Citation Nr: 0302101 Decision Date: 02/04/03 Archive Date: 02/19/03 DOCKET NO. 00-20 076 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Buffalo, New York THE ISSUE Entitlement to service connection for left leg varicose veins on a direct basis or as secondary to stasis dermatitis of the left leg. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD M. Salari, Counsel INTRODUCTION The veteran had active duty service from July 1977 to July 1981 and from March 1983 to May 1986. This appeal comes before the Board of Veterans' Appeals (Board) from a June 2000 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO) in Buffalo, New York. FINDING OF FACT Left leg varicose veins are related to the appellant's in- service thermal injury. CONCLUSION OF LAW Left leg varicose veins were incurred in service. 38 U.S.C.A. §§ 1131, 5103, 5103A, 5107 (West 1991 & Supp. 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326 (2002). REASONS AND BASES FOR FINDING AND CONCLUSION The veteran served on active duty, in pertinent part, at Fort Wainwright, Alaska. The service medical records neither document any evidence of varicose veins at service entrance, nor any diagnosis of varicose veins during active duty service. The records do show that the veteran was seen for a rash on his legs on several occasions and was diagnosed with chronic dermatitis of the legs. In January 1980 and April 1985, he was also seen for frostbite of the left foot. A December 1986 VA examination revealed that the veteran had stasis dermatitis due to an in-service thermal injury. A February 1987 rating decision awarded service connection for residuals of left frozen foot (frostbite), and left leg stasis dermatitis. A February 1988 VA orthopedic examination report indicates a diagnosis of residuals of frostbite of the left foot, with persistent, unchanged vasomotor instability symptoms, particularly at the left great toe, with cold sensitivity to cold. A June 1989 VA outpatient clinic note records that the appellant was positive for Raynaud's at 32°F. VA examination in December 1989 noted prominent left calf veins from the knee to the ankle, and then to the foot. A December 1989 VA treatment report noted that the veteran had left leg erythema, scaling, and lichenification, with varicosities. The diagnosis was stasis dermatitis. An October 1997 VA examination report indicates that the veteran had left leg dermatitis, likely secondary to venous stasis in the setting of varicose veins. Treatment resistance was judged to be likely due to a cold injury. A February 1998 VA examination report indicates that the veteran had varicose veins in the left leg. The diagnosis was stasis dermatitis, involving the left lower extremity from the knee down, with evidence of chronic venous insufficiency, varicose veins, and a chronic eczematous-type stasis rash. A February 1999 treatment report notes that the veteran had left lower leg dermatitis. The assessment was question of vascular etiology. A VA treatment report received in April 2000 indicates that the veteran's left leg was examined. He was diagnosed with stasis dermatitis due to varicose veins and chronic stasis/lichenoid dermatitis. An August 2000 VA outpatient clinic report opined that the veteran had varicose veins and dermatitis dating from his military service. Another VA treatment report, received in April 2001, notes that the veteran had stasis dermatitis secondary to left leg varicose veins. Service connection for a disability may be granted when it is due to a disease or injury incurred coincident with service, or if preexisting service, was aggravated therein. 38 U.S.C.A. § 1131; 38 C.F.R. § 3.303. A disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310. In the case at hand, the Board finds that direct service connection for varicose veins of the left leg is warranted. As noted above, the service medical records do not document any evidence of varicose veins upon entry into service. During service, he was diagnosed with chronic dermatitis, and he has been awarded service connection for stasis dermatitis of the left leg. The medical records state that the veteran's stasis dermatitis was caused by varicose veins. Thus, the logical conclusion is that varicose veins were incurred in service, as a result of which the veteran also incurred stasis dermatitis. Finally, it is well to note that a VA health care professional in August 2000 found that varicose veins were related to the appellant's active duty service. Given this evidence, service connection for varicose veins of the left leg must be granted. The Board notes that there has been a change in the law during the pendency of the appellant's claim. The Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096 (2000) (VCAA), significantly added to the statutory law concerning VA's duties when processing claims for VA benefits. This law redefines the obligations of VA with respect to the duty to assist and includes an enhanced duty to notify a claimant as to the information and evidence necessary to substantiate a claim for VA benefits. Implementing regulations are codified, in pertinent part, at 38 C.F.R. §§ 3.102, 3.159, 3.326(a) (2002). The VCAA and the implementing regulations are liberalizing and are therefore applicable to the issue on appeal. See Karnas v. Derwinski, 1 Vet. App. 308, 312-313 (1991). In light of the fact that there has been a full grant of benefits in the case at hand, the veteran is not prejudiced by the Board's review of the claim on the basis of the current record. ORDER Service connection for left leg varicose veins is granted. DEREK R. BROWN Member, Board of Veterans' Appeals IMPORTANT NOTICE: We have attached a VA Form 4597 that tells you what steps you can take if you disagree with our decision. We are in the process of updating the form to reflect changes in the law effective on December 27, 2001. See the Veterans Education and Benefits Expansion Act of 2001, Pub. L. No. 107-103, 115 Stat. 976 (2001). In the meanwhile, please note these important corrections to the advice in the form: ? These changes apply to the section entitled "Appeal to the United States Court of Appeals for Veterans Claims." (1) A "Notice of Disagreement filed on or after November 18, 1988" is no longer required to appeal to the Court. (2) You are no longer required to file a copy of your Notice of Appeal with VA's General Counsel. ? In the section entitled "Representation before VA," filing a "Notice of Disagreement with respect to the claim on or after November 18, 1988" is no longer a condition for an attorney-at-law or a VA accredited agent to charge you a fee for representing you.