Case A26040504

LAURA E. COLLINS · 2026 · Case ID: A26040504

MIXED

Summary

The veteran, who served from January 1973 to January 1993, appeals a December 2020 rating decision. The veteran initially appealed service connection for asthma and a 10 percent rating for multiple noncompensable disabilities, but these issues were withdrawn at a January 2025 Board hearing. The primary appeal concerned entitlement to a higher rating for tension headaches, which were previously granted service connection at a noncompensable level effective April 18, 2020. The veteran also appealed denials of compensable ratings for eczema and allergic rhinitis. For tension headaches, the Board applied the benefit of the doubt, granting a 30 percent rating based on the veteran's testimony at the hearing, which described headaches occurring "once or twice a week" and requiring him to "get away from everything" until medication took effect, approximating prostrating attacks. The Board found a higher rating unwarranted as the veteran's symptoms, even without medication, did not meet the criteria for severe economic inadaptability. Service connection for asthma and the 10 percent rating were dismissed due to withdrawal. The claims for eczema and allergic rhinitis were denied, as the evidence did not meet the criteria for a compensable rating, particularly regarding the frequency of lesions, body area affected, or use of systemic therapy for eczema, and the absence of nasal polyps or significant obstruction for allergic rhinitis.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210403-151297

Full Decision Text

Citation Nr: A26040504
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 210403-151297
DATE: April 30, 2026

ORDER

The claim of entitlement to service connection for asthma is dismissed.

The claim of entitlement to a 10 percent rating based on multiple noncompensable service-connected disabilities is dismissed.

Entitlement to a 30 percent initial rating for tension headaches since April 18, 2020 is granted, subject to the laws and regulations governing the award of monetary benefits.

Entitlement to a compensable rating for eczema is denied.

Entitlement to a compensable rating for allergic rhinitis is denied.

FINDINGS OF FACT

1. At the February 2024 Board hearing, prior to the promulgation of a decision in the appeal, the appellant requested to withdraw his appeals as to the issues of entitlement to service connection for asthma and to a 10 percent rating based on multiple noncompensable service-connected disabilities.

2. The competent and credible evidence of record is in approximate balance as to whether, since April 18, 2020, tension headaches were manifested by characteristic prostrating attacks occurring on average once a month over the last several months, but not by very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability.

3. The competent and credible evidence is neither evenly nor approximately balanced as to whether eczema was manifested by 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.

4. The competent and credible evidence is neither evenly nor approximately balanced as to whether the Veteran's allergic rhinitis resulted in polyps or at least 50 percent obstruction of a nasal passage.

CONCLUSIONS OF LAW

1. The criteria for withdrawal of the appeals of the issues of entitlement to service connection for asthma and to a 10 percent rating based on multiple noncompensable service-connected disabilities by the appellant are met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

2. The criteria for entitlement to a 30 percent rating, but no higher, for tension headaches since April 18, 2020 are met. 38 U.S.C. §§ 1155, 5107, 5110; 38 C.F.R. §§ 3.400, 3.655, 4.1, 4.7, 4.124a, DC 8100.

3. The criteria for entitlement to a compensable disability rating for eczema have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.118, DC 7806.

4. The criteria for entitlement to a compensable disability rating for allergic rhinitis are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.7, 4.96, DC 6522.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 1973 to January 1993.

These matters are before the?Board of Veterans' Appeals?(Board) on appeal of a December 2020 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In the April 3, 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on January 28, 2025.

Therefore, the Board may only consider the evidence of record at the time of the December 2020 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
28, 2025.

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.

1. The claim of entitlement to service connection for asthma is dismissed.

2. The claim of entitlement to a 10 percent rating based on multiple, noncompensable service-connected disabilities is dismissed.

An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.205. Withdrawal may be made by the appellant or by his authorized representative. 38 C.F.R. § 20.205. An oral withdrawal of an appeal, such as one made at a hearing, must be (1) explicit, (2) unambiguous, and (3) done with a full understanding of the consequences of such action on the part of the claimant. DeLisio v. Shinseki, 25 Vet. App. 45, 57 (2011); see Acree v. O'Rourke, 891 F.3d 1009, 1014 (Fed. Cir. 2018) (the Board must address all three prongs of the DeLisio standard when it applies). If the appeal involves multiple issues, the withdrawal must specify that the appeal is withdrawn in its entirety or list the issue(s) withdrawn from the appeal. 38 C.F.R. § 20.205 (b)(1).

Here, at the January 28, 2025 Board hearing, prior to the promulgation of a decision in the appeal, the Veteran, through his representative, explicitly and unambiguously informed the Board that he wished to withdraw his appeals as to the issues of entitlement to service connection for asthma and to a 10 percent rating based on multiple, noncompensable service-connected disabilities. The undersigned explained the consequences of such action and the Veteran and his representative expressed understanding and continued desire to withdraw the appeals. The Board finds that the criteria for an oral withdrawal are met and the issues of entitlement to service connection for asthma and to a 10 percent rating based on multiple, noncompensable service-connected disabilities are dismissed.

3. Entitlement to a 30 percent rating for tension headaches is granted.

The Veteran contends that his tension headaches are more severely disabling than represented by the currently assigned noncompensable rating. The Veteran was granted service connection for tension headaches in a December 2020 rating decision, rated noncompensable, effective April 18, 2020. He appealed from the initial rating.

Disability evaluations are determined by the application of the VA's Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

Where an increase in the level of a service-connected disability is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1999). Nevertheless, separate ratings can be assigned for separate periods of time based on the facts found, a practice known as "staged" ratings. See Fenderson v. West, 12 Vet. App. 119, 126 (1999). The analysis is therefore undertaken with consideration of the possibility that different ratings may be warranted for different time periods within the period on appeal.

Where there is a question as to which of the two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more
4.1.

Where there is a question as to which of the 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.

If the positive and negative evidence is in approximate balance, the claimant receives the benefit of the doubt. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The Veteran's tension headaches are evaluated under 38 C.F.R. § 4.124a, DC 8100. Under this code, headaches with characteristic prostrating attacks averaging one in two months over the last several months warrant a 10 percent evaluation. Headaches with characteristic prostrating attacks occurring on average once a month over the last several months warrant a 30 percent evaluation. Headaches with very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability warrant a 50 percent evaluation, which is the maximum evaluation available under this DC. 38 C.F.R. § 4.124a, DC 8100.

The rating criteria of DC 8100 are considered successive, meaning that a claimant cannot fulfill the criteria of the higher rating without fulfilling those of the next lower rating. Johnson v. Wilkie, 30 Vet. App. 245, 252 (2018). This renders 38 C.F.R. §§ 4.7 and 4.21 inapplicable. Id.

On VA examination in December 2020, the Veteran described headaches which occurred in the occipital region, were throbbing in nature and lasted a few hours at a time. They occurred "approximately [three] times per month" and resolved with use of ibuprofen. The examiner indicated that the headaches did not approximate "characteristic prostrating attacks of migraine/non-migraine headache pain" and there were not "very prostrating and prolonged attacks of migraines/non-migraine pain productive of severe economic inadaptability." There was no specific functional impairment associated with the tension headaches.

At his January 2025 Board hearing, the Veteran reported that his headaches required him to take Tylenol. While waiting for the Tylenol to take effect, he would need to "get away from everything" and "get to myself." He stated that he had a headache where he needed to get away "probably once a week ... maybe once or twice a week."

In Jones v. Shinseki, the United States Court of Appeals for Veterans Claims (Court) held that when assigning a disability evaluation, the Board may not consider the ameliorative effects of medication when those effects are not explicitly contemplated by the rating criteria. 26 Vet. App. 56, 61 (2012). In Ingram v. Collins, the Court reaffirmed its central holding in Jones. See Ingram v. Collins, 38 Vet. App. 130 (2025). DC 8100 does not account for the effects of medication. Therefore, the Board must discount the effects of medication in rating the Veteran's tension headaches. 38 C.F.R. § 4.124a.

In this case, while the VA examiner found no characteristic prostrating attacks of migraine/non-migraine headache pain, the examiner did not explicitly discount the effects of medication. The Veteran's January 2025 Board hearing testimony indicates that the Veteran's headaches caused him to need to "get away from everything" and be by himself until his medication took effect. This testimony provides no evidence of the severity of headaches in the absence of medication. The Board resolves reasonable doubt in the Veteran's favor and concludes that, in the absence of medication, his headaches would approximate characteristic prostrating attacks of migraine/non-migraine headache pain occurring "once or twice per week." Therefore, a 30 percent rating for tension headaches is warranted.

However, a rating in excess of 30 percent is not warranted for tension headaches in this case. Accepting the Veteran's description of his headaches at the January 2025 Board hearing, his headaches do not approximate "very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability" as required to support a higher
until his medication took effect. This testimony provides no evidence of the severity of headaches in the absence of medication. The Board resolves reasonable doubt in the Veteran's favor and concludes that, in the absence of medication, his headaches would approximate characteristic prostrating attacks of migraine/non-migraine headache pain occurring "once or twice per week." Therefore, a 30 percent rating for tension headaches is warranted.

However, a rating in excess of 30 percent is not warranted for tension headaches in this case. Accepting the Veteran's description of his headaches at the January 2025 Board hearing, his headaches do not approximate "very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability" as required to support a higher 50 percent rating. Significantly, while the Veteran reported a need to get away and be by himself, he did not describe being unable to do any tasks, as would be expected if his headaches were "completely prostrating." Moreover, the Veteran has not described his headaches as producing severe economic inadaptability, even in the absence of medication. Accordingly, the evidence weighs persuasively against a higher 50 percent rating.

As discussed above, the December 2020 VA examiner did not explicitly discount the effects of medication. However, in this case the Veteran's January 2025 Board hearing testimony provides a sufficient description of the severity of headaches in the absence of medication to inform the Board's judgment on this matter. As such, remand to obtain another medical opinion discounting the effects of medication would only serve to delay adjudication without any further benefit flowing to the Veteran. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991) (holding that remand is unnecessary where it would impose additional burdens on the Board with no benefits flowing to the veteran). Accordingly, remand is not required on this basis.

Based on the foregoing, the competent and credible evidence is in approximate balance as to whether tension headaches were manifested by characteristic prostrating attacks occurring on average once a month over the last several months, but not by very frequent, completely prostrating, and prolonged attacks productive of severe economic inadaptability, since April 18, 2020. The claim is granted, in part.

4. Entitlement to a compensable rating for eczema is denied.

The Veteran contends that his eczema is more severely disabling than represented by the currently assigned noncompensable rating. The Veteran was granted service connection for eczema in a December 2020 rating decision, rated noncompensable, effective April 18, 2020. He appealed from the initial rating.

This appeal is governed by the amended rating criteria for skin disabilities, effective August 13, 2018. Under the amended rating criteria for skin disabilities, a new General Rating Formula for the Skin applies to DCs 7806, 7809, 7813 to 7816, 7820 to 7822, and 7824. 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, 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 for 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 immun
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 DC 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."

On VA examination in December 2020, the Veteran described eczema on the right side of his neck, right knee and right arm. He reported eczema outbreaks approximately one to two times per month. The eczema was treated with topical cortisone cream for less than six weeks in the past twelve months. No other medications were used to treat eczema. Eczema affected less than five percent of the total body area and less than five percent of the exposed area. There was no associated scarring or disfigurement of the head, face or neck and there was no specific functional impairment related to eczema.

At his January 2025 Board hearing, the Veteran described an eczema rash around his neck, back, legs and groin. He stated that since the VA examination in December 2020, the rash had spread down his body and he was now on "near-constant" use of topical medication for the condition.

The evidence of record weighs persuasively against finding that a compensable rating is warranted for eczema during the period on appeal. In this regard, there is no evidence that eczema affected at least 5 percent, but less than 20 percent, of the entire body or at least 5 percent, but less than 20 percent, of exposed areas, or of any use of systemic therapy. On the contrary, the December 2020 VA examiner found that eczema affected less than five percent of the total body area, and the Veteran has reported only topical medication during the period on appeal.

The Board acknowledges that at the January 2025 Board hearing, the Veteran described his eczema spreading down his body, and stated that he now used topical medications constantly, or nearly constantly. The Veteran's testimony generally indicates that his eczema has worsened since the December 2020 examination. While the Veteran's testimony at the January 2025 Board hearing may be considered by the Board, the question on appeal regards the severity of the Veteran's condition at the time of the December 2020 rating decision. The Veteran's testimony describing worsening eczema since the December 2020 VA examination is thus not relevant to the period for consideration. There is no evidence of record indicating that the Veteran's eczema actually affected five percent of his total body area or five percent of the exposed area, and the Board cannot extrapolate such evidence from the Veteran's testimony.

While the Veteran used a corticosteroid, it is not considered "systemic" because it was a topical corticosteroid (administered through the skin), and amended DC 7806 specifically defines systemic medication as "treatment that is administered through any route other than the skin." With regard to the fact the Veteran reported constant topical medication use, a higher rating for eczema cannot be assigned based on use of topical medication alone, even where such medication is used constantly. Rather, a compensable rating under DC 7806 requires showing that the condition affects five percent of the total body area of five percent of the exposed area, or some degree of systemic medication. As these findings are not shown during the period for consideration on appeal, a higher rating must be denied.

The Board acknowledges that the Veteran used medication to treat his eczema during the period on appeal. The applicable diagnostic criteria explicitly contemplate medication use, so the Board is not required to discount the beneficial effects of medication when assigning an evaluation under this provision, and the December 2020 VA examination is not rendered inadequate for failure to discount any such beneficial effects.

Based on the foregoing, the competent and credible evidence is neither evenly nor approximately balanced as to whether a compensable rating for eczema is warranted. Rather
that the condition affects five percent of the total body area of five percent of the exposed area, or some degree of systemic medication. As these findings are not shown during the period for consideration on appeal, a higher rating must be denied.

Based on the foregoing, the competent and credible evidence is neither evenly nor approximately balanced as to whether a compensable rating for eczema is warranted. Rather, the evidence persuasively weighs against finding 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. The benefit of the doubt doctrine does not apply. 38 U.S.C. § 5107 (b), Lynch, supra. The claim is denied.

5. Entitlement to a compensable rating for allergic rhinitis is denied.

Diagnostic Code 6522 provides rating criteria for allergic or vasomotor rhinitis. A 10 percent rating is warranted for this if there are no polyps and either (1) greater than 50-percent obstruction of nasal passage on both sides or (2) complete obstruction on one side.

The Veteran is currently receiving a 0 percent (noncompensable) rating for this disability because he does not meet the criteria for a 10 percent rating or higher. The Board finds that this is the correct assessment and a compensable rating is not warranted.

In a December 2020 VA examination for rhinitis and sinusitis, the Veteran's diagnosis of allergic rhinitis was confirmed based on an in-person examination and review of the Veteran's electronic claims file. The Veteran reported that nasal congestion occurred mostly in the summer months, and that dusty situations trigger congestion and sneezing episodes. He took BC Powder if he needed it. The examiner indicated that there was permanent hypertrophy of the nasal turbinates, but there were no nasal polyps. Neither nasal passage was obstructed by 50 percent or more, to include complete obstruction.

At the January 2025 hearing , the Veteran's testimony focused on symptoms and a nasal scope that occurred during service. Relevant to the period on appeal, the Veteran testified that being around dust causes sneezing episodes and a lot of perspiration that "goes away, but I just have a lot of that."

There are no medical records documenting complaint, treatment, or diagnosis of nasal polyps or obstruction of 50 percent or greater. The Veteran has not asserted that either of these conditions are present.

The December 2020 examination report shows that the Veteran's documented hypertrophy of the nasal turbinates was not so severe that it blocked either nasal passage by 50 percent or more. Therefore, this symptom does not warrant a higher rating.

Neither the lay nor medical evidence shows that the Veteran had nasal polyps or sufficient obstruction in either nasal passage to meet the criteria for a compensable rating under DC 6522.

This DC does not explicitly contemplate medication use, so the Board must discount any ameliorative effects of medication in evaluating this disability. See Ingram. 38 Vet. App. 130. However, in this case the Veteran did not describe any ameliorating effects from the BC Powder he took when needed. He does not contend that without medication, his symptoms would meet the criteria for a higher rating. In order for the consideration of the medication to warrant a higher rating, the evidence would need to show that without the BC Powder, allergic rhinitis would cause nasal polyps or obstruction of nasal passage to at least 50 percent. Here, there is simply no contention, report, or evidence indicating that BC Powder, a common over-the-counter pain and fever reducer, reduced nasal obstruction to less than 50 percent or eliminated nasal polyps. Therefore, this consideration does not result in a higher rating.

Based on the foregoing, the Board finds that the competent and credible evidence is neither evenly nor approximately balanced as to whether a compensable rating for allergic rhinitis is warranted. Rather, the evidence persuasively weighs against the assignment of a 10 percent rating or higher. The benefit of the doubt doctrine does not apply. 38?U.S.C. §?5107(b), Lynch v. McDonough, 21 F
nasal passage to at least 50 percent. Here, there is simply no contention, report, or evidence indicating that BC Powder, a common over-the-counter pain and fever reducer, reduced nasal obstruction to less than 50 percent or eliminated nasal polyps. Therefore, this consideration does not result in a higher rating.

Based on the foregoing, the Board finds that the competent and credible evidence is neither evenly nor approximately balanced as to whether a compensable rating for allergic rhinitis is warranted. Rather, the evidence persuasively weighs against the assignment of a 10 percent rating or higher. The benefit of the doubt doctrine does not apply. 38?U.S.C. §?5107(b), Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (holding the benefit-of-the-doubt doctrine is not for application when the evidence is persuasively for or against the claim). The claim is denied.

Laura E. Collins

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Bametzreider, Paul

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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