BVA9501539 DOCKET NO. 94-01 967 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUE Entitlement to an increased rating for residuals of a temporal craniotomy with headaches, currently rated as 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Heather J. Harner, Associate Counsel INTRODUCTION The veteran served on active duty from August 1961 to August 1969. This appeal to the Board of Veterans' Appeals (Board) arises from a November 1992 decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Chicago, Illinois. A hearing on appeal before J. U. Johnson, who is a member of the Board, was held in Chicago, Illinois, in January 1994. During the hearing, the veteran raised the issues of entitlement to service connection on a secondary basis for a neuropsychiatric disorder and for gastritis. He raised as well the issue of entitlement to a total rating based upon individual unemployability due to service-connected disabilities. These issues have not been developed for appellate consideration and are not inextricably intertwined with the issue presently before the Board. Accordingly, they are not addressed herein, but are referred to the RO for appropriate action. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that headaches which are a residual of his service-connected temporal craniotomy are more disabling than is reflected by the current disability rating. He avers that he experiences frequent, debilitating headaches, sometimes accompanied by dizziness and increased anxiety. He further avers that he has experienced an impairment of his cognitive functioning abilities since the craniotomy resulting in memory deficits; concentration difficulties; slowness of thinking; and difficulty reading, writing, and communicating. He requests relief in the form of an increased disability rating. 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 evidence supports a grant of a 50 percent disability rating for residuals of a temporal craniotomy with headaches. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appeal has been obtained. 2. The veteran has almost constant headaches with a central nervous system disturbance and vertigo. 3. The veteran's headaches are debilitating and productive of severe economic inadaptability. CONCLUSION OF LAW A 50 percent disability rating for residuals of a temporal craniotomy with headaches is warranted. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. § 4.124, Code 8100 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, we note that the veteran's claim is well grounded. By this, we mean that he has submitted a claim which is plausible. We further conclude the VA has met its statutory duty to assist the veteran in the development of his claim, and that no further assistance is required to satisfy the provisions of 38 U.S.C.A. § 5107 (West 1991). During his period of service, the veteran suffered a brain hemorrhage following a blow above his left eyebrow when he was hit by the lid of his car trunk. A craniotomy was performed in the left temporal area of the brain to correct the hemorrhage. Recovery was satisfactory but the veteran has experienced headaches since that time. He was granted service connection along with a 10 percent disability rating upon his discharge from service in 1969. He now contends that the headaches have increased in severity, warranting a higher disability rating. The veteran testified at the personal hearing on appeal that his headaches have grown much more debilitating during the last few years. He stated that he cannot remember things as he had been able to in past years. He also stated that he experiences frequent headaches with pressure, lightheadedness and dizziness, and that at least once every two weeks he has headaches which put him "out of commission entirely" for up to three days. Due to his memory losses, dizziness, and the necessity to lie down when he experiences a severe headache, the veteran explained that his earned income has dropped. We find nothing in the veteran's medical records to contradict the substance of this testimony and thus find it to be credible. Outpatient treatment records reflect that the veteran has been seen by various specialists in an effort to control or alleviate his headaches. Medical records contained in the veteran's claims file also indicate that the veteran takes prescription medication for his headaches. The veteran's headaches may be rated by analogy to migraine headaches. The current 10 percent disability rating reflects characteristic prostrating attacks averaging one in two months over the last several months. Characteristic prostrating attacks occurring on an average once a month over the last several months will be rated as 30 percent disabling. Very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability will be rated as 50 percent disabling. 38 C.F.R. § 4.124a, Code 8100 (1993). As the veteran experiences frequent completely prostrating and prolonged headaches, and as his headaches interfere with his ability to pursue employment, the Board holds that the evidence supports a grant of a 50 percent disability rating for headache residuals of a temporal craniotomy. A basis for a higher schedular rating is not shown. Consideration has also been given to the potential application of the various provisions of 38 C.F.R. Parts 3 and 4, whether or not they were raised by the veteran, as required by Schafrath v. Derwinski, 1 Vet.App. 589 (1991). In particular, we find that the evidence discussed above does not suggest that the veteran's headache residuals of a temporal craniotomy presents such an exceptional or unusual disability picture as to render impractical the application of the regular schedular standards so as to warrant an assignment of an extraschedular evaluation under 38 C.F.R. § 3.321(b) (1993). For example, the disability does not require frequent periods of hospitalization, nor does it present marked interference with employment that is not already contemplated by the current evaluation. ORDER Entitlement to a 50 percent disability rating for residuals of a temporal craniotomy with headaches is granted, subject to the laws and regulations governing the payment of monetary awards. J. U. JOHNSON 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.