the Veteran with a current disability.

As noted above, while the Veteran's STRs show a complaint for bilateral foot and leg pain in 1989; the STRs do not show an objective medical documentation or diagnosis specifically affecting the right or left ankle. While June 2013 VA examiner noted the complaint of foot pain in service but found it brief and no evidence of diagnosis for the right or left ankle.

The Board next notes that the most recent Board remands in January 2021 and November 2024 requested an examination and etiology of the Veteran's claimed right and left ankle disability in relation to service and the Veteran's service connected feet and knees.

As noted above, the Veteran did not appear for scheduled VA examinations relating to the Veteran's claimed right and left ankles in November 2023 and September 2025; the Veteran in September 2025 further stated their intention not to participate in any further examinations relating to their ankles.

Review of the record does not show the Veteran provide any further reason for cancellation or not appearing for examination and did not attempt to reschedule the examinations.

The Board notes here that the Veteran must be prepared to meet his obligations by cooperating with VA efforts to provide an adequate medical examination. See Olson v. Principi, 3 Vet. App
iology of the Veteran's claimed right and left ankle disability in relation to service and the Veteran's service connected feet and knees.

Review of the record does not show the Veteran provide any further reason for cancellation or not appearing for examination and did not attempt to reschedule the examinations.

The Board notes here that the Veteran must be prepared to meet his obligations by cooperating with VA efforts to provide an adequate medical examination. See Olson v. Principi, 3 Vet. App. 480 (1992). In this regard, the Court has held that "[t]he duty to assist is not always a one-way street. If a Veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence." See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991).

As such, the Veteran must cooperate in VA's efforts to obtain evidence needed to adjudicate the Veteran's claims, including keeping his contact information up to date, attending scheduled VA examinations, and promptly communicating with VA why the Veteran cannot attend a scheduled VA examination.

Here the Board finds that the Veteran has not cooperated with VA efforts to provide the Veteran with an adequate medical examination which may have produced competent evidence on the nature and etiology of the Veteran's claimed right and left ankle disabilities. Unfortunately, the Veteran did not appear for the scheduled VA examinations and did not attempt to reschedule them; the Veteran has also expressed an intent to no longer participate in any examination for the ankle. The Veteran's failure to undergo the VA examination without just cause prevented the development of evidence regarding this aspect of the claim. Such evidence could have been beneficial to the Veteran's claim.

Since the Veteran failed to respond to VA requests to attend or rescheduled examinations and did not provide cause for doing so, the service-connection claims shall be decided based on the evidence of record. See 38 C.F.R. § 3.655 (b).

The September 2021 VA examiner did not find the Veteran's right or left ankle disability to be related to service.

The Board notes that in the November 2024 Board remand, the Board found the record showed Veteran had also raised a theory of secondary service connection in connection to the Veteran's feet and knee disabilities; as such, the Board had requested an etiology opinion on the Veteran's ankles in relation to the Veteran's feet and knees.

As addressed above, the Veteran did not appear for scheduled examinations to provide an etiology opinion to addressed the raised theory. As such, there is no evidence to show the Veteran's right or left ankle disability was caused by or aggravated by the Veteran's feet and knee disabilities.

The Board acknowledges the Veteran's statements that right and left ankle disabilities were related to the Veteran's service to include the Veteran's service connected feet and knee disabilities. Certainly, the Veteran is competent to describe experiencing symptoms in service and recurring thereafter. Indeed, treatment records corroborate at least to some extent the Veteran's history of symptoms. Nevertheless, as lay persons, the Veteran does not have the training or expertise to render a competent opinion which is more probative than the VA examiner's opinion on this issue, as this is a medical determination that is complex. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 309 (2007); Layno v. Brown, 6 Vet. App. 465, 469-71 (1994)).

As such, the Board finds that the Veteran's opinion is outweighed by the competent opinions of the VA examiner. See id. ; see also King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012).

The Veteran has not otherwise submitted any other opinion or medically objective evidence in support of the appeal.

Therefore, the Board finds that the evidence of record weighs persuasively against of service connection for the Veteran's right and left ankle disabilities. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the evidence of record weighs persuasively against the claim, that doctrine is not applicable. 38 C.F.R. § 3.102 ; Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990).

Increased Rating

Disability ratings are based upon VA's Schedule for Rating Disabilities as set forth in
. 2012).

The Veteran has not otherwise submitted any other opinion or medically objective evidence in support of the appeal.

Increased Rating

Disability ratings are based upon VA's Schedule for Rating Disabilities as set forth in 38 C.F.R. Part 4. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity in civil occupations. 38 U.S.C. § 1155. The disability must be viewed in relation to its history. 38 C.F.R. § 4.1. A higher evaluation shall be assigned where the disability picture more nearly approximates the criteria for the next higher evaluation. 38 C.F.R. § 4.7.

The Board must consider entitlement to "staged" ratings to compensate for times since filing a claim when the disability may have been more severe than at other times during the course of the appeal. See Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). Where, as here, entitlement to compensation has already been established and an increase in disability rating is at issue, the present level of disability is of primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994).

Thus, although the Board has thoroughly reviewed all evidence of record, the more critical evidence consists of the evidence generated during the appeal period. Further, the Board must evaluate the medical evidence of record since the filing of the claim for increased rating and consider the appropriateness of a "staged" rating (i.e., the assignment of different ratings for distinct periods of time, based on the facts). See Hart v. Mansfield, 21 Vet. App. 505 (2007).

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 for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All benefit of the doubt will be resolved in the Veteran's favor. 38 C.F.R. § 4.3.

Right and Left knee disability

The Veteran is service-connected for a right and left knee disability evaluated at 10 percent each under Diagnostic Code (DC) 5260.

The Board notes that during the pendency of the appeal, the rating criteria for evaluating musculoskeletal disabilities under 38 C.F.R. § 4.71a were amended effective February 7, 2021. 85 Fed. Reg. 230 (Nov. 30, 2020). These amendments revised select diagnostic codes "to ensure that this portion of the rating schedule uses current medical terminology and provides detailed and updated criteria for the evaluation of musculoskeletal disabilities." Id.

If a law or regulation changes during the course of a claim or an appeal, the version more favorable to the Veteran will apply, to the extent permitted by any stated effective date in the amendment in question. 38 U.S.C. § 5110 (g). If the revised version of the regulation is more favorable, the implementation of that regulation under 38 U.S.C. § 5110 (g) can be no earlier than the effective date of that change. If the former version is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. 38 U.S.C. § 5110.

Under DC 5260, limitation of flexion is rated as follows: flexion limited to 60 degrees warrants a noncompensable rating; flexion limited to 45 degrees warrants a 10 percent rating; flexion limited to 30 degrees warrants a 20 percent rating; and flexion limited to 15 degrees warrants a 30 percent rating. See 38 C.F.R. § 4.71a , DC 5260.

Diagnostic Code 5261 provides for a 10 percent rating when extension is limited to 10 degrees; a 20 percent rating with extension limited to 15 degrees; a 30 percent rating with extension limited to 20 degrees; a 40 percent rating with extension limited to 30 degrees; and a 50 percent rating is assigned with extension limited to 45 degrees. 38 C.F.R. § 4
able rating; flexion limited to 45 degrees warrants a 10 percent rating; flexion limited to 30 degrees warrants a 20 percent rating; and flexion limited to 15 degrees warrants a 30 percent rating. See 38 C.F.R. § 4.71a , DC 5260.

Under Diagnostic Code 5258, a 20 percent rating is warranted for a dislocated semilunar cartilage, with frequent episodes of locking, pain, and effusion into the joint. 38 C.F.R. § 4.71a.

Diagnostic Code 5010 provides that arthritis, due to trauma, substantiated by X-ray findings should be rated as degenerative arthritis under Diagnostic Code 5003. 38 C.F.R. § 4.71 (a).

Diagnostic Code 5003 provides that degenerative arthritis established by X-ray findings will be rated on the basis of limitation of motion under the appropriate diagnostic codes for the specific joint or joints involved (DC 5200 etc.). When however, the limitation of motion of the specific joint or joints involved is noncompensable under the appropriate diagnostic codes, a rating of 10 percent is for application for each such major joint or group of minor joints affected by limitation of motion, to be combined, not added under diagnostic code 5003. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. In the absence of limitation of motion, it is rated as the following: 20 percent is assigned With X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups, with occasional incapacitating exacerbations; and a 10 percent is assigned with X-ray evidence of involvement of 2 or more major joints or 2 or more minor joint groups.

Note (1): The 20 percent and 10 percent ratings based on X-ray findings, will not be combined with ratings based on limitation of motion.

Note (2): The 20 percent and 10 percent ratings based on X-ray findings, will not be utilized in rating conditions listed under diagnostic codes 5013 to 5024, inclusive.

Diagnostic Code 5262 previously provides ratings for impairment of the tibia and fibula. A 40 percent rating is assigned for nonunion with loose motion requiring a knee brace; a 30 percent rating is assigned for malunion with marked knee or ankle disability; a 20 percent rating is assigned for malunion with moderate ankle or knee disability; and a 10 percent rating is assigned for malunion with slight knee or ankle disability. 38 C.F.R. § 4.71 (a).

The Board notes that revision of Diagnostic Code 5262 provides that malunion of the tibia and fibula should be evaluated under Diagnostic Codes 5256, 5257, 5260, or 5261 for the knee or 5270 or 5271 for the ankle, whichever results in the highest evaluation. The revised Diagnostic Code for 5262 also provides for medial tibial stress syndrome or shin splints, which is not applicable in this case and is accordingly not provided. Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020) (to be codified at 38 C.F.R. § 4.71a , Diagnostic Code 5262).

Diagnostic Code 5263 provides for a 10 percent rating for genu recurvatum, acquired, traumatic, with weakness and insecurity in weight-bearing objectively demonstrated. 38 C.F.R. § 4.71 (a).

Other applicable diagnostic codes include Diagnostic Code 5259 which provides for assignment of a 10 percent rating for removal of symptomatic semilunar cartilage. 38 C.F.R. § 4.71 (a).

The Board finds the remaining Diagnostic Codes 5258 through 5261 were not changed by the February 7, 2021 code revision.

Procedurally, this appeal stems from a June 2011 claim for an increased evaluation for the right and left knee.

In a June 2013 examination, the examiner observed the Veteran's use of a cane "keeps the right knee stiff while walking...[and] sits with right knee extended." The Veteran did not report any flareups or functional impairment.

The examiner further noted that without
include Diagnostic Code 5259 which provides for assignment of a 10 percent rating for removal of symptomatic semilunar cartilage. 38 C.F.R. § 4.71 (a).

The Board finds the remaining Diagnostic Codes 5258 through 5261 were not changed by the February 7, 2021 code revision.

Procedurally, this appeal stems from a June 2011 claim for an increased evaluation for the right and left knee.

The examiner further noted that without the cane, the Veteran demonstrated "greater flexibility in both knees" with normal alignment and less stiffness.

The Veteran demonstrated 145 degrees flexion with both the right and left knee with no limitation to extension. The Veteran "complained" of pain in both hips during the examination, but no other pain was reported with the knee range of motion.

In a May 2016 VA examination, the Veteran reported no change in symptoms, no flareups, and no functional impairment.

The Veteran demonstrated full range of motion in both knees with no pain and no other physical complications.

In an August 2019 VA examination, the Veteran reported symptoms of daily pain and regular use of a cane. The Veteran did not report flareups or functional impairment.

The Veteran did not report a history of instability.

The Veteran demonstrated flexion to 130 degrees for both the right and left knee. The Veteran reported pain with flexion.

The Veteran demonstrated normal stability with no other physical complications.

At the March 2020 hearing, the Veteran testified that they used heavy "loader braces" with no recent treatment; the Veteran stated that they would fall without braces and experienced weakness with use of the stairs. The Veteran also reported difficulty with bending.

A June 2020 provider noted the Veteran's long history of knee pain since their separation from service but did not provide any measurements or further details on the severity of the Veteran's knee disabilities.

The Veteran did not appeal for scheduled VA examinations in September 2025 as requested by the November 2024 Board remand. As a result, the Board will decide the claim based on the evidence of record. 38 C.F.R. § 3.655 (b).

After review of the evidence of record, the Board finds the evidence persuasively against a finding for a disability rating in excess of 10 percent for the Veteran's right and left knee disability.

As noted above, a 10 percent rating is the maximum available under Diagnostic Code 5010 (2019). A 20 percent rating is not warranted under Diagnostic Code 5260 unless flexion is limited 30 degrees or less.

There is no indication in any of the Veteran's treatment records or examinations that the Veteran's right or left knee impairment has ever had impairment of flexion to 30 degrees or extension to 15 degrees, even when painful motion, flare ups, and other types of impairment are taken into consideration.

At worst, Veteran's right and left knee flexion was estimated to 130 degrees for the right and left knee as documented at the August 2019 VA examination.

A higher rating is not warranted under Diagnostic Code 5003 because there is no X-ray evidence of degenerative arthritis involving 2 or more major or minor joints with occasional incapacitating exacerbations.

The Board has further considered other applicable diagnostic codes associated with the knee. However, medical treatment records did not reveal the Veteran had ankylosis of the knees (Diagnostic Code 5256), a dislocated semilunar cartilage (Diagnostic Code 5258), removal of symptomatic semilunar cartilage (Diagnostic Code 5259), a tibia or fibular impairment (Diagnostic Code 5262) or genu recurvatum (Diagnostic Code 5263) associated with the right or left knee.

The evidence also does not support a finding of any instability of the right or left knee.

Additionally, the Veteran had not undergone surgery for the right or left knee; therefore, separate ratings under DC 7800-7805 are not warranted.

The Board recognizes under DeLuca v. Brown, 8 Vet. App. 202 (1995) VA must consider "functional loss" of a musculoskeletal disability separately from consideration under the DCs. "Functional loss" may occur as a result of weakness or pain on motion. Here, the evidence shows that the Veteran pain on movement; disturbance of locomotion; and interference with sitting, standing, and weight-bearing. However, the Board finds that given the extent of the Veteran's knee motion and the extent of functional and occupational impairment indicated in the record, there is no evidence of a disability picture that is commensurate to a limitation
knee; therefore, separate ratings under DC 7800-7805 are not warranted.

The Board recognizes under DeLuca v. Brown, 8 Vet. App. 202 (1995) VA must consider "functional loss" of a musculoskeletal disability separately from consideration under the DCs. "Functional loss" may occur as a result of weakness or pain on motion. Here, the evidence shows that the Veteran pain on movement; disturbance of locomotion; and interference with sitting, standing, and weight-bearing. However, the Board finds that given the extent of the Veteran's knee motion and the extent of functional and occupational impairment indicated in the record, there is no evidence of a disability picture that is commensurate to a limitation of flexion to the extent necessary to establish entitlement to a higher disability rating, even after taking his functional loss into full consideration. See DeLuca, 8 Vet. App. at 204-07 ; 38 C.F.R. §§ 4.40, 4.45, 4.71a, DC 5260.

The Board has considered the Veteran's statements regarding the severity of the Veteran's right and left knee disability. However, as a lay person, the Veteran does not have the training or expertise to render a competent opinion which is more probative than the VA examiner's opinion on this issue, as this is a medical determination that is complex. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 309 (2007); Layno v. Brown, 6 Vet. App. 465, 469-71 (1994)). Thus, the lay opinions by themselves are outweighed by the VA examiner's findings. See id. ; see also King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012) (affirming the Court's conclusion that the Board did not improperly discount the weight of a lay opinion in finding a medical expert's opinion more probative on the issue of medical causation).

As noted above, the Veteran did not appear for a scheduled September 2025 VA examination to assess the current severity of the right and left knee disability. See Olson v. Principi, 3 Vet. App. 480 (1992). The Veteran has not otherwise submitted any medically objective evidence in support of the appeal.

Accordingly, the evidence of record is persuasively against the claims for a rating in excess of 10 percent for service-connected right and left knee disability under DC 5260.

Right and Left Foot flexible pes planovalgus

The Veteran is service connected for right foot flexible pes planovalgus at 20 percent prior to May 25, 2016; left foot flexible pes planovalgus at 10 percent prior to May 25, 2016; and bilateral flexible pes planovalgus at 30 percent since January 25, 2016.

The Board notes that a disability rating that has been continuously rated at or above a certain percentage for at least 20 years is a protected rating. A protected rating cannot be reduced, let alone eliminated, absent a showing of fraud. 38 C.F.R. § 3.951.

Here, the Veteran has been in receipt of a 20 percent evaluation for right foot flexible pes planovalgus effective December 16, 1997 and 10 percent for left foot flexible pes planovalgus effective January 24, 2001, more than 20 years ago. As such, the ratings are protected.

The Board next notes that the Veteran's right and left foot flexible pes planovalgus prior to January 25, 2016 was evaluated under Diagnostic Code (DC) 5299-5276 for the right foot, and under DC 5262-5276.

A hyphenated code may be used to identify the proper evaluation of a disability or a residual from disease. The first code of a hyphenated code identifies the diagnosed disease or condition. The second code of a hyphenated code identifies the criteria in the Schedule for Rating Disabilities used to evaluate the disability.

Furthermore, unlisted disabilities requiring rating by analogy are coded with the first two numbers of the schedule provisions most closely related body part and 99. Here, the hyphenated diagnostic code indicates that the Veteran's left flexible pes planovalgus disability is currently rated as analogous to a disabilities of the musculoskeletal system (Diagnostic Code 5299) under the acquired flatfoot criteria (Diagnostic Code 5276). 38 C.F.R. § 4.71a, Diagnostic Code 5299-5276.

The Board notes that during the
hyphenated code identifies the diagnosed disease or condition. The second code of a hyphenated code identifies the criteria in the Schedule for Rating Disabilities used to evaluate the disability.

The Board notes that this appeal stems from a June 2011 claim for an increased rating for the feet.

While the rating of the same disability under various diagnoses is to be avoided, that does not preclude the assignment of separate ratings for separate and distinct symptomatology where none of the symptomatology justifying a rating under one diagnostic code is duplicative of or overlapping with the symptomatology justifying a rating under another diagnostic code. Esteban v. Brown, 6 Vet. App. 259 (1994).

The Board notes that the diagnostic code used to evaluate the Veteran's pes planus under DC 5276 was not changed by the February 2021 revision.

Diagnostic Code 5276 for acquired flatfoot provides a 10 percent rating is warranted for moderate pes planus where the weight-bearing lines are over or medial to the great toes and there is inward bowing of the tendon achilles and pain on manipulation and use of the feet.

A 30 percent rating is assigned for severe bilateral pes planus, with objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated indication of swelling on use, and characteristic callosities.

A 50 percent rating is assigned for pronounced bilateral acquired pes planus manifested by marked pronation, extreme tenderness of the plantar surfaces of the feet, and marked inward displacement and severe spasm of the tendon Achilles on manipulation, which is not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a , Diagnostic Code 5276. DC 5276

Under the version prior to the February 2021 revisions, DC Code 5262 provides schedular ratings for impairment of the tibia and fibula. Malunion with a slight ankle disability warrants a 10 percent rating; malunion with a moderate ankle disability warrants a 20 percent rating; and malunion with a marked ankle disability warrants a 30 percent rating. Evidence of nonunion of the tibia and fibula with loose motion requiring a brace warrants a 40 percent evaluation. 38 C.F.R. § 4.71a, Diagnostic Code 5262.

Under the pre-amendment criteria, evidence of actual malunion or nonunion of the tibia and fibula is not necessary when rating by analogy. Stankevich v. Nicholson,19 Vet. App. 470(2006) (holding that the law recognizes that disabilities rated under analogous code sections will not show all of the objective criteria of the analogous rating).

Under Diagnostic Code 5262, the terms "slight," "moderate" and "marked" are not defined in the rating schedule or assigned objective degree of limitation measurements as with other diagnostic codes. When the Board assigns a rating based on criteria with undefined terms such as "slight" and "moderate," the Board's responsibility to provide reasons or bases to facilitate judicial review includes the obligation to "disclose the standard under which it is operating." Johnson v. Wil
ula is not necessary when rating by analogy. Stankevich v. Nicholson,19 Vet. App. 470(2006) (holding that the law recognizes that disabilities rated under analogous code sections will not show all of the objective criteria of the analogous rating).

The Board notes that as with any regulatory interpretation where the terms are not defined in the regulation, it is reasonable to presume that those terms carry their ordinary dictionary meaning. See Moody v. Wilkie, 30 Vet. App. 329, 336 (2018); see also Kisor v. Wilkie, 139 S. Ct. 2400, 2415 (2019) (holding that where regulatory terms are unambiguous, the plain meaning dictionary definition can be used). Here, the Board finds the relevant descriptive terms to be unambiguous, rendering a plain dictionary meaning appropriate for application. According to Merriam Webster's Collegiate Dictionary 999 (11th Ed. 2007), "slight" means small in amount. Moderate means "tending toward the mean or average amount or dimension." Marked means "having a distinctive or emphasized character." The use of the terminology within a VA examination report is not in and of itself dispositive. Rather than applying a mechanical formula, the Board must evaluate all the evidence to the end that its decisions are equitable and just. 38 C.F.R. § 4.6.

In applying the relevant terms to the evidence of record, the Board is also mindful that the Court has indicated that when a "regulation does not speak to the type of evidence required... [it] certainly does not, by its terms, restrict evidence to 'objective' evidence." See Petitti v. McDonald, 27 Vet. App. 415, 427 (2015). Further, based on the Court's holding in English v. Wilkie, 30 Vet. App. 347, 352-53 (2018), objective medical evidence is likely not required to "establish" instability under pre-amended Diagnostic Code 5262, and the Board cannot categorically find objective medical evidence more probative than lay evidence.

In a June 2013 VA examination for the feet, the Veteran reported symptoms of pain in the rear heel and calf occurring "a couple times a month" and limiting the Veteran's ability to stand and walk.

The examiner found the Veteran able to stand on tip toes with support but unable to stand on heels. The Veteran demonstrated a stiff-legged gait due to knees but not the feet.

In a January 2016 VA examination, the Veteran reported pain after standing walking more than 10 minutes; the Veteran denied flareups or functional impairment.

The examiner found the Veteran with pain on use and manipulation of both feet, accentuated with use.

The examiner found no evidence of characteristic calluses. The examiner noted the Veteran use of orthotics but remained symptomatic.

The examiner found the Veteran with marked deformity of both feet but with no marked pronation.

The examiner found the Veteran with decreased longitudinal arch height of both feet on weight bearing but with no lower extremity deformity.

The examiner found the Veteran to demonstrate "inward" bowing of the Achilles tendon but did not find marked inward displacement or severe spasms of the Achilles tendon on manipulation of the feet.

In a May 2016 VA examination, the Veteran reported pain while getting up in the morning with no flareups or functional impairment.

The examiner found the Veteran with pain on use of both feet.

The examiner found no evidence of swelling or characteristic calluses.

The examiner did not find the Veteran with extreme tenderness of plantar surfaces on either foot; marked deformity of either foot; marked pronation of either foot; evidence of weight-bearing line falling over or medial to the great toe; or lower extremity deformity other than pes planus causing alteration of the weight-bearing line.

The examiner did note the Veteran's bilateral stress fracture that occurred 25 years ago with reported chronic pain with weight-bearing.

In an August 2019 VA examination, the Veteran reported pain with standing and walking; the Veteran also reported flareups but no functional impairment.

The examiner found the Veteran with pain on use and manipulation of both feet, accentuated with use.

The examiner found no evidence of pain with manipulation or characteristic calluses. The examiner noted the Veteran use of
erness of plantar surfaces on either foot; marked deformity of either foot; marked pronation of either foot; evidence of weight-bearing line falling over or medial to the great toe; or lower extremity deformity other than pes planus causing alteration of the weight-bearing line.

The examiner did note the Veteran's bilateral stress fracture that occurred 25 years ago with reported chronic pain with weight-bearing.

In an August 2019 VA examination, the Veteran reported pain with standing and walking; the Veteran also reported flareups but no functional impairment.

The examiner found the Veteran with pain on use and manipulation of both feet, accentuated with use.

The examiner found no evidence of pain with manipulation or characteristic calluses. The examiner noted the Veteran use of orthotics but remained symptomatic.

The examiner found the Veteran with marked deformity of both feet but with no marked pronation or extreme tenderness.

The examiner found the Veteran with decreased longitudinal arch height of both feet on weight bearing but with no lower extremity deformity.

The examiner found the Veteran to demonstrate "inward" bowing of the Achilles tendon but did not find marked inward displacement or severe spasms of the Achilles tendon on manipulation of the feet.

In March 2020, the Veteran testified to symptoms of pain in the feet and heels to the point where the Veteran stated they were unable to put pressure on them. The Veteran described occasional spasms that affected their gait and required use of a cane.

After review of the evidence of record prior to January 25, 2016, the Board does not find the Veteran's left flexible pes planovalgus warrants an increased evaluation in excess of 10 percent or an increased evaluation in excess of 20 percent for right flexible pes plano valgus.

While the Veteran reports symptoms of bilateral feet pain, there is no indication of pain on manipulation, marked deformity, swelling on use, characteristic callosities, extreme tenderness, or any other symptom indicating a more severe level of disability prior to January 25, 2016.

The Board next does not find the evidence of record since January 25, 2016 shows the Veteran's bilateral flexible pes planovalgus warrants an increased evaluation in excess of 30 percent.

The Veteran's bilateral flexible pes planovalgus during this period was manifested by pain and swelling on use of the feet, and pain on manipulation in both feet; decreased longitudinal arch height of both feet on weight-bearing; weight-bearing line falling over or medial to the great toe in both feet; pain on movement, weight-bearing, and non-weight-bearing; swelling; disturbance of locomotion; and interference with standing. These findings more closely approximate the criteria for a 30 percent rating under Diagnostic Code 5276.

The Board finds no probative lay or medical evidence since January 25, 20216 demonstrating that the Veteran's service-connected bilateral flexible pes planovalgus has been manifested by marked pronation in either foot, extreme tenderness of plantar surfaces of the feet, or marked inward displacement and severe spasm of the tendo Achillis on manipulation of each foot, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, Diagnostic Code 5276.

As noted above, the Veteran did not appear for a September 2025 VA examination to assess the current severity of their claimed disabilities.

The Board has also considered the other Diagnostic Codes pertaining to the foot. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); see also Lyles v. Shulkin, 29 Vet. App. 107 (2017). In Scott v. Wilkie, the Federal Circuit expressly adopted the Court's holding that disabilities specifically listed in the rating schedule may only be rated under Diagnostic Codes which specifically pertain to them. Scott v. Wilkie, 920 F.3d 1375 (Fed. Cir. 2019) (citing Copeland v. McDonald, 27 Vet. App. 333, 336 (2015)).

The Federal Circuit also expressly adopted the Court's holding that unlisted conditions may be rated by analogy to Diagnostic Codes that may not describe the unlisted disability but addresses disabilities that may be productive of similar symptoms. Scott, 920 F.3d 1375 (citing Yancy v. McDonald, 27 Vet. App. 484, 493 (2016). Finally, the Federal
disabilities specifically listed in the rating schedule may only be rated under Diagnostic Codes which specifically pertain to them. Scott v. Wilkie, 920 F.3d 1375 (Fed. Cir. 2019) (citing Copeland v. McDonald, 27 Vet. App. 333, 336 (2015)).

The Federal Circuit also expressly adopted the Court's holding that unlisted conditions may be rated by analogy to Diagnostic Codes that may not describe the unlisted disability but addresses disabilities that may be productive of similar symptoms. Scott, 920 F.3d 1375 (citing Yancy v. McDonald, 27 Vet. App. 484, 493 (2016). Finally, the Federal Circuit concluded that the Board must also consider assigning separate ratings under analogous Diagnostic Codes, when rating an unlisted service-connected foot disability exhibiting distinct manifestations, even when service connection has also been granted for one of the eight conditions listed in the rating schedule. Id.

Here, the Veteran's disability is specifically listed under the rating schedule and therefore cannot be rated under a different Diagnostic Code. The Board has considered whether Diagnostic Code 5284 (for "other" foot injuries) is applicable to this case. However, the Board finds that the Veteran's flexible pes planovalgus is adequately contemplated by the assigned rating under Diagnostic Code 5276, as it pertains directly to flatfoot. As such, Diagnostic Code 5276 is the proper diagnostic code to apply to the Veteran's service-connected bilateral flexible pes planovalgus.

The Board has also considered higher evaluations under other diagnostic codes pertaining to disabilities of the feet; however, there is no evidence demonstrating claw foot or malunion or nonunion of the tarsal or metatarsal bones; as such, the applicable DCs for those conditions do not apply. The Veteran is already serviced connected for bilateral flexible pes planovalgus.

Additionally, the criteria used to evaluate the feet were recently revised, effective February 7, 2021, to provide evaluation of plantar fasciitis under new DC 5269. 85 Fed. Reg. 76453 (Nov. 30, 2020), rev'd 86 Fed. Reg. 8142 (Feb. 4, 2021). However, the evidence from January 18, 2021 does not reflect that the Veteran has plantar fasciitis; therefore, a separate or higher rating under this new DC from the effective date of the revised regulation is not warranted.

Overall, the Veteran's bilateral flexible pes planovalgus since June 25, 2016 is manifested by pain and on use of the feet; decreased longitudinal arch height of both feet on weight-bearing; weight-bearing line falling over or medial to the great toe in both feet; disturbance of locomotion; and interference with standing and walking. These findings more closely approximate the criteria for a 30 percent rating under Diagnostic Code 5276.

Accordingly, the evidence of record is persuasively against the claims for an increased evaluation in excess of 10 percent or an increased evaluation in excess of 20 percent for right flexible pes planovalgus prior to January 25, 2016; and against an increased evaluation in excess of 30 percent for bilateral flexible pes planovalgus since January 25, 2016. In denying such a rating, the Board finds the benefit of the doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.

Total disability rating based upon individual unemployability (TDIU)

VA will grant a total rating for compensation purposes based on unemployability when the evidence shows that the Veteran is precluded from obtaining or maintaining any substantially gainful employment consistent with his education and occupational experience, by reason of his service-connected disabilities. 38 C.F.R. §§ 3.340, 3.341, 4.16.

Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when the disabled person is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that the Veteran meets the schedular requirements. 38 C.F.R. § 3.340.

Specifically, if there is only one such disability, this disability shall be ratable at 60 percent or more; if there are two or more disabilities, there shall be at least one disability that is ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a).

For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following disabilities will be considered as one disability: (1
as a result of service-connected disabilities, provided that the Veteran meets the schedular requirements. 38 C.F.R. § 3.340.

For the above purpose of one 60 percent disability, or one 40 percent disability in combination, the following disabilities will be considered as one disability: (1) Disabilities of one or both upper extremities, or of one or both lower extremities, including the bilateral factor, if applicable, (2) disabilities resulting from common etiology or a single accident, (3) disabilities affecting a single body system, e.g. orthopedic, digestive, respiratory, cardiovascular-renal, neuropsychiatric, (4) multiple injuries incurred in action, or (5) multiple disabilities incurred as a prisoner of war. 38 C.F.R. § 4.16 (a).

The central inquiry is, "whether the veteran's service-connected disabilities alone are of sufficient severity to produce unemployability." Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993).

In determining whether unemployability exists, consideration may be given to the Veteran's level of education, special training, and previous work experience, but not to his age or to any impairment caused by non-service-connected disabilities. 38 C.F.R. §§ 3.341, 4.16, 4.19.

"Substantially gainful employment" is that employment" which is ordinarily followed by the nondisabled to earn their livelihood with earnings common to the particular occupation in the community where the veteran resides." Moore v. Derwinski, 1 Vet. App. 356, 358 (1991).

"Marginal employment shall not be considered substantially gainful employment." 38 C.F.R. § 4.16 (a). For purposes of 38. C.F.R. § 4.16, marginal employment generally shall be deemed to exist when a veteran's earned annual income does not exceed the amount established by the U.S. Department of Commerce as the poverty threshold for one person. Marginal employment may also be held to exist, on a facts-found basis (includes but is not limited to employment in a protected environment such as a family business or sheltered workshop), when earned annual income exceeds the poverty threshold. Consideration shall be given in all claims to the nature of the employment and the reason for termination. Id.

The sole fact that a claimant is unemployed or has difficulty obtaining employment is not enough; the ultimate question is whether the Veteran is capable of performing the physical and mental acts required by employment, not whether he or she can find employment. Van Hoose v. Brown, 4 Vet. App. 361 (1993).

The ultimate responsibility for a TDIU determination is a factual rather than a medical question and is an adjudicative determination made by the Board or the AOJ. Geib, 733 F.3d at 1354 (citing 38 C.F.R. § 4.16 (a)).

As noted above, the issue of TDIU was raised as part and parcel of an underlying increased rating claim for knees and feet that appealed a June 2013 rating decision. Rice v. Shinseki, 22 Vet. App. 447, 455 (2009).

In such a situation, the claim for TDIU has the same appeal period as that of the increased rating claim; in this case, the Veteran submitted a June 2011 claim for an increased rating for knees and feet. However, the Board notes that during the one year look back period prior to the June 2011 claim, the only relevant evidence that pertains to TDIU indicates that the Veteran was employed; the Veteran in May 2016 reported employment up until last year. Therefore, there is no reason to grant TDIU during the one year look back period from the June 2011 claim.

As noted above, the Veteran is in receipt of TDIU effective from May 25, 2016.

Prior to May 25, 2016, the Veteran was service connected for a psychiatric disorder evaluated at 30 percent; bilateral flexible pes planovalgus evaluated at 30 percent; back disability at 20 percent; left knee disability at 10 percent; right knee disability at 10 percent; tendonitis of both knees, chondromalacia patella as noncompensable from February 22
was employed; the Veteran in May 2016 reported employment up until last year. Therefore, there is no reason to grant TDIU during the one year look back period from the June 2011 claim.

As noted above, the Veteran is in receipt of TDIU effective from May 25, 2016.

Prior to May 25, 2016, the Veteran was service connected for a psychiatric disorder evaluated at 30 percent; bilateral flexible pes planovalgus evaluated at 30 percent; back disability at 20 percent; left knee disability at 10 percent; right knee disability at 10 percent; tendonitis of both knees, chondromalacia patella as noncompensable from February 22, 1990 to January 23, 2001; and irritable bowel syndrome as noncompensable.

The Veteran's combined rating was 50 percent from January 24, 2001; 60 percent from June 2, 2011; and 70 percent from June 30, 2014.

In March 2012 the Veteran requested their appeal be expedited based on financial hardship; the Veteran reported working as a custodian but was informed their position was temporary and would end in May.

In a June 2013 VA examination the Veteran reported that after his separation from service they worked several jobs to include department or retail stores. The Veteran stated that the majority of their work was as a carpenter working in construction and hanging drywall; the Veteran denied injury to their feet or lower extremities during this type of work.

The Veteran stated that in April 2008 they began working for the US Post Office for maintenance; then in June 2011 began carrying mail for 8 to 10 hours daily.

The Veteran stated that their mail-carrying duties caused pain in their feet, knees, and ankles. The Veteran stated that they now currently drive a mail carrier and therefore did not need to get out; the Veteran also reported working "on restriction from VA" and having 2 days off each work related to their feet, knees, and ankles.

The Veteran reported symptoms of pain in the rear heel and calf occurring "a couple times a month" and limiting their standing and walking.

In a June 2013 examination for the knee, the examiner observed the Veteran's use of a cane "keeps the right knee stiff while walking...[and] sits with right knee extended." The Veteran did not report any flareups or functional impairment.

The examiner further noted that without the cane, the Veteran demonstrated "greater flexibility in both knees" with normal alignment and less stiffness.

In a January 2015 VA examination for psychiatric disorders, the Veteran reported that they currently work for the US Postal Office as a mail carrier since 2008. The Veteran described the work as stressful, where work is mostly "walking which I can't do anymore"; the Veteran noted that they were given less opportunities to drive and transfer requests were denied.

In a January 2016 VA examination for the feet, the Veteran reported symptoms of pain after standing or walking more than 10 minutes; the Veteran denied flareups or functional impairment.

In a May 2016 VA examination for the knee, the Veteran reported no change in symptoms, no flareups, and no functional impairment.

The Veteran demonstrated full range of motion in both knees with no pain and no other physical complications.

The Veteran also reported that they worked as a mail carrier until last year when they retired.

In a May 2016 VA examination for psychiatric disorders, the Veteran reported that they retired in April 2015 as a mail carrier for the US postal office. The Veteran stated that over time the Veteran was eventually unable to perform their job duties "...all the walking -everything that was associated with the job anymore."

The Veteran stated that they were on light duty for some time but their physical concerns "progressively got worse...couldn't do it anymore...I had to give it up."

The examiner found the Veteran withs symptoms of depressed mood; chronic sleep impairment; flattened affect; disturbance of motivation and mood; difficulty in establishing effective work and social relationships; and intermittent inability to perform activities of daily living to include maintaining personal hygiene.

In Social Security Administration (SSA) records associated with the claims record in January 2025, an unfavorable decision was made by an Administrative Law Judge (ALJ) relating to SSA benefits. The decision noted the Veteran had not engaged in substantial gainful activity since April 13, 2015 and had several disabilities or impairments relating to the lower extremities, bilateral knees, Raynaud phenomemon, and osteoporosis.

The ALJ found the evidence demonstrated the Veteran still demonstrated residual functional capacity and therefore did not meet the SSA criteria for disability.

The Board notes that the SSA decision considered non-service connected disabilities and criteria in reaching their decision; as such, the Board finds the decision
of daily living to include maintaining personal hygiene.

The ALJ found the evidence demonstrated the Veteran still demonstrated residual functional capacity and therefore did not meet the SSA criteria for disability.

The Board notes that the SSA decision considered non-service connected disabilities and criteria in reaching their decision; as such, the Board finds the decision to have less probative value.

In August 2025 the Veteran submitted employer information response from the US Postal Service documenting the Veteran working as a laborer custodian carrier from April 2008 until April 13, 2015.

After review of the record prior to May 25, 2016, the Board resolves reasonable doubt and finds entitlement to TDIU from April 13, 2015 to May 25, 2016 is warranted.

From April 13, 2015 to May 25, 2016 May 25, 2016, the Veteran's combined evaluation of service-connected disabilities was 70 percent effective from June 30, 2014; as indicated above, disabilities resulting from common etiology of single accident will be considered as one disability for purposes the minimal criteria for TDIU. As the Veteran's right and left flexible pes planovalgus with stress fracture were associated with the Veteran's knee disabilities and therefore of common etiology, the disabilities are combined using the Combined Ratings Table resulting in a 40 percent evaluation. See 38 C.F.R. § 4.25 and 4.26.

Accordingly, the Veteran meets the threshold schedular requirement for TDIU. 38 C.F.R. § 4.16(a). The question remains, however, whether the Veteran has been precluded from obtaining or maintaining a substantially gainful occupation as a result of their service-connected disabilities.

The Board acknowledges that the focus of a TDIU rating should not be on the Veteran's unemployment and the reasons why the Veteran is unemployed; rather, the focus must be on whether the Veteran's service-connected disabilities currently render him unable to secure or follow substantially gainful employment.

The Veteran has consistently reported that symptoms relating to their service-connected disabilities interfered with their ability to perform their job.

As documented in the May 2016 VA examination for psychiatric disorders, the Veteran reported employment with the US Postal Office until April 2015 when they retired because they were unable to perform the physical duties of the job to include carrying mail.

The Veteran has stated that even with assistance to include driving a mail carrier; their physical difficulties resulting from symptoms from service-connected disabilities progressed to the point where the Veteran found themselves unable to continue and therefore stopped working for the US Postal Office.

The August 2025 employer information response from the US Postal Office documents the Veteran last working on April 13, 2015. The evidence demonstrates that the Veteran has not worked since that date.

Although the VA examiners opinions of record prior to May 25, 2016 did not specifically state the Veteran was unemployable, they did note that the symptoms of the Veteran's disabilities did impact or limit the Veteran's ability to perform any occupational work involving such activities.

The Board notes that the Veteran's previous work history carpenter and mail carrier were positions that would involve activities that the evidence shows the Veteran is either unable to or will have difficulty performing these duties.

Moreover, the "applicable regulations place responsibility for the ultimate TDIU determination on the VA, not a medical examiner." See Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013).

As such, reasonable doubt is resolved in the Veteran's favor and entitlement to TDIU from April 13, 2015 to May 25, 2016 is granted. See 38 C.F.R. §§ 3.102, 4.16(a).

MICHAEL LANE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Yang, Jonathan

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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