INTERVERTEBRAL DISC SYNDROME

G.J. SUH · 2026 · Case ID: 26004901

MIXED

Summary

The veteran, who served in the United States Army from June 1968 to July 1988, including receiving a Combat Infantryman Badge, appeals decisions regarding his lumbar spine disability and hemorrhoids. The Board granted a 20 percent rating for the lumbar spine disability for the period prior to March 16, 2020, resolving doubt in the veteran's favor, but denied higher ratings for this condition throughout the appeal period. The Board found the veteran's lumbar spine disability, rated under DC 5243-5237, had a combined range of motion of 120 degrees prior to March 16, 2020, which warranted the 20 percent rating, but did not meet criteria for higher ratings due to lack of ankylosis or more severe flexion limitations. For hemorrhoids, the Board denied a higher rating, finding the current 10 percent rating sufficient as symptoms did not include anemia, fissures, or prolapsed internal hemorrhoids. However, the Board granted an earlier effective date of October 12, 2016, for the 10 percent hemorrhoid rating, finding a factually ascertainable increase in severity occurred within one year of the April 2017 claim, based on a colonoscopy finding large internal hemorrhoids. The claim for an earlier effective date for the lumbar spine disability was denied as no earlier unadjudicated claim or factually ascertainable increase within the appeal period was established.

Rationale

Benefit of doubt resolved in favor of Veteran; Combined range of motion of 120 degrees prior to March 16, 2020; No higher rating warranted due to lack of ankylosis or more severe flexion limitations

Service Branch

ARMY

Special Benefit

EARLIER EFFECTIVE DATE

Docket No.

18-53 052

Full Decision Text

Citation Nr: 26004901
Decision Date: 04/23/26 Archive Date: 04/23/26

DOCKET NO. 18-53 052
DATE: April 23, 2026

ORDER

A rating of 20 percent, but no higher, prior to March 16, 2020, for a lumbar strain with intervertebral disc syndrome (lumbar spine disability) is granted subject to the statutes and regulations governing the payment of monetary benefits.

A rating in excess of 20 percent since March 16, 2020, for the lumbar spine disability is denied.

A rating in excess of 10 percent for hemorrhoids is denied.

An earlier effective date of October 12, 2016, for the award of a 10 percent rating for hemorrhoids is granted.

An effective date prior to April 4, 2017, for the award of an increased rating for the lumbar spine disability is denied.

FINDINGS OF FACT

1. Resolving all reasonable doubt in favor of the Veteran, prior to March 16, 2020, his lumbar spine disability manifested in a combined range of motion of 120 degrees with consideration of additional functional loss during flare-ups.

2. At no point during the appeal period has the Veteran's lumbar spine disability manifested in ankylosis (or the functional equivalent thereof) or forward flexion to 30 degrees or less, even with consideration of functional loss during flares and with repeated use, and the Veteran has not experienced any incapacitating episodes.

3. The Veteran's hemorrhoids have not manifested in anemia, fissures, continually prolapsed internal hemorrhoids, or any episodes of thrombosis.

4. Resolving all reasonable doubt in favor of the Veteran, his hemorrhoids underwent a factually ascertainable increase within one year of his April 2017 claim for increase.

5. VA received the Veteran's formal claim for an increased rating for his lumbar spine disability on April 4, 2017. There are no earlier, unadjudicated claims.

CONCLUSIONS OF LAW

1. The criteria for a rating of 20 percent, but no higher, prior to March 16, 2020, for a lumbar spine disability have been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.40, 4.59, 4.71a, Diagnostic Code (DC) 5243-5237.

2. The criteria for a rating in excess of 20 percent for a lumbar spine disability since March 16, 2020, have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.40, 4.59, 4.71a, DC 5243-5237.

3. The criteria for a rating in excess of 10 percent for hemorrhoids have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.114, DC 7336.

4. The criteria for an earlier effective date of October 12, 2016, for the award of a 10 percent rating for hemorrhoids have been met. 38 U.S.C. §§ 1155, 5101, 5107, 5110; 38 C.F.R. §§ 3.102, 3.400(o).

5. The criteria for an effective date prior to April 4, 2017, for the award of a 20 percent rating for a lumbar spine disability have not been met. 38 U.S.C. §§ 1155, 5101, 5107, 5110; 38 C.F.R. §§ 3.102, 3.400(o).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty with the United States Army from June 1968 to July 1988. For his service, he received among others, a Combat Infantryman Badge.

These matters come before the Board of Veterans' Appeals (Board) on appeal of a June 2017 rating decision issued by a Department of Veterans Affairs (VA) regional office, an agency of original jurisdiction (AOJ).

The Board remanded the claims on appeal in January 2020, April 2023, and April 2024 for additional development. The Board's
5110; 38 C.F.R. §§ 3.102, 3.400(o).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty with the United States Army from June 1968 to July 1988. For his service, he received among others, a Combat Infantryman Badge.

The Board remanded the claims on appeal in January 2020, April 2023, and April 2024 for additional development. The Board's remand directives have been substantially completed as the requested opinions have been obtained. See Stegall v. West, 11 Vet. App. 268 (1998).

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.902(c); 38 U.S.C. § 7107(a)(2).

Increased Rating

Ratings are based on a schedule of reductions in earning capacity from specific injuries or combination of injuries. The ratings shall be based, as far as practicable, upon the average impairments of earning capacity resulting from such injuries in civil occupations. 38 U.S.C. § 1155. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1.

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. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3.

The issue of entitlement to an increased rating in excess of 20 percent prior to March 16, 2020, and in excess of 20 percent therefrom, for the lumbar spine disability.

The Veteran seeks increased ratings for his lumbar spine disability.

For the reasons that follow, and resolving all reasonable doubt in favor of the Veteran, the Board finds that an increased 20 percent rating is warranted for the period prior to March 16, 2020, but that increased ratings otherwise are not warranted.

The Veteran's low back disability has been rated 10 percent disabling prior to March 16, 2020, and 20 percent disabling thereafter pursuant to DC 5243-5237. Hyphenated diagnostic codes are used when a rating under one code requires use of an additional diagnostic code to identify the basis for the rating assigned. 38 C.F.R. § 4.27. Here, the hyphenated diagnostic code indicates that the Veteran's IVDS (DC 5243) has been rated based upon the rating for a lumbosacral strain (DC 5237).

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. 76453 (Nov. 30, 2020) (to be codified as 38 C.F.R. § 4.71a). Relating to the spine, only DC 5243 was revised, and the change only pertained to the assignment of the DC. Notably, the criteria used to rate disabilities of the spine were not changed.

Disabilities of the spine (other than IVDS when evaluated on the basis of incapacitating episodes) are to be rated under the General Rating Formula for Diseases and Injuries of the Spine. 38 C.F.R. § 4.71a, DCs 5235-5243. These criteria are to be applied irrespective of whether there are symptoms such as pain (whether or not it radiates), stiffness, or aching in the affected area of the spine, and they "are meant to encompass and take into account the presence of pain, stiffness, or aching, which are generally present when there is a disability of the spine." 68 Fed. Reg. 51, 454 (Aug. 27, 2003).

Under the General Rating Formula, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees
juries of the Spine. 38 C.F.R. § 4.71a, DCs 5235-5243. These criteria are to be applied irrespective of whether there are symptoms such as pain (whether or not it radiates), stiffness, or aching in the affected area of the spine, and they "are meant to encompass and take into account the presence of pain, stiffness, or aching, which are generally present when there is a disability of the spine." 68 Fed. Reg. 51, 454 (Aug. 27, 2003).

Under the General Rating Formula, a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent rating is assigned where forward flexion of the thoracolumbar spine is to 30 degrees or less, or if there is favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine, while a 100 percent rating is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Rating Formula. Additionally, any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under the appropriate diagnostic codes. Id. at Note (1).

Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The normal combined range of motion of the thoracolumbar spine is 240 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. 38 C.F.R. § 4.71a, DCs 5235-5243, Note (2).

Unfavorable ankylosis is defined, in pertinent part, as "a condition in which the entire thoracolumbar spine is fixed in flexion or extension." Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. Id.

In Chavis v. McDonough, the Court held that the requirement of ankylosis can be met with evidence of the functional equivalent of ankylosis ((i.e., functional immobility of the joint) during a flare-up and/or with repeated use due to the DeLuca factors. 34 Vet. App. 1 (2021).

IVDS is evaluated under either the General Rating Formula or under the IVDS Formula, whichever results in the higher evaluation when all disabilities are combined. 38 C.F.R. § 4.71a. An incapacitating episode is defined as a period of acute signs and symptoms due to IVDS that requires bed rest prescribed by a physician and treatment by a physician. 38 C.F.R. § 4.71a, DC 5243, Note (1), Formula for Rating IVDS Based on Incapacitating Episodes.

Under the IVDS Formula for intervertebral disc syndrome, a 10 percent disability rating is warranted when there are incapacitating episodes having a total duration of at least 1 week but less than 2 weeks during the past 12 months. A 20 percent rating is warranted for IVDS with incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months. A 40 percent rating is warranted for incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months. A maximum 60 percent rating is warranted for incapacitating episodes having a total duration of at least six weeks during the past 12 months is warranted. 38 C.F.R. § 4.71a, Diagnostic Code 5243. An
disability rating is warranted when there are incapacitating episodes having a total duration of at least 1 week but less than 2 weeks during the past 12 months. A 20 percent rating is warranted for IVDS with incapacitating episodes having a total duration of at least two weeks but less than four weeks during the past 12 months. A 40 percent rating is warranted for incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past 12 months. A maximum 60 percent rating is warranted for incapacitating episodes having a total duration of at least six weeks during the past 12 months is warranted. 38 C.F.R. § 4.71a, Diagnostic Code 5243. An incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome which requires bed rest prescribed by a physician and treatment by a physician.

When evaluating joint disabilities rated on the basis of limitation of motion, VA must consider granting a higher rating in cases in which functional loss due to pain, weakness, excess fatigability, or incoordination is demonstrated, and those factors are not contemplated in the relevant rating criteria. See 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202 (1995). "Although pain may cause a functional loss, pain itself does not constitute functional loss." Mitchell v. Shinseki, 25 Vet. App. 32, 37 (2011) (emphasis in original). Painful motion is deemed to be limitation of motion and warrants the minimum compensable rating for the joint, even if there is no actual limitation of motion. 38 C.F.R. § 4.59; Lichtenfels v. Derwinski; 1 Vet. App. 484, 488 (1991). The provisions of 38 C.F.R. § 4.59 relating to painful motion are not limited to arthritis and must be considered when raised by the claimant or when reasonably raised by the record. Burton v. Shinseki, 25 Vet. App. 1 (2011).

The Board must also consider whether VA examiners have elicited information concerning the "severity, frequency, duration, or functional loss manifestations" of such flare-ups. Sharp v. Shulkin, 29 Vet. App. 26 (2017).

The United States Court of Appeals for Veterans Claims (Court) also has issued the opinion of Correia v. McDonald, 28 Vet. App. 158 (2016), which clarifies additional requirements that VA examiners should address when assessing musculoskeletal disabilities, holding specifically, that the joints involved should be tested for pain on both active and passive motion, in weight-bearing and non-weight bearing and, if possible, with the range of the opposite undamaged joint.

After reviewing the lay and medical evidence of record, and resolving all reasonable doubt in favor of the Veteran, the Board finds that an increased, 20 percent rating is warranted for the period prior to March 16, 2020, but that a rating higher than 20 percent is not warranted at any point during the appeal period.

In this regard, a 20 percent rating was awarded based on a March 2020 VA fee-based examination that showed the Veteran's lumbar spine disability manifested in a combined range of motion of 120 degrees when considering additional functional loss during flares. In a September 2024 VA fee-based opinion pursuant to the Board's April 2024 remand, the examiner indicated that the findings in the March 2020 examination represented the severity of the Veteran's lumbar spine disability throughout the entire appeal period.

Accordingly, as the only VA examination conducted during the period prior to March 2020 was found to be inadequate in the January 2020 Board remand, and the September 2024 examiner's opinion indicates that the Veteran's lumbar spine disability has been of the same severity throughout the entire appeal period, the Board resolves all reasonable doubt in favor of the Veteran and finds that a 20 percent rating is warranted for the period prior to March 16, 2020.

However, the Board finds that a rating higher than 20 percent is not warranted at any point during the appeal period. The evidence of record shows that the Veteran's forward flexion has been, at worst, limited to 70 degrees, even with consideration of additional functional loss during flares and repeated use. See March 2020 VA fee-based examination.

Moreover, the March 2020 VA fee-based examiner noted that the Veteran did not have ankylosis, and as the Veteran has been able to achieve some range of motion during a flare up and with repeated use, there also is no
of the Veteran and finds that a 20 percent rating is warranted for the period prior to March 16, 2020.

Moreover, the March 2020 VA fee-based examiner noted that the Veteran did not have ankylosis, and as the Veteran has been able to achieve some range of motion during a flare up and with repeated use, there also is no evidence suggesting the functional equivalent of ankylosis.

As the Veteran's forward flexion is limited to, at worst, 70 degrees, even with consideration of additional functional loss during flares and repeated use, and he does not experience ankylosis or the functional equivalent thereof, the Board finds that a rating in excess of 20 percent is not warranted at any point during the appeal period.

Additionally, a higher rating also is not warranted under the IVDS Formula as there is no evidence of incapacitating episodes having a total duration of at least 4 weeks in the past 12 months.

The Board has considered whether separate ratings are warranted for neurologic impairment. However, the record shows the Veteran already has been granted service connection for radiculopathy of the left lower extremity as secondary to his lumbar spine disability. The Veteran has not appealed the assignment of the separate evaluation or effective date for this neurologic condition. See De Hart v. McDonough, 37 Vet. App. 371, 375 (2024) (holding that distinct and separately evaluated neurological complications of an underlying spinal disability do not remain part and parcel of a claim for a higher rating for the spinal disability once they have been separately addressed and adjudicated in a VA decision).

While the Board acknowledges the Veteran's reports of back pain and difficulty with lifting more than five pounds, the Board finds that such symptoms and functional impairment are contemplated by his current 20 percent rating.

In sum, the Board finds that the Veteran's lumbar spine disability has more nearly approximated the criteria corresponding to a rating of 20 percent throughout the entire appeal period but has not more nearly approximated a higher rating at any point, even with consideration of additional functional loss following repeated use and with flare-ups. As such, a rating of 20 percent, but no higher is granted prior to March 16, 2020, but a rating higher than 20 percent since March 16, 2020, is denied.

The issue of entitlement to a rating in excess of 10 percent for hemorrhoids.

The Veteran contends that a higher rating is warranted for his hemorrhoids. For the reasons that follow, the Board finds that an increased rating is not warranted.

The Veteran's hemorrhoids are currently rated 10 percent disabling throughout the entire appeal period pursuant to DC 7336.

The Board notes that VA recently amended the Rating Schedule for evaluating digestive system disabilities effective?May 19, 2024. See?89 Fed. Reg. 19375?(March 18, 2024) (eff. May 19, 2024). These revisions apply to all applications for benefits received by the VA or that are pending before the AOJ on or after May 19, 2024. Claims pending prior to the effective date will be considered under both the old and new rating criteria and the criteria which is more favorable to the Veteran's claim(s) will be applied. The Federal Circuit has held that the Board?may?not apply a current regulation prior to its effective date unless the regulation explicitly provides otherwise. Kuzma v. Principi,?341 F.3d 1327?(Fed. Cir. 2003).

Under the former version of DC 7336, a 10 percent rating is warranted where hemorrhoids are large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences. A 20 percent rating is warranted for hemorrhoids with persistent bleeding and with secondary anemia, or with fissures. 38 C.F.R. § 4.114.

Under the revised version of DC 7336, a 10 percent rating is provided for prolapsed internal hemorrhoids with two or less episodes per year of thrombosis; or external hemorrhoids with three or more episodes per year of thrombosis. Id. A 20 precent rating is provided for internal or external hemorrhoids with persistent bleeding and anemia; or continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis. Id.

Preliminarily, the Board notes that the Veteran
recurrences. A 20 percent rating is warranted for hemorrhoids with persistent bleeding and with secondary anemia, or with fissures. 38 C.F.R. § 4.114.

Preliminarily, the Board notes that the Veteran initially underwent a VA fee-based examination for his hemorrhoids in April 2017, but in the January 2020 remand, the Board found that the examination was inadequate. As such, it will not be considered in rating the Veteran's hemorrhoids.

Based on review of the lay and medical evidence of record, the Board finds that a rating higher than 10 percent is not warranted at any point during the appeal period, under the former or revised criteria.

In this regard, the evidence of record shows that while the Veteran experiences large external hemorrhoids with some bleeding, they do not manifest in anemia, fissures, continually prolapsed internal hemorrhoids, or any episodes of thrombosis. See March 2020 VA fee-based examination; September 2024 VA opinion (indicating that the March 2020 examination represents the severity of the Veteran's hemorrhoids throughout the appeal period); VA treatment records.

While the Board acknowledges that the Veteran's hemorrhoids manifest in bleeding, pain, itching, swelling, and difficulty with prolonged sitting, the Board finds such symptoms and functional impairment are contemplated by his current 10 percent rating.

Additionally, the Board also acknowledges that at the March 2020 VA fee-based examination the Veteran reported that his hemorrhoids interfere with his ability to work. However, a review of the record shows that the Veteran already is in receipt of a total disability rating based on individual unemployability (TDIU) for the entire period on appeal.

In sum, the Board finds the Veteran's hemorrhoids have not more nearly approximated the criteria for a 20 percent rating at any point during the appeal period under the former or revised DC 7336. Accordingly, the claim for an increased rating is denied.

Earlier Effective Date

The general rule is that the effective date of such an award "shall not be earlier than the date of receipt of application therefor." 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400(o)(1). Date of receipt means the date on which VA received a claim, information, or evidence. 38 C.F.R. § 3.1(r).

An exception to that rule applies under circumstances where evidence demonstrates a factually ascertainable increase in disability during the one-year period preceding the date of receipt of a claim for increased compensation. 38 U.S.C. § 5110(3). In that situation, the law provides that the effective date of the award shall be the earliest date as of which it is ascertainable that an increase in disability had occurred, if application is received within one year from such date. Id.; 38 C.F.R. § 3.400(o)(2); Harper v. Brown, 10 Vet. App. 125 (1997).

Generally, in all other cases, the effective date will be the date of receipt of claim or date entitlement arose, whichever is later. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400(o)(1); VAOPGCPREC 12-98, 63 Fed. Reg. 56,703 (Oct. 22, 1998).

Therefore, three possible dates may be assigned depending on the facts of a case: (1) if an increase in disability occurs after the claim is filed, the date that the increase is shown to have occurred (date entitlement arose) (38 C.F.R. § 3.400(o)(1)); (2) if an increase in disability precedes the claim by a year or less, the date that the increase is shown to have occurred (factually ascertainable) (38 C.F.R. § 3.400(o)(2)); or (3) if an increase in disability precedes the claim by more than a year, the date that the claim is received (date of claim) (38 C.F.R. § 3.400(o)(2)). Harper, 10 Vet. App. at 126.

Effective March 24, 2015, VA amended its regulations so that all
the increase is shown to have occurred (date entitlement arose) (38 C.F.R. § 3.400(o)(1)); (2) if an increase in disability precedes the claim by a year or less, the date that the increase is shown to have occurred (factually ascertainable) (38 C.F.R. § 3.400(o)(2)); or (3) if an increase in disability precedes the claim by more than a year, the date that the claim is received (date of claim) (38 C.F.R. § 3.400(o)(2)). Harper, 10 Vet. App. at 126.

Effective March 24, 2015, VA amended its regulations so that all claims, in order to be valid, must be submitted on a form prescribed by the Secretary. 38 C.F.R. § 20.201; 79 Fed. Reg. 57660, 57696 (Sept. 25, 2014). Prior to March 24, 2015, however, VA recognized formal and informal claims. The amended regulations apply only to claims filed on or after March 24, 2015. Inasmuch as the current claim was filed after such date, the amendments are applicable to the Veteran's appeal.

The amended regulations allow a claimant to submit an intent to file a claim, and VA may recognize the receipt date of the intent to file a claim as the date of claim so long as VA receives a complete claim form within one year. 38 C.F.R. § 3.155 (b). If submitted in writing, the intent to file must be on a standardized form. Id.

Prior to March 24, 2015, a claim was "a formal or informal communication in writing requesting a determination of entitlement, or evidencing a belief in entitlement, to a benefit." 38 C.F.R. § 3.1(p).

An informal claim is "[a]ny communication or action indicating intent to apply for one or more benefits." 38 C.F.R. § 3.155 (a). VA must look to all communications from a claimant that may be interpreted as applications or claims - formal and informal - for benefits and is required to identify and act on informal claims for benefits. Servello v. Derwinski, 3 Vet. App. 196, 198 (1992). The essential elements for any claim, whether formal or informal, are: (1) an intent to apply for benefits; (2) an identification of the benefits sought; and (3) a communication in writing. Brokowski, 23 Vet. App. at 84; MacPhee v. Nicholson, 459 F.3d 1323, 1326-27 (Fed. Cir. 2006) (holding that the plain language of the regulations requires a claimant to have intent to file a claim for VA benefits). Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. 38 C.F.R. § 3.155(a).

The term 'date entitlement arose' is the date when the claimant met the requirements for the benefits sought on a facts-found basis. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400; McGrath v. Gober, 14 Vet. App. 28, 35 (2000).

The issue of entitlement to an earlier effective date of October 12, 2016, for the award of a 10 percent rating for hemorrhoids.

The Veteran contends that an earlier effective date is warranted for the grant of a 10 percent rating for his hemorrhoids. For the reasons that follow, and resolving all reasonable doubt in favor of the Veteran, the Board finds that an earlier effective date of October 12, 2016, is warranted.

Turning to the record, as noted above, the Veteran's current appeal stems from an April 2017 claim for increase. After a sympathetic review of the evidence of record, the Board finds that the Veteran's hemorrhoids underwent a factually ascertainable increase in severity within one year of his April 2017 claim.

Specifically, the record shows that the Veteran underwent a colonoscopy on October 12, 2016. Although the initial reason for the colonoscopy was not related to his hemorrhoids, during the procedure, large internal hemorrhoids were noted, and they were severe enough that it was recommended the Veteran undergo internal hemorrhoid banding. While large external hemorrhoids were noted during the Veteran's earlier 2005 colonoscopy, no banding or other treatment was recommended. Such indicates that the Veteran's hemorrhoids
increase. After a sympathetic review of the evidence of record, the Board finds that the Veteran's hemorrhoids underwent a factually ascertainable increase in severity within one year of his April 2017 claim.

While it is not clear whether the Veteran's hemorrhoids actually became worse in October 2016 or at an earlier date, particularly since his hemorrhoids were an incidental finding, the Board will resolve all reasonable doubt in favor of the Veteran and find that his hemorrhoids underwent a factually ascertainable increase within one of his April 2017 claim. As such, an earlier effective date of October 12, 2016, is warranted.

However, the Board finds that an even earlier effective date is not warranted. In this regard, an October 1989 rating decision granted service connection for hemorrhoids and assigned an initial rating. No new and material evidence was received within one year of its issuance, and the Veteran did not submit a Notice of Disagreement to the decision. As such, it became final.

There also is no evidence of, and the Veteran has not contended, that he filed a claim for an increased rating prior to April 2017 that remained unadjudicated. Thus, an effective date earlier than October 12, 2016, is not warranted.

Accordingly, as the Veteran's hemorrhoids underwent a factually ascertainable increase within one year of his April 2017 claim, an earlier effective date of October 12, 2016, is warranted, and the claim is granted.

The issue of entitlement to an effective date prior to April 4, 2017, for the award of an increased rating for the lumbar spine disability.

The Veteran seeks an earlier effective date for the award of a 20 percent rating for his lumbar spine disability. For the reasons that follow, the Board finds that an earlier effective date is not warranted.

Turning to the evidence of record, service connection for a lumbar spine disability was granted in the October 1989 rating decision at which time an initial rating was assigned. For the same reasons explained above, that rating decision became final.

Thereafter, the Veteran filed a claim for an increased rating for his lumbar spine disability on April 4, 2017, which was addressed by the June 2017 rating decision on appeal. There is no evidence of record to indicate, and the Veteran does not contend, that there was an earlier, unadjudicated claim for an increased rating for his lumbar spine disability.

The Board also finds that the record does not contain factually ascertainable evidence demonstrating that the increase in the Veteran's service-connected lumbar spine disability occurred during the year prior to April 4, 2017. 38 U.S.C. § 5110(b)(2); 38 C.F.R. § 3.400(o)(2); Harper, 10 Vet. App. at 126.

(Continued on next page)

In sum, the date of claim of record, April 4, 2017, is the controlling date for the effective date assigned under the factual circumstances in this matter. Accordingly, an earlier effective date is not warranted.

G.J. Suh

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board E. Mortimer, Associate Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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