The Veteran's claim for a higher rating for his recurrent lower back strain to include IVDS prior to August 13, 2018 was granted. However, the claim for a rating in excess of 40 percent after that date was denied.

The Veteran's back disability, rated at 40 percent since March 14, 2022, is granted effective from that date.

The Veteran's claim for higher ratings for his service-connected back disability, bilateral lower extremity radiculopathies, and hypertension was denied. The rating for IVDS with bilateral facet arthropathy thoracolumbar spondylosis is not met as the evidence did not show forward flexion to 60 degrees or less, combined range of motion of 120 degrees or less, muscle spasm or guarding severe enough to result in an abnormal gait or spinal contour, or ankylosis (or its functional equivalent).,The Veteran's claims for higher ratings for his service-connected right and left lower extremity radiculopathies were not met as the evidence did not show at least moderate incomplete paralysis of the femoral nerve or sciatic nerve. The rating for hypertension was also denied.

The Veteran's claim for a higher rating for lumbosacral strain with IVDS from January 23, 2020 is denied. The claim for service connection for erectile dysfunction as secondary to major depressive disorder is granted. The Veteran is also entitled to SMC based on the loss of use of a creative organ.

The Board has determined that the Veteran is in need of personal care services for a minimum of six continuous months due to his inability to perform multiple activities of daily living and a need for supervision based on symptoms or residuals of neurological impairment. The decision also requires an evaluation of whether participation in the PCAFC program would be in the best interest of the Veteran.