Citation Nr: 9914140 Decision Date: 05/24/99 Archive Date: 06/07/99 DOCKET NO. 94-11 506 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Phoenix, Arizona THE ISSUES 1. Entitlement to service connection for a strained arch of the right foot. 2. Entitlement to service connection for a right knee disorder. 3. Entitlement to service connection for a neck disorder. 4. Entitlement to service connection for varicocele and epididymitis. 5. Entitlement to an initial compensable evaluation for the residuals of herpes simplex virus infection. 6. Entitlement to an initial evaluation in excess of 10 percent for pseudofolliculitis barbae, keloids under the chin, and alopecia areata of the scalp. 7. Entitlement to an initial evaluation in excess of 10 percent for rhinitis. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD D. L. Smith, Associate Counsel INTRODUCTION The veteran had active service from January 1982 to October 1992. This appeal is before the Board of Veterans' Appeals (Board) from a July 1993 determination of the Phoenix, Arizona, Department of Veterans Affairs (VA) Regional Office (RO). Initially, the Board notes that this case involves an appeal as to the initial ratings for the veteran's herpes simplex virus infection; pseudofolliculitis barbae, keloids under the chin, and alopecia areata of the scalp; and, rhinitis. The issue of an initial evaluation differs from an increased rating claim where entitlement to compensation had previously been established. See Fenderson v. West, 12 Vet. App. 119, 126 (1999) (holding that in initial rating cases, separate ratings can be assigned for separate periods of time based on the facts found, a practice known as "staged" ratings). FINDINGS OF FACT 1. The claim for service connection for strained arch of the right foot is not supported by cognizable evidence showing that the claim is plausible or capable of substantiation. 2. The claim for service connection for a right knee disorder is not supported by cognizable evidence showing that the claim is plausible or capable of substantiation. 3. The claim for service connection for a neck disorder is not supported by cognizable evidence showing that the claim is plausible or capable of substantiation. 4. Entitlement to service connection for varicocele and epididymitis lacks legal merit as service connection has already been granted for spermatoceles. 5. The probative medical evidence shows that the lesions due to the viral infection by the herpes simplex virus are slight and present on both a small and nonexposed area. 6. The probative medical evidence shows that pseudofolliculitis barbae is moderately disfiguring and is present on an extensive exposed area, but is neither severely disfiguring nor productive of marked disfigurement. 7. The probative medical evidence does not show that alopecia areata of the scalp is manifested by greater than slight symptoms or that keloids under the chin are moderately disfiguring, tender and painful on objective demonstration, or poorly nourished with repeated ulceration. 8. The probative medical evidence does not show that allergic rhinitis is manifested by polyps or by moderate crusting and ozena. CONCLUSIONS OF LAW 1. The veteran's claim for service connection for strained arch of the right foot is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). 2. The veteran's claim for service connection for right knee disorder is not well grounded. 38 U.S.C.A. § 5107(a). 3. The veteran's claim for service connection for a neck disorder is not well grounded. 38 U.S.C.A. § 5107(a). 4. The criteria for service connection for varicocele and epididymitis have not been met. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303 (1998). 5. The criteria for an initial compensable evaluation for the residuals of herpes simplex virus infection have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 4.7, 4.20, 4.118, Diagnostic Code 7806 (1998). 6. The criteria for an initial evaluation in excess of 10 percent for pseudofolliculitis barbae, keloids under the chin, and alopecia areata of the scalp have not been met. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. §§ 4.7, 4.118, Diagnostic Codes 7800, 7806 (1998). 7. The criteria for an initial evaluation in excess of 10 percent for rhinitis have not been met. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. §§ 4.7, 4.97, Diagnostic Code 6501 (1996); 61 Fed. Reg. 46,720 (1996) (effective October 7, 1996) (codified at 38 C.F.R. §§ 4.7, 4.97, Diagnostic Code 6522 (1998)). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Criteria: Service Connection The initial question is whether the veteran has submitted a well-grounded claim. A well grounded claim is a plausible claim, one which is meritorious on its own or capable of substantiation. Such a claim need not be conclusive but only possible to satisfy the initial burden of 38 U.S.C.A. § 5107(a) (West 1991). Murphy v. Derwinski, 1 Vet. App.78, 81 (1990). In order for a claim to be well grounded, there must be (1) competent evidence of a current disability (a medical diagnosis); (2) of incurrence or aggravation of a disease or injury in service (lay or medical evidence); and (3) of a nexus between the in-service injury or disease and the current disability (medical evidence). Caluza v. Brown, 7 Vet. App. 498 (1995). Where the determinative issue involves medical etiology, competent medical evidence that the claim is "plausible" is required in order for the claim to be well grounded. See Caluza, 7 Vet. App. at 504; Lathan v. Brown, 7 Vet. App. 359, 365 (1995); Grottveit v. Brown, 5 Vet. App. 91 (1993). For the purposes of determining whether a claim is well grounded, the credibility of the evidence in support of the claim is generally presumed. Arms v. West, 12 Vet. App. 188, 193 (1999) (citing Robinette v. Brown, 8 Vet. App. 69, 75 (1995)). Where the claim is well grounded VA has a statutory duty to assist the veteran in his claim. 38 U.S.C.A. § 5107(a) (West 1991). The duty to assist under § 5107(a) includes the duty to obtain pertinent records. See Block v. Brown, 7 Vet. App. 343 (1994); Smith v. Brown, 7 Vet. App. 255 (1994); Caffrey v. Brown, 6 Vet. App. 377 (1994). Service connection may be granted for a disability resulting from personal injury suffered or disease contracted in line of duty or for aggravation of preexisting injury suffered or disease contracted in line of duty. 38 U.S.C.A. §§ 1110, 1131 (West 1991). Where a veteran served during a period of war or peacetime service on or after January 1, 1947, and a presumptive disease such as arthritis becomes manifest to a degree of 10 percent within one year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 1991 & Supp. 1998); 38 C.F.R. §§ 3.307, 3.309 (1998). Further, for the showing of chronic disease in service, there are required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or diagnosis including the word "chronic." 38 C.F.R. § 3.303(b). When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. Id. Regulations also provide that service connection may be granted for any disease diagnosed after discharge when all of the evidence including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). When, after consideration of all of the evidence and material of record in an appropriate case before VA, there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b); 38 C.F.R. §§ 3.102, 4.3 (1998); see also Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990) (finding that entitlement need not be established by a fair preponderance of the evidence). Service connection for strain of the arch of the right foot Factual background The service medical records do not show any complaints, treatment or a diagnosis of a strained arch of the right foot. The veteran reported a strained arch, spasms, and tightness of the arch of the right foot in an April 1993 VA examination. The examiner found that there were no significant residual problems, other than occasional minor aches and pain. X-rays of the right foot revealed minimal hallux valgus, small sesamoids beneath the distal ends of the second, third, fourth, and fifth metatarsals. VA outpatient treatment records show that the veteran was seen in January 1994 at which time he was given a prescription for orthotics. The record contains a private report showing that he ordered a pair of orthotics in January 1994. The veteran reported at his May 1994 personal hearing he was told that he had flat feet in response to his pain of the arch and that his big toe disorder could have caused the flat feet. He reported that he worked on hard floors during service and wore boots which could have caused his arch problem. An August 1994 VA outpatient treatment report shows that the veteran reported painful arches, bilaterally. The assessment was bilateral plantar fasciitis. An assessment in a separate August 1994 report shows that the orthotics were causing irritation to the medial band of the plantar fascia. A follow-up examination shows that he had no complaints or pain with the orthotic adjustment. During an April 1995 personal hearing the veteran reported that he complained of his right foot problems during service to physicians, but never specifically sought treatment for his strain of the right arch. He reported that he was diagnosed shortly following separation from service with a weakened right arch. A July 1995 VA outpatient treatment report shows an assessment of tibial sesamoiditis. The veteran complained of pain of the right big toe in an August 1995 VA treatment report. The report shows that orthotics had not helped pain under the great toe, but had eliminated arch pain. On physical examination, the examiner found pain on palpation of the first metatarsal head, right plantar metatarsal and right tibial sesamoid. The diagnoses were metatarsalgia of the first metatarsal head, possible sesamoiditis of the right tibial sesamoids. Physical examination of the right foot on VA examination in April 1996 revealed pronation of the right foot and pain on palpation of the sesamoid area and at the right first metatarsophalangeal joint. The diagnosis was painful tibial sesamoid, right, secondary to pronation (weak arch) of the right foot. In an August 1996 VA examination, the examiner found that the veteran had pes planus somewhat more on the right than the left and moderate bilateral hallux valgus somewhat more on the right than the left. The examiner also found some pronation of the right foot. The examiner opined that there was no etiologic relationship between the stated right big toe injury during service and the later development of a strained arch. He further noted that the veteran had bilateral pes planus and bilateral hallux valgus, somewhat more on the right than the left, and that these were basically preexisting conditions. A December 1996 medical report of a private podiatrist shows that the veteran reported pain in the area of the arch and first metatarsal that started during service in 1991 or 1992. The veteran reported that he injured his first metatarsophalangeal joint of the right foot and had a job where he was on his feet six to eight hours at a time. The examiner's diagnoses included hallux abducto-valgus bilateral pronation, degenerative joint disease, residual metaductus, and foot sprain. The examiner noted that the veteran had a congenital abnormality of the metaductus, which would predispose a pes planus foot structure. The examiner informed the veteran that repetitive trauma, extended periods of standing, and athletic activities certainly cause exacerbation of the deformity. A December 1996 medical report of a private podiatrist shows diagnoses of hallux valgus deformity, foot pain, and plantar fasciitis. The veteran requested the examiner to give an opinion as to whether standing for long periods in combat- type boots could have precipitated or caused his foot problems. The examiner opined that such an activity, if extensive over long periods of time, could possibly be contributory to his health status. He further explained that it would be somewhat impossible to be specific as to the etiology, but that the above should be considered at least one possibility. In December 1996, the veteran submitted several excerpts from various sources regarding the nature of foot disorders including flat feet, plantar fasciitis, and hallux valgus. A September 1997 VA examination report shows diagnoses of moderate right tibial sesamoiditis, moderate plantar fasciitis greater on the right than the left, and mild bilateral bunion deformity. Analysis The Board reiterates the three requirements for a well grounded claim: (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of inservice incurrence or aggravation of a disease or injury; and, (3) medical evidence of a nexus between the claimed inservice injury or disease and a current disability. See Caluza, supra. Following a review of the evidence of record, the Board finds that the veteran's claim for service connection for strain of the arch of the right foot is not well grounded. With respect to the first element, the probative medical evidence shows that the veteran has a current right foot disability. For example, the August 1996 VA examination report shows pronation of the right foot and hallux valgus, and painful right tibial sesamoid secondary to the pronation. The probative medical evidence also shows that the veteran has pes planus. Thus, the record contains medical evidence of a current right foot disability. With respect to the inservice injury or disease element, the Board notes that the veteran reported at his April 1995 personal hearing that his right foot pain began during service. In addition, the December 1996 private medical report shows that the veteran reported that his right foot pain had its onset during service. In this regard, the Board notes that the veteran is competent to relate symptoms of foot pain. Layno v. Brown, 6 Vet. App. 465 (1994); see also Falzone v. Brown, 8 Vet. App. 398, 405 (1995). The Board finds that the record does not contain evidence of a nexus between the veteran's right foot pain reported to have had its onset during service and his current right foot diagnoses. The Board notes that, generally speaking, lay persons are not competent to offer evidence that requires medical knowledge. See Grottveit v. Brown, 5 Vet. App. 91, 93 (1993) (holding that lay assertions of medical causation cannot constitute evidence to render a claim well grounded); see also Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992) (holding that a witness must be competent in order for his statements or testimony to be probative as to the facts under consideration). The issue of whether the veteran's current right foot disability is linked to his claimed inservice right foot pain involves an issue of medical causation. The Board finds that the two medical opinions of the private podiatrists are too general and speculative to provide a nexus between the veteran's current right foot disability and complaints of foot pain during service. The first opinion links exacerbation of the foot deformity to repetitive trauma, extended periods of standing, and athletic activities. This opinion is speculative because the examiner did not link the veteran's current right foot disorders to the veteran's history of extended periods of standing during service. The report shows that the veteran was on his feet for extended periods of time in the course of the day in connection with his current employment. The examiner does not link the veteran's right foot disorders to his history of extended periods of standing during service as a food service worker versus the veteran's extended periods of standing in his current employment as a postal carrier. Secondly, the examiner noted that the veteran had a congenital abnormality, which could predispose him to a pes planus foot structure. The regulations provide that congenital or developmental defects are not diseases or injuries within the meaning of applicable legislation. 38 C.F.R. § 3.303(c). In connection with this regulation, VA General Counsel has held that service connection may be granted for diseases, but not defects, of congenital, developmental or familial origin. VAOPGCPREC 82-90 (O.G.C. Prec. 82-90). Hence, the congenital abnormality noted by the examiner may not be service connected under VA regulations. The Board also finds that the opinion provided by the second private podiatrist in December 1996 is too speculative to provide a nexus between the veteran's current right foot disability and his complaints of inservice foot pain. The veteran requested an opinion whether his combat boots could have caused or precipitated his foot problems. The opinion shows that the examiner did not reply in the affirmative, but rather found that standing for long periods of time, if extensive, could possibly be contributory to his health status. In this case, "could possibly be contributory to his health status" is too inconclusive to establish a nexus. See Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). The podiatrist states in the next sentence that it would be somewhat impossible to be specific as to the etiology, but the long periods of standing should be considered as one possibility. Here, "somewhat impossible" is too indefinite to render the veteran's claim well-grounded. Id. The Board notes that the veteran is currently service connected for hallux valgus of the right great toe due to an inservice injury. The veteran contends that his fallen arch of the right foot is due to his great toe injury. The regulations provide that disability which is proximately due to or the result of a service-connected disease or injury shall be service connected, and when thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. 38 C.F.R. § 3.310 (1998). The probative medical evidence does not show that the veteran's right arch disorder is proximately due to or the result of his service-connected right great toe disability. The only evidence expressing a relationship between the veteran's arch disorder and his service-connected great toe is against the claim. The VA examiner in August 1996 opined that there is no etiologic relationship between the right big toe injury and the development of the strained arch. The Board notes that this issue requires competent medical evidence; hence, the lay testimony of the veteran does not well ground his claim for a right arch strain on a theory of secondary service connection. Caluza and Espiritu, supra. Service connection for a right knee disorder Factual background The service medical records show that the veteran was seen in July 1986 for several abrasions following a motor vehicle accident including abrasions of the right knee. The service medical records do not show any other complaints of treatment for or a diagnosis of a right knee disorder during service. In an April 1993 VA examination, the examiner characterized the veteran's right knee pain when kneeling down as having no significant residual problems and further noted that the veteran had only occasional minor aches and pains. X-ray films revealed minimal loss of the medial articular space and a small exostosis along the lateral side of the proximal tibia was noted anterior to the articulation with the fibula. The veteran reported at his May 1994 personal hearing before a hearing officer at the RO that he injured his right knee during service in a motor vehicle accident. He reported current problems of sharp pain when he kneels down. A January 1998 VA outpatient treatment report shows that the veteran was seen for complaints of right knee pain for three months. The diagnosis was chondromalacia patella. Analysis The Board finds that the veteran's claim for service connection for a right knee disorder is not well grounded because no competent nexus evidence has been submitted to support his claim. The Board notes that the evidence of record shows that the veteran currently has a diagnosis of chondromalacia patella of the right knee as shown in a January 1998 VA outpatient treatment report. Hence, the first element of a current disability has been established. Caluza, supra. The record also contains evidence of an inservice injury. The service medical records show that the veteran sustained abrasions of the right knee in July 1986. However, the probative evidence does not establish the third element for a well grounded claim, that is, the record does not show that the veteran's current diagnosis of chondromalacia patella is linked to his inservice abrasions. The Board notes that the issue of whether a right knee abrasion is linked to a current diagnosis of chondromalacia patella involves an issue of medical causation for which competent medical evidence is required. See Grottveit and Espiritu, supra. The record does not contain any such nexus evidence. In this regard, the veteran reported in a July 1998 statement that the VA orthopedic physician informed him that his inservice injury, where he hit his right knee, caused his current knee disorder. The United States Court of Appeals for Veterans Claims (known as the United States Court of Veterans Appeals prior to March 1, 1999) (hereinafter, "the Court") has held that statements of a physician filtered through a lay person's sensibilities is too attenuated and inherently unreliable to constitute medical evidence. Robinette v. Brown, 8 Vet. App. 69, 77 (1996). Moreover, the January 1998 VA outpatient report from the orthopedic clinic contains no indication that the veteran's inservice knee injury is linked to the current diagnosis. In the absence of medical nexus evidence, the Board must deny the veteran's right knee claim as not well grounded. Service connection for a neck disorder Factual background The service medical records show that the veteran was treated for abrasions to the head and neck following the July 1986 motor vehicle accident. The July 1986 report shows that examination of the cervical spine was nontender and x-rays were negative. A September 1986 report shows the veteran had a piece of glass excised under local anesthetic. The VA examiner in April 1993 found that range of motion of the cervical spine was within normal limits. The examiner noted no significant discomfort was found objectively. The examiner's impression was cervical muscle pain. He characterized the disorder as no significant residual problem and occasional minor aches and pains. X-rays of the cervical spine were essentially within normal limits. VA outpatient treatment records show the veteran was seen for complaints of neck pain between May 1993 and October 1993. He reported that he had neck pain since he initially injured his neck five to six years before in the May 1993 report. The examiner found decreased range of motion in all directions and diagnosed probable degenerative disc disease. The June 1993 report shows an assessment of muscle movement spasm. The October 1993 report shows an assessment of chronic neck pain. In a March 1994 VA outpatient orthopedic report, the examiner noted no neck pain for two years following the motor vehicle accident and current pain on any motion or activity. Physical examination of the neck was normal and the examiner diagnosed cervical spondylosis of unknown etiology. The x- ray report shows no change from previous evaluations and was noted by the radiologist to be essentially within normal limits. The veteran reported that he currently has pain when he moves his neck at his May 1994 personal hearing. He reported that he hurt his neck during the motor vehicle accident at which time he hit his head on the windshield. Analysis Initially the Board notes that the veteran is currently service connected for the residuals of excision of a piece of glass of the neck as a result of the July 1986 inservice injury. The Board will address the issue of service connection for a neck disorder separate from the neck disability resulting from the excision of the piece of glass. In the case at hand, the Board finds that the veteran's claim for service connection for a neck disorder is not well grounded. Although the record contains medical evidence of a neck injury as a result of the July 1986 motor vehicle accident, the evidence of record regarding the veteran's neck disorder does not establish the third requirement, that is, medical evidence of a nexus between the inservice injury or disease and a current disability. Caluza, supra. The Board notes that the record does not contain medical nexus evidence linking the veteran's inservice neck injury and the current diagnoses of probable degenerative joint disease, muscle motion spasm, soft tissue joint injury, and cervical spondylosis. The Board notes, however, that evidence of a nexus between an inservice injury and a current disability may be provided by continuity of symptomatology under 38 C.F.R. § 3.303(b). Savage v. Gober, 10 Vet. App. 488, 498 (1997). The Board finds that the last sentence of 38 C.F.R. § 3.303(b) is applicable to the facts in the instant case. That sentence states "[w]hen the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim." Id. Here, the veteran reported that he injured his neck during service due to the July 1986 motor vehicle accident. The service medical records contain no complaints of, or treatment for a neck disorder other than abrasions following the accident, thus, chronicity during service of the neck disorder is not adequately supported in the record and continuity of symptomatology following discharge is required to support the claim of service connection for a neck disorder. See Savage, 10 Vet. App. at 498. Competent evidence must relate the present condition to the continuity of symptomatology. Savage, supra. Under these circumstances, the Board finds that the claim is not well grounded because the question of whether there is a relationship between the current diagnoses and the continuity of symptomatology demonstrated involves a medical question which the veteran, as a lay person, is not competent to offer. See Grottveit and Espiritu, supra. The probative medical evidence contains diagnoses of probable degenerative joint disease, muscle motion spasm, soft tissue joint injury, and cervical spondylosis. Here, continuity of symptomatology cannot be used to well ground the claim without competent medical evidence that links the asserted neck pain symptomatology to the current diagnoses. The record does not contain such medical evidence. For these reasons and bases, the Board finds that the absence of competent medical evidence establishing a nexus between the veteran's current neck disorder and his inservice injury or the neck pain of which he has complained since service renders not well grounded his claim for service connection for the residuals of the inservice neck injury. Service connection for varicocele and epididymitis Factual background The veteran was seen on approximately nine occasions during service between January 1985 and March 1992 for cysts of the right testicle. The January 1985 report shows an assessment of right spermatocele. In August 1986, the examiner found a cystic mass along the right cord and diagnosed varicocele. The same examiner in September 1987 found a cystic mass of the right distal cord and diagnosed spermatocele. A September 1988 report shows an assessment of questionable epididymal cyst of the right supratesticular area. A March 1992 urology consultation report shows symptoms of a palpable mass of the right testis. The examiner found a 1.5 centimeter granuloma at the right epididymal head and diagnosed granuloma of the right epididymis. At his May 1994 personal hearing, the veteran reported that he was treated during service for varicocele, spermatocele, and epididymitis during service, which he indicated were given different names. He reported that the masses always bother him and are tender when he bumps the scrotum and also cause discomfort during sexual intercourse. A September 1994 VA outpatient report shows the veteran reported scrotal tenderness. The examiner's assessment shows testicular mass and questionable cyst and questionable varicocele. A September 1994 ultrasound report of the right testicle shows that there was no evidence of a hydrocele or varicocele. The procedure revealed three cysts all located at the superior aspect of the epididymis. A February 1995 report shows an assessment of epididymal cysts based upon the results of the ultrasound findings. An April 1996 scrotal ultrasound revealed three cystic fluid- filled appearing echo-densities of variegated size superior to the visualized right testicular silhouette, consistent with spermatoceles. The April 1996 VA examination report shows that on physical examination, there were three smooth cystic lesions having characteristics of a spermatocele located in the head of the epididymis from the size of a pea to the size of a small marble. The examiner's diagnosis was multiple spermatoceles. Analysis The Board notes that the veteran requested service connection in his January 1993 original claim for "spermatocele/varicocele/epididymitis." In an October 1996 rating decision, the RO granted service connection for spermatoceles. Thus, the issue currently before the Board is whether service connection is warranted for varicocele and epididymitis. A varicocele is a "condition manifested by abnormal dilation of the veins of the spermatic cord, [which results] in impaired drainage of blood into the spermatic cord veins when the patient assumes the upright position." Nici v. Brown, 9 Vet. App. 494, 495 (1996) (citing Stedman's Medical Dictionary 1907 (26th ed. 1995)). Spermatocele is defined as a "[c]yst of the epididymis containing spermatozoa." Stedman's Medical Dictionary 1644 (26th ed. 1995). Epididymitis is defined as "an inflammation of the epididymis," which is "the elongated cordlike structure along the posterior border of the testis." Wright v. Gober, 10 Vet. App. 343, 345 (1997) (citing Dorland's Illustrated Medical Dictionary 566 (28th ed. 1988)). The Board finds that the following language in the VA regulations are instructive in the current appeal; "[d]ifferent examiners, at different times, will not describe the same disability in the same language." In the case at hand the Board finds that service connection is not warranted for either varicocele and epididymitis on the basis that the symptomatology for which the veteran sought service connection has been service connected under the diagnosis of spermatoceles. Hence, to service connect varicocele and epididymitis would constitute service connection for the same disability under various diagnoses. In the context of rating service-connected disabilities, the regulations provide that the evaluation of the same disability under various diagnoses is to be avoided. 38 C.F.R. § 4.14 (1998). The probative medical evidence, inservice and postservice, shows that the veteran is currently service connected for the symptomatology for which he sought treatment during service, notwithstanding the different diagnoses provided by the examiners. As noted above, the examiners during the veteran's service consistently found a testicular mass on the superior aspect of the right testicle, notwithstanding the different diagnoses including spermatocele, varicocele, epididymal cyst, and granuloma. The postservice medical evidence shows that on ultrasound in September 1994, the examiner diagnosed three masses as epididymal cysts. On the subsequent April 1996 ultrasound report, the examiner found three smooth cystic lesions and diagnosed spermatoceles. Each ultrasound report shows that the location of the cysts was in the same area, that is, the superior aspect of the epidymidis. Accordingly, the probative medical evidence consistently shows that the veteran was seen for a testicular mass on the superior aspect of the right testicle, currently diagnosed on the basis of scrotal ultrasound as three spermatoceles. Following a review of the probative medical evidence of record and the veteran's contentions, the Board finds that the veteran has been granted service connection for the inservice symptomatology for which he sought service connection. Accordingly, the Board finds that service connection for varicocele and epididymitis is not warranted as service connection already has been granted for spermatoceles. Cf. Ashford v. Brown, 10 Vet. App. 120, 123 (1997) (finding that the veteran's lung disability, by any name, remained the same and was inextricably intertwined with his previous claim for service connection for a lung disorder and thus was subject to the reopening requirements of 38 U.S.C. § 5108). In light of the fact that the veteran is already service connected for spermatoceles, the Board finds that the claims for varicocele and epididymitis lack legal merit. Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). Other matters Although the Board considered and denied the veteran's claims for a neck disorder and a right knee disorder on grounds different from that of the RO, which denied the claims on the merits, the veteran has not been prejudiced by the decision. This is because in assuming that the claims were well grounded, the RO accorded the appellant greater consideration than his claims in fact warranted under the circumstances. Bernard v. Brown, 4 Vet. App. 384 (1993). In light of the implausibility of the appellant's claims and the failure to meet his initial burden in the adjudication process, the Board concludes that he has not been prejudiced by the decision to deny his appeal for service connection for a neck disorder and a right knee disorder. The Board further finds that the RO has advised the veteran of the evidence necessary to establish a well grounded claim in the April and August 1998 supplemental statements of the case. The veteran has not indicated the existence of any evidence that has not already been obtained that would well ground his claims. McKnight v. Gober, 131 F.3d 1483 (Fed. Cir. 1997); Epps v. Brown, 9 Vet. App. 341, 344 (1996), aff'd sub nom. Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997). The veteran's service representative contended in the April 1999 informal hearing presentation that VA has expanded its duty to assist and the obligation of VA to fully develop a claim before making a decision on claims that are not well grounded citing provisions of the VA Adjudication Procedure Manual M21-1. M21-1, Part IV, paras. 1.01(b), 2.10(f). The representative asserts that if the record lacks evidence of any of the three elements of the Caluza test, then it is very likely due to a procedural defect in the manner that the RO handled the case. The representative does not identify any such procedural defects. Following a review of the record, the Board finds that the RO was not under a duty to assist the appellant in developing facts pertinent to his claims for service connection prior to the submission of a well grounded claim. In this regard the United States Court of Appeals for the Federal Circuit (hereinafter, "Court of Appeals") recently held that under 38 U.S.C. A. § 5107(a), VA has a duty to assist only those claimants who have established well grounded claims. Epps v. Gober, 126 F.3d 1464, 1469 (Fed. Cir. 1997). The Court of Appeals further stated with respect to the doctrine of benefit of the doubt contained in 38 U.S.C. A. § 5107(b): Moreover, the last sentence of § 5107(b) makes it clear that a claimant's § 5107(a) burden to submit evidence sufficient to establish a "well grounded" claim is the claimant's alone. ... [T]he statute indicates that giving the benefit of the doubt to a claimant does not relieve the claimant of carrying the burden of establishing a well grounded claim. Id. at 1469. The Board is bound by the precedent decision of the Court of Appeals in Epps. In Tobler v. Derwinski, 2 Vet. App. 8, 14 (1991), the Court held that a decision in that Court, unless or until overturned in an en banc decision, or by the Court of Appeals; and, any rulings, interpretations, or conclusions of law contained in such a decision are authoritative and binding as of the date the decision is issued and are to be considered and, when applicable, are to be followed by VA agencies of original jurisdiction, the Board of Veterans' Appeals, and the Secretary in adjudicating and resolving claims. The regulations provide that in consideration of appeals, the Board is bound by applicable statutes, VA regulations, and precedent opinions of the General Counsel of the Department of Veterans Affairs. The Board is not bound by Department manuals, circulars, or similar administrative issues. 38 C.F.R. § 19.5 (1998). The Board notes that the Manual M21-1 is issued by the VA Chief Benefits Director and according to the regulation it does not appear that the Board would be bound by such an administrative issue. But see Cohen v. Brown, 10 Vet. App. 128, 138 (1997) (holding that certain Manual M21-1 provisions are substantive rules which are equivalent of VA regulations). The statutory guidance on this issue states that the Board shall be bound in its decisions by the regulations of the department, instructions of the Secretary, and the precedent opinions of the chief legal officer of the department. 38 U.S.C.A. § 7104(c) (West 1991 & Supp. 1998). The General Counsel of VA has held that the provisions of Manual M21-1, Part I, paragraph 50.45 did not constitute "instructions of the Secretary." VAOPGCPREC 07-92 (O.G.C. Prec. 07-92). Moreover, the Board is not bound by an administrative issuance that is in conflict with binding judicial decisions. Bernard v. Brown, 4 Vet. App. 384, 394 (1993). The regulation promulgated regarding VA's duty to provide assistance in developing claims tracks the language of the statute. 38 U.S.C.A. § 5107(a); 38 C.F.R. § 3.159 (1998). The Court of Appeals clearly held in Epps that the claimant must submit a well grounded claim before the duty to assist attaches to the claim. Criteria: Increased Evaluations Disability evaluations are determined by the application of a schedule of ratings which is based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C.A. § 1155; 38 C.F.R. Part 4 (1998). Generally, the degrees of disabilities specified are considered adequate to compensate for a loss of working time proportionate to the severity of the disability. 38 C.F.R. § 4.1. In considering the residuals of injury, it is essential to trace the medical-industrial history of the disabled person from the original injury, considering the nature of the injury and the attendant circumstances, and the requirements for, and the effect of, treatment over past periods, and the course of the recovery to date. 38 C.F.R. § 4.41. Where an increase in a service-connected disability is at issue, the present level of disability is of primary concern. Although review of the recorded history of a service- connected disability is important in making a more accurate evaluation, see 38 C.F.R. § 4.2, the regulations do not give past medical reports precedence over current findings. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). When, after consideration of all of the evidence and material of record in an appropriate case before VA, there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; see also Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990) (finding that entitlement need not be established by a fair preponderance of the evidence). Entitlement to a compensable initial evaluation for the residuals of herpes simplex virus infection Factual background The veteran reported in the April 1993 VA examination that his symptoms due to his herpes infection flare up once in every two to three months. The examiner found no herpetic lesions at the time of examination. The examiner diagnosed recurrent herpes infection, in remission at the time of examination. A VA outpatient treatment report dated in January 1994 shows that the veteran sought medication for herpes. He reported four episodes of herpes per year. The diagnosis was herpes genitalis and hydrocortisone cream was prescribed for the lesions. In February 1994, the veteran was seen for complaints of genital warts. The examiner found a pinpoint condyloma at the right lateral midshaft and diagnosed condyloma acuminatum. The veteran reported at his May 1994 personal hearing that outbreaks of his lesions last approximately one and one half weeks and cause a burning, itching sensation. VA outpatient treatment records dated in September and November 1994, and February 1995 show that the veteran was seen for symptoms of scrotal tenderness and painful penile scar. A June 1995 VA urology examination of the penis revealed no evidence of acute or chronic infection. VA examination of the veteran in April 1996 revealed no evidence of condyloma. The examiner diagnosed history of condyloma. Criteria In the absence of a specific diagnostic code for herpes, disability ratings for residuals of herpes must be evaluated on the basis of analogy. When an unlisted condition is encountered it will be permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. Conjectural analogies will be avoided, as will the use of analogous ratings for conditions of doubtful diagnosis, or for those not fully supported by clinical and laboratory findings. Nor will ratings assigned to organic diseases and injuries be assigned by analogy to conditions of functional origin. 38 C.F.R. § 4.20. In the instant case, herpes simplex virus infection is evaluated pursuant to the schedular criteria for the skin. The applicable provisions provide a 10 percent evaluation for superficial, poorly nourished scars, with repeated ulceration. 38 C.F.R. § 4.118, Diagnostic Code 7803. A 10 percent evaluation is warranted for superficial scars which are tender and painful on objective demonstration. 38 C.F.R. § 4.118, Diagnostic Code 7804. Other scars are rated on limitation on function of part affected. 38 C.F.R. § 4.118; Diagnostic Code 7805. The schedular criteria for eczema provide a noncompensable evaluation when there is slight, if any, exfoliation, exudation or itching, if on a nonexposed surface or small area. 38 C.F.R. § 4.118, Diagnostic Code 7806. A compensable evaluation of 10 percent is warranted for eczema with exfoliation, exudation or itching, if involving an exposed surface or extensive area; and a 30 percent evaluation is warranted for exudation or constant itching, extensive lesions or marked disfigurement. Id. Analysis The Board finds that the veteran has presented a well- grounded claim for an initial compensable rating for his service-connected herpes within the meaning of 38 U.S.C.A. § 5107(a). When a claimant is awarded service connection for a disability and subsequently appeals the RO's initial assignment of a rating for that disability, the claim continues to be well grounded as long as the rating schedule provides for a higher rating and the claim remains open. Shipwash v. Brown, 8 Vet. App. 218, 224 (1995). The Board is also satisfied that all relevant facts have been properly developed. The record contains a VA general medical examination performed in June 1995 and VA urology examinations in June 1995 and April 1996. The record also contains VA outpatient treatment records reflecting treatment for the genitourinary system. No further assistance to the veteran is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107. The Board finds that a compensable evaluation is not warranted for the residuals of the veteran's herpes simplex viral infection. First, the probative medical evidence does not show that the herpetic lesions consist of superficial poorly nourished scars or are ulcerated. The medical evidence also does not show that the lesions are tender and painful on objective demonstration. Second, the herpetic lesions are not manifested by exfoliation, exudation or itching, on an exposed surface or extensive area; nor are the lesions manifested by exudation or constant itching, extensive lesions or marked disfigurement to warrant a compensable evaluation pursuant to the criteria for eczema. The Board notes that the assignment of a particular diagnostic code is "completely dependent on the facts of a particular case." Butts v. Brown, 5 Vet. App. 532, 538 (1993). In the instant case, the veteran's disease is manifested by approximately four episodes per year consisting of lesions on the veteran's penis. The veteran described the outbreaks of the lesions as causing an itching and burning sensation. The Board finds that the veteran's symptomatology is more closely approximates the nature of the impairment contemplated in the schedular criteria for eczema. The Court has found that in a case involving herpes, a medical examination must be performed when the infection is in its active stage. Bowers v. Derwinski, 2 Vet. App. 675, 676 (1992). The Board finds that the VA outpatient treatment reports dated in January and February 1994 show examination of the veteran's disease at its active stage. The January 1994 report shows an assessment of herpes genitalis and that he was prescribed hydrocortisone. The examiner in the February report described the lesion as a pinpoint condyloma on the midshaft of the veteran's penis. These reports establish that the veteran's disease is present on a small nonexposed area. The reports do not show that the veteran's disease involves an exposed or extensive area. The Board finds that the veteran's symptomatology approximates the criteria for slight eczema on a nonexposed area. As noted above, the veteran was examined on several occasions at which time lesions were not observed. For example, lesions were not found on VA examinations performed in April 1993, June 1995, and April 1996. These examinations are probative of the frequency of the lesions, which are not shown to be manifested by constant exudation or itching for an evaluation of 30 percent. Based upon a full review of the record, the Board finds that the evidence is not so evenly balanced as to require application of the benefit of the doubt in favor of the veteran. Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). Accordingly, the Board finds that the criteria have not been met for an initial compensable schedular evaluation for the residuals of herpes simplex virus infection. 38 U.S.C.A. § 1155; 38 C.F.R. § 4.118, Diagnostic Code 7806. As the Board noted earlier, this case involves an appeal as to the initial rating of the veteran's residuals of herpes simplex virus infection, rather than an increased rating claim where entitlement to compensation had previously been established. Fenderson v. West, 12 Vet. App. 119, 126 (1999). In initial rating cases, separate ratings can be assigned for separate periods of time based on the facts found, a practice known as "staged" ratings. As the Board has denied entitlement to an initial compensable evaluation for the appellant's residuals of herpes simplex virus infection, assignment of staged ratings is not for consideration. Entitlement to an initial evaluation in excess of 10 percent for pseudofolliculitis barbae, keloids under the chin, and alopecia areata of the scalp Factual background In an April 1993 VA examination, the veteran reported that he did not shave his beard off and the examiner noted that there were no acute lesions due to pseudofolliculitis barbae. The veteran also reported that he had laceration scars under his chin due to the inservice motor vehicle accident. The examiner noted that keloid formation due to the lacerations were not observable through the veteran's thick beard. The veteran also reported that he had a 1 centimeter area of alopecia over the left temple. The examiner noted that the area was very minor and was not very significant, nor disfiguring. A February 1994 VA outpatient report shows an assessment of a patch of alopecia and a March 1994 VA report shows that the alopecia areata was found to be stable. The veteran reported at his May 1994 personal hearing before the hearing officer that his pseudofolliculitis barbae causes problems when he has to shave. He reported that he must shave when he has an assignment as a part-time model and that four out of five times, shaving causes bumps. He reported that his beard does not completely cover the keloids under his chin. The veteran described his alopecia areata as a little spot of loss of hair on the left side of his face. On VA examination in May 1996, the examiner noted a small area of alopecia in the left upper sideburn measuring approximately 7 by 13 millimeters in greatest dimension. The examiner found no inflammation, erythema, or scaling. Criteria The Board notes that pseudofolliculitis is an unlisted condition in the schedule of ratings. 38 C.F.R. § 4.20. Pseudofolliculitis is evaluated by analogy to the schedule of ratings for the skin. Disfiguring scars of the head face or neck warrant an evaluation of 10 percent when such scars are moderately disfiguring in degree. 38 C.F.R. § 4.118, Diagnostic Code 7800. Disfiguring scars of the head, face or neck that are severe in degree especially if manifested by a marked and unsightly deformity of eyelids, lips, or auricles warrant a 30 percent evaluation. Id. In addition, a 10 percent evaluation is warranted for superficial scars which are tender and painful on objective demonstration. 38 C.F.R. § 4.118, Diagnostic Code 7804. The applicable provisions also provide a 10 percent evaluation for superficial, poorly nourished scars, with repeated ulceration. 38 C.F.R. § 4.118, Diagnostic Code 7803. Other scars are rated on the basis of loss of function of the part affected. 38 C.F.R. § 4.118; Diagnostic Code 7805. The schedular criteria for eczema provide compensable evaluation of 10 percent when manifested by exfoliation, exudation or itching, if involving an exposed surface or extensive area; and a 30 percent evaluation is warranted for exudation or constant itching, extensive lesions or marked disfigurement. 38 C.F.R. § 4.118, Diagnostic Code 7806. Analysis The Board finds that the veteran has presented a well- grounded claim for an initial rating in excess of 10 percent for his skin disabilities within the meaning of 38 U.S.C.A. § 5107(a); Shipwash, 8 Vet. App. 218 at 224. The Board is also satisfied that all relevant facts have been properly developed. The record contains a general VA examination performed in April 1993, a May 1996 dermatological examination, and VA outpatient treatment records. No further assistance to the veteran is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107. Initially, the Board notes that the veteran is currently in receipt of a 10 percent evaluation for three separate disabilities affecting the same bodily system. The veteran sustained lacerations of the chin due to the July 1986 motor vehicle accident during service. The probative medical evidence also shows that he has two separate skin disorders, alopecia areata and pseudofolliculitis, in the facial area. Notwithstanding the three separate diagnoses, the Board finds that an initial evaluation greater than 10 percent for pseudofolliculitis barbae, keloids under the chin, and alopecia areata of the scalp is not warranted. The probative medical evidence does not show that the keloids under the chin and alopecia areata warrant compensable evaluations. The VA examiner in April 1993 characterized the alopecia as very minor and the May 1995 examination report shows that the alopecia was localized to a small area. The examiner found that there was no inflammation, erythema, or scaling. Thus, the probative medical evidence does not show that the alopecia is manifested by greater than slight symptoms. The probative evidence also does not show that the keloids under the chin are moderately disfiguring, tender and painful on objective demonstration, or poorly nourished with repeated ulceration to warrant a compensable evaluation. The April 1993 VA examination report shows that the examiner described the keloids as minor and found that the veteran's beard successfully covered the keloids. The probative evidence shows that pseudofolliculitis barbae is manifested by a beard, which when shaved, results in lesions on an extensive portion of the face. The Board finds that the veteran's manifestations meet the schedular criteria for a 10 percent evaluation under the criteria for disfiguring scars of the face as well as the criteria for eczema. The veteran also gave testimony at his personal hearing with respect to the impact of the disorder on his part-time employment. The evidence does not show that pseudofolliculitis barbae is severe such that it is productive of marked or unsightly deformity of the eyelids, lips, or auricles. 38 C.F.R. § 4.118, Diagnostic Code 7800. The evidence also does not show that the pseudofolliculitis barbae is manifested by constant itching or exudation, extensive lesions, or marked disfigurement to warrant an evaluation of 30 percent under the schedular criteria for eczema. 38 C.F.R. § 4.118, Diagnostic Code 7806. In this regard, the VA examiner noted in April 1993 that no acute lesions of pseudofolliculitis were found on examination. Based upon a full review of the record, the Board finds that the evidence is not so evenly balanced as to require application of the benefit of the doubt in favor of the veteran. Gilbert, 1 Vet. App. at 56. Accordingly, the Board finds that the criteria have not been met for an initial, schedular evaluation greater than 10 percent for pseudofolliculitis barbae, keloids under the chin, and alopecia areata of the scalp. 38 U.S.C.A. § 1155; 38 C.F.R. § 4.118, Diagnostic Codes 7800, 7806. As the Board noted earlier, this case involves an appeal as to the initial rating of the veteran's skin disabilities, rather than an increased rating claim where entitlement to compensation had been previously established. Fenderson. In initial rating cases, separate ratings can be assigned for separate periods of time based on the facts found (staged ratings). In view of the Board's denial of entitlement to an increased evaluation for the appellant's skin disabilities, a staged rating is not warranted. Entitlement to an initial evaluation for rhinitis greater than 10 percent Factual Background The April 1993 VA examination report shows an assessment of minor sinusitis and rhinitis, well-controlled with use of medication. X-rays of the frontal, ethmoid, maxillary and sphenoid sinuses were essentially clear and the examiner found that the study was essentially normal. A March 1995 VA outpatient treatment report shows that the veteran sought treatment for rhinitis. Physical examination revealed a blockage of the right side of the nose by swollen turbinates. The assessment was allergic rhinitis. The veteran reported in an April 1996 VA examination that he had symptoms of chronic sneezing, watery rhinorrhea, pruritus, and lacrimation of both eyes. Physical examination of the external nose and nasal vestibule was normal. Examination of the septum revealed a mild spur along the left floor of the nose. The examiner noted that the inferior turbinates, inferior olfactory area, and superior turbinates were essentially normal. The examiner found no evidence of nasal polyps or purulent discharge. An allergy screen showed mild reaction to eleven antigens and very mild reaction to another thirteen antigens. The diagnosis was allergic rhinitis. A May 1996 computed axial tomography (CAT) scan of the sinuses found marked hypertrophy at the mucosa around the inferior middle nasal turbinates on the right and to a significantly lesser extent on the left. The examiner also noted some mucosal thickening in the ethmoid air cells and minimal blockage of the ostia around the middle nasal turbinate, the ostiomeatal complex on the bone window on the right side, but not the left. Criteria The Board notes that the schedule of ratings for diseases of the respiratory system was amended in September 1996 during the pendency of the veteran's appeal. 61 Fed. Reg. 46,720 (1996) (effective October 7, 1996) (codified at 38 C.F.R. § 4.97). Where a regulation changes after a claim has been filed or reopened but before the administrative or judicial appeal process has been concluded, the "version most favorable to appellant" applies. Karnas v. Derwinski, 1 Vet. App. 308, 313 (1991). The criteria in effect prior to October 7, 1996, for chronic atrophic rhinitis provided a 10 percent evaluation for the disorder when manifested by definite atrophy of intranasal structure and moderate secretion. 38 C.F.R. § 4.96, Diagnostic Code 6501 (1996). The next higher evaluation of 30 percent required moderate crusting and ozena, and atrophic changes. Id. The amended criteria provide a 10 percent evaluation for allergic or vasomotor rhinitis when manifested by greater than 50 percent obstruction of nasal passage on both sides or complete obstruction on one side, without polyps. 38 C.F.R. § 4.97, Diagnostic Code 6522 (1998). Allergic rhinitis manifested by polyps warrants an evaluation of 30 percent. Id. Analysis The Board finds that the veteran has presented a well- grounded claim for an initial rating in excess of 10 percent for his allergic rhinitis within the meaning of 38 U.S.C.A. § 5107(a); Shipwash, supra. The Board is also satisfied that all relevant facts have been properly developed. The record contains a general VA examination performed in April 1993, an April 1996 VA examination of the sinuses, and a May 1996 CAT scan of the sinuses. No further assistance to the veteran is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107. In the case at hand, the Board finds that an evaluation in excess of 10 percent is not warranted for allergic rhinitis pursuant to the old or the revised criteria. The probative evidence shows that the veteran's allergic rhinitis is manifested by symptoms of chronic sneezing, watery rhinorrhea, pruritus, and lacrimation of the eyes, and obstruction of the right turbinate. The May 1996 VA CAT scan report shows clinical findings of marked hypertrophy at the mucosa around the inferior middle nasal turbinates on the right and some mucosal thickening in the ethmoid air cells. The probative medical evidence does not show that the veteran has moderate crusting and ozena for a 30 percent evaluation under the old criteria for chronic atrophic rhinitis. The probative medical evidence also does not show that the veteran has nasal polyps to warrant a 30 percent evaluation under the amended criteria for allergic rhinitis. Following a review of the entire record, the Board finds that the evidence is not so evenly balanced as to require application of the benefit of the doubt in favor of the veteran's claim. Gilbert, supra. Accordingly, the Board finds that the criteria have not been met for an initial evaluation greater than 10 percent for allergic rhinitis. 38 U.S.C.A. § 1155; 38 C.F.R. § 4.118, Diagnostic Codes 7800, 7806. As the Board has noted, this case involves an appeal as to the initial rating of the appellant's rhinitis, rather than an increased rating claim where entitlement to compensation had been previously established. Fenderson. In view of the fact that the Board has denied entitlement to an initial evaluation in excess of 10 percent for rhinitis, assignment of staged ratings is not applicable to the veteran's appeal. ORDER The veteran not having submitted well grounded claims of entitlement to service connection for strained arch of the right foot, a right knee disorder, and a neck disorder, the appeal is denied. Entitlement to service connection for varicocele and epididymitis is denied as a matter of law. Entitlement to an initial compensable evaluation for herpes simplex virus infection is denied. Entitlement to an initial evaluation in excess of 10 percent for pseudofolliculitis barbae, keloids under the chin, and alopecia areata of the scalp is denied. Entitlement to an initial evaluation in excess of 10 percent for rhinitis is denied. RONALD R. BOSCH Member, Board of Veterans' Appeals