Case A26038652

JOHN Z. JONES · 2026 · Case ID: A26038652

MIXED

Summary

The veteran, who served in the U.S. Army from November 1993 to February 1996, May 2000 to August 2000, and September 2012 to October 2013, with service in Afghanistan and Southwest Asia, appeals the denial of service connection for dyspnea and seeks increased ratings for PTSD with MDD and GAD, and bilateral leg radiculopathy. The Board dismissed the dyspnea claim as moot because service connection was granted by the AOJ. For OSA, the Board granted service connection, finding it had its onset during service, despite conflicting VA and private medical opinions. The VA opinions generally found less likelihood of service connection, citing obesity as a primary factor, while a private opinion linked it to service. The Board ultimately granted service connection, resolving doubt in the veteran's favor. For PTSD with MDD and GAD, the veteran sought a 100% rating but was denied an increase beyond the existing 70% rating. The Board found the evidence did not meet the criteria for total occupational and social impairment, citing the absence of gross impairment in thought processes, persistent delusions/hallucinations, or inability to perform daily living activities. For bilateral leg radiculopathy, the veteran sought higher ratings beyond the existing 10% for mild incomplete paralysis. The Board denied higher ratings, finding the evidence persuasively against moderate or severe impairment, noting normal strength, reflexes, and sensory exams, and only occasional sciatic symptoms. The Board found the evidence against the veteran's claims for higher ratings, thus the benefit of the doubt doctrine was not applicable.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250610-553490

Full Decision Text

Citation Nr: A26038652
Decision Date: 04/24/26 Archive Date: 04/24/26

DOCKET NO. 250610-553490
DATE: April 24, 2026

ORDER

The appeal for service connection for dyspnea is dismissed.

Service connection for obstructive sleep apnea (OSA) is granted.

A rating higher than 70 percent for posttraumatic stress disorder (PTSD) with major depressive disorder (MDD) and generalized anxiety disorder (GAD) is denied.

A rating higher than 10 percent for left leg radiculopathy (sciatic nerve) associated with lumbosacral strain with intervertebral disc syndrome is denied.

A rating higher than 10 percent for right leg radiculopathy (sciatic nerve) associated with lumbosacral strain with intervertebral disc syndrome is denied.

FINDINGS OF FACT

1. In a January 2025 rating decision, the Agency of Original Jurisdiction (AOJ) granted service connection for respiratory insufficiency (dyspnea), which represents a full grant of the benefit sought in the appeal.

2. Resolving all reasonable doubt in the Veteran's favor, his OSA had its onset during active service.

3. The severity, frequency, and duration of the Veteran's symptoms of PTSD with MDD and GAD do not more closely approximate total occupational and social impairment.

4. The Veteran's left and right leg radiculopathy (sciatic nerve) manifested by no more than mild incomplete paralysis of the sciatic nerve.

CONCLUSIONS OF LAW

1. As the benefit sought on appeal has been granted in full, there remains no question of law or fact on appeal, and the appeal is dismissed as to the claim of service connection for dyspnea. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

2. The criteria for service connection for OSA have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309.

3. The criteria for a rating higher than 70 percent for PTSD with MDD and GAD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.126, 4.130, Diagnostic Code (DC) 9411.

4. The criteria for a rating higher than 10 percent for left leg radiculopathy (sciatic nerve) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520.

5. 5. The criteria for a rating higher than 10 percent for right leg radiculopathy (sciatic nerve) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, DC 8520.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States (U.S.) Army from November 1993 to February 1996, from May 2000 to August 2000, and from September 2012 to October 2013. He was awarded the Afghanistan Campaign Medal with Campaign Star and Bronze Star Medal.

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

In the June 10, 2025, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the March 2025 agency of original jurisdiction (AOJ) decision on appeal for the issues of service connection for dyspnea and increased ratings for PTSD with MDD and GAD and left and right leg radiculopathy (sciatic nerve), and the April 2025 AOJ decision on appeal for the issue of service connection for OSA, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form
the evidence of record at the time of the March 2025 agency of original jurisdiction (AOJ) decision on appeal for the issues of service connection for dyspnea and increased ratings for PTSD with MDD and GAD and left and right leg radiculopathy (sciatic nerve), and the April 2025 AOJ decision on appeal for the issue of service connection for OSA, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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.

Dismissal - Service Connection for Dyspnea

The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. As the AOJ granted service connection for respiratory insufficiency (dyspnea), the Board finds that the Veteran's appeal as to this issue has been rendered moot because the benefit sought on appeal has been granted in full. There remains no question of law or fact for the Board to resolve on this issue. See 38 U.S.C. § 7105. In other words, the appeal ended once the AOJ granted service connection for respiratory insufficiency (dyspnea). Accordingly, the appeal is dismissed.

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.

Certain chronic diseases, including OSA (as an organic disease of the nervous system), will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303, 3.307, 3.309.

OSA

The Veteran contends that his OSA had its onset during active service.

The AOJ found that the Veteran has been diagnosed with a disability as his VA treatment records show a diagnosis of moderate OSA and hypoxemia without evidence of sleep disordered breathing. In addition, the AOJ conceded participation in a toxic exposure risk activity (TERA) as the evidence of record shows exposure to environmental toxins in Southwest Asia. The Board is bound by these favorable findings. See 38 C.F.R. § 3.104(c). The Veteran's service treatment records (STRs) also show that he reported trouble sleeping and feeling tired or having low energy following his deployment to Afghanistan. See STR received August 2018. Accordingly, the Board finds that the first two elements of service connection are satisfied.

Regarding the third element, nexus, the evidence consists of VA examinations, a private examination, and lay statements.

The Veteran was afforded a VA examination in August 2019. The Veteran reported that his symptoms of OSA began around 2013 as fellow soldiers complained about his loud snoring as well as periodic apnea followed by gasping during sleep while deployed to Afghanistan. The Veteran further reported that he did not immediately seek treatment and was not diagnosed with OSA until June 2019. The VA examiner opined that the Veteran's OSA was less likely than not incurred in or caused by the claimed injury, event, or illness. The rationale stated that the Veteran's STRs are silent regarding any objective medical evidence of a sleep disorder and while he did report trouble sleeping by which he was bothered a little in September 2013, no diagnostic action was taken to objectively identify the etiology. The rationale further stated that trouble sleeping usually refers to insomnia, and he was later diagnosed and treated for insomnia with sedative hypnotics until they were no longer effective in May 2019 and the Veteran was referred to have a sleep study that confirmed a diagnosis of moderate OSA. The rationale also stated that the Veteran appears to be suffering from two different types of sleep disorder: insomnia which began as trouble sleeping during active duty and moderate OSA for which no specific onset can be estimated without resorting to mere speculation. The examiner concluded that there is no objective medical evidence in provided service records that could establish a direct relationship between the Veteran's current moderate OSA and his military service.

The Veteran underwent a private examination in July 2024. See Medical Treatment Record - Non-Government Facility received August 2024. The examiner noted that the Veteran has a history of heavy snoring and cessation of respirations during sleep during his time of active duty and the same symptoms persist without hiatus to the present. The examiner also noted that the Veteran has a diagnosis of OSA. The examiner concluded that the Veteran's onset of OSA was during active-duty military service while deployed to the Southwest Asia Theater of Operations and has persisted to the present.

The Veteran was afforded another VA examination in October 2024. He reported that he was informed by a fellow service member of his noisy snoring, especially while deployed to Afghanistan, and later his wife, who also observed loud snoring and apnea. The Veteran's wife convinced him to get evaluated and the Veteran was diagnosed with moderate OSA in 2019.

In January 2025, a VA clinician opined that the Veteran's OSA was less likely than not incurred in or caused by the indicated TERA, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran. The rationale stated that there is no medical or scientific evidence available that identifies a causal relationship between the TERA and the development of the claimed condition of OSA.

In January 2025, a VA clinician opined that the Veteran's OSA was less likely than not incurred in or caused by the indicated TERAs, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran to include burn pits, environmental hazards/particulate matter, garbage, industrial pollution, vehicle/truck exhaust fumes, toxic chemicals and sewage pond in Southwest Asia. The rationale stated that the polysomnography report found OSA rather than central apnea which would be due to central nervous system issues resulting from possible exposure. The rationale further stated that the Veteran was diagnosed with obesity as his BMI has been over 30, which is a leading risk factor of OSA. The VA clinician concluded that the cause of the Veteran's OSA is more likely obesity and there is no evidence of respiratory obstruction or central apnea that could be attributed to any toxic exposure while in service.

Finally, in April 2025, a VA clinician opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale stated that there is no record of chronic or recurrent sleep apnea-like problems such as snoring or witnessed apneic breathing beginning in the service to reflect the current diagnosis of OSA. The rationale further stated that a nexus for service connection cannot be made at this time due to the missing elements of origin of the condition dating to service and no permanent residual or chronic disability is shown by the service medical records or demonstrated by evidence immediately following separation from service.

Based on the foregoing, the Board finds that the evidence of record shows that the Veteran's OSA at least as likely as not had
VA clinician opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale stated that there is no record of chronic or recurrent sleep apnea-like problems such as snoring or witnessed apneic breathing beginning in the service to reflect the current diagnosis of OSA. The rationale further stated that a nexus for service connection cannot be made at this time due to the missing elements of origin of the condition dating to service and no permanent residual or chronic disability is shown by the service medical records or demonstrated by evidence immediately following separation from service.

Based on the foregoing, the Board finds that the evidence of record shows that the Veteran's OSA at least as likely as not had its onset during active service and has continued since. The Veteran is competent to describe his symptoms as they are capable of lay observation. Layno v. Brown, 6 Vet. App. 465, 470 (1994). Additionally, the Board finds the statements credible and entitled to great probative weight as they are internally consistent and supported by the other evidence of record.

Based on the foregoing, after resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's OSA began during active service and that he has had OSA ever since. See 38 C.F.R. § 3.102. Accordingly, service connection for OSA is granted.

Increased Rating

Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities. The percentage ratings are based on the average impairment of earning capacity and individual disabilities are assigned separate DCs. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran. 38 C.F.R. § 4.3. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, present level of disability is the primary concern. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994).

In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991); Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Whether the issue is one of an initial rating or an increased rating, separate ratings can be assigned for separate periods of time based on the facts found, a practice known as "staged" ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007).

Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Separate DCs identify the various percentage ratings for each disability and the criteria for specific ratings. However, the evaluation of the same disability under various diagnoses, known as pyramiding, is to be avoided. 38 C.F.R. § 4.14.

PTSD with MDD and GAD

The Veteran contends that a higher rating is warranted for his service-connected PTSD with MDD and GAD. Specifically, the Veteran is seeking a 100 percent rating. See June 2025 VA Form 10182 Notice of Disagreement.

The Veteran is assigned a 70 percent rating effective August 27, 2024, for his service-connected PTSD with MDD and GAD pursuant to 38 C.F.R. § 4.130, DC 9411, which is part of the General Rating Formula for Mental Disorders.

Under the General Formula, the Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013).

When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions,
. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013).

When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran's capacity for adjustment during periods of remission. The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment, rather than solely on the examiner's assessment of the level of disability at the moment of the examination. When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment but shall not assign an evaluation solely based on social impairment. 38 C.F.R. § 4.126.

A 70 percent disability rating is warranted when there is occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); and inability to establish and maintain effective relationships.

A 100 percent rating is warranted for a mental disorder when there is total occupational and social impairment due to such symptoms as gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of close relatives, own occupation or own name.

The use of the term "such as" in the general rating formula for mental disorders in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list but rather are to serve as examples of the type and degree of symptoms, or their effects, that would justify a particular rating. See Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). It is not required to find the presence of all, most, or even some, of the enumerated symptoms recited for particular ratings. Id. The use of the phrase "such symptoms as," followed by a list of examples, provides guidance as to the severity of the symptoms contemplated for each rating, in addition to permitting consideration of other symptoms particular to each veteran and disorder, and the effect of those symptoms on his or her social and work situation. Id.

In Vazquez-Claudio v. Shinseki, 713 F.3d 112 (Fed. Cir. 2013), the Federal Circuit stated that "a Veteran may only qualify for a given disability rating under § 4.130 by demonstrating the particular symptoms associated with that percentage, or others of similar severity, frequency, and duration." It was further noted that "§ 4.130 requires not only the presence of certain symptoms but also that those symptoms have caused occupational and social impairment in most of the referenced areas."

Turning to the evidence of record, the Veteran underwent a private examination in July 2024. See Medical Treatment Record - Non-Government Facility received August 2024; see also VA Examination received August 2024. The private examiner found that the Veteran had occupation and social impairment with reduced reliability and productivity. The Veteran's symptoms included depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, such as forgetting names, directions or recent events, flattened effect, disturbances of motivation and mood, and difficulty adapting to stressful circumstances. In addition, the examiner found that the Veteran's symptoms include suicidal ideation, irritability, and anger.

The Veteran was afforded a VA examination in February 2025. The examiner found that the Veteran has occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. The examiner found that the Veteran's symptoms include depressed mood, anxiety, suspiciousness, near-continuous panic or depression affecting the ability to function independently, appropriately and effectively, chronic sleep impairment, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, including work or a work like setting, inability to establish and maintain effective relationships, and obsessional rituals which interfere with routine activities. On examination, the Veteran presented as casually dressed in fair hygiene. He was cooperative and oriented x4. His speech was normal in rate, tone, rhythm and volume and his mood was congruent with his affect. The Veteran seemed to make appropriate eye contact. His thought process was linear and goal oriented. No problems in memory or recall were observed. The Veteran denied current suicidal ideation, homicidal ideation, self-injurious behavior, and hallucinations. There was no evidence of delusional thoughts, and the Veteran had good insight and judgment.

The Board finds that the evidence of record does not reflect symptoms that would meet the criteria for a 100 percent rating. Although the presence or absence of certain symptoms is not dispositive to the issue of the proper disability rating, the presence or absence of symptoms is useful in determining the severity of the condition. Here, there is no evidence of gross impairment in thought processes or communication; persistent delusions or hallucinations; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name; or symptoms of similar severity. Although the Veteran's psychiatric symptoms have impacted his work, relationships, thinking, and mood, his overall occupational and social impairment is contemplated by the assigned 70 percent evaluation. Without evidence of total occupational and social impairment, a higher rating of 100 percent is not warranted.

As the evidence is persuasively against the Veteran's claim for a higher rating for his PTSD with MDD and GAD, it must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. §§ 5107; 38 C.F.R. §§ 3.102.

Left and Right Leg Radiculopathy

The Veteran contends that higher ratings are warranted for his service-connected left and right leg radiculopathy (sciatic nerve).

The Veteran is assigned a 10 percent rating for left leg radiculopathy and a 10 percent rating for right leg radiculopathy under DC 8520, which pertains to paralysis of the sciatic nerve.

Under DC 8520, a 10 percent rating is warranted for mild incomplete paralysis. A 20 percent rating is warranted for moderate incomplete paralysis. A 40 percent rating is warranted for moderately severe incomplete paralysis. A 60 percent rating is warranted for severe incomplete paralysis, with marked muscular atrophy. An 80 percent rating is warranted for complete paralysis. Complete paralysis consists of the foot dangling and dropping, with no active movement possible of the muscles below the knee and flexion of the knee weakened or lost. 38 C.F.R. § 4.124a.

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

The words "mild," "moderate," "moderately severe," and "severe" as used in the various DCs are not defined in the Rating Schedule. Regulations provide that ratings for peripheral neurological disorders are to be assigned based the relative impairment of motor function, trophic changes, or sensory disturbance.
.F.R. § 4.124a, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017).

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

Although not binding, VA's Adjudication Procedures Manual contains guidance on how to differentiate between mild, moderate, moderately severe, and severe ratings. See VA Adjudication Procedures Manual (M21-1), V.iii.12.A.2.c. In the present case, the Board will take notice of this M21-1 guidance when assigning ratings for radiculopathy. The Court has emphasized in recent VA case law that the Board is required to consider "relevant provisions" of the M21-1 in some circumstances, especially when favorable to the veteran's case. See e.g., Stover v. McDonough, 35 Vet. App. 394 (2022); Andrews v. McDonough, 34 Vet. App. 216, 223 (2021); Wilson v. McDonough, 35 Vet. App. 75, 80 (2021). That is, the Board may take notice of the M21-1 guidelines to help differentiate between mild, moderate, moderately severe, and severe incomplete paralysis when determining the appropriate rating for a peripheral nerve disability.

The M21-1 indicates that mild incomplete paralysis may be shown by "a very minimal reflex or motor abnormality" or "sensory deficits that are lower graded, less persistent, or affecting a small area." Moderate incomplete paralysis may be shown by "combinations of significant sensory changes and reflex or motor changes of a lower degree," or "motor and/or reflex impairment such as weakness or diminished or hyperactive reflexes (with or without sensory impairment) graded as medically moderate." Moderately severe incomplete paralysis may be shown by "motor and/or reflex impairment (for example, weakness or diminished or hyperactive reflexes) at a grade reflecting a high level of limitation or disability" and "atrophy may be present." Severe incomplete paralysis motor and/or reflex impairment (for example, atrophy, weakness, or diminished or hyperactive reflexes) are expected at a grade reflecting a very high level of limitation or disability and may contain signs/symptoms resembling some of those expected in cases of complete paralysis of the nerve. For the sciatic nerve, marked muscular atrophy is expected. See 38 C.F.R. § 4.124a, DC 8520; see also M21-1, Part V.iii.12.A.2.c.

Turning to the evidence of record, the Veteran was afforded a VA examination for his lumbar spine disability in November 2024. On examination, the Veteran's muscle strength, reflex, and sensory exams were normal and the Veteran had a negative straight leg raising test. In March 2025, the examiner clarified that the Veteran has radicular pain or other signs or symptoms due to radiculopathy, including mild intermittent pain of the left and right lower extremities.

The Veteran was also afforded a VA examination for peripheral nerves conditions in November 2024. He reported that he experiences occasional or rare episodes of sciatic symptoms down the lower extremities bilaterally. The Veteran's muscle strength, reflex exam, and sensory exam were normal, and he did not have muscle atrophy. The Veteran did not have trophic changes. The Veteran's gait was normal. The examiner concluded that the Veteran has mild incomplete paralysis of the left and right sciatic nerve. Regarding functional impairment, the examiner noted that the Veteran lost 0-1 week of work in the last 12 months and he has significant sciatic symptoms that prevent movement such as walking and going up and down stairs and significant discomfort with prolonged sitting, which makes it difficult to perform his work duties.

Based on the foregoing, the Board finds that the evidence of record is persuasively against finding that the Veteran's left and right leg radiculopathy has resulted in moderate incomplete paralysis of the left and right sciatic nerves. The evidence shows that his symptoms are wholly sensory in nature and, at most, mild in severity. As noted
was normal. The examiner concluded that the Veteran has mild incomplete paralysis of the left and right sciatic nerve. Regarding functional impairment, the examiner noted that the Veteran lost 0-1 week of work in the last 12 months and he has significant sciatic symptoms that prevent movement such as walking and going up and down stairs and significant discomfort with prolonged sitting, which makes it difficult to perform his work duties.

Based on the foregoing, the Board finds that the evidence of record is persuasively against finding that the Veteran's left and right leg radiculopathy has resulted in moderate incomplete paralysis of the left and right sciatic nerves. The evidence shows that his symptoms are wholly sensory in nature and, at most, mild in severity. As noted above, when the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. Here, the examinations showed that the Veteran's left and right lower extremity had normal strength, normal reflexes, and normal sensory responses, with no indication of incomplete paralysis of the moderate degree. Moreover, the Veteran reported that he experiences very occasional episodes of sciatica. Accordingly, his claims for disability ratings higher than 10 percent for radiculopathy of the left and right leg are denied.

In reaching the above conclusions, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the evidence is persuasively against the Veteran's claims, that doctrine is not applicable in this appeal. 38 U.S.C. § 5107(b).

JOHN Z. JONES

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Kernen, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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