INTERVERTEBRAL DISC SYNDROME

C. CRAWFORD · 2026 · Case ID: 26005055

MIXED

Summary

The veteran, who served from June 2005 to June 2013, appeals the denial of an increased rating for his service-connected lumbar strain. The Board previously denied a rating in excess of 20 percent, which was vacated and remanded by the Court of Appeals for Veterans Claims. The veteran's claim for an increased rating was recharacterized to reflect a partial grant of benefits, with an initial 40 percent rating granted prior to August 25, 2025, and a denial for any rating exceeding 40 percent thereafter. The Board reviewed multiple VA examinations, noting that while the veteran experienced pain and episodes of his back "locking up" during flare-ups, these did not meet the criteria for functional loss comparable to ankylosis or its functional equivalent. The Board found that the August 2025 examination, along with its December 2025 addendum, substantially complied with prior remand directives, addressing range of motion, pain, and the nature of the "locking up" episodes. The Board disagreed with the veteran's attorney's argument that separate 20 percent ratings should be assigned for residuals, finding that the lumbar strain did not result in neurologic abnormalities or warrant separate ratings under the Spine Formula. The Board concluded that the evidence was persuasively against a rating higher than 40 percent, rendering the benefit of the doubt doctrine inapplicable, and thus denied the appeal for an increased rating beyond 40 percent.

Rationale

August 2025 VA examination found forward flexion limited to 10 degrees during flare-up, with pain.; Examiner explained "locking up" episodes do not constitute functional ankylosis.; No ankylosis or neurologic abnormalities found; no IVDS or incapacitating episodes.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

19-03 550

Full Decision Text

Citation Nr: 26005055
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 19-03 550
DATE: April 29, 2026

ORDER

Prior to August 25, 2025, an initial 40 percent rating, but no higher, for lumbar strain is granted; subject to the laws and regulations governing the payment of monetary benefits.

Since August 25, 2025, an initial rating in excess of 40 percent for lumbar strain is denied.

FINDING OF FACT

Throughout the increased rating period, the Veteran's lumbar strain has been productive of forward flexion to 30 degrees or less, but not unfavorable ankylosis of the entire spine or entire thoracolumbar spine or its functional equivalent, even during a flare-up.

CONCLUSIONS OF LAW

1. Prior to August 25, 2025, the criteria for an initial 40 percent rating, but no higher, for lumbar strain have been met. 38?U.S.C. §§?1155, 5107; 38?C.F.R. §§?4.3, 4.7, 4.40, 4.45, 4.71(a), Diagnostic Codes (DCs) 5235-5243.

2. Since August 25, 2025, the criteria for a rating in excess of 40 percent for lumbar strain have not been met. 38?U.S.C. §§?1155, 5107; 38?C.F.R. §§?4.3, 4.7, 4.40, 4.45, 4.71(a), Diagnostic Codes (DCs) 5235-5243.

REASONS AND BASES FOR FINDING AND CONCLUSIONS

The Veteran served on active duty from June 2005 to June 2013.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision.

Previously the Board denied a rating in excess of 20 percent for lumbar strain in a June 2022 decision, which the Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In a July 2023 memorandum decision, the Court vacated the Board's denial of a rating in excess of 20 percent for the lumber strain and returned the claim to the Board. In a February 2024 decision, the Board denied the claim, and the Veteran again appealed to the Court. The Court granted a joint motion for partial remand (JMPR) in February 2025 which returned the claim to the Board.

In August 2020, the Veteran notified the Board that he desired a hearing for the lumbar strain issue. In February 2021, the Veteran withdrew his hearing request for the lumbar strain issue.

The Board also notes that in October 2022, the AOJ issued a proposed decision regarding recoupment of separation pay. In November 2022, the Veteran's representative requested a hearing before the AOJ regarding the recoupment of separation pay as proposed in October 2022. A hearing before the AOJ was scheduled for September 2024. However, the Veteran's attorney withdrew the hearing request. There is no indication that the Veteran wishes to have another hearing before the Board on the lumbar strain issue. Therefore, the Board will proceed with adjudicating the issues currently on appeal.

In a February 2026 rating decision, the Veteran's lumbar strain rating was increased to 40 percent from August 25, 2025. However, as this does not reflect a full grant of the benefit sought, the issue remains before the Board and has been recharacterized to reflect this partial grant of benefits. See AB v. Brown, 6 Vet. App. 35 (1993).

When last on appeal, the Board also remanded a claim of entitlement to service connection for a right shoulder disorder. In a December 2025 rating decision, service connection for right shoulder strain was granted, effective October 30, 2015. As this represents a full grant of the benefit sought, the issue is no longer on appeal. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997).

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
rating decision, service connection for right shoulder strain was granted, effective October 30, 2015. As this represents a full grant of the benefit sought, the issue is no longer on appeal. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997).

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.?????

Separate ratings can be assigned for separate periods based on the facts found practice known as "staged" ratings. Fenderson v. West,?12?Vet. App.?119?(1999).?Staged ratings?are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield,?21?Vet. App.?505?(2007).????

For musculoskeletal disabilities, such as those to the spine, there are additional criteria. Functional loss may be due to absence of part, or all, of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective enervation, or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by visible behavior of the claimant undertaking the motion.? Weakness is as important as limitation of motion; a part that becomes painful on use must be regarded as seriously disabled. 38?C.F.R. §§?4.10, 4.40, 4.45.????

VA must analyze the evidence of pain, weakened movement, excess fatigability, or incoordination and determine the level of associated functional loss under 38?C.F.R. §?4.40, which requires VA to regard as "seriously disabled" any part of the musculoskeletal system that becomes painful on use.????

Although pain may cause a functional loss, "pain itself does not rise to the level of functional loss as contemplated by VA regulations applicable to the musculoskeletal system."? Rather, pain may result in functional loss, but only if it limits the ability "to perform the normal working movements of the body with normal excursion, strength, speed, coordination, or endurance."?Mitchell v. Shinseki, 25?Vet. App.?32 (2011), quoting 38?C.F.R. §?4.40.????

With respect to joints, in particular, the factors of disability reside in reductions of normal excursion of movements in different planes.? Inquiry will be directed to more or less than normal movement, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity, or atrophy of disuse.? 38?C.F.R. §?4.45.????

Furthermore, the intent of the rating schedule is to recognize painful motion with joint or particular pathology as productive of disability.? Thus, actually painful, unstable, or malaligned joints, due to healed injury, are entitled to at least the minimum compensable rating for the joint.? The joints 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.? 38?C.F.R. §?4.59.????

When 38?C.F.R. §?4.59 is raised by the claimant or reasonably raised by the record, even in non-arthritis context, the Board should address its applicability.??Burton v. Shinseki, 25?Vet. App.?1, 5 (2011).??

Entitlement to an initial rating in excess of 20 percent for lumbar strain prior to August 25, 2025 and in excess of 40 percent thereafter

The Veteran's
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.? 38?C.F.R. §?4.59.????

Entitlement to an initial rating in excess of 20 percent for lumbar strain prior to August 25, 2025 and in excess of 40 percent thereafter

The Veteran's lumbar spine disability is rated according to 38?C.F.R. §?4.71a, General Rating Formula for Diseases and Injuries of the Spine (Spine Formula).? The formula provides for: a 100 percent rating for unfavorable ankylosis of the entire spine; a 50?percent rating for unfavorable ankylosis of the entire thoracolumbar spine; a 40 percent rating for forward flexion of the thoracolumbar spine 30 degrees or less; and a 20 percent rating for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees or 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.? Id.????

In addition to the Spine Formula, VA's regulations contain a Formula for Rating Intervertebral Disc Syndrome (IVDS) Based on Incapacitating Episodes (IVDS Formula). Ratings under this DC are assigned according to the duration of "incapacitating episodes" throughout the year due to IVDS. An "incapacitating episode" is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. A 20 percent evaluation is warranted for incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks during the past 12 months. A 40 percent evaluation is warranted for incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months. Finally, a 60 percent evaluation is warranted for incapacitating episodes having a total duration of at least 6 weeks during the past 12 months. 38?C.F.R. §?4.71a, IVDS Formula.

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). DC 5237 was not?amended.

Any associated objective neurological abnormalities, including, but not limited to, bowel or bladder impairment, are to be evaluated separately under an appropriate diagnostic code. 38 C.F.R. § 4.71a, Spine Formula, Note 1.

Unfavorable ankylosis is defined as "a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching." Id., Note 5. Additionally, fixation of a spinal segment in neutral position (zero degrees) is "always" considered favorable ankylosis. Id.

The U.S. Court of Appeals for Veterans Claims held that the requirement of ankylosis in the General Rating Formula for Injuries and Diseases of the Spine can be met with evidence of the functional equivalent of ankylosis (i.e.,?functional immobility of the joint) during a flare-up. Chavis v. McDonough, 34?Vet. App.?1 (2021).

VA awarded service connection for lumbar strain effective October 30, 2015, the date of the Veteran's intent to file. Thus, the Board will discuss the relevant evidence of record regarding the Veteran's lumbar strain symptoms since October 30, 2015. 38 C.F.R

The Veteran was first afforded an examination of his lumbar strain in August 2016. In September 2019, the Board found that the range of motion testing in this examination was inadequate as it did not comply with Correia v. McDonald, 28?Vet. App.?158 (2016) (holding that regulations require testing for pain on active and passive motion and in weight-bearing and nonweight-bearing for joint disabilities). Therefore, the Board remanded the claim to afford the Veteran a new examination of his lumbar spine.

Testing for neurological abnormalities in the Veteran's lower extremities was also conducted during the August 2016 VA examination, which is unaffected by any deficiency in the range of motion testing. On examination, muscle strength, deep tendon reflexes, and sensation were normal throughout the lower extremities, and the examiner found that the Veteran did not have radiculopathy.

In December 2019, the Veteran was afforded another VA examination. The Veteran reported having daily lumbar and thoracic pain. He also described his back as a locking up or back muscles spasming with prolonged driving. The Veteran reported that he had no surgery, physical therapy, or follow-up care since his last visit to a VA medical center for his back in 2014. The Veteran had flare-ups of pain once per week which lasted about half a day. Lying on the floor and doing straightening exercises helped relieve his pain. The examiner stated that the Veteran was able to demonstrate how he moves with and without symptoms that occur during a flare-up.

Range of motion was to 50 degrees in forward flexion, 10 degrees in extension, and 20 degrees in right and left lateral flexion and lateral rotation, all without further reduction in range of motion on repetitive motion testing or with repeated use over time. Although pain was noted in all active motion and in weight-bearing, the examiner found range of motion itself did not contribute to functional loss, and pain noted on examination did not result in or cause functional loss. Range of motion during a flare-up was to 40 degrees in forward flexion, to 10 degrees in extension, and to 15 degrees in right and left lateral flexion and lateral rotation. The Veteran did not have ankylosis, any neurologic abnormality in the lower extremities, or IVDS.

The Court in the July 2023 memorandum decision directed the Board to discuss whether the December 2019 examination substantially complied with its September 2019 remand directives. However, in response to the January 2025 JMPR, the Board remanded the claim to obtain further information regarding the point at which the Veteran's pain on forward flexion and extension started and whether there was additional functional loss with repeated use over time.

The Veteran was afforded another VA examination of his lumbar spine in August 2025. The Veteran reported that he had flare-ups whenever he drives because the back was in one position for an extended period of time. This resulted in a tightness/stiffness in the back between his tailbone and the center of the back, which he described as the back "locking up." He also stated that his lumbar strain affects what he would normally do in everyday situations and that there are a lot of things he does not do. The Veteran did not give specifics, repeatedly said "just everything." Range of motion was to 40 degrees on forward flexion, 10 degrees on extension, 15 degrees on right lateral flexion, 5 degrees on left lateral flexion, and 20 degrees on right and left lateral rotation, all without further reduction on repetitive motion testing. Pain began at 20 degrees in forward flexion, 5 degrees in extension, 10 degrees in right lateral flexion, 0 degrees in left lateral flexion, and 20 degrees in right and left lateral rotation. Passive range of motion was not conducted because it was medically contraindicated as it may cause severe pain or risk of further injury. Pain was noted in active motion. Tenderness
said "just everything." Range of motion was to 40 degrees on forward flexion, 10 degrees on extension, 15 degrees on right lateral flexion, 5 degrees on left lateral flexion, and 20 degrees on right and left lateral rotation, all without further reduction on repetitive motion testing. Pain began at 20 degrees in forward flexion, 5 degrees in extension, 10 degrees in right lateral flexion, 0 degrees in left lateral flexion, and 20 degrees in right and left lateral rotation. Passive range of motion was not conducted because it was medically contraindicated as it may cause severe pain or risk of further injury. Pain was noted in active motion. Tenderness of the thoracic and lumbar spine muscles was noted. No further reduction was expected with repeated use over time. During a flare-up range of motion was estimated to be to 10 degrees in forward flexion, 0 degrees in extension and left lateral flexion, 10 degrees in right lateral flexion, and 15 degrees in right and left lateral rotation. The Veteran did have localized tenderness of the spinal muscles but was able to perform all normal activities of daily living independently. Muscle strength, deep tendon reflexes, and sensation to light touch were normal throughout both lower extremities. There was no muscle atrophy or trophic changes. No ankylosis was noted. Functional impairment was noted as increased pain with prolonged sitting such that the Veteran has to call off work or rearrange his schedule once or twice per month because of his back.

In December 2025, the examiner also addressed the inquiries in the Board's prior remand. In particular, with regard to the Veteran's reports of his back "locking up," the examiner stated that this was not indicative of ankylosis or its functional equivalent. Rather, functional ankylosis refers to functional loss so severe that spinal motion is effectively absent resulting in a functionally fixed spine, even in the absence of anatomic fusion. This determination is based on the degree of functional immobility during flare-ups. The Veteran's reports of episodic "locking up" of the back during flare-ups is typical of lumbar strain. During flare-ups, functional capacity may be significantly limited, particularly with prolonged sitting, walking, climbing stairs, standing, kneeling, and squatting. Although spinal motion may be substantially restricted and painful during acute flares, motion is not reduced to zero, and the spine is not rendered functionally immobile in a fixed position as the Veteran retains the ability to reposition, ambulate, and change posture despite increased pain and muscular guarding. By comparison, true ankylosis is associated with fixed spinal segment and persistent loss of motion, resulting in an inability to meaningfully reposition or alter spinal posture regardless of symptom fluctuation. In contrast, the Veteran's flare-related limitations still allow for retained spinal motion and functional use, even during periods of heightened symptoms. Therefore, the Veteran's reported episodes of his back "locking up" do not result in functional loss comparable to ankylosis as spinal motion is not functionally fixed or absent during flare periods.

The examiner also estimated that flare-ups at the time of the prior VA examination would result in range of motion limited to 30 degrees in forward flexion, 10 degrees in extension, right and left lateral flexion and right and left lateral rotation.

Finally, the examiner noted that the Veteran did take over-the-counter medication for pain. However, it was not possible to evaluate his level of disability in the absence of the ameliorative effects of medication because the effect of over-the-counter medication varies based on pharmacologic response, dosage, duration, and comorbid conditions. These factors cannot be objectively quantified or replicated in a clinical setting. See Ingram v. Collins, 38 Vet. App. 130 (2025).

The Board finds that the August 2025 examination report, along with the December 2025 addendum, substantially complied with the Board's prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998) (requiring substantial compliance, not strict compliance, with the Board's remand directives). In particular, the report provides range of motion for testing in active range of motion and estimated range of motion during a flare-up and indicates where pain began in range of motion. See Stegall v. West, 11 Vet. App. 268 (1998); Correia v. McDonald, 28 Vet. App. 158, 169-70 (2016). Passive range of motion testing could not be conducted because it was medically contraindicated. Thus, a remand for such testing to occur would be futile
Stegall v. West, 11 Vet. App. 268 (1998) (requiring substantial compliance, not strict compliance, with the Board's remand directives). In particular, the report provides range of motion for testing in active range of motion and estimated range of motion during a flare-up and indicates where pain began in range of motion. See Stegall v. West, 11 Vet. App. 268 (1998); Correia v. McDonald, 28 Vet. App. 158, 169-70 (2016). Passive range of motion testing could not be conducted because it was medically contraindicated. Thus, a remand for such testing to occur would be futile. See 38 C.F.R. § 3.159. The December 2025 examiner also provided estimated range of motion with additional functional loss due to the Veteran's back locking up when driving. The examiner explained that the Veteran's lumbar spine, even during a flare-up, was not functionally in a fixed position as the Veteran retained the ability to reposition and adjust the spine. Finally, the examiner addressed the Veteran's use of over-the-counter medication to alleviate pain and concluded that it was not possible to quantify as to the ameliorative effects of medication because several factors influenced the effectiveness of such medication. See Ingram, supra. As the examiner addressed the ameliorative effects of medication as completely as possible by providing a reason why the ameliorative effects of medication could not be quantified, the Board finds that the opinion is adequate to decide the claim. See 38 C.F.R. § 3.159(d). Thus, the Board finds that all necessary information to rate the Veteran's lumbar strain has been available to the Board and that there has been substantial compliance with the Board's prior remand directives.

The Board finds that for the entire increased rating period on appeal, the Veteran's lumbar strain has been productive of range of motion limited to 30 degrees or less in forward flexion during a flare-up, but not unfavorable ankylosis of the entire spine or entire thoracolumbar spine or its functional equivalent. Because the Veteran's range of motion has been stable or gotten worse over time, there is no prejudice to the Veteran in using the results of the August 2025 examination to rate the lumbsacral strain for the entire increased rating period on appeal. The August 2025 examination shows range of motion in forward flexion limited to 10 degrees during a flare-up. However, no ankylosis was found on examination. Although the Veteran experienced pain at 0 degrees for left lateral flexion and range of motion during a flare-up was reduced to 0 degrees in extension and left lateral flexion, there is no indication that the entire spine or entire thoracolumbar spine is fixed in a non-neutral position. Further, there is no indication of the additional disability required by VA's definition of unfavorable ankylosis. 38 C.F.R. § 4.71a, Spine Formula, Note 1. In the December 2025 addendum opinion, the examiner also thoroughly explained why the Veteran's lumbar strain is not productive of the functional equivalent of ankylosis, even during a flare-up. Further, a rating is not warranted under the IVDS Formula because the Veteran does not have IVDS, and there is no indication of incapacitating episodes requiring bedrest. Finally, there is no indication of radiculopathy or other neurologic abnormality which would warrant a separate rating. Thus, the Board finds that, as the evidence is persuasively against an initial rating in excess of 40 percent, the benefit of the doubt doctrine is not applicable, 38 C.F.R. § 3.102, and the appeal is denied.

As a final matter, in February 2021, the Veteran, through his representative, submitted an argument for an increased rating for lumbar strain in which the representative instead argues that the Veteran would be entitled to separate 20 percent ratings based on his forward flexion and muscle spasm or guarding. Expanding on his contentions, the representative argued:

There should be no doubt that [the Veteran] would be entitled to separate 20-percent ratings for his service-connected lumbar spine disability residuals but for Cullen [v. Shinseki, 24 Vet. App. 74 (2010)]. This is where Morgan [v. Wilkie, 31 Vet. App. 162 (2019),] and Deluca [v. Brown, 8?Vet. App.?202 (1995),] come into play. [The Veteran] avers that the Board must look at all of his residuals
separate 20 percent ratings based on his forward flexion and muscle spasm or guarding. Expanding on his contentions, the representative argued:

There should be no doubt that [the Veteran] would be entitled to separate 20-percent ratings for his service-connected lumbar spine disability residuals but for Cullen [v. Shinseki, 24 Vet. App. 74 (2010)]. This is where Morgan [v. Wilkie, 31 Vet. App. 162 (2019),] and Deluca [v. Brown, 8?Vet. App.?202 (1995),] come into play. [The Veteran] avers that the Board must look at all of his residuals to properly compensate him. [The Veteran] avers that the severity of his low back disability residuals is akin to him having more than one service-connected respiratory or gastrointestinal disability.

To that end, for example, VA regulations provide that, for ratings under DCs 6600 through 6817, a "single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation where the severity of the overall disability warrants such elevation." 38?C.F.R. § 4.96(a). In other words, VA is to evaluate the predominant disability and elevate such where the severity warrants such elevation. In concert with that, "[w]here 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 (2020).

Although [the Veteran] does not have two separate, service-connected lumbar spine disabilities, he does have residuals of his service-connected disability that would merit separate ratings if permitted by law. But that should not preclude the Board from addressing all avenues of schedular rating in this case before resorting to an extraschedular analysis and this would necessarily include consideration of a higher rating for all lumbar spine disability residuals in accordance with DeLuca and 38?C.F.R. §?4.7.

The Board should be guided by how VA already treats multiple service-connected respiratory or gastrointestinal disabilities for the purpose of elevating the rating where the severity of the [the Veteran's] overall disability picture warrants such. The overall disability picture in [the Veteran's] case merits such consideration and a higher rating based on his disability residuals. This would be consistent with DeLuca and all VA regulations addressed by the Court in DeLuca. Consequently, the Veteran avers that he is entitled to an increased rating for his service-connected low back disability.

The Board disagrees with the Veteran's attorney. As noted in the representative's argument, separate symptoms of the same disability generally are not entitled to separate ratings under the same diagnostic code under Cullen. Moreover, the Board finds the representative has conflated symptoms with residuals. The examiner found the Veteran's lumbar strain did not result in any neurologic abnormality, i.e., there was no residuals of his lumbar strain, other than the symptoms noted in the Spine Formula which would warrant a separate rating under 38 C.F.R. § 4.71a, Spine Formula, Note 1. Additionally, the representative has highlighted no evidence, to include any treatment records, to support the argument that additional ratings for lumbar strain are warranted.

(Continued on next page)

Thus, as stated above, prior to August 25, 2025 a 40 percent rating, but no higher, for lumbar strain is granted and since August 25, 2025 a rating in excess of 40 percent for lumbar strain is denied.

C. CRAWFORD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board J. George

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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