Citation Nr: 0003241 Decision Date: 02/09/00 Archive Date: 02/15/00 DOCKET NO. 94-21 871A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Houston, Texas THE ISSUES 1. Entitlement to an evaluation in excess of zero percent for hypertension prior to June 16, 1997. 2. Entitlement to an evaluation in excess of 10 percent for hypertension since June 16, 1997. 3. Entitlement to an evaluation in excess of 10 percent for asthma prior to January 22, 1999. 4. Entitlement to an evaluation in excess of 30 percent for asthma since January 22, 1999. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD K. K. Enferadi, Associate Counsel INTRODUCTION The veteran had active service from June 1979 to September 1992. This matter arises before the Board of Veterans' Appeals (Board) from a July 1993 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) that granted service connection for hypertension and assigned a zero percent rating effective from September 30, 1992, and granted service connection for asthma and assigned a 10 percent rating effective from the same date. The Board notes that during the pendency of this appeal in the December 1997 rating decision, the RO increased evaluation for the veteran's hypertension from zero percent to 10 percent, effective from June 16, 1997. Further, as to the veteran's asthma, in the rating decision dated in June 1999, the RO increased the rating from 10 percent to 30 percent, effective from January 22, 1999. However, since the rating criteria provide for a higher evaluation for these disabilities, the appeal is continued. Where there is no clearly expressed intent to limit an appeal, the RO is required to consider entitlement to all available ratings for that condition. AB v. Brown, 6 Vet. App. 35 (1993). FINDINGS OF FACT 1. Prior to June 16, 1997, the veteran's hypertension was evidenced by such readings as 150/90; 130/82; and 146/86; it was noted that he was not on medication. 2. On examination in June 1997, it was noted that the veteran was on medication for his hypertension; since June 16, 1997, the veteran's hypertension is manifested by diastolic readings that most recently ranged from 80 to 99, and no systolic reading above 170; the most recent blood pressure was noted at 143/86. 3. Prior to January 22, 1999, the veteran's asthma was manifested by intermittent symptoms, suspected bronchitis, and increased allergies. 4. After January 22, 1999, the veteran's asthma was symptomatic of mild to moderate symptomatology, such as upper respiratory difficulties, including wheezing and mild dyspnea. CONCLUSIONS OF LAW 1. The schedular criteria for a compensable evaluation for hypertension prior to June 16, 1997 have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. § 4.104, Diagnostic Code 7101 (1996); 38 C.F.R. § 4.104, Diagnostic Code 7101 (1999). 2. The schedular criteria for an evaluation in excess of 10 percent for hypertension since June 16, 1997 have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. § 4.104, Diagnostic Code 7101 (1996); 38 C.F.R. § 4.104, Diagnostic Code 7101 (1999). 3. The schedular criteria for an evaluation in excess of 10 percent for asthma prior to January 22, 1999 have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996); 38 C.F.R. § 4.97, Diagnostic Code 6602 (1999). 4. The schedular criteria for an evaluation in excess of 30 percent for asthma since January 22, 1999 have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996); 38 C.F.R. § 4.97, Diagnostic Code 6602 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION Background A review of the record reveals that the RO granted service connection for hypertension and asthma in a July 1993 rating decision. At that time, the RO assigned a zero percent evaluation for the veteran's hypertension, effective from September 30, 1992 based on findings of elevated blood pressure beginning in 1989 and a subsequent diagnosis of hypertension with a blood pressure reading of 155/90. The 10 percent evaluation for asthma was primarily based on records of treatment for asthma beginning in 1989. VA outpatient records that date from 1981 to 1992 are of record. Records prior to 1989 are not relevant to the veteran's current claims. Overall, the veteran continued to complain of difficulty with breathing. In a June 1989 record, the examiner reported a three-month history of asthma and diagnosed reactive airway disease. The veteran was issued a nebulizer and prescribed Terbutaline and Cromolyn. An Allergy Service conducted laboratory tests in December 1991, the report of which discloses that FEV 1.0 was not reached. In a March 1992 VA clinical record, the veteran reported difficulties with breathing and reportedly had been hospitalized recently for an asthmatic attack. The veteran had signs of wheezing and coarseness in his chest. Asthma was diagnosed. The blood pressure reading at that time was 130/82. VA examination conducted in December 1992 revealed normal breath sounds with a few rhonchi basilar bilaterally. The veteran reported that he was hospitalized in February 1992 for one week for his asthma and that he had been treated in the emergency room several times. The veteran also stated that he had undergone pulmonary function tests. The diagnosis rendered at that time was intermittent symptomatic asthma. By way of history, the veteran indicated that he had been monitored for elevated blood pressure in November 1991 but that he did not need any medication. The pertinent diagnosis was hypertension, mild. He was urged to reduced salt intake and weight. VA outpatient records dated from March to May 1993 reveal continued complaints related to the veteran's asthma. The veteran was advised to continue with inhalers. The veteran also was diagnosed with suspected bronchitis. Medications included Ventolin, Azmacort, Methocarbamol, and Motrin. Blood pressure readings during that period of time ranged from 132/90 to 138/56. During a general VA examination conducted in September 1994, the examiner recited the veteran's past medical history. It was noted that he had been diagnosed with hypertension but that he had never had to be treated. It was also noted that since the prior examination, the veteran's symptomatology related to his asthma had changed. He reported that the veteran attended the allergy clinic regularly for multiple allergy symptoms and that he had been treated on two occasions in the emergency room. The veteran complained of shortness of breath on exertions, frequent wheezing during the fall and spring seasons, and nocturnal dyspnea. The veteran was taking Azmacort and Proventil at that time. On examination, the examiner noted a blood pressure of 146/86 without distress, cyanosis, or clubbing. The lungs were clear without wheezes, rhonchi, or rales. There was no prolongation of the expiratory phase. However, the examiner noted that such findings did not preclude different auscultation findings when the veteran's asthma was exacerbated. Pertinent diagnoses rendered included intermittent asthma, symptomatic, multiple allergies, and hypertension. VA lung test administered in November 1994 revealed that pre-use of bronchodilators, FEV1/FVC actual percentage was 80 and predicted percentage was 82. Post-test comments were to the effect that use of bronchodilators was not indicated with that test. A report from VA examination dated in June 1997 reveals that the veteran was taking medication for hypertension and continued to take Terfenadine, Azmacort, and use albuterol inhalers. The veteran reportedly was on a prednisone taper in 1996 when he was evaluated in the emergency room for increased symptomatology of asthma. The veteran further reported that he had not been hospitalized for asthma since his discharge from service, but continued to experience wheezing and nocturnal dyspnea that required him to sit up and use the inhaler. The veteran also reported that he had been treated on an emergency basis four times in the past year and had frequent upper respiratory infections associated with his breathing problems. On examination, the veteran's blood pressure reading was 165/88 post-medication. There was no cyanosis or clubbing. Further, the examiner noted that the veteran had mild to moderate dyspnea on exertion. Auscultation of the lungs revealed occasional basilar wheezes and mild prolongation of the expiratory phase. Pertinent diagnoses rendered were asthma, intermittently symptomatic with multiple allergies and hypertension on medication. It was the examiner's opinion that the veteran's disorders had not changed since the prior examination. However, also noted is that upon a thorough review of the veteran's records, he had a persistent cough and upper respiratory infection that was treated with antibiotics. Interpretation from a contemporaneous pulmonary test revealed normal physiology with a diagnosis of asthma. A VA medical record dated in January 1999 reveals that the veteran complained of exacerbated symptoms of asthma and elevated blood pressure readings. He reported that three weeks earlier, he was treated for his symptoms and given steroids. The veteran reported that he measured his blood pressure through the use of a home machine and noticed that readings were more elevated at night. The veteran reported readings of 150/100; otherwise, 140/90. No complaints of chest pain, shortness of breath, or nasal discharge were noted at that time. On examination, the examiner noted a blood pressure of 143/89, that the chest was clear to auscultation, and that there were no wheezes or sinus tenderness. The diagnoses rendered were asthma/allergic rhinitis and hypertension. The examiner recommended that the veteran continue with the same medications for his asthma and with Metoprolol twice daily and increased the dosage of Verapamil. During VA examination conducted in February 1999, the examiner recited the veteran's past medical history in detail with regard to both his asthma and upper respiratory difficulties and as to the veteran's history of hypertension. The examiner reported that the veteran had mild dyspnea, probably due to obesity. Blood pressure taken at that time was 170/92. The veteran's lungs were clear without wheezes, rhonchi, or rales. Pertinent diagnoses rendered were asthma with frequent asthmatic attacks with worsening of the condition since the veteran's last examination. The examiner noted that the veteran's physical and lung examination at that time were normal, which was well possible between the attacks. Further, the veteran was diagnosed with poorly controlled hypertension. Also dated in February 1999 are two VA progress notes indicative of treatment for upper respiratory problems. During the first visit, the veteran's blood pressure reading was 160/92. On examination, the examiner noted wheezing respiration with cough and diagnosed an upper respiratory tract infection with asthma exacerbation and possible bronchitis. Appropriate antibiotic medication was given. Also, as to the medication for hypertension, the examiner noted that the veteran should stop taking Metoprolol and increase the Verapamil. During the second visit, one day later, the veteran was treated in urgent care for complaints of difficulties with breathing. The veteran was coughing up white and brown phlegm. VA clinical entries dated in March 1999 disclose that the veteran received weekly immunotherapy for multiple allergies that have been implicated in his moderately severe asthma. The veteran reported that since his last exacerbation the previous month, his symptoms had not improved. In between time, the veteran reportedly was seen by a private physician, unable to get appointments with VA. He was given an albuterol inhaler, a prescription for an air pump, a mixing chamber and nebulizer, and a Medrol dose pack. The veteran was on the fourth day of this corticosteroid treatment. As to the veteran's blood pressure at that time, he had been monitoring himself and reported twice daily readings of 138/80; 140/90; 138/92; 158/95; 140/82; 122/84; 131/91; 102/68; 124/92; 152/96; 155/98; and 140/99 representative of a 6-day period. Two days later, the veteran was again seen for progress, at which time the veteran's blood pressure was 144/84. Noted in the report is that one out of six diastolic readings in the last six days was over 100. As to the veteran's lungs, on forced expiration, there was no wheezing in the veteran's lungs. The examiner discontinued the Azmacort and added Flovent twice daily and increased the medication for the veteran's hypertension. A pulmonary test dated in March 1999 discloses that bronchodilators were not indicated. FEV-1/FVC percentages were noted as actual of 83.22 percent and predicted at 81.69 percent. An urgent care noted dated in April 1999 reveals blood pressure of 143/66. Analysis The veteran contends that he is entitled to increased evaluations with respect to his service-connected disabilities of hypertension and asthma. Initially, the Board notes that a claim placed in appellate status by disagreement with the initial rating award and not yet ultimately resolved is an original claim as opposed to a new claim for increase. Fenderson v. West, 12 Vet. App. 119 (1999). In such cases, separate ratings may be assigned for separate periods of time based on the facts found, a practice known as "staged" ratings. Id., slip. op. at 9. Thus, the record in its entirety will be reviewed in making a determination on the veteran's current claims. Id. Disability evaluations are determined, as far as practicable, upon the average impairment of earning capacity attributable to specific injuries or combination of injuries coincident with military service. 38 U.S.C.A. § 1155; 38 C.F.R. § 4.1 (1999). Each disability must be viewed in relation to its history with an emphasis placed on the limitation of activity imposed by that disability. 38 C.F.R. § 4.1. The degrees of disability contemplated in the evaluative rating process are considered adequate to compensate for loss of working time due to exacerbation or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. VA law states that upon careful consideration of all ascertainable and collected data, if a reasonable doubt arises concerning service origin, the degree of disability, or any other relevant matter, such doubt will be resolved in favor of the veteran. 38 U.S.C.A. § 5107(b); 38 C.F.R. §§ 3.102, 4.3 (1999). Further, where there is a question as to which of two evaluations applies to the veteran's disability, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower evaluation will be assigned. 38 C.F.R. § 4.7 (1999). Hypertension Hypertension is evaluated under 38 C.F.R. Part 4, Diagnostic Code 7101 (1999). During the course of this veteran's appeal, the rating criteria associated with diseases of the cardiovascular system were amended effective on January 12, 1998. Pursuant to Karnas v. Derwinski, 1 Vet. App. 308, 311, (1991), where a law or regulation changes after the claim has been filed or reopened before an administrative or judicial process has concluded, the version most favorable to the veteran applies unless Congress provides otherwise, or permits the VA Secretary to do otherwise. As to the regulations currently in place, a rating of 10 percent is assigned where the diastolic pressure predominantly remains at 100 or more, or where the systolic pressure primarily remains at 160 or more; or, the veteran has a history of a diastolic pressure of 100 or more and requires continuous medication for control. To warrant the next higher rating of 20 percent, the veteran must demonstrate a diastolic pressure predominantly at 110 or more, or a systolic pressure predominantly of 200 or more. A rating of 40 percent requires evidence of a diastolic pressure of 120 or more. The maximum rating of 60 percent is assigned where there is evidence of diastolic pressure predominantly 130 or more. 38 C.F.R. § 4.104, Diagnostic Code 7101 (1999). Pertinent note following said regulations: Note 1: Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90 mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160 mm. or greater with a diastolic blood pressure of less than 90 mm. Id. Prior to the effectuated regulatory changes that pertain to hypertensive vascular disease, a 10 percent rating is merited with diastolic pressure predominantly 100 or more; a 20 percent rating for diastolic pressure predominantly 110 or more with definite symptoms; a 40 percent evaluation for diastolic pressure predominantly 120 or more and moderately severe symptoms; and a maximum of 60 percent for diastolic pressure predominantly 130 or more and severe symptoms. 38 C.F.R. § 4.104, Diagnostic Code 7101 (1996). Pertinent notes that follow the regulations include that for the 40 percent and 60 percent ratings under Diagnostic Code 7101, careful attention to diagnosis and repeated blood pressure readings is needed. Also, when continuous medication is necessary for the control of hypertension with a history of diastolic blood pressure predominantly 100 or more, a minimum of 10 percent will be assigned. Id. As an initial matter, the regulations that pertain to hypertension, both those prior to the amendments and those afterward essentially have few distinctions. The new criteria provide for an evaluation based on systolic pressure as well as diastolic pressure and do not require a showing of "definite symptoms," "moderately severe symptoms," or "severe symptoms." See supra 38 C.F.R. § 4.104, Diagnostic Code 7101 (1999). In this veteran's case, with respect to entitlement to an evaluation in excess of zero percent for hypertension before June 16, 1997, based on the pertinent clinical data of record, the evidence does not support a rating above zero percent prior to June 16, 1997. Such determination is based on both the rating criteria prior to the regulatory change and post-amendment. 38 C.F.R. § 4.104, Diagnostic Code 7101 (1996); 38 C.F.R. § 4.104, Diagnostic Code 7101 (1999). Essentially, the veteran's diastolic pressure did not remain predominantly at 100 or more, there was no reading of systolic pressure at 160 or more, or the need for medication for control with a history of diastolic pressure of 100 or more. From the period extending from March 1992 to June 1997, the veteran's reported diastolic pressure measured at ranges from 56 to 90. A diastolic pressure reading of 88 in June 1997 was noted to be post-medication. Nonetheless, the above blood pressure readings neither demonstrate a predominant diastolic reading of 100 or more nor is the clinical evidence of record indicative of a history of such readings with medication required for control until June 1997. Further, the record is unclear as to when the veteran first began taking medication to control his hypertension, given that the first mention of such appears in the June 1997 record. Thus, under either criteria, the former or the latter, the veteran's rating with respect to his hypertension does not merit an evaluation in excess of zero percent prior to June 16, 1997. Id. As to an evaluation greater than 10 percent for hypertension since June 16, 1997, the record equally does not support an increased evaluation. Specifically, in January 1999, the veteran complained of elevated blood pressure readings and reported readings of 150/100, primarily at night and otherwise, 140/90. On examination, as indicated above, the reading was 143/89. Thereafter, the blood pressure reading during the February 1999 examination was 170/92. In the March 1999 clinical entry, the veteran reported that he monitored his blood pressure twice daily and diastolic readings ranged from 68, 80, 90, 92, 95 and up to 99, representative of a 6-day period. On examination, the blood pressure was noted at 144/84 and shortly thereafter, was measured at 143/64. Thus, in light of these clinical findings, the veteran does not warrant an evaluation in excess of the current 10 percent since June 16, 1997 under either rating criteria. Id. Overall, the veteran has not provided evidence of diastolic pressure predominantly 110 or more with definite symptoms, as required under the former regulations for a 20 percent evaluation. See 38 C.F.R. § 4.104, Diagnostic Code 7101 (1996). Further, the veteran has not submitted competent evidence of diastolic pressure predominantly at 110 or more, or a systolic pressure predominantly of 200 or more. In fact, there are no systolic pressure readings of record that reach 200. Thus, the current provisions also do not provide for an evaluation greater than the present 10 percent post June 16, 1997. 38 C.F.R. § 4.104, Diagnostic Code 7101 (1999). Therefore, given the above evidence of record, the veteran's evaluations both prior to June 16, 1997 and since such date remain the same. Generally speaking, the evidence of record preponderates against an evaluation greater than zero percent prior to June 16, 1997 and against an evaluation in excess of 10 percent since June 16, 1997. Although the veteran's contentions speak otherwise, this veteran has not presented evidence of such skills, training, or the requisite qualifications so as to render any of his statements medically competent. 2 Vet. App. 492 (1992). Therefore, absent medical evidence to substantiate objective findings as required by the pertinent rating criteria noted above, the veteran's hypertension in this case does not merit an increased evaluation. Id. Asthma The regulations that pertain to diseases of the trachea and bronchi, which include asthma, also were amended during the pendency of this appeal. As to the criteria prior to the changes in October 7, 1996, VA regulations provide that an evaluation of 10 percent is warranted where there is indication of paroxysms of asthmatic type breathing (high pitched expiratory wheezing and dyspnea) occurring several times per year with no clinical findings between such attacks. Note: At the time of examination, if there are no clinical findings of asthma, a verified history of asthmatic attacks must be of record. For the next higher evaluation of 30 percent, the evidence must demonstrate moderate symptomatology, asthmatic attacks rather frequently (separated by only 10-14 day intervals) with moderate dyspnea on exertion between attacks. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996). An evaluation of 60 percent is appropriate where there is severe symptomatology with frequent attacks of asthma, such as one or more attacks weekly, marked dyspnea on exertion between attacks with only temporary relief by medication; more than light manual labor precluded. The maximum evaluation of 100 percent is given with pronounced symptoms, very frequent asthma attacks with severe dyspnea on slight exertion between attacks and with marked loss of weight or other evidence of severe impairment of health. Id. The regulations in place since October 7, 1996 require that for an evaluation of 10 percent, the forced expiratory volume (FEV-1) is that of 71 to 80 percent predicted; or FEV-1/FVC is that of 71 to 80 percent, or; intermittent inhalational or oral bronchodilator therapy is in use. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1999). A 30 percent evaluation is warranted for FEV-1 of 56 to 70 percent, or; FEV-1/FVC of 56 to 70 percent, or; daily inhalational or oral bronchodilator therapy, or; inhalational anti-inflammatory medication. An evaluation of 60 percent requires evidence of FEV-1 of 40 to 55 percent predicted, or; FEV-1/FVC of 40 to 55 percent, or; at least monthly visits to a physician for required care of exacerbations, or; intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids. As to the maximum rating of 100 percent, the regulations require evidence of an FEV-1 less than 40 percent predicted, or; FEV-1/FVC less than 40 percent, or; more than one attack per week with episodes of respiratory failure, or; requires daily use of systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1999). This veteran asserts that he is entitled to an evaluation in excess of 10 percent for asthma prior to January 22, 1999. Essentially, the veteran contends that the record supports that symptomatology referable to his asthmatic disorder prior to that time were productive of moderate impairment that included asthmatic attacks and required ongoing treatment. A review of the record dictates that prior to January 22, 1999, the veteran's disorder indeed was generally persistent, requiring the use of a nebulizer beginning apparently in June 1989, and subsequent regular use of various medications for control. However, pathology associated with the veteran's asthma does not support an evaluation in excess of 10 percent prior to January 22, 1999 under either the former or the newer rating criteria. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996); 38 C.F.R. § 4.97, Diagnostic Code 6602 (1999). Significantly, in February 1992, the veteran's asthma was noted as intermittent. One year later, in March 1993, the veteran again complained of symptomatology associated with his asthma and upper respiratory difficulties. At that time, the veteran was told to continue with the use of inhalers, particularly in light of suspected bronchitis. Various medications were in use at that time as well. Another year later, in September 1994, the examiner noted that pathology associated with the veteran's asthma had somewhat changed. Primarily, the veteran had begun to experience multiple allergy symptoms, including wheezing, shortness of breath on exertion, and nocturnal dyspnea. Such symptomatology apparently was implicated in the veteran's asthmatic disorder. Furthermore, the veteran reported that he had been seen on an emergency basis on several occasions. At that point in time, nonetheless, the veteran's lungs were clear, even though the examiner noted that such is considered normal in between asthmatic attacks. Nonetheless, in spite of these findings, the evidence of record does not substantiate rather frequent asthmatic attacks or treatment more frequent than annual visits to the doctor for related complaints. Thus, in this regard, pursuant to the former regulations, the clinical data of record do not support evidence of moderate symptomatology so as to merit an evaluation above 10 percent prior to January 22, 1999. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996). Moreover, a special lung test administered two months later in November 1994 disclosed an FEV1/FVC actual percentage of 80; such finding is encompassed within the 10 percent rating under the amended criteria. 38 C.F.R. § 4.97, Diagnostic Code 6602. Additionally, as noted above, during the June 1997 VA examination, the veteran stated that he had not been hospitalized since service, but that he was experiencing certain symptoms of his asthma that had required several emergency room visits. Nonetheless, overall, the reported findings were indicative of mild to moderate symptomatology and did not rise to the level required for the next higher evaluation, neither under the current or former regulatory provisions. Id; 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996). Thus, given these data, the evidence does not substantiate that the veteran's asthma is productive of impairment to the extent required for an evaluation greater than 10 percent prior to January 22, 1999 under either criteria and as such, the 10 percent rating for that time period is appropriate. Id. Furthermore, the pertinent rating criteria do not support an evaluation in excess of 30 percent since January 22, 1999. Specifically, neither the former regulations nor the amended ones provide an avenue for a 60 percent or greater evaluation for the veteran's disabling asthma. Id. Overall, the veteran has not submitted evidence of such severe impairment so as to justify an increase above the current 30 percent rating. Id. As stated above, the prior regulations require evidence of severe symptomatology, such as one or more asthmatic attacks weekly, marked dyspnea on exertion, and only mild relief with medication. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996). Under the current regulations, the veteran must provide clinical findings of FEV-1 of 40 to 55 percent predicted, or FEV-1/FVC of 40 to 55 percent, or at least monthly visits to a physician or intermittent use of systemic steroids. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1999). In light of these criteria, the pertinent clinical data do not substantiate findings required for a 60 percent evaluation. More specifically, objective findings from the January 1999 examination do not reflect severe impairment to the extent required by the rating criteria under Diagnostic Code 6602. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996). For example, the veteran had no complaints of shortness of breath at that time, no indications of wheezing or sinus problems, and the chest was clear to auscultation. The examiner essentially recommended that the veteran continue with the same prescriptions for control of his asthma. Moreover, symptomatology of the veteran's asthma as indicated in the February 1999 VA reports was no greater than mild to moderate in nature. The veteran's lungs were noted as clear at that time, without wheezing or rhonchi. Further, in spite of the weekly immunotherapy the veteran receives for his multiple allergy syndrome and upper respiratory infections, as noted in VA outpatient notes dated in March 1999, there is no evidence that pathology associated with the veteran's asthma, per se, is productive of severe impairment. Thus, in spite of the veteran's contentions that his symptomatology has worsened, the record does not support such increased symptomatology so as to warrant a 60 percent evaluation before January 22, 1999 under the former provisions. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1996). Additionally, clinical findings from the March 1999 pulmonary test do not support an evaluation greater than 30 percent under the present rating criteria. 38 C.F.R. § 4.97, Diagnostic Code 6602 (1999). The results from the veteran's lung mechanics test disclose an actual percentage of 83.22 and a predicted percentage of 81.69, well below the required levels for the next higher evaluation. Id. Therefore, in light of the relevant evidence of record, the schedular criteria do not substantiate an evaluation in excess of 30 percent for asthma since January 22, 38 C.F.R. 4.97, Diagnostic Code 6602 (1996); (1999). ORDER Entitlement to an evaluation in excess of zero percent for hypertension prior to June 16, 1997 is denied. Entitlement to an evaluation in excess of 10 percent for hypertension since June 16, 1997 is denied. Entitlement to an evaluation in excess of 10 percent for asthma prior to January 22, 1999 is denied. Entitlement to an evaluation in excess of 30 percent for asthma since January 22, 1999 is denied. V. L. Jordan Member, Board of Veterans' Appeals