Citation Nr: 21063623 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 13-31 088A DATE: October 14, 2021 ORDER Entitlement to a compensable rating for hypertension (HTN) is denied. Entitlement to an initial compensable rating for left inguinal hernia, status post repair, is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran's HTN has manifested with diastolic pressure predominantly 100 or more, or that he had a history of diastolic pressure predominantly 100 or more and requires continuous medication for control. 2. The preponderance of the evidence is against finding that the Veteran's left inguinal hernia, status post repair, has manifested with a recurrent left inguinal hernia. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial compensable rating for HTN have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.104, Diagnostic Code 7101. 2. The criteria for entitlement to an initial compensable rating for left inguinal hernia, status post repair, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.114, Diagnostic Code 7338. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1983 to May 2008. This appeal to the Board of Veterans' Appeals (Board) arose from a February 2010 rating decision issued by the Department of Veterans Affairs (VA). See March 2010 Notice of Disagreement (NOD); September 2013 Statement of the Case (SOC); November 2013 Substantive Appeal (VA Form 9). In March 2021, the Board remanded the claims for further development. March 2021 Board Decision. As noted in the March 2021 Board decision, the Veteran requested a hearing before a veterans law judge, and a March 2021 hearing was scheduled, but the Veteran then withdrew his request. See January 2021 BVA Letter; March 2021 Board Decision. The agency of original jurisdiction developed the evidence and continued the denial of the Veteran's claims. July 2021 Supplemental Statement of the Case. The claims are now back before the Board. Increased Rating Disability ratings are determined by the application of the VA's Schedule for Rating Disabilities. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. § Part 4. Ratings for service-connected disabilities are determined by comparing the Veteran's symptoms with criteria listed in VA's Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. See 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, the higher evaluation will be assigned to the disability picture that more nearly approximates the criteria required for that rating. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 C.F.R. § 4.31. The Board has considered the entire record, but only the evidence pertinent to the rating criteria and current disability will be discussed. See Gonzales v. West, 218 F. 3d 1378 (Fed. Cir. 2000). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the Veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 1. Entitlement to a compensable rating for HTN. The Veteran asserts that his HTN warrants a higher rating because he believes it is the cause of his sleep problems. See March 2010 NOD; May 2014 VA Form 9. The Veteran's HTN is currently evaluated under Diagnostic Code 7101 and rated as noncompensable, or zero percent disabling. See February 2010 Rating Decision. Under Diagnostic Code 7101, a 10 percent rating is warranted for HTN that manifests with diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. 38 C.F.R. § 4.104. The next higher rating of 20 percent is warranted for a diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more. Id. After careful and thorough consideration of the evidence, the Board finds that the Veteran's HTN does not meet the criteria for a compensable rating. The Veteran was afforded two VA examinations to assess his HTN. The November 2009 VA examiner noted that the Veteran had a previous diagnosis of HTN, but that the Veteran reported that he was never placed on blood pressure medication. See November 2009 VA Examination for Digestive Condition / Miscellaneous. The November 2009 VA examiner found blood pressure measurements of 134/84, 126/78, and 126/88. Id. The May 2021 VA examiner noted that the Veteran was now on medications to control his HTN, but that he does not have a history of a diastolic blood pressure elevation to predominantly 100 or more. May 2021 VA Examination for Hypertension. The May 2021 VA examiner found blood pressure measurements of 138/90, 140/90, and 142/90. Id. The VA examiners' findings are probative as they are from medical professionals qualified to evaluate the Veteran's HTN symptoms and provide detailed reports that are relevant to the rating criteria. The examiners' findings are against finding that the Veteran's HTN warrant a compensable rating. The Board considered the medical treatment evidence and finds that it is consistent with the VA examiners' findings that the Veteran has not had diastolic blood pressure elevation predominantly 100 or more at any time during the period on appeal. See, e.g., March 2009 Private medical treatment evidence; June 2012 VA treatment evidence; October 2014 Private medical treatment evidence; November 2016 Private medical treatment evidence; August 2019 VA treatment evidence. The Board also considered the Veteran's lay statements that his HTN causes his sleep problems. While the Veteran is competent to report symptoms that he experiences, he is not competent to state the cause of his symptom or whether his symptoms warrant a specific rating under the schedule for rating disabilities. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed Cir. 2006); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). In this case, the Veteran's reported sleep problems are not relevant to the rating criteria for his HTN. See 38 C.F.R. § 4.104, Diagnostic Code 7101. Moreover, the Veteran is not competent to opine that his sleep problems are due to his HTN and there is no medical evidence suggesting a connection. The Board, thus, finds that the preponderance of the evidence is against finding that the Veteran has, or has had a history of, diastolic blood pressure elevation predominantly 100 or more. Accordingly, entitlement to a compensable rating for HTN is not warranted. 2. Entitlement to an initial compensable rating for left inguinal hernia, status post repair. The Veteran asserts entitlement to a compensable rating for his left inguinal hernia, status post repair, because the area is very tender. November 2013 Correspondence. The Veteran's left inguinal hernia, status post repair, is currently evaluated under Diagnostic Code 7338 and rated as noncompensable, or zero percent disabling. See February 2010 Rating Decision. Under Diagnostic Code 7338, a noncompensable rating is warranted if an inguinal hernia is small, reducible, without true hernia protrusion, or if it is not operated on, but remediable. 38 C.F.R. § 4.114. A 10 percent rating is warranted if it is postoperative recurrent, readily reducible and well supported by truss or belt. Id. The next higher rating of 30 percent is warranted for a hernia that is small, postoperative recurrent, or unoperated irremediable, not well supported by truss, or not readily reducible. Id. In this case, the Board finds that the evidence is against finding that the Veteran had had a recurrent left inguinal hernia since his surgery. The medical treatment evidence shows no evidence of a recurrent left inguinal hernia since his 1996 surgery. The Veteran was afforded two VA examinations to assess for a left inguinal hernia. The November 2009 VA examiner noted that the Veteran's treatment records show the Veteran had a right inguinal hernia in 2009, but his 1996 hernia surgery was healed with no current problems. November 2009 VA Examination for Digestive Conditions / Miscellaneous. The VA examiner found no evidence of a left inguinal hernia during the exam. Id. The May 2021 VA examiner noted that the Veteran reported having a dull pain when bending over and tenderness around the left inguinal hernia surgery area. May 2021 VA Examination for Hernias. The May 2021 VA examiner found no evidence of a hernia during the examination and opined that the Veteran's dull pain and tenderness was not due to a recurrent hernia, but possibly his left inguinal hernia surgery scar. See June 2021 VA Examination Addendum Report. The VA examiners are medical professionals qualified to evaluate the Veteran's left inguinal hernia, status post repair, and provided detailed reports to support their findings. The Board finds their findings and opinions to be probative for these reasons. The Board considered the Veteran's lay statement that his dull pain and tenderness are due to a recurrence of his left inguinal hernia. While the Veteran is competent to report having experienced symptoms of pain, the causation falls outside of the realm of knowledge of a lay person as it is a medically complex question. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011); Jandreau, 492 F.3d at 1377. Moreover, as discussed above, the May 2021 VA examiner attributed the Veteran's dull pain and tenderness to the hernia repair scar and not to a recurrence of a left inguinal hernia. The Board finds the Veteran's statements that the pain to a hernia to not be probative. The Board notes that his left inguinal hernia repair scar was service-connected and assigned a 10 percent rating in a separate rating decision. See July 2021 Rating Decision. (Continued on the next page) The Board, thus, finds that the preponderance of the evidence is against finding that the Veteran has had a postoperative recurrence of a left inguinal hernia. Accordingly, entitlement to a compensable rating for left inguinal hernia, status post repair, is not warranted. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Lin 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.