Citation Nr: 18102402 Decision Date: 05/15/18 Archive Date: 05/15/18 DOCKET NO. 17-14 340 DATE: May 15, 2018 ORDER Entitlement to a rating in excess of 10 percent for service-connected residuals, fracture, deviated septum, is denied. FINDING OF FACT The Veteran’s service-connected residuals, fracture, deviated septum, is manifested by obstruction of the nasal passage on both sides or complete obstruction on one side. CONCLUSION OF LAW The criteria for a rating in excess of 10 percent for service-connected residuals, fracture, deviated septum, have not been satisfied. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, 4.97, Diagnostic Code (DC) 6502. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active from September 1953 to September 1956. In April 2018, the Veteran testified at a video conference hearing before the undersigned Veterans Law Judge. A copy of the transcript of that hearing is of record. Entitlement to a rating in excess of 10 percent for service-connected residuals, fracture, deviated septum. Disability evaluations are determined by the application of the Schedule for Rating Disability evaluations are determined by evaluating the extent to which a claimant’s service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing his symptomatology with the criteria set forth in the Schedule for Rating Disabilities (rating schedule). 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10. If two evaluations are potentially applicable, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that evaluation; otherwise, the lower evaluation will be assigned. 38 C.F.R. § 4.7. The Veteran’s entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where an increase in the level of a service-connected disability is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1994). The Board has considered the Veteran’s claim and decided entitlement based on the evidence. Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record, with respect to his claims. See Doucette v. Shulkin, 28 Vet. App. 366, 369-70 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). The Veteran’s service-connected deviated septum is rated as 10 percent disabling pursuant to 38 C.F.R. § 4.97, DC 6502. Under DC 6502, a maximum 10 percent rating is warranted for traumatic deviation of the nasal septum with 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side. This is the only schedular rating provided under this diagnostic code. Id. During VA examination in May 2016, the Veteran was referred for left-sided epistaxis, nosebleeds. The physician noted his use of a prescription medication for a cardiac disability. Physical examination, including scope, was normal. During VA treatment in July 2016, the Veteran was seen for recurrent epistaxis, and reported good results with the use of Vaseline and nasal spray. He complained of a new symptom, ear pain, only while not using hearing aids. Physical examination of the deviated septum was unremarkable, and the ear examination was normal. On VA examination in August 2016, the Veteran complained of sharp pains in his right ear, nosebleeds, attributed to prescription medication use, and more difficulty breathing on the right side. There was not at least 50 percent obstruction of the nasal passages on both sides, however, there was complete obstruction on the right, without other pertinent physical findings, no other complications, conditions, signs, or symptoms, related to the disability. In his January 2017 Substantive Appeal, the Veteran asserted that he had a hard time breathing, that he could only breathe on one side of nose, and that he had earaches because of his nose. During his April 2018 Board hearing, the Veteran asserted that he had problems with his service-connected deviated septum, but only on the right side. He complained of headaches, sinus issues, earaches, and tinnitus, and reported that he took blood thinners and had nosebleeds, and that he had glaucoma. As noted, under DC 6502, the only applicable rating criteria, a maximum 10 percent rating is warranted for traumatic deviation of the nasal septum with 50 percent obstruction of the nasal passage on both sides or complete obstruction on one side. Indeed, clinical findings indicate that the Veteran has complete obstruction on one side, the right side, and his disability thus warrants the maximum 10 percent rating. There is no higher rating for a deviated septum disability. 38 C.F.R. § 4.97, DC 6502. While the Veteran asserts that his complaints of earaches, right-ear pain, tinnitus, nosebleeds, headaches, glaucoma, and sinus issues serve as evidence that his disability warrants a higher rating, there is no competent evidence showing that such are symptoms of his service-connected residuals, fracture, deviated septum, or disabilities associated with the same. Significantly, the VA examiner, in August 2016, specifically found no other complications, conditions, signs, or symptoms, related to the disability. Service connection for glaucoma was denied by a November 2007 rating decision. The Veteran’s ear pain was considered by his VA treatment providers, no diagnosis was found. The Veteran’s VA treatment records are silent for treatment of any sinusitis. The Veteran’s nosebleeds have been attributed to the prescription medication he takes for a cardiac disability. No examiner or treatment provider has opined that the Veteran’s service-connected residuals, fracture, deviated septum, is manifested by any symptoms beyond complete obstruction on one side. Thus, the Board has considered the Veteran’s lay assertions as to the symptoms to which he attributes to his service-connected residuals, fracture, deviated septum, and finds such question to be complex in nature. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). There is no evidence that the Veteran possesses the requisite skill, training, or experience to determine the symptomatology attributed to his disability. Thus, his lay statements in this regard are not competent and lack probative value in the present appeal. In addition, his lay opinions are outweighed by that of the August 2016 VA examiner, as they do not have a similar medical background or expertise. King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012) (affirming the Court’s conclusion that the Board did not improperly discount the weight of a lay opinion in finding a medical expert’s opinion more probative on the issue of medical causation). The Board has considered whether a higher rating might be warranted for any time during the pendency of this appeal. Hart v. Mansfield, 21 Vet. App. 505 (2007). However, the Board finds that the evidence of record demonstrates that during the entire appellate period, the Veteran’s service-connected residuals, fracture, deviated septum, does not warrant a rating in excess of 10 percent. The claim must be denied. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Purdum, Counsel