Citation Nr: 18148778 Decision Date: 11/09/18 Archive Date: 11/08/18 DOCKET NO. 16-41 313 DATE: November 9, 2018 ORDER Entitlement to a compensable disability rating for service connected allergic rhinitis is denied. Entitlement to a compensable disability rating prior to January 31, 2017 and to a rating higher than 10 percent thereafter, for service connected hypertension is denied. Entitlement to a compensable disability rating for service connected dermatitis, also claimed as folliculitis of the scalp, is denied. FINDINGS OF FACT 1. For the entire appeal period, the Veteran's allergic rhinitis has not been manifested by complete obstruction of one side of the nose, or greater than 50-percent obstruction of both nasal passages. 2. Prior to January 31, 2017 the Veteran's hypertension has not been manifested by at least diastolic pressure predominantly 100 or more, systolic pressure predominantly 160 or more, a history of diastolic pressure 100 or more that requires continuous medication for control. 3. From January 31, 2017 onward, the Veteran's hypertension has been manifested by no worse than historic diastolic pressure of 100 or more that requires continuous medication for control. 4. For the entire appeal period, the Veteran’s dermatitis, also claimed as folliculitis of the scalp, has not been manifested by any symptoms. CONCLUSIONS OF LAW 1. The criteria for entitlement to a compensable disability rating for service connected allergic rhinitis have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.7, 4.31, 4.97, Diagnostic Code 6522 (2017). 2. The criteria for entitlement to a compensable disability rating prior to January 31, 2017 and to a rating higher than 10 percent thereafter, for service-connected hypertension have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 4.1, 4.7, 4.104, Diagnostic Code 7101 (2017). 3. The criteria for entitlement to a compensable disability rating for service connected dermatitis have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.7, 4.31, 4.118, Diagnostic Code 7806 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Increased Rating Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the appellant working or seeking work. 38 C.F.R. § 4.2. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. The regulations require review of the recorded history of a disability by the adjudicator to ensure an accurate evaluation, however, the regulations do not give past medical reports precedence over the current medical findings. Where an increase in the disability rating is at issue, the present level of the Veteran’s disability is the primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). It is also noted that staged ratings are appropriate for an increased rating claim whenever the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). 1. Allergic Rhinitis The Veteran contends that an initial compensable rating is warranted for her service-connected allergic rhinitis. Service connection for allergic rhinitis was granted by the RO in a November 2014 rating decision, and a noncompensable rating was assigned, effective June 24, 2014, under 38 C.F.R. § 4.97, Diagnostic Code 6522. Following the Veteran’s September 2015 claim for increase, the noncompensable rating was continued by way of a January 2016 rating decision. Under Diagnostic Code 6522, allergic rhinitis warrants a 10 percent rating where there are no polyps, but with greater than 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side. 38 C.F.R. § 4.97. A maximum 30 percent rating is for application when there are polyps. Id. In October 2014, the Veteran underwent a VA Examination. The Veteran’s service treatment records showed a history of allergic rhinitis in service, which has been present since. The examiner noted that she has used Zyrtec since 2003. Physical examination showed no nasal polyps bilaterally. There was no evidence of permanent hypertrophy of the turbinates or granulomatous disease. There was no evidence of complete obstruction of either the left or right nasal passage nor was there evidence of greater than 50 percent obstruction of the nasal passage on both sides due to rhinitis. The Veteran underwent further examinations in April 2015 and December 2015. At both examinations, the examiners found no evidence of complete obstruction of either the left or right nasal passage nor evidence of greater than 50 percent obstruction of the nasal passage on both sides due to rhinitis Based upon review of the evidence of record, the Board finds that the Veteran is not entitled to a compensable rating for her service-connected allergic rhinitis. The evidence of record fails to demonstrate allergic rhinitis with either greater than 50 percent obstruction of the nasal passage on both sides or with complete obstruction on one side. Despite the Veteran’s complaints, the treatment records and VA examinations of record do not reflect symptomatology meeting the rating criteria for a 10 percent rating pursuant to Diagnostic Code 6522. As such, a compensable rating for allergic rhinitis must be denied. 2. Hypertension Service connection for hypertension was awarded by way of a December 2006 rating decision. Following the Veteran's September 2015 claim for increase, the noncompensable rating was continued by way of the January 2016 rating decision on appeal. Following a January 2017 examination, the Veteran was assigned a 10 percent rating in a February 2018 rating decision. The Veteran’s service-connected hypertension is rated as 10 percent disabling under Diagnostic Code 7101, which pertains to hypertensive vascular disease (hypertension and isolated systolic hypertension). Under that diagnostic code, a 10 percent rating is assigned for diastolic pressure predominantly 100 or more, or systolic pressure predominantly 160 or more, or where an individual with a history of diastolic pressure predominantly 100 or more requires continuous medication for control. A 20 percent rating is assigned for diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. A 40 percent rating is assigned for diastolic pressure predominantly 120 or more. The highest rating, 60 percent, is assigned for diastolic pressure predominantly 130 or more. 38 C.F.R. § 4.104, Diagnostic Code 7101 (2017). The report of an October 2014 VA medical examination shows the Veteran's blood pressure on the date of examination as 140 over 98, 137 over 87, and 150 over 98. The Veteran managed her blood pressure with Maxzide. The December 2015 VA examination shows the Veteran's blood pressure as 146 over 90, 140 over 90, and 148 over 94. The Veteran managed her blood pressure with triamterene. The January 31, 2017 VA medical examination shows the Veteran's blood pressure as 142 over 98, 142 over 102, and 146 over 110. The Veteran continued to manage her blood pressure with triamterene. During the appeal period, treatment records show the Veteran's blood pressure as 139 over 90 and 159 over 88 in March 2015, 132 over 90 in July 2016, 148 over 103 in September 2016, 131 over 85 in November 2016, 132 over 88 in December 2016, 122 over 82 and 137 over 87 in February 2017, 144 over 93 in March 2017, 110 over 70 in May 2017. During this period the Veteran continued to control her blood pressure with medications. Blood pressure readings in March 2018 were 132 over 82 and 137 over 87. At this time, the Veteran indicated she was no longer taking any blood pressure medication. The evidence of record does not indicate that prior to January 31, 2017 the Veteran's diastolic pressure was predominantly 100 or more, systolic pressure was predominantly 160 or more, or the Veteran had a history of diastolic pressure 100 or more that required continuous medication for control. As such, for this period, a compensable disability rating is not warranted. Since January 31, 2017, the evidence of record does not indicate that the Veteran's diastolic pressure is predominantly 110 or more or systolic pressure is predominantly 200 more. The Veteran has a single diastolic pressure reading of 110 and has never had a systolic pressure of 200 or greater. As such, for this period, a disability rating of 20 percent is not warranted. 3. Dermatitis The Veteran contends that she is entitled to a compensable disability rating for her service-connected dermatitis. Service connection for dermatitis, originally called pityriasis rosea, was awarded by way of a June 2015 rating decision. A 10 percent rating was awarded. Following the Veteran’s September 2015 claim for increase, the diagnosis was changed to folliculitis of the scalp and a noncompensable rating was awarded by way of the January 2016 rating decision on appeal. Under Diagnostic Code 7806 for dermatitis, a 0 percent rating is warranted when less than 5 percent of the entire body or less than 5 percent of exposed areas are affected, and no more than topical therapy was required during the past 12-month period. Compensable ratings require five percent or more of the entire body or exposed areas or the use of corticosteroids or other immunosuppressive drugs. Throughout the entire appeal period, there has been no lay or medical evidence of record indicating that the Veteran's service-connected folliculitis of the scalp has been symptomatic. The December 2015 VA examiner noted that the Veteran was last seen by her primary care provider for the condition in about 2008. At that time, she was treated with antibiotics. VA medical records are negative as to any complaints of, or treatment for, folliculitis of the scalp during the entire appeal period. By the December 2015 examination, the Veteran had no erythema or lesions on her scalp. The examiner also noted that the Veteran had short thinning hair on the front and sides of her head and some flaking in the back where the hair was thicker. The examiner indicated that the Veteran does not currently have any skin condition. Given that the Veteran has not been symptomatic for her folliculitis of the scalp during the appeal period, such that it did not affect the entire body or exposed areas, and the evidence of record, to include lay statements indicate that the Veteran has not received any treatment for this disability, much less corticosteroids or other immunosuppressive drugs, the Board finds that a compensable disability rating for folliculitis of the scalp is not warranted. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Uller, Associate Counsel