SINUSITIS

Summary

The veteran, who served in Kuwait and Uzbekistan, appeals the denial of service connection for sinusitis, right and left upper extremity radiculopathy, sleep disturbances, allergic rhinitis, and increased ratings for lumbar spine osteoarthritis and left knee patellofemoral syndrome. The Board denied service connection for sinusitis, finding the Veteran's reported symptoms were more likely allergic rhinitis, supported by a normal sinus imaging study, and that the VA examiner's opinion was more persuasive than the Veteran's lay statements. For radiculopathy and sleep disturbances, the Board denied claims due to lack of specific in-service events or nexus to service-connected conditions, noting the absence of supporting evidence beyond the Veteran's assertions. The right knee disability claim was remanded for further development, as the Board found the examiner's opinion regarding secondary aggravation was implicitly addressed by the lack of gait abnormalities, but acknowledged the need for clearer development. Increased ratings for lumbar spine osteoarthritis and left knee patellofemoral syndrome were denied as the Veteran's range of motion and symptoms did not meet the criteria for higher evaluations, with the Board finding the evidence persuasively against the higher ratings. Allergic rhinitis was also denied as the Veteran's symptoms did not meet the criteria for a compensable rating.

Rationale

Weight of evidence against current diagnosis; Examiner opined symptoms were allergic rhinitis; Normal sinus imaging results

Full Decision Text

Citation Nr: A26038183
Decision Date: 04/23/26	Archive Date: 04/23/26

DOCKET NO. 250916-587173
DATE: April 23, 2026

ORDER

Entitlement to service connection for sinusitis is denied.

Entitlement to service connection for right upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, is denied.

Entitlement to service connection for left upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, is denied.

Entitlement to service connection for sleep disturbances, to include as proximately due to or aggravated by another service connected disability, is denied.  

Entitlement to service connection for a right knee disability, to include as proximately due to or aggravated by another service connected disability, is remanded.

Entitlement to a disability rating in excess of 10 percent for osteoarthritis of the lumbar spine is denied.

Entitlement to a compensable disability rating for allergic rhinitis is denied.

Entitlement to a disability rating in excess of 10 percent for patellofemoral syndrome, with degenerative arthritis, left knee is denied. 

REMANDED

Entitlement to service connection for a right knee disability, to include as proximately due to or aggravated by another service connected disability, is remanded. 

FINDINGS OF FACT

1. The weight of the evidence is persuasively against a finding that the Veteran has a current diagnosis of sinusitis.

2. The weight of the evidence is persuasively against a finding that the Veteran's right and left upper extremity radiculopathy are the result of an in-service event, injury, or occurrence; or that the Veteran's right and left upper extremity radiculopathy are proximately due to or aggravated by another service connected disability.

3. There is no evidence to support a finding that the Veteran has a sleep-related disability that is due to an in-service event, injury, or occurrence, to include in service onset; or that is proximately due to or aggravated by another service connected disability.

4. The weight of the evidence is persuasively against a finding that a right knee disability has been caused or aggravated by the service-connected left knee disability.

5. The weight of the evidence is persuasively against a finding that the Veteran's osteoarthritis of the lumbar spine has manifested as forward flexion of the spine is greater than 30 degrees but not greater than 60 degrees; combined range of motion of the thoracolumbar spine is not greater than 120 degrees; or where there is muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spine contour such as scoliosis, reversed lordosis, or abnormal kyphosis at any point during the period on appeal.

6. The weight of the evidence is persuasively against a finding that the Veteran's allergic rhinitis has manifested as allergic rhinitis without polyps, but with greater than 50 percent obstruction of the nasal passages on both sides or complete obstruction on one side; or as allergic rhinitis with polyps.

7. The weight of the evidence is persuasively against a finding that the Veteran's left knee disability has manifested as limitation of flexion to 30 degrees.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for sinusitis are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to service connection for right upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. The criteria for entitlement to service connection for left upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for entitlement to service connection for sleep disturbances are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

5. The criteria for entitlement to service connection for right knee disability as secondary to left knee disability are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§
 or aggravated by another service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for entitlement to service connection for sleep disturbances are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

5. The criteria for entitlement to service connection for right knee disability as secondary to left knee disability are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

6. The criteria for entitlement to a disability rating in excess of 10 percent for osteoarthritis of the lumbar spine are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a.

7. The criteria for entitlement to a compensable disability rating for allergic rhinitis are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.97.

8. The criteria for entitlement to a disability rating in excess of 10 percent for patellofemoral syndrome, with degenerative arthritis, left knee are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The rating decisions on appeal were issued in April 2025, February 2025, and December 2024 and constitute initial decisions; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. 

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 April 2025, February 2025, and December 2024  agency of original jurisdiction (AOJ) decisions 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. 

Evidence was added to the claims file during a period of time when new evidence was not allowed.  As the Board is deciding the claims of entitlement to service connection for sinusitis; entitlement to service connection for right upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability; entitlement to service connection for left upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability; entitlement to service connection for sleep disturbances, to include as proximately due to or aggravated by another service connected disability; entitlement to a disability rating in excess of 10 percent for osteoarthritis of the lumbar spine; entitlement to a compensable disability rating for allergic rhinitis; and entitlement to a disability rating in excess of 10 percent for patellofemoral syndrome, with degenerative arthritis, left knee, it may not consider this evidence in its decision.  38 C.F.R. § 20.300.  The Veteran may file a Supplemental Claim 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, 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 claim of entitlement to service connection for a right knee disability, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii). 

Service Connection

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury;
 the claim of entitlement to service connection for a right knee disability, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii). 

Service Connection

Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303.

Entitlement to service connection may be established on a secondary basis where there is evidence of (1) a current, non-service-connected disability, (2) a current service-connected disability, and (3) evidence that the non-service-connected disability is either (i) proximately due to or the result of a service-connected disability or (ii) aggravated (increased in severity) beyond its natural progression by a service-connected disability. 38 U.S.C. § 1110; Allen v. Brown, 7 Vet. App. 439, 446 (1995); 38 C.F.R. § 3.310.

With respect to the all of the Veteran's service connection claims, the rating decisions on appeal reflect the common favorable findings that the Veteran had service in Kuwait from April 1999 to December 1999, and December 2000 to July 2001, Uzbekistan from March 3, 2004 to May 1, 2004 and Djibouti from August 31, 2004 to November 1, 2004; and the Veteran was exposed to jet fuel, burn pits, and other toxins during military service. Additional favorable findings specific to the claimed disabilities are addressed below. 

1. Entitlement to service connection for sinusitis is denied. 

The Veteran's service treatment records (STRs) reflect that he reported sinus problems during his period of active service while completing various health questionnaires. 

In October 2004 the Veteran presented to a military treating provider and reported a six day history of nosebleeds and runny nose. 05/28/2009, STR - Medical at 94. The October 2004 military provider  stated that the Veteran had a "history of sinus infections at this time of year" and characterized the Veteran's symptoms as sinusitis. Id. 

A June 2005 military asthma assessment reflects that providers indicated the Veteran had no history of documented sinusitis. 05/28/2009, STR - Medical at 30. 

The Veteran's separation examination does not reflect any diagnosis of sinusitis. 05/28/2009, STR - Medical at 6; 06/17/2009, VA Examination at 5.

The Veteran was afforded a VA examination in August 2024. He reported frequent nasal discharge with itching of the nose, tearing of the eyes, and post nasal drip. The Veteran also reported experiencing a pulsating headache approximately once or twice every 2 years. 

In their examination report and opinion, the August 2024 examiner acknowledged the Veteran's reports of in-service sinusitis and the October 2004 military provider's assessment of the Veteran as having sinusitis. However, the examiner opined that at the time of the examination the Veteran had no current symptoms to suggest chronic sinusitis. With respect to both the Veteran's lay reports of sinusitis and the military treating provider's characterization, the examiner noted that "the term sinusitis is often used incorrectly for any symptoms in the upper respiratory tract such as nasal discharge, congestion, and headache, which are often more likely to be symptoms of rhinitis rather than sinusitis." 08/30/2024, C&P Exam at 1. Laypeople are competent to report symptoms and experiences observable by their senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). However, the Board finds that the Veteran is not competent to make the medical distinction as to whether symptoms of nasal discharge, congestion, and headache are symptoms of sinusitis as compared to rhinitis or migraine. 

The Board here notes that service connection is already in effect for allergic rhinitis for the entire period on appeal. The examiner
 symptoms of rhinitis rather than sinusitis." 08/30/2024, C&P Exam at 1. Laypeople are competent to report symptoms and experiences observable by their senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). However, the Board finds that the Veteran is not competent to make the medical distinction as to whether symptoms of nasal discharge, congestion, and headache are symptoms of sinusitis as compared to rhinitis or migraine. 

The Board here notes that service connection is already in effect for allergic rhinitis for the entire period on appeal. The examiner concluded that the symptoms described by the Veteran currently as sinusitis, and those documented during his period of active service, were more likely than not symptoms of allergic rhinitis, and that it was less likely than not that the Veteran had a current diagnosis of sinusitis. The examiner characterized the Veteran's reported headaches as retro-orbital migraines.

The Board notes that the August 2024 VA examiner ordered an imaging study of the Veteran's paranasal sinuses that was not completed until approximately one week after the signature date on the opinion. The report findings, and the examiner's letter to the Veteran informing him of the test results, indicated that the paranasal sinuses were normal. 01/30/2025, CAPRI at 38 -39. To the extent that the examiner erred in failing to wait for the imaging study results, the Board finds this error to be harmless in light of the normal imaging study findings.

Given the above, the weight of the evidence is persuasively against a finding that the Veteran has a current diagnosis of sinusitis. 

The criteria for entitlement to service connection for sinusitis are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

2. Entitlement to service connection for right upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, is denied. 

3. Entitlement to service connection for left upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, is denied. 

The February 2025 rating decision on appeal reflects the favorable findings that the Veteran has current diagnoses of right and left upper extremity radiculopathy. 

The Veteran seeks service connection for a disability claimed as neurological pain and numbness "from the shoulders down." 07/31/2024, VA 21-526EZ, Fully Developed Claim (Compensation). The Veteran has not advanced any specific theory of entitlement as to his claimed neurological disability; identified an in-service injury, event, or occurrence he contends has caused the claimed neurological disability; or advanced any contentions that his claimed disability had its onset during his period of active service. 

The Veteran's separation examination does not reflect any complaints or diagnosis related to upper extremity neurological disabilities. 05/28/2009, STR - Medical at 6; 06/17/2009, VA Examination. 

In August 2024 a VA examiner documented a diagnosis of right and left (bilateral) cervical radiculopathy. The examiner stated that on neurological examination the Veteran showed evidence of cervical radiculopathy involving the ulnar nerve. The examiner noted an August 2024 imaging study showing degenerative arthritis with foraminal stenosis of the cervical spine. Service connection is not in effect for any cervical spine disability, nor has the Veteran advanced any contentions related to a cervical spine injury or disability. 

The examiner opined that it was less likely than not that the Veteran's bilateral upper extremity radiculopathy was proximately due to or aggravated by his service connected right and left shoulder disabilities and/or his service connected lumbar spine disability.

Given the above, the weight of the evidence is persuasively against a finding that the Veteran's right and left upper extremity radiculopathy are the result of an in-service event, injury, or occurrence; or that the Veteran's right and left upper extremity radiculopathy are proximately due to or aggravated by another service connected disability. 

The criteria for entitlement to service connection for right and left upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. Entitlement to service connection for sleep disturbances, to include as proximately due to or aggravated by another service connected disability, is denied.  

The Veteran seeks
 result of an in-service event, injury, or occurrence; or that the Veteran's right and left upper extremity radiculopathy are proximately due to or aggravated by another service connected disability. 

The criteria for entitlement to service connection for right and left upper extremity radiculopathy, to include as proximately due to or aggravated by another service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. Entitlement to service connection for sleep disturbances, to include as proximately due to or aggravated by another service connected disability, is denied.  

The Veteran seeks service connection for a disability claimed as "sleep disturbances." 07/31/2024, VA 21-526EZ, Fully Developed Claim (Compensation). He has not any specific theory of entitlement as to his claimed neurological disability; identified an in-service injury, event, or occurrence he contends has caused the claimed neurological disability; or advanced any contentions that his claimed disability had its onset during his period of active service. 

The Veteran's separation examination does not reflect any complaints or diagnosis related to sleep disturbances. 05/28/2009, STR - Medical at 6; 06/17/2009, VA Examination. The Veteran was afforded a VA medical examination prior to his separation from active service; a pulmonary review of system showed no history of sleep apnea and a psychiatric review of systems showed no history of sleep impairment. Id. The STRs generally do not reflect any complaints or diagnoses related to sleep disturbances. The Veteran's VA treatment records do not reflect any complaints or diagnoses related to sleep disturbances. 

The Board acknowledges that VA will provide a medical examination or obtain a medical opinion where there is: (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service; (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with a veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79, 82-83 (2006)

However, the Board finds that the standard outlined in McLendon has not been met in this case. Beyond the mere fact that the Veteran has claimed entitlement to service connection for "sleep disturbances", there is no evidence (lay or otherwise) relating to any sleep disability; and no evidence (lay or otherwise) relating to an in-service event, injury, or disease. "The duty to assist is not always a one-way street. If a veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence". Wood v. Derwinski, 1 Vet. App. 190, 193 (U.S. 1991).

There is no evidence to support a finding that the Veteran has a sleep-related disability that is due to an in-service event, injury, or occurrence, to include in service onset; or that is proximately due to or aggravated by another service connected disability.

In sum, the criteria for entitlement to service connection for sleep disturbances are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310. 

5. Entitlement to service connection for a right knee disability, to include as proximately due to or aggravated by another service connected disability, is denied.

The Veteran claims service connection for the right knee, as secondary to his service-connected left knee.  

At the outset, the Board notes that service connection on a direct basis is not warranted as there is no showing of in-service incurrence of a right knee disability and no showing of continuity of symptomatology dating back to service.

With respect to the secondary service connection claim, the rating decision on appeal reflects the favorable finding that the Veteran has been diagnosed with right patellofemoral pain syndrome and degenerative arthritis. He is also service-connected for left knee disability.  However, the weight of the evidence is against a finding that the service-connected left knee has either caused or aggravated the Veteran's right knee disability.

The Veteran was afforded a VA examination in November 2024. The November 2024 VA examiner documented diagnoses of right knee patellofemoral syndrome and degenerative arthritis of the right knee. The Veteran reported that he began having pain in his right knee approximately one year prior. 

The November 2024 VA examiner opined that it was less likely than not that the Veteran's right knee disabilities were proximately due to his service connected left knee disability
 Veteran has been diagnosed with right patellofemoral pain syndrome and degenerative arthritis. He is also service-connected for left knee disability.  However, the weight of the evidence is against a finding that the service-connected left knee has either caused or aggravated the Veteran's right knee disability.

The Veteran was afforded a VA examination in November 2024. The November 2024 VA examiner documented diagnoses of right knee patellofemoral syndrome and degenerative arthritis of the right knee. The Veteran reported that he began having pain in his right knee approximately one year prior. 

The November 2024 VA examiner opined that it was less likely than not that the Veteran's right knee disabilities were proximately due to his service connected left knee disability. The examiner stated as follows:

"In order for a weight bearing joint like the left knee to adversely impact the function of the contralateral joint (i.e., the right knee), the left knee condition has to be significant enough to result in an antalgic gait in an effort to offload weight from the left knee. Over months to years, the abnormal forces directed towards the right knee can lead to the development of chronic strain or degenerative arthritis... However, the Veteran's gait is totally normal, and therefore in the absences of abnormally directed forces, it is less likely than not that the Veteran's degenerative arthritis of the [right] knee is secondary to his service connected [left] knee."

It is acknowledged that the examination report does not contain a distinct opinion as to secondary aggravation.  However, from the examiner's response, as included above, it is clear that the absence of gait changes would be applicable to both causation and aggravation in this case.  Therefore, remanding for addendum here would serve no useful purpose and instead would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the appellant.  Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991). 

Increased Rating

Disability ratings are determined by applying the criteria set forth in the VA Schedule of Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Disabilities must be reviewed in relation to their history. 38 C.F.R. § 4.1. Other applicable general policy considerations are: interpreting reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating many accurately reflect the elements of disability; resolving any reasonable doubt regarding the degree of disability in favor of the claimant; where there is a questions as to which of two evaluations apply, assigning a higher of the two where the disability pictures more nearly approximates the criteria for the next higher rating; and, evaluating functional impairment on the basis of lack of usefulness, and the effects of the disability upon the person's ordinary activity. See 38 C.F.R. §§ 4.2, 4.3, 4.7, 4.10; see also Schafrath v. Derwinski, 1 Vet. App. 589 (1991).

1. Entitlement to a disability rating in excess of 10 percent for osteoarthritis of the lumbar spine is denied. 

The Veteran's lumbar spine disability is rated under the General Rating Formula for Diseases and Injuries of the Spine. 38 C.F.R. § 4.71a. 

A 10 percent rating is warranted where forward flexion of the thoracolumbar spine is greater than 60 degrees but not greater than 85 degrees; the combined range of motion of the thoracolumbar spine is greater than 120 degrees but not greater than 235 degrees; where there is muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spine contour; or where there is vertebral body fracture with loss of 50 percent or more of the height. The next higher rating is warranted where forward flexion of the spine is greater than 30 degrees but not greater than 60 degrees; combined range of motion of the thoracolumbar spine is not greater than 120 degrees; or where there is muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spine contour such as scoliosis, reversed lordosis, or abnormal kyphosis. 

The Veteran was afforded a VA examination in August 2024. He reported being unable to walk more than half a mile before needing to stop and being unable to lift more than 20 pounds from the ground.  He denied flare ups of his lumbar spine disability and denied radiation of pain into either leg. On initial range of motion testing the examiner documented forward flexion
ion of the spine is greater than 30 degrees but not greater than 60 degrees; combined range of motion of the thoracolumbar spine is not greater than 120 degrees; or where there is muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spine contour such as scoliosis, reversed lordosis, or abnormal kyphosis. 

The Veteran was afforded a VA examination in August 2024. He reported being unable to walk more than half a mile before needing to stop and being unable to lift more than 20 pounds from the ground.  He denied flare ups of his lumbar spine disability and denied radiation of pain into either leg. On initial range of motion testing the examiner documented forward flexion to 78 degrees and a combined range of motion of 166 degrees. The examiner documented no additional functional loss or loss of range of motion after repetitive use testing and estimated there would be no additional loss of range of motion after repeated use over time. The examiner documented no localized tenderness, guarding, or muscle spasm of the thoracolumbar spine, and no signs or symptoms of lumbar radiculopathy. 

Given the above, the weight of the evidence is persuasively against a finding that the Veteran's osteoarthritis of the lumbar spine has manifested as forward flexion of the spine is greater than 30 degrees but not greater than 60 degrees; combined range of motion of the thoracolumbar spine is not greater than 120 degrees; or where there is muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spine contour such as scoliosis, reversed lordosis, or abnormal kyphosis at any point during the period on appeal. 

The criteria for entitlement to a disability rating in excess of 10 percent for osteoarthritis of the lumbar spine are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a. 

2. Entitlement to a compensable disability rating for allergic rhinitis is denied. 

The Veteran's allergic rhinitis is rated under Diagnostic Code 6522. 38 C.F.R. § 4.97. A compensable rating is warranted where there is allergic rhinitis without polyps, but with greater than 50 percent obstruction of the nasal passages on both sides or complete obstruction on one side. The highest schedular rating of 30 percent is warranted where there is allergic rhinitis with polyps. 

The Veteran was afforded a VA examination in August 2024. He reported frequent nasal discharge with congestion almost every night. The Veteran reported itching of the notes and eyes with tearing and postnasal drip, and that occasionally he has to go to urgent care for his symptoms. The August 2024 VA examiner documented no polyps; no obstruction of greater than 50 percent of the nasal passages on both sides; and no complete obstruction of the nasal passage on one side. 

Given the above, the weight of the evidence is persuasively against a finding that the Veteran's allergic rhinitis has manifested as allergic rhinitis without polyps, but with greater than 50 percent obstruction of the nasal passages on both sides or complete obstruction on one side; or as allergic rhinitis with polyps. 

The criteria for entitlement to a compensable disability rating for allergic rhinitis are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.97.

3. Entitlement to a disability rating in excess of 10 percent for patellofemoral syndrome, with degenerative arthritis, left knee is denied. 

Currently, the Veteran's left knee disability is rated under Diagnostic Code 5260 on the basis of limitation of extension. 38 C.F.R. § 4.71a. Under Diagnostic Code 5260 a 10 percent rating is warranted where flexion is limited to 45 degrees. The next higher rating of 20 percent is warranted where flexion is limited to 30 degrees. 

The Veteran was afforded a VA examination in August 2024. He reported being unable to ascend or descend stairs without use of a hand rail; being unable to walk more than a half a mile without stopping; and being unable to kneel or squat. The Veteran denied flare ups of his left knee disability. The Veteran reported experiencing effusion into the lateral side of the knee approximately once per week.

The August 2024 VA examiner documented left knee flexion to 90 degrees with full extension on initial range of motion testing in both passive and active range of motion. The examiner documented no additional loss of range of motion after repetitive use testing and estimated no additional loss of
 20 percent is warranted where flexion is limited to 30 degrees. 

The Veteran was afforded a VA examination in August 2024. He reported being unable to ascend or descend stairs without use of a hand rail; being unable to walk more than a half a mile without stopping; and being unable to kneel or squat. The Veteran denied flare ups of his left knee disability. The Veteran reported experiencing effusion into the lateral side of the knee approximately once per week.

The August 2024 VA examiner documented left knee flexion to 90 degrees with full extension on initial range of motion testing in both passive and active range of motion. The examiner documented no additional loss of range of motion after repetitive use testing and estimated no additional loss of range of motion after repeated use over time. The examiner documented that the Veteran had no history of left knee instability, subluxation, ligament tear, or meniscal condition. 

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The weight of the evidence is persuasively against a finding that the Veteran's left knee disability has manifested as limitation of flexion to 30 degrees; thus, there is no question to resolve and the lower rating is appropriate. The Board has considered whether any other diagnostic codes would be appropriate to evaluate symptoms of the Veteran's disability. 38 C.F.R. §§ 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991).  

In sum, the criteria for entitlement to a disability rating in excess of 10 percent for patellofemoral syndrome, with degenerative arthritis, left knee are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.7, 4.71a. 

 

 

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Sametshaw, Eric C.

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.