Case A26039543

MELANIE J. MANN · 2026 · Case ID: A26039543

MIXED

Summary

The Veteran, who served from August 1966 to August 1970, appeals decisions concerning service connection for a tumor of the lymph nodes and saliva gland, eczema, hypertension, radiculopathy of both sciatic nerves, and bilateral sensorineural hearing loss. The Veteran also sought an earlier effective date for several granted benefits, including PTSD, special monthly compensation (SMC) based on housebound criteria, Dependents' Educational Assistance (DEA), and increased ratings for bilateral lower extremity radiculopathies. The Board granted earlier effective dates for these benefits, moving them to May 15, 2024, based on the Veteran's intent to file. Service connection for PTSD, SMC, and DEA were granted, and the radiculopathies of the left and right sciatic nerves were increased to 40 percent each. However, the Board denied service connection for the tumor, finding it unrelated to service or TERA based on a VA examiner's opinion that it was less likely than not service-related. The claim for eczema was denied a compensable rating, as the Veteran's topical treatment did not meet the criteria for systemic therapy, and the condition was clear at the time of examination. The claim for an increased rating for hypertension was denied, as the Veteran's blood pressure readings, even when off medication, did not meet the criteria for a higher rating, and the Board noted it could not consider ameliorative effects of medication beyond what the rating schedule allows. The claim for bilateral sensorineural hearing loss was denied a compensable rating, as audiometric testing did not meet the criteria for a higher rating or an exceptional pattern, and the Board found lay statements less probative than the objective test results.

Rationale

Intent to file received May 14, 2024.; Fully developed claim received April 17, 2025.; Board found intent to file date warranted earlier effective date.

Special Benefit

SMC - HOUSEBOUND

Docket No.

251119-596554

Full Decision Text

Citation Nr: A26039543
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 251119-596554
DATE: April 28, 2026

ORDER

Entitlement to an effective date of May 15, 2024 for service connection for posttraumatic stress disorder is granted.

Entitlement to an effective date of May 15, 2024 for special monthly compensation based on housebound criteria is granted.

Entitlement to an effective date of May 15, 2024 for Dependents' Educational Assistance (DEA) is granted.

Entitlement to an effective date of May 15, 2024 for the increase in disability rating for radiculopathy of the sciatic nerve of the left lower extremity is granted.

Entitlement to an effective date of May 15, 2024 for the increase in disability rating for radiculopathy of the sciatic nerve of the right lower extremity is granted.

Entitlement to service connection for lymph nodes and saliva gland removal due to tumor is denied.

Entitlement to a compensable disability rating for eczema is denied.

Entitlement to a disability rating in excess of 10 percent for hypertension is denied.

Entitlement to a disability rating of 40 percent for radiculopathy of the sciatic nerve of the left lower extremity is granted.

Entitlement to a disability rating of 40 percent for radiculopathy of the sciatic nerve of the right lower extremity is granted.

Entitlement to a compensable disability rating for bilateral sensorineural hearing loss is denied.

FINDINGS OF FACT

1. The Veteran submitted an intent to file form which VA received on May 14, 2024. The Veteran submitted a claim for posttraumatic stress disorder in a fully developed claim in April 2025. The Veteran has continuously pursued his claim.

2. The Veteran's special monthly compensation based on housebound criteria was granted in part and parcel with his 100 percent rating for posttraumatic stress disorder.

3. The Veteran's eligibility for Dependents' Educational Assistance was granted in part and parcel with his 100 percent rating for posttraumatic stress disorder.

4. The Veteran submitted an intent to file form which VA received on May 14, 2024. The Veteran submitted a claim for increase for his service-connected bilateral lower extremity neuropathies in a fully developed claim in April 2025. The Veteran has continuously pursued his claim.

5. The Veteran's lymph nodes and saliva gland removal due to tumor is not related to herbicide exposure.

6. The Veteran's skin condition presented without any visible characteristic lesions, scarring, or disfigurement of the head, face, or neck; it did not cover 5 to 20 percent of entire body or exposed areas. Treatment consisted of topical cream, which does not qualify as intermittent systemic therapy as defined by the regulations.

7. During the entire period on appeal, there is a history of diastolic pressure of predominantly 100 or more and continuous medication is required to control blood pressure.

8. The Veteran's radiculopathy of the left lower extremity manifests as moderately severe involvement of the sciatic nerve.

9. The Veteran's radiculopathy of the right lower extremity manifests as moderately severe involvement of the sciatic nerve.

10. During the period on appeal, the Veteran's bilateral hearing loss resulted in at worst a numeric designation of I for his right ear and III for his left ear.

CONCLUSIONS OF LAW

1. The criteria for an effective date of May 15, 2024 for service connection for posttraumatic stress disorder have been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400.

2. The criteria for an effective date of May 15, 2024 for special monthly compensation based on housebound criteria have been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400.

3. The criteria for an effective date of May 15, 2024 for Dependents' Educational Assistance (DEA) have been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400.

4. The criteria for an effective date of May 15, 2024 for the increase in disability rating for radiculopathy of the sciatic nerve of the left lower extremity have been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400.

5. The criteria for an effective date of May 15, 2024 for the increase in disability rating for radiculopathy of the sciatic nerve of the right lower extremity have been met. 38 U.S.C.
for Dependents' Educational Assistance (DEA) have been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400.

6. Lymph nodes and saliva gland removal due to tumor is not related to service. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.307, 3.309.

7. The criteria for a compensable rating for eczema have not been met. 38 U.S.C. §§ 1155, 5107 (2024); 38 C.F.R. § 4.118, Diagnostic Code 7806.

8. The criteria for a disability rating in excess of 10 percent for hypertension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.159, 3.344, 4.3, 4.7, 4.14, 4.104, Diagnostic Code 7101.

9. The criteria for a disability rating of 40 percent for radiculopathy of the sciatic nerve of the left lower extremity have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.124a, Diagnostic Code 8520.

10. The criteria for a disability rating of 40 percent for radiculopathy of the sciatic nerve of the right lower extremity have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.124a, Diagnostic Code 8520.

11. The criteria for a compensable disability rating for bilateral sensorineural hearing loss have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321, 4.85, Diagnostic Code 6100.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from August 1966 to August 1970. The Veteran's awards include the National Defense Service Medal and the Vietnam Service Medal. The Board thanks the Veteran for his service.

On August 23, 2017, the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA). Pub. L. No. 115-55, 131 Stat. 1105 (2017) went into effect. This law creates a new framework for Veterans dissatisfied with VA's decision on their claim to seek review on or after February 19, 2019. As this case is an appeal of July 2025, September 2025, and October 2025 rating decisions, this decision has been written consistent with the new AMA framework.

In November 2025, the Veteran submitted a VA Form 10182 (Decision Review Request: Board Appeal) electing a hearing with a Veterans Law Judge. A Board hearing was held on January 8, 2026.

Therefore, the Board may only consider the evidence of record at the time of the July 2025, September 2025, and October 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R
or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran 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.

EFFECTIVE DATE

1. Entitlement to an effective date of May 15, 2024 for service connection for posttraumatic stress disorder

2. Entitlement to an effective date of May 15, 2024 for special monthly compensation based on housebound criteria

3. Entitlement to an effective date of May 15, 2024 for Dependents' Educational Assistance (DEA)

4. Entitlement to an effective date of May 15, 2024 for the increase in disability rating for radiculopathy of the sciatic nerve of the left lower extremity

5. Entitlement to an effective date of May 15, 2024 for the increase in disability rating for radiculopathy of the sciatic nerve of the right lower extremity

After review, the Board finds that the Veteran is correct and that new effective dates warranted for his claims.

The assignment of effective dates of awards is generally governed by 38 U.S.C. § 5110 and 38 C.F.R. § 3.400. Except as otherwise provided, the effective date of an evaluation and an award of pension, compensation, or dependency and indemnity compensation based on an original claim or a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date the claim arose, whichever is later. 38 C.F.R. § 3.400.

For claims for an increase in a service-connected disability, if an increase in disability occurred within one year prior to the claim, the increase is effective as of the date the increase was "factually ascertainable." If the increase occurred more than one year prior to the claim, the increase is effective the date of claim. If the increase occurred after the date of claim, the effective date is the date of increase. 38 U.S.C. § 5110(b); 38 C.F.R. § 3.400(o)(1), (2); VAOPGCPREC 12-98.

In determining when an increase is "factually ascertainable," all of the evidence must be looked to, including testimonial evidence and expert medical opinions, and an effective date must be assigned based on that evidence. See McGrath v. Gober, 14 Vet. App. 28, 35-36 (2000); VAOPGCPREC 12-98. Thus, "it is the information in a medical opinion, and not the date the medical opinion [that] was provided that is relevant when assigning an effective date." Tatum v. Shinseki, 24 Vet. App. 139, 145 (2010); see also Young v. McDonald, 766 F.3d 1348 (Fed. Cir. 2014).

The Veteran and his representative argue that an effective date of at least May 15, 2024 is warranted. They specifically contend that an intent to file was submitted on that date.

The current effective date for all of the Veteran's claims is April 17, 2025, the date VA received his fully developed claim.

The record clearly demonstrates that the Veteran' submitted an intent to file form which was received by VA on May 15, 2024. Subsequently, the Veteran submitted a fully developed claim which was received by VA on April 17, 2025. This claim included a claim of service connection for posttraumatic stress disorder as well as a claims for increase of the Veteran's bilateral lower extremity neuropathies.

In a July 2025 rating decision, the Veteran's claim for service connection for left knee patella chondromalacia was granted. In the same rating decision, the Veteran's claims for increased ratings for his bilateral lower extremity neuropathies were granted.

The Board notes that the facts are undebatable, in that the Veteran continuously pursued
Veteran' submitted an intent to file form which was received by VA on May 15, 2024. Subsequently, the Veteran submitted a fully developed claim which was received by VA on April 17, 2025. This claim included a claim of service connection for posttraumatic stress disorder as well as a claims for increase of the Veteran's bilateral lower extremity neuropathies.

The Board notes that the facts are undebatable, in that the Veteran continuously pursued his claim since his intent to file was received by VA. Given this, the Board finds that the Veteran's claim of service connection for posttraumatic stress disorder and increased ratings for bilateral lower extremity neuropathies should all be afforded effective dates of May 15, 2024.

As a part of the grant of service connection for posttraumatic stress disorder, the July 2025 rating decision also granted special monthly compensation (SMC) based on housebound criteria and DEA, due to meeting the requirements for both due to his 100 percent rating for posttraumatic stress disorder. Given that the Board is moving the effective date of service connection for posttraumatic stress disorder back to May 15, 2024, the Board finds that the effective dates of SMC under 38 U.S.C. § 1114(s) and DEA should also be moved back to May 14, 2024.

SERVICE CONNECTION

1. Entitlement to service connection for lymph nodes and saliva gland removal due to tumor

Veterans are entitled to compensation if they develop a disability "resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty." 38 U.S.C. §§ 1110 (wartime service), 1131 (peacetime service).

To establish entitlement to service-connected compensation benefits, a Veteran must show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service -the so-called 'nexus' requirement." See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. See Baldwin v. West, 13 Vet. App. 1, 8 (1999).

The Veteran's service records confirm that he served on active duty in Vietnam. His exposure to herbicide agents is thus presumed. 38 C.F.R. § 3.307(e)(6)(iii).

If a veteran was exposed to an herbicide agent during active military, naval, or air service, certain diseases shall be service-connected even though there is no record of such disease during service. 38 C.F.R. § 3.309(e).

The Veteran's disorder is not identified under 38 C.F.R. § 3.309(e). However, the availability of presumptive service connection for a disability based on exposure to herbicides does not preclude a Veteran from establishing service connection with proof of direct causation. Stefl v. Nicholson, 21 Vet. App. 120 (2007); see also Combee v. Brown, 34 F. 3d 1039 (Fed. Cir. 1994).

The Veteran solely maintains that his disorder is related to in-service toxic risk exposure activity (TERA). See e.g. VA Form 20-0995 Supplemental Claim Application, received April 17, 2025. Given this, the Board will only consider whether the Veteran's disorder is due to a TERA.

In the October 2025 rating decision on appeal that addressed the Veteran's claim of service connection, the AOJ favorably found that the Veteran participated in a TERA and that the Veteran had a disability. The Board is bound by favorable findings of the AOJ unless rebutted by evidence that identifies clear and unmistakable (undebatable) error. 38 C.F.R. § 3.104(c).

Given this, the Board notes that the only remaining element of service connection is nexus.

The Veteran was afforded a VA examination for his lymph nodes and saliva gland removal due
al Claim Application, received April 17, 2025. Given this, the Board will only consider whether the Veteran's disorder is due to a TERA.

Given this, the Board notes that the only remaining element of service connection is nexus.

The Veteran was afforded a VA examination for his lymph nodes and saliva gland removal due to tumor in September 2025. The VA examiner concluded that the Veteran's disorder was less likely than not related to his TERA and wrote the following: "Pleomorphic adenoma is a benign tumor of the salivary gland and, as noted by the National Library of Medicine - StatPearls, is the most common salivary gland tumor. They account for 84% of parotid gland tumors, which is the location of the Veteran's tumor. No environmental chemical exposure risk factors are listed, although ionizing radiation to the head and neck is a risk factor. The reactive lymph node is secondary to the parotid tumor and is not malignant either. The scar is due to the surgical removal of the parotid (salivary) gland and lymph node. Other literature search of the National Library of Medicine and other sources did not reveal any chemical exposure risk factors for the Veteran's pleomorphic adenoma or references to associations with military service or occupations in general or specific..."

In evaluating a claim, the Board must determine the value of all evidence submitted, including lay and medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1335 (2006). The evaluation of evidence generally involves a three-step inquiry. First, the Board must determine whether the evidence comes from a "competent" source. Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159(a); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007), Layno v. Brown, 6 Vet. App. 465, 470 (1994). Lay evidence can also be competent and sufficient evidence of a diagnosis if (1) the medical issue is within the competence of a layperson, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Kahana v. Shinseki, 24 Vet. App. 428, 433 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

If the evidence is competent, the Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). (observing that once evidence is determined to be competent, the Board must determine whether such evidence is also credible). After determining the competency and credibility of evidence, the Board must then weigh its probative value. In this regard, the Board may properly consider internal inconsistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. Caluza v. Brown, 7 Vet. App. 498, 511-12 (1995).

The probative value of a medical opinion primarily comes from its reasoning; threshold considerations are whether a person opining is suitably qualified and sufficiently informed. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In this case, the Board accepts the September 2025 VA medical opinion that the Veteran's disorder is less likely than not related to service as probative medical evidence on this point. The Board notes that the examiner rendered this opinion after thoroughly reviewing the claims file and relevant medical records. The examiner noted the Veteran's pertinent history and provided a reasoned analysis of the case. See McCray v. Wilkie, 31 Vet. App. 243, 256 (2019).

The Board has considered the lay statements of the Veteran regarding his disorder. The Veteran is competent to provide evidence of what he experiences, including his symptomatology and medical history. See Layno v. Brown, 6 Vet. App. 465, 469
). In this case, the Board accepts the September 2025 VA medical opinion that the Veteran's disorder is less likely than not related to service as probative medical evidence on this point. The Board notes that the examiner rendered this opinion after thoroughly reviewing the claims file and relevant medical records. The examiner noted the Veteran's pertinent history and provided a reasoned analysis of the case. See McCray v. Wilkie, 31 Vet. App. 243, 256 (2019).

The Board has considered the lay statements of the Veteran regarding his disorder. The Veteran is competent to provide evidence of what he experiences, including his symptomatology and medical history. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). The Veteran is competent to report what he experienced. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, the Board does not find his statements to be as probative as the VA examiner's opinion, which was based on extensive review of the record, thorough examination, consideration of the lay statements, and the VA examiner's medical expertise.

Accordingly, the most probative evidence of record persuasively weighs against the claim of entitlement to service connection for lymph node and saliva gland removal due to tumor. The contemporaneous records establish that relevant systems were normal at separation and service treatment records do not document any relevant notations. The more probative evidence establishes that the Veteran's disorder is not related to his TERA. The evidence establishes that the remote onset of his disorder, specifically, the tumor itself, is unrelated to service. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt rule does not apply and service connection for lymph node and saliva gland removal is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

INCREASED RATINGS

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. The ratings are intended to compensate impairment in earning capacity due to a service-connected disease or injury. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

Separate diagnostic codes identify the various disabilities and the criteria for specific ratings. If two disability evaluations are potentially applicable, the higher evaluation will be assigned to the disability picture that more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of a veteran. 38 C.F.R. § 4.3.

1. Entitlement to a compensable disability rating for eczema

The Veteran's eczema is rated under Diagnostic Code 7806.

The Veteran's eczema is rated under Diagnostic Code 7806 and is currently rated as noncompensable.

Diagnostic Code 7806 is rated under a new General Rating Formula for the Skin. 38 C.F.R. § 4.118. The General Rating Formula for the Skin provides that 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, psoralen with long-wave ultraviolet-A light (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 rating is assigned for at least one of the following
light (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 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, PUVA, or other immunosuppressive drugs required over the past 12-month period. 38 C.F.R. § 4.118, General Rating Formula for the Skin.

As it pertains to amended Diagnostic Code 7806, 38 C.F.R. § 4.118(a) explicitly states 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."

The Veteran was afforded two VA examinations for his eczema.

The first VA examination occurred in May 2025. The Veteran was noted to have received treatment within the past 12 months, in particular corticosteroids (Triamcinolone). The medication was applied topically, and usage was less than six weeks over the past twelve months. The eczema was described as currently without any visible characteristic lesions at the time of the examination. The eczema did not impact the Veteran's ability to work.

The next VA examination occurred in May 2025. The Veteran was noted to have received treatment within the past 12 months, in particular corticosteroids (Triamcinolone). The medication was applied topically, and usage was six weeks or more over the past twelve months, but not at constant use. The eczema was described as currently without any visible characteristic lesions at the time of the examination. The eczema did not impact the Veteran's ability to work.

The Veteran testified in his January 2026 hearing about his eczema symptoms. He noted that his eczema manifests where he used to wear his combat boots. He testified that the eczema would leave sores and irritated skin prone to bleeding.

After a thorough consideration of the evidence, the Board finds that entitlement to a compensable rating is not warranted at this time. In order to receive a compensable rating, the Veteran would need to use intermittent systemic therapy for a total duration of less than 6 weeks. While the Veteran uses a corticosteroid cream, the Veteran's topical treatment is not considered to be systemic, as defined in the regulations. It is administered on the skin. A 10 percent rating would also be warranted for involvement of 5 to 20 percent of exposed areas or the entire body. It was noted by the examiner that the Veteran's skin condition was clear and showed no visible characteristic lesions.

The Board notes that the Veteran reported that his eczema comes and goes; however, the ratings under Diagnostic Code 7806 require to rate the severity of the Veteran's eczema at the time of his examination. The Board notes the post-hearing submission of a picture of his eczema, but the regulations are clear that the Veteran's rating is based on the symptoms at the time of his examination.

The Board is sympathetic to the Veteran's situation, particularly with the severity of his symptoms. However, it is bound by the statutes enacted by Congress and as a result of their application, must deny the Veteran's claim.

Accordingly, the most probative evidence of record persuasively weighs against the claim of entitlement to a compensable rating for eczema. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt rule does not apply and a compensable rating for eczema is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. Entitlement to a disability rating in excess of 10 percent for hypertension

The Veteran's hypertension is rated under Diagnostic Code 7101. He is currently in receipt of a 10 percent rating.

Under Diagnostic Code 7101, a 10 percent rating
rating for eczema. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt rule does not apply and a compensable rating for eczema is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. Entitlement to a disability rating in excess of 10 percent for hypertension

The Veteran's hypertension is rated under Diagnostic Code 7101. He is currently in receipt of a 10 percent rating.

Under Diagnostic Code 7101, a 10 percent rating is applicable if diastolic pressure is predominantly 100 or more, or systolic pressure is predominantly 160 or more, or there is a history of diastolic pressure of predominantly 100 or more and continuous medication is required to control blood pressure. A 20 percent rating is warranted if diastolic pressure is predominantly 110 or more or systolic pressure is predominantly 200 or more. A 40 percent rating is warranted where diastolic pressure is predominantly 120 or more. A 60 percent rating is warranted where diastolic pressure is predominantly 130 or more. 38 C.F.R. § 4.104, Diagnostic Code 7101.

The Board notes that rating criteria for cardiovascular systems in 38 C.F.R. § 4.104, which includes the ratings for hypertension, were modified effective November 14, 2021. See 86 Fed. Reg. 54089 (Sept. 9, 2021). However, the criteria for hypertension under Diagnostic Code 7101 was not changed, and the Board finds that no other diagnostic codes are pertinent to this claim.

The Veteran was afforded a VA examination in May 2025. Blood pressure readings measured 154/88, 168/90, and 160/92. The VA examiner noted that the Veteran does not have a history of a diastolic blood pressure elevation to predominantly 100 or more. The examiner did not find isolated systolic hypertension (that the systolic blood pressure is predominantly 160mm or greater with a diastolic blood pressure of less than 90mm). The examiner noted that the Veteran did have use medication to control his hypertension.

The Board has reviewed the Veteran's treatment records including submitted treatment records discussing the Veteran's hypertension. During the Veteran's hearing, he testified that his hypertension could be above 200 systolic if he did not take his medication.

After review, the Board finds that a compensable rating is not warranted. CAPRI records and other treatment records do not show that diastolic pressure is predominantly 110 or more or systolic pressure is predominantly 200 or more. Review of treatment records indicate that the Veteran's systolic pressure ranges in the 160s at worst while on medication. Treatment records also indicates that the Veteran's diastolic pressure tends to range in the low 90s while on medication. As such, the requirements for a higher rating are not met.

The Board also notes that it cannot consider the ameliorative effects of medication when the rating criteria considers the effects of medication. See Davis v. McDonough, No. 21-4309, 2022 U.S. App. Vet. Claims LEXIS 976 (Vet. App. June 27, 2022). While the Veteran testified that off his medication his symptoms are worse, the Board cannot use this testimony to increase his rating, as the rating criteria for hypertension already considers the effects of medication.

Accordingly, the most probative evidence of record persuasively weighs against the claim of entitlement to a higher percent rating for hypertension. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt rule does not apply and a higher rating for hypertension is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

3. Entitlement to a disability rating of 40 percent for radiculopathy of the sciatic nerve of the left lower extremity

4. Entitlement to a disability rating of 40 percent for radiculopathy of the sciatic nerve of the right lower extremity

After review, the Board finds that a 40 percent disability rating is warranted.

3. Entitlement to a disability rating of 40 percent for radiculopathy of the sciatic nerve of the left lower extremity

4. Entitlement to a disability rating of 40 percent for radiculopathy of the sciatic nerve of the right lower extremity

After review, the Board finds that a 40 percent disability rating is warranted.

The Veteran's radiculopathies are rated under Diagnostic Code 8520. Diagnostic Code 8520. Under Diagnostic Code 8520, paralysis of the sciatic nerve: a 10 percent rating is warranted for mild incomplete paralysis, a 20 percent rating is warranted for moderate incomplete paralysis, a 40 percent rating is warranted for moderately severe incomplete paralysis, and a 60 percent rating is warranted for severe incomplete paralysis with evidence of marked muscular atrophy. 38 C.F.R. § 4.124a.

Complete paralysis will be evaluated as 80 percent disabling for such symptoms as foot dangling and dropping, no active movement possible of muscles below the knee, and flexion of the knee weakened or (very rarely) lost. Id.

The terms "slight," "moderate," and "severe" are not defined in the rating schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to arrive at a just and equitable decision. Additionally, the use of such terminology by VA examiners and others, although an element to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6.

The term "incomplete paralysis" with peripheral nerve injuries indicates a degree of loss or impaired function substantially less than the type pictured for complete paralysis given with each nerve, whether due to the varied level of the nerve lesion or to partial regeneration. When the involvement is wholly sensory, the rating should be for mild, or at most, the moderate degree. See note at "Diseases of the Peripheral Nerves" in 38 C.F.R. § 4.124(a).

Neuritis, cranial or peripheral, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated at a maximum equal to severe, incomplete, paralysis. 38 C.F.R. § 4.123. The maximum rating which may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatic nerve involvement, for moderately severe, incomplete paralysis. Id.

The Veteran was afforded a VA examination in May 2025. The VA examiner concluded that the Veteran had incomplete paralysis in both sciatic nerves of the lower extremities. The examiner measured the severity as "moderate." The Veteran had paresthesias and/or dysesthesias in both lower extremities as well as constant pain; the severity of each symptom was found to be moderate. Muscle atrophy was not found. Muscle strength testing was normal. The reflex examination results were normal. The sensory examination results were also normal. There were no trophic changes observed. Assistive device usage was not noted. The examiner found that functioning was not diminished enough that amputation with prosthesis would equally serve the veteran.

The VA examiner noted that the Veteran's radiculopathies did not have any functional impact. However, the examiner's finding is contradictory with the Veteran's personally reported medical history in the examination: "He was referred to pain management and has had 4 ESI by [his doctor] in 2024 and 2025. In between the epidural steroid injections (ESI), he has difficulty walking, has difficulty raising his left leg to ascend stairs. He has low back pain on both sides and has extreme pain and tingling in the left leg radiating from his anterior thigh and at times as far as down his leg into his ankle."

During his hearing, the Veteran credibly reported falling and that he'd have balance issues with his legs. In particular, he noted that his left leg had given out on him multiple times. He also noted the use of a cane, a back belt, and a sciatica belt.

After review, the Board finds that both of the Veteran's radiculopathies should be increased to 40 percent.

In particular, the Board finds that while the radiculopathy was primarily manifested by sensory disturbance and pain, the Veteran's reporting makes it clear that there was impairment of motor functions, such as an inability to walk and sometimes to balance on his legs without help from a cane and other assistive locomotive devices. As such, the level of impairment is most analogous to moderately severe incomplete paralysis as it involves some non-sens
his legs. In particular, he noted that his left leg had given out on him multiple times. He also noted the use of a cane, a back belt, and a sciatica belt.

After review, the Board finds that both of the Veteran's radiculopathies should be increased to 40 percent.

However, the Board finds that a rating in excess of 40 percent is not warranted during this appeal period. There were no findings of muscle atrophy. There was no foot drop or dangling, and knee movement was not impaired. In other words, the criteria for severe incomplete paralysis with evidence of marked muscle atrophy was not found, and there was no complete paralysis. As such, higher ratings of 60 and 80 percent are not warranted for either extremity.

5. Entitlement to a compensable disability rating for bilateral sensorineural hearing loss

The Veteran's bilateral hearing loss is rated under Diagnostic Code 6100. He currently receives a noncompensable rating.

With respect to claims for service connection for hearing loss, the United States Court of Appeals for Veterans Claims (Court) has held that the threshold for normal hearing is from 0 to 20 decibels, and that higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). The Court further opined that 38 C.F.R. § 3.385, discussed below, then operates to establish when a hearing loss disability can be service connected. Id. at 159.

For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385.

In general, to evaluate the degree of disability from defective hearing, the Rating Schedule establishes eleven auditory acuity levels from Level I for essentially normal acuity through Level XI for profound deafness. 38 C.F.R. §§ 4.85, 4.87, Tables VI, VIa, VII. Organic impairment of hearing acuity is measured by the results of controlled speech discrimination tests together with the average hearing threshold level as measured by a pure tone audiometry test in the frequencies of 1,000, 2,000, 3,000, and 4,000 cycles per second. See 38 C.F.R. § 4.85(a), (d). Ratings of hearing loss disability involve mechanical application of the rating criteria to the findings on official audiometry. See Lendenmann v. Principi, 3 Vet. App. 345 (1992).

Exceptional patterns of hearing impairment are rated under 38 C.F.R. § 4.86. Specifically, an exceptional pattern of hearing loss is hearing loss of 55 decibels or more in each of the four specified frequencies (i.e. 1000, 2000, 3000, and 4000 Hertz), and hearing loss with a pure tone threshold of 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. 38 C.F.R. § 4.86(a), (b).

The Veteran first received a VA examination for his hearing loss in June 2025. The following results were recorded:

HERTZ CNC

1000 2000 3000 4000 Avg

RIGHT 35 35 35 45 38 94%

LEFT 35 45 30 40 38 88%

There is not an exceptional pattern of hearing loss in either ear. Applying 38 C.F.R. § 4.85, Table VI to the above audiological findings, the Veteran has a numeric designation of I for his right ear and II for his left ear. Application of 38 C.F.R. § 4.85, Table VII, results in a noncompensable evaluation.

The Veteran received an additional VA examination
in June 2025. The following results were recorded:

HERTZ CNC

1000 2000 3000 4000 Avg

RIGHT 35 35 35 45 38 94%

LEFT 35 45 30 40 38 88%

The Veteran received an additional VA examination for his hearing loss in October 2025. The following results were recorded:

HERTZ CNC

1000 2000 3000 4000 Avg

RIGHT 40 35 40 45 40 92%

LEFT 35 45 35 35 37.5 80%

There is not an exceptional pattern of hearing loss in either ear. Applying 38 C.F.R. § 4.85, Table VI to the above audiological findings, the Veteran has a numeric designation of I for his right ear and III for his left ear. Application of 38 C.F.R. § 4.85, Table VII, results in a noncompensable evaluation.

The Board has also reviewed the claims file, to include treatment records submitted post-hearing, when reviewing this claim.

The evidence is against a compensable evaluation for the bilateral hearing loss disorder. The evidence of record does not more nearly reflect the criteria for a higher evaluation. 38 C.F.R. § 4.7.

The Veteran's representative argues that the Veteran should be provided with a new examination, given that the October 2025 was conducted with a portable unit as opposed to being tested in a closed unit. The Board finds that this is not a duty to assist error, as portable units are commonly used for testing hearing loss. Even if this consisted of a duty to assist error, the Board notes that there is still the VA examination from June 2025, which provides useable results in line with the October 2025 examination.

To the extent that the Veteran reports that his hearing acuity is worse than evaluated during this period, the Board has considered his statements. However, far more probative of the degree of the disability are the results of testing prepared by a skilled professional since the schedular criteria are predicated on audiological findings rather than subjective reports of severity of hearing loss. In essence, lay statements are of limited probative value. As a layperson, the Veteran is competent to report difficulty with his hearing; however, he is not competent to assign particular speech recognition scores or puretone decibel reading to his current acuity problems. As indicated above, ratings of hearing loss disability involve mechanical application of the rating criteria to the findings on official audiometry.

The Board is sympathetic to the Veteran's situation, particularly with the severity of his symptoms and the difficulties with his hearing aids. However, it is bound by the statutes enacted by Congress and as a result of their application, must deny the Veteran's claim.

Accordingly, the most probative evidence of record persuasively weighs against the claim of entitlement to a compensable rating for left ear hearing loss. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt rule does not apply and compensable rating for left ear hearing loss is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

Melanie J. Mann

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Nelson, Jonah A

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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