BVA9509471 DOCKET NO. 90-52 700 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to an increased schedular disability rating for service-connected irritable bowel syndrome, currently rated as 10 percent disabling. 2. Entitlement to an increased schedular disability rating for the service-connected residuals of bilateral frozen feet, currently rated as 10 percent disabling. REPRESENTATION Appellant represented by: Steven E. Vagle, Attorney ATTORNEY FOR THE BOARD L. L. Gann, Associate Counsel INTRODUCTION The veteran had active service from June 1941 to November 1945. He was a prisoner-of-war of the German government from November 1944 to May 1945. This appeal arises from a rating decision dated in July 1989 from the St. Petersburg, Florida, Regional Office (RO), which denied an increased schedular rating for the veteran's service-connected frozen foot residuals, and awarded a 10 percent schedular rating for service-connected irritable bowel syndrome, and denied service connection for bilateral peripheral neuropathy. In August 1991, September 1992, and December 1993, the Board of Veterans' Appeals (Board) remanded this case to the RO to ensure compliance with due process considerations, and to obtain additional evidentiary development. We note that in February 1992, subsequent to the Board's first remand, the RO granted the veteran's claim for service connection for bilateral peripheral polyneuropathy, secondary to his POW experiences, and awarded 10 percent schedular disability ratings for the symptomatology noted in each leg. Inasmuch as the veteran did not appeal the schedular ratings assigned, the RO's action was considered to be a full grant of benefits on appeal, and no further consideration has been, or will be given, to this issue. The veteran's representative also submitted written argument in March 1994 disputing the effective dates of the schedular ratings respectively assigned by the RO in February 1992, for service-connected bilateral peripheral neuropathy and for irritable bowel syndrome. As noted by the RO, however, the representative first proffered these contentions almost two years after the veteran was originally notified of the schedular evaluations assigned. Since he did not timely appeal the February 1992 rating decision, the effective dates assigned in that action are final, and may not be reconsidered in the absence of new and material evidence. See 38 U.S.C.A. §§ 5108, 7105 (West 1991); 38 C.F.R. § 3.156 (1994). Thus the only remaining issues on appeal are those noted on the front page of this decision. The claims folder was most recently returned and docketed at the Board in January 1995, and the case is now ready for appellate review and consideration. In April 1995, the veteran's representative submitted additional argument, as well as copies of medical records not considered by the RO prior to certification of this appeal to the Board. We note, however, that the representative's correspondence specifically requested to Board to review this evidence, without regard to the RO's failure to review these records. We need not, therefore, return this claim to the RO for readjudication. See 38 C.F.R. § 20.1304 (1994). CONTENTIONS OF APPELLANT ON APPEAL The veteran essentially contends that his service-connected irritable bowel syndrome should be granted a rating in excess of 10 percent in light of the severity and frequency of his symptomatology, including diarrhea and constipation. He also asserts that his service-connected bilateral frozen foot residuals also warrant an increased schedular evaluation, particularly in light of the chronic paresthesia of the lower extremities from which he has suffered since service. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that a rating in excess of 10 percent is not warranted for the veteran's service-connected irritable bowel syndrome. Furthermore, we find that a rating in excess of 10 percent is not warranted for the veteran's service-connected residuals of bilateral frozen feet. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. In July 1989, the RO granted service connection for irritable bowel syndrome, and assigned a 10 percent schedular rating, which continues in effect. 3. The veteran's irritable bowel syndrome is manifested by recurrent episodes of constipation and occasional episodes of diarrhea. Some of these episodes are accompanied by abdominal discomfort, although during the course of his most recent Department of Veterans Affairs (VA) examination, he denied any significant abdominal pain or gastrointestinal bleeding. His weight is normal and he is not anemic. 4. In February 1947, the RO granted service connection for the residuals of bilateral frozen feet, and awarded a 10 percent disability evaluation. That schedular rating has remained in effect since the RO's initial award. 5. The veteran contends that he has suffered from bilateral paresthesia of the feet and lower legs since his separation from service in 1945, which he attributes to his bilateral trench foot in service. These symptoms have been associated with his bilateral peripheral neuropathy of the lower extremities, for which he has been awarded separate grants of service connection. 6. The veteran also suffers from bilateral peripheral vascular disease, with a claudicatory component, for which he has undergone multiple revascularization procedures. VA examiners opined in June 1989 and in December 1992 that his vascular symptomatology is most likely the result of progressive atherosclerosis occurring with age. The most recent VA examination, dated in July 1994, noted that he is currently being treated for high blood pressure and arteriosclerotic heart disease. CONCLUSIONS OF LAW 1. A schedular disability rating in excess of 10 percent is not warranted for the veteran's service-connected irritable bowel syndrome. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. § 4.7, Part 4, Diagnostic Code 7319 (1994). 2. A schedular disability rating in excess of 10 percent is not warranted for the veteran's service-connected residuals of bilateral frozen feet. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. § 4.14, Part 4, Diagnostic Code 7122 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board notes that the veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107 (West 1991). A well grounded claim is a plausible claim, one which is meritorious on its own or capable of substantiation. Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). We are also satisfied that all relevant facts have been properly developed so that further assistance to the veteran is not required. The veteran's original claim was received in September 1945. Service-connection for "Residuals of trench foot, mild" was granted in a February 1947 rating decision, and a 10 percent schedular disability rating was assigned effective from November 22, 1945. This schedular evaluation was confirmed in rating actions dated in May 1949, June 1979, November 1983, and July 1989. In the July 1989 decision, the RO also awarded service-connection for "Irritable bowel syndrome," and assigned a 10 percent schedular disability evaluation, effective from May 20, 1988. The veteran appeals from the 10 percent schedular ratings confirmed and/or assigned by the RO for his frozen foot residuals and irritable bowel syndrome in this rating action. These ratings were confirmed in subsequent rating actions issued in February 1992, March 1993, and October 1994. I. Irritable Bowel Syndrome The veteran appeals the RO's denial of an increased schedular disability rating for service-connected irritable bowel syndrome. Irritable bowel syndrome is rated pursuant to 38 C.F.R. Part 4, Diagnostic Code 7319 (1994), which states that mild symptomatology, such as disturbances of bowel function and occasional episodes of abdominal distress will warrant a noncompensable disability rating. Moderate manifestations, such as frequent episodes of bowel disturbances with abdominal distress, will be granted a 10 percent schedular rating. Where symptomatology is severe, with diarrhea, or episodes of alternating diarrhea and constipation, with more or less constant abdominal distress, a schedular evaluation of 30 percent will be awarded. Where there is a question as to which of 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 (1994). In a June 1989 VA examination, the veteran gave a subjective history of having eaten "contaminated" food while he was a POW. He also noted a history of nutritional deprivation during his captivity. Since service, he has experienced frequent loose bowel movements, approximately three to four times a day, accompanied by occasional abdominal pain. A 1983 barium enema indicated the presence of diverticulosis. The veteran also indicated that treatment with thiamine injections had alleviated his symptoms somewhat. On examination, his abdomen was soft and slightly obese, with no tenderness, tumors or organomegaly. Bowel sounds were normal. The examiner found that the subjective symptoms of recurrent diarrhea and abdominal pain, coupled with the presence of diverticulosis, were compatible with an irritable bowel syndrome. The veteran underwent another VA examination in December 1991, which found no abdominal masses, and active bowel sounds. A barium enema performed in association with this examination noted a "moderate number of sigmoid diverticula, without radiographic evidence of diverticulitis." Both the distal ileum and appendix appeared to be normal. The diagnosis was sigmoid diverticulosis. In March 1992, he sought VA outpatient treatment for "a problem with my bowels." He complained of tremendous gas, with morning emesis. His bowel movements were "very small and hard." A history of irritable bowel syndrome and diverticulosis was noted. Examination found the veteran to be "in no acute distress." His abdomen was slightly bloated, with no masses, and active bowel sounds. The diagnosis was irritable bowel syndrome. The next day, the veteran was admitted to the Lake City, Florida, VA Medical Center (VAMC) in March 1992, for a fecal impaction with partial small bowel obstruction. He presented to the facility with a two-day history of nausea, vomiting, decreased appetite, and mild abdominal pain. He stated that the onset of these symptoms occurred suddenly two days previously, after eating, and that he had not had a bowel movement since that time. His abdominal pain was diffuse and mild. Examination revealed a markedly distended abdomen with no bowel sounds auscultated. There was no tenderness or peritoneal signs of rebound or guarding. Guaiac was negative. He was admitted to the surgical service, where an x-ray showed multiple air/fluid levels with a marked amount of stool throughout the length of the colon. His electrolyte results were consistent with hypochloremic/hypokalemic metabolic alkalosis. He was manually disimpacted and treated with daily soap suds enemas. His manifestations improved and his electrolytes normalized. It was believed by examiners that the veteran's symptoms may have been attributable to the medication Nortriptyline, which was discontinued. His gastrointestinal functioning returned to normal. In a December 1992 VA examination, he again noted a history of intestinal problems since service, with recurrent episodes of diarrhea. He indicated, however, that the pattern of his symptoms had recently changed, and now manifested mainly as constipation. He denied any significant abdominal pain and denied any recent GI bleeding. His weight was normal, he was not anemic or malnourished, and he specifically denied any specific abdominal disturbance. The diagnosis was spastic colon, or irritable bowel syndrome, which the examiner felt was related to "the stress of being a POW." The most recent VA examination, performed in July 1994, noted a history of hard stool, followed by softer stools, occurring approximately three to four times per week. He denied episodes diarrhea, but did have constipation frequently. He indicated that his appetite was good, with no nausea, vomiting, or abdominal pain, although he did experience excessive flatus occasionally. Examination found that the abdomen was soft and nontender, with normal bowel sounds and a negative rectal examination. An upper gastrointestinal series enema indicated the presence of a small reducible hiatal hernia with tertiary contractions seen in the distal esophagus. There was no evidence of ulcer disease. A duodenal diverticular was seen in the second portion of the duodenum, but the small intestine was normal. A barium enema noted multiple diverticula involving the colon, with some spasm and apparent tracing of barium seen in the sigmoid colon area, suggesting possible diverticulitis. The diagnoses were a history of irritable bowel syndrome, with diverticulitis of the colon by x-ray. Upon review of the entire record, including the most recently obtained medical evidence, we conclude that a rating in excess of 10 percent is not currently warranted for the veteran's service-connected irritable bowel syndrome. Although the evidence sufficiently demonstrates that his gastrointestinal manifestations constitute a compensable disability pursuant to the applicable rating criteria, we do not find that these manifestations more nearly approximate a "severe" disability picture. The medical evidence presented does not indicate that the veteran suffers from "more or less constant abdominal distress" in association with his irritable bowel syndrome. Although he suffered from recurrent episodes of diarrhea approximately three to four times per week for many years, and now suffers from "frequent" constipation, there is no evidence that these episodes are constant or occur on a daily basis. Moreover, the veteran specifically denied in both the December 1992 and July 1994 VA examinations that he suffered from most other abdominal complaints, such as nausea, vomiting, abdominal pain, or other abdominal disturbances. With the exception of occasional flatus, his most recent VA examination was negative for any objective clinical findings other than recurrent constipation. Although the veteran was hospitalized for more than ten days during March 1992 for a fecal impaction and accompanying dehydration, the examiners did not find that these symptoms were either chronic or recurrent manifestations associated with his irritable bowel syndrome. In fact, he stated that his symptoms had a rapid onset, and the VA treating physicians attributed these symptoms to the use of the prescription drug Nortriptyline, rather than to any underlying disorder. The veteran's representative has raised several allegations concerning the March 1992 VA hospitalization record. He contends that the VA outpatient treatment for "irritable bowel syndrome" on the day before the veteran's admittance into the VA hospital in March 1992 does establish that his fecal impaction was really caused by irritable bowel syndrome, rather than a reaction to the drug Nortriptyline. He also cites to a subsequent document dated in January 1993 by Dr. R. Glasser, a VA neurologist, which noted that the veteran continued to take Nortriptyline for paresthesias related to peripheral vascular disease in his lower extremities. According to the representative, "VA neurologists determined that nortriptyline had not been the cause [of the veteran's fecal impaction], and they continued to prescribe the nortriptyline." A detailed review of these records indicates, however, that the representative's arguments are founded on little more than his own medical speculation and interpretation. We first note that we give greater weight to the conclusion of the March 1992 VA hospitalization report than the single VA outpatient record written the day before this hospitalization. The treating hospital physicians had a greater opportunity to examine, observe, and evaluate the veteran's condition during his eleven-day hospital stay than did the VA outpatient examiner in his single consultation. Thus the diagnosis made by the hospital examiners is grounded in far more medical evidence and objective information than the one made by the outpatient physician. Moreover, we are in disagreement with the representative's statements that VA neurologists subsequently determined that nortriptyline had not caused the veteran's March 1992 fecal impaction. From our reading of the reports by Dr. Glasser or the VA hospital pharmacy it does not appear that the relationship between the use of nortriptyline for a neurological condition, and its effect on the veteran's gastrointestinal disorder was discussed. Dr. Glasser does not refer to either this hospitalization or the veteran's gastrointestinal complaints, nor was a subjective history of an irritable bowel condition noted during the course of Dr. Glasser's examination report. While it is unknown whether Dr. Glasser had any knowledge of the veteran's other medical conditions, it seems clear from a review of this report and VA pharmacy reports that the representative's allegations are based on supposition rather than any actual statements made by a medical professional. As the representative is a lay person, with no medical expertise upon which to base his conclusions, his statements are entitled to little, if any, probative weight. See Espiritu v. Derwinski, 2 Vet.App. 492 (1992). It is clear from the numerous lower gastrointestinal studies performed since 1983 that the veteran does suffer from a bowel disorder, diagnosed specifically as diverticulosis, and that he suffers from varying complaints associated with this condition. The evidence presented does not, however, demonstrate that his symptomatology more nearly results in a severe, rather than a moderate, disability for compensation purposes. Therefore, we find that a schedular rating of 30 percent is not warranted for the veteran's service-connected irritable bowel syndrome. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. § 4.7, Part 4, Diagnostic Code 7319 (1994). II. Residuals of Bilateral Frozen Feet The veteran's residuals of bilateral frozen feet are evaluated pursuant to the rating criteria defined at 38 C.F.R. Part 4, Diagnostic Code 7122 (1994). Where residual symptomatology is mild, such as the presence of chilblains, the rating for a bilateral disability will be 10 percent. A 30 percent bilateral disability is manifested by persistent moderate swelling, tenderness, redness, and other similar symptoms. In cases where there is a loss of toes or other parts of the foot, and persistent severe symptoms bilaterally, a 50 percent schedular evaluation will be assigned. Throughout the course of this appeal the primary residual complaint registered by the veteran with regard to his frozen feet residuals is the presence of bilateral paresthesias in his feet and lower legs. He states that these burning, painful, numb sensations have been present since service, and have even prevented his use of bed covers at night, as the very weight of blankets results in severe pain. On numerous occasions, he has attributed these manifestations to both his exposure to extreme cold, as well as profound malnutrition, during his POW incarceration. We note, however, that in its February 1992 rating decision, the RO awarded service connection for bilateral peripheral neuropathy, and assigned a separate 10 percent disability rating for each lower extremity. This action was based primarily upon a January 1992 VA neurological examination which found the objective presence of bilateral paresthesias located from the knees to the feet, and noted that the veteran had complained of these same symptoms since 1945. The examiner opined that these manifestations were indicative of peripheral neuropathy caused by malnutrition, although the original findings proximate to service originally attributed these paresthesias to the veteran's bilateral frozen feet. Electromyography and nerve conduction studies confirmed the presence of peripheral neuropathy. The RO conceded service- connection for this disorder, although it could not definitively determine whether this condition was due to malnutrition or bilateral frozen feet. The evaluation of the same disability under various diagnoses is to be avoided. See 38 C.F.R. § 4.14 (1994). In this instance, the primary symptomatology claimed by the veteran with regard to his frozen feet has already been associated with the RO's grant of service connection for bilateral peripheral neuropathy. Although it was indicated by the RO that his paresthesias may be attributable to either malnutrition, or frozen feet in service, the fact remains that he is already receiving compensation for these neurological manifestations under another rating code. Therefore, in order to avoid "pyramiding" of disability ratings, we may not give further consideration to these symptoms with regard to the claim for an increased rating for bilateral frozen feet residuals. See Fanning v. Brown, 4 Vet.App. 225 (1993); Brady v. Brown, 4 Vet.App. 203 (1993) Thus the issue remaining is whether the veteran currently suffers any residual manifestations from his bilateral frozen feet in service which would warrant an increase in his schedular disability rating. In the June 1989 VA examination report, the veteran again noted the presence of paresthesias in the lower extremities. A review of the record also reveals a long history of circulatory problems in both extremities. He had previously undergone a bilateral common iliac endarterectomy in July 1973, a bilateral aorto-femoral bypass and exploration/embolectomy from the right common iliac artery in March 1976, and a right saphenous vein femoropopliteal bypass in August 1976. VA hospitalization records attributed these circulatory conditions to "atherosclerotic" peripheral vascular disease. Another VA hospitalization report, dated in April 1986, also diagnosed the presence of arteriosclerotic peripheral vascular disease, as well as arteriosclerotic cardiovascular disease. At the time of the 1989 examination, the veteran was scheduled to undergo additional surgical treatment for blockage in the right femoral artery. The VA examiner noted the presence of surgical scars at both groins. Femoral pulses were normal bilaterally, but the popliteal and pedal pulses were absent bilaterally. There was mild hyperpigmented skin noted in both lower legs at the distal part, and mild cyanosis in both feet and lower legs, the skin temperature was somewhat cold in the lower extremities beneath both knees, but there no skin ulceration was found. According to the assessment by the VA examiner, the veteran's foot problems were attributable to severe peripheral arterial insufficiency which could be a condition occurring after service, and is part of the normal aging process. He believed that the veteran's post-service recovery from frozen feet in service was probably "fairly good." The January 1992 VA neurology examination also noted the presence of a "superimposed vascular disorder of the lower extremities" which was first diagnosed and treated in 1970, and that this vascular insufficiency could have contributed to the severity of the veteran's peripheral neuropathy. The examiner did not, however, give any opinion as to the etiology of the vascular disorder itself. Accompanying x- rays, taken in December 1991, noted the presence of arteriosclerotic cardiovascular disease, with no cardiomegaly. Another series of VA examinations were performed in December 1992. The first examiner, a specialist in gastrointestinal disorders, noted a history of skin discoloration and paresthesias. The veteran claimed that he did not tolerate extremes of temperature very well, but had no other manifestations of peripheral vascular disease. On examination, his skin was discolored and his toes were "purplish" with a paucity of hair on the feet. Skin temperature was slightly cool. The examiner found "no cardiac involvement that we are aware of." An addendum by another examiner, however, noted that the veteran denied any problems with vascular disease. His examination found dopplerable pulses in the lower extremities bilaterally. The toes were ruberous, but there was no evidence of ulceration or tissue loss. The second examiner found that the veteran is a "stable claudicator" who did not require any vascular procedures at the time. He opined that the paresthesias noted since service were not related to vascular disease, which was the likely result of progressive atherosclerosis caused by aging. The veteran was then referred to a VA neurologist, who conducted an examination in January 1993. A history of bilateral paresthesias since 1944, as well as extensive peripheral vascular disease since the 1970's, was given. The examiner noted moderate ruber of the toes, bilaterally, and marked alopecia of both lower extremities, with no ulcerations. Sensory testing produced some very mild deficits in the lower extremities. The diagnoses were peripheral neuropathy, most likely secondary to bilateral frozen feet, and peripheral vascular disease with a claudicatory component which exacerbates his peripheral neuropathy symptoms. The most recent VA examination, dated in July 1994, noted previous treatment for peripheral vascular disease, as well as arteriosclerotic heart disease and high blood pressure. The veteran also indicated current treatment for both arteriosclerotic heart disease and high blood pressure. He takes several prescription medications, including a diuretic to help control swelling in his feet which he attributed to his heart disease. He did state that upon walking any distance, such as three blocks, he gets pain in his calves and hips. This pain is relieved upon resting. He also noted the presence of occasional pain in his feet, which is alleviated somewhat by exercising or stomping on the floor. Examination found normal femoral pulses, but posterior tibial pulses were absent, as was a dorsalis pedis pulse on left. The feet were, however, warm and of normal color. X-rays of the feet revealed minimal arthritis of the MP joints of the great toes, and calcaneal spurring on the left. The diagnoses were peripheral vascular disease with claudication, minimal arthritic changes of the MP joints in the great toes, and histories of frozen feet, and hypertensive/arteriosclerotic heart disease. After review of the record, we conclude that a rating in excess of 10 percent is not warranted for the veteran's service-connected residuals of bilateral frozen feet. There is some evidence that he currently suffers from mild hyperpigmented skin on the lower legs bilaterally, with occasional skin temperature changes in his lower extremities, ruber of the toes and a paucity of hair on the feet. We note, however, that the overwhelming weight of the evidence demonstrates that these symptoms are not the residual effects of bilateral frozen feet. The veteran suffers from a long history of circulatory problems with peripheral vascular disease. He has undergone multiple surgical procedures to maintain adequate arterial and venous circulation in his lower extremities. Numerous examinations have reported that his circulation continues to be questionable, in light of findings such as lowered skin temperature, cyanosis of the feet and lower legs, and absent popliteal and pedal pulses. While both the veteran's wife and his representative have proffered allegations that the manifestations of peripheral vascular disease are the result of bilateral frozen feet in service, service connection for this disorder was denied by the RO both in June 1979, and again in November 1983. Moreover, no positive evidence supporting this theory has been presented. The numerous VA hospitalization reports, dated in 1975, 1976, and 1986, for his various vascularization procedures note only the presence of an "atherosclerotic" peripheral vascular disease. No connection is made in these reports between the onset of this disorder and the history of bilateral frozen feet. Moreover, VA examiners of record have not opined that there is such a link between these two disorders. In fact, both the June 1989 examiner, and one of the December 1992 examiners, specifically found that the veteran's peripheral vascular disease was most likely due to progressive atherosclerosis caused by aging. The most recent VA examiner found only a history of bilateral frozen feet, with no current symptomatology or findings directly attributed to residuals of this condition. We acknowledge that some of the veteran's recurrent pain and aching of the feet may indeed be associated with the residual effects of frozen feet. These symptoms are consistent with those noted in VA examinations dated in 1947 and 1949, as well as his 1983 POW medical survey. We note, however, that according to the subjective histories given in the course of these examinations, his other foot symptomatology, including skin blistering, ulcerations, and discoloration, actually improved and eventually cleared while he was still a captive of the German government. By his own statements, as well as the subjective findings of various VA examiners, the only complaints associated with in-service frozen feet from 1944 to 1970 were the bilateral paresthesias, and some foot pain and aching after walking. From the more recent medical evidence, it does not appear that these complaints, or the severity and frequency of the symptoms noted, have changed in any material way. The most recent VA medical examination did reveal the presence of "minimal arthritic changes" of the MP joints in the large toes, bilaterally. Although it is plausible that these degenerative changes could have a traumatic component related to cold exposure in service, the rating codes do not provide any basis upon which to grant an increased rating. The rating criteria at 38 C.F.R. Part 4, Diagnostic Code 5010-5003 (1994) states that x-ray evidence showing arthritic involvement in two or more major or minor joint groups will warrant a 10 percent schedular evaluation. Only if such x- ray evidence is accompanied by evidence of occasional, incapacitating exacerbations will a 20 percent rating be granted. No evidence has been presented, however, which indicates that the minimal arthritis noted in the veteran's great toes results in any type of incapacitating exacerbations. We find, therefore, that the record simply does not demonstrate that the veteran's current residuals attributable to his bilateral frozen feet in service currently result in more than the mild impairment reflected by his 10 percent schedular rating for this disability. Inasmuch as his only consistent complaints have been rated pursuant to another diagnostic code, and as his current manifestations of temperature change, discoloration, and swelling have been attributed to non-service-connected disabilities, we find that an increased schedular disability rating for the residuals of bilateral frozen feet is not warranted. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4, Diagnostic Code 7122 (1994). ORDER Entitlement to a schedular disability rating in excess of 10 percent for service-connected irritable bowel syndrome is denied. Entitlement to a schedular disability rating in excess of 10 percent for service-connected residuals of bilateral frozen feet is denied. JACK W. BLASINGAME Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.