United States Court of Appeals 

for the Federal Circuit ______________________ 

JOHN W. WEBB,

Claimant-Appellant

v.

DENIS MCDONOUGH, SECRETARY OF 

VETERANS AFFAIRS,

Respondent-Appellee

______________________ 

2022-1243

______________________ 

Appeal from the United States Court of Appeals for 

Veterans Claims in No. 20-8064, Judge Michael P. Allen.

______________________ 

Decided: June 29, 2023

______________________ 

JENNIFER TRACY SHANNON HEALY, Veterans Legal Advocacy Group, Arlington, VA, argued for claimant-appellant. Also represented by HAROLD HAMILTON HOFFMAN,

III, MEGAN EILEEN HOFFMAN. 

 ANDREW JAMES HUNTER, Commercial Litigation 

Branch, Civil Division, United States Department of Justice, Washington, DC, argued for respondent-appellee. 

Also represented by BRIAN M. BOYNTON, DEBORAH ANN 

BYNUM, PATRICIA M. MCCARTHY; AMANDA BLACKMON,

BRIAN D. GRIFFIN, Office of General Counsel, United States 

Department of Veterans Affairs, Washington, DC. 

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2 WEBB v. MCDONOUGH

 ______________________ 

Before TARANTO, CHEN, and STOLL, Circuit Judges. 

STOLL, Circuit Judge. 

Some veterans have service-connected conditions that

are not listed in the Department of Veterans Affairs’ (VA) 

Schedule of Disability Ratings. In those circumstances, the 

VA can choose an appropriate disability rating for the veteran’s unlisted condition by analogizing it to a listed one. 

This appeal involves the framework for how the VA performs such a rating by analogy.

John W. Webb appeals a decision of the U.S. Court of 

Appeals for Veterans Claims (Veterans Court) affirming 

the Board of Veterans’ Appeals’ determination that he was 

not entitled to a compensable disability rating for his unlisted service-connected condition because he did not meet 

all the criteria of the analogous condition’s diagnostic code. 

Because the Veterans Court misinterpreted the requirements of the applicable regulation, 38 C.F.R. § 4.20, we vacate its decision and remand for further consideration.

BACKGROUND

The VA promulgates a Schedule for Rating Disabilities 

that provides an extensive list of disabilities identified by 

unique diagnostic codes, each of which has at least one corresponding disability rating. 38 U.S.C. § 1155; 38 C.F.R. 

pt. 4. Although the Schedule is extensive, it is possible that 

a particular veteran’s disability does not clearly fall under 

one of the delineated diagnostic codes. VA regulations address this possibility:

When an unlisted condition is encountered it will 

be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and 

symptomatology are closely analogous.

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WEBB v. MCDONOUGH 3

38 C.F.R. § 4.20. In other words, this regulation provides 

that a veteran having an “unlisted” condition, i.e., one that 

is not included on the Schedule, can be rated analogously 

to—and given the associated disability rating of—a listed 

disease or injury, provided that the affected functions, anatomical location, and symptomatology of the veteran’s 

condition are “closely analogous” to those of the listed disease or injury. For example, “a veteran’s non-migraine 

headaches could be rated as analogous to migraine headaches.” Jeffrey D. Parker, Getting the Train Back on Track: 

Legal Principles to Guide Extra-Schedular Referrals in 

U.S. Department of Veterans Affairs Disability Rating 

Claim Adjudications, 28 FED. CIR. B.J. 175, 192 (2019).

In Lendenmann v. Principi, the Veterans Court elaborated on this regulatory guidance, explaining that, “[i]n deciding whether a listed disease or injury is ‘closely related’ 

to the veteran’s ailment, the VA may take into consideration three factors” when determining which diagnostic code 

is most “closely analogous” to a given unlisted disability: “(1) whether the ‘functions affected’ by ailments are 

analogous; (2) whether the ‘anatomical localization’ of the 

ailments is analogous; and (3) whether the ‘symptomatology’ of the ailments is analogous.” 3 Vet. App. 345, 350 

(1992) (quoting 38 C.F.R. § 4.20).1

With this brief legal background in mind, we now turn 

to the facts of this case. Mr. Webb served in the Army from 

1968 to 1970, receiving an honorable discharge. After the 

conclusion of his service, Mr. Webb developed, among other 

ailments, service-connected prostate cancer, the treatment 

1 We note that Lendenmann requires that each of 

these three factors be “analogous,” while § 4.20 requires 

that these factors be “closely analogous.” To the extent this 

inconsistency is meaningful, however, we need not address 

it further here, as it makes no difference to our opinion in 

this case. 

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4 WEBB v. MCDONOUGH

for which caused him to develop erectile dysfunction (ED). 

In 2015, after Mr. Webb reopened an earlier claim requesting disability benefits for his ED, a Regional Office (RO) of 

the VA issued a decision assigning Mr. Webb a noncompensable (i.e., zero percent) rating for his disability. At that 

time, the Schedule did not include a diagnostic code for ED. 

See 38 C.F.R. § 4.115b (2015).2 As a result, the RO rated 

Mr. Webb’s disability by analogy to diagnostic code (DC)

7522, which provides for a 20 percent disability rating for 

“[p]enis, deformity, with loss of erectile power.” Id.

DC 7522. With little discussion, the RO determined that 

Mr. Webb’s particular disability entitled him only to a noncompensable rating. See J.A. 774–75, 780. 

Mr. Webb appealed to the Board, which affirmed the 

RO’s determination. J.A. 13–20. The Board acknowledged 

that Mr. Webb’s disability had been rated by analogy, as 

provided for by 38 C.F.R. § 4.20, but explained that 

DC 7522 required Mr. Webb to show “deformity of the penis with loss of erectile power.” J.A. 18–19. Because 

Mr. Webb did not have such a deformity, the Board determined that he was not entitled to a compensable disability 

rating. J.A. 19 (“As no penile deformity has been shown, a 

separate compensable rating for erectile dysfunction under 

DC 7522 is not warranted . . . .”).

2 The Schedule has since been revised to provide for 

a zero percent, i.e., noncompensable, disability rating for 

ED alone. See 38 C.F.R. § 4.115b, DC 7522 (2021) (providing a zero percent rating for “[e]rectile dysfunction, with or 

without penile deformity”). The government properly notes 

that this revised version of DC 7522 does not apply to 

Mr. Webb’s case because nothing in the revised rule indicates that it was intended to apply retroactively. See

38 U.S.C. § 5110(g); see also Appellee’s Br. 7 n.3 (agreeing 

that the revised version of DC 7522 does not apply to 

Mr. Webb’s case).

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WEBB v. MCDONOUGH 5

The Veterans Court affirmed. In its brief opinion, the 

Veterans Court determined that a prior Veterans Court decision, Williams v. Wilkie, 30 Vet. App. 134 (2018), was “fatal to [Mr. Webb]’s argument.” Webb v. McDonough, 

No. 20-8064, 2021 WL 3625395, at *1 (Vet. App. Aug. 17, 

2021). The court explained its view that “[i]mplicit in the 

[c]ourt’s holding in Williams is that[,] when ED is rated under DC 7522, a claimant must establish a penile deformity 

to be entitled to” benefits, and thus that Mr. Webb’s argument “is foreclosed by” Williams. Id. at *2. 

Mr. Webb appeals. We have jurisdiction under

38 U.S.C. § 7292(c).

DISCUSSION

On appeal, Mr. Webb challenges the Veterans Court’s 

interpretation of 38 C.F.R. § 4.20. We review the Veterans 

Court’s interpretation of a regulation de novo. See

38 U.S.C. § 7292(c); Pickett v. McDonough, 64 F.4th 1342, 

1345 (Fed. Cir. 2023).

In its brief analysis affirming the Board’s conclusion 

that Mr. Webb was not entitled to benefits, the Veterans 

Court addressed neither the explicit requirements of § 4.20 

nor the Lendenmann factors. See Webb, 2021 WL 3625395, 

at *1–3. In other words, the court did not address whether 

the functions affected, anatomical location, and symptomatology of Mr. Webb’s condition are closely analogous to 

the functions affected, anatomical location, and symptomatology of the condition listed under DC 7522. The Veterans Court was not alone—indeed, at no point in 

Mr. Webb’s case, including before the RO and the Board, 

did any agency or court substantively discuss the text of 

§ 4.20 (or even the related guidance in Lendenmann) and 

analyze its application to Mr. Webb’s unlisted condition. 

Rather, instead of engaging with the explicit language of 

this regulation, the VA and the Veterans Court required 

Mr. Webb to strictly meet the requirements of DC 7522 as 

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6 WEBB v. MCDONOUGH

if he were being directly rated under that code. J.A. 18–19, 

774–76, 780; Webb, 2021 WL 3625395, at *1–2.

We conclude that the Veterans Court erred by requiring Mr. Webb, to be eligible for benefits, to show that his 

unlisted condition identically matched the criteria of the 

listed condition to which his condition was rated by analogy. In doing so, the Veterans Court imposed a requirement not stated in § 4.20, the sole regulation governing 

rating by analogy. We hold that, when rating by analogy 

under § 4.20, the VA must adhere to the requirements of 

that regulation. The listed disease or injury to which a veteran’s unlisted condition is being rated by analogy must be 

only “closely related,” not identical, to the unlisted condition. That regulation provides guidance for determining 

whether a listed condition is “closely related” to the unlisted condition: it is one “in which not only the functions 

affected, but the anatomical localization and symptomatology are closely analogous” to the unlisted condition. 

38 C.F.R. § 4.20; see also Lendenmann, 3 Vet. App. at 350–

51. Further, once the VA has concluded that a listed disease or injury is “closely analogous” to a veteran’s unlisted 

condition, we see no source of law directing the VA to withhold the rating based on the qualifying criteria associated 

with that listed disease or injury’s diagnostic code.

The regulatory text supports our conclusion. Section 4.20 provides that when “an unlisted condition is encountered,” the VA can rate that disability “under a closely 

related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous.” 38 C.F.R. § 4.20 (emphases 

added). The regulation thus contemplates that it will be 

applied to certain conditions that are unlisted, i.e., not 

identical to those that are listed and assigned a specific diagnostic code. When such an unlisted condition is encountered, the VA may choose a “closely related”—again, not 

identical—listed condition to which it will rate the veteran’s unlisted condition by analogy. As a matter of plain 

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WEBB v. MCDONOUGH 7

language, it would be nonsensical to require a veteran’s unlisted disability to precisely meet the criteria for a listed

disease or injury’s diagnostic code. After all, if a veteran’s 

condition did precisely meet the requirements of a listed 

condition, that condition could simply be rated under that 

listed condition’s diagnostic code; there would be no need 

to rate by analogy. See, e.g., Ulysses Copeland v. McDonald, 27 Vet. App. 333, 336 (2015) (“Where, however, a condition is listed in the schedule, rating by analogy is not 

appropriate.”). Concluding otherwise—and requiring a 

veteran’s unlisted condition to satisfy each of the criteria of 

a listed condition—would eviscerate the text and purpose 

of § 4.20, which explicitly allows for rating by analogy.

Our conclusion aligns not only with the regulatory text 

but also with Veterans Court precedent. In Stankevich 

v. Nicholson, for example, the Veterans Court determined 

that the Board erred by requiring a veteran with an unlisted condition to demonstrate that his disability satisfied 

each requirement of a listed condition to which his disability was being rated by analogy. 19 Vet. App. 470, 472–73

(2006). Specifically, the Board rated a veteran’s undiagnosed, chronic joint pain by analogy to DC 5003, for arthritis. Id. at 471. The Board found that the veteran could not 

be awarded benefits because he had not been diagnosed 

with arthritis, a requirement listed in the schedule for 

DC 5003. Id. at 472. The Veterans Court explained this 

was error, because “[t]he function affected, anatomical localization, or symptomatology of an undiagnosed illness 

cannot be analogous if the Board applies that rating criteria to require objective evidence of a diagnosed disability.” 

Id. Strictly applying the criteria of the analogous diagnostic code, the Veterans Court explained, was “arbitrary and 

capricious because the analogy is, at best, illusory.” Id.

at 472–73.

Similarly, in Lendenmann, the Veterans Court set 

forth factors that the Board must consider to determine 

which listed disease or injury is most analogous to the 

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8 WEBB v. MCDONOUGH

veteran’s unlisted condition. 3 Vet. App. at 350–51 (quoting 38 C.F.R. § 4.20). Lendenmann thus clearly contemplates that such an unlisted condition would, by definition, 

not perfectly match the symptoms of any one listed condition. Id.3

The Veterans Court determined it was bound by what 

it viewed as an implicit holding in Williams requiring a veteran seeking to be rated by analogy to DC 7522 to meet the 

criteria of that diagnostic code. Contrary to the Veterans 

3 And, as Mr. Webb highlights in his briefing, the 

Veterans Court has, in nonprecedential decisions, repeatedly concluded similarly in cases specifically involving rating by analogy to DC 7522. Appellant’s Br. 2 & n.4. For 

example, in Hernandez v. McDonough, No. 20-0665, 

2021 WL 3285043 (Vet. App. Aug. 2, 2021), the Veterans 

Court explained that “[u]nder an analogous rating code, 

the disability being rated is not expected to manifest all the 

objective criteria of the analogous rating.” Id. at *4 (citing 

Stankevich, 19 Vet. App. at 472). Similarly, in Ellis 

v. McDonald, No. 15-1264, 2016 WL 3541006 (Vet. App. 

June 29, 2016), the Veterans Court reversed the Board, 

stating that “the Board itself rated ED by analogy,” and 

“therefore a veteran [did] not necessarily have to show” all 

the requirements of the analogous diagnostic code. Id.

at *3 (cleaned up). In another example, the Veterans Court

vacated the Board’s decision in Wilkins v. McDonald, 

No. 13-3260, 2015 WL 9463256 (Vet. App. Dec. 28, 2015), 

explaining that, “[i]n its attempt to rate by analogy, it appears that the Board explains that Mr. Wilkins is not entitled to a compensable disability rating . . . because he fails 

to meet the requirements for a listed [condition].” Id. at *3. 

In the Wilkins court’s view, the Board’s “discussion [was] 

troubling because, if Mr. Wilkins had the symptoms of Diagnostic Code 7522, then rating by analogy would not be 

necessary.” Id.

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WEBB v. MCDONOUGH 9

Court’s conclusion, Williams requires no such thing. 

There, a veteran simply sought a rating under DC 7522, 

arguing that he had both ED and a deformity. Williams, 

30 Vet. App. at 135–36. The Williams court remanded for 

the Board to determine, in the first instance, whether the 

veteran’s internal deformity was indeed a “deformity” as 

contemplated by DC 7522. Id. at 138. In other words, the 

veteran in Williams explicitly claimed that he met each of 

the requirements of the diagnostic code under which he 

sought benefits. This case is readily distinguishable—all 

parties agree that Mr. Webb does not meet each of the requirements of DC 7522. That is, of course, why he seeks to 

be rated by analogy and not directly under a listed code. 

The government cites to Green v. West for the proposition that, “[o]nce a diagnostic code [is] assigned for an analogous rating . . . , application of the criteria and the ratings 

for that code [is] required.” 11 Vet. App. 472, 475 (1998); 

see Appellee’s Br. 11–12. In the government’s view, Green

counsels in favor of affirmance. But just as Williams does 

not support the government’s and Veterans Court’s position, neither does this one isolated sentence in Green. The 

context of this sentence is instructive. In Green, the VA 

had erroneously applied an outdated version of the Rating 

Schedule to a veteran’s case. Id. at 475. In the cited paragraph, the Veterans Court explained to the Board that, on 

remand, it had to apply the rating schedule as currently 

written, i.e., as amended, which would be more favorable 

to the veteran. Id. (“The [Board is] required to reevaluate 

the veteran’s claim using the amended rating schedule.”). 

In other words, this sentence in Green was not speaking 

broadly about how rating by analogy should be accomplished in all instances. Rather, properly taken in context, 

this statement simply informs the VA that, when determining which listed condition should be used to rate a veteran’s condition by analogy, it must apply the relevant 

version of the rating schedule. 

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10 WEBB v. MCDONOUGH

In this case, Mr. Webb seeks to have his unlisted condition rated by analogy under § 4.20, which explicitly does 

not require that he demonstrate that his condition is identical to a listed one. But no agency or court has yet appropriately applied the explicit requirements of § 4.20 to 

Mr. Webb’s case. Instead, the Veterans Court concluded 

that he is not entitled to benefits because his unlisted condition did not meet each of the criteria of a listed condition—a requirement not present in the words of the 

regulation. Because the Veterans Court thus misinterpreted the requirements of § 4.20, we vacate and remand

for that court to “suit the action to the word, the word to 

the action,”4—in other words, to reconsider Mr. Webb’s 

case under a proper understanding of § 4.20 as informed by 

this opinion. 

CONCLUSION

We have considered the government’s remaining arguments and find them unpersuasive. For the reasons above, 

we vacate the Veterans Court’s decision and remand for 

proceedings consistent with this opinion.

VACATED AND REMANDED

COSTS

Costs to appellant. 

4 WILLIAM SHAKESPEARE, HAMLET act 3, sc. 2, ll. 18–

19. 

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