BVA9501118 DOCKET NO. 93-08 241 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to an increased rating for bronchial asthma, currently evaluated as 30 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Brian J. Milmoe, Counsel INTRODUCTION The veteran served on active duty from April 1980 to March 1983. The schedular evaluation for the veteran's service-connected bronchial asthma was increased from 10 percent to 30 percent by action of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia, in November 1991. Due to the veteran's disagreement with the rating assigned, an appeal was initiated, the merits of which are herein addressed. CONTENTIONS OF APPELLANT ON APPEAL It is contended by the veteran, in substance, that a 60 percent schedular rating is for assignment for her bronchial asthma on the basis of asthmatic attacks occurring 2-3 times weekly, use of multiple medications with little or no relief resulting, and marked dyspnea on exertion. Her employment in an unspecified job reportedly was curtailed "for a while," reportedly because of her breathing difficulties. DECISION OF THE BOARD The Board of Veterans' Appeals (BVA or 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(s). Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of BVA that a preponderance of the evidence is against the veteran's claim for increase for bronchial asthma. FINDINGS OF FACT 1. The veteran's bronchial asthma is at present not more than moderate in degree, without frequent attacks occurring once or more weekly, marked dyspnea on exertion between attacks, or more than light manual labor precluded. 2. An exceptional or unusual disability picture is not shown to be associated with the veteran's bronchial asthma. CONCLUSION OF LAW The schedular and extraschedular criteria for the assignment of an increased rating for bronchial asthma have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.96, and Part 4, Code 6602 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION At the outset, BVA finds that the veteran's claim for increase is "well-grounded" within the meaning of 38 U.S.C.A. § 5107(a). That is , she has presented a claim which is plausible. As well, BVA concludes, following a review of the record, that all relevant facts have been properly developed and that no useful purpose would be served by remanding the case to the RO for additional action. Accordingly, VA has no further obligation to assist the veteran in the development of facts pertinent to this case. Disability evaluations are determined by the application of a schedule of ratings which is based on the average impairment of earning capacity. 38 U.S.C.A. § 1155. For the assignment of a 60 percent evaluation, bronchial asthma must be severe in degree, with frequent attacks of asthma (one or more attacks weekly), marked dyspnea on exertion between attacks with only temporary relief by medication, and more than light manual labor precluded. 38 C.F.R. Part 4, Code 6602. Moderate bronchial asthma, with rather frequent attacks (separated by only 10-14 day intervals) and moderate dyspnea on exertion between attacks, warrants a 30 percent evaluation. Service connection for bronchial asthma was established by the RO in a rating decision of August 1984, at which time a 10 percent rating was assigned under Diagnostic Code 6602 of the VA's Schedule for Rating Disabilities. Service medical records reflect that the veteran was treated for variously diagnosed respiratory difficulties between October 1981 and January 1982; findings from a VA medical examination in March 1984 culminated in a diagnosis of bronchial asthma. Treatment records developed since December 1988 denote multiple exacerbations of the veteran's asthma, but there has been no showing that she has suffered an asthmatic attack one or more times weekly since 1988. Those attacks for which she sought treatment were noted to include wheezing of the lungs and dyspnea on exertion. In the midst of an exacerbation of her asthma in January 1989, she reported to a VA medical provider that, although she was experiencing dyspnea on taking 3-4 steps, she was fine between attacks. There was a point in February 1990 that the veteran's dyspnea on exertion was described as chronic, but subsequently compiled reports in no way demonstrate the continued presence of dyspnea during periods in which her asthma was not exacerbated. In August 1990, it was noted by a treating physician that the veteran's wheezing and dyspnea were easily relieved by medication; in February 1991, when pulmonary function studies were interpreted as being normal, it was indicated that the veteran had been doing well in the previous six months and that her asthma was clinically stable. No recent asthma attacks were noted in June 1991, although exacerbations of asthma necessitated treatment in July and August 1991. When hospitalized in January 1992 for management of unrelated disability, it was recorded for clinical purposes that it had been more than one month since the veteran had suffered an asthma attack. On the occasion of a VA medical examination March 1992, the veteran voiced complaints of wheezing, increasingly poor exercise tolerance, and easy fatigability. She reportedly was utilizing various medications for control of her asthma, in addition to a home breathing machine. She was noted to be in obvious respiratory distress, and although the lungs were clear to auscultation and percussion, significant expiratory wheezing was present in all lung fields. No rhonchi or crackles were appreciated. Pulmonary function studies in April 1992 disclosed a forced vital capacity that was 64 percent of predicted normal and a forced expiratory volume of one second of 54 percent of normal. When examined in April 1992, she characterized her primary complaints as wheezing and shortness of breath. Only mild respiratory distress was in evidence, as manifested by tachypnea and hyperpnea. The lungs were resonant, there was normal tactile fremitus, and her breath sounds were vesicular in type, without rales or rhonchi. There was no delay in the expiratory phase of respiration. Regarding the contentions advanced by the veteran as to the current severity of her service-connected respiratory disorder, BVA notes that she has produced no supporting evidence that her asthma has adversely affected her ability to maintain employment. She has indicated only vaguely that for some unspecified period she was forced to discontinue her job, also unspecified, "for a while" because of her asthma. No examining or treating physician or other qualified medical professional has opined that the veteran's asthma precludes the performance of job duties requiring more than a light level of exertion. Similarly, she has offered no supporting evidence that her asthmatic attacks are occurring 2-3 times weekly and the clinical evidence presented in no way substantiates such claim or her assertion that she is bothered by marked dyspnea on exertion between asthma attacks. While it is shown that use of multiple medications is required for management of her symptomatology, treatment have specifically found that her prescribed medication regimen easily controls her symptoms. In all, credible evidence demonstrating an increased level of severity of the veteran's asthma beyond that contemplated by the currently assigned 30 percent evaluation has not been presented. Also, it is not shown that the disability in question has resulted in an exceptional or unusual disability picture, with there being a marked interference with employment or frequent periods of hospitalization for treatment of her asthma, such as to warrant the assignment of an increased rating on an extraschedular basis. Accordingly, the instant appeal must be denied. ORDER An increased rating for bronchial asthma is denied. BRUCE KANNEE 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.