Citation Nr: 0004433 Decision Date: 02/18/00 Archive Date: 02/23/00 DOCKET NO. 98-12 507 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Detroit, Michigan THE ISSUE Entitlement to an increased evaluation for chronic atopic eczema, currently evaluated as 30 percent disabling. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Jason R. Davitian, Associate Counsel INTRODUCTION The veteran served on active duty from October 1953 to March 1955. This case is before the Board of Veterans' Appeals (BVA or Board) on appeal from a February 1998 rating decision of the Department of Veterans Affairs (VA) Regional Office in Detroit, Michigan (RO), which denied the benefit sought on appeal. In statements on appeal, the veteran's representative raised the issues of entitlement to additional separate service connection for disabilities of the ankle and respiratory system, claimed as secondarily due to the disability at issue. Such matters have not been adjudicated by the RO and are not inextricably intertwined with the increased rating issue on appeal. As such, they are referred to the originating agency for appropriate action. FINDING OF FACT The service-connected chronic atopic eczema has been clinically demonstrated to be systemic with involvement of several areas of the body, including the hands, ankles and arms, with bleeding indicative of skin ulceration, and healed excoriations. CONCLUSION OF LAW The criteria for an increased, 50 percent, rating for chronic atopic eczema have been met. 38 U.S.C.A. §§ 5107, 1155 (West 1991); 38 C.F.R. Part 4, Diagnostic Code 7806 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a preliminary matter, the Board finds that the veteran's claim for an increased rating is plausible and capable of substantiation and, thus, well grounded within the meaning of 38 U.S.C.A. § 5107(a). When a veteran submits a well- grounded claim, VA must assist him in developing facts pertinent to that claim. The Board notes that the veteran was afforded a VA dermatologic examination in December 1997. While records of VA outpatient treatment, as reported by the veteran in July 1997, are not of record, the Board notes that this decision awards the veteran the highest schedular rating assignable for the disability at issue. As such, no practical reason could be served by remanding the case to obtain those records. A remand is inappropriate where there is no possibility of any benefit flowing to the veteran. Soyini v. Derwinski, 1 Vet. App. 540 (1991). As such, the Board is satisfied that all available relevant evidence that may be obtained has been obtained regarding the claim, and that no further assistance to the veteran is required to comply with 38 U.S.C.A. § 5107(a). In accordance with 38 C.F.R. §§ 4.1, 4.2, and Schafrath v. Derwinski, 1 Vet. App. 589 (1991), the Board has reviewed the service medical records and all other evidence of record pertaining to the history of the veteran's service-connected disability. The Board has found nothing in the historical record that would lead to the conclusion that the current evidence of record is not adequate for rating purposes. The Board is of the opinion that this case presents no evidentiary considerations, except as noted below, that would warrant an exposition of the remote clinical history and findings pertaining to the disability at issue. Disability evaluations 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. 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; 38 C.F.R. §§ 4.1, 4.10. Regulations require that, where there is a question as to which of two evaluations is to be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The current 30 percent evaluation is warranted for eczema manifested by constant exudation or itching, extensive lesions, or marked disfigurement. A maximum 50 percent schedular evaluation is for assignment for eczema with ulceration, or extensive exfoliation or crusting, and systemic or nervous manifestations, or when exceptionally repugnant. 38 C.F.R. § 4.118, Diagnostic Code 7806. On VA dermatologic examination of the veteran in December 1997, it was reported as medical history that the veteran was receiving treatment for the disability at issue, had required hospitalization for the disorder on multiple occasions subsequent to service, and recently had a secondary infection of the ankles which caused his ankles and feet to swell. He reportedly was treated with antibiotics. Physical examination revealed the ankle skin was inflamed, and blood was noted around both ankles, both wrists and one arm. Healed excoriations from scratching were observed on his back, upper arms, and shoulder. The examiner commented the veteran had eczema in several areas of the body and that the excoriations were indications of generalized pruritus. The clinical diagnosis was severe, active, atopic dermatitis, disabling at times. X-rays of the ankles showed no osteomyelitis. The criteria for the next higher evaluation contemplates ulceration, extensive crusting, and systemic involvement. Such manifestations have been clinically established in the current appeal on VA examination in December 1997. In this regard, the Board finds that the objective demonstration of blood around both ankles, both wrists and one arm is consistent with ulceration. Healed excoriations from scratching on the back, upper arm and shoulder, indicative of pruritus, is consistent with extensive crusting. Moreover, a finding of systemic involvement is supported by the examiner's observation of involvement of "several areas of the body," including the ankles, arms and back. As the criteria for the next higher evaluation have been objectively demonstrated in a report of VA clinical examination of record, the Board finds that the evidence supports an increased, 50 percent, evaluation for eczema. This is the maximum schedular evaluation assignable for the disability at issue. The Board is required to address the issue of entitlement to an extraschedular rating under 38 C.F.R. § 3.321 only in cases where the issue is expressly raised by the claimant or the record before the Board contains evidence of "exceptional or unusual" circumstances indicating that the rating schedule may be inadequate to compensate for the average impairment of earning capacity due to the disability. See VA O.G.C. Prec. Op. 6-96 (August 16, 1996). In this case, consideration of an extraschedular rating has not been expressly raised. Further, the record before the Board does not contain evidence of "exceptional or unusual" circumstances that would preclude the use of the regular rating schedule. ORDER An increased, 50 percent, evaluation for chronic atopic eczema is granted, subject to the applicable laws and regulations governing the award of monetary benefits. U. R. POWELL Member, Board of Veterans' Appeals