THIGH IMPAIRMENT

MARY E. RUDE · 2026 · Case ID: 26004952

DENIED

Summary

The veteran, who served in the Marine Corps from May 1967 to March 1970, appeals the denial of increased disability ratings for his right hip condition. The veteran sought higher evaluations for limitation of extension, flexion, and adduction/abduction/rotation of the right hip, citing pain, flare-ups, and functional limitations. The Board reviewed multiple VA examinations conducted between March 2018 and April 2026, along with the veteran's lay statements and treatment records. The March 2018 VA exam found no pain or functional loss, with normal ranges of motion. Subsequent exams noted increased pain, flare-ups, and some decreased range of motion, particularly in the May 2024 and November 2025 exams, with the April 2026 exam detailing significant limitations during flare-ups and with repeated use. However, the Board found the evidence did not meet the criteria for higher ratings under Diagnostic Codes 5251, 5252, or 5253. Specifically, the veteran's reported limitations, even considering pain and flare-ups, did not consistently meet the thresholds for higher percentages, such as flexion limited to 30 degrees or less, or specific limitations in abduction/adduction/rotation. The Board also addressed the impact of medication, noting that while ameliorative effects were not considered, the available evidence and examinations did not support a higher rating. The Board concluded that the evidence persuasively weighed against higher ratings, and the benefit-of-the-doubt doctrine did not apply as the evidence was not in approximate balance. Therefore, the appeals for increased ratings were denied.

Rationale

Evidence did not meet criteria for compensable rating under DC 5251.; Extension not limited to 5 degrees at any time.; Weight of evidence is against assignment of higher rating.

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

5251

Docket No.

20-01 419

Full Decision Text

Citation Nr: 26004952
Decision Date: 04/27/26 Archive Date: 04/27/26

DOCKET NO. 20-01 419
DATE: April 27, 2026

ORDER

Entitlement to a compensable rating for limitation of extension of the right thigh is denied.

Entitlement to a rating in excess of 10 percent for limitation of flexion of the right thigh due to right sacroiliac joint arthritis with right hip dysfunction is denied.

Entitlement to a compensable rating, prior to November 6, 2025, and a rating in excess of 10 percent thereafter, for limitation of abduction, adduction and rotation of the right thigh due to right sacroiliac joint arthritis with right hip dysfunction is denied.

FINDINGS OF FACT

1. The persuasive evidence of record is against a finding that the Veteran's right hip disability, limitation of extension, has manifested to a limitation of 5 degrees.

2. The persuasive evidence of record is against a finding that the Veteran's right hip disability, limitation of flexion, had manifested to a limitation of 30 degrees or less.

3. Prior to November 6, 2025, the persuasive evidence of record is against finding that the Veteran's right hip limitation of abduction, adduction and rotation, manifested to limitation of rotation that prevented "toe-out" rotation of more than 15 degrees, limitation of abduction with motion lost beyond 10 degrees, or limitation of adduction that prevented him from crossing his legs.

4. From November 6, 2025, the persuasive evidence of record is against finding that the Veteran's right hip disability, limitation of abduction, adduction and rotation, had manifested to limitation of abduction with motion lost beyond 10 degrees or limitation of adduction that prevented him from crossing his legs.

CONCLUSIONS OF LAW

1. The criteria for entitlement to a compensable rating for limitation of extension of the right thigh have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.71a, Diagnostic Code (DC) 5251.

2. The criteria for entitlement to a rating in excess of 10 percent for limitation of flexion of the right thigh due to right sacroiliac joint arthritis with right hip dysfunction have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.71a, DC 5252.

3. The criteria for entitlement to a compensable rating, prior to November 6, 2025, and a rating in excess of 10 percent thereafter, for limitation of abduction, adduction and rotation of the right thigh due to right sacroiliac joint arthritis with right hip dysfunction have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.40, 4.71a, DC 5253.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7101(a)(2).

The Veteran served on active duty in the Marine Corps from May 1967 to March 1970.

This case comes before the Board of Veterans' Appeals (Board) on appeal from an April 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office.

In January 2022, the Veteran testified before the undersigned Acting Veterans Law Judge via a virtual hearing. A transcript of the hearing is of record.

In April 2024, the Board issued a decision remanding the Veteran's claims for additional development. The Board now finds there was substantial compliance with its May 2025 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998).

The Board acknowledges that the Veteran submitted a request for a total disability rating based on individual unemployability in March 2026. While a claim for a TDIU can be accepted as part of a claim for an increased rating, per Rice v. Shinseki, 22 Vet. App. 447 (2009), in this case, the Veteran has written that he is unable to work due to other disabilities in addition to his right hip disorder. The Regional Office is currently undergoing development for this claim, and it has not
Board now finds there was substantial compliance with its May 2025 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998).

The Board acknowledges that the Veteran submitted a request for a total disability rating based on individual unemployability in March 2026. While a claim for a TDIU can be accepted as part of a claim for an increased rating, per Rice v. Shinseki, 22 Vet. App. 447 (2009), in this case, the Veteran has written that he is unable to work due to other disabilities in addition to his right hip disorder. The Regional Office is currently undergoing development for this claim, and it has not yet adjudicated the issue in the first instance. The Board therefore finds that it would be premature to include the issue as part of the appeal at this time.

Increased Rating

Disability ratings are determined by applying the criteria set forth in the schedule of ratings. The percentage ratings are based on the average impairment of earning capacity, and individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. When a question arises as to which of two ratings apply under a single diagnostic code, the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. As such, the Board must consider all potentially applicable diagnostic codes when rating a Veteran's disability. However, evaluation of the same manifestation of the same disability under various diagnoses, otherwise known as "pyramiding," is to be avoided. 38 C.F.R. § 4.14; Esteban v. Brown, 6 Vet. App. 259, 261 (1994).

While the Veteran's entire history is reviewed when making a disability determination, where service connection has already been established and increase in the disability rating is at issue, it is the present level of the disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55 (1994). However, staged ratings are appropriate for an increase rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).

Additionally, if the positive evidence supporting a claim and the negative evidence indicating a denial of the claim is relatively equal, the Veteran is entitled to the benefit of the doubt. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102, 4.3. Accordingly, any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. Id.

Disability of the musculoskeletal system is primarily the inability, due to damage or infection in the parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance. When evaluating musculoskeletal disabilities based on limitation of motion, the Veteran is entitled to at least the minimum compensable evaluation if motion is accompanied by painful motion with joints. 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. See 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1 (2011). Additionally, pain is also relevant to assignment of a rating in excess of the minimum compensable rating, but only if that pain results in demonstrated functional impairment. Mitchell v. Shinseki, 25 Vet. App. 32, 37-38 (2011); see 38 C.F.R. §§ 4.40, 4.45. Functional impairment as contemplated by 38 C.F.R. §§ 4.40 and 4.45 includes less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell, 25 Vet. App. at 44. Joint pain alone, without evidence of decreased functional ability, does not warrant a higher rating. See generally Mitchell, 25 Vet. App. 32.

Moreover, the Board must consider functional loss caused by pain or other factors listed in 38 C.F.R. §§ 4.40 and 4.45 that could occur during flare-ups or after repeated use. See DeLuca v. Brown, 8 Vet. App. 202 (
normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell, 25 Vet. App. at 44. Joint pain alone, without evidence of decreased functional ability, does not warrant a higher rating. See generally Mitchell, 25 Vet. App. 32.

Moreover, the Board must consider functional loss caused by pain or other factors listed in 38 C.F.R. §§ 4.40 and 4.45 that could occur during flare-ups or after repeated use. See DeLuca v. Brown, 8 Vet. App. 202 (1995). Nonetheless, despite the relevance of the background factors delineated in §§ 4.40 or 4.45 when evaluating a disability, the rating to be assigned is based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a (musculoskeletal system) or § 4.73 (muscle injury); therefore, a separate or higher rating predicated solely on §§ 4.40 or 4.45 is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016).

Right Hip Disability Ratings

The Veteran seeks higher evaluations for his right hip disability, which is evaluated separately under the limitation of extension, limitation of flexion, and limitation of adduction, abduction, and rotation.

Under DC 5251, which evaluates limitation of extension of the thigh, a 10 percent rating is warranted for extension limited to 5 degrees. See 38 C.F.R. § 4.71a, DC 5251.

Under DC 5252, which evaluates limitation of flexion of the thigh, a 10 percent rating is warranted for flexion limited to 45 degrees; a 20 percent rating is warranted for flexion limited to 30 degrees; a 30 percent rating is warranted for flexion limited to 20 degrees; and the highest rating of 40 percent is warranted for flexion limited to 10 degrees. See 38 C.F.R. § 4.71a, DC 5252.

Under DC 5253, which evaluates thigh impairment, a 10 percent rating is warranted for thigh impairment of limitation of rotation of, cannot toe-out more than 15 degrees, affected leg. A 10 percent rating is warranted for thigh impairment of limitation of abduction of, cannot cross legs. The highest rating of 20 percent is warranted for thigh impairment of limitation of abduction of, motion lost beyond 10 degrees. See 38 C.F.R. § 4.71a, DC 5253.

For VA purposes, normal flexion of the thigh/hip is from 0 to 125 degrees, normal extension of the thigh/hip is 0 degrees, and abduction from 0 to 45 degrees. 38 C.F.R. § 4.71a, Plate II.

The Board notes that effective February 7, 2021, the regulations pertaining to the musculoskeletal system were revised. Relevant to this instant matter, DCs 5251 through 5253 remains unchanged.

Medical treatment records during the appeal period reflect complaints of, and treatment for, right hip pain, muscular restriction in the hip, tight hip, some thigh climbing when returning to flexion, and some pain when returning from an extended position.

In the March 2018 VA examination, the Veteran reported no right hip pain, no flare-ups, and no functional loss/impairment. Upon examination, the Veteran's range of motion (ROM) testing of the right hip revealed flexion to 110 degrees, extension to 15 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to 40 degrees, and internal rotation to 30 degrees. There was no pain on exam, no pain with weight-bearing, or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. The Veteran was not able to perform repetitive use testing with at least three repetitions due to recent surgery. He was not examined immediately after repetitive use testing, and pain, weakness, fatigability or incoordination did not significantly limit functional ability with repeated use over a period of time. There was a reduction in muscle strength, but not entirely due to the right hip. There was no evidence of muscle atrophy, ankylosis, malunion or nonunion of the femur, or flail hip joint shown. Diagnostic testing was performed, but no degenerative or traumatic arthritis was documented. In addition, there was no evidence of pain with passive ROM or non-weight bearing.

In an
or associated soft tissue. The Veteran was not able to perform repetitive use testing with at least three repetitions due to recent surgery. He was not examined immediately after repetitive use testing, and pain, weakness, fatigability or incoordination did not significantly limit functional ability with repeated use over a period of time. There was a reduction in muscle strength, but not entirely due to the right hip. There was no evidence of muscle atrophy, ankylosis, malunion or nonunion of the femur, or flail hip joint shown. Diagnostic testing was performed, but no degenerative or traumatic arthritis was documented. In addition, there was no evidence of pain with passive ROM or non-weight bearing.

In an October 2018 VA treatment note, the Veteran's right hip passive ROM was "WFL" (within functional limits) for flexion, internal rotation, and external rotation. He had a 4 out of 5 for hip abduction strength.

In the May 2024 VA examination, the examiner noted the Veteran's reports of pain in the area of his sacroiliac joint that radiates to his right buttock, where he needs to take frequent breaks when hunting or working, with his right leg giving out about 6 weeks ago. He further reported having flare-ups that have not improved since surgery, and have been happening for many years, that feel like a knife slowly turning and pushing into his sacroiliac joint. The pain will be so severe that he needs to lie on the ground. His flare-ups occur several times a day to once every few months, lasts 15 minutes, precipitated by unknown causes, and alleviated by rest, time, and lying flat. He is unable to move bilateral legs during a flare-up of symptoms. He also experiences functional loss/impairment, described as the inability to move lower extremity during flares. Upon examination, the Veteran's ROM testing of the right hip revealed flexion to 70 degrees, extension to 30 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to 30 degrees, and internal rotation to 30 degrees. ROM itself contributes to a functional loss, as less movement than normal. Adduction is not limited such that the Veteran cannot cross legs. There was no evidence of pain, objective evidence of crepitus, or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. After repetitive-use testing, there was no additional loss of function or ROM. The Veteran was not examined immediately after repetitive use over time, but pain and fatigability significantly limited functional ability with repeated use over a period of time, described in terms of ROM as flexion to 65 degrees, extension to 25 degrees, abduction to 25 degrees, adduction to 15 degrees, external rotation to 25 degrees, and internal rotation to 25 degrees. He was not examined during a flare-up, but pain, weakness, and lack of endurance significantly limited functional ability with flare-ups, described in terms of ROM as flexion to 60 degrees, extension to 20 degrees, abduction to 20 degrees, adduction to 10 degrees, external rotation to 20 degrees, and internal rotation to 20 degrees. Additional factors contributed to the disability, such as disturbance of locomotion (difficulty walking long distances) and less movement than normal (decreased ROM). There was no evidence of muscle atrophy, ankylosis, malunion or nonunion of the femur, or flail hip joint shown. He had surgery in December 2023, with residuals of pain and decreased ROM. Diagnostic testing and passive ROM was not performed.

In the November 2024 addendum to the May 2024 VA examination, the examiner provided a retrospective opinion of the estimated flare-ups in terms of ROM from March 2018 to December 2023. The results were based on information procured from relevant sources including lay statement of the Veteran, and were as follows: flexion to 70 degrees, extension to 30 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to 30 degrees, and internal rotation to 30 degrees.

In the December 2024 VA examination, the examiner noted the Veteran's current symptoms of gait and prolonged walking cause hip discomfort, sharp stabbing, and knifelike through low back. He did not report having any flare-ups or functional loss/impairment of the right hip. Upon examination, the Veteran's ROM testing of the right hip revealed flexion to 110 degrees, extension to 15 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to 40 degrees, and internal rotation to 30 degrees. Passive ROM is the same as active. ROM itself did not contribute to a functional loss. Adduction is not limited such that the Veteran cannot cross legs. There was evidence of pain with weight-bearing and active motion, but does not result in/cause functional loss; however, there was no objective evidence of crepitus or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. After repetitive-use testing, there was no additional loss of function or ROM. The Veteran was not examined immediately after repetitive use over time or during a flare-up, and pain, weakness, fatigability or incoordination did not significantly limit functional ability with repeated use over a period of time or with flare-ups. Additional factors contributed to the disability, such as interference with standing, disturbance of locomotion, and less movement than normal - described as the hip pain usually coincides with low back or SI joint pain, together stopping him from proceeding and he must sit down. There was no evidence of muscle atrophy, ankylosis, malunion or nonunion of the femur, or flail hip joint shown. Diagnostic testing was not performed.

In the May 2025 VA examination, the examiner noted the Veteran's reports of experiencing pain, stiffness, decreased ROM, sleep disturbance, and gait abnormality. He further reported having flare-ups that occur 2-3 times per week, last 30 minutes up to several hours, precipitated by prolonged standing and walking, and alleviated by rest, time, and pain medications. During flare-up symptoms, he has to limit his physical activities and take additional pain medications. He also reported having functional loss/impairment, described as prolonged standing and walking exacerbate hip pain. Upon examination, the Veteran's ROM testing of the right hip revealed flexion to 100 degrees, extension to 15 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to 40 degrees, and internal rotation to 30 degrees. Passive ROM was the same as active. Adduction was not limited such that the Veteran cannot cross legs. There was evidence of pain with weight-bearing and active/passive motion, that caused functional loss, as described as impaired ability to stand for extended periods, walk for extended distances, difficulty performing squatting, bending, lifting/carrying, pushing/pulling, twisting or climbing, and inability to perform high impact activities such as running, jumping, or jogging. There was no objective evidence of crepitus or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. The Veteran was able to perform repetitive-use testing with at least three repetitions, with no additional loss of function. He was not examined immediately after repetitive use over time, but pain, fatigability, and lack of endurance significantly limited functional ability with repeated use over a period of time, described in terms of ROM as flexion to 90 degrees, extension to 10 degrees, abduction to 20 degrees, adduction to 15 degrees, external rotation to 30 degrees, and internal rotation to 20 degrees. He was not examined during a flare-up, but pain, fatigability, and lack of endurance significantly limited functional ability with flare-ups, described in terms of ROM as flexion to 90 degrees, extension to 10 degrees, abduction to 20 degrees, adduction to 15 degrees, external rotation to 30 degrees, and internal rotation to 20 degrees. Additional factors contributed to the disability, such as interference with sitting and standing, disturbance of locomotion, and less movement than normal - described as impaired ability to stand for extended periods, walk for extended distances, difficulty performing squatting, bending, lifting/carrying, pushing/pulling, twisting or climbing, and inability to perform high impact activities such as running, jumping, or jogging. There was no evidence of muscle atrophy, ankylosis, malunion or nonunion of the femur, or flail hip joint shown.

In the November 2025 VA examination, the examiner noted
to 20 degrees, adduction to 15 degrees, external rotation to 30 degrees, and internal rotation to 20 degrees. Additional factors contributed to the disability, such as interference with sitting and standing, disturbance of locomotion, and less movement than normal - described as impaired ability to stand for extended periods, walk for extended distances, difficulty performing squatting, bending, lifting/carrying, pushing/pulling, twisting or climbing, and inability to perform high impact activities such as running, jumping, or jogging. There was no evidence of muscle atrophy, ankylosis, malunion or nonunion of the femur, or flail hip joint shown.

In the November 2025 VA examination, the examiner noted the Veteran's reports of having persistent right hip and sacroiliac joint pain, limitation in thigh movement, flare-ups described as sharp, stabbing pain, difficulty performing physical activities, and periodic episodes where the right leg gives out and requires rest or lying flat for symptom relief. He further reports having flare-ups that occur daily, last all day with variable intensity, precipitated by walking distances greater than 50 yards, prolonged standing, or attempting physical exertion, alleviated by rest and medication. During flare-ups, he is unable to walk uphill, and experiences substantial limitations with mobility and weight-bearing on the right side. He also reported having functional loss/impairment, described as the inability to walk long distances, trouble going uphill or climbing stairs, and feelings of weakness. Upon examination, the Veteran's ROM testing of the right hip revealed flexion to 60 degrees, extension to 20 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to 20 degrees, and internal rotation to 20 degrees. Passive ROM was the same as active. Adduction was not limited such that the Veteran cannot cross legs. There was evidence of pain with weight-bearing and active/passive motion, but it did not result in/cause functional loss. There was no objective evidence of crepitus or objective evidence of localized tenderness or pain on palpation of the joint or associated soft tissue. The Veteran was able to perform repetitive-use testing with at least three repetitions, with no additional loss of function or ROM. Pain, fatigability, and lack of endurance significantly limited functional ability with repeated use over a period of time, described in terms of ROM as flexion to 55 degrees, extension to 20 degrees, abduction to 25 degrees, adduction to 20 degrees, external rotation to 20 degrees, and internal rotation to 20 degrees. He was not examined during a flare-up, but pain, fatigability, weakness, lack of endurance, and incoordination significantly limited functional ability with flare-ups, described in terms of ROM as flexion to 50 degrees, extension to 15 degrees, abduction to 20 degrees, adduction to 20 degrees, external rotation to 15 degrees, and internal rotation to 15 degrees. Additional factors contributed to the disability, such as interference with sitting and standing, disturbance of locomotion, instability of station, and less movement than normal - described as decreased mobility of the right hip, functional weakness in the right lower extremity during flare-ups, altered gait mechanics, pain and stiffness significantly impact ability to walk/stand/sit for extended periods, and unsteadiness with ambulation. There was no evidence of muscle atrophy, ankylosis, malunion or nonunion of the femur, or flail hip joint shown. The examiner remarked that the Veteran reported taking medications that relieved or reduced the severity of his disability symptoms, however, it was not possible to evaluate the severity of the disability as if not taking medications without resorting to mere speculation.

The Veteran most recently attended a VA examination in April 2026. He reported having years of on-going pain in the bilateral hips. Which had progressed and worsened over the years. Since the last examination in 2025, the pain in both hips was much worse, making it difficult to get out of bed and ambulate. He currently had pain and stiffness in the bilateral hips, now affecting his sleep. He had a mildly altered gait pattern. He had daily flare ups that lasted from a few hours to all day, and caused achy, sometimes sharp pain in both hips and made him unable to walk more than a grocery aisle, or sit longer than 15 minutes. His hip pain made it difficult to bend, squat, or climb stairs, and flare ups or increased activity led to pain and fatigue, with difficulty transitioning from sitting to standing. Active and Passive ROM testing of the right hip revealed flexion to 50 degrees, extension to 20 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to
He currently had pain and stiffness in the bilateral hips, now affecting his sleep. He had a mildly altered gait pattern. He had daily flare ups that lasted from a few hours to all day, and caused achy, sometimes sharp pain in both hips and made him unable to walk more than a grocery aisle, or sit longer than 15 minutes. His hip pain made it difficult to bend, squat, or climb stairs, and flare ups or increased activity led to pain and fatigue, with difficulty transitioning from sitting to standing. Active and Passive ROM testing of the right hip revealed flexion to 50 degrees, extension to 20 degrees, abduction to 30 degrees, adduction to 20 degrees, external rotation to 20 degrees, and internal rotation to 20 degrees. There was no additional loss of function after three repetitions. With repeated use over time, flexion would be limited to 45 degrees, and the remaining range of motion findings were unchanged. With flare ups, flexion would be limited to 40 degrees, extension would be limited to 15 degrees, and the remaining range of motion findings would be unchanged. Limitation in adduction did not prevent the Veteran from being able to cross his legs, including during flare-ups and with repeated motion. There was no muscle atrophy or ankylosis, and the Veteran did not use an assistive device. The condition did impact his ability to work, by causing interference with bending, squatting, kneeling, and climbing stairs. His limitations included reduced tolerance for prolonged sitting with stiffness upon standing, impaired ability to lift or carry heavy objects, and slowed ambulation. The examiner wrote that the Veteran took several medications to treat the condition, but it was not possible to calculate the impact of the medications on the Veteran's functioning, and it was medically contraindicated to discontinue ot alter medications to the purposes of the examinations; therefore, it was not possible to determine the severity of functional impact in the absence of this medication without resorting to mere speculation.

Lay statements of record throughout the appeal period reflect the Veteran's assertions that his condition has worsened, with flare-ups that make him fall to the ground due to excruciating pain that he cannot stand up.

Considering the foregoing, to include consideration of the provisions of 38 C.F.R. §§ 4.40 and 4.45, and DeLuca, the Board finds that increased ratings throughout any period on appeal are not warranted for the Veteran's right hip disabilities.

The Board appreciates that the Veteran has reported having ongoing, chronic pain in his right hip, and that this pain makes walking, standing, and many other physical disabilities much more difficult. But the weight of the evidence of record is not sufficient to meet the criteria for the next-higher ratings under DCs 5251, 5252, or 5253.

The Veteran has not been found to have extension limited to 5 degrees at any time, including with consideration of reports of pain and limitation during flare ups and repeated use. A compensable rating for limitation of flexion of the right thigh due to right sacroiliac joint arthritis with right hip dysfunction is now warranted. 38 C.F.R. § 4.71a, DC 5251.

The evidence also does not support finding that a rating higher than 10 percent for limitation of flexion of the right thigh due to right sacroiliac joint arthritis with right hip dysfunction can be assigned. The Veteran was initially awarded a 10 percent rating under 38 C.F.R. § 4.59 for right thigh limitation of flexion because even though he did not have a compensable level of limitation of flexion under DC 5252, because he did have limitation of motion that was painful. While the Veteran showed worsened range of flexion measurements at the April 2026 VA examination-flexion limited to 45 degrees with repeated use over time and 40 degrees with flare ups-this still only meets the criteria for a rating of 10 percent under 38 C.F.R. § 4.71a, DC 5252. At no time has the Veteran ever been found to have flexion limited to 30 degrees or less, and a rating higher than 10 percent is not warranted. The Board recognizes that the Veteran has reported severe pain with flexion, but he is now awarded more than the minimum compensable rating, and a higher rating, in the absence of a finding that pain or flare ups would cause actually functional limitations that are the equivalent of limitation to 30 degrees of flexion or less, is not required. See 38 C.F.R. §§ 4.40, 4.45; Mitchell, 25 Vet. App. 32, 37-38.

Prior to November 6, 2025
5252. At no time has the Veteran ever been found to have flexion limited to 30 degrees or less, and a rating higher than 10 percent is not warranted. The Board recognizes that the Veteran has reported severe pain with flexion, but he is now awarded more than the minimum compensable rating, and a higher rating, in the absence of a finding that pain or flare ups would cause actually functional limitations that are the equivalent of limitation to 30 degrees of flexion or less, is not required. See 38 C.F.R. §§ 4.40, 4.45; Mitchell, 25 Vet. App. 32, 37-38.

Prior to November 6, 2025, the evidence also does not indicate that the Veteran ever had external rotation limited to 15 degrees, limitation of adduction that prevented the Veteran from crossing his legs, or limitation of abduction lost beyond 10 degrees, including with reports of pain and of motion lost with repeated use and flare ups are taken into consideration. 38 C.F.R. § 4.71a, DC 5253. A compensable rating for limitation of abduction, adduction and rotation of the right thigh due to right sacroiliac joint arthritis with right hip dysfunction, prior to November 6, 2025, is therefore not warranted.

In addition, from November 6, 2025, the Veteran was awarded an increased 10 percent rating based on the finding that external rotation was limited to 15 degrees. See 38 C.F.R. § 4.71a, DC 5253. The evidence does not, however, indicate that the Veteran ever had limitation of adduction that prevented the Veteran from being able to cross his legs, or that he had limitation of abduction lost beyond 10 degrees, including when the Veteran's reports of pain and of motion lost with repeated use and flare ups are taken into consideration. In the absence of such findings, a rating higher than 10 percent from November 6, 2025, for limitation of abduction, adduction and rotation of the right thigh cannot be assigned.

The Board has considered the November 6, 2025 effective date that was assigned for the increased 10 percent rating. The effective date for an increased rating should be based on the medical evidence showing when the increase in the level of disability actually occurred. See 38 C.F.R. § 3.400(o)(2). Effective dates should not be mechanically assigned based solely on the date of the VA examination, but should include consideration of all of the facts to determine the date that the increase in disability was ascertainable. Swain v. McDonald, 27?Vet. App.?219, 224 (2015). There is no indication in the VA treatment records or any other documented evidence that the Veteran's disability underwent an increase in severity manifesting with a compensable limitation of adduction, abduction, or rotation prior to November 6, 2025. The earliest documented evidence that the Veteran's right leg had external rotation limited to 15 degrees was at the November 2025 VA examination. In the absence of any other evidence indicating that the Veteran's right leg adduction, abduction, or rotation had worsened to a level allowing for separate compensable rating prior to November 6, 2025, the Board is unable to assign an earlier effective date for this increase.

In reaching the above conclusions, the Board acknowledges that the Court has held that in assigning a disability rating, VA may not consider the ameliorative effects of medication where such effects are not explicitly contemplated by the rating criteria. Jones v. Shinseki, 26 Vet. App. 56 (2012). More recently, the Court stated that the "the Board [is] obligated to discount the beneficial effects of the medication taken for each disability and evaluate the baseline severity of those disabilities" and held that "Jones applies in the evaluation of musculoskeletal disabilities where the relevant [diagnostic code] does not reference medication as a factor in evaluation." Ingram v. Collins, 38 Vet. App. 130 Claims (2025).

In this case, the Veteran reported taking medications for relief of his right hip symptoms. The beneficial effects of the Veteran's medication and treatment are not known, and an attempt to remand this appeal to order an addendum medical opinion based on Jones and Ingram, and in the lens of the rating criteria under § 4.71a, would almost certainly require an examiner to engage in medical speculation that would result in a medical opinion that lacks the degree of certainty to ascertain, even under the benefit-of-the-doubt standard, the impact of the ameliorative effects of medication on the severity of a veteran's musculoskeletal disability in terms of range of motion. See
38 Vet. App. 130 Claims (2025).

The requirement that the Secretary "may not consider the relief afforded by [a veteran's] medication when" applying the rating schedule, as Jones demands...invites medical speculation in trying to guess what a veteran's symptoms might be without the medication, or medical malpractice in the cessation of medication so that the veteran's symptoms without medication might be recorded. The former invites non-helpful guesswork by medical practitioners, ... and the latter raises, at a minimum, serious ethical concerns that no court should encourage. That Jones essentially requires the Board to consider whether a medical examination is required to determine how serious a veteran's symptoms would have been in an alternate reality in which he or she was not taking his or her required medication should alone demonstrate the fallacy of the Jones holding.

McCarroll v. McDonald,28 Vet. App. 267, 278 (2016) (internal citations omitted).

The November 2025 and April 2026 VA examiner did address the possible ameliorative impact of the Veteran's hydrocodone, bus she found that it was not possible to determine the severity of the functional impact in the absence of the hydrocodone that he took every 6 hours without resort to speculation, and pointed out that it would be contraindicated for the Veteran to abstain from a dose of his medication just for the purpose of VA examination. The Board finds that this does adequately address this question, and it is highly unlikely that remand to obtain another medical opinion on the ameliorative effects of medication would result in a probative, non-speculative opinion. The Board does not wish to further delay adjudication of the Veteran's appeal to engage in likely unfruitful further development pursuant to Jones and Ingram. The Board instead emphasizes that the VA examiners, in rendering range of motion findings, noted and considered the Veteran's lay statements describing functional limitations when his pain and functional impairment was at its worst. As such, the Board finds the reports and the evidentiary record are adequate to base the current decisions.

The Board has also considered the Veteran's lay statements and his reports that his symptoms, including pain, have limited his ability to use his right hip. The Veteran is competent to report his symptoms as he has experienced them, including the impact they have had on his ability to perform certain activities. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). These assertions are, however, found to be consistent with the ratings currently assigned. Even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by his statements regarding having pain and functional impairment do not indicate any further severity which would more nearly approximate the criteria for higher ratings. While the Veteran has reported having restrictions with movement and difficulty with heavy lifting, prolonged standing, walking, jogging and climbing stairs, etc. his reports do not indicate a restriction of use to such an extent that any higher ratings criteria could apply. See 38 C.F.R. § 4.59; see also Mitchell, 25 Vet. App.at 38-43. The Board finds that even taking these reports into consideration, the evidence persuasively weighs against the assignment of a rating higher than the currently assigned ratings under DCs 5251, 5252, and 5253.

The Board concludes that, as the evidence persuasively favors against assigning ratings higher than what are currently assigned, it is not in approximate balance, and the benefit-of-the-doubt rule does not apply. See Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021). Higher ratings are not warranted, and the claims are

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