Entitlement to a rating of 40 percent, but no more, for voiding dysfunction is granted on and after May 6, 2020, subject to the laws and regulations governing the payment of monetary benefits.

Citation Nr: A26069971 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 260422-669746 DATE: July 30, 2026 ORDER Entitlement to a rating of 40 percent, but no more, for voiding dysfunction is granted on and after May 6, 2020, subject to the laws and regulations governing the payment of monetary benefits. FINDING OF FACT Throughout the period on appeal, the Veteran's voiding dysfunction has manifested as urine leakage requiring the wearing of absorbent materials which must be changed 2 to 4 times per day and a daytime voiding interval of less than one hour or awakening to void five or more times per night, but not as urine leakage requiring the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day, obstructed voiding, or urinary tract infection. CONCLUSION OF LAW With resolution of reasonable doubt in the Veteran's favor, the criteria for a disability rating of 40 percent, but no higher, for voiding dysfunction have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.115a, 4.115b, Diagnostic Code 7542. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Navy from July 1992 to September 1996 and from May 2000 to November 2016. The rating decision that led to this appeal was issued in December 2025 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. Later in December 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of the December 2025 decision. In January 2026, the Agency of Original Jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior December 2025 decision. In the April 2026 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 December 2025 AOJ decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. No evidence pertaining to this issue was submitted during a period the Board may not consider. Under the AMA, a veteran has the right to select a different Board review option by submitting a new VA Form 10182 within one year of the rating decision on appeal, or within 60 days of the date that the Board received the VA Form 10182, whichever date is later. 38 C.F.R. § 20.202(c)(2). The period to change AMA dockets has not elapsed. However, in a signed statement submitted with the Notice of Disagreement, the Veteran's attorney waived the remaining time and the right to change appeal lanes at the Board and requested that the Board issue a decision as soon as possible. Therefore, the Board may proceed to decide the appeal. Williams v. McDonough, 37 Vet. App. 305 (2024). Neither the Veteran nor his attorney have raised any issue with the duty to notify or duty to assist with regard to the issue being decided on its merits below that occurred prior to the rating decision on appeal. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). 1. Voiding Dysfunction The Veteran contends that his voiding dysfunction warrants a rating higher than that currently assigned. It is currently rated under 38 C.F.R. § 4.115b, Diagnostic Code 7542, for neurogenic bladder, with a 20 percent rating on and after May 6, 2020. The Veteran's attorney has requested a 40 percent rating. The full period of service connection is on appeal. Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate Diagnostic Codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. "Staged" ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). Given the nature of the present claim?for a higher initial evaluation, the Board has considered all evidence of severity from the effective date?for the award?of service connection. ?Fenderson?v. West, 12?Vet. App.?119 (1999).? Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. During the pendency of the appeal, the rating criteria for evaluating genitourinary disabilities under 38?C.F.R. §?4.115b were amended effective November 14, 2021. 86 Fed. Reg. 54081 (Sept. 30, 2021). These amendments revised select diagnostic codes to ensure that the rating schedule "uses current medical terminology and to provide detailed and updated criteria for the evaluation of genitourinary conditions for disability rating purposes." Id. If a law or regulation changes during the course of a claim or an appeal, the version more favorable to the appellant will apply, to the extent permitted by any stated effective date in the amendment in question. 38?U.S.C. §?5110(g). If the revised version of the regulation is more favorable, the implementation of that regulation under 38?U.S.C. §?5110(g) can be no earlier than the effective date of that change. If the former version is more favorable, VA can apply the earlier version of the regulation for the period prior to, and from, the effective date of the change. 38?U.S.C. §?5110. Because this claim was pending prior to the effective date of the amendment, VA must consider the Veteran's claim under both sets of rating criteria and apply the criteria that are more favorable to the Veteran's claim. Under the prior criteria, Diagnostic Code 7542 provides for rating as voiding dysfunction. 38?C.F.R. §?4.115b, Diagnostic Code 7542 (2020). The amended criteria added the option of rating as urinary tract infection, "whichever is predominant." 38?C.F.R. §?4.115b, Diagnostic Code 7542. Because the record contains no evidence of urinary tract infection attributable to the Veteran's voiding dysfunction and the Veteran has not contended that he has had urinary tract infections attributable to his voiding dysfunction, it is unnecessary to describe the rating criteria for urinary tract infection. The rating criteria for voiding dysfunction were not altered by the amendments. Voiding dysfunction is rated as urine leakage, frequency, or obstructed voiding; only the predominant area of dysfunction shall be considered for rating purposes. 38 C.F.R. § 4.115a. Because the record contains no evidence of obstructed voiding attributable to the Veteran's voiding dysfunction and the Veteran has not contended that he has had obstructed voiding attributable to his voiding dysfunction, it is unnecessary to describe the rating criteria for obstructed voiding. Urine leakage is rated as follows: a 60 percent rating is warranted for leakage requiring the use of an appliance or the wearing of absorbent materials which must be changed more than four times per day, a 40 percent rating is warranted for leakage requiring the wearing of absorbent materials which must be changed two to four times per day, and a 20 percent rating is warranted for leakage requiring the wearing of absorbent materials which must be changed less than two times per day. Id. Urinary frequency is rated as follows: a 40 percent rating is warranted for a daytime voiding interval of less than one hour or awakening to void five or more times per night and a 20 percent rating is warranted for a daytime voiding interval between one and two hours or awakening to void three to four times per night. Id. In a July 2020 statement, the Veteran reported that he had to use the restroom "about once every hour" and also woke up "about 3 to 4 times per night" to use the restroom. He added that, in addition to this, he had "leakage each day, about twice per day," and occasional nighttime incontinence. He reported a need to wear absorbent material that he changed twice per day and a frequent need to change his clothes. In an August 2020 statement, the Veteran's spouse reported that the Veteran used the restroom "about once an hour and woke up 4-5 times per night to use the restroom," as well as having urinary incontinence "around 3 times per day" and "leakage at night around 1-2 times." She added that he needed to change absorbent material "1-2 times per day" and sometimes left outings early due to a need to change his clothes. The Veteran has submitted a September 2020 medical opinion by a private clinician, based on review of records. Based on records including the lay statements referenced above, the clinician characterized the Veteran's level of urinary incontinence and urinary frequency as "severe," including "fourteen to sixteen trips to the bathroom daily along with at least five trips nightly" and that he was "forced to don absorbent adult briefs and despite same, he has had numerous episodes of incontinence." The clinician concluded that "per the VA rating system for this gentleman's voiding dysfunction, since his daytime voiding interval is in between one and two hours, nightly voiding interval is at least five times nightly, and he dons absorbent material that must be changes (sic) four (4) times per day, his voiding dysfunction is properly rated at 60%." This reflects a misreading of the rating criteria: the maximum schedular rating for urinary frequency is 40 percent and, to meet the schedular criteria for a 60 percent rating for urine leakage, there must be either a need to use an appliance or a need to change absorbent materials more than 4 times per day. A need to change them 4 times per day warrants a 40 percent rating. 38 C.F.R. § 4.115a. The Veteran was afforded a VA examination for urinary tract conditions in November 2025. The clinician diagnosed a voiding dysfunction. The Veteran reported a continued increase in urinary frequency and leakage, but no current treatment. The clinician indicated that the Veteran's urine leakage did not require the wearing of absorbent material or the use of an appliance. The clinician also indicated that the Veteran's urinary frequency manifested as a daytime voiding interval between 1 and 2 hours and nighttime awakening to void 3 to 4 times. There were no signs or symptoms of obstructed voiding and there was no history of recurrent, symptomatic bladder or urethral infections. The clinician indicated that the Veteran's voiding dysfunction would have an impact on his ability to work because increased urinary frequency would interfere with the ability to complete job duties. The Board notes the Veteran's attorney's contention in a December 2025 statement that the November 2025 VA examiner "explicitly found that the Veteran's voiding dysfunction results in urine leakage requiring the wearing of absorbent materials that must be changed two to four times per day" and that this finding "is clear, unambiguous, and directly corresponds to the regulatory criteria for a 40 percent evaluation under 38 C.F.R. § 4.115a." The Veteran's attorney made similar contentions in an April 2026 statement. However, as stated above, this is an inaccurate reading of the November 2025 VA examination report, which specifically indicated that the Veteran's urine leakage did not require the wearing of absorbent material. Based on the evidence described above, the Board finds that, affording the Veteran the benefit of the doubt, the Veteran's voiding dysfunction warrants an evaluation of 40 percent from the beginning of the period on appeal. The Veteran's spouse's August 2020 statement indicated that he needed to wake up four to five times per night and the September 2020 private medical opinion indicated that he needed to wake up "at least" five times per night to use the restroom. This warrants a 40 percent rating based on urinary frequency, which is the maximum schedular rating for urinary frequency. In addition, the Veteran's July 2020 statement indicated a need to change absorbent material twice per day, his spouse's August 2020 statement indicated a need to change absorbent material once or twice per day, and the September 2020 private medical opinion indicated that he needed to change absorbent material four times per day. These statements and findings are consistent with a 40 percent rating based on urine leakage. 38 C.F.R. § 4.115a. The Board does not, however, find that the criteria for a rating in excess of 40 percent were more nearly approximated by the Veteran's symptoms at any point during the period on appeal. A rating in excess of 40 percent is only warranted under Diagnostic Code 7542 if urine leakage requires the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day. The record contains no evidence of the use of an appliance and the most severe statement of his symptoms indicates that he must change absorbent materials 4 times per day, not more. The Board has also considered the Veteran's and his spouse's assertions regarding his voiding symptoms, which they are competent to provide. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). Their statements are also credible and are part of the basis for the increased rating granted above. However, the competence of a lay person to provide a medical opinion must be determined on a case by case basis. Kahana v. Shinseki, 24 Vet. App. 428 (2011). The rating criteria for neurogenic bladder are specific and the criteria for a rating in excess of 40 percent depend on the use of an appliance or the wearing of absorbent materials which must be changed more than 4 times per day. Nothing in the Veteran's or his spouse's statements constitutes a report that any of these criteria have been met. Thus, to the extent that the Veteran's or his spouse's statements regarding his symptoms constitute a contention that those symptoms match the criteria for an increased rating, their probative value is low. In sum, the Board finds that the effects of the Veteran's voiding dysfunction were most consistent with a disability rating of 40 percent, which is the rating requested by his attorney, throughout the period on appeal. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Frank, 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.