ULNAR NERVE PARALYSIS

HARVEY P. ROBERTS · 2026 · Case ID: A26019904

MIXED

Summary

The veteran, who served from July 2005 to October 2012, appeals the denial of higher ratings for several service-connected disabilities. The Board granted increased ratings for bilateral ulnar nerve neuropathy and median nerve radiculopathy. Specifically, the veteran received a 70% rating for right upper extremity ulnar nerve neuropathy and a 60% rating for left upper extremity ulnar nerve neuropathy, based on severe incomplete paralysis. Additionally, a 50% rating was granted for right upper extremity median nerve radiculopathy and a 40% rating for left upper extremity median nerve radiculopathy, also based on severe incomplete paralysis. The Board found that while the veteran reported constant numbness and severe paresthesias, the VA examiner's findings of mild incomplete paralysis for ulnar nerves and moderate incomplete paralysis for median nerves, combined with the veteran's subjective reports, supported the severe incomplete paralysis classification for the granted ratings. The Board also considered the veteran's allegations that the VA examiner did not properly conduct the examinations, but found the presumption of regularity was not overcome as the examination reports contained the necessary measurements and findings. The claims for higher ratings for cervical spine and low back disabilities, currently rated at 20%, were denied as the evidence did not support a greater degree of limitation or incapacitating episodes than already recognized. The claim for a higher rating for inguinal hernia was also denied, as the veteran's hernia was surgically repaired and showed no recurrence or symptoms warranting a higher rating under current or prior criteria.

Rationale

Severe incomplete paralysis of right ulnar nerve; Constant numbness and severe paresthesias reported; Examiner's findings support 70% rating

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

8513

Docket No.

250926-592344

Full Decision Text

Citation Nr: A26019904
Decision Date: 03/05/26 Archive Date: 03/05/26

DOCKET NO. 250926-592344
DATE: March 5, 2026

ORDER

Entitlement to a 70 percent rating, but not higher, for right upper extremity ulnar nerve neuropathy is granted.

Entitlement to a 60 percent rating, but not higher, for left upper extremity ulnar nerve neuropathy is granted.

Entitlement to a separate 50 percent rating, but not higher, for right upper extremity median nerve radiculopathy is granted.

Entitlement to a separate 40 percent rating, but not higher, for left upper extremity median nerve radiculopathy is granted.

Entitlement to a rating in excess of 20 percent for a cervical spine disability is denied.

Entitlement to a rating in excess of 20 percent for a low back disability is denied.

Entitlement to a rating in excess of 0 percent for an inguinal hernia is denied.

FINDINGS OF FACT

1. During the period under review, the Veteran's right upper extremity ulnar nerve neuropathy disability was manifested by symptomatology more nearly approximating severe incomplete paralysis of the ulnar nerve; during the same period, the disability's symptomatology did not more nearly approximate complete paralysis of that nerve.

2. During the period under review, the Veteran's left upper extremity ulnar nerve neuropathy disability was manifested by symptomatology more nearly approximating severe incomplete paralysis of the ulnar nerve; during the same period, the disability's symptomatology did not more nearly approximate complete paralysis of that nerve.

3. During the period under review, the Veteran's right upper extremity median nerve radiculopathy disability was manifested by symptomatology more nearly approximating severe incomplete paralysis of the median nerve; during the same period, the disability's symptomatology did not more nearly approximate complete paralysis of that nerve.

4. During the period under review, the Veteran's left upper extremity median nerve radiculopathy disability was manifested by symptomatology more nearly approximating severe incomplete paralysis of the median nerve; during the same period, the disability's symptomatology did not more nearly approximate complete paralysis of that nerve.

5. During the period under review, the Veteran's cervical spine disability was manifested by symptomatology more nearly approximating limitation of forward flexion of the cervical spine to 25 degrees; during that same period, the Veteran's cervical spine disability was not manifested by symptomatology that the nearly approximated limitation of forward flexion of the cervical spine to 15 degrees or less, or favorable ankylosis of the entire cervical spine.

6. During the period under review, the Veteran's low back disability was manifested by symptomatology more nearly approximating a limitation of forward flexion of the thoracolumbar spine to, at worst, 45 degrees; during the same period, the Veteran's low back disability was not manifested by symptomatology more nearly approximating a limitation of forward flexion of the thoracolumbar spine to 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine.

7. During the period under review, the Veteran's hernia symptomatology more nearly approximated a surgically repaired hernia without evidence of recurrence; during the same period, the disability was not manifested by symptomatology more nearly approximating either a recurrent postoperative hernias, readily reducible and well supported by truss or belt; or an irreparable hernia (new or recurrent) present for 12 months or more; with hernia size smaller than three centimeters.

CONCLUSIONS OF LAW

1. The criteria for a 70 percent rating, but not higher, for right upper extremity ulnar nerve neuropathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8513.

2. The criteria for a 60 percent rating, but not higher, for left upper extremity ulnar nerve neuropathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8513.

3. The criteria for a 50 percent rating, but not higher, for right upper extremity median nerve radiculopathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8515.

4. The criteria for a 40 percent rating, but not higher, for left upper extremity
ity ulnar nerve neuropathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8513.

4. The criteria for a 40 percent rating, but not higher, for left upper extremity median nerve radiculopathy have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8515.

5. The criteria for a rating in excess of 20 percent for a cervical spine disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5243.

6. The criteria for a rating in excess of 20 percent for a low back disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5237.

7. The criteria for a rating in excess of 0 percent for an inguinal hernia have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.114, Diagnostic Code 7338.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from July 2005 to October 2012.

This appeal comes before the Board of Veterans' Appeals (Board) from a January 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) which is the Agency of Original Jurisdiction (AOJ). In the September 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the January 2025 AOJ decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran wants VA to consider any evidence that was submitted that the Board cannot consider, the Veteran may file a Supplemental Claim, VA Form 20-0995, and submit or identify that evidence. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. 38 C.F.R. § 3.2501. Specific instructions for filing a Supplemental Claim are included with this decision.

In the September 2025 Notice of Disagreement, the Veteran also indicated wanting to appeal an October 2024 rating decision which proposed reducing the rating assigned for a service-connected psychiatric disability from 70 percent to 30 percent. That rating decision also reported deferring decisions regarding increased ratings for right and left upper extremity ulnar nerve neuropathy, cervical spine, low back and hernia disabilities. In the Notice of Disagreement, the Veteran indicated wanting to appeal the deferrals listed in the October 2024 rating decision. The Board notes that, because the AOJ only proposed reducing the rating for a psychiatric disability in the October 2024 rating decision, the AOJ did not reach a decision which could be appealed. Because the AOJ deferred reaching decisions on those issues in the October 2024 rating decision rather than making decisions in those matters, the AOJ did not make any decisions that could be appealed. The Board notes, in the January 2025 rating decision on appeal, the AOJ made decisions regarding the claims for increased ratings for right and left upper ulnar nerve neuropathy, cervical spine, low back and hernia disabilities; and the Board will adjudicate the Veteran's appeals of those decisions in this document. However, because the AOJ only proposed reducing the rating for a psychiatric disability, the AOJ did not make
in the October 2024 rating decision, the AOJ did not reach a decision which could be appealed. Because the AOJ deferred reaching decisions on those issues in the October 2024 rating decision rather than making decisions in those matters, the AOJ did not make any decisions that could be appealed. The Board notes, in the January 2025 rating decision on appeal, the AOJ made decisions regarding the claims for increased ratings for right and left upper ulnar nerve neuropathy, cervical spine, low back and hernia disabilities; and the Board will adjudicate the Veteran's appeals of those decisions in this document. However, because the AOJ only proposed reducing the rating for a psychiatric disability, the AOJ did not make any decision regarding that issue that could be appealed. Because the AOJ did not make any decisions that could be appealed in the October 2024 rating decision, no issues from that decision are currently on appeal before the Board.

Increased Ratings

Disability ratings are determined by the application of VA's Schedule for Rating Disabilities, which is based on average impairment of earning capacity resulting from a service-connected disability. 38U.S.C. §1155; 38 C.F.R. Part 4. Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3.

Veterans may have separate ratings under different diagnostic codes for the same injury. However, the critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. Esteban v. Brown, 6 Vet. App. 259 (1994).

When rating musculoskeletal disabilities based on limitation of motion, the rater must consider whether there is functional loss caused by pain or other factors that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. Consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. 38 C.F.R. §§ 4.40, 4.45; DeLuca v. Brown, 8 Vet. App. 202 (1995); Mitchell v. Shinseki, 25 Vet. App. 32 (2011). Nonetheless, even when the background factors listed in 38 C.F.R. § 4.40 or 38 C.F.R. § 4.45 are relevant when rating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a. A separate or higher rating itself is not appropriate. Thompson v. McDonald, 815 F.3d 781 (Fed. Cir. 2016).

Painful motion is a factor to be considered with any form of arthritis, but is not limited to disabilities involving arthritis. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1 (2011).

The examiner must record the results of range of motion testing for pain on both active and passive motion, and in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. Correia v. McDonald, 28 Vet. App. 158 (2016).

VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the veterans themselves, when a flare-up is not observable at the time of examination. Sharp v. Shulkin, 29 Vet. App. 26 (2017).

Neither the Veteran nor the Veteran's representative has raised any other issues, nor have any other issues been reasonably raised by the record. Doucette v. Shulkin, 28 Vet. App. 366 (2017). Moreover, as the Veteran has not contended, nor does the evidence show that the disabilities make the Veteran unemployable, the issue of entitlement to a total disability rating based on individual unemployability has not been raised by the record. Rice v. Shinseki, 22 Vet. App. 447 (2009).

The Veteran's entire history is to be considered when assigning disability ratings. 38 C.F.R. §4
. App. 26 (2017).

The Veteran's entire history is to be considered when assigning disability ratings. 38 C.F.R. §4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). A Veteran may experience multiple distinct degrees of disability that may result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505 (2007). The following analysis is undertaken with consideration of the possibility that different ratings may be warranted for different time periods.

Presumption of Regularity

During the period under review, in December 2024, a VA examiner performed several examinations to determine the severity of the service-connected disabilities. In several statements made to VA employees, the Veteran indicated that the VA examiner did not perform the examinations correctly. The Veteran stated that, even though the December 2024 VA examination reports contained the measurements required to rate the disabilities under VA regulations, the VA examiner did not actually take any measurements. The Veteran stated that the VA examiner only took 10 minutes in performing the examinations. The Veteran indicated being surprised to find that the December 2024 VA examination reports contained measurements, because the examiner did not take any measurements during the examinations.

Under the presumption of regularity, VA employees are presumed to have performed their duties correctly and in accordance with the law. Rizzo v. Shinseki, 580 F.3d 1288 (Fed Cir. 2009) (applying the presumption of regularity to VA medical examiners in the discharge of their regular duties). In order to overcome that presumption of regularity, the Veteran would have to submit clear evidence indicating that the examiner did not perform the required duties in a regular manner. Miley v. Principi, 366 F.3d 1343 (Fed. Cir. 2004) (requiring clear evidence to rebut the presumption of regularity).

The Board has considered the Veteran's statements indicating that the December 2024 VA examiner performed the examinations in a rapid manner. The Board notes that the speed with which an examiner performed an examination is not a concern as long as the examiner performed the examination in accordance with guidelines and provided the information necessary for rating under the pertinent regulations. However, the Veteran also stated that the examiner did not take any measurements in performing the examinations. However, in reviewing the December 2024 VA examination reports, the Board notes that the VA examiner reported providing examinations using the required instrument, a goniometer, specified by VA. The examination reports contain the detailed information required by VA to allow for the rating of the Veteran's disabilities. Based on the examiner's findings, the Board will be partially granting the claims for higher ratings for neuropathy and radiculopathy disabilities. Because the examination reports contained the required findings, the Veteran's comments indicating that the examiner did not make any such findings during the examination are not clear evidence indicating that the examiner failed to perform the examiner's duties. Therefore, the presumption of regularity has not been overcome and the Board will proceed to use the examiner's findings in adjudicating the Veteran's claims.

1. Entitlement to a rating in excess of 20 percent for right upper extremity ulnar nerve neuropathy

2. Entitlement to a rating in excess of 20 percent for left upper extremity ulnar nerve neuropathy

3. Entitlement to a separate rating for right upper extremity median nerve radiculopathy

4. Entitlement to a separate rating for left upper extremity median nerve radiculopathy

The Veteran is seeking higher ratings, because the Veteran contends that, during the period under review, the service-connected right and left upper extremity ulnar nerve neuropathy disabilities were both of greater severity than contemplated by the assigned 20 percent ratings. Based on the findings in the December 2024 VA examination report, the Board will also assign separate ratings for right and left upper extremity median nerve radiculopathy disabilities, caused by the service-connected cervical spine disability.

During the period under review, the Veteran's right and left upper extremity ulnar nerve neuropathy disabilities were assigned 20
extremity median nerve radiculopathy

4. Entitlement to a separate rating for left upper extremity median nerve radiculopathy

During the period under review, the Veteran's right and left upper extremity ulnar nerve neuropathy disabilities were assigned 20 percent ratings under Diagnostic Code 8513, the criteria used in rating all radicular nerve groups. Under those criteria, mild incomplete paralysis is rated 20 percent disabling for both the major and minor extremity. Moderate incomplete paralysis is rated 40 percent disabling for the major extremity and 30 percent disabling for the minor extremity. Severe incomplete paralysis is rated 70 percent disabling for the major extremity and 60 percent disabling for the minor extremity. Complete paralysis of all radicular nerve groups is rated 90 percent disabling for the major extremity and 80 percent disabling for the minor extremity. 38 C.F.R. § 4.124a, Diagnostic Code 8513.

Additionally, ratings may be assigned for median nerve radiculopathy disabilities under Diagnostic Code 8515. Under those criteria, mild incomplete paralysis is rated 10 percent for both the major and minor extremity. Moderate incomplete paralysis is rated 30 percent for the major extremity and 20 percent for the minor extremity. Severe incomplete paralysis is rated 50 percent rating for the major extremity and 40 percent rating for the minor extremity. Complete paralysis is rated 70 percent rating for the major extremity and 60 percent rating for the minor extremity. 38 C.F.R § 4.124a, Diagnostic Code 8515.

The words mild, moderate, and severe as used in the various Diagnostic Codes are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy. 38 C.F.R. §§ 4.123, 4.124.

The term incomplete paralysis indicates a degree of lost or impaired function substantially less than the type picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor. 38 C.F.R. § 4.124a, Note at Diseases of the Peripheral Nerves. The Note to 38 C.F.R. § 4.124a establishes a maximum rating for conditions that are wholly sensory, as opposed to a minimum rating for conditions that are more than wholly sensory. Miller v. Shulkin, 28 Vet. App. 376 (2017).

When a Diagnostic Code contains undefined subjective terms of degree, the Board must disclose the standard under which it is defining these terms. Johnson v. Wilkie, 30 Vet. App. 245 (2018). In discussing the meaning of the terms such as slight, moderate, and severe, the Board is permitted to consult with a dictionary. Nielson v. Shinseki, 23 Vet. App. 56 (2009); Hime v. McDonald, 28 Vet. App. 1 (2016); Prokarym v. McDonald, 27 Vet. App. 307 (2015).

According to MERRIAM WEBSTER'S COLLEGIATE DICTIONARY 999 (11th Ed. 2007), slight means small in amount. Moderate means limited in scope or effect. Severe means very painful or harmful or of a great degree. However, what is classified as severe can be dependent on the Diagnostic Code used. Breniser v. Shinseki, 25 Vet. App. 64 (2011).

On examination, the December 2024 VA examiner diagnosed bilateral ulnar nerve compression and cervical spine radiculopathy. When describing which nerves were affected by the disabilities, the examiner reported that the Veteran experienced moderate incomplete paralysis of the right and left median nerves, and mild incomplete paralysis of the right and left ulnar nerves. The examiner indicated that the Veteran did not experience paralysis of any other nerves. The examiner indicated that the Veteran was right-handed. The examiner found that the Veteran had moderate intermittent pain, usually dull, in the bilateral lower extremities. The examiner also noted that the Veteran had severe paresthesias and/or dysesthesias, and severe numbness in the bilateral upper extremities. The examiner indicated that the Veteran did not have constant pain in either extremity. On muscle strength testing, the examiner noted normal strength in both extremities throughout testing. The Veteran did not have any noted muscle atrophy or trophic changes. The examiner found that the Veteran had decreased sensations to light touch bilaterally at the hand/fingers, but normal sensations at the shoulder area and inner/outer forearm bilaterally. The examiner indicated that deep tendon reflexes were normal on examination. The examiner also noted that the Veteran did not use assistive devices and that the Veteran's arm functioning was not so diminished that amputation with prosthesis would equally serve the Veteran. When describing the functional impact that the disability symptomatology would have on the Veteran's ability to work, the examiner stated that the Veteran would experience decreased grip strength in the bilateral hands when holding items for longer than a minute or so. Moreover, when working with a wrench or other small tools requiring dexterity, the tools would slip out of the Veteran's hands.

The Board notes that the December 2024 VA examiner determined that the Veteran experienced severe neurological symptomatology in both upper extremities due to the effects of both the ulnar nerve neuropathy and median nerve radiculopathy disabilities. Because the Board cannot differentiate between the symptoms caused by either individual disability, the Board will attribute the severe symptoms noted by the VA examiner to both disabilities. Mittleider v. West, 11 Vet. App. 181 (1998).

From this evidence, the Board finds that the Veteran's disabilities during the period under review more nearly approximated the severe incomplete paralysis of the bilateral ulnar nerves required for a 70 percent rating in the right upper extremity and a 60 percent rating in the left upper extremity. In the December 2024 VA examination report, the VA examiner found that the Veteran had mild incomplete paralysis of the ulnar nerves. However, in the same report, the Veteran reported having constant numbness in the hands and intermittent numbness in both arms below the elbows. On testing, the VA examiner indicated that the Veteran experienced severe numbness, and paresthesias and/or dysesthesias symptoms in both upper extremities. The Board finds that symptomatology more nearly approximated the severe incomplete paralysis of the ulnar nerves contemplated by a 70 percent rating for the right (major) upper extremity and a 60 percent rating the left (minor) extremity under Diagnostic Code 8513. 38 C.F.R. § 4.124a.

The Board also finds that the symptomatology for the disabilities during the period under review did not more nearly approximate the complete paralysis of the bilateral ulnar nerves required for a next higher 90 percent rating in the right upper extremity or a next higher 80 percent rating in the left upper extremity. In the December 2024 VA examination report, the VA examiner specifically found that the Veteran had only incomplete, rather than complete, paralysis of the ulnar nerve in each extremity. Therefore, the Board finds that such symptomatology did not more nearly approximate the severe incomplete paralysis of the ulnar nerves contemplated by next higher ratings under Diagnostic Code 8513. 38 C
38 C.F.R. § 4.124a.

From this evidence, the also Board finds that the service-connected cervical spine disability directly caused right and left median nerve radiculopathy symptoms. The Board also finds that those disabilities during the period under review more nearly approximated the severe incomplete paralysis of the bilateral median nerves required for a 50 percent rating in the right upper extremity and a 40 percent rating in the left upper extremity. In the December 2024 VA examination report, the VA examiner found that the Veteran had moderate incomplete paralysis of the median nerves. However, in the same report, the Veteran reported having constant numbness in the hands and intermittent numbness in both arms below the elbows. On testing, the VA examiner indicated that the Veteran experienced severe numbness, and paresthesias and/or dysesthesias symptoms in both upper extremities. The Board finds that such symptomatology more nearly approximated the severe incomplete paralysis of the median nerves contemplated by a 50 percent rating for the right (major) upper extremity and a 40 percent rating the left (minor) extremity under Diagnostic Code 8515. 38 C.F.R. § 4.124a.

The Board also finds that the symptomatology for these disabilities during the period under review did not more nearly approximate the complete paralysis of the median nerves required for a next higher 70 percent rating in the right upper extremity or a next higher 60 percent rating in the left upper extremity. In the December 2024 VA examination report, the VA examiner specifically found that the Veteran had only incomplete, rather than complete, paralysis of the median nerve in each extremity. Therefore, the Board finds that such symptomatology did not more nearly approximate the severe incomplete paralysis of the median nerves contemplated by next higher ratings under Diagnostic Code 8515. 38 C.F.R. § 4.124a.

The Board acknowledges the Veteran's lay assertions of neurological disability symptomatology resulting in numbness in both upper extremities. In this instance, the Board finds the clinical evidence of record matches the ratings assigned by this decision. The Board has considered all other potentially applicable Diagnostic Codes, but there is insufficient evidence showing the Veteran had neurological impairment associated with any other peripheral nerves. Therefore, the Board finds that a separate or higher rating under a different Diagnostic Code is not warranted.

Accordingly, the Board finds that the evidence for the period under review persuasively weighed in favor of an 80 percent rating, but not higher, for right upper extremity ulnar nerve neuropathy and a 70 percent rating, but not higher, for left upper extremity ulnar nerve neuropathy. The Board also finds that the evidence of record for the period under review persuasively weighed in favor of a 50 percent rating, but not higher, for right upper extremity median nerve radiculopathy and a 70 percent rating, but not higher, for left upper extremity median nerve radiculopathy. Because there is no reasonable doubt to resolve in favor of the Veteran regarding any claims for ratings in excess of those granted in this decision, any such claims must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

5. Entitlement to a rating in excess of 20 percent for a cervical spine disability

The Veteran is seeking a higher rating for a cervical spine disability, because the Veteran contends that the cervical spine disability symptoms during the period under review were of greater severity than contemplated by the assigned 20 percent rating.

The cervical spine disability is currently rated under 38 C.F.R. §
any claims for ratings in excess of those granted in this decision, any such claims must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

5. Entitlement to a rating in excess of 20 percent for a cervical spine disability

The cervical spine disability is currently rated under 38 C.F.R. § 4.71a, Diagnostic Code 5243, for intervertebral disc syndrome (IVDS). Diagnostic Code 5243 provides that IVDS is to be rated either under the General Rating Formula for Diseases and Injuries of the Spine (General Formula) or under the Formula for Rating IVDS Based on Incapacitating Episodes (IVDS Formula), whichever method results in the higher rating when all disabilities are combined under 38 C.F.R. § 4.25.

The IVDS Formula provides that a 10 percent rating is assigned for IVDS with incapacitating episodes having a total duration of at least one week, but less than two weeks, during the past 12 months. A 20 percent rating is assigned 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 assigned for IVDS with incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during the past 12 months. A 60 percent rating is assigned for IVDS with incapacitating episodes having a total duration of at least six weeks during the past 12 months. 38 C.F.R. § 4.71a, IVDS Formula.

For purposes of ratings under Diagnostic Code 5243, 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. 38 C.F.R. § 4.71a, IVDS Formula, Note 1.

Under the General Formula, a 10 percent rating is assigned for forward flexion of the cervical spine greater than 30 degrees, but not greater than 40 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 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 assigned for forward flexion of the cervical spine greater than 15 degrees but not greater than 30 degrees; or the combined range of motion of the cervical spine not greater than 170 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 30 percent rating is assigned for forward flexion of the cervical spine to 15 degrees or less; or favorable ankylosis of the entire cervical spine. A 40 percent rating is assigned for unfavorable ankylosis of the entire cervical spine. A 100 percent rating is assigned for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Formula.

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

Ankylosis is defined as immobility and consolidation of a joint due to disease, injury, or surgical procedure. DORLAND'S ILLUSTRATED MEDICAL DICTIONARY, 94 (32nd ed. 2012). Fixation of a spinal segment in the neutral position at 0 degrees always represents favorable ankylosis. 38 C.F.R. § 4.71a, General Formula, Note 5.

In a December 2024 VA examination report, the VA examiner reported interviewing the Veteran, reviewing the record of evidence, and performing an examination in order to catalog the severity of all manifestations of the Veteran's cervical spine disability symptomatology. During the interview, the Veteran reported experiencing neck pain in the morning until the Veteran used an icepack, and having pain to the lower occipital area. The Veteran indicated going to a chiropractor once or twice a month for cervical spine disability treatment. The Veteran also indicated taking 3000 milligrams of Tylenol every day for pain treatment. In describing flare-ups, the Veteran reported having severe flare-ups two to three times per week, lasting up to one-and-a-half hours each. The Veteran stated that the flare-ups occurred randomly and were not alleviated by any external means. When asked to describe the functional impairments caused by the cervical spine disability, the Veteran indicated having a decreased range of motion of the cervical spine and pain with movement.

On examination, the December 2024 VA examiner indicated that, on active and passive range of motion testing, cervical spine flexion was possible to 35 degrees; extension to 40 degrees; right lateral flexion to 45 degrees; left lateral flexion to 45 degrees; right lateral rotation to 40 degrees; and left lateral rotation to 60 degrees, with pain noted on left lateral flexion and left lateral rotation. The examiner also noted that the Veteran experienced pain on weight-bearing. The examiner stated that the pain would cause the Veteran to avoid moving the neck too often. There was no additional loss of function or range of motion after three repetitions. The examiner indicated that pain and a lack of endurance would significantly limit functional ability with repeated use over time. Although the Veteran was not being examined immediately after repeated use over time, the VA examiner, based on information procured from relevant sources including the lay statements of the Veteran, estimated that immediately after repeated use over time, cervical spine flexion would be possible to 30 degrees; extension to 40 degrees; right lateral flexion to 40 degrees; left lateral flexion to 40 degrees; right lateral rotation to 35 degrees; and left lateral rotation to 55 degrees. Although the Veteran was not being examined during a flare-up, the examiner stated that pain and a lack of endurance would significantly limit functional ability during a flare-up. However, the examiner estimated that, during a flare-up, cervical spine flexion would be possible to 25 degrees; extension to 35 degrees; right lateral flexion to 35 degrees; left lateral flexion to 3 degrees; right lateral rotation to 30 degrees; and left lateral rotation to 50 degrees.

The December 2024 VA examiner stated that there was evidence of crepitus, but no evidence of localized tenderness, or pain on palpation of a joint or associated soft tissue. The examiner indicated that the Veteran did not experience guarding or muscle spasm of the cervical spine. The examiner noted no imaging evidence of a cervical vertebral fracture with loss of 50 percent or more of height. The examiner found no evidence of ankylosis. The examiner indicated that the Veteran did not experience any incapacitating episodes necessitating bed rest prescribed by a physician within the previous 12 months. The examiner also noted that the Veteran did not use assistive devices due to the cervical spine disability and that the Veteran's functioning in the extremities was not so diminished that amputation with prosthesis would equally serve the Veteran.

Based on the above, the Board finds that the Veteran's cervical spine disability symptomatology during the period under review more nearly approximated that required for the currently assigned 20 percent rating. At the December 2024 VA examination, the examiner noted that forward flexion of the cervical spine was limited to, at worst, 25 degrees during flare-ups. The Board finds that the Veteran's cervical spine disability symptomatology more nearly approximated the limitation of forward flexion of the cervical spine to greater than 15 degrees, but not greater than 30 degrees contemplated by the currently assigned 20 percent rating under the General Formula. 38 C.F.R. § 4.71a, Diagnostic Code 5243.

The Board finds that the evidence for the period under review persuasively weighed against a rating in excess of 20 percent for the Veteran's cervical spine disability due to IVDS based on incapacitating episodes. The record for the period under review did not contain any notation suggesting that the Veteran was ever prescribed bed rest by a physician for a duration that
degrees during flare-ups. The Board finds that the Veteran's cervical spine disability symptomatology more nearly approximated the limitation of forward flexion of the cervical spine to greater than 15 degrees, but not greater than 30 degrees contemplated by the currently assigned 20 percent rating under the General Formula. 38 C.F.R. § 4.71a, Diagnostic Code 5243.

The Board finds that the evidence for the period under review persuasively weighed against a rating in excess of 20 percent for the Veteran's cervical spine disability due to IVDS based on incapacitating episodes. The record for the period under review did not contain any notation suggesting that the Veteran was ever prescribed bed rest by a physician for a duration that met the criteria for a higher rating. Therefore, the record for the period under review did not contain sufficient evidence indicating that the Veteran experienced incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during any 12 month period as required for a next higher 40 percent rating under the IVDS Formula utilized in Diagnostic Code 5243. 38 C.F.R. § 4.71a, Diagnostic Code 5243.

The Board also finds that, during the period under review, the Veteran's cervical spine disability did not more nearly approximate the limitation of forward flexion of the cervical spine to 15 degrees or less, or favorable ankylosis of the entire cervical spine contemplated by the next higher 30 percent rating under the General Formula. The record of evidence for the period under review, lay and medical, did not contain any notation suggesting a limitation of forward flexion of the cervical spine to 15 degrees or the existence of ankylosis of the cervical spine. At the December 2024 VA examination, the examiner specifically found that the Veteran experienced a limitation of forward flexion of the cervical spine to, at worst, 25 degrees. The examiner also specifically found that there was no evidence of ankylosis of the cervical spine. Therefore, the record for the entire period under review did not contain sufficient evidence indicating that the Veteran's cervical spine symptomatology more nearly approximated that required for the next higher 30 percent rating under the General Formula. 38 C.F.R. § 4.71a, Diagnostic Code 5243.

The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to the Veteran's cervical spine disability during the period under review. The Board notes the Veteran's reports of neck pain and limited range of motion of the cervical spine. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the Veteran's statements did not result in symptomatology more nearly approximating limitation of forward flexion of the cervical spine to 30 degrees, or favorable ankylosis of the cervical spine as required for a next higher 30 percent rating under the General Formula. Moreover, the record contained no indication that the Veteran's cervical spine caused sufficient incapacitating episodes to allow for a next higher 40 percent rating under the IVDS Formula. 38 C.F.R. § 4.71a, Diagnostic Code 5243.

In reaching this determination, the Board acknowledges that VA is required to discount beneficial medication effects when relevant rating criteria do not specifically contemplate medication use. Ingram v. Collins, 38 Vet. App. 130 (2025). Here, the Board is aware that the Veteran took medication to treat pain symptomatology. However, the Board finds that, during the period under review, even when discounting the benefits of the Veteran's medication usage, the evidence did not indicate that the Veteran would have experienced a limitation of forward flexion of the cervical spine to 15 degrees or less, or favorable ankylosis of the entire cervical spine contemplated by the next higher 30 percent rating under the General Formula; or incapacitating episodes having a total duration of at least four weeks, but less than six weeks, during any 12 month period required for a next higher 40 percent rating under the IVDS Formula. 38 C.F.R. § 4.71a, Diagnostic Code 5243.

Accordingly, the Board finds that the evidence for the period under review persuasively weighed against the claim for a rating in excess of 20 percent for a cervical spine disability. As there is no reasonable doubt to resolve in favor of the Veteran, the claim for a higher rating is denied. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (2021).

6. Entitlement to a rating in excess of 20 percent for a low back disability

The Veteran
. 38 C.F.R. § 4.71a, Diagnostic Code 5243.

6. Entitlement to a rating in excess of 20 percent for a low back disability

The Veteran is seeking a higher rating for a low back disability, because the Veteran contends that the low back symptomatology during the period under review was more severe than contemplated by the assigned 20 percent rating.

Diagnostic Code 5237, the criteria for rating lumbosacral strains, utilizes the General Formula. Under the General Formula criteria for lumbosacral disabilities, a 10 percent rating is assigned 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 assigned 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 for forward flexion of the thoracolumbar spine to 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent rating is assigned for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, General Formula.

In a December 2024 VA examination report, the VA examiner reported interviewing the Veteran, reviewing the record of evidence, and performing an examination in order to catalog the severity of all manifestations of the Veteran's low back disability symptomatology. During the interview, the Veteran reported experiencing severe pain in the lower back and decreased mobility. The Veteran indicated being unable to bend down and pick up anything, and being unable to sit or stand for more than 10 to 15 minutes due to pain. The Veteran also indicated taking 200 milligrams of Celebrex and 3000 milligrams of Tylenol every day for pain treatment. The Veteran also reported seeing a chiropractor once or twice a month. In describing flare-ups, the Veteran reported having severe flare-ups twice a day, lasting up to three hours each. The Veteran stated that the flare-ups occurred randomly and were not alleviated by any external means. When asked to describe the functional impairments caused by the low back disability, the Veteran indicated experiencing severe pain in the lower back and decreased mobility; being unable to bend down and pick up anything; and being unable to sit or stand for more than 10 to 15 minutes due to pain.

On examination, the December 2024 VA examiner indicated that, on active and passive range of motion testing, lumbosacral spine flexion was possible to 50 degrees; extension to 10 degrees; right lateral flexion to 15 degrees; left lateral flexion to 15 degrees; right lateral rotation to 15 degrees; and left lateral rotation to 15 degrees, with pain noted on left lateral flexion and left lateral rotation. The examiner noted that the Veteran experienced pain not resulting in limitation of function during all ranges of active motion, except for right lateral flexion and during all ranges of passive motion except for extension. The examiner also noted that the Veteran experienced pain on weight-bearing, nonweight-bearing, and on rest and non-movement. In describing the functional loss experienced by the Veteran due to the low back disability symptomatology, the examiner wrote that the Veteran's symptoms were as described by the Veteran, including an inability to bend down and pick up objects, and an inability to sit or stand for any extended period due to pain. The examiner stated that the Veteran was unable to perform repetitive use testing with at least three repetitions due to the severe pain
. The examiner noted that the Veteran experienced pain not resulting in limitation of function during all ranges of active motion, except for right lateral flexion and during all ranges of passive motion except for extension. The examiner also noted that the Veteran experienced pain on weight-bearing, nonweight-bearing, and on rest and non-movement. In describing the functional loss experienced by the Veteran due to the low back disability symptomatology, the examiner wrote that the Veteran's symptoms were as described by the Veteran, including an inability to bend down and pick up objects, and an inability to sit or stand for any extended period due to pain. The examiner stated that the Veteran was unable to perform repetitive use testing with at least three repetitions due to the severe pain and stiffness in the back. The examiner indicated that pain and a lack of endurance would significantly limit functional ability with repeated use over time. Although the Veteran was not being examined immediately after repeated use over time, the VA examiner, based on information procured from relevant sources including the lay statements of the Veteran, estimated that the Veteran's lumbosacral spine range of motion immediately after repeated use over time would be flexion possible to 45 degrees; extension to 5 degrees; right lateral flexion to 10 degrees; left lateral flexion to 10 degrees; right lateral rotation to 10 degrees; and left lateral rotation to 10 degrees. Although the Veteran was not being examined during a flare-up, the examiner stated that pain and a lack of endurance would significantly limit functional ability during a flare-up. The examiner estimated that, during a flare-up, the lumbosacral spine range of motion would be flexion possible to 45 degrees; extension to 5 degrees; right lateral flexion to 10 degrees; left lateral flexion to 10 degrees; right lateral rotation to 10 degrees; and left lateral rotation to 10 degrees.

The December 2024 VA examiner stated that there was no evidence of crepitus, localized tenderness, or pain on palpation of a joint or associated soft tissue. The examiner indicated that the Veteran did not experience guarding or muscle spasm of the lumbar spine. The examiner noted no imaging evidence of a thoracolumbar vertebral fracture. The examiner found no evidence of ankylosis or neurological abnormalities. The examiner indicated that the Veteran did not experience any incapacitating episodes necessitating bed rest prescribed by a physician within the previous 12 months. The examiner noted that the Veteran regularly utilized a brace due to the low back disability. The examiner also indicated that the Veteran's functioning in the extremities was not so diminished that amputation with prosthesis would equally serve the Veteran. The examiner stated that the Veteran's low back disability would functionally impact the Veteran's ability to perform any type of occupational task, because the Veteran would be unable to pick up anything off the ground, bend down, kneel, or twist side to side. The examiner found that the Veteran also could not stand more than 10 to 15 minutes before needing to sit. The Veteran also indicated having difficulty with stairs and performing tasks, such as walking the Veteran's dog.

Based on the above, the Board finds that the Veteran's low back disability symptomatology during the period under review more nearly approximated that required for the currently assigned 20 percent rating. At the December 2024 VA examination, the examiner noted that forward flexion of the thoracolumbar spine was limited to, at worst, 45 degrees after repeated use over time and during flare-ups. The Board finds that the Veteran's low back disability symptomatology more nearly approximated the limitation of forward flexion of the thoracolumbar spine to greater than 30 degrees, but not greater than 60 degrees, contemplated by the currently assigned 20 percent rating under Diagnostic Code 5237. 38 C.F.R. § 4.71a.

The Board also finds that, during the evidentiary period, the Veteran's low back disability symptomatology did not more nearly approximate the limitation of forward flexion of the thoracolumbar spine to 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine contemplated by the next higher 40 percent rating under Diagnostic Code 5237. 38 C.F.R. § 4.71a. The record for the evidentiary period did not contain any notation suggesting limitation of forward flexion to any point less than the 45 degrees noted in the December 2024 VA examination report. Although the Veteran reported being unable to bend over and pick up objects, the Board notes that an individual who can only bend forward for 45 degrees would be unable to pick objects off the ground. Moreover, the record of evidence did not contain any notation indicating the existence of anky
spine to 30 degrees or less, or favorable ankylosis of the entire thoracolumbar spine contemplated by the next higher 40 percent rating under Diagnostic Code 5237. 38 C.F.R. § 4.71a. The record for the evidentiary period did not contain any notation suggesting limitation of forward flexion to any point less than the 45 degrees noted in the December 2024 VA examination report. Although the Veteran reported being unable to bend over and pick up objects, the Board notes that an individual who can only bend forward for 45 degrees would be unable to pick objects off the ground. Moreover, the record of evidence did not contain any notation indicating the existence of ankylosis of the thoracolumbar spine. In the December 2024 VA medical examination report, the VA examiner found that there was no evidence of ankylosis. Therefore, the record for the entire evidentiary period did not contain sufficient evidence indicating that the Veteran's low back symptomatology more nearly approximated that required for the next higher 40 percent rating under Diagnostic Code 5237. 38 C.F.R. § 4.71a.

The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to the Veteran's low back disability during the evidentiary period. The Board notes the Veteran's reports of difficulty with bending, sitting for prolonged periods, standing, walking, and twisting due to the low back disability. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the Veteran's statements did not result in symptomatology more nearly approximating a limitation of forward flexion of the thoracolumbar spine to 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine as required for a next higher 40 percent rating under Diagnostic Code 5237. 38 C.F.R. § 4.71a.

Consideration has also been given to assigning a rating under the IVDS Formula, found at Diagnostic Code 5243. However, the evidence for the evidentiary period contained no indication that the Veteran ever experienced IVDS symptomatology or that the Veteran was prescribed bed rest by a physician for any duration as is required for a rating under Diagnostic Code 5243. 38 C.F.R. § 4.71a, IVDS Formula. Therefore, a rating under Diagnostic Code 5243 would not be appropriate.

Regarding neurological impairment, the lay and medical evidence of record for the evidentiary period weighed against a finding that the Veteran had any neurological abnormality associated with the low back disability. Therefore, the evidence weighed against the assignment of any separate rating for a neurological disability related to the low back disability.

In reaching this determination, the Board acknowledges that VA is required to discount beneficial medication effects when relevant rating criteria do not specifically contemplate medication use. Ingram v. Collins, 38 Vet. App. 130 (2025). Here, the Board is aware that the Veteran took medication to treat pain symptomatology. However, the Board finds that, during the period under review, even when discounting the benefits of the Veteran's medication usage, the evidence did not indicate that the Veteran would have experienced a limitation of forward flexion of the thoracolumbar spine to 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine as required for a next higher 40 percent rating under Diagnostic Code 5237. 38 C.F.R. § 4.71a.

Accordingly, the Board finds that the evidence for the period under review persuasively weighed against the claim for a rating in excess of 30 percent for a low back disability. As there is no reasonable doubt to resolve in favor of the Veteran, the claim for a higher rating is denied. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (2021

7. Entitlement to a rating in excess of 0 percent for an inguinal hernia

The Veteran is seeking a higher rating for an inguinal hernia, because the Veteran contends that the hernia disability symptomatology during the period under review was more severe than contemplated by the assigned 0 percent rating

7. Entitlement to a rating in excess of 0 percent for an inguinal hernia

The inguinal hernia was rated during the period under review using the criteria listed under Diagnostic Code 7338. During that period, the criteria listed under that Diagnostic Code changed. If a law or regulation changes during the course of a claim or an appeal, the version more favorable to the veteran will apply, to the extent permitted by any stated effective date in the amendment in question. If the revised version of the regulation is more favorable, the implementation of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. If the former version is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. 38 U.S.C. § 5110; Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003).

Under the criteria in effect prior to May 19, 2024, under Diagnostic Code 7338, a 0 percent rating is assigned for an inguinal hernia that is small, reducible, or without true hernia protrusion, or not operated but remediable. A 10 percent rating is assigned for recurrent postoperative hernias, readily reducible and well supported by truss or belt. A 30 percent rating is assigned for small recurrent postoperative hernias or unoperated irremediable hernias, not well supported by truss, or not readily reducible. A 60 percent rating is assigned for large, recurrent postoperative hernias that are not well supported under ordinary conditions and not readily reducible when considered inoperable. 38 C.F.R. § 4.114, Diagnostic Code 7338 (2023).

As of May 19, 2024, a 10 percent rating is assigned for an irreparable hernia (new or recurrent) present for 12 months or more; with hernia size smaller than three centimeters. A 20 percent rating is assigned for an irreparable hernia (new or recurrent) present for 12 months or more with size equal to three centimeters, but less than 15 centimeters in one dimension, and pain when bending over, activities of daily living, walking, or climbing stairs. A 30 percent rating is assigned for an irreparable hernia (new or recurrent) present for 12 months or more with size equal to three centimeters or greater, but less than 15 centimeters in one dimension, and pain when performing at least two of the foregoing activities. A 60 percent rating is assigned for an irreparable hernia (new or recurrent) present for 12 months or more with size equal to 15 centimeters or greater in one dimension, and pain when performing at least two of the foregoing activities. A 100 percent rating is assigned for an irreparable hernia (new or recurrent) present for 12 months or more with size equal to 15 centimeters or greater in one dimension and pain when performing at least three of the foregoing activities. 38 C.F.R. § 4.114, Diagnostic Code 7338 (2024).

Reviewing the evidence, in a December 2024 VA examination report, the VA examiner reported interviewing the Veteran, reviewing the record of evidence, and performing an examination in order to catalog the severity of all manifestations of the Veteran's inguinal hernia disability symptomatology. During the interview, the Veteran reported having a surgical repair for a hernia in October 2006. The Veteran indicated not having experienced any recurrence of the hernia and not having to seek any treatment for it. The Veteran denied any noticeable bulging, pain to palpation, or pain with lifting.

The December 2024 VA examiner indicated that the records showed that the Veteran underwent a right inguinal hernia repair in October 2006. The examiner further noted that there was no evidence of a current or recurrent hernia on examination.

From this record, the Board finds that the Veteran's hernia disability symptomatology was not manifested by symptomatology more nearly approximating that required for a next higher 10 percent rating under the criteria in effect both prior to and as of May 19, 2024. In the December 2024 VA examination report, the examiner noted that, after the Veteran underwent a successful hernia repair procedure, a current or recurrent hernia was not found on examination. The Board finds that the Veteran's symptoms did not more nearly approximate those of recurrent postoperative hernias, that are readily reducible and well supported by truss or belt contemplated by the criteria for a 10 percent rating in effect prior to May 19, 2024. 38 C.F.R. § 4.114, Diagnostic Code 7338 (2023). Likewise, the Veteran's symptoms did not more nearly approximate those of an irreparable hernia (new or recurrent) present for 12 months or more, with hernia size smaller than three centimeters required contemplated by the criteria for a 10 percent rating in effect as of May 19, 2024. 38 C.F.R. § 4.114, Diagnostic Code 7338 (2024).

Accordingly, the Board finds that the evidence for the period under review persuasively weighed against the claim for a rating in excess of 0 percent for a hernia disability. The Board finds that the evidence is not in approximate balance. As there is no reasonable doubt to resolve in favor of the Veteran, the claim for a higher rating is denied. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (2021).

Harvey P. Roberts

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T.M. Gillett, 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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