Decision Date: 11/13/95				Archive Date: 
11/09/95 
DOCKET NO.  93-20 927	)	DATE 
	) 
	) 
 
On appeal from the 
Department of Veterans Affairs Regional Office in Columbia, 
South Carolina 
 
 
THE ISSUE 
 
Entitlement to an increased (compensable) rating for 
Reiter's syndrome. 
 
 
REPRESENTATION 
 
Appellant represented by:	Disabled American Veterans 
 
 
WITNESS AT HEARING ON APPEAL 
 
The veteran 
 
 
ATTORNEY FOR THE BOARD 
 
Robert B. Swanson, Associate Counsel 
INTRODUCTION 
 
The veteran had active service from July 1978 to March 
1981.This matter comes before the Board of Veterans' Appeals 
(Board) on appeal from a March 1992 rating decision by the 
Department of Veterans Affairs (VA) Regional Office (RO) in 
Columbia, South Carolina. 
 
 
CONTENTIONS OF APPELLANT ON APPEAL 
 
The veteran contends that an increased rating for his 
Reiter's syndrome is warranted due to a recent increase in 
the severity of the disability. 
 
 
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 the evidence supports granting a 
20 percent rating for the veteran's Reiter's syndrome. 
 
 
FINDINGS OF FACT 
 
1. All relevant evidence necessary for an equitable 
disposition of the appellant's appeal has been obtained by 
the RO. 
 
2. The current manifestations of the veteran's Reiter's 
syndrome include periodic pain of multiple joints. 
 
 
CONCLUSION OF LAW 
 
The criteria for a 20 percent rating for the veteran's 
Reiter's syndrome have been met.  38 U.S.C.A. §§ 1155, 
5107(b) (West 1991); 38 C.F.R. §§ 4.20, 4.71a, Diagnostic 
Code 5002 (1994). 
 
 
REASONS AND BASES FOR FINDINGS AND CONCLUSION 
 
The veteran is seeking an increased rating for his Reiter's 
syndrome.  He has presented a well-grounded claim, which is 
a claim that is plausible, as required by 38 U.S.C.A. § 
5107(a) (West 1991).  The VA, in turn, has assisted the 
veteran in fully developing the facts relevant to his claim 
as required by 38 U.S.C.A. § 5107(a).According to the 
veteran's service medical records, Reiter's syndrome was 
diagnosed in September 1980, and he received periodic 
treatment thereafter.  In October 1980, the veteran received 
outpatient treatment after complaining of left foot and 
right leg pain.  He reported that he was somewhat improved, 
and denied any urinary or visual symptoms.  The findings 
were Reiter's symptom residuals of left ankle and foot 
arthritis and right knee arthritis.  The diagnosis was 
Reiter's syndrome.  In May 1981, a VA general medical 
examination was conducted.  Clinical findings included a 
red, swollen, and warm left hallux.  A bone scan revealed 
increased focal joint activity in the left elbow, left 
wrist, left thumb, right knee, left ankle, left second toe, 
and both T-M joints.  X-rays of the back and left toes were 
unremarkable.  The diagnosis was active Reiter's syndrome 
arthritis.  The prognosis was that the arthritis was 
expected to be active for twenty to forty years.  In July 
1981, the RO granted service connection for Reiter's 
syndrome, and assigned a noncompensable rating, effective 
from March 1981. 
 
In November 1989, the veteran received treatment from a 
private physician, Joe N. Jarrett, for right thumb pain and 
swelling.  The diagnosis was probable over-use synovitis of 
the right thumb IP joint.  He was again seen by Dr. Jarrett 
in January 1992 for right heel, left hip, and left shoulder 
pain.  The diagnosis was Reiter's syndrome with right 
plantar fasciitis, left SI joint inflammation, and left 
trapezius myositis.  In April 1992, a letter from Dr. 
Jarrett was submitted.  In the letter, Dr. Jarrett indicated 
that he had seen the veteran twice, once in November 1989 
and once in January 1992.  He related that although he had 
not seen the veteran since January 1992, it was quite likely 
that the veteran experienced further exacerbations of his 
Reiter's syndrome.   
 
VA outpatient treatment records show that when the veteran 
was seen in May 1992, he indicated his current complaints 
included right ankle and heel pain, shoulder pain, and back 
pain.  Clinical evaluation revealed that all joints were 
essentially unremarkable except for right Achilles 
tenderness.  The diagnostic assessment was rule out Reiter's 
syndrome.  Treatment was to include Naprosyn. 
 
The veteran was seen in December 1992 for right heel and 
Achilles tendon pain.  Examination revealed right ankle 
tenderness at the Achilles insertion.  The diagnostic 
impression was Reiter's syndrome.  His medication was to be 
changed to Voltaren. 
 
When the veteran was seen by the VA in April 1993, he stated 
the Voltaren gave him improved relief but that, more days 
than not, he had trouble with his right heel.  Left 
sacroiliac joint complaints were also noted.  The veteran 
indicated he was functional in the mornings but that by 
afternoon the pain slowed him down.  He denied eye or 
genitourinary problems at the current time.  Examination 
revealed right ankle tenderness and swelling at the Achilles 
insertion and left sacriliac joint tenderness.  The 
diagnostic assessment was Reiter's syndrome.   
 
In August 1993, the veteran testified before a Board member 
at a hearing that was held at the RO.  During the hearing, 
the veteran related that his symptoms were arthritic pain of 
the feet, low back, right shoulder, and right thumb.  As to 
the frequency of his symptoms in 1993, he indicated that as 
of the date of the hearing he had had about five 
exacerbations, each of which lasted about two to four days.  
With respect to treatment, he reported that he had been 
taking medication daily for about one and one-half years, 
which fairly controlled his joint swelling, although he 
still experienced episodic pain.  In support of his claim, 
he submitted a prescription dispensal report, which relates 
prescriptions dispensed from February 1991 through January 
1992. 
 
The veteran's Reiter's syndrome is currently rated as 
noncompensable.  He asserts that his symptoms include 
arthritic pain of multiple joints.  A 20 percent rating for 
rheumatoid arthritis is assigned under the Schedule for 
Rating Disabilities (Schedule) when there are one or two 
exacerbations a year in a well-established diagnosis.  38 
C.F.R. § 4.71a, Diagnostic Code 5002.  The treatment reports 
of record relate that the veteran has received periodic VA 
and private outpatient treatment for multiple joint pain, 
which has been associated with his Reiter's syndrome.  
Moreover, the treatment reports and the veteran's testimony 
indicate that his Reiter's syndrome exacerbations have 
occurred several times a year.  Based upon the foregoing, 
the Board finds that the evidence supports granting a 20 
percent rating for the veteran's Reiter's syndrome.  38 
U.S.C.A. § 1155; 38 C.F.R. §§ 4.20, 4.71a, Diagnostic Code 
5002.  The criteria for an evaluation greater than 20 
percent have not, however, been met.  The evidence is not so 
evenly balanced as to raise doubt with respect to any 
material issue.  38 U.S.C.A. § 5107(b).  In reaching its 
decision, the Board has considered the complete history of 
the disability at issue as well as the current clinical 
manifestations and the effect the disability may have on the 
earning capacity of the veteran.  38 C.F.R. §§ 4.1, 4.2, 
4.41 (1994). 
 
The Board finds that the veteran's disability picture is not 
so exceptional or unusual as to warrant an extraschedular 
evaluation.  38 C.F.R. § 3.321(b) (1994).  His Reiter's 
syndrome has not caused marked interference with employment 
or necessitated frequent periods of hospitalization. 
 
 
 
 
 
 
 
 
 
 
 
ORDER 
 
Entitlement to a 20 percent rating for Reiter's syndrome is 
granted, subject to the law and regulations governing the 
payment of monetary benefits. 
 
 
		 
	JAMES R. ANTHONY 
	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. 
 
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