BVA9506203 DOCKET NO. 93-08 619 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to service connection for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, a right and left toe disability, heart disability and blisters on the heels. 2. Entitlement to increased (compensable) evaluations for a post operative scar for a pilonidal cyst, defective hearing of the left ear, and a chalazion of the right eye. ATTORNEY FOR THE BOARD Nadine W. Benjamin, Counsel INTRODUCTION The veteran served on active duty from June 1971 to June 1991. This appeal comes to the Board of Veterans' Appeals (Board) on appeal from an April 1992 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that service connection is warranted for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, a right and left toe disability, heart disability and blisters on the heels, which he argues were incurred in service. He further argues that compensable ratings are warranted for his service-connected post operative scar for a pilonidal cyst, defective hearing of the left ear, and a chalazion of the right eye. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that on the issue of entitlement to service connection for right and left toe disability, the evidence is at least in equipoise, and thus, with the resolution of reasonable doubt in the veteran's favor, supports the veteran's claim of entitlement to service connection. The Board additionally finds that on the issues of entitlement to service connection for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, heart disability and blisters on the heels, the veteran has not submitted evidence of well grounded claims. The Board further finds that the preponderance of the evidence is against the veteran's claims of entitlement to compensable evaluations for his service-connected post operative scar for a pilonidal cyst, defective hearing of the left ear, and a chalazion of the right eye. FINDINGS OF FACT 1. On the issues of entitlement to service connection for right and left toe disability and increased evaluations for his service-connected post operative scar for a pilonidal cyst, defective hearing of the left ear, and a chalazion of the right eye, all relevant evidence for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The veteran has right and left toenail disability classified as onychomycosis, disability related to service. 3. The claims for service connection for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, heart disability and blisters on the heels are not plausible. 4. The veteran's scar due to removal of a pilonidal cyst is well healed; there is no impairment of function. 5. The veteran has Level I hearing in the left ear. 6. The veteran's chalazion of the right eye is asymptomatic; it is not shown to be disfiguring, and visual impairment is not shown. 7. The veteran's scar due to removal of a pilonidal cyst, defective hearing of the left ear and chalazion of the right eye do not present unusual or exceptional disability pictures. CONCLUSIONS OF LAW 1. Onychomycosis of the right and left toenails was incurred in service. 38 U.S.C.A. § § 1110, 1131, 5107 (West 1991). 2. The claims for service connection for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, heart disability and blisters on the heels are not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). 3. The criteria for an increased (compensable) evaluation for post operative scar for a pilonidal cyst have not been met. 38 U.S.C.A. § § 1155, 5107 (West 1991); 38 C.F.R. § § 3.321(b) and Part 4, Code 7805 (1994). 4. The criteria for an increased (compensable) evaluation for defective hearing of the left ear have not been met. 38 U.S.C.A. § § 1155, 5107 (West 1991); 38 C.F.R. § § 3.321(b) and Part 4, Code 6100 (1994). 5. The criteria for an increased (compensable) evaluation for chalazion of the right eye have not been met. 38 U.S.C.A. § § 1155, 5107 (West 1991); 38 C.F.R. § § 3.321(b) and Part 4, Codes 6009, 7800, 7803, 7804, 7805, 7819, 6009 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Right and Left Toe Disability Initially, the Board notes that on this issue, the veteran has submitted a well grounded claim within the meaning of 38 U.S.C.A. § 5107 (West 1991). That is, the Board finds that the veteran has presented claim that is plausible and capable of substantiation. The Board is also satisfied that all relevant evidence regarding the claim has been obtained, and that no further assistance to the veteran is required to comply with 38 U.S.C.A. § 5107(a) (1994). Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § § 1110, 1131 (West 1991). The veteran's April 1971 service entrance examination report shows no right or left toe abnormality. His service medical records show that the veteran underwent a periodic examination in December 1978, and tinea cruris, dermatophytosis pedis was noted. He was treated in 1979 for a sore toenail on the left foot. In 1983, he was seen for a loose great toenail of the right foot. The nail bed was noted to be slightly inflamed with infection. In 1985, he was treated for right toenail injury, and on examination, it was noted that the toenail was blue and it was ecchymosic behind the nail. No disability was noted at separation in March 1991; however on examination by the VA in August 1991, a mild fungal infection of the toenails, especially the big toe, was noted. Mild onychomycosis was diagnosed. The Board notes that the veteran was treated during service for problems with the right and left toes and the VA has diagnosed onychomycosis of the toenails. The Board finds that with the resolution of reasonable doubt in the veteran's favor, the evidence supports a finding that he has onychomycosis of the toenails related to service. Accordingly, service connection is warranted. II. Right Leg and Hip Disability, Residuals of Burns of the Left Arm, Pulled Muscle of the Right Shoulder, Left Eye Disability, Residuals of a Left Ankle Sprain, Residuals of Strained Muscle of the Left Side, Chronic Headaches, Chronic Sinusitis, Heart Disability and Blisters on the Heels. The threshold question to be answered on these issues is whether the veteran has presented evidence of well-grounded claims, that is, claims which are plausible and meritorious on their own or capable of substantiation. If he has not, his appeal on these issues must fail. 38 U.S.C.A. § 5107(a) (West 1991); Murphy v. Derwinski, 1 Vet. App. 78 (1990). The Board finds that the veteran's claims for service connection for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, heart disability and blisters on the heels are not well grounded, and there is no further duty to assist the veteran in the development of his claims. In August 1971, he complained of blisters on his heels causing problems when marching and running. Service medical records show that the veteran was treated during service for right leg pain in July 1983 and also for a hip problem in July 1973. In September 1978, he was treated for a 1st degree burn of the left arm. In May 1982, he complained of a pulled muscle in the right shoulder, and right shoulder pain in January 1984. He was treated in November 1977 for a swollen left eye and in November 1978 for a left eye stye with redness, swelling and tearing. In March 1983, he was treated after twisting his left ankle, and a sprain was noted. In January 1976 and March 1982, he complained of a pulled muscle of the left side of the back. He complained of headaches caused by stuffy sinuses in March 1982 and he also complained of headache in January 1985 along with upper respiratory symptoms. He also complained of sinus congestion in August 1982. At separation, he gave a history of sinusitis. The veteran had an abnormal Electrocardiogram (EKG) in March 1991; on follow-up in April 1991, probable bronchitis was found. With the exception of a history of sinusitis and an abnormal EKG and the diagnosis of intraventricular conduction delay, asymptomatic, no residual disabilities were noted on the veteran's separation examination report. Further there is no post-service medical evidence of the existence of any of the disabilities in question, and none, including sinusitis and/or a heart disorder, were found on the VA examination conducted in August 1991. In the absence of medical evidence of current disability, the claims of entitlement to service connection for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, heart disability and blisters on the heels are not plausible, and are, therefore, not well grounded. Where a determinative issue involves medical causation, competent medical evidence to the effect that the claim is plausible is required to establish that the claim is well grounded. Grottveit v. Brown, 5 Vet.App. 91, 93 (1993). However, there is no current medical opinion of record linking the above-noted claimed disabilities with service. III. Post Operative Scar for a Pilonidal Cyst, Defective Hearing of the Left Ear, and a Chalazion of the Right Eye. As a preliminary matter, the Board finds that these claims are well grounded within the meaning of 38 U.S.C.A. § 5107 (West 1991). That is, the Board finds that these claims are plausible and capable of substantiation. The Board is also satisfied that all relevant evidence regarding the claims has been obtained, and that no further assistance to the veteran is required to comply with 38 U.S.C.A. § 5107(a) (1994). In accordance with 38 C.F.R. § § 4.1, 4.2 (1994) and Schafrath v. Derwinski, 1 Vet.App. 589 (1991), the Board has reviewed the veteran's service medical records and all other evidence of record pertaining to the history these service-connected disabilities, and has found nothing in the historical record that would lead to a conclusion that the current evidence of record is not adequate for rating purposes. Moreover, the Board is of the opinion that this case presents no evidentiary considerations that would warrant an exposition of the remote clinical histories and findings pertaining to the disabilities at issue. Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule), found in 38 C.F.R. Part 4 (1994). The Board attempts to determine the extent to which the veteran's service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, and the assigned rating is based, as far as practicable, upon the average impairment of earning capacity in civil occupations. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. § § 4.1, 4.10 (1994). A. Post Operative Scar for a Pilonidal Cyst The RO granted service connection for post operative scar for a pilonidal cyst in April 1992, and a noncompensable rating was assigned. Under the Rating Schedule, scars are rated on limitation of function of the affected part. 38 C.F.R. Part 4, Code 7805 (1994). Superficial scars may be rated at 10 percent if they are tender and painful on objective demonstration or if they are poorly nourished with repeated ulceration. 38 C.F.R. Part 4, Codes 7803, 7804 (1994). While the veteran contends that his pilonidal cyst scar is tender and painful, this has not been shown by the objective clinical evidence of record. The Board notes that on examination by the VA in August 1991, the examiner reported that the veteran had a well healed scar in the pilonidal area. No sinus tract or discharge was noted. By way of history, the veteran reported that the condition flared up occasionally. The diagnosis notes the presence of a scar. The Board finds that an increased rating is not warranted since there is no showing of any limitation of function due to the scar, and pain and tenderness are not objectively shown. Further, there is no showing that the scar is poorly nourished with repeated ulceration. Additionally, the Board finds that no unusual or exceptional disability factors warranting extraschedular consideration have been presented. 38 C.F.R. § 3.321(b)(1) (1994). B. Defective Hearing of the Left Ear The RO granted service connection for defective hearing of the left ear in April 1992. The severity of hearing loss is determined, for VA benefits purposes, by comparison of audiometric test results with specific criteria set forth an 38 C.F.R. § 4.87a, Part 4 Diagnostic Codes 6100 thorough 6110 (1994). The schedule set forth at 38 C.F.R. § 4.87a (1994) establishes 11 auditory acuity levels, designated from Level I for mild hearing loss to Level XI for profound deafness. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4, 4.85, 4.87a, Diagnostic Codes 6100 through 6110 (1994). Evaluations of unilateral defective hearing range from noncompensable to 10 percent based on organic impairment of hearing acuity as measured by the results of controlled speech discrimination tests together with the average hearing threshold level as measured by pure tone audiometric testing in the frequencies 1,000, 2,000, 3,000 and 4,000 cycles per second. To evaluate the degree of disability from defective hearing, the rating schedule establishes 11 auditory acuity levels from numeric designations I through XI. In situations where service connection has been granted only for defective hearing involving one ear, and the veteran does not have total deafness in both ears, the hearing acuity of the nonservice-connected ear is considered a numeric designation of I. In such situations, the maximum 10 percent evaluation is assignable where hearing in the service-connected ear is at numeric designation X or XI. Tables found at the rating schedule provide the method for determining the current rating. 38 C.F.R. § 4.85 et seq., including Codes 6100, 6101 (1994). The results of the veteran's audiometric testing in August 1991 do not demonstrate that his defective hearing of the left ear is severe enough to warrant a compensable evaluation under the Rating Schedule. On examination, he was found to have a 22 decibel pure tone threshold average in the left ear and a 92 percent speech recognition score. When entered into Table VI of the Rating Schedule, a hearing impairment of Level I is found. Level I for the left ear and Level I for the nonservice-connected right ear, results in a zero percent evaluation for the service- connected left ear defective hearing, utilizing Table VII. 38 C.F.R. Part 4, Code 6100 (1994). The veteran's defective hearing of the left ear clearly fits the criteria for a noncompensable rating. Moreover, the Board finds that no unusual or exceptional disability factors warranting extraschedular consideration have been presented. 38 C.F.R. § 3.321(b)(1) (1994). The Board finds that an increased rating is not warranted. C. Chalazion of the Right Eye In April 1992, the RO granted service connection for a chalazion of the right eye, and assigned a noncompensable rating. This disorder is rated under the Rating Schedule as scars, based on disfigurement, pain etc. and also on impairment of visual acuity under Diagnostic Codes 7819 and 6009. 38 C.F.R. Part 4, Diagnostic Codes 6009, 7819 (1994). Under Diagnostic Code 7819, the veteran's disorder is rated as scars and a 10 percent rating would require a showing of moderate disfigurement, tenderness and pain on objective demonstration, repeated ulceration or limitation of function. 38 C.F.R. Part 4, Diagnostic Codes 7800, 7803, 7804, 7805 (1994). Under Diagnostic Code 6009, a compensable rating may be assigned if there is impairment of visual acuity or field loss, pain, rest requirements or episodic incapacity with a minimum of 10 percent for active pathology. When the veteran was examined by a private consultant in September 1991, it was noted that he had a subacute chalazion of the right lower lid which had been treated with topical antibiotics and hot compresses. It was noted that the remainder of the eye examination was unremarkable. Thus, there being no finding of disfigurement, pain, tenderness or visual impairment or other symptoms , the Board finds that the currently assigned noncompensable rating is proper under the Rating Schedule. No unusual or exceptional disability factors warranting extraschedular consideration have been presented. 38 C.F.R. § 3.321(b)(1) (1994). The Board finds that an increased rating is not warranted. ORDER Service connection for onychomycosis of the right and left toenails is granted. Evidence of well-grounded claims not having been submitted, the claims of entitlement to service connection for right leg and hip disability, residuals of burns of the left arm, pulled muscle of the right shoulder, left eye disability, residuals of a left ankle sprain, residuals of strained muscle of the left side, chronic headaches, chronic sinusitis, heart disability and blisters on the heels are dismissed. Increased (compensable) evaluations for a post operative scar for a pilonidal cyst, defective hearing of the left ear, and a chalazion of the right eye are denied. ROBERT E. SULLIVAN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.