BVA9500230 DOCKET NO. 93-07 023 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUES 1. Entitlement to an increased (compensable) evaluation for hemorrhoids. 2. Entitlement to an increased (compensable) evaluation for duodenal ulcer with history of gastroenteritis. REPRESENTATION Appellant represented by: Texas Veterans Commission ATTORNEY FOR THE BOARD T. Reichelderfer, Associate Counsel INTRODUCTION The veteran served on active duty from November 1961 to November 1991. This case arises from a rating decision of March 1992 from the Waco, Texas, Regional Office (RO). CONTENTIONS OF APPELLANT ON APPEAL The veteran contends, in essence, that the RO erred when it granted noncompen- sable disability ratings for hemorrhoids and duodenal ulcer. He specifically alleges that he has frequent recurrences of hemorrhoids with bleeding. He also alleges that he still has a duodenal ulcer, that it is painful, that he has recurrences one or two times per month, and that he takes antacids. DECISION OF THE BOARD The Board of Veterans' Appeals (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 files. 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 preponderance of the evidence is against his claim for a compensable rating for hemorrhoids. It is also the decision of the Board that the evidence favors granting a 10 percent disability rating for duodenal ulcer with history of gastroenteritis. FINDINGS OF FACT 1. All evidence necessary for an equitable disposition of the veteran's claim has been developed. 2. Hemorrhoids as manifested by small external hemorrhoids and intermittent bleeding is productive of no more than moderate disability. 3. A duodenal ulcer as manifested by gastrointestinal distress and pain is productive of no more than mild disability. 4. Neither an exceptional nor an unusual disability picture has been demonstrated that would render impractical the application of the regular schedular standards for rating hemorrhoids and duodenal ulcer. CONCLUSION OF LAW 1. The criteria for a compensable rating for hemorrhoids are not met. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. § 3.321(b)(1), Part 4, Diagnostic Code 7336. 2. The criteria for a 10 percent rating for duodenal ulcer with history of gastroenteritis are met. 38 U.S.C.A. §§ 1155, 5107(b) (West 1991); 38 C.F.R. § 3.321(b)(1), Part 4, Diagnostic Code 7305. REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, the Board finds that the veteran's claims are "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991); that is, plausible claims have been presented. The veteran has not indicated that relevant evidence of probative value may be obtained which has not already been associated with his claims folder. Accordingly, the Board finds that the duty to assist him, as mandated by 38 U.S.C.A. § 5107(a) (West 1991), has been satisfied. Service connection for disabilities classified as "hemorrhoids" and "duodenal ulcer with history of gastroenteritis" was granted by the RO in a rating decision dated in March 1992. A noncompensable rating was assigned for each disability following a review of the service medical records and the report of a Department of Veterans Affairs (VA) examination dated in January 1992. I. Entitlement to a compensable rating for hemorrhoids. The veteran contends that the evidence of record was not properly considered, that his hemorrhoids are more severe than currently evaluated, and that an increased rating is therefore warranted. After a review of the evidence of record, the Board finds that his contentions are not supported by the evidence, and that his claim fails. The severity of a disability from hemorrhoids is ascertained, for VA rating purposed, by application of the criteria set forth in Diagnostic Code 7336 of VA's Schedule for Rating Disabilities, 38 C.F.R. Part 4 (1993) (Schedule). Under these criteria, a rating greater than that currently in effect is warranted for irreducible, large or thrombotic hemorrhoids with excessive redundant tissue, evidencing frequent recurrences or for hemorrhoids with persistent bleeding and with secondary anemia or with fissures. The service medical records indicate that the veteran has a history of hemorrhoids. A military hospital report, dated in June 1988, notes bleeding hemorrhoids however physical examination notes no external hemorrhoids. The report of medical history and the report of medical examination, both conducted in August 1991 in conjunc-tion with the veteran's retirement, indicate external hemorrhoid. The report of a VA examination, dated in January 1992, indicates that the veteran complained of flare-ups once per month, and at the time of the examination, his hemorrhoids were asymptomatic. The report also notes that there were three small external hemorrhoids that were not thrombosed, however, they were slightly prolapsed. No rectal bleeding was noted. The Board notes that the evidence, most notably the report of the retirement examination in August 1991 and the report of the VA examination in January 1992, shows external hemorrhoids. The VA examination also noted that the hemorrhoids were slightly prolapsed. However, the VA examination report also notes that the hemorrhoids are not thrombosed, that there was no bleeding present, and the veteran indicated that they were asymptomatic at the time of the examination. While the veteran complains of frequent recurrences of his hemorrhoids with bleeding, the current medical evidence does not show that his hemorrhoids are large or thrombotic, irreducible, with excessive redundant tissue; or that there is persistent bleeding sufficient to cause anemia or fissures. Accordingly, the Board finds that the evidence shows that his hemorrhoids are no more than moderate in severity, and thus do not satisfy the criteria of Diagnostic Code 7336 for a compensable rating. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4, Diagnostic Code 7336. The Board also does not find that the veteran's hemorrhoids present such an exceptional or unusual disability picture, as would be manifested by marked interference with employment or by frequent periods of hospitalization, that would render impractical the application of the regular schedular standards. 38 C.F.R. § 3.321(b)(1) (1993). II. Entitlement to a compensable rating for duodenal ulcer. The veteran contends that he continues to have symptoms from his duodenal ulcer, that he takes antacids, and that his ulcer is more severe than contemplated by the noncompensable rating currently assigned. After a review of the evidence of record, the Board finds that a 10 percent rating is warranted. The severity of a disability from duodenal ulcer is ascertained, for VA rating purposed, by application of the criteria set forth in Diagnostic Code 7305 of VA's Schedule for Rating Disabilities, 38 C.F.R. Part 4 (1993) (Schedule). Under these criteria, a rating greater than that currently in effect is warranted for mild recurring symptoms once or twice yearly. Symptoms include, but are not limited to pain, vomiting, hematemesis (vomiting blood), melena (passage of dark stools), anemia, and weight loss. The service medical records show that the veteran was diagnosed and treated non surgically for a duodenal ulcer in 1975 and 1976. The radiographic report of an upper GI series, dated in January 1982, indicates that the stomach and duodenum do not show an intrinsic or extrinsic abnormality, and that no ulcer or duodenal cap deformity was seen. The report of medical history, dated in October 1987, indicates a history of duodenal ulcer and good results with Mylanta. The report of a military hospitalization, dated in June 1988, indicates some indigestion. The report of medical history, dated in August 1991 in conjunction with the veteran's retirement, notes the veteran had a duodenal ulcer 1975 and 1976, which was treated with Mylanta and resolved. The VA examination, dated in January 1992, does not indicated any complaints or findings related to a duodenal ulcer. A clinical record from a VA facility, dated in June 1992, indicates that the veteran complained of intermittent GI distress responding to antacids, with Mylanta II being prescribed. The Board notes that the service medical records show that the veteran's duodenal ulcer is healed, and the report of the VA examination in January 1992 does not show any complaints or findings related to the veteran's duodenal ulcer. However, the service medical records also show indigestion and the use of antacids. Additionally, the veteran stated in his substantive appeal that he continues to have pain that is relieved with antacids, and the VA clinical record of June 1992 indicates that the veteran was complaining of GI distress, with Mylanta being prescribed for relief. Since the evidence demonstrates that there are continued complaints of pain and distress that is relieved with antacids, and the veteran continues to take antacids, the Board finds, with application of the benefit of the doubt provisions of 38 U.S.C.A. § 5107(b) (West 1991), that he continues to have symptoms from his duodenal ulcer that may be characterized as mild. Accordingly, the veteran is entitled to a 10 percent disability rating for a duodenal ulcer under Diagnostic Code 7305. 38 U.S.C.A. §§ 1155, 5107(b) (West 1991); 38 C.F.R. Part 4, Diagnostic Code 7305. The Board does not find that the veteran's duodenal ulcer presents such an exceptional or unusual disability picture, as would be manifested by marked interference with employment or by frequent periods of hospitalization, that would render impractical the application of the regular schedular standards. 38 C.F.R. § 3.321(b)(1) (1993). ORDER An increased disability rating for hemorrhoids is denied. A 10 percent disability rating for duodenal ulcer with history of gastroenteritis is granted subject to the laws and regulations governing the disbursement of monetary benefits. LAWRENCE M. 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.