Citation Nr: 20006785 Decision Date: 01/28/20 Archive Date: 01/27/20 DOCKET NO. 16-43 224 DATE: January 28, 2020 ORDER Entitlement to an initial compensable rating for service-connected hypertension is denied. Entitlement to service connection for diabetes mellitus is denied. Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities is denied. Entitlement to service connection for a back condition is denied. Entitlement to service connection for a bilateral knee condition is denied. Entitlement to service connection for a bilateral hip condition is denied. Entitlement to service connection for a bilateral foot condition is denied. Entitlement to service connection for a right wrist condition is denied. REMANDED Entitlement to service connection for hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for an acquired psychiatric condition, to include as secondary to service-connected conditions is remanded. Entitlement to service connection for hypertensive retinopathy is remanded. Entitlement to service connection for renal disease is remanded. Entitlement to service connection for early vascular dementia is remanded. FINDINGS OF FACT 1. The Veteran’s hypertension required continuous medication for control, however the preponderance of the evidence is against a finding that there was a history of diastolic pressure that was predominantly 100 or more. The Veteran also did not have systolic pressure that was predominantly 160 or more. 2. The preponderance of the evidence is against a finding that the Veteran’s diabetes mellitus was caused by or incurred in service, or manifested to a compensable degree within one year of separation from service. 3. The preponderance of the evidence demonstrates that the Veteran’s peripheral neuropathy was secondary to diabetes mellitus, which is not service connected. The preponderance of the evidence is against a finding that peripheral neuropathy was caused by or incurred in service. 4. The preponderance of the evidence is against a finding that the Veteran’s back condition was caused by or incurred in service. 5. The preponderance of the evidence is against a finding that a condition of the bilateral knees or legs was caused by or incurred in service. 6. The preponderance of the evidence is against a finding that the Veteran’s hip strain, or any other bilateral hip condition was caused by or incurred in service. 7. The preponderance of the evidence is against a finding that the Veteran had a bilateral foot condition that was caused by or incurred in service. 8. The preponderance of the evidence is against a finding that the Veteran’s right wrist condition was caused by or incurred in service. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial compensable rating for service-connected hypertension have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.321, 4.104, Diagnostic Code 7101 (2019). 2. The criteria for entitlement to service connection for diabetes mellitus have not been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310 (2019). 3. The criteria for entitlement to service connection for peripheral neuropathy of the bilateral lower extremities have not been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303, 3.310 (2019). 4. The criteria for entitlement to service connection for a back condition have not been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303, 3.310 (2019). 5. The criteria for entitlement to service connection for a bilateral knee condition have not been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303, 3.310 (2019). 6. The criteria for entitlement to service connection for a bilateral hip condition have not been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303, 3.310 (2019). 7. The criteria for Entitlement to service connection for a bilateral foot condition have not been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303, 3.310 (2019). 8. The criteria for entitlement to service connection for a right wrist condition have not been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. § 3.102, 3.303, 3.310 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from September 1960 to March 1961, and from December 1970 to February 1975. The Veteran passed away in March 2019, and the Appellant has been substituted as the valid claimant in this appeal. This case comes on appeal of a May 2015 rating decision. The Board notes that the Veteran was scheduled to testify at a hearing before the Board but was unable to attend that hearing. After the Appellant was substituted on the claim in June 2019, VA informed the Appellant of her rights to testify at a trial before the Board. In December 2019, the Board informed the Appellant that the case had been returned to the Board’s docket and advised her of rights regarding additional evidence and testimony. As the Appellant has not requested a Board hearing, the Board will proceed with adjudication. 1. Entitlement to an initial compensable rating for service-connected hypertension Disability evaluations are determined by the application of the facts presented to the VA’s Schedule for Rating Disabilities (Rating Schedule) at 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 civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Reasonable doubt as to the degree of disability will be resolved in the Veteran’s favor. 38 C.F.R. § 4.3. Where an increase in the level of a disability is at issue, the primary concern is the present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1994). Where the evidence contains factual findings that demonstrate distinct time periods in which the service-connected disability exhibits symptoms that would warrant different evaluations during the course of the appeal, the assignment of staged ratings is appropriate. See Fenderson v. West, 12 Vet. App. (1999); Hart v. Mansfield, 21 Vet. App. (2007). In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a Veteran’s service-connected disabilities. 38 C.F.R. § 4.14. The Veteran filed a claim of entitlement to service connection for hypertension in May 2014. In the May 2015 rating decision on appeal, the agency of original jurisdiction (AOJ) granted entitlement to service connection for hypertension at a 0 percent rating. The Veteran submitted a timely notice of disagreement with that rating, therefore the evaluation for hypertension is on appeal from the date of the initial claim. Hypertension is rated under 38 C.F.R. § 4.104, Diagnostic Code 7101. As a preliminary matter, Diagnostic Code 7101 Note (1) states that, “Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm.” Under Diagnostic Code 7101, a rating of 10 percent is warranted for diastolic pressure that is predominantly 100 or more, or; systolic pressure that is predominantly 160 or more, or; as a minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. A rating of 20 percent is warranted where diastolic pressure is predominantly 110 or more, or where systolic pressure is predominantly 200 or more. A rating of 40 percent where diastolic pressure is predominantly 120 or more. A rating of 60 percent where diastolic pressure is predominantly 130 or more. The Board notes that “predominantly” is not defined in the Rating Schedule, however the Board understands it to have its ordinary meaning of “for the most part,” or “mainly.” See Merriam-Webster’s Collegiate Dictionary, 978 (11th ed. 2012). The Veteran’s service connection for hypertension was based on evidence in his service treatment records that blood pressure readings had exceeded a diastolic pressure of 100 on more than one occasion from 1972 to 1973. Post-service the Veteran’s hypertension was first documented in 2004, however it was controlled by medication. Throughout the period on appeal, there were no findings demonstrating that the Veteran’s systolic blood pressure was predominantly 160 or more, or that his diastolic pressure was 100 or more. Medical records show, however, that the Veteran’s hypertension required him to take Lisinopril to maintain control of the condition. Therefore, a minimum rating of 10 percent would be required if the evidence indicated a history of diastolic pressure that was 100 or more. Here, there is no such evidence. Aside from the in-service incidents noted above, in which diastolic pressure reached 100 on multiple occasions from 1972 to 1973, there is no other evidence showing diastolic pressure of at least 100. Indeed, the first post-service blood pressure readings available begin in February 2000 VA treatment records. There, the Veteran is shown to have had blood pressure readings in a normal range. Although blood pressure eventually increased over time, it did not reach a diastolic pressure of at least 100. The Board notes that there is a significant amount of time between the Veteran’s separation from service and February 2000 for which there are no records of blood pressure readings. However, the Veteran did not provide any evidence—to include lay testimony—that his diastolic blood pressure was 100 or greater during this time. Based on these findings, the Board does not deem the few in-service diastolic blood pressure readings of 100 or greater to represent a predominance in the Veteran’s hypertension history. Instead, the preponderance of the evidence demonstrates that, throughout the period on appeal, the Veteran’s systolic blood pressure was not predominantly 160 or greater, the Veteran’s diastolic blood pressure was nor predominantly 100 or greater, and—although the Veteran required the use of medication to control his blood pressure—there was no evidence of a history of the Veteran’s diastolic blood pressure being predominantly 100 or greater. As the preponderance of the evidence is against this finding, the “benefit of the doubt” rule is not applicable and the Board must deny the claim of entitlement to an initial compensable rating. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Service Connection Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303, 3.304. Service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Walker v. Shinseki, 701 F.3d 1331 (Fed. Cir. 2013). For chronic diseases listed in 38 C.F.R. § 3.309(a), including diabetes, the linkage element of service connection may also be established by demonstrating continuity of symptoms since service. 38 C.F.R. § 3.303(b); see Walker v. Shinseki, 708 F.3d 1331 (Fed.Cir.2013). 38 C.F.R. § 3.307(a)(3) provides for presumptive service connection for chronic diseases that become manifest to a degree of 10 percent or more within 1 year from the date of separation from service. Notwithstanding the lack of evidence of disease or injury during service, service connection may still be granted if all of the evidence, including that pertinent to service, establishes that the disability was incurred in service. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d). 2. Entitlement to service connection for diabetes mellitus The Veteran had a well-documented diagnosis of diabetes mellitus prior to his death. At issue, therefore, is whether diabetes was caused by or incurred in service. November 1996 VA treatment records indicate that the Veteran’s optometrist had recently told him that he had diabetes. Follow-up treatment confirmed the Veteran’s diagnosis. There is no indication, however, that diabetes started in, or had any relationship to, service. Service treatment records do not demonstrate any diagnosis of diabetes or symptoms indicative of diabetes. The Veteran himself did not claim that diabetes began in service, nor did he provide any other explanation as to why diabetes was causally related to service. Furthermore, there is no indication that diabetes manifested to a compensable degree within one year of separation from service. In short, the evidence strongly suggests that diabetes manifested decades after the Veteran’s separation from service, with no causal relationship to any in-service illness, injury, or event. Based on the foregoing, the preponderance of the evidence is against a finding that the Veteran’s diabetes was caused by or incurred in service. As the preponderance of the evidence is against this finding, the “benefit of the doubt” rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 3. Entitlement to service connection for peripheral neuropathy of the bilateral lower extremities The evidence demonstrates that the Veteran suffered from peripheral neuropathy of the bilateral lower extremities for several years. In April 2015, the Veteran underwent a VA examination for the condition. There, the examiner explained that the Veteran’s lower extremity neuropathy was secondary to diabetes. Shortly after being diagnosed with diabetes, the Veteran began experiencing numbness and weakness in his legs that had gotten more severe over time. As was addressed above, the Veteran’s diabetes itself is not service connected. Although the Veteran himself did not identify an in-service onset of neuropathy, service treatment records showed that the Veteran was seen during service for complaints of right-side numbness. Therefore, the VA examiner was asked to opine as to whether this indicated an in-service onset of neuropathy. The examiner stated that these two conditions were not related. Instead, the in-service episode was determined to be a central nervous system issue, while the disability relevant to this claim affected the Veteran’s peripheral nerves. Per the examiner, these represented two separate and distinct diagnoses. Therefore, based on the foregoing, the preponderance of the evidence is against a finding that the Veteran’s peripheral neuropathy was caused by or incurred in service, or was secondary to a service-connected condition. As the preponderance of the evidence is against this finding, the “benefit of the doubt” rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 4. Entitlement to service connection for a bilateral knee condition 5. Entitlement to service connection for a bilateral hip condition 6. Entitlement to service connection for a back condition 7. Entitlement to service connection for a bilateral foot condition The Board notes that the Veteran’s post-service treatment records, especially in the years immediately prior to the Veteran’s death, demonstrate the Veteran’s significant, ongoing problems related to pain in the low back and lower extremities. Initially, these problems manifested as weakness and numbness in the Veteran’s legs, due to diabetic peripheral neuropathy. Over time, this peripheral neuropathy led to instability and the Veteran experienced regular falls, ultimately causing greater problems in his back and lower extremities. Numerous records also indicate that the peripheral neuropathy increased in severity and scope as the Veteran’s health deteriorated. In April 2013, the Veteran also began to complain of pain in his hip, buttocks, and lower back that was diagnosed as a hip strain, with subsequent pain in these areas evaluated as muscular. Additionally, x-rays showed narrowing of the lumbosacral spine. The Board therefore acknowledges that the Veteran experienced great difficulty with pain and lack of mobility in the back and lower extremities. At issue, however, is whether any of these conditions were caused by or incurred in service. Here, there is no evidence to suggest that they were. As was noted, the cause of the Veteran’s initial lower extremity pain was clearly identified as non-service connected diabetic peripheral neuropathy, exacerbated by numerous falls. In April 2013, the Veteran admitted to falling an average of seven or eight times per month. Furthermore, there is no evidence in the Veteran’s service treatment records showing an in-service injury that might be related to these later disabilities. Indeed, the Veteran himself did not identify any such injury or provide statements to explain why these issues were related to service. Accordingly, the preponderance of the evidence is against a finding that the Veteran’s hip strain, lumbosacral spinal narrowing, or bilateral lower extremity pain were caused by or incurred in service. As the preponderance of the evidence is against such a finding, the “benefit of the doubt” rule is not applicable and the Board must deny the claims. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 8. Entitlement to service connection for a right wrist condition Post-service treatment records demonstrate that the Veteran had complaints of right wrist pain. Specifically, November 2013 VA treatment records indicate that the Veteran had a diagnosis of carpal tunnel syndrome, exacerbated by diabetic neuropathy. An April 2013 VA telephone encounter also showed that the Veteran had injured his wrist secondary to landing on it in a fall. As was discussed above, neither the diabetic neuropathy nor the conditions resulting in the Veteran’s frequent falls were service connected. The Board notes that December 1972 service treatment records show that the Veteran was seen for complaints of numbness of the right side, to include the right wrist. Although the Veteran was not specifically examined for his right wrist condition, in his April 2015 peripheral neuropathy examination, the examiner addressed the December 1972 records. As was noted above, the examiner explained that the December 1972 incident was related to a condition of the central nervous system, and that the peripheral nerve conditions the Veteran experienced at the time of the examination were separate and distinct from one another. Moreover, the Board also notes that the Veteran did not provide any testimony or explanation as to why his right wrist condition was related to service. Accordingly, the preponderance of the evidence is against a finding that the Veteran’s right wrist condition was caused by or incurred in service. As the preponderance of the evidence is against such a finding, the “benefit of the doubt” rule is not applicable and the Board must deny the claims. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND 1. Entitlement to service connection for hypertensive retinopathy is remanded. 2. Entitlement to service connection for renal disease is remanded. 3. Entitlement to service connection for early vascular dementia is remanded. In September 2017, the AOJ issued a rating decision denying the above issues. At the same time, the AOJ denied the issues of entitlement to service connection for heart disease and entitlement to service connection for depression. Later in September 2017, the Veteran submitted a notice of disagreement, listing disagreement with all issues denied in the September 2017 rating decision. Although the issue of entitlement to service connection for a heart condition was later granted in full, and the issue of entitlement to service connection for depression was incorporated into other issues on appeal, to date the AOJ has not issued a statement of the case (SOC) regarding entitlement to service connection for hypertensive retinopathy, renal disease, or early vascular dementia. When there has been an initial AOJ adjudication of a claim and a notice of disagreement has been filed as to its denial, the Veteran is entitled to a statement of the case, and the AOJ’s failure to issue a statement of the case is a procedural defect requiring remand. Manlincon v. West, 12 Vet. App. 238 (1999). As the Appellant has been substituted as a valid claimant on the Veteran’s appeal, she is entitled to the same procedural rights as the Veteran. Accordingly, the Board must remand these issues so that the AOJ may issue an SOC. 4. Entitlement to service connection for an acquired psychiatric condition, to include as secondary to service-connected conditions is remanded. 5. Entitlement to service connection for hearing loss is remanded. 6. Entitlement to service connection for tinnitus is remanded. When VA undertakes the effort to provide an examination, even if not statutorily obligated to do so, it must provide an adequate one. Barr v. Nicholson, 21 Vet. App. 303 (2007). For an examination to be adequate, it must address the Veteran’s medical history, and any medical opinions provided in such examination must be supported by sufficient medical rationale. Here, both the Veteran’s April 2015 examination for hearing loss and tinnitus, and the August 2017 examination for mental disorders were not accompanied by adequate medical opinions. Regarding the examination for hearing loss and tinnitus, the examiner opined that it was less likely than not that the Veteran’s hearing loss was caused by or incurred in service. By way of rationale, the examiner explained that there were no positive threshold shifts during service. This opinion both failed to address the entirety of the evidence in the Veteran’s service treatment records and failed to provide an adequate medical opinion. First, the Board notes that the Veteran had two periods of service. As was noted in the April 2015 examination, on the Veteran’s 1960 induction examination, it appears the Veteran was only given a whisper hearing test and audiometric data was not obtained, although hearing appeared to be within normal limits. However, when the Veteran was discharged from service the first time in 1961, audiometric data from his March 1961 separation examination showed hearing acuity as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 45 35 35 n/a 35 LEFT 25 25 0 n/a 15 Additionally, the examiner explicitly wrote “hearing loss bilateral” under the summary of defects and diagnoses. The Veteran reenlisted in 1970 and at his December 1970 enlistment examination, audiometric findings which utilized the ISO-ANSI standard were: HERTZ 500 1000 2000 3000 4000 RIGHT 15 10 20 n/a 25 LEFT 20 15 15 n/a 15 At the time of the Veteran’s January 1975 separation examination, audiometric findings were: HERTZ 500 1000 2000 3000 4000 RIGHT 25 25 25 n/a 30 LEFT 25 25 25 n/a 25 Therefore, there are two issues that must be addressed. First, given the findings of hearing loss on the March 1961 separation examination, followed by a December 1970 enlistment examination demonstrating hearing within normal limits, it is unclear whether there is evidence of a noise-related injury that could have affected the Veteran’s hearing later in life. Second, given that there are indeed shifts in the Veteran’s hearing acuity between his 1970 and 1975 examinations—to include a shift of 15 decibels at the 1000 Hertz frequency and hearing acuity at the 4000 Hertz frequency in the right ear that is beyond the VA definition of “normal” hearing—further explanation is necessary as to why this does not constitute a significant threshold shift. Additionally, an adequate medical opinion must be supported by sufficient rationale. In the April 2015 examination, the examiner only presented the evidence found, but did not explain why that evidence led to the conclusions in the examiner’s opinion. On remand, a new opinion must be obtained to rectify these inadequacies. Notably, the examiner opined that the Veteran’s reported tinnitus was caused by his hearing loss disability. As such, the issue of entitlement to service connection for tinnitus is inextricably intertwined with the hearing loss issue and must be remanded as well. Regarding the Veteran’s mental disorders examination, the examiner reported that the Veteran did not have a diagnosed mental health condition. The Veteran’s VA treatment records note several instances in which the Veteran was diagnosed with depression and anxiety disorders. Indeed, later in the August 2017 examination, the examiner reported that the Veteran was in mental health treatment and on psychiatric medications. The examiner did not provide any explanation as to how the Veteran did not have a diagnosed mental health disability in light of this evidence. The Board therefore cannot consider this examination to be adequate. Moreover, subsequent to the August 2017 examination, the Veteran was service connected for a heart condition. On remand, a new opinion should be obtained addressing the Veteran’s full medical record. If any acquired psychiatric disability is observed in the record, the opining examiner should address whether such disability was caused by or incurred in service, or was caused or aggravated by any service-connected disability. The matters are REMANDED for the following action: 1. Furnish the Appellant with an SOC pertaining to the issues of entitlement to service connection for hypertensive retinopathy, renal disease, and early vascular dementia, in accordance with 38 C.F.R. §§ 19.26, 19.29 and Manlincon v. West, 12 Vet. App. 238 (1999). 2. Obtain a new medical opinion from an appropriate examiner regarding the Veteran’s hearing loss disability. The examiner should review the entire claims file, to include a copy of this Remand, and the examiner’s report should include discussion of the Veteran’s documented history and assertions. Then, the examiner should render an opinion, as to whether it is at least as likely as not (i.e., there is a 50 percent or greater probability) that the Veteran’s hearing loss disability during the pendency of this claim had onset in, or is otherwise related to service. In doing so, the examiner should consider the following: - The Veteran’s apparently normal hearing examination upon entry to service in 1960 - The hearing loss disability noted on the Veteran’s separation examination in 1961 (presumably under the ASA standard) - The Veteran’s 1970 enlistment examination documenting hearing within normal limits under the ISO-ANSI standard - The Veteran’s 1975 separation examination demonstrating hearing thresholds at higher decibels than the 1970 enlistment examination, to include a shift of 15 decibels at the 1000 Hertz frequency, and a hearing threshold of 30 decibels at the 4000 Hertz measurement in the right ear (presumably under the ISO-ANSI standard) - The possibility that, irrespective of separation examination findings, an in-service noise injury ultimately caused the Veteran’s hearing loss disability The examiner should set forth all findings, along with complete rationale for the conclusions reached, in a printed report. Complete rationale should include an explanation of the evidence identified in support of the conclusion, as well as an explanation as to why such evidence leads to the examiner’s conclusion. 3. Obtain a new medical opinion from an appropriate examiner regarding the Veteran’s mental health. The examiner should review the entire claims file, to include a copy of this Remand, and the examiner’s report should include discussion of the Veteran’s documented history and assertions. After review of the file, the examiner should identify any diagnosed acquired psychiatric disorder. Then, for any identified disability, the examiner should render an opinion, as to whether it is at least as likely as not (i.e., there is a 50 percent or greater probability) that the Veteran’s had onset in, or is otherwise related to service. The examiner should also address whether it is at least as likely as not that any acquired psychiatric disorder was caused or aggravated by a service-connected condition. If the examiner determines that the Veteran did not have an acquired psychiatric disorder, the examiner should reconcile such finding with the Veteran’s history of mental health treatment and problem lists that included depression and anxiety. The examiner should set forth all findings, along with complete rationale for the conclusions reached, in a printed report. Complete rationale should include an explanation of the evidence identified in support of the conclusion, as well as an explanation as to why such evidence leads to the examiner’s conclusion. 4. Then, readjudicate the issues remaining on appeal. If the benefits sought remain denied, send the Appellant and her representative a supplemental statement of the case. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Giaquinto, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.