BVA9508195 DOCKET NO. 93-16 387 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Boston, Massachusetts THE ISSUE Entitlement to an increased rating for bilateral trench foot, currently rated at 30 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Alberto H. Zapata, Associate Counsel INTRODUCTION The veteran served on active duty from November 1943 to December 1945. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that his service-connected bilateral trench foot disability is more severe than currently rated. The veteran's current symptoms are manifested by pain, swelling, and numbness in both feet; he cannot walk for long periods of time. 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 preponderance of the evidence is against an increased rating for the veteran's bilateral trench foot. FINDING OF FACT The veteran's bilateral trench foot has not resulted in more than moderate residual impairment. CONCLUSION OF LAW The criteria for a rating in excess of 30 percent for bilateral trench foot have not been met. 38 U.S.C.A. § 1155, 5107 (b) (West 1991); 38 C.F.R. § § 4.104, Diagnostic Code 7122 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, the Board notes that the veteran's claim for entitlement to an increased rating for his service-connected bilateral trench foot is well grounded according to 38 U.S.C.A. § 5107 (a); his claim is plausible and capable of substantiation. The Board is satisfied that all relevant facts have been properly developed and no further assistance to the veteran is required in order to comply with 38 U.S.C.A. § 5107 (a). The veteran was originally granted service connection for trench foot in 1947 and assigned a non-compensable rating under Diagnostic Code 7122. The RO granted an increase to 30 percent in a January 1993 rating decision. Relevant testimony from the veteran's hearing held at the RO in September 1992 includes his comments concerning chronic numbness of both feet; furthermore, upon physical activity, his feet are prone to swelling. The veteran has received treatment at both private and VA facilities. Of record is a July 1992 letter from Naren B. Sodha, M.D., of the Neurology Group in Worcester, Massachusetts, summarizing her assessment of the veteran. He was seen by Dr. Sodha for complaints of numbness in the feet and occasional sharp pain in the toes. Upon examination the doctor noted that vibration was impaired in both feet while position sense was present. Decreased extension of the great toes was found. The clinical impression was that the findings and symptoms were indicative of sensory neuropathy, while the history of the disability indicated a cold injury to both feet and legs related to the veteran's war service. A follow-up conduction study was recommended and the resulting report is of record. The electromyographic (EMG) study of the feet revealed mild changes of chronic denervation; no recordable H reflex or peroneal sensory nerve potential was found, bilaterally; conduction velocities were slow bilaterally. The conclusion resulting from the EMG test was mild abnormalities which indicated peripheral neuropathy (motor-sensory) in both feet. At a November 1992 VA examination of the veteran, the examiner noted that the veteran's trench foot has been a constant problem ever since his separation from service. The veteran presented with complaints of difficulty in walking due to a lack of sensation in the feet. The examiner noted that nerve conduction studies confirmed bilateral sensory neuropathy The examiner found that the feet exhibited good capillary refill; no dorsal pedis pulses were palpated, bilaterally; popliteal and tibial pulses were strong; no vibration or pin prick sensation was elicited from the toes to mid-calf; no edema was noted at the time of the examination. The resulting diagnosis was peripheral neuropathy and residuals of trench feet. In accordance with 38 C.F.R. § § 4.1, 4.2, 4.41 (injury cases) and 4.42 (1994) and Schafrath v. Derwinski, 1 Vet.App. 589 (1991), the Board has reviewed the service medical records pertaining to the history of bilateral trench foot. The Board has found nothing in the historical record which would lead it to conclude 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 which would warrant an exposition of the remote clinical histories and findings pertaining to the disability 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 (1992). The Rating Schedule is applied to the specific evidence contained in the veteran's claims file bearing in mind that the ratings represent the average impairment in earnings capacity resulting from the veteran's original in-service injury and its residuals in civil occupations. 38 C.F.R. § 4.1 (1994). Under the provisions of the rating schedule, a 30 percent rating is warranted for residuals of frozen feet manifested by persistent moderate swelling, tenderness, redness and related symptomatology of both feet. A 50 percent rating is warranted if the residuals of frozen feet are manifested by persistent severe symptoms and there was loss of toes. 38 C.F.R. § 4.104, Diagnostic Code 7122. In this case, the veteran has not suffered the loss of any of his toes due to his in-service cold injury disability nor has severe residual impairment been shown; therefore, a rating higher than his current rating of 30 percent is not warranted. ORDER An increased rating for bilateral trench foot is 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. CONTINUED ON NEXT PAGE) 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.