The July 2023 Board decision that denied entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11,…

Citation Nr: 26001389 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 15-14 081 DATE: January 30, 2026 ORDER The July 2023 Board decision that denied entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is vacated. The July 2023 Board decision that denied entitlement to a higher (compensable) initial rating for the service-connected urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is vacated. Entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is dismissed. Entitlement to a higher (compensable) initial rating for the service-connected urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is dismissed. Entitlement to a higher initial rating in excess of 20 percent for the service-connected lumbar spine disability from February 11, 2011 to November 5, 2012 is denied. Entitlement to a higher initial rating of 40 percent for the service-connected lumbar spine disability from March 1, 2013 to January 22, 2014 is granted. Entitlement to a higher initial rating in excess of 20 percent for the service-connected lumbar spine disability from May 1, 2014 to October 16, 2018 is denied. Entitlement to a higher initial rating in excess of 20 percent for the service-connected lumbar spine disability from February 1, 2019 is denied. FINDINGS OF FACT 1. The issue of entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11, 2011 was improperly certified to the Board and the July 2023 Board decision adjudicating this issue was rendered in error. 2. The issue of entitlement to a higher (compensable) initial rating for the service-connected urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 was improperly certified to the Board and the July 2023 Board decision adjudicating this issue was rendered in error. 3. The claims of entitlement to higher (compensable) initial ratings for the service-connected bowel incontinence and urinary incontinence disabilities are being adjudicated in a different appeal stream under the Appeals Modernization Act (AMA), separate and apart from the instant appeal; there is no case or controversy in the Legacy system for the Board to adjudicate in the instant Decision. 4. From February 11, 2011 to November 5, 2012, the service-connected lumbar spine disability did not manifest in forward flexion of the thoracolumbar spine at 30 degrees or less, ankylosis, or incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months to warrant a higher rating. 5. From March 1, 2013 to January 22, 2014, the service-connected lumbar spine disability manifested in incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months; without evidence of forward flexion of the thoracolumbar spine at 30 degrees or less or ankylosis. 6. From May 1, 2014 to October 16, 2018, the service-connected lumbar spine disability did not manifest in forward flexion of the thoracolumbar spine at 30 degrees or less, ankylosis, or incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months to warrant a higher rating. 7. From February 1, 2019, the service-connected lumbar spine disability did not manifest in forward flexion of the thoracolumbar spine at 30 degrees or less, ankylosis, or incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months to warrant a higher rating. CONCLUSIONS OF LAW 1. The criteria for vacating the July 2023 Board decision that denied entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11, 2011 have been met. 38 U.S.C. § 7104(a); 38 C.F.R. §§ 20.104, 20.202. 2. The criteria for vacating the July 2023 Board decision that denied entitlement to a higher (compensable) initial rating for the service-connected urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 have been met. 38 U.S.C. § 7104(a); 38 C.F.R. §§ 20.104, 20.202. 3. The criteria for dismissal of the claim of entitlement to a higher (compensable) initial rating for the service-connected urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 have been met. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.2500, 20.203. 4. The criteria for dismissal of the claim of entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11, 2011 have been met. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.2500, 20.203. 5. The criteria for entitlement to a higher rating in excess of 20 percent for the service-connected lumbar spine disability from February 11, 2011 to November 5, 2012 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.59, 4.71a, Diagnostic Code (DC) 5242. 6. The criteria for entitlement to a higher rating of 40 percent for the service-connected lumbar spine disability from March 1, 2013 to January 22, 2014 have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.59, 4.71a, DC 5242. 7. The criteria for entitlement to a higher rating in excess of 20 percent for the service-connected lumbar spine disability from May 1, 2014 to October 16, 2018 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.59, 4.71a, DC 5243. 8. The criteria for entitlement to a higher rating in excess of 20 percent for the service-connected lumbar spine disability from February 1, 2019 have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.59, 4.71a, DC 5242. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the United States Marine Corps from April 1993 to March 1994. These issues arose out of an appeal of a March 2021 Board decision to the United States Court of Appeals for Veterans Claims (Court). In an Order dated in March 2022, the Court adopted a Joint Motion for Partial Remand (JMPR) filed by the parties. The parties agreed that the Board failed to remand the issues of entitlement to higher initial ratings for the left and right lower extremity radiculopathies for the issuance of a Statement of the Case (SOC). The parties also agreed that the Board failed to address whether the Veteran is entitled to separate ratings for bowel or bladder impairment related to the service-connected lumbar spine disability. In the instant case, the Veteran reported bowel and urinary incontinence after a post-lumbar laminectomy and has asserted that the lumbar spine disability is neurologically connected to the bowel and bladder incontinence. Pursuant to Note 1 of the General Rating Formula for Diseases and Injuries of the Spine, 38 C.F.R. § 4.71a, rating officials must "[e]valuate any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, separately, under an appropriate diagnostic code." The parties agreed that remand was warranted. In July 2022, the Board remanded the issues of entitlement to higher initial ratings for the left and right lower extremity radiculopathies for the issuance of a SOC and entitlement to an initial rating in excess of 20 percent for a lumbar disability for a VA examination opinion to determine if the Veteran is entitled to separate ratings for bowel or urinary incontinence related to the lumbar spine disability. VA examinations and opinions were rendered in January 2023. In a January 2023 rating decision, the agency of original jurisdiction (AOJ) granted service connection for bowel and urinary incontinence each rated at 0 percent from February 11, 2011. Another rating decision was issued in May 2023, continuing the ratings for bowel and urinary incontinence. A May 2023 Supplemental Statement of the Case (SSOC) denied entitlement to an initial rating higher than 20 percent for the lumbar spine disability. In July 2023, the Board denied entitlement to higher (compensable) initial ratings for the service-connected bowel incontinence and urinary incontinence disabilities from February 11, 2011. In January 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a January 2023 decision, requesting higher (compensable) initial ratings for the service-connected bowel incontinence and urinary incontinence disabilities. In May 2024, the AOJ issued the HLR decision on appeal, denying entitlement to higher (compensable) initial ratings for the service-connected bowel incontinence and urinary incontinence disabilities. In the May 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. 1. The July 2023 Board decision that denied entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is vacated. 2. The July 2023 Board decision that denied entitlement to a higher (compensable) initial rating for the service-connected urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is vacated. Upon review of the record, these claims stem from a March 2021 Board decision, which granted a 20 percent initial rating for the service-connected lumbar spine disability. The Veteran appealed the March 2021 decision to the United States Court of Appeals for Veterans Claims (CAVC), which adapted a March 2022 Joint Motion for Partial Remand (JMPR). In the March 2022 JMPR, the parties agreed that remand is required to address symptoms documented in January 2019 private treatment records, specifically evidence about the Veteran's bowel and urinary incontinence post-lumbar laminectomy. In a July 2022 Board decision, the Board remanded, in part, the issue of entitlement to an initial rating in excess of 20 percent for a lumbar disability for records and VA examinations with corresponding opinions. The issues of entitlement to service connection for bladder incontinence and urinary incontinence, with 0 percent ratings from February 11, 2011, were granted by the AOJ in a January 2023 rating decision. Another rating decision was issued in May 2023, continuing the 0 percent ratings for both disabilities. The Board notes that neither rating decision was appealed in the Legacy appeal stream. Even though the Veteran did not appeal the issues with a notice of disagreement in the Legacy appeal stream, the Board adjudicated the issues in July 2023. The Board finds that the issues of entitlement to a higher (compensable) initial ratings for the service-connected bowel and urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 were erroneously certified to the Board in the Legacy appeal stream and the Board rendered the July 2023 decision in error. The Board notes that these issues are being adjudicated in the AMA system in a separate appeal stream (docket E250505-541115). Based on the foregoing, the Board vacates the July 2023 decision that denied entitlement to a higher (compensable) initial ratings for the service-connected bowel and urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011. 3. Entitlement to a higher (compensable) initial rating for the service-connected bowel incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is dismissed. 4. Entitlement to a higher (compensable) initial rating for the service-connected urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011 is dismissed. In order to appeal an issue adjudicated in a rating decision to the Board, a notice of disagreement must be filed. See 38 C.F.R. § 20.202. The Board shall decide all questions pertaining to its jurisdictional authority to review a particular case and, in cases which it has determined it does not have jurisdiction, the Board may issue a dismissal. See 38 C.F.R. § 20.204. As explained above, the Board did not have jurisdiction to issue the denials in the July 2023 Board decision and therefore does not have jurisdiction to adjudicate the claims in the instant Decision. The claims of entitlement to higher (compensable) initial ratings for the service-connected bowel incontinence and urinary incontinence disabilities are being adjudicated in a different appeal stream under the AMA, separate and apart from the instant appeal. There is no case or controversy in the Legacy system for the Board to adjudicate in the instant Decision. Based on the foregoing, the Board must dismiss the Veteran's claims of entitlement to a higher (compensable) initial rating for the service-connected bowel and urinary incontinence associated with the service-connected lumbar spine disability from February 11, 2011. Legal Authority for Increased Rating Disability ratings are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the veteran. See 38 C.F.R. § 4.3. Separate evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as "staged" ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). VA's determination of the present level of a disability may result in a conclusion that the disability has undergone varying and distinct levels of severity throughout the entire time period the increased-rating claim has been pending. Hart v. Mansfield, supra. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, see 38 C.F.R. § 4.2, the regulations do not give past medical reports precedence over current findings. Francisco v. Brown, 7 Vet. App. 55 (1994). However, the Board must also consider staged ratings. Hart v. Mansfield, supra. The veteran's entire history is considered when assigning disability ratings. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). A review of the recorded history of a disability is necessary to make an accurate rating. 38 C.F.R. §§ 4.2, 4.41. The regulations do not give past medical reports precedence over current findings where such current findings are adequate and relevant to the rating issue. Francisco v. Brown, supra; Powell v. West, 13 Vet. App. 31 (1999). The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, supra. The assignment of a particular diagnostic code is dependent on the facts of a particular case. See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual's relevant medical history, the current diagnosis, and demonstrated symptomatology. In reviewing the claim for a higher rating, the Board must consider which diagnostic code or codes are most appropriate for application in the veteran's case and provide an explanation for the conclusion. See Tedeschi v. Brown, 7 Vet. App. 411, 414 (1995). 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. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). In this regard, 38 C.F.R. § 4.59 requires that "[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint." Correia v. McDonald, 28 Vet. App. 158 (2016). Further, 38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the Diagnostic Code under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). 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 (musculoskeletal system) or § 4.73 (muscle injury); 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 [or 4.73] 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). During the pendency of this appeal, VA issued revised schedular criteria for rating musculoskeletal disabilities, including some of the diagnostic codes for rating spine disabilities under 38 C.F.R. § 4.71a, which became effective February 7, 2021. However, consideration under the revised schedular criteria should not be undertaken before such criteria became effective. The effective date rule contained in 38 U.S.C. § 5110(g) prevents the application of a later, liberalizing law to a claim prior to the effective date of the liberalizing law. That is, for any date prior to February 7, 2021, neither the Agency of Original Jurisdiction (AOJ) nor the Board could apply the revised rating schedule. Where a law or regulation changes during the pendency of a claim for a higher rating, the Board must first determine whether the revised version is more favorable to the veteran. In so doing, it may be necessary for the Board to apply both the old and new versions of the regulation. If the revised version of the regulation is more favorable, the retroactive reach of that regulation under 38 U.S.C. § 5110(g) can be no earlier than the effective date of that change. The Board must apply both the former and the revised versions of the regulation for the period prior and subsequent to the regulatory change, but an effective date based on the revised criteria may be no earlier than the date of the change. As such, VA must consider the claims pursuant to the former and revised regulations during the course of this appeal. See VAOPGCPREC 3-2000, 65 Fed. Reg. 33,422 (2000); DeSousa v. Gober, 10 Vet. App. 461, 467 (1997). VA thus must consider the claim for a higher rating pursuant to the former and revised regulations during the latter part of this appeal. See VAOPGCPREC 3-2000, 65 Fed. Reg. 33,422 (2000); DeSousa v. Gober, supra. Therefore, the Board will consider the Veteran's claim under the old criteria prior to February 7, 2021, and both the old and new rating criteria from February 7, 2021. The criteria that is more favorable to the Veteran will be applied. Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings sufficiently characteristic to identify the disease and the resulting disability and above all, coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. Therefore, the Board has considered the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the veteran, as well as the entire history of the veteran's disability in reaching its decision. Schafrath v. Derwinski, supra. In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a veteran's service-connected disability. 38 C.F.R. § 4.14. It is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes, however, the critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no obligation to discuss, in detail, the extensive evidence of record. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis will focus specifically on what the evidence shows, or fails to show, as it relates to the Veteran's claim. When there is an approximate balance of positive and negative evidence as to any issue material to the determination of a matter, VA will resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). Diagnostic Code 5243 is part of the General Rating Formula for Disease and Injuries of the Spine (General Rating Formula). Diagnostic Code 5243 provides rating criteria for degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome. Under the Formula for Rating Intervertebral Disc Syndrome based on Incapacitating Episodes, a 10 percent rating is assigned with incapacitating episodes having a total duration of at least one week but less than two weeks during the past 12 months. A 20 percent rating is assigned with incapacitating episodes having a total duration of at least two weeks but less than 4 weeks during the past 12 months. A 40 percent rating is assigned with incapacitating episodes having a total duration of at least four weeks but less than 6 weeks during the past 12 months. A maximum schedular 60 percent rating is warranted with incapacitating episodes having a total duration of at least six weeks during the past 12 months. 38 C.F.R. § 4.71a. Under the General Rating Formula for Rating Diseases and Injuries of the Spine, with or without symptoms such as pain, stiffness or aching in the area of the spine affected by residuals of injury or disease, the following ratings will apply: a 10 percent rating is warranted for forward flexion of the thoracolumbar spine greater than 60 degrees but not greater than 85 degrees; or, forward flexion of the cervical spine greater than 30 degrees but not greater than 40 degrees; or, combined range of motion of the thoracolumbar spine greater than 120 degrees but not greater than 235 degrees; or, combined range of motion of the cervical spine greater than 170 degrees but not greater than 335 degrees; or, muscle spasm, guarding, or localized tenderness not resulting in abnormal gait or abnormal spinal contour; or, vertebral body fracture with loss of 50 percent or more of the height. A 20 percent rating is warranted when forward flexion of the thoracolumbar spine is greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the cervical spine is greater than 15 degrees but not greater than 30 degrees; or, combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the cervical spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 30 percent rating is warranted when forward flexion of the cervical spine is 15 degrees or less; or favorable ankylosis of the entire cervical spine. A 40 percent rating is warranted for unfavorable ankylosis of the entire cervical spine; or forward flexion of the thoracolumbar spine to 30 degrees or less; or favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is warranted for unfavorable ankylosis of the entire thoracolumbar spine. A schedular maximum 100 percent rating is warranted for unfavorable ankylosis of the entire spine. 38 C.F.R. § 4.71a, Diagnostic Code 5237. For VA compensation purposes, normal forward flexion of the cervical spine is zero to 45 degrees, extension is zero to 45 degrees, left and right lateral flexion are zero to 45 degrees and left and right lateral rotation are zero to 80 degrees. Normal forward flexion of the thoracolumbar spine is zero to 90 degrees, extension is zero to 30 degrees, left and right lateral flexion are zero to 30 degrees, and left and right lateral rotation are zero to 30 degrees. The combined range of motion refers to the sum of the range of forward flexion, extension, left and right lateral flexion, and left and right rotation. The normal combined range of motion of the cervical spine is 340 degrees and of the thoracolumbar spine is 240 degrees. The normal ranges of motion for each component of spinal motion provided in this note are the maximum that can be used for calculation of the combined range of motion. See Note (2); see also Plate V.5242-5243 Note (1) to the General Rating Formula specifies that any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, should be separately evaluated under an appropriate diagnostic code. A disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination, and endurance. Functional loss may be due to the absence or deformity of structures or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior in undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. § 4.40. With respect to joints, in particular, the factors of disability reside in reductions of normal excursion of movements in different planes. Inquiry will be directed to more or less than normal movement, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity or atrophy of disuse. 38 C.F.R. § 4.45. Although pain may cause functional loss, pain itself does not constitute functional loss. Rather, pain must affect some aspect of "the normal working movements of the body," such as "excursion, strength, speed, coordination, and endurance," in order to constitute functional loss. Mitchell v. Shinseki, supra; see also DeLuca v. Brown, supra. The Board notes that effective February 7, 2021, the criteria for schedule of ratings for the musculoskeletal system was revised. See 86 Fed. Reg. 8142 (Feb. 4, 2021) (codified at 38 C.F.R. pt. 4). In the present case, the Veteran's claim for an increased rating stems from a claim filed in February 2011. Moreover, Diagnostic Code 5237 is unchanged under the revised criteria. Under the amended criteria, Diagnostic Code 5243 is only used when there is disc herniation with compression and/or irritation of the adjacent nerve root; assign Diagnostic Code 5242 for all other disc diagnoses. The rating criteria and evaluation under Diagnostic Code 5243 remain unchanged. The appropriate criteria are discussed below. In the instant case, the Veteran was in receipt of multiple 100 percent disability ratings for convalescence related to the service-connected lumbar spine disability under 38 C.F.R. § 4.30. The Veteran was in receipt of a 100 percent disability rating from November 5, 2012 to March 1, 2013, January 22, 2014 to May 1, 2014, and October 16, 2018 to February 1, 2019. The Board excludes these 100 percent rating periods from this decision as the Veteran has already received the maximum rating. 1. Entitlement to a higher rating in excess of 20 percent for the service-connected lumbar spine disability from February 11, 2011 to November 5, 2012 is denied. During this period on appeal, from February 11, 2011 to November 5, 2012, the Veteran was in receipt of a 20 percent disability rating under Diagnostic Code 5242. Turning to the evidence, in a June 2011 VA examination, the Veteran reported mobility difficulties, stiffness, decreased motion in the spine, and numbness. He denied fatigue, spasms and paresthesia, but endorsed flareups described as pain in the back occurring twice a week and lasting 3 days. He reported impaired prolonged sitting, standing, walking, repetitive bending, and heavy lifting. The VA examiner measured initial and repetitive range of motion, noting forward flexion at 75 degrees and a combined range of motion at 180 degrees with additional functional loss in the form of pain, fatigue, and lack of endurance after repeated use testing. The VA examiner noted there were no incapacitating episodes. Based on the foregoing, the Board finds that the service-connected lumbar spine disability did not manifest in forward flexion of the thoracolumbar spine at 30 degrees or less, or ankylosis to warrant a higher rating from February 11, 2011 to November 5, 2012. The Board is cognizant of the holding in Chavis v. McDonough, 34 Vet. App. 1 (2021). The Chavis decision suggests that the Veteran might be eligible for a higher rating if, due to weakness, fatigability, lack of coordination, restricted or excess movement, or pain on movement during flare-ups, his symptoms cause him to experience the functional equivalent of ankylosis. Id. at 10. However, in this case, the Board finds that ankylosis has not been shown at any time. There was no evidence of fixation or stiffness. While the Veteran has reported some functional impairment, including difficulty with prolonged sitting, standing, walking, repetitive bending, and heavy lifting, he had, at worst, forward flexion at 75 degrees and a combined range of motion at 180 degrees at that time. Accordingly, functional ankylosis has not been shown during this period on appeal. In terms of incapacitating episodes, there is no evidence of intervertebral disc syndrome with incapacitating episodes during this period on appeal. Thus, a higher rating under Diagnostic Code 5243 is not warranted. See 38 C.F.R. § 4.71a, Diagnostic Code 5243, Note (1). Although the Veteran had pain with range of motion, the Court has clearly indicated that painful motion does not equate to limited motion. Mitchell v. Shinseki, supra. Rather, pain must affect some aspect of the normal working movements of the body such as excursion, strength, speed, coordination, and endurance to constitute a functional loss. Id. To the extent that the Veteran endorsed flares-ups, the effect of any pain in the Veteran's lumbar spine is already contemplated in the assigned rating. The Board has also considered whether a higher or separate rating is warranted for neurological impairments related to the Veteran's lumbar spine. During this period on appeal, the Veteran was service connected for separate ratings for radiculopathy in the left lower extremity, bowel incontinence, and urinary incontinence. The Veteran has not alleged, and the record does not suggest, impairments related to the right lower extremity at this time. Therefore, a higher or separate rating for neurological impairment in the right lower extremity is not warranted. In making its determination in this case, the Board acknowledges the Veteran's belief that his lumbar spine symptoms are more severe than the current rating reflects. While thew Board recognizes that the Veteran is competent to provide statements regarding his observable symptomatology, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Rather, the Board finds the medical evidence in which professionals with medical expertise examined the Veteran, acknowledged his reported symptoms, and described the manifestations of such disability considering the rating criteria to be more persuasive than the Veteran's reports regarding the severity of his condition. Accordingly, the Board finds that a rating in excess of 20 percent for lumbar spine disability from February 11, 2011 to November 5, 2012 is not warranted. The appeal is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, supra. 2. Entitlement to a higher rating of 40 percent for the service-connected lumbar spine disability from March 1, 2013 to January 22, 2014 is granted. During this period on appeal, from March 1, 2013 to January 22, 2014, the Veteran was in receipt of a 20 percent disability rating under Diagnostic Code 5242. In the August 2013 VA examination, the Veteran reported pain radiating down his legs and endorsed flareups, occurring two times a week with additional pain and fatiguability. The VA examiner measured initial range of motion with forward flexion at 80 degrees and a combined range of motion at 200 degrees. The VA examiner measured range of motion after repetitive use testing with forward flexion at 85 degrees and combined range of motion at 205 degrees. The VA examiner noted additional functional loss in the form of pain. The VA examiner found no muscle spasms or guarding. Ankylosis is not documented. The Veteran was diagnosed with Intervertebral Disc Syndrome (IVDS), experiencing at least four weeks but less than six weeks of incapacitating episodes over the past 12 months. In December 2013 VA treatment records, the VA examiner measured initial range of motion with forward flexion at 45 degrees and a combined range of motion at 115 degrees. The VA examiner measured range of motion after repetitive use, noting no additional limitation of motion or functional loss. There are no notations about ankylosis. Based on the foregoing, the Board finds that the service-connected lumbar spine disability manifested in incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months, which warrants a higher rating of 40 percent from March 1, 2013 to January 22, 2014. In recognition of Chavis, the Board finds that ankylosis has not been shown at any time. There was no evidence of fixation or stiffness, or evidence of functional impairment consistent with ankylosis. Accordingly, functional ankylosis has not been shown during this period on appeal. Although the Veteran had pain with range of motion, the Court has clearly indicated that pain must affect some aspect of the normal working movements of the body such as excursion, strength, speed, coordination, and endurance to constitute a functional loss. Mitchell v. Shinseki, supra. To the extent that the Veteran endorsed flares-ups, the effect of any pain in the Veteran's lumbar spine is already contemplated in the assigned rating. The Board has also considered whether a higher or separate rating is warranted for neurological impairments related to the Veteran's lumbar spine. During this period on appeal, the Veteran was service-connected for separate ratings for radiculopathy in both lower extremities, bowel incontinence, and urinary incontinence. Accordingly, the Board finds that a rating of 40 percent for lumbar spine disability is warranted from March 1, 2013 to January 22, 2014. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, supra. 3. Entitlement to a higher rating in excess of 20 percent for the service-connected lumbar spine disability from May 1, 2014 to October 16, 2018 is denied. During this period on appeal, from May 1, 2014 to October 16, 2018, the Veteran was in receipt of a 20 percent disability rating under Diagnostic Code 5242-5243. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27. The hyphenated diagnostic code in this case indicates that the service-connected lumbar spine disability, degenerative arthritis (DC 5242) and IVDS (DC 5243). In the April 2016 VA examination, the Veteran reported pain and flareups. The VA examiner measured initial range of motion with forward flexion at 60 degrees and a combined range of motion at 155 degrees. There was no additional decreased range of motion or functional loss during observed repetitive use testing. After repeated use over time testing, the VA examiner measured forward flexion at 50 degrees and a combined range of motion at 120 degrees. The VA examiner explained that he was unable to estimate measurements during a flareup because the Veteran was unwilling to provoke a flareup. The VA examiner noted that the Veteran did not have ankylosis and did not experience incapacitating episodes. Based on the foregoing, the Board finds that the service-connected lumbar spine disability did not manifest in forward flexion of the thoracolumbar spine at 30 degrees or less or ankylosis to warrant a higher rating from May 1, 2014 to October 16, 2018. In recognition of Chavis, the Board finds that ankylosis has not been shown at any time. There was no evidence of fixation or stiffness, or evidence of functional impairment consistent with ankylosis. Accordingly, functional ankylosis has not been shown during this period on appeal. Although the Veteran had pain with range of motion, the Court has clearly indicated that pain must affect some aspect of the normal working movements of the body such as excursion, strength, speed, coordination, and endurance to constitute a functional loss. Mitchell v. Shinseki, supra. To the extent that the Veteran endorsed flares-ups, the effect of any pain in the Veteran's lumbar spine is already contemplated in the assigned rating. In terms of incapacitating episodes, there is no evidence of IVDS with incapacitating episodes during this period on appeal. Thus, a higher rating under Diagnostic Code 5243 is not warranted. See 38 C.F.R. § 4.71a, Diagnostic Code 5243, Note (1). While there is evidence of painful motion, there is no evidence that it affected some aspect of the normal working movements of the body such as excursion, strength, speed, coordination, and endurance to constitute a functional loss. Mitchell v. Shinseki, supra. To the extent that the Veteran endorsed flares-ups, the effect of any pain in the Veteran's lumbar spine is already contemplated in the assigned rating. During this period on appeal, the Veteran was service-connected for separate ratings for radiculopathy in both lower extremities, bowel incontinence, and urinary incontinence. Even though the Veteran asserts that his symptoms are worse than the current rating reflects, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. See Woehlaert v. Nicholson, supra. Accordingly, the Board finds that a rating in excess of 20 percent for lumbar spine disability from May 1, 2014 to October 16, 2018 is not warranted. The appeal is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, supra. 4. Entitlement to a higher rating in excess of 20 percent for the service-connected lumbar spine disability from February 1, 2019 is denied. The Veteran is currently in receipt of a 20 percent disability rating from February 1, 2019 under Diagnostic Code 5242-5243. There is no probative, specific, medical evidence of record pertaining to this period on appeal to warrant a higher initial rating in excess of 20 percent for the service-connected lumbar spine disability from February 1, 2019. The Veteran generally asserts that he is entitled to a higher rating, but, as previously explained, he is not competent to provide an opinion regarding the severity of his symptomatology in accordance with the rating criteria. See Woehlaert v. Nicholson, supra. The Board finds that, from February 1, 2019, the service-connected lumbar spine disability did not manifest in forward flexion of the thoracolumbar spine at 30 degrees or less, ankylosis, or incapacitating episodes having a total duration of at least 4 weeks but less than 6 weeks during the past 12 months to warrant a higher rating. Accordingly, the Board finds that a rating in excess of 20 percent for lumbar spine disability from February 1, 2019 is not warranted. The appeal is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, supra. David H. Robertson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Costantino, Danielle K. 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.