Case A25104807

S. SCHICK · 2025 · Case ID: A25104807

DENIED

Summary

The veteran, who served in the U.S. Navy from June 1999 to August 2009, including service in the Global War on Terrorism, appeals the denial of an earlier effective date for his 70 percent disability rating for major depressive disorder and an initial compensable rating for tinea versicolor. The veteran sought an earlier effective date for his major depressive disorder, arguing that evidence submitted within a year prior to his claim showed a factually ascertainable worsening. However, the Board found that the evidence during the relevant period, primarily VA treatment records noting denial of symptoms and a single instance of missing work, was insufficient to establish a factually ascertainable increase in disability. For tinea versicolor, the veteran sought an initial compensable rating. The Board reviewed the VA Schedule for Rating Disabilities for skin conditions, noting the criteria for a 10 percent rating require lesions involving at least five percent of the body or intermittent systemic therapy for less than six weeks. The VA examination found the veteran's condition covered less than five percent of his body and involved only topical treatment for less than six weeks, thus not meeting the criteria for a compensable rating. The Board denied both claims.

Rationale

No factually ascertainable increase in disability in the year prior to claim; VA treatment records noted denial of symptoms; Single instance of missing work insufficient for increase

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250609-557078

Full Decision Text

Citation Nr: A25104807
Decision Date: 12/04/25 Archive Date: 12/04/25

DOCKET NO. 250609-557078
DATE: December 4, 2025

ORDER

Entitlement to an effective date prior to October 15, 2023, for the grant of a 70 percent disability rating for major depressive disorder, recurrent, moderate, with anxious distress is denied.

Entitlement to an initial compensable disability rating for tinea versicolor is denied.

FINDINGS OF FACT

1. The appellant's claim for an increased disability rating for his major depressive disorder, recurrent, moderate, with anxious distress was received by the Department of Veterans Affairs (VA) on October 15, 2023.

2. The appellant's major depressive disorder, recurrent, moderate, with anxious distress did not show a factually ascertainable increase in the disability in the year prior to October 15, 2023.

3. The appellant's tinea versicolor does not manifest with characteristic lesions involving at least five percent of the entire effected body; at least five percent but less than 20 percent of exposed areas affected; or required intermittent systemic therapy for a total duration of less than six weeks over a 12-month period.

CONCLUSIONS OF LAW

1. The criteria for entitlement to an effective date prior to October 15, 2023, for the grant of a 70 percent disability rating for major depressive disorder, recurrent, moderate, with anxious distress are not met. 38 U.S.C. §§ 1155, 5110; 38 C.F.R. §§ 3.400.

2. The criteria for entitlement to an initial compensable disability rating for tinea versicolor are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.118, Diagnostic Code (DC) 7813.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The appellant served on active duty in the United States Navy from June 1999 to August 2009. He is the recipient of the Global War on Terrorism Expeditionary Medal and the Global War on Terrorism Service Medal, among others.

These matters come before the Board of Veterans' Appeals (Board) on appeal from a June 2024 Higher-Level Review (HLR) of two February 2024 rating decisions by VA's Veterans Benefits Administration (VBA), the agency of original jurisdiction (AOJ), under the modernized review system. See 38 C.F.R. § 3.2400. VA received a timely June 2025 notice of disagreement (NOD) to the June 2024 HLR rating decision, selecting the Direct Review Docket.

The issue of entitlement to a TDIU as a result of service-connected disabilities is part and parcel of an increased rating claim. Rice v. Shinseki, 22 Vet. App. 447, 453 (2009). However, the evidence during the appeal period does not show, nor does the appellant claim, that he was unemployable due to his service-connected disabilities. As such, the appellant has not alleged that his service-connected tinnitus impacted his ability to find and retain full-time employment during the appeal period, and TDIU is not implicated.

As the appellant has selected the Direct Review Docket, the Board may only consider the evidence of record before the AOJ at the time of its decision on the issues on appeal. See 38 C.F.R. §§ 20.300(a), 301. The Board will not consider evidence received after the AOJ decision unless the claimant files a timely request for a Board hearing or an opportunity to submit additional evidence on the NOD (VA Form 10182). 38 C.F.R. § 20.301. The appellant has not filed such a request. If additional evidence was submitted after the AOJ decision, the Board will not consider it. If the appellant would like VA to consider any evidence that was added to the claims file that the Board could not consider, the appellant may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision. See also Cook v. McDonough, 36 Vet. App. 175 (2023).

1. Entitlement to an effective date prior to October 15, 2023, for the grant of a 70 percent disability rating for major
any evidence that was added to the claims file that the Board could not consider, the appellant may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision. See also Cook v. McDonough, 36 Vet. App. 175 (2023).

1. Entitlement to an effective date prior to October 15, 2023, for the grant of a 70 percent disability rating for major depressive disorder, recurrent, moderate, with anxious distress.

The appellant contends that he is entitled to an effective date prior to October 15, 2023, for the grant of a 70 percent disability rating for his major depressive disorder, recurrent, moderate, with anxious distress. Specifically, the appellant alleges that evidence submitted within a year prior to the claim for an increased disability rating shows clear and ascertainable worsening. See VA Form 10182, June 9, 2025.

In general, effective dates of an award of compensation are based on the date of receipt of the claim or the date entitlement arose, whichever is later. See 38 C.F.R. § 3.400. An effective date for a claim for increase may also be granted prior to the date of claim if it is factually ascertainable that an increase in disability had occurred within one year from the date of claim. See 38 U.S.C. § 5110(b)(3); see also 38 C.F.R. § 3.400(o).

The appellant is currently in receipt of a 70 percent disability rating effective October 15, 2023, the date of receipt of his claim for an increased disability rating. As such, the only means by which an earlier effective date may be granted is if there was a factually ascertainable increase in his major depressive disorder, recurrent, moderate, with anxious distress in the year prior to October 15, 2023.

Upon review of the evidence, there was no factually ascertainable increase in the appellant's major depressive disorder, recurrent, moderate, with anxious distress in the one year prior to October 15, 2023. Between October 15, 2022, and October 15, 2023, the only references to the appellant's mental health are found in February 2023 and July 2023 VA treatment records which noted the appellant denying mental health symptoms. See VA Treatment Record, Emergency Dept E&M Note, February 22, 2023; VA Treatment Record, Primary Care Note, July 27, 2023. In a November 2023 statement, the appellant described his mental health symptoms but makes only one reference to symptoms as they presented between October 15, 2022, and October 15, 2023, saying, during the week of September 23, 2023, his symptoms made him physically ill to the point where he missed work. See Statement by the Appellant, November 10, 2023. No other evidence of record within the review window addresses the appellant's mental health. While the appellant's reference to missing work due to his psychiatric disorder the week of September 23, 2023, is credible, that is insufficient to show a factually ascertainable increase, as it references a single instance. As such, entitlement to an effective date prior to October 15, 2023, for the grant of a 70 percent disability rating for major depressive disorder, recurrent, moderate, with anxious distress is not warranted.

2. Entitlement to an initial compensable disability rating for tinea versicolor.

The appellant contends that he is entitled to an initial compensable disability rating for his tinea versicolor.

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. Disabilities must be reviewed in relation to their history. Where there is a question as to which of two evaluations apply, the Board assigns the higher of the two where the disability picture more nearly approximates the criteria for the next higher rating. See?38?U.S.C. §?1155;?38?C.F.R. §§?4.1, 4.7, 4.10; Schafrath v. Derwinski,?1?Vet. App.?589?(Vet. App. 1991).

Where entitlement to compensation has been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Francisco v. Brown
of earning capacity resulting from disability. Disabilities must be reviewed in relation to their history. Where there is a question as to which of two evaluations apply, the Board assigns the higher of the two where the disability picture more nearly approximates the criteria for the next higher rating. See?38?U.S.C. §?1155;?38?C.F.R. §§?4.1, 4.7, 4.10; Schafrath v. Derwinski,?1?Vet. App.?589?(Vet. App. 1991).

Where entitlement to compensation has been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Francisco v. Brown,?7?Vet. App.?55, 58?(1994). If later evidence indicates that the degree of disability increased or decreased following the assignment of a disability rating, staged ratings may be assigned for separate periods of time. Hart v. Mansfield,?21?Vet. App.?505?(2007) (noting that staged ratings are appropriate whenever the factual findings show distinct time periods in which a disability exhibits symptoms that warrant different ratings). When adjudicating an increased rating claim, the relevant time period for consideration is the time period one year before the claim was filed. Hart,?21 Vet. App. at 509.

Pyramiding, that is the evaluation of the same disability or the same manifestation of a disability under different diagnostic codes, is to be avoided when evaluating a veteran's service-connected disability.? 38?C.F.R. §?4.14. Separate disability ratings may be assigned for distinct disabilities resulting from the same injury so long as the symptomatology for one condition was not "duplicative of or overlapping with the symptomatology" of the other condition. See Esteban v. Brown,?6?Vet. App.? 259, 262?(Vet. App. 1994).

It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. ?38?C.F.R. §?4.3.

The appellant's tinea versicolor is currently assigned a noncompensable disability rating under DC 7813. 38 C.F.R. § 4.118.

The Board notes that the rating criteria for the skin were amended most recently on August 13, 2018. These new regulations apply to all applications for benefits received by VA or that are pending before the agency of original jurisdiction on or after August 13, 2018. In this case, the period on appeal is after the 2018 amendments, and thus the amendments were not promulgated during the pendency on appeal. Therefore, only the current regulations will be considered in this decision.

VA regulations explicitly state that systemic therapy is treatment that is administered through any route other than the skin, and topical therapy is treatment that is administered through the skin. 38 C.F.R. § 4.118(a).

Under the current regulation, a "General Rating Formula" for the skin applies to DC 7813. See 38 C.F.R. § 4.118. Under this Formula:

A noncompensable rating is assigned for no more than topical therapy required over the past 12-month period and at least one of the following: characteristic lesions involving less than 5 percent of the entire body affected; or characteristic lesions involving less than 5 percent of exposed areas affected.

A 10 percent rating is assigned for at least one of the following: characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or at least 5 percent, but less than 20 percent, of exposed areas affected; or intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12- month period.

A 30 percent rating is assigned at least one of the following: characteristic lesions involving more than 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period.

A 60 percent
, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12- month period.

A 60 percent rating is assigned for at least one of the following: characteristic lesions involving more than 40 percent of the entire body, or more than 40 percent of exposed areas affected; or constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required over the past 12-month period. Or rate as disfigurement of the head, face, or neck (DC 7800) or scars (DC's 7801, 7802, 7803, 7804, or 7805), depending on the predominant disability. 38 C.F.R. § 4.118, General Rating for the Skin for DCs 7806, 7809, 7813-7816, 7820-7822, and 7824.

Upon review of the record, the evidence does not show the appellant's tinea versicolor manifests with characteristic lesions involving at least five percent of the entire effected body; at least five percent but less than 20 percent of exposed areas affected; or required intermittent systemic therapy for a total duration of less than six weeks over a 12-month period.

The appellant was afforded a VA examination of his skin in May 2023 which diagnosed the appellant with tinea versicolor. See VA Skin Diseases Disability Benefits Questionnaire (DBQ), May 4, 2023. The clinician determined that the appellant's tinea versicolor covered less than five percent of his total body area and zero percent of his exposed body area. The appellant's treatment for his disability was noted as only using Selsun Blue through topical application for a duration of less than six weeks over the preceding 12 months. No other treatment was mentioned by the appellant or noted by the clinician.

Outside of the May 2023 VA examination, no other evidence suggests the appellant's tinea versicolor manifests with symptoms sufficient for a 10 percent disability rating or higher. The Board has also considered whether any other DCs related to disabilities of the skin would provide for a higher disability evaluation. However, the evidence does not reflect that the tinea versicolor would warrant a higher rating under a different diagnostic code. See 38 C.F.R. § 4.118. As such, entitlement to an initial compensable disability rating for tinea versicolor is not warranted.

S. Schick

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Lee N. Feldman, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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