BVA9501363 DOCKET NO. 93-03 522 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Honolulu, Hawaii THE ISSUES 1. Entitlement to service connection for shortening of the back ligaments. 2. Entitlement to service connection for arthritis of the hands. 3. Entitlement to service connection for arthritis of feet. 4. Entitlement to service connection for arthritis of the right shoulder. 5. Entitlement to service connection for arthritis of the knees. 6. Entitlement to service connection for bursitis and tendinitis of the right shoulder. 7. Entitlement to service connection for bursitis and tendinitis of the left shoulder. 8. Entitlement to service connection for right wrist tendinitis with cartilage breakdown. 9. Entitlement to service connection for left wrist tendinitis. 10. Entitlement to service connection for left elbow tendinitis. 11. Entitlement to service connection for right elbow tendinitis. 12. Entitlement to service connection for laryngitis. 13. Entitlement to service connection for shingles, other than as due to Agent Orange exposure. 13. Entitlement to an increased rating for arthritis of the lumbar spine with a history of compression fracture and arthritis of the left shoulder, currently evaluated as 10 percent disabling. 15. Entitlement to an increased rating for acne, currently evaluated as 10 percent disabling. 16. Entitlement to an increased (compensable) rating for a left inguinal hernia. 17. Entitlement to an increased (compensable) rating for bilateral hearing loss disability. 18. Entitlement to an increased (compensable) rating for hemorrhoids. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Mark D. Hindin, Counsel INTRODUCTION The veteran had active service from October 1959 to September 1989. This appeal arises from an August 1990, rating decision in which the regional office (RO) denied entitlement to service connection for some disabilities; and granted service connection for other disabilities, establishing compensable or noncompensable evaluations, as listed in the "Issues" section of this decision. In his notice of disagreement, the veteran wrote that: My appeal and Disagreement extend to disability compensation, dependency, hospitalization and treatment, vocational rehabilitation, education, insurance and other benefits applicable by law or regulation. To the extent this statement is a claim for additional benefits, such claim has not been developed and is referred to the RO for appropriate action and clarification. At a hearing before a hearing officer at the RO in February 1992, the veteran and his representative made statements which could be construed as dropping the issues of entitlement to service connection for shortening of back ligaments, and entitlement to an increased rating for arthritis of the lumbar spine and left shoulder. However, he subsequently made contentions at the hearing regarding his entitlement to those benefits and the Board will consider those issues in this decision. The veteran also made statements which could be construed as a claim of service connection for a bilateral hip disability. This issue has not been developed for appellate consideration and is referred to the RO for appropriate action. In statements on appeal, it appears to have been additionally asserted that service connection is warranted for residuals of exposure to Agent Orange, including shingles. Inasmuch as this issue is not inextricably intertwined with any issue on appeal, and has not been adjudicated by the RO, and as such, not developed for appellate consideration at this time, it is referred to the RO for appropriate action. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he developed shortening of the back ligaments; arthritis of the hands, feet, right shoulder, and knees; and bursitis or tendinitis of the shoulders, wrists, and elbows during service and that these disabilities may have developed as the result of a serious automobile accident in 1963. He further asserts that he developed shingles in Vietnam. He also contends that service connection for laryngitis is warranted because he was found to have that condition during service. The veteran maintains that he experiences ongoing pain in his low back and shoulder and that his symptoms have increased since service. He asserts that his left inguinal hernia has recurred with more severe symptoms than he experienced during service, and that it prevents him from performing heavy lifting. He also contends that his hearing loss disability makes it difficult for him to understand conversa-tions. In addition, he contends that he experiences constant hemorrhoids and acne. 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 the evidence is in favor of the grant of a separate 20 percent evaluation for the residuals of a lumbar fracture with arthritis, and a 10 percent evaluation for arthritis of the left shoulder; that the evidence supports a compensable evaluation for a left inguinal hernia, and that the preponderance of the evidence is against the grant of service connection for right shoulder bursitis, or for laryngitis, and is also against the grant an increased rating for acne, or a compensable evaluation for bilateral hearing loss disability, or hemorrhoids. It is also the decision of the Board that the veteran has not submitted well-grounded claims of service connection for shortening of the back ligaments; arthritis of the hands, feet, right shoulder, or knees; or for tendinitis and bursitis of the left shoulder, tendinitis of the right wrist with cartilage breakdown, tendinitis of the left wrist, tendinitis of the elbows; or for shingles. FINDINGS OF FACT 1. There is no credible current evidence of shortening of the back ligaments; arthritis of the hands, feet, right shoulder, or knees; or for tendinitis and bursitis of the left shoulder, tendinitis of the right wrist with cartilage breakdown, tendinitis of the left wrist, tendinitis of the elbows; or shingles. 2. The episode of right shoulder bursitis reported during service was acute and transitory. 3. Chronic right shoulder bursitis or tendinitis has not been demonstrated. 4. The episodes of laryngitis reported during service were acute and transitory. 5. Chronic laryngitis has not been demonstrated. 6. Residuals of a fracture of the lumbar spine are manifested principally by demonstrable deformity and slight limitation of motion. 7. Arthritis of the left shoulder is manifested by minimal X-ray findings and tenderness at the anterolateral acromion. 8. The veteran has had acne involving the head face and neck, without current findings, or extensive lesions or marked disfigurement. 9. A small, recurrent, remediable left inguinal hernia has been demonstrated. 10. The veteran has level II hearing loss in both ears. 11. The veteran has minimal external hemorrhoids without evidence of large or thrombotic, irreducible hemorrhoids, or excessive redundant tissue, evidencing frequent recurrences. CONCLUSIONS OF LAW 1. The veteran has not presented well-grounded claims for service connection for shortening of the back ligaments; arthritis of the hands, feet, right shoulder, or knees; or for tendinitis and bursitis of the left shoulder, tendinitis of the right wrist with cartilage breakdown, tendinitis of the left wrist, tendinitis of the elbows; or for shingles. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1131, 5107 (West 1991); 38 C.F.R. §§ 3.303, 3.307, 3.309 (1993). 2. Chronic right shoulder bursitis or tendinitis was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303 (1993). 3. Chronic laryngitis was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303 (1993). 4. A 20 percent evaluation for residuals of a fracture of the lumbar spine with arthritis is warranted. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. Part 4, Diagnostic Codes 5285, 5292 (1991). 5. A 10 percent evaluation is warranted for left shoulder arthritis. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. § 4.40, Part 4, Diagnostic Code 5003 (1993). 6. An evaluation in excess of 10 percent for acne is not warranted. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. § 4.20, Part 4, Diagnostic Code 7899-7806 (1993). 7. A 10 percent evaluation for a left inguinal hernia is warranted. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. Part 4, Diagnostic Code 7338 (1993). 8. A compensable evaluation for bilateral hearing loss disability is not warranted. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. Part 4, Diagnostic Code 6100 (1993). 9. A compensable evaluation for hemorrhoids is not warranted. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. Part 4, Diagnostic Code 7336 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Service Connection for Disabilities Other Than Right Shoulder Bursitis and Laryngitis. Under the provisions of 38 U.S.C.A. § 5107 the veteran has the initial burden of submitting evidence of well-grounded claims. If his claims are not well-grounded, the VA does not have jurisdiction to adjudicate those claims, and those claims must be dismissed. Boeck v. Brown, 6 Vet.App. 14 (1993). The United States Court of Veterans Appeals (the Court) has provided guidance as to what constitutes a well-grounded claim. The Court has held that claims of service connection must be accompanied by supporting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded. Tirpak v. Derwinski, 2 Vet.App. 609 (1992). In the instant case the veteran has failed to furnish such evidence. A claim is not well grounded where there is no medical evidence that the claimed condition is actually present. Rabideau v. Derwinski, 2 Vet.App. 141 (1992). The veteran has submitted what one examiner described as a "laundry list" of disabilities for which there is no medical evidence of their current existence. The veteran's claims of service connection for shortening of the back ligaments; arthritis of the hands, feet, right shoulder, or knees; or for tendinitis and bursitis of the left shoulder, tendinitis of the right wrist with cartilage breakdown, tendinitis of the left wrist, tendinitis of the elbows; and shingles fall into the category of claims for which there is no medical evidence of their current existence. A possible exception could be said to exist in the case of the veteran's claim of service connection for arthritis of the hands. On examination by a private physician in October 1990, the veteran reported that he "thought" he was getting arthritis over the left middle finger and complained of painful and swollen joints recently. The examiner then recorded, based on physical examination, that the veteran had osteoarthritis of several fingers but especially of the left middle finger, and assessed the veteran as having osteoarthritis. This evidence cannot serve to render the claim of service connection for arthritis of the hands well grounded. First, the physician's opinion appears to have been based solely on the history related by the veteran. There were no reported clinical findings or any indication of an X-ray examination. A diagnosis of osteoarthritis would require such an examination. 38 C.F.R. § 4.71, Diagnostic Code 5003. A medical opinion based solely on a history supplied by a veteran is of no probative weight. See, Reonal v. Brown, 5 Vet.App. 458 (1993). The Board also notes that there is no evidence of the claimed hand arthritis during service or within one year thereafter. As a lay person, the veteran would not be able to diagnose the conditions for which he is claiming service connection in himself, and credible medical evidence would be necessary to render his claims well-grounded. Grottveit v. Brown, 5 Vet.App. 91 (1991). Despite having undergone VA examination, examinations for VA , and having obtained his own private medical evaluations, the veteran has submitted no evidence that he currently has shortening of the back ligaments; arthritis of the hands, feet, right shoulder, and knees; tendinitis and bursitis of the left shoulder, tendinitis of the wrists and elbows; or shingles. The Board does note that the veteran has complained of some of the conditions at issue on private medical and chiropractic treatment. However, there is no objective clinical demonstration of these conditions. VA may have a duty to inform a veteran of the evidence necessary to render his claim well grounded. Robinette v. Brown, No. 93- 985 (U.S. Vet. App. Sept. 12, 1994) reconsideration granted in part (Oct. 21, 1994) (per curiam). In this case the veteran should have received such information through a VA claim form he completed in October 1989, and in the subsequent notices of rating decisions, statement of the case, supplemental statement of the case, and hearing officer's decision. II. Whether the Additional Issues are Well Grounded The Board finds that the veteran has presented well-grounded claims within the meaning of 38 U.S.C.A. § 5107, with regard to the issues other than those discussed in the preceding section of this decision. In this regard he has submitted evidence in support of those claims which renders them plausible. The Board also finds that VA has complied with its obligation to assist him with the development of those claims under the same code provision. At the hearing on appeal, the veteran asserted that some of his service medical records were missing. However, the RO has sought all available records. The available records are voluminous. III. Right Shoulder Bursitis and Tendinitis The service medical records contain a notation dated in July 1977, showing that the veteran was seen after reportedly pulling a muscle in the right shoulder. He complained of pain, but there was no limitation of motion. The impression was subscapular bursitis. There were no further findings referable to bursitis of the right shoulder during service. The veteran did not report such a disability in his report of medical history completed for separation from service in July 1989. This is a significant omission inasmuch as he did list at least 27 other disabilities or complaints. Likewise, right shoulder bursitis was not reported on examination for separation from service in July 1989. Following service the veteran was seen by a private physician in January 1990. At that time the veteran was found to have localized tenderness over the subdeltoid bursa of the right shoulder. The assessment was bursitis of the right shoulder. However, such a finding was not duplicated on VA examination in February 1990, or on orthopedic examination for VA in April 1992. On the latter examination, the veteran was found to have only slight tenderness at the anterolateral acromion bilaterally without any reported inflammation of the bursa. Service connection can only be granted for chronic disability due to injury or disease incurred in or aggravated by service, presumed to have been incurred in service, or shown to be etiologically due to service. In this case the veteran had a single finding of bursitis in the right shoulder following an injury in 1977. There were no additional findings during service and only an isolated post service finding in January 1990, without subsequent confirmation on more detailed examinations. The record does not demonstrate chronic bursitis of the right shoulder either during service or thereafter. The Board is unable to conclude on the basis of this record that chronic bursitis was incurred in service. There has also been no credible evidence of tendinitis of the right shoulder since service. IV. Laryngitis In July 1974, the veteran was reported to have had a cough for approximately 6 months. It was noted that he had smoked one pack of cigarettes a day for many years. In August 1974, the assessment was smokers cough versus bronchitis. Later that month it was noted that he had discontinued smoking and that his cough had diminished. The service medical records do not report similar complaints until September 1985, when he complained of hoarseness with some coughing for one month. The assessments included laryngitis. In July 1989, the veteran noted a chronic cough in the report of medical history completed for separation from service. On examination for separation from service in July 1989, there were no findings referable to laryngitis. In September 1989, the veteran reported that 4 years earlier he had experienced hoarseness and weakness of his voice. Within the previous six months he had noticed the onset of voice fatigue with frequent cough. The impression was normal vocal nodules and a reportedly normal chest X-ray examination. Following service the veteran was seen by a private physician in April 1991, when it was reported that he had been ill for approximately one week. His symptoms included a sore throat, hoarseness and stuffiness. The assessment was probable viral syndrome. He reported similar symptoms in September 1991, which were again attributed to an upper respiratory infection. This record shows that while the veteran did complain of hoarseness on a few occasions during service, and was noted to have laryngitis on one occasion, he has never been found to have chronic laryngitis. Similar findings on two occasions after service were attributed to acute upper respiratory infections. Chronic laryngitis was not found on VA examinations or examinations for VA. In the absence of evidence showing chronic laryngitis in service or thereafter, service connection for such a disability is not warranted. V. Residuals of a Lumbar Fracture with Arthritis The RO has evaluated the veteran's lumbar spine fracture with arthritis together with arthritis of the left shoulder under Diagnostic Code 5003; 38 C.F.R. § 4.71(a) (1993), and has granted a combined 10 percent evaluation under provisions which provide for such a rating where there is X-ray evidence of arthritic involvement of two or more major joint groups or two or more minor joint groups without limitation of motion or incapacitating exacerbations. The veteran has testified that his lumbar fracture was incurred in an automobile accident and that most of his treatment records are unavailable. The service medical records do contain a physical profile record dated in May 1963, in which it was reported that the veteran had a compression fracture of the first and second lumbar vertebrae and involving the spinous process of the first lumbar vertebra. On VA examination in February 1990, the veteran was reported to have a full range of motion in all of his joints. An X-ray examination was interpreted as showing slight narrowing of the first lumbar interspace with localized hypertrophic change. The relevant diagnosis was residuals of a lumbosacral spine fracture. On orthopedic examination for VA in April 1992, the examiner reported that the veteran could bend forward and bring his hands to within two inches of his toes, extend 20 degrees, and twist 90 degrees in each direction. The veteran was found to have a "little bit" of lumbar spine tenderness. An X-ray examination of the lumbar spine was interpreted as showing "a little bit" of disc space narrowing at the level of the first and second lumbar vertebrae with some osteophytes. Although the veteran's disability has been evaluated under the provisions of Diagnostic Code 5003, it could also be evaluated unde the provisions of Diagnostic Code 5285; 38 C.F.R. § 4.71(a), which provides for the evaluation of vertebral fractures on the basis of definite limited motion or muscle spasm, with the addition of 10 percent for demonstrable deformity of the vertebral body. Viewed in a light most favorable to the veteran, the most recent examination shows that he has slight limitation of motion of the lumbar spine. Such limitation of motion warrants a 10 percent evaluation under the provisions of Diagnostic Code 5292; 38 C.F.R. § 4.71(a). The X-ray findings, which are localized to the area of the original fracture, can be seen as showing vertebral deformity. Accordingly, it would be appropriate to grant a 10 percent evaluation for limitation of motion and an additional 10 percent for vertebral deformity with a resultant 20 percent evaluation for the back disability. There is no evidence of more than slight limitation of motion or other findings which would warrant more than a 20 percent evaluation for the lumbar spine disability. VI. Left Shoulder Arthritis Minimal degenerative changes of the left shoulder were initially demonstrated on an X-ray examination during service in September 1983. On the examination for VA in April 1992, the orthopedic examiner found that the veteran had a full range of motion in the left shoulder, but noted slight tenderness in the anterolateral acromion bilaterally. The examiner interpreted an X-ray examination as appearing normal, and added that he did not "really find too much in the way of significant pathology in the shoulders." Diagnostic Code 5003 provides for a 10 percent evaluation for each major joint where there is X-ray evidence of arthritis and demonstrable limitation of motion which would not meet the criteria for a compensable evaluation under the appropriate diagnostic code for limitation of motion of that joint. In view of the X-ray findings during service, and the fact that service connection has been established for arthritis of the left shoulder, the Board finds that there is X-ray evidence of arthritis of the left shoulder. Although there have been no explicit findings of limitation of motion, the finding of tenderness in the anterolateral acromion could be construed as a loss of function equivalent to limitation of motion. 38 C.F.R. § 4.40. Again viewed in a light most favorable to the veteran, it can be said that he has X-ray evidence of arthritis of a major joint with findings equivalent to limitation of motion which would be noncompensable under the Diagnostic Code relating to limitation of motion of a shoulder. 38 C.F.R. §§ 4.45 (1993). Therefore, a 10 percent evaluation is warranted for arthritis of the left shoulder. The veteran would not meet the criteria for an evaluation in excess of 10 percent under other schedular criteria. VII. Acne The veteran's acne has been rated by analogy to eczema under Diagnostic Code 7806; 38 C.F.R. § 4.118 (1993). Under that diagnostic code, a skin disease manifested by exfoliation, exudation or itching, if involving an exposed surface or extensive area warrants a 10 percent evaluation. The next higher evaluation, 30 percent, requires exudation or itching which is constant, with extensive lesions, or marked disfigurement. On treatment by his private physician in January 1990, the veteran was noted to be taking antibiotics for acne. The physician did not offer a description of the veteran's acne but did note that the disability was present. On VA examination in February 1990, the veteran had acne of the face, chest, and back without other findings referable to the skin. The veteran underwent a dermatologic examination for VA in April 1992. At that time the examiner could find no active lesions, but noted that there was visible acne scarring on the face and back. The scars were described as the "smaller, discrete, grouped type," cribriform in pattern. The examiner opined that the scars did not constitute a handicap for the veteran in his interaction with clients. It was felt no antibiotic treatment was needed. From this record it can be seen that the veteran's disability in no way meets or approximates the criteria for a 30 percent evaluation. Even at its reported worst, which occurred on VA examination in February 1990, he did not have exfoliation, exudation or itching. On the most recent VA examination active lesions were not present, and the visible acne scarring was not shown to constitute moderate or marked disfigurement. Accordingly, the Board must conclude that an evaluation in excess of 10 percent for acne is not warranted. 38 C.F.R. §§ 7800, 7806 (1993). VIII. Left Inguinal Hernia Inguinal hernias are evaluated under Diagnostic Code 7338, 38 C.F.R. § 4.114 (1993), which provides for a noncompensable evaluation where the hernia is small, reducible and without true hernia protrusion, or where it has not been operated on but is remediable. A 10 percent evaluation is provided where the hernia is recurrent, postoperative, readily reducible and well supported by a truss or belt. A small, postoperative recurrent, or unoperated irremediable, inguinal hernia, not well supported by truss, or not readily reducible, warrants a 30 percent evaluation. In this case the veteran did undergo surgery for a left inguinal hernia during service in August 1989. Since service, the only evidence of a recurrent inguinal hernia took place on treatment by the veteran's private physician in October 1990. At that time the veteran complained of some bulging and discomfort in the area of the hernia repair. The examiner noted that the veteran did have a left inguinal hernia but did not report any associated abnormal findings. The assessment was recurrent inguinal hernia. An inguinal hernia was not found on the VA examination in February 1990. On urology examination for VA in April 1992, physical examination revealed some bulging of the left inguinal hernia which the examiner described as a mild hernia. The summary assessment was mild left recurrent inguinal hernia. Further repair treatment was recommended only in the event the veteran's inguinal pain or bulging increased. The record establishes that the veteran has a small recurrent postoperative left inguinal hernia. As such, a 10 percent evaluation is warranted. There has been no demonstration of associated discomfort or bulging to a degree so as to clinically justify re-repair treatment. Moreover, the recurrent postoperative left inguinal hernia has not been shown to be irremediable so as to warrant a higher evaluation. IX. Bilateral Hearing Loss Disability Evaluations of bilateral defective hearing range from noncompensable to 100 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 audiometry tests in the frequencies 1,000, 2,000, 3,000 and 4,000 cycles per second. To evaluate the degree of disability from bilateral service-connected defective hearing, the revised rating schedule establishes eleven auditory acuity levels designated from level I for essentially normal acuity through level XI for profound deafness. 38 C.F.R. §§ 4.85 and 4.87, Diagnostic Codes 6100 to 6110 (1993). On the authorized audiological evaluation conducted in April 1992, and certified in May 1992, pure tone thresholds, in decibels, were as follows: Hertz 1,000 2,000 3,000 4,000 Average Right 15 15 25 50 26 Left 20 25 50 50 36 Speech audiometry revealed speech recognition ability of 88 percent in the right ear and of 84 percent in the left ear. These results equate to level II hearing loss in the right ear and level II hearing loss in the left ear. Under the provisions of Diagnostic Code 6100, such hearing loss warrants a noncompensable evaluation. Although the veteran has reported of subjective difficulties, his level of hearing loss disability is evaluated under the rating schedule at only a noncompensable level. X. Hemorrhoids Hemorrhoids are evaluated under Diagnostic Code 7336, 38 C.F.R. § 4.114 (1993). A noncompensable evaluation is provided under that diagnostic code for hemorrhoids which are mild or moderate. A 10 percent evaluation requires that there be hemorrhoids which are large or thrombotic, and irreducible, with excessive redundant tissue, evidencing frequent recurrence. Since service, the veteran's hemorrhoids were found to be most severe on VA examination in February 1990, when he was noted to have mild external hemorrhoids. More recently, on gastroenterology examination for VA in April 1992, he was noted to have an external anal skin tag. A flexible sigmoidoscopy revealed only internal hemorrhoids. The postoperative diagnosis was mild internal hemorrhoids. Findings during the dermatologic examination for VA in May 1992, including inspection of the anal ring and perianal region, did not show any lesions of clinical importance. A digital rectal examination was not performed. In short, there is no evidence of large or thrombotic hemorrhoids, which are irreducible, nor are there findings of excessive redundant tissue. In the absence of evidence showing more than minimal hemorrhoids, the Board is unable to conclude that a compensable evaluation is warranted. XI. General Considerations With Regard to Increased Ratings In reaching its conclusions in this case the Board has considered all of the provisions of Chapters 3 and 4 of 38 C.F.R. (1993). The Board has specifically considered the provisions of 38 C.F.R. § 3.321, pertaining to extra-schedular evaluations. However, the veteran's disabilities have not required frequent periods of hospitalization, or been shown to markedly interfere with employment, beyond the level contemplated by his schedular evaluations. Accordingly, the Board has found that his disability picture, is not so unusual as to render impractical the application of the regular schedular criteria. The Board has also considered the provisions of 38 C.F.R. § 4.7, which provides for assignment of the next higher evaluation where the disability picture more closely approximates the criteria for the next higher evaluation. As discussed above, the veteran's disabilities do not more closely approximate the criteria for the next higher evaluations. The Board has been unable to find a basis under any other regulation, which would permit the allowance of an increased rating for the veteran's service- connected disabilities beyond those granted in this decision. ORDER Having failed to submit evidence that they are well-grounded, the veteran's claims of service connection for shortening of the back ligaments; arthritis of the hands, feet, right shoulder, or knees; or for tendinitis and bursitis of the left shoulder, tendinitis of the right wrist with cartilage breakdown, tendinitis of the left wrist, tendinitis of the elbows; and for shingles are dismissed. Service connection for right shoulder bursitis and tendinitis, and laryngitis is denied A 20 percent evaluation for residuals of a fracture of the lumbar spine with arthritis and a 10 percent evaluation for arthritis of the left shoulder are granted, subject to the laws and regulations governing the payment of monetary awards. An increased, 10 percent, evaluation for a left inguinal hernia is granted, subject to the laws and regulations governing the payment of monetary awards. An increased rating for acne, and a compensable evaluation for bilateral hearing loss disability, and hemorrhoids are denied. U. R. POWELL 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.