Case A26032454

H.M. WALKER · 2026 · Case ID: A26032454

MIXED

Summary

The veteran served from July 1980 to February 1984. The veteran appeals the denial of increased ratings for several service-connected conditions, including bilateral hearing loss, tinnitus, obstructive sleep apnea (OSA), left foot pes planus with plantar fasciitis and degenerative arthritis, left knee disability with total knee arthroplasty, a painful left knee surgical scar, and a skin tag residual of hemorrhoid surgery. The veteran also appealed the denial of entitlement to specially adapted housing (SAH). The Board denied the claims for increased ratings for bilateral hearing loss, tinnitus, left foot disability, left knee disability, left knee surgical scar, and skin tag residuals, finding that the evidence did not support ratings higher than those already assigned or that the criteria for a compensable rating were not met. The Board dismissed claims for earlier effective dates for several service-connected conditions, citing finality rules and lack of argument. The Board denied the SAH claim, finding the veteran did not meet the statutory criteria for eligibility. The Board remanded claims for service connection for gastrointestinal reflux disease (GERD), a low back disorder, a right foot disorder, a right knee disorder, erectile dysfunction, and total disability based on individual unemployability (TDIU), citing duty to assist errors in the VA examinations which failed to adequately address the veteran's claimed in-service onset of symptoms.

Special Benefit

TDIU; EARLIER EFFECTIVE DATE; AUTO / ADAPTIVE EQUIPMENT

Docket No.

250421-540830

Full Decision Text

Citation Nr: A26032454
Decision Date: 04/08/26 Archive Date: 04/08/26

DOCKET NO. 250421-540830
DATE: April 8, 2026

ORDER

Entitlement to an earlier effective date for the grant of service connection for a left foot disability, to include left foot pes planus, is dismissed.

Entitlement to an earlier effective date for the grant of service connection for a skin tag as a residual of a hemorrhoid is dismissed.

Entitlement to an earlier effective date for the grant of service connection for a left knee disability is dismissed.

Entitlement to an earlier effective date for the grant of service connection for obstructive sleep apnea (OSA) is dismissed.

Entitlement to an earlier effective date for the grant of service connection for a painful left knee surgical scar is dismissed.

Entitlement to an earlier effective date for the grant of service connection for a left knee surgical scar is dismissed.

Entitlement to an earlier effective date for the grant of service connection for bilateral hearing loss is dismissed.

Entitlement to an earlier effective date for the grant of service connection for tinnitus is dismissed.

Entitlement to a compensable disability rating for bilateral hearing loss is denied.

Entitlement to a disability rating higher than 10 percent for tinnitus is denied.

Entitlement to a disability rating higher than 50 percent rating for OSA is denied.

Entitlement to a disability rating higher than 30 percent for left foot pes planus with plantar fasciitis and degenerative arthritis (left foot disability), is denied.

Entitlement to a disability rating higher than 30 percent for a left knee disability, to include left knee tricompartmental osteoarthritis with total knee arthroplasty, is denied.

Entitlement to a disability rating higher than 10 percent for a painful surgical scar of the left knee is denied.

Entitlement to a compensable disability rating for the painful surgical scar of the left knee on the basis of size is denied.

Entitlement to a disability rating higher than 10 percent for a skin tag, residual of hemorrhoid surgery, is denied.

Entitlement to specially adapted housing (SAH) is denied.

REMANDED

Entitlement to service connection for gastrointestinal reflux disease (GERD) is remanded.

Entitlement to service connection for a low back disorder is remanded.

Entitlement to service connection for a right foot disorder is remanded.

Entitlement to service connection for a right knee disorder is remanded.

Entitlement to service connection for erectile dysfunction is remanded.

Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded.

FINDINGS OF FACT

1. In final rating decisions from August 2012, March 2019, November 2020, and November 2021, the AOJ granted service connection for tinnitus, a skin tag, OSA, bilateral hearing loss, a left foot disability, a left knee disability, and left knee surgical scars.

2. The Veteran has Level I hearing of the right ear and Level I hearing of the left ear.

3. The Veteran's tinnitus is rated at 10 percent, which is the maximum schedular rating permitted for tinnitus.

4. The Veteran's OSA does not have symptoms of chronic respiratory failure with carbon dioxide retention, or cor pulmonale, or require tracheostomy.

5. The Veteran has service connection for left foot pes planus with plantar fasciitis and degenerative arthritis (previously rated as left foot disability) and does not have service connection for right foot pes planus and has not had surgical treatment.

6. The Veteran's left knee disability, to include tricompartmental osteoarthritis with TKA, was rated at 30 percent under Diagnostic Code 5055; the Veteran does not have chronic residuals consisting of severe painful motion or weakness in the affected extremity or intermediate degrees of residuals weakness, pain or limitation of motion by analogy to Diagnostic Code 5256 ankylosis), 5261 (extension), or 5262 (tibia and fibula impairment).

7. The Veteran has 1 left knee surgical scar that is painful and not unstable.

8. The Veteran's 1 surgical scar of the left knee (also separately rated as painful) is of an area less than 144 square inches and is not associated with soft tissue damage.

9. The Veteran has excessive redundant tissue following hemorrhoids surgery but does not have hemorrhoids or persistent bleeding or secondary anemia or with fissures.

10. The Veteran's service-connected conditions do not manifest with blindness in both eyes, full thickness or subdermal burns, or the loss of use of an upper or lower extremity.

CONCLUSIONS OF LAW

1. The claims for earlier effective dates for the grants of
impairment).

7. The Veteran has 1 left knee surgical scar that is painful and not unstable.

8. The Veteran's 1 surgical scar of the left knee (also separately rated as painful) is of an area less than 144 square inches and is not associated with soft tissue damage.

9. The Veteran has excessive redundant tissue following hemorrhoids surgery but does not have hemorrhoids or persistent bleeding or secondary anemia or with fissures.

10. The Veteran's service-connected conditions do not manifest with blindness in both eyes, full thickness or subdermal burns, or the loss of use of an upper or lower extremity.

CONCLUSIONS OF LAW

1. The claims for earlier effective dates for the grants of service connection for OSA, a left foot disability a left knee disability and left knee surgical scars, bilateral hearing loss, and tinnitus are dismissed. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.105, 3.151, 3.155, 3.400. Rudd v. Nicholson, 20 Vet. App. 296, 300 (2006).

2. The criteria for a compensable rating for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100.

3. The Veteran has the maximum 10 percent rating possible for tinnitus. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.114, Diagnostic Code 6260.

4. The criteria for a disability rating higher than 50 percent for OSA have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.97, Diagnostic Code 6847.

5. The criteria for a disability rating higher than 30 percent for the left foot disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.71a, Diagnostic Code 5276.

6. The criteria for a disability rating higher than 30 percent for the left knee disability, post-TKA, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.71a, Diagnostic Code 5250.

7. The criteria for a disability rating in excess of 10 percent for painful left knee surgical scar have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7804.

8. The criteria for a separate compensable disability rating for the service-connected left knee painful surgical scar based on size of scar have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7802.

9. The criteria for a disability rating higher than 10 percent for skin tag residuals of hemorrhoids surgery have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code 7336.

10. The criteria for eligibility for SAH have not been met. 38 U.S.C. §§ 2101, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.809.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active duty from July 1980 to February 1984.

For the claims for entitlement to service connection, the rating decision on appeal was issued in July 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

For the claim for entitlement to SAH a separate, later AMA rating decision was issued in July 2024.

For the increased rating claims for OSA, tinnitus, a left knee disability, and the two separate left knee surgical scars, a January 2025 AMA rating decision addressed these claims, following a February 29, 2024 claim.

For
BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active duty from July 1980 to February 1984.

For the claim for entitlement to SAH a separate, later AMA rating decision was issued in July 2024.

For the increased rating claims for a left foot disability, a skin tag, and bilateral hearing loss, a February 2025 AMA rating decision addressed these matters.

For the TDIU claim, that matter was most recently addressed in an April 2025 AMA rating decision.

In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement or NOD), the Veteran elected the Direct Review docket.

For any of the same issues for which the Veteran has appealed separate rating decisions addressing the same issues, the considering the most recent rating decision addressed by the April 2025 NOD as the one on appeal allows for consideration of the most complete record for the Veteran. As such, although the Veteran appealed multiple rating decisions addressing the bilateral hearing loss rating claim, including from January 2025, February 2025, and the July 2024, the February 2025 rating decision will be considered the one on appeal. For the TDIU claim, although there are other rating decisions denying a TDIU, including January 2025 and February 2025 rating decisions appealed by the Veteran, the Board will consider the most recent TDIU decision of April 2025 for the TDIU claim as the one on appeal.

Also in the April 2025 NOD, the Veteran appears to have attempted to appeal the ratings and effective dates for the issues for which service connection is being sought. As there is no effective date or rating in effect for the service connection issues, disagreeing with such matters is not possible. For the increased rating issues, the Veteran disputed the ratings and the effective dates for service connection.

Therefore, the Board may only consider the evidence of record at the time of the respective agency of original jurisdiction (AOJ) decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the respective AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claims for service connection and entitlement to a TDIU, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

The Board notes enough has elapsed since the rating decisions on appeal and the NOD such that the Veteran is no longer able to request a docket switch.

Earlier Effective Date Claims

1. Entitlement to an earlier effective date for the grant of service connection for a left foot disability, to include left foot pes planus, is dismissed.

2. Entitlement to an earlier effective date for the grant of service connection for a skin tag as a residual of a hemorrhoid is dismissed.

3. Entitlement to an earlier effective date for the grant of service connection for a left knee disability is dismissed.

4. Entitlement to an earlier effective date for the grant of service connection for OSA is dismissed.

5. Entitlement to an earlier effective date for the grant of service connection for a painful left knee surgical scar is dismissed.

6. Entitlement to an earlier effective date for the grant of service connection for a left knee surgical scar is dismissed.

7. Entitlement to an earlier effective date for the grant of service connection for bilateral hearing loss is dismissed.

8. Entitlement to an earlier effective date for the grant of service connection for tinnitus is dismissed.

In the April 2025 NOD, the Veteran's attorney appealed the effective dates for
to an earlier effective date for the grant of service connection for a left knee disability is dismissed.

4. Entitlement to an earlier effective date for the grant of service connection for OSA is dismissed.

5. Entitlement to an earlier effective date for the grant of service connection for a painful left knee surgical scar is dismissed.

6. Entitlement to an earlier effective date for the grant of service connection for a left knee surgical scar is dismissed.

7. Entitlement to an earlier effective date for the grant of service connection for bilateral hearing loss is dismissed.

8. Entitlement to an earlier effective date for the grant of service connection for tinnitus is dismissed.

In the April 2025 NOD, the Veteran's attorney appealed the effective dates for the grants of service connection for these already service-connected claims. No argument was provided as to why an earlier date was warranted for any claim.

An August 2012 rating decision granted service connection for tinnitus and a skin tag.

A February 2019 Board decision granted service connection for OSA and bilateral hearing loss. A March 2019 rating decision enacted those grants.

A November 2020 rating decision granted service connection for a left foot disability.

A November 2021 rating decision granted service connection for the left knee disability and the painful surgical scar and a separate rating for the surgical scar of the left knee.

The current claims for earlier effective date for the noted disabilities arise from claims for increased rating made years after each issues' respective rating decisions that had established service connection.

A claimant may not file, and VA has no authority to adjudicate, a freestanding earlier effective date claim, as such a claim would vitiate the rule of finality. Rudd, supra. Earlier effective date claims must arise on appeal from the rating decision granting the disputed effective date. Once an adjudication assigning an effective date becomes final, the finality of the effective date may only be overcome by a request for revision based on clear and unmistakable error. Id. at 299. In the present case, service connection for each disability was granted in rating decisions as noted above and each rating decision was a final decision, with no NOD filed within 1 year of that rating decision and no new and material evidence or new and relevant evidence associated within 1 year of that rating decision. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156(b), 20.1103. As such, the Board should dismiss any subsequently filed earlier effective date claim based on lack of jurisdiction.

The claims for entitlement to an earlier effective date for the grants of service connection for a left foot disability, a skin tag, a left knee disability and left knee surgical scars, OSA, bilateral hearing loss, and tinnitus are each dismissed.

9. Evaluation of bilateral hearing loss, which is currently 0 percent disabling, is continued.

The Veteran is seeking a compensable rating. Neither he nor his attorney have provided any argument as to why a higher rating is warranted. The current claim was made in February 2024.

Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz). 38 C.F.R. § 4.85, Diagnostic Code 6100.

To evaluate the degree of disability from bilateral service-connected hearing loss, the schedule establishes 11 auditory hearing acuity levels designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. 38 C.F.R. § 4.85, Tables VI and VII.

An exceptional pattern of hearing impairment occurs when the pure tone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more. 38 C.F.R. § 4.86(a). In that situation, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. Further, when the average pure tone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral, and that numeral will then be elevated to the next higher numeral. 38 C.F.R. § 4.86(b).

An April 2024 VA examination reveals that the Veteran reported that
38 C.F.R. § 4.86(a). In that situation, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. Further, when the average pure tone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral, and that numeral will then be elevated to the next higher numeral. 38 C.F.R. § 4.86(b).

An April 2024 VA examination reveals that the Veteran reported that the Veteran reported difficulty hearing in conversations. 38 C.F.R. § 4.10; Martinak v. Nicholson, 21 Vet. App. 447 (2007). The Veteran's Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows:

HERTZ

1000 2000 3000 4000 Avg CNC

RIGHT 25 30 35 45 33.27 100

LEFT 20 20 30 35 26.25 96

Applying the results to Table VI, the findings yield a numeric designation of Level I in the right ear and Level I in the left ear. Entering the resulting bilateral numeric designation of Level I for the right ear and Level I for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a 0 percent disability rating under Diagnostic Code 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown.

Based on the evidence above, a compensable rating for the Veteran's bilateral hearing loss is not warranted.

The Board expressly acknowledges its consideration of the lay evidence of record when adjudicating this claim, including his report of difficulty hearing conversations. The Veteran is competent to report difficulty hearing; however, disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenmann v. Principi, 3 Vet. App. 345 (1992).

The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran describes is contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). The Veteran's main complaint is reduced hearing acuity and clarity, which is what is contemplated in the rating assigned. See Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017).

Accordingly, the most probative evidence of record persuasively weighs against the claim of entitlement to a compensable rating. As the most probative evidence of record persuasively weighs against a compensable rating the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). Entitlement to a compensable disability rating for bilateral hearing loss is denied.

10. Entitlement to a disability rating higher than the maximum 10 percent for tinnitus is denied.

The Veteran is in receipt of a 10 percent rating for tinnitus, under Diagnostic Code 6260. The Veteran and his attorney have claimed that a higher rating is warranted but has not provided any argument as to why a higher rating is warranted.

Under 38 C.F.R. § 4.87, Diagnostic Code 6260, recurrent tinnitus is assigned a 10 percent rating. Under Note (2) following that code, only a single evaluation may be assigned for recurrent tinnitus, whether the sound is perceived in one ear, both ears, or in the head. In short, Diagnostic Code 6260 only allows for a maximum single 10 percent evaluation for recurrent tinnitus.

Courts have addressed the question of whether a separate 10 percent disability rating can be assigned for tinnitus in both ears and concluded that a separate rating for each ear cannot be granted. The Federal Circuit found that 38 C.F.R. § 4.25(b) and Diagnostic Code 6260 limits a Veteran to a single disability rating for tinnitus, regardless of whether the tinnitus is unilateral or bilateral. Smith v. Nicholson, 451 F.3d 1344 (Fed. Cir. 2006).

The Veteran has not raised any other issues, nor have any other
head. In short, Diagnostic Code 6260 only allows for a maximum single 10 percent evaluation for recurrent tinnitus.

The Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record. Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

Additionally, the application of the law to the undisputed facts is dispositive of this appeal. As such, no discussion of VA's duties to notify and assist is necessary. Neither the appellant nor his representative has identified, and the record does not otherwise indicate any additional existing evidence that is necessary for a fair adjudication of the claim that has not been obtained. Hence, no further notice or assistance is required to fulfill VA's duty to assist in the development of the claim.

In this case, the service-connected tinnitus has been assigned the maximum schedular rating available for tinnitus. See 38 C.F.R. § 4.87, Diagnostic Code 6260. As there is no legal basis upon which to award a higher evaluation, or separate schedular evaluations for tinnitus in each ear, the appeal must be denied. See Sabonis v. Brown, 6 Vet. App. 426 (1994).

11. Entitlement to a disability rating higher than 50 percent for OSA is denied.

The Veteran and his attorney claim that a disability rating higher than 50 percent for OSA is warranted but have not provided any argument as to why a higher rating is warranted.

The Veteran is in receipt of a 50 percent rating for OSA, under Diagnostic Code 6847.

Under 38 C.F.R. § 4.104, Diagnostic Code 6847 for sleep apnea syndrome, the next higher rating after 50 percent is 100 percent. A maximum 100 percent rating for OSA is only warranted if OSA is causing chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requiring the performance of a tracheostomy.

In a March 2019 rating decision, the AOJ initially granted service connection for OSA with a 50 percent rating.

The Veteran filed the current claim for a higher rating in February 2024.

VA and private medical records do not indicate OSA causing chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requiring the performance of a tracheostomy.

In conjunction with the current claim, the Veteran underwent a VA examination in August 2024. The VA examiner noted that the Veteran reported feeling much better with his CPAP and would wake up not congested and feeling refreshed. The examiner did not find chronic respiratory failure, carbon dioxide retention, cor pulmonale, requiring a tracheostomy, or persistent daytime hypersomnolence. The examiner also found no functional impact due to the Veteran's OSA.

Thus, because the competent evidence of record does not show that the Veteran has had chronic respiratory failure with carbon dioxide retention, cor pulmonale, or required the performance of a tracheostomy, a disability rating higher than 50 percent is not warranted.

As the most probative evidence persuasively weighs against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). Entitlement to a disability rating higher than 50 percent for OSA is denied.

12. Entitlement to a disability rating higher than 30 percent for left foot disability is denied.

The Veteran's left foot disability includes service connection for left foot pes planus with plantar fasciitis and degenerative arthritis. The Veteran is currently rated at 30 percent under Diagnostic Code 5276 for pes planus. The Veteran is seeking a higher rating but neither he nor his attorney has provided any argument as to why a higher rating is warranted. The Board notes that at the time of this decision, the Veteran does not have service connection for any right foot disabilities. To the extent any current ratings may be affected by a later service connection of right foot disorder(s) such changed ratings will be considered after service connection is determined for such disorders. In the present case, the Veteran's claim for service connection for any right foot disorders is subject to a Board remand, as discussed in the REMAND section of this decision.

The Board notes that historically, plantar fasciitis was rated by analogy, usually under Diagnostic Code 5276 (pes planus) or Diagnostic Code 5284 (other foot injuries; however, effective February 7, 2021, VA amended the rating schedule by adding Diagnostic Code 5269 for plantar fasciitis. The present claim arose from a February 2024 claim and will consider all applicable diagnostic codes.

The Veteran's left foot pes planus is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5276, for acquired flatfoot. Under Diagnostic Code 5276, a 30 percent rating is warranted for severe bilateral acquired flat foot; objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 30 percent rating is also warranted for pronounced unilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. A maximum 50 percent rating is warranted for bilateral acquired flatfoot; marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo achillis on manipulation, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, Diagnostic Code 5276.

The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, even in the absence of arthritis, to include in situations where the disability at issue is not evaluated based on range of motion measurements. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011); Southall-Norman v. McDonald, 28 Vet. App. 346 (2016).

The Board finds that the evidence of record persuasively weighs against a rating in excess of 30 percent for the pes planus. The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain in the right foot per his March 2024 VA examination. The Veteran also reported flare-ups twice a day, for 10 minutes, with severe pain precipitated by walking and climbing. He reported it was alleviated with rest and orthotics. The Veteran also reported limited extended standing, walking, and climbing. Similarly, in his January 2025 VA examination, the Veteran reported constant moderately severe pain with prolonged weightbearing.

However, even considering the Veteran's lay reports of symptoms and functional loss, the degree of additional limitation reflected by his statements would not result in symptoms more nearly approximating pronounced bilateral acquired flatfoot. As previously noted, at the time of this decision, the Veteran does not have service connection for a right foot disability, including right foot pes planus.

The Board has also considered the other Diagnostic Codes pertaining to the foot. Other disability ratings may be assigned only if the symptomatology for a disability is not duplicative or overlapping with the symptomatology of any other disability. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); see also Lyles v. Shulkin, 29 Vet. App. 107 (2017). In Scott v. Wilkie, the Federal Circuit expressly adopted the Court's holding that disabilities specifically listed in the rating schedule may only be rated under Diagnostic Codes which specifically pertain to them. Scott v. Wilkie, 920 F.3d 1375 (Fed. Cir. 2019) (citing Copeland v. McDonald, 27 Vet. App. 333, 336 (2015)). The Federal Circuit also expressly adopted the Court's holding that unlisted conditions may be rated by analogy to Diagnostic Codes that may not describe the unlisted disability but addresses disabilities that may be productive of similar symptoms. Scott, 920 F.3d 1375 (citing Yancy v. McDonald, 27 Vet. App. 484, 493 (2016). Finally, the Federal Circuit concluded that the Board must also consider assigning separate ratings under analogous Diagnostic Codes, when rating an unlisted service-connected foot disability exhibiting distinct manifestations, even when service connection has also been granted for one of the eight conditions listed in the rating schedule. Id.

Here, the Veteran's disability is specifically noted as pes planus and is listed under the rating schedule and therefore cannot be rated under a different Diagnostic Code. Additionally, the Board has also considered the Veteran's left plantar fasciitis and arthritis. The evidence of record does not reflect that the Veteran has any other service-connected foot disabilities that would warrant a separate rating under a different Diagnostic Code. The evidence of record is against a finding that the disabilities have distinct manifestations from those that are already being compensated. See 38 C.F.R. § 4.14. Diagnostic Code 5276 for pes planus already considers severe pain on manipulation and on use.

Additionally, Diagnostic Code 5269 for plantar fasciitis, unilateral plantar fasciitis, which would warrant a 10 percent rating, a higher rating would not be indicated unless the Veteran had no relief from both non-surgical and surgical treatment, bilateral. Neither VA examiner indicated that any surgical intervention had been recommended for a higher or separate rating on that basis. The same effects of reduced endurance of standing, ambulating, weight bearing were noted for both plantar fasciitis and pes planus. VA medical records similarly do not indicate any indication of surgical intervention.

Similarly, under Diagnostic Code 5003 for degenerative arthritis, degenerative arthritis is considered for limitation of motion, which must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion.

Neither the Veteran nor the examiners has indicated that the Veteran has symptoms regarding his feet other than pain, which is already considered under Diagnostic Code 5276 for pes planus and thus separate ratings for the same symptoms under Diagnostic Code 5003 for degenerative arthritis and Diagnostic Code 5269 for plantar fasciitis is not indicated.

The Board finds that the evidence of record does not reflect that the Veteran has any other service-connected foot disabilities that would warrant a separate rating under a different Diagnostic Code. The Board notes that the Veteran has other service-connected foot disabilities. However, the evidence of record is against a finding that the disabilities have distinct manifestations from those that are already being compensated. See 38 C.F.R. § 4.14.

In conclusion, the Board finds that the evidence of record persuasively weighs against a rating higher than 30 percent for the left foot disability. As the evidence of record persuasively weighs against a rating in excess of 30 percent, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

12. Entitlement to a disability rating higher than 30 percent for a left knee disability, post-TKA, is denied.

The Veteran has claimed that a higher rating is warranted for his left knee disability, which is currently rated at 30 percent under Diagnostic Code 5055. Neither the Veteran nor his attorney has provided argument as to why a higher rating is warranted.

The Veteran filed the current claim in February 2024.

Under Diagnostic Code 5055, a minimum 30 percent evaluation
5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

12. Entitlement to a disability rating higher than 30 percent for a left knee disability, post-TKA, is denied.

The Veteran filed the current claim in February 2024.

Under Diagnostic Code 5055, a minimum 30 percent evaluation is warranted for total replacement only. With intermediate degrees of residual weakness, pain or limitation of motion the knee should be rated by analogy to diagnostic codes 5256 (ankylosis), 5261 (extension), or 5262 (impairment of the tibia and fibula). With chronic residuals consisting of severe painful motion or weakness in the affected extremity a 60 percent is warranted. 38 C.F.R. § 4.71a.

The terms "slight," "moderate" or "intermediate" and "severe" are not defined in the Rating Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6.

The Board notes that the Veteran has already received a 100 percent rating for his TKA or knee replacement and the current claim takes place over 4 months following implantation of prosthesis or resurfacing, such that a rating over 60 percent is not warranted.

The Board will thus turn to the question of whether there are intermediate degrees of residual weakness, pain or limitation of motion the knee such that the left knee disability should be rated by analogy to diagnostic codes 5256 (ankylosis), 5261 (extension), or 5262 (impairment of the tibia and fibula), under Diagnostic Code

When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating 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 under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) ("[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran's disability, after which a rating is determined based on the § 4.71a criteria.").

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

In August 2024, the Veteran underwent a VA examination for the left knee. The Veteran reported that his knee onset was 2021 and that it got so bad with his left knee hurt so much he had it replaced; he claimed that his condition has remained the same since onset. He then reported that his knee had gotten a little better, but that he still got swelling and aching when he climbed the stairs and would need to sit down for a while. If he sat too long, he claimed that the knee got stiff, and if he stood too long it got painful too. He reported flareups weekly for two hours with increased aching, stiffness and swelling with increased activity; it was of a moderate severity. The Veteran reported that his knee limited his kneeling, crawling on hands and knees, navigating stairs, and prolonged sitting and standing.

The December 2024 VA examiner
so bad with his left knee hurt so much he had it replaced; he claimed that his condition has remained the same since onset. He then reported that his knee had gotten a little better, but that he still got swelling and aching when he climbed the stairs and would need to sit down for a while. If he sat too long, he claimed that the knee got stiff, and if he stood too long it got painful too. He reported flareups weekly for two hours with increased aching, stiffness and swelling with increased activity; it was of a moderate severity. The Veteran reported that his knee limited his kneeling, crawling on hands and knees, navigating stairs, and prolonged sitting and standing.

The December 2024 VA examiner found the most limited range of motion found was 100 degrees flexion to 2 degrees extension. The examiner noted that the Veteran did not report instability or recurrent subluxation of his knee. The examiner found no instability. The Veteran had moderate global knee pain as a residual of his TKA. The examiner specifically found no ankylosis of the left knee joint and no tibial or fibular impairment.

Given the findings of no ankylosis and no tibial or fibular impairment, the Board finds that separate ratings under Diagnostic Code 5256 for ankylosis and Diagnostic Code 5262 for impairment of the tibia and fibula are not warranted.

The Board acknowledges the Veteran's lay reports of symptoms and that there was functional loss due to pain. However, even considering the Veteran's lay reports of symptoms and noted functional loss, the degree of additional limitation reflected by the statements that the Veteran did not have ankylosis (or its functional equivalent) or tibial or fibular impairment and the most severe determination of limitation of extension determined by the VA examiner was less than would be indicated for a 0 percent rating, with the next higher level of limitation of motion being 0 percent.

Under the findings of the VA examiner, the Veteran does not meet the level of a 0 percent rating for extension.

The Board has also considered whether a higher rating is warranted under Diagnostic Code 5055 for prosthetic replacement of the knee joint with chronic residuals consisting of severe painful motion or weakness in the affected extremity, which would be indicated by a 60 percent rating.

The VA examiner found only moderate global knee pain. Additionally, the examiner specifically found that the Veteran did not have total knee joint residuals of intermediate degrees of residual weakness, pain, or limitation of motion or chronic residuals consisting of severe painful motion or weakness. The examiner did note some limited range of motion (as noted above), pain, and inability to crouch, kneel, or crawl without increased pain.

The Board has also considered VA medical records. During his VA examination the Veteran indicated that his knee pain has remained the same or improved slightly since its onset, per his VA examination. Post-TKA medical records generally indicate an improvement of his knee pain. For example, an August 2021 medical record from his SSA records noted that following his knee replacement in May, he continued to have mild to moderate pain with swelling in knee. An August 2024 VA physical therapy record noted that the Veteran reported that his knee was feeling ok that day, though he had not done much that day. He reported that he was planning to go to Kenya later that month. The examiner noted that the Veteran continued complaints of left knee pain and swelling, as well as instability. The examiner noted that the Veteran tolerated the physical therapy session without complaints of increased symptoms.

For the reasons outlined above, the Board finds that the most probative evidence of record does not support finding that a 60 percent rating or higher is warranted under Diagnostic Code 5055.

13. Entitlement to a disability rating higher than 10 percent for a painful surgical scar of the left knee is denied.

14. Entitlement to a compensable disability rating for the painful surgical scar of the left knee on the basis of size is denied.

In a November 2021 rating decision, the AOJ granted service connection for the Veteran's left knee surgical scar with two separate ratings for the same knee scar. The AOJ granted a 10 percent rating under Diagnostic Code 7804 for painful scar and a separate 0 percent rating under Diagnostic Code 7802 based on the size of the painful scar.

The Veteran is seeking a
itlement to a disability rating higher than 30 percent for the left knee disability is denied.

13. Entitlement to a disability rating higher than 10 percent for a painful surgical scar of the left knee is denied.

14. Entitlement to a compensable disability rating for the painful surgical scar of the left knee on the basis of size is denied.

The Veteran is seeking a higher rating. Neither the Veteran nor his attorney have provided any argument as to why a higher rating would be warranted.

Regarding the rating of the left knee surgical scar based on size, the scar is rated under Diagnostic Code 7802.

Since August 13, 2018, Diagnostic Code 7802 is for burn scar(s) or scar(s) due to other causes, not of the head, face, or neck, that are not associated with underlying soft tissue damage. 38 C.F.R. § 4.118.

The Veteran also has a separate rating for the same left knee surgical scar under Diagnostic Code 7804.

Under Diagnostic Code 7804, one or two scars that are unstable or painful scars warrants a 10 percent rating. Three or four scars that are unstable or painful scars warrants a 20 percent rating. Five or more scars that are unstable or painful warrants a 30 percent rating. 38 C.F.R. § 4.118. Note 1 to Diagnostic Code 7804 instructs that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Id.

The Board finds that the evidence of record persuasively weighs against the assignment of a rating in excess of 10 percent under Diagnostic Code 7804 because the Veteran's scar is not manifest by three or four scars that are unstable or painful.

The Board further finds that the evidence of record persuasively weighs against the assignment of a compensable evaluation under Diagnostic Code 7802 because the Veteran's left knee surgical is not manifest by an area or areas of 144 square inches (929 sq. cm.) or greater.

Per the December 2024 VA examination, the Veteran has one left knee TKA surgical scar measuring 16 cm x 0.5 cm. The scar was not tender on evaluation and was not unstable. The examiner found no underlying soft tissue damage and no limitation of function caused by the scar. The examiner noted that the Veteran reported that about once a week his knee would get stiff if he sat too long and swell a little and the scar would get tight.

The Board further notes that VA medical records are silent as to any complaints of, or treatment for, the Veteran's scar during the appeal period.

The Board has also considered the other Diagnostic Codes pertaining to scars. However, the Veteran's left knee surgical scar is not of the head, face, or neck, is not deep and non-linear, and is not associated with underlying soft tissue damage. Therefore, Diagnostic Codes 7800 and 7801 are inapplicable. Finally, the evidence of record shows there are no other disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-04 as contemplated under both pre- and post-August 13, 2018, Diagnostic Code 7805.

The Board acknowledges that the Veteran believes that the disability on appeal has been more severe than the assigned disability rating reflects. Moreover, the Veteran is competent to report observable symptoms, to include pain. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, the Veteran does not assert, and medical treatment records do not show that the Veteran's left knee surgical scar is manifested by an area or areas of 144 square inches (929 sq. cm.) or greater or that he has more than one painful scar.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's claim for a compensable rating for the left knee surgical scar under Diagnostic Code 7802. Also, the Board finds that the evidence of record weighs against a rating higher than 10 percent for his left knee surgical scar under Diagnostic Code 7804. As the evidence of record persuasively weighs against a compensable rating, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.
144 square inches (929 sq. cm.) or greater or that he has more than one painful scar.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's claim for a compensable rating for the left knee surgical scar under Diagnostic Code 7802. Also, the Board finds that the evidence of record weighs against a rating higher than 10 percent for his left knee surgical scar under Diagnostic Code 7804. As the evidence of record persuasively weighs against a compensable rating, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

15. Entitlement to a disability rating higher than 10 percent for a skin tag, residual of hemorrhoid surgery, is denied.

Neither the Veteran nor his attorney have provided any argument as to why a higher rating is warranted for the Veteran's skin tag residuals of hemorrhoids surgery. The skin tag residuals of hemorrhoids surgery are rated under Diagnostic Code 7336.

The Veteran filed the current claim on February 24, 2024. The criteria for Diagnostic Code 7336 were changed on May 19, 2024. As such, the Board will consider both the old and new criteria from the May 19, 2024 date of change where applicable.

Under the criteria in effect prior to May 19, 2024, Diagnostic Code 7336 pertains to both external and internal hemorrhoids, providing a noncompensable rating for mild or moderate hemorrhoids; a 10 percent rating for large or thrombotic hemorrhoids, irreducible, with excess redundant tissue, evidencing frequent recurrences; and a 20 percent rating for hemorrhoids with persistent bleeding and with secondary anemia, or with fissures. 38 C.F.R. § 4.114 (2023), Diagnostic Code 7336.

From May 19, 2024, Diagnostic Code 7336 for hemorrhoids, external or internal, a 10 percent rating is warranted for prolapsed internal hemorrhoids with two or less episodes per year of thrombosis; or external hemorrhoids with three or more episodes per year of thrombosis. A 20 percent rating is warranted for internal or external hemorrhoids with persistent bleeding and anemia; or continuously prolapsed internal hemorrhoids with three or more episodes per year of thrombosis. 38 C.F.R. § 4.114 (2025), Diagnostic Code 7336.

As an initial matter, the Board notes that the January 2025 VA examiner for the anus and rectum found that the Veteran did not currently have hemorrhoids. The Veteran reported that his symptoms had progressed/worsened so that he had itching and pain in the rectal area with rectal bleeding following bowel movements noted to be bright red on toilet paper. Functional impact was noted as interfering with endurance of sitting and driving; needs to frequently reposition due to pain.

In contrast, during his August 2024 VA examination for the skin, the Veteran reported that his condition had stayed the same since surgery but also reported that it hurts more as he gained weight. He indicated he had a hard time reaching back there to clean up and noticed more pain where the surgery had occurred. There was no blood on the toilet paper anymore. The examiner noted no pertinent findings or functional impact, and the Veteran did not consent to physical examination of the anus.

Additionally, VA medical records for the appeal period are silent as to any complaints of, or treatment for, hemorrhoids.

Given that no hemorrhoids are present following the Veteran's in-service surgery for hemorrhoids in the 1980s, a rating under the current criteria for Diagnostic Code 7336 (2025) is not warranted.

Additionally, the January 2025 VA examiner found that although the Veteran reported bleeding, there was no secondary anemia, or fissures, such that a higher rating under the prior criteria of Diagnostic Code 7336 (2023) is not warranted.

Even if the Board were to accept the Veteran's report of a worsening symptoms causing bleeding and additional pain when sitting, a higher rating would not be warranted. Indeed, his prior report was that they did not bleed and only experienced pain when wiping. In either case, the Board finds that a higher rating is not warranted.

The AOJ appears to have previously granted a 10 percent rating under the prior Diagnostic Code 7336 (2023) for hemorrhoids, giving the Veteran the benefit of the doubt regarding his excess redundant tissue, though the Veteran's hemorrhoids had been surgically removed and had not recurred. Even considering possible worsening, based on the Veteran's reports during his 2025 VA examination, the Veteran's symptoms are still consistent with the 10 percent rating and do not reach a level approximating a 20 percent rating. In other words, even if the Board were to accept the Veteran's later reports of persistent bleeding, there is no evidence of secondary anemia or with fissures for a higher rating.

16. Entitlement to specially adapted housing (SAH) is denied.

The Veteran contends that the severity of his disabilities warrants a certificate of eligibility for SAH. Neither he nor his attorney have explained how the Veteran meets the eligibility criteria.

Financial assistance in acquiring SAH is available to a veteran who has a permanent and total service-connected disability due to: (1) amyotrophic lateral sclerosis (ALS) rated as 100 percent under 38 C.F.R. § 4.123a, diagnostic code (DC) 8017; (2) blindness in both eyes; (3) full thickness or subdermal burns that have resulted in contractures with limitation of motion of two or more extremities or of at least one extremity and the trunk; or (4) the loss or loss of use of both upper extremities such as to preclude use of the arms at or above the elbows. SAH is also available to a veteran with a permanent and total disability that precludes locomotion due to: (a) the loss or loss of use of both lower extremities; (b) the loss or loss of use of one lower extremity, together with residuals of organic disease or injury which so affect the functions of balance and propulsion as to preclude locomotion; or (c) the loss or loss of use of one lower extremity together with the loss or loss of use of one upper extremity which so affect the functions of balance or propulsion as to preclude locomotion. 38 U.S.C. § 2101(a); 38 C.F.R. § 3.809.

The phrase "preclude locomotion" is defined as the necessity for regular and constant use of a wheelchair, braces, crutches, or cane as a normal mode of locomotion, although occasional locomotion by other methods may be possible. 38 C.F.R. § 3.809(c).

Here, the Veteran is not service connected for ALS, a burn injury, an inhalation injury, blindness in both eyes, or an upper extremity condition. The Veteran does not contend otherwise.

To the extent that the Veteran's service-connected right knee and right foot disabilities may preclude locomotion, the Board notes the findings of the VA examinations discussed in the above decision related to rating such disabilities, including from January 2025 and August 2024. Regarding the Veteran's service-connected lower extremity conditions, VA examiners consistently found that the Veteran was able to walk, though at times with a cane.

Regarding functional limitations, the VA examiners' noted limitations such as squatting, crawling, and prolonged standing, but the Veteran does not have service connection for any disorders of the right extremity at the time of this decision, such that loss of use of both extremities is not indicated. Also, the Veteran does not have the loss or loss of use of one lower extremity, together with residuals of organic disease or injury which so affect the functions of balance and propulsion as to preclude locomotion or the loss or loss of use of one lower extremity together with the loss or loss of use of one upper extremity which so affect the functions of balance or propulsion as to preclude locomotion. As previously noted, the Veteran does not have service connection for a
examiners' noted limitations such as squatting, crawling, and prolonged standing, but the Veteran does not have service connection for any disorders of the right extremity at the time of this decision, such that loss of use of both extremities is not indicated. Also, the Veteran does not have the loss or loss of use of one lower extremity, together with residuals of organic disease or injury which so affect the functions of balance and propulsion as to preclude locomotion or the loss or loss of use of one lower extremity together with the loss or loss of use of one upper extremity which so affect the functions of balance or propulsion as to preclude locomotion. As previously noted, the Veteran does not have service connection for a disability of the upper extremity and none of the VA examiners have indicated that the Veteran is precluded from locomotion.

Indeed, a June 2024 VA medical record found that the Veteran had no strength, range-of-motion, dexterity, or coordination deficits which would preclude the Veteran from performance of primary activities of daily living. Additionally, the Veteran self-reported ability to complete complex tasks which require a high level of cognition such as driving a motor vehicle, completing errands in the community, and attending medical appointments independently. The Veteran reported that he can walk a block with his walker, but he needs to take a break. The Veteran further reported that he takes the garbage out with the use of his cane. He could drive independently.

Eligibility for SAH is determined by the existing law and regulations that require the Veteran to meet at least one of the criteria enumerated under 38 C.F.R. §§ 3.809.

In other words, the benefits cannot be granted based upon need or usefulness alone. Because the Veteran is not service-connected for a burn injury or ALS disability, and does not have a service-connected disability resulting in the loss or permanent loss of use of one or both hands or feet, loss or permanent loss of use of one or both upper or lower extremities, or vision impairment manifesting with the better eye having central visual acuity of 20/200 or a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20 degrees, he does not qualify as eligible for SAH under 38 C.F.R. §§ 3.809. As such, the claim must be denied.

REASONS FOR REMAND

1. Entitlement to service connection for GERD is remanded.

2. Entitlement to service connection for a low back disorder is remanded.

3. Entitlement to service connection for a right foot disorder is remanded.

In March 2024, VA examinations were obtained to address the claims for entitlement to service connection for GERD, a low back disorder, and a right foot disorder. The VA examiner appears to have based their medical opinion solely on their inability to find any documentation of the claimed disorders in service. However, an examiner may not ignore that lay evidence and base his opinion that there is no relationship to service on the absence of in-service corroborating medical records. Dalton v. Nicholson, 21 Vet. App. 23, 39-40 (2007).

The Veteran has claimed that he has had symptoms of the claimed disorders in service. As such, new VA medical opinions are necessary to provide an adequate opinion for each claim.

This remand is required to cure the above-described pre-decisional duty to assist errors.

4. Entitlement to service connection for a right knee disorder is remanded.

5. Entitlement to service connection for erectile dysfunction is remanded.

The Board cannot make a fully-informed decision on the issues of entitlement to service connection for a right knee disorder or for erectile dysfunction because no VA examiner has opined whether the Veteran has such disorders and if so, whether they are due to service.

This remand is required to cure the above-described pre-decisional duty to assist errors.

6. Entitlement to a TDIU is remanded.

As to the TDIU, such a claim is inextricably intertwined with the issues on appeal for service connection being remanded. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are "inextricably intertwined" when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other
right knee disorder or for erectile dysfunction because no VA examiner has opined whether the Veteran has such disorders and if so, whether they are due to service.

This remand is required to cure the above-described pre-decisional duty to assist errors.

6. Entitlement to a TDIU is remanded.

As to the TDIU, such a claim is inextricably intertwined with the issues on appeal for service connection being remanded. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are "inextricably intertwined" when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issue has been rendered). See Green v. McDonough, 37 Vet. App. 127, 136 (2024) (remand for correction of an error by the AOJ in satisfying a statutory or regulatory duty includes a remand of the issue of entitlement to a TDIU based on a Board decision granting service connection that impacts the issue of whether TDIU is warranted).

The matters are REMANDED for the following actions:

1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's claimed (a) GERD, (b) low back disorder, and/or (c) right foot disorder is at least as likely as not related to service. During his respective March 2024 VA examinations, the Veteran claimed that symptoms for these disorders began during service.

If the VA medical opinion provider determines that a new VA examination is warranted for any of the claimed disorders, one should be obtained.

A fully articulated medical rationale for any opinion expressed must be set forth in the medical report. The VA medical opinion provider should discuss the particulars of this Veteran's medical history and relevant medical science as applicable to this case, which may reasonably explain the medical guidance in the study of this case.

2. Schedule the Veteran for a VA examination for the claimed right knee disorder. The examiner must review the claims file.

If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below.

The examiner is asked to provide a response to the following:

Is a right knee disorder at least as likely as not related to service?

3. Schedule the Veteran for a VA examination for the claimed erectile dysfunction. The examiner must review the claims file.

The examiner is asked to provide a response to the following:

Is the claimed erectile dysfunction at least as likely as not related to service?

H.M. WALKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Lindio

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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