Citation Nr: 18161017 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 17-42 160 DATE: December 28, 2018 ORDER Entitlement to a rating in excess of 10 percent for fibromyalgia is denied. Entitlement to a rating in excess of 10 percent for hiatal hernia is denied. Entitlement to a 30 percent rating for bilateral glaucoma is granted. Entitlement to an effective date earlier than January 22, 2014, for the 10 percent rating for fibromyalgia is denied. Entitlement to an effective date earlier than April 15, 2014, for the 10 percent rating for hiatal hernia is denied. Entitlement to an effective date earlier than January 22, 2013, for the 30 percent rating for bilateral glaucoma is denied. FINDINGS OF FACT 1. The Veteran’s fibromyalgia is manifested by widespread musculoskeletal pain and stiffness and muscle fatigability, which is present more than one-third of the time, but is not episodic with exacerbations often precipitated by environmental or emotional stress or by overexertion or refractory to therapy. 2. The Veteran’s hiatal hernia is manifested by symptoms of dysphagia, pyrosis, and reflux, without evidence of regurgitation or substernal arm or shoulder pain productive of considerable impairment in health. 3. For the period of appeal prior to May 1, 2015, the Veteran’s bilateral glaucoma required continuous use of medication for control and was manifested by corrected distance vision in the right eye of at least 20/50 and in the left eye of at least 20/40, with an average remaining field of vision in the right eye of 31 degrees and in the left eye of 50 degrees. For the period of appeal from May 1, 2015, the Veteran’s bilateral glaucoma requires continuous use of medication for control and is manifested by corrected distance vision in the right eye of being able to see hand motions and in the left eye of at least 20/40. 4. In May 1980, service connection was granted for fibromyalgia (then rated as organic disease manifested by muscle and joint pain), hernia, and bilateral glaucoma, effective May 1, 1978. 5. The Veteran filed a claim for entitlement to increased ratings for fibromyalgia and bilateral glaucoma on January 22, 2014, and filed a claim for entitlement to an increased rating for hiatal hernia on April 15, 2014. 6. There is no evidence of any communication in the claims file after the May 1980 decision and prior to the January and April 2014 claims indicating intent to file a claim for an increased rating for fibromyalgia, hiatal hernia, and/or bilateral glaucoma. 7. It is not factually ascertainable that an increase in the fibromyalgia or hiatal hernia occurred within one year from the date of the increased rating claims. 8. The December 2014 rating decision increased the rating for bilateral glaucoma effective January 22, 2013, one year prior to the date the claim was received, which is the earliest date of entitlement. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for fibromyalgia are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.71a, Diagnostic Code 5025. 2. The criteria for a rating in excess of 10 percent for hiatal hernia are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.114, Diagnostic Code 7399-7346. 3. The criteria for a 30 percent rating for bilateral glaucoma are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.79, Diagnostic Code 6013. 4. The criteria for an effective date earlier than January 22, 2014, for the grant of the 10 percent rating for fibromyalgia are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.155, 3.157, 3.159, 3.400. 5. The criteria for an effective date earlier than April 15, 2014, for the grant of the 10 percent rating for hiatal hernia are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.155, 3.157, 3.159, 3.400. 6. The criteria for an effective date earlier than January 22, 2013, for the grant of the 30 percent rating for bilateral glaucoma are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.155, 3.157, 3.159, 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Air Force for 24 years, from October 1953 to April 1978. In a July 2017 substantive appeal, the Veteran requested a hearing before a Veterans Law Judge; however, in September 2018, his representative withdrew his hearing request, noting that the Veteran was in therapy for a fall he sustained. See 38 C.F.R. § 20.704(d). Increased Ratings Disability evaluations are determined by the application of VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civil occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. 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 veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant’s favor. 38 C.F.R. § 4.3. 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. 1. Increased rating for fibromyalgia. The Veteran’s fibromyalgia has been assigned a 10 percent rating from January 22, 2014, under Diagnostic Code 5025, for fibromyalgia. Under Diagnostic Code 5025, a 10 percent rating is assigned for fibromyalgia that requires continuous medication for control. A 20 percent rating is assigned for episodic fibromyalgia with exacerbations often precipitated by environmental or emotional stress or by overexertion, but that are present more than one-third of the time. A schedular maximum 40 percent rating is assigned for fibromyalgia with widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, or Raynaud’s-like symptoms, that is constant, or nearly so, and refractory to therapy. “Widespread pain” means pain in both the left and right sides of the body that is both above and below the waist, and that affects both axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities. 38 C.F.R. § 4.71a, Diagnostic Code 5025. The Board finds that a rating in excess of 10 percent is not warranted at any point during the period of appeal. The Veteran had a VA examination for fibromyalgia in August 2014. He reported taking Vicodin, Elavil, Ambien, and Tylenol, which he took continuously. The Veteran’s symptoms included widespread musculoskeletal pain and stiffness, and muscle fatigability resulting in easy fatigability, which were present more than one-third of the time. He had tender points for pain at the bilateral lateral epicondyle, bilateral buttocks, bilateral greater trochanters, and bilateral knees at the medial joint line. The Veteran’s symptoms were not episodic with exacerbations often precipitated by environmental or emotional stress or by overexertion, or refractory to therapy. He did not have symptoms of paresthesias, headache, depression, anxiety, irritable bowel symptoms, Raynaud’s-like symptoms, or other symptoms. VA treatment records indicate that in December 2014, the Veteran reported having muscle cramps, joint pain, joint stiffness, and joint deformity due to fibromyalgia. In November 2016 treatment records, the Veteran was noted to have musculoskeletal pain that was moderate in severity, occurred constantly, and was worsening. In sum, the preponderance of the evidence is against the assignment of a rating higher than 10 percent for fibromyalgia. Although the Veteran has reported widespread musculoskeletal pain and stiffness, which are present more than one-third of the time, such symptomatology is contemplated in the currently assigned 10 percent disability rating for fibromyalgia. The Veteran has not been found to have symptoms of paresthesias, headache, depression, anxiety, irritable bowel symptoms, Raynaud’s-like symptoms, or other symptoms. Moreover, his symptoms have not been found to be episodic with exacerbations often precipitated by environmental or emotional stress or by overexertion to warrant a higher 20 percent rating. 2. Increased rating for hiatal hernia. The Veteran’s hernia has been assigned a 10 percent rating from January 22, 2014, under Diagnostic Code 7399-7346. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the assigned rating; the additional code is shown after the hyphen. The provisions of 38 C.F.R. § 4.27 provide that unlisted disabilities requiring rating by analogy will be coded with the first two numbers of the schedule provisions for the most closely related body part and 99. Here, the hyphenated diagnostic code indicates that the Veteran’s hernia is rated as analogous to a disease of the digestive system (Diagnostic Code 7399) under the criteria for hernia hiatal (Diagnostic Code 7346). 38 C.F.R. § 4.79. Under Diagnostic Code 7346, a 10 percent rating is warranted for a hiatal hernia with two or more of the symptoms for the 30 percent evaluation of less severity. A 30 percent rating is warranted for persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. A 60 percent rating is warranted for symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health. (Material weight loss is not defined in Diagnostic Code 7346, but “substantial weight loss” is defined under 38 C.F.R. § 4.112 as a loss of greater than 20 percent of the individual’s baseline weight, sustained for three months or longer, and “minor weight loss” is defined as a weight loss of 10 to 20 percent of the individual’s baseline weight, sustained for three months or longer under.) 38 C.F.R. § 4.114, Diagnostic Code 7346. The Board finds that a rating in excess of 10 percent is not warranted at any point during the period of appeal. A December 2013 private treatment record indicates that the Veteran reported that his gastroesophageal reflux disease (GERD) was improving and he denied having constipation, diarrhea, dyspnea, fever, and rash. The Veteran had a VA examination in August 2014, in which he reported that taking Aciphex continually for the hernia. The Veteran reported symptoms of dysphagia, pyrosis (heartburn), and reflux. He did not have persistently recurrent epigastric distress, infrequent episodes of epigastric distress, regurgitation, substernal arm or shoulder pain, sleep disturbance caused by esophageal reflux, anemia, nausea, vomiting, hematemesis, or melena. He also did not have an esophageal stricture, spasm of the esophagus, or an acquired diverticulum of the esophagus, and there were no other pertinent physical findings, complications, conditions, signs, and/or symptoms related to the hernia. VA treatment records indicate that in December 2014, the Veteran reported having heartburn, which was okay with medication. In August 2016 and January 2017 private treatment records, the Veteran’s GERD was noted to be mild and not changing. He did not have dyspnea, nausea, weight gain, or weight loss. In sum, the preponderance of the evidence is against the assignment of a rating higher than 10 percent for the hiatal hernia. The Veteran has been found to have symptoms of dysphagia, pyrosis (heartburn), and reflux which are symptoms that are contemplated by the currently assigned 10 percent disability rating. The Veteran has not been found to have substernal or arm or shoulder pain, or symptoms that are productive of considerable impairment of health to warrant a higher 30 percent rating. There is also no other diagnostic code that would be appropriate to evaluate the Veteran’s hernia. 38 C.F.R. § 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991). 38 C.F.R. § 4.114 expressly states that ratings under diagnostic codes 7301 to 7329 inclusive, 7331, 7342, and 7345 to 7348 inclusive, will not be combined with each other; a single evaluation will be assigned under the diagnostic code which reflects the predominant disability picture, which, in this case, is the service-connected hiatal hernia. 3. Increased rating for bilateral glaucoma. The Veteran’s bilateral glaucoma has been assigned a 10 percent rating from January 22, 2013, under Diagnostic Code 5013, for open-angle glaucoma. Rating criteria Under Diagnostic Code 6013, open-angle glaucoma is evaluated based on visual impairment with a minimum evaluation of 10 percent if continuous medication is required. 38 C.F.R. § 4.79. With respect to field of vision impairment, 38 C.F.R. § 4.76a, Table III, the normal visual field extent at the 8 principal meridians totals 500 degrees. The normal for the 8 principal meridians are as follows: 85 degrees temporally; 85 degrees down temporally; 65 degrees down; 50 degrees down nasally; 60 degrees nasally; 55 degrees up nasally; 45 degrees up; and 55 degrees up temporally. The extent of visual field contraction in each eye is determined by recording the extent of the remaining visual fields in each of the eight 45-degree principal meridians. The degrees lost are then added together to determine the total number of degrees lost, which are subtracted from 500. The total remaining degrees of the visual field are then divided by eight to represent the average contraction for rating purposes. 38 C.F.R. § 4.76a. Under Diagnostic Code 6080, visual field defects are evaluated as follows: A 10 percent evaluation for concentric contraction of visual field with remaining field of 46 to 60 degrees bilaterally or unilaterally; with remaining field of 31 to 45 degrees unilaterally; with remaining field of 16 to 30 degrees unilaterally; loss of superior half of visual field bilaterally or unilaterally; loss of interior half of visual field unilaterally; loss of nasal half of visual field bilaterally or unilaterally; and loss of temporal half of visual field unilaterally. A 20 percent evaluation if assigned for concentric contraction of visual field with remaining field of 6 to 15 degrees unilaterally. A 30 percent evaluation is assigned for concentric contraction of visual field with remaining field of 31 to 45 degrees bilaterally; remaining field of 5 degrees unilaterally; loss of inferior half of visual filed bilaterally; loss of temporal half of visual field bilaterally; and homonymous hemianopsia visual filed defects. A 50 percent rating is assigned for concentric contraction of visual field with remaining field of 16 to 30 degrees bilaterally. A 70 percent rating is assigned for concentric contraction of visual field with remaining field of 6 to 15 degrees bilaterally. A 100 percent rating is assigned for concentric contraction of visual field with remaining field of 5 degrees bilaterally. Visual impairment is also rated based on impairment of visual acuity (excluding developmental errors of refraction). 38 C.F.R. § 4.79, Diagnostic Codes 6061-6066. 38 C.F.R. § 4.76(b) dictates that evaluation of visual acuity should be done on the basis of corrected distance vision with central fixation, unless the lens required to correct distance vision in the poorer eye differs by more than three diopters from the lens required to correct distance vision in the better eye. A 10 percent rating is warranted only when there is (1) 20/50 vision in one eye with 20/40 or 20/50 vision in the other eye; (2) 20/70 vision in one eye with 20/40 vision in the other eye; or (3) 20/100 vision in one eye with 20/40 vision in the other eye. A 20 percent rating is warranted when there is (1) 20/70 vision in one eye with 20/50 vision in the other eye; (2) 20/100 vision in one eye with 20/50 vision in the other eye; (3) 20/200 vision in one eye with 20/40 vision in the other eye; or (4) 15/200 vision in one eye with 20/40 vision in the other eye. A 30 percent rating is warranted (1) when vision in both eyes is correctable to 20/70; (2) when vision in one eye is correctable to 20/100 and vision in the other eye is correctable to 20/70; (3) when vision in one eye is correctable to 20/200 and vision in the other eye is correctable to 20/50; (4) when vision in one eye is correctable to 15/200 and vision in the other eye is correctable to 20/50; (5) when vision in one eye is correctable to 10/200 and vision in the other eye is correctable to 20/40; (6) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 20/40; and (7) when vision in one eye is no more than light perception and vision in the other eye is correctable to 20/40. A 40 percent rating is warranted (1) when vision in one eye is correctable to 15/200 and vision in the other eye is correctable to 20/70; (2) when vision in one eye is correctable to 10/200 and vision in the other eye is correctable to 20/50; (3) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 20/50; (4) when vision in one eye is no more than light perception and vision in the other eye is correctable to 20/50 or (5) when there is anatomical loss of one eye and vision in the other eye is correctable to 20/40. A 50 percent disability rating is warranted (1) when vision in one eye is correctable to 20/100 and vision in the other eye is correctable to 20/100; (2) when vision in one eye is correctable to 10/200 and vision in the other eye is correctable to 20/70; (3) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 20/70; (4) when vision in one eye is no more than light perception and vision in the other eye is correctable to 20/70; or (5) when there is anatomical loss of one eye and vision in the other eye is correctable to 20/50. A 60 percent disability rating is warranted (1) when vision in one eye is correctable to 20/200 and vision in the other eye is correctable to 20/100; (2) when vision in one eye is correctable to 15/200 and vision in the other eye is correctable to 20/100; (3) when vision in one eye is correctable to 10/200 and vision in the other eye is correctable to 20/200; (4) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 20/100; (5) when vision in one eye is no more than light perception and vision in the other eye is correctable to 20/100; or (6) when there is anatomical loss of one eye and vision in the other eye is correctable to 20/70 or 20/100. A 70 percent disability rating is warranted (1) when vision in one eye is correctable to 20/200 and vision in the other eye is correctable to 20/200; (2) when vision in one eye is correctable to 15/200 and vision in the other eye is correctable to 20/200; (3) when vision in one eye is correctable to 10/200 and vision in the other eye is correctable to 20/200; (4) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 20/200; (5) when vision in one eye is no more than light perception and vision in the other eye is correctable to 20/200; or (6) when there is anatomical loss of one eye and vision in the other eye is correctable to 20/200. An 80 percent disability rating is warranted (1) when vision in one eye is correctable to 15/200 and vision in the other eye is correctable to 15/200; (2) when vision in one eye is correctable to 10/200 and vision in the other eye is correctable to 15/200; (3) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 15/200; (4) when vision in one eye is no more than light perception and vision in the other eye is correctable to 15/200; or (5) when there is anatomical loss of one eye and vision in the other eye is correctable to 15/200. A 90 percent disability rating is warranted only (1) when vision in one eye is correctable to 10/200 and vision in the other eye is correctable to 10/200; (2) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 10/200; (3) when vision in one eye is no more than light perception and vision in the other eye is correctable to 10/200; or (4) when there is anatomical loss of one eye and vision in the other eye is correctable to 10/200. A 100 percent disability rating is warranted only (1) when vision in one eye is correctable to 5/200 and vision in the other eye is correctable to 5/200; (2) when vision in one eye is no more than light perception and vision in the other eye is correctable to 5/200; (3) when there is anatomical loss of one eye and vision in the other eye is correctable to 5/200; (4) when there is no more than light perception in both eyes; or (5) when there is anatomical loss of both eyes. To determine the rating for visual impairment when both decreased visual acuity and visual field defect are present in one or both eyes and are service-connected, separately rate the visual acuity and visual field defect, expressed as a level of visual acuity, and combine them under the provisions of 38 C.F.R. § 4.25. Analysis The Board finds that for the entire period of appeal, a 30 percent rating is warranted. Private treatment records indicate that in February 2014, the Veteran’s corrected right eye vision was 20/40 and the left eye was 20/25. The Veteran had a VA eye examination in July 2014. He indicated that his glaucoma had gotten worse over time. He took Xalatan and Cosopt for the glaucoma. On examination, the Veteran’s corrected right eye distance vision was 20/50 and his corrected left eye distance vision was 20/40 or better. His pupils were round, equal in diameter, and reactive to light. There was no afferent pupillary defect, anatomical loss, light perception only, extremely poor vision, blindness, a corneal irregularity that resulted in severe irregular astigmatism, or diplopia (double vision). The Veteran’s right eye had a cataract removed and a posterior chamber intraocular lens, and the left eye had preoperative a nuclear cataract. The examiner indicated that the Veteran did not have a visual field defect; however, a Goldman Visual Field test showed bilateral visual field contractions. The right eye showed: temporally 30 degrees, down temporally 30 degrees, down 28 degrees, down nasally 33 degrees, nasally 31 degrees, up nasally 33 degrees, up 30 degrees, and up temporally 30 degrees. Total field of vision was 245 degrees, with an average contraction of 31 degrees. The left eye showed: temporally 70 degrees, down temporally 52 degrees, down 50 degrees, down nasally 50 degrees, nasally 50 degrees, up nasally 50 degrees, up 40 degrees, and up temporally 40 degrees. Total field of vision was 402 degrees, with an average contraction of 50 degrees. In an August 2014 private treatment record, the left eye was noted to be 20/50-1 and the left eye was 20/40-2. In September 2014, the right eye was 20/40 and the left eye was 20/20. In November 2014, the right eye was 20/50 and the left eye was 20/20. In April 2015, the Veteran’s corrected distance visual acuity was noted to be 20/40 bilaterally. In May 2015, the Veteran reported having severe eye pain after a bleb needling. He was found to have aqueous misdirection of the right eye and started on aqueous suppressants. A few days later he reported feeling better; however, he was seen several more times for hypotony of the right eye, status post bleb needling. In June 2015, the Veteran denied having any pain or discomfort and felt a lot better, but his visual acuity was still blurry in the right eye. Beginning in May 2015, the left eye visual acuity was noted as being “20/HM” (hand motion). In October 2015, the Veteran indicated that he could see colors with his left eye. In February 2016, the Veteran reported that he still could not see out of his right eye very well. His corrected vision was 20/400 in the right eye and 20/40+2 in the left eye. In May 2016, the right eye was 20/400 and the left eye was 20/50+2. In January 2017, the Veteran’s corrected vision was hand motion in the right eye and 20/40+2 in the left eye. In May 2017, the Veteran was noted to have a “serious choroidal detachment” and hypotony of the right eye. A drainage of the choroidal was recommended. The Veteran had the right eye procedure and in a post-operative follow-up, the choroidal detachment was noted to be resolved. In May 2017, the Veteran’s corrected right eye vision was hand motion and the corrected left eye was 20/40. The Veteran was referred to a new ophthalmologist, Dr. S.D., for a glaucoma evaluation also in May 2017. He reported that he had light perception only in his right eye and his left eye was blurry. He used Lumigan eye drops. The Veteran’s corrected right eye vision was hand motion and his left eye was 20/30-2. His left eye field of vision was full to finger counting. Dr. S.D. indicated the Veteran had left eye glaucoma at an indeterminant stage, traumatic glaucoma and vision to hand motion only in the right eye, and combined forms of age-related cataracts of the left eye. Dr. S.D. noted that the Veteran’s right eye vision would not improve with glaucoma treatment, but the goal was to cease vision deterioration. Dr. S.D. also completed an eye conditions disability benefits questionnaire in July 2017. She indicated that the Veteran had glaucoma for approximately 45 years, and he had age-related cataracts of the left eye. The Veteran’s corrected distance vision was to hand motion only in the right eye and 20/40 or better in the left eye. His pupils were round, equal in diameter, reactive to light, and there was no afferent pupilar defect present. The Veteran did not have a corneal irregularity that resulted in severe irregular astigmatism or diplopia (double vision). Dr. S.D. indicated that the Veteran’s decrease in visual acuity or other visual impairment was attributable to glaucoma. In sum, for the period of appeal prior to May 1, 2015, the bilateral glaucoma was productive of visual acuity no worse than 20/50 in the right eye and 20/40 in the left eye, which warrants a 10 percent rating for impairment of visual acuity under Diagnostic Code 6066. For this period of appeal, the glaucoma was also productive of a visual field of 31 degrees in the right eye and 50 degrees in the left eye, which warrants a 10 percent rating under Diagnostic Code 6080. As discussed above, when both decreased visual acuity and visual field defect are present, they are separately rated and expressed as a level of visual acuity, and then combined under the provisions of § 4.25. Here, a visual field of 31 degrees in the right eye is equated with 20/70 visual acuity, and 50 degrees in the left eye is equated with 20/50 visual acuity, which warrants a 20 percent rating. These ratings combined warrant a 30 percent rating for the bilateral glaucoma. For the period of appeal from May 1, 2015, the Board equates “hand motion” visual acuity to no more than light perception in the right eye. For this period of appeal, the left eye was consistently noted to be 20/40. Such level of visual acuity impairment warrants a 30 percent rating under Diagnostic Code 6064. As such, a rating of 30 percent for the bilateral glaucoma is granted for the entire period of appeal. The Board notes that it has considered whether entitlement to special monthly compensation (SMC) is warranted. However, SMC requires (1) blindness of one eye with 5/200 visual acuity or less and blindness of the other eye having only light perception; (2) blindness of one eye with 5/200 visual acuity or less and anatomical loss of, or blindness having no light perception in the other eye; (3) blindness of one eye having only light perception and anatomical loss of, or blindness having no light perception in the other eye; or (4) blindness in both eyes with visual acuity of 5/200 or less or having only light perception or less. In this case, the Veteran’s left eye visual acuity has not been found to be 2/500 or less, nor has it been found to have only light perception to meet the criteria for entitlement to SMC. See 38 C.F.R. § 3.350. Effective Dates The assignment of effective dates is generally governed by 38 U.S.C. § 5110 and 38 C.F.R. § 3.400. Unless specifically provided otherwise, the effective date of an award based on an original claim, a claim reopened after final adjudication, or a claim for increased compensation shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefore. 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400. An effective date for a claim for increase may be granted prior to the date of claim if it is factually ascertainable that an increase in disability had occurred within one year from the date of claim. 38 U.S.C. § 5110(b)(2); 38 C.F.R. § 3.400(o)(1) and (2). Thus, according to Harper v. Brown, 10 Vet. App. 125, 126 (1997), three possible effective dates may be assigned depending on the facts of the particular case: (1) if an increase in disability occurs after the claim is filed, the date that the increase is shown to have occurred (date entitlement arose) (38 C.F.R. § 3.400 (o)(1)); (2) if an increase in disability precedes the claim by a year or less, the date that the increase is shown to have occurred (i.e., the date the increase is factually ascertainable) (38 C.F.R. § 3.400 (o)(2)); or, (3) if an increase in disability precedes the claim by more than a year, the date that the claim is received (date of claim) (38 C.F.R. § 3.400 (o)(2)). In summary, determining the appropriate effective date for an increased rating under the effective date statutes and regulations involves an analysis of the evidence to determine (1) when a claim for an increased rating was received, and, if possible, (2) when the increase in disability actually occurred. 38 C.F.R. § 3.155, 3.400(o)(2). Furthermore, according to 38 C.F.R. § 3.157 (b)(1) (in effect prior for claims filed prior to March 24, 2015), receipt of a VA outpatient or hospital examination or admission to a VA hospital could be accepted as an informal claim for increased benefits “when such report[] relate[s] to examination or treatment of a disability for which service-connection has previously been established...” 38 C.F.R. § 3.157(b)(1); see MacPhee v. Nicholson, 459 F.3d 1323, 1328 (Fed. Cir. 2006); see also Crawford v. Brown, 5 Vet. App. 33, 35-36 (1993). The date on the VA outpatient or hospital examination will be accepted as the date of claim. 38 C.F.R. § 3.159(b). When the evidence is from a private physician, the date of receipt of such evidence will be accepted as the date of receipt of an informal claim. 38 C.F.R. § 3.157(b)(2) (in effect for claims filed prior to March 24, 2015). 4. Earlier effective dates for increased ratings for fibromyalgia, hiatal hernia, and bilateral glaucoma. Service connection was granted in May 1980 for fibromyalgia (then rated as organic disease manifested by muscle and joint pain), hernia, and bilateral glaucoma, effective May 1, 1978. The Veteran submitted claims for increased ratings for fibromyalgia and glaucoma on January 22, 2014. The Veteran submitted an authorization and consent to release information form on April 15, 2014, which the RO construed as a claim for an increased rating for hiatal hernia. In a December 2014 rating decision, the RO increased the rating for fibromyalgia from noncompensable (zero percent) to 10 percent, effective January 22, 2014; increased the rating for hiatal hernia from noncompensable to 10 percent, effective April 15, 2014; and increased the rating for bilateral glaucoma from noncompensable to 10 percent, effective from January 22, 2013. The Veteran contends that the effective dates for the increased ratings should be May 1, 1978, the day he separated from active military service. See the February 2015 notice of disagreement. It is somewhat unclear whether the Veteran is asserting that the effective date for service connection should be May 1, 1978, or that the increased rating should date back to May 1, 1978. The Board notes, however, that service connection for all three disabilities has already been in effect since May 1, 1978. Moreover, the RO has treated the claims as earlier effective dates for the increased ratings. As such, the Board will do the same. The Board finds as a preliminary matter that there is no evidence of any communication in the claims file subsequent to the May 1980 decision and prior to the January and April 2014 claims indicating intent to file a claim for an increased rating for fibromyalgia, hiatal hernia, and/or bilateral glaucoma. Fibromyalgia A 10 percent rating for fibromyalgia requires continuous medication for control. Private treatment records indicate that the Veteran was prescribed medication for his fibromyalgia prior to one year before the date the increased rating claim was received on January 22, 2014. Specifically, in private treatment records dated in March 2012, the Veteran was noted to be taking Vicodin, Elavil, Ambien, and Tylenol. Thus, the increase in the fibromyalgia disability occurred more than one year prior to receipt of the increased rating claim. As there is no evidence of an intent to file a claim for an increased rating prior to the January 2014 claim, the effective date for the increased 10 percent rating is the date the increased rating claim was received (January 22, 2014) and the appeal is denied. See 38 C.F.R. § 3.155, 3.400(o)(2); Harper v. Brown, 10 Vet. App. 125, 126 (1997). Hiatal hernia A 10 percent rating is warranted for a hiatal hernia with two or more of the symptoms for the 30 percent evaluation of less severity (a 30 percent rating is warranted for persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health). Private treatment records indicate that the Veteran reported having symptoms of reflux and epigastric pain due to the hiatal hernia as far back as March 2009. Thus, the increase in the hernia disability occurred more than one year prior to receipt of the increased rating claim. As there is no evidence of an intent to file a claim for an increased rating prior to the April 2014 claim, the effective date for the increased 10 percent rating is the date the increased rating claim was received (April 15, 2014) and the appeal is denied. See 38 C.F.R. § 3.155, 3.400(o)(2); Harper v. Brown, 10 Vet. App. 125, 126 (1997). Bilateral glaucoma As noted above, the claim for an increased rating for bilateral glaucoma was received on January 22, 2014. In a December 2014 rating decision, the RO increased the rating from noncompensable to 10 percent (which the Board increased to 30 percent herein), effective January 22, 2013, which is one year prior to the date the increased rating claim was received. As there is no evidence of an intent to file a claim for an increased rating prior to the January 2014 claim, the effective date of January 22, 2013, is the earliest possible date of entitlement for the increased rating for bilateral glaucoma, and the appeal is denied. See 38 C.F.R. § 3.155, 3.400(o)(2); Harper v. Brown, 10 Vet. App. 125, 126 (1997). H. SEESEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Nelson, Counsel