BVA9501108 DOCKET NO. 93-12 545 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUES 1. Entitlement to a disability evaluation in excess of 50 percent for acne vulgaris with furuncles and recurring draining tracts of the left and right axillae. 2. Entitlement to a separate disability rating for multiple pits and scars as a result of service-connected acne vulgaris. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Christopher B. Moran, Counsel INTRODUCTION The veteran served on active duty from January 1964 to January 1968. The Board of Veterans' Appeals (Board) notes that both in a statement dated in October 1990 and during a hearing on appeal at the Department of Veterans Affairs (VA) Regional Office (RO) in November 1992 the veteran appears to have again raised the issue of entitlement to a total disability rating for compensation based on individual unemployability. Such matter is referred to the RO for appropriate action. CONTENTIONS OF APPELLANT ON APPEAL It is contended by the veteran, in essence, that the multiple pits and scars associated with acne and surgery for treatment of acne should be rated separately from the service-connected acne vulgaris, since they are manifested by recurring painful flare- ups with drainage and disfigurement and pulling of the skin under each arm pit. Moreover, the veteran argues that his service- connected acne vulgaris is manifested by symptomatology warranting a disability evaluation greater than 50 percent on an extraschedular basis and that such an evaluation is supported by the evidence of record, including unretouched color photographs showing the wide-spread nature of the service-connected skin disorder. 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 the claim for a separate disability rating for multiple pits and scars as a result of service-connected acne and for an increased evaluation for acne vulgaris with furuncles and recurring draining tracts, left and right axillae. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The current 50 percent evaluation in effect for acne vulgaris with multiple pits and scars, furuncles and recurring tracts of the left and right axillae is the maximum evaluation assignable under the applicable schedular criteria and the disorder does not present such an exceptional or unusual disability picture as to render inapplicable the regular schedular criteria. 3. Secondary service-connection has been established for postoperative neuropathy and muscle weakness of the right and left axilla evaluated at 10 percent each under 38 C.F.R. and Part 4, Diagnostic Code 8719. 4. The veteran's acne vulgaris with scarring, furuncles and recurring tracts of the left and right axillae does not involve separate and distinct manifestations which are not contemplated by the evaluations currently in effect, nor is more than slight disfigurement of the head, face or neck shown. CONCLUSIONS OF LAW 1. A separate disability evaluation for multiple acne pits and scars is not warranted. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 4.14, 4.20, 4.31, and Part 4, Diagnostic Codes 7800, 7803, 7804, 7805, 7806 (1993). 2. The criteria for an evaluation in excess of 50 percent for acne vulgaris with furuncles and recurring draining tracts of the left and right axillae have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 3.321, 4.1, 4.20 and Part 4, Diagnostic Code 7806 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Duty to Assist We have found that the veteran's claims are "well grounded" within the meaning of statute and judicial construction. 38 U.S.C.A. § 5107(a) (West 1991); Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). The VA, therefore, has the duty to assist the veteran in the development of facts pertinent to his claim. In this regard, we note that the current evidence of record, includes the veteran's service medical records, along with post-service private and VA clinical data, including outpatient records and reports of examinations, numerous color photographs showing the affected areas of skin, and a hearing transcript from a personal hearing before a hearing officer at the RO in November 1992. Upon a review of the entire record, the Board concludes that the data currently on file provide a sufficient basis to address the merits of the veteran's claims. There is no indication that there are additional pertinent outstanding records which the VA has not attempted to obtain. II. Pertinent Law and Regulations The Board notes that disability evaluations are based as far as practicable upon the average impairment of earning capacity resulting from the disability. 38 U.S.C.A. § 1155 (West 1991). The average impairment as set forth in the VA's Schedule for Rating Disabilities, 38 C.F.R. Part 4 (1993), includes diagnostic codes which represent particular disabilities. The rating schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries. Generally, the degrees of disability specified are adequate to compensate for a considerable loss of working time, from exacerbation or illness proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. When an unlisted condition is encountered, it will be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. Conjectural analogies will be avoided, as will the use of analogous ratings for conditions of doubtful diagnosis or for those not fully supported by clinical and laboratory findings. 38 C.F.R. § 4.20 (1993). Moreover, we note that where there is a question as to which of two evaluations shall 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 (1993). Also, ratings shall be based as far as practicable, upon the average impairment of earning capacity with an extraschedular evaluation assigned commensurate with the average earning capacity impairment due exclusively to service-connected disability or disabilities in exceptional cases where the schedular evaluations are found to be inadequate. 38 C.F.R. § 3.321(b). The governing norm in exceptional cases is a finding that the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization as to render impractical the application of the regular schedular standards. Id. We note that the veteran's acne vulgaris with multiple scars, furuncles and recurring tracts of the axillae is rated as eczema under 38 C.F.R. Part 4, Diagnostic Code 7806, since, as shown by the schedular criteria, the anatomical localization and symptomatology are closely analogous. 38 C.F.R. § 4.20. Where there is ulceration or extensive exfoliation or crusting and systemic or nervous manifestations or exceptionally repugnant, a maximum 50 percent schedular evaluation is warranted. A 30 percent evaluation is provided where there is exudation or constant itching, extensive lesions, or marked disfigurement. A 10 percent evaluation is warranted where there is exfoliation, exudation or itching involving an exposed surface or extensive area. A zero percent contemplates slight, if any, exfoliation, exudation or itching, if on a nonexposed surface or small area. Moreover, we note that in accordance with 38 C.F.R. Part 4, Diagnostic Code 7800 for disfiguring scars of the head, face or neck, the assignment of a maximum 50 percent schedular evaluation is authorized where there is complete or exceptionally repugnant deformity of one side of the face or marked or bilateral disfigurement. A 30 percent evaluation is provided for severe disfigurement especially if there is a marked and unsightly deformity of the eyelids, lips or auricles. A 10 percent evaluation is provided for moderate disfigurement. A noncompensable rating is provided for slight disfigurement. However, when in addition to tissue loss and cicatrization, there is marked discoloration, color contrast, or the like, the 50 percent rating under Code 7800 may be increased to 80 percent, the 30 percent increased to 50 percent, and the 10 percent increased to 30 percent. For superficial and poorly nourished scars with repeated ulceration, a sole 10 percent evaluation is provided under 38 C.F.R. Part 4, Diagnostic Code 7803. For superficial scars that are tender and painful on objective demonstration, a 10 percent evaluation is warranted under 38 C.F.R. Part 4, Diagnostic Code 7804. Other scars are rated on limitation of function of the affected part. 38 C.F.R. Part 4, Diagnostic Code 7805. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 C.F.R. § 4.31 (1993). The provisions of 38 C.F.R. § 4.14 preclude the assignment of separate ratings for the same manifestations under different diagnoses. The critical element is that none of the symptomatology for any of the conditions is duplicative of or overlapping with the symptomatology of the other conditions. Esteban v. Brown, 6 Vet.App. 259 (1994). Impairment associated with a veteran's service-connected disability may be rated separately unless it constitutes the same disability or the same manifestation. Esteban, 6 Vet.App. at 261. The critical element is that none of the symptomatology is duplicative or overlapping; the manifestations of the disabilities must be separate and distinct. Esteban, 6 Vet.App. at 261, 262. III. History A historical review of the record shows that service connection for acne was originally established by a rating determination by the RO in October 1968 with an evaluation of 10 percent based upon aggravation of a preexisting disorder during active service and objective findings noted on an initial post service VA examination in September 1968 revealing abscess, left axilla, and acne of the shoulders and back, and old scars. It was indicated that the acne scars were shown at induction without any active condition, but that the condition increased in service, became active, and that there were boils at the time of discharge. A service induction examination revealed acne vulgaris of the back. The service medical records show that, in August 1966, the veteran was hospitalized for approximately two weeks for an abscess of his back for about one week prior to admission. He stated that he had had a similar boil in 1964 on his back which required incision and drainage. Physical examination was normal with the exception of marked acne vulgaris noted on the back of his neck and on his back. He had a hard induration over the inferior aspect of the left scapula which was nonfluctuant. He was placed on conservative therapy consisting of various back scrubs and sunlight treatment. A dermatology consultation indicated that the veteran had severe acne vulgaris. In early February 1967, the veteran underwent an approximately 5 day period of hospitalization for a large furuncle on the anterior chest wall that was present for two weeks prior to a sick call visit. The lesion was incised and drained. He was admitted to a hospital ward because of the size of the defect remaining on the chest wall. Following treatment, the lesion appeared to be healing well and he was discharged on the fifth hospital day with followup for dressing changes. In March 1967, he was seen for abscess, subcutaneous, multiple, back. It was noted that he had been previously admitted approximately one month earlier with the same diagnosis on the anterior chest wall. On admission he presented with a 7- to 10- day history of tenderness of the back and stated that he had boils many times before and that his father also presented with the same condition. A physical examination revealed fluctuating, tender masses of the upper back bilaterally and an early furuncle on the left axilla. The abscesses were incised and drained. He was transferred to the dermatology service for evaluation and treatment of a longstanding condition. At that time, it was noted that it was the second hospital admission for the veteran who presented with a chief complaint of two draining cysts of the back. He had acne vulgaris since teenage years which the veteran felt became worse during active duty. During the preceding two years, he noted occasional tender cyst formation over the chest and back. It was noted that he had been admitted to the surgical service in August 1966 for a large abscess of the back which was managed successfully with conservative treatment. Two days prior to admission, he had two tender cysts of the back incised and drained and was started on systemic penicillin therapy. On objective examination for hospital admission which was limited to the skin, multiple black comedones were noted over the chest and back. Two draining cystic lesions were present over the back. Moderate post acne scarring was noted over the face. Comedone extraction was performed on two occasions. At hospital discharge, his condition was described as asymptomatic. A physical examination showed two healed cystic lesions of the back. In January 1968, the veteran was seen for recurrent axillary abscesses which were incised and drained. On a report of a physical examination dated in January 1968, for separation from active duty, an evaluation of the upper extremities revealed axillary abscess almost resolved. No other pertinent finding was noted. On an initial post-service VA dermatology examination in September 1968, the veteran stated that he had had trouble with recurring infections in the left armpit for about the preceding three years. He also had extensive acne over his back with some involvement of the chest and face for a number of years and had a lot of scarring from these areas. The veteran indicated that, when he was stationed in Vietnam, he developed infection in the left armpit and, after he was returned to the United States, he was hospitalized and this furuncle was opened and drained on at least two occasions, but had reoccurred. He stated that it also moved around in different places in the left armpit and became painful. On physical examination, the left axilla revealed a fluctuant abscess measuring from 1 1/2 to 2 centimeters in diameter. There were 2 or 3 well-healed scars from earlier abscesses that were removed. The face showed extensive ice- picked type scarring of acne vulgaris. Over the back and shoulders, there were numerous large and small acne pustules with many double or triple comedones and some sebaceous cysts. There was some scarring in each inguinal area and a few small scars present on the anterior chest, though not at all prominent. Diagnoses were abscess, left axilla, acne vulgaris, moderately severe, of the shoulders and back with extensive scarring of the shoulders, back and face. There was indication by the examiner that the veteran may continue to have some trouble with the condition from time to time indefinitely and should definitely have surgical drainage of the abscesses of the left axilla as well as antibiotic therapy. An RO rating determination dated in late October 1973 assigned a 30 percent evaluation for acne vulgaris, with furuncles with recurrent draining tracts of the left axilla, in accordance with the provisions of 38 C.F.R. and Part 4, Diagnostic Code 7806. Evidence at the time from Marjorie E. Harwood, M.D. , referred to a 6-year history of persistent recurring draining tracts of the left axilla, considered an inflammatory reaction of the apocrine sweat glands with secondary bacterial infection. Compresses and antibiotics were only considered palliative. It was indicated that the condition would remain chronic unless excised. Other evidence showed that the veteran was hospitalized in mid-October 1973 for excision and drainage of a left axilla area abscess. In July 1974, the veteran underwent excision of a recurring draining abscess in the right axilla. In a September 1974 statement, Leonard W. Glass, M.D. , reported operating on the veteran three months earlier at which time a subtotal axillary resection of the right side was undertaken and that, approximately one year prior, the left side had been done. Furthermore, it was noted that it would take 3 to 4 months for the veteran to regain full range of motion of his extremity after such operation. On a report of a VA dermatology evaluation in March 1975, the scalp was clear. The axillae reflected atrophic scarred skin; no actively draining tracts or cysts were present. The chest and back revealed scattered comedones with no draining. The inguinal area was without active lesions. Impression was hidradenitis suppurative and acne lesions quiescent. On a report of a VA neurological examination dated in April 1975, there was indication that the veteran was service connected for acute acne vulgaris with furuncles and recurrent drainage on both axillae. His furuncles were persistent and required several days' absence from work. Infections and temperature due to the infections occurred often during the years. Therefore, it was noted that surgery was performed on both axillae. The first was performed in 1973 on the left side and removal of the axillary glands was undertaken in order to prevent further production of furuncles with an excellent result. Therefore, a right side procedure was performed in 1974. The outcome of both surgeries was described as excellent. The symptoms of furuncles did not occur any more as of the time of the examination and the veteran did not require any further absence from work except both upper extremities became very weak after two minutes of exercise. It was indicated that there was a severe hypalgesia and hypesthesia in the distribution of the lateral cord and posterior cord of the axillary nerves producing neuropathies of the musculocutaneous nerves in the distribution of the axillary nerves. Neurologic examination at that time was confined to both upper extremities which revealed no gross evidence of any muscle atrophy or fasciculations. Strength was good, but became weak after two minutes of exercise. There were severe hypalgesia and hypesthesia in the distribution of the brachial plexus, affecting the musculocutaneous nerve on both sides. There was a postoperative scar on both axillae secondary to removal of the glands. The teres minor on both sides appeared to be slightly atrophied. Sensation was lost over the deltoid bilaterally. The range of motion in all joints was normal but severe weakness was noted after minimal exercise. Diagnosis was musculocutaneous nerve neuropathies, secondary to surgery. An RO rating determination dated in June 1975 established service connection for postoperative neuropathy and muscle weakness of the right axilla (major) and left axilla (minor) separately evaluated at 10 percent for each upper extremity, in accordance with 38 C.F.R. Part 4, Diagnostic Code 8719. Received in support of the veteran's current claim was a statement dated in September 1988 from Victor G. Villarreal, M.D., certifying that the veteran was seen in mid-July 1988 due to an abscess in the back of the neck measuring 2 inches transversely and 1 1/2 inches vertically. An incision and drainage were done and the veteran was seen again in July 1988 on two occasions. It was also indicated that when the veteran was seen in September 1988 for recurrence of the same abscess, he was given an antibiotic to see if an incision and drainage were not needed. VA outpatient clinical records revealed treatment for cystic acne flareups between approximately March 1989 and May 1990. In March 1989, the veteran was seen for incision and drainage of a cyst on the posterior neck. The area was very tender. It was noted that he had a long history of cysts on his back and history of cysts on axillae and neck areas. In June and August 1989, he was also seen for dermatologic complaints. Specifically in August 1989, he complained of recurrent boils on the neck and chronic rash involving his neck and face. He also complained of chronic cysts, boils in the neck, axillary and groin areas which he noted as stress-related. On examination, multiple surgical scars of the neck, back, and axillae, numerous open comedones and a firm dermal nodule to the left and right of the submental area were noted. In November 1989, he was referred to the plastic surgery clinic for a recurrent inflamed area of the left posterior neck and right submental area. On examination in December 1989 the disorder was described as quiescent with excision planned on the right anterior neck. In May 1990, he was seen for right axilla drainage. In June 1990, he was seen for complaints of right axilla cystic drainage. On examination, minimal drainage was noted from a furuncle in the right axilla area. On a report of a VA psychiatric examination in June 1990, the veteran noted that, beginning in 1973, he started having episodes of nervousness and anxiety after surgery. He stated that he had to undergo resection of multiple furuncles from underneath both axillae. He stated that he periodically had flareups of the furuncles which could occur anywhere on his body. He stated that, when he had flareups of the furuncles, which occurred about once every 2 or 3 months, he became irritable. In a statement dated in June 1990, Malek M. Nazemi, M.D., reported evaluating the veteran at that time for a history of recurrent episodes of severe degree of folliculitis, mostly occurring on the trunk, neck and extremities. On repeated occasions, the veteran had excision and drainage with the last being in March 1990 according to the veteran. On examination, the veteran had three big draining lesions, one in the left upper thigh, one on the abdomen, and one under the right axilla. Multiple scars were all over his body and there was evidence of old and relatively more recent folliculitis present everywhere. Impression and comments included severe degree of recurrent folliculitis. In February 1991, the veteran underwent a VA examination for acne vulgaris with furuncles and recurring tracts of the axillae, postoperative, and also focused on scars resulting from multiple surgeries for service-connected acne vulgaris. The veteran noted that in 1965, he developed some large papules and furuncles involving his back, buttocks, both axillary regions, chest, abdomen and face. Subsequently, he was examined by military physicians and they diagnosed acne vulgaris with furuncles. He stated that he was treated on an outpatient basis. He further noted that the furuncles were lanced and packed, and antibiotics were prescribed. Physicians also prescribed infrared light treatments. He stated that, in spite of medical and surgical treatment, he continued to have recurrences of acne vulgaris and furuncles. In 1973, he had surgery of the left axilla for removal of furuncles. In 1974, he underwent surgery of the right axilla for removal of furuncles. In 1978, he had surgery on his right upper back for removal of furuncles. He further stated that between 1965 and 1989, he underwent multiple lancings and packings of papules and furuncles that occurred on his face, chest, back, buttocks and both axillae. Furthermore, he noted that, despite medication and special cream applied to his skin, he still continued to have periodic tenderness and itching involving his face, back, axillae, chest and buttocks. He noted that he went for followup treatment approximately once per month. A dermatological examination in February 1991 of the face revealed the presence of small papules and pustules. Multiple tiny pits and scars were also noted throughout the face. Further examination revealed that there were some excoriations of the papules. There was also tenderness noted, particularly in both cheeks. An examination of the back revealed the presence of multiple papules and pustules. Multiple tiny pits and scars were also noted. There was tenderness on palpation of the papules and pustules. An examination of the buttocks revealed the presence of multiple tiny papules and pustules, as well as tiny pits and scars. An examination of the axillae revealed the presence of tiny papules and pustules in both axillae, as well as tiny pits and scars in both axillae. There was some tenderness to palpation, bilaterally. An examination of the chest revealed multiple tiny papules and pustules, as well as multiple pits and scars. An examination of the abdomen revealed multiple papules and pustules, as well as some pits and scars. There was definite tenderness to palpation of the papules and pustules. Diagnoses were as follows: Acne vulgaris with furuncles, recurrent; status post surgeries for furuncle tracts in both axillae; scars, due to multiple surgeries for service-connected acne vulgaris; and status post multiple surgeries for acne vulgaris involving the face, chest, back and buttocks. It was indicated that his condition was moderately controlled with antibiotics. An RO rating determination dated in March 1991 assigned a 50 percent evaluation for acne vulgaris with multiple scars, furuncles and recurring tracts, axillae, postoperative, effective from March 6, 1989. In November 1992, the veteran attended a personal hearing at the RO before a hearing officer. In addition to sworn testimony, the veteran submitted numerous color photographs of the affected areas of his body. On a report of a VA peripheral nerve examination in March 1993, an evaluation of the upper extremities revealed mild hypoesthesia on the ulnar aspect of both upper extremities and also on both axillae. Further examination revealed that pinprick and vibratory sensations were depressed in both upper extremities. Deep tendon reflexes were also slightly depressed in both upper extremities. There was no limitation of motion of the upper extremities. Further examination revealed minimal muscle weakness involving primarily the biceps and triceps of both upper extremities. Diagnoses were ulnar neuropathy involving the right upper extremity and right axillae; ulnar neuropathy involving the left upper extremity and left axilla; and minimal weakness, involving both upper extremities. An RO rating determination dated in April 1993 confirmed and continued the separate 10 percent ratings in effect for neuropathy and muscle weakness of the right and left axilla. IV. Increased Rating With respect to the veteran's claim of entitlement to a disability evaluation in excess of 50 percent for his skin disorder, he essentially argues that his overall skin disorder is manifested by multiple pits and scars, furuncles and recurring draining tracts of both axillae, with periodic acute exacerbations, and including tenderness and itching involving his face, back, axillae, chest and buttocks, and is productive of impairment, as demonstrated by clinical findings and color photographs, warranting a higher rating, including on an extraschedular basis. The current 50 percent evaluation for the veteran's service- connected skin disorder contemplates ulceration, extensive exfoliation, crusting, systemic or nervous manifestations, exceptional repugnancy, exudation, constant itching, extensive lesions, marked disfigurement, and an exposed surface or extensive area. The current 50 percent evaluation is the maximum evaluation assignable under the applicable diagnostic code, and there is no other applicable diagnostic code under which the disorder can be appropriately evaluated. Any pain, tenderness, or itching associated with such things as ulcerations or lesions is included and an "exposed surface" includes the face. Under 38 C.F.R. § 3.321(b), a higher evaluation can be assigned, if the disorder is shown to be so exceptional or unusual as to render inapplicable the regular schedular criteria. Such is not shown here. The veteran has pustules and papules, and periodic recurrences of furuncles, as well as residuals of prior exacerbations of the disorder. The disability evaluations assigned under the rating schedule contemplate periodic exacerbations. 38 C.F.R. § 4.1. There is no showing of such things as marked interference with employment, as opposed to impairment in earning capacity and loss of working time which are contemplated by the current 50 percent evaluation, or a need for frequent periods of hospitalization. Overall, the disorder is not shown to present such an exceptional or unusual disability picture to support a finding that it would not be practical to apply the regular schedular standards, i.e., the provisions of 38 C.F.R. § 4.20 and the criteria of Diagnostic Code 7806. Therefore, an evaluation greater than 50 percent cannot be assigned. V. Separate Rating The veteran contends that he should receive a separate evaluation for the scarring and disfigurement from his service-connected skin disorder. Symptoms and manifestations that are not duplicative or overlapping can be evaluated separately, but the same manifestation cannot be separately evaluated under different diagnostic codes. An evaluation based solely on disfigurement from scarring is only available if the disfigurement involves the head, face or neck. 38 C.F.R. Part 4, Diagnostic Code 7800. Sight disfigurement is assigned a noncompensable evaluation. Id. In this case, the evidence does not show more than slight disfigurement of the head, face or neck. The veteran has not contended such, nor do the photographs that he has submitted show any such disfigurement. Any disfigurement of his body from scarring is contemplated by the evaluation in effect under Diagnostic Code 7806. Therefore, a separate evaluation for disfiguring scars cannot be assigned. The veteran contends that the scarring in his axillae limits motion or interferes with the function of his shoulders. Such limitation, however, is already contemplated by the compensable evaluation in effect for the neuropathy of each axilla area. See 38 C.F.R. Part 4, Diagnostic Codes 8519, 8619, 8719 (1993). There is no symptomatology of any of the scarring on the remainder of his body that is not already included in the 50 percent evaluation in effect under Diagnostic Code 7806. ORDER Entitlement to a separate disability rating for multiple pits and scars as a result of service-connected acne vulgaris is denied. An increased evaluation for acne vulgaris with furuncles and recurring draining tracts of the left and right axillae is denied. WILLIAM J. REDDY 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.