Citation Nr: 21065041 Decision Date: 10/22/21 Archive Date: 10/22/21 DOCKET NO. 17-04 944 DATE: October 22, 2021 ORDER Entitlement to a compensable rating prior to May 18, 2017 and greater than a 30 percent rating thereafter for allergic rhinitis is denied. Entitlement to an initial 10 percent rating for left hand sprain is granted for the entire period on appeal. FINDINGS OF FACT 1. Prior to May 18, 2017, the Veteran's allergic rhinitis was neither productive of polyps, nor of greater than 50 percent obstruction of nasal passage on both sides or complete obstruction on one side; thereafter, the Veteran's allergic rhinitis manifested in symptoms that more nearly approximate allergic rhinitis with polyps. 2. The Veteran's left hand sprain manifested in painful motion; the condition did not manifest in a gap of more than two inches (5.1 cm) between the thumb pad and the fingers. CONCLUSIONS OF LAW 1. The criteria a compensable rating prior to May 18, 2017 and greater than a 30 percent rating thereafter for allergic rhinitis have not been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.7, 4.21, 4.31, 4.97, Diagnostic Code 6522. 2. The criteria for a 10 percent rating, but no higher, for left hand sprain have been met for the entire appeal period. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.2, 4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5228. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1983 to July 1987 and January 1989 to February 1991. This matter comes before the Board of Veterans' Appeals (Board) from a June 2014 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared for a hearing before the undersigned Veterans Law Judge in February 2020. A transcript of the proceeding is of record. This claim was previously remanded by the Board in October 2020 for further development, to include providing VA examinations and updating VA treatment records. The Board finds substantial compliance with the remand directives and therefore another remand is not necessary. Stegall v. West, 11 Vet. App. 268 (1998). Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the appellant or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000); Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000). Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). Increased Rating 1. Entitlement to an increased rating for allergic rhinitis The Veteran contends he is entitled to a higher rating for his allergic rhinitis. The Veteran was granted service connection for allergic rhinitis in a June 2014 rating decision with an initial rating of 0 percent effective June 2013. The Veteran timely appealed the initial rating awarded. His rating was later increased to 30 percent effective May 2017. Allergic rhinitis is rated under DC 6522, which pertains to allergic or vasomotor rhinitis. 38 C.F.R. § 4.97. Under this DC, a 10 percent rating is warranted for rhinitis without polyps but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction on one side. A 30 percent rating is warranted for rhinitis with polyps. The Veteran reports experiencing tearing of the eyes, itchy eyes, noses and ears, nasal congestion, and one-sided obstruction. He takes allergy medications daily to help him breathe. See January 2017 substantive appeal. At the February 2020 Board hearing the Veteran reported these symptoms worsened since the October 2017 VA examination. He reported having to wear a mask outside during allergy season. The April 2014, October 2017, and April 2021 VA examinations show that he does not have 50-percent obstruction in both sides, or total on one side, or polyps. However, the Board resolves reasonable doubt in his favor and finds that his condition more nearly approximates the 30 percent rating criteria as of May 2017 given his reports of trouble breathing. However, the preponderance of the evidence is against such a finding prior to May 2017. To the extent that the Veteran contends entitlement to higher ratings, the preponderance of the evidence is against the claim; there is no reasonable doubt to be resolved; and any further increased rating is not warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, supra. Entitlement to an increased rating for left hand sprain The Veteran seeks a higher rating for his left hand sprain. Service connection was granted in a June 2014 rating decision with a noncompensable rating effective June 25, 2013. The Veteran timely appealed the initial rating awarded. Under DC 5228, a noncompensable rating is warranted for limitation of motion of the thumb with a gap of less than one inch (2.5 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the finger. A 10 percent rating is warranted for limitation of motion of the thumb, with a gap of one to two inches (2.5 to 5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers. A maximum 20 percent rating is warranted for limitation of motion of the thumb with a gap of more than two inches (5.1 cm) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers. See 38 C.F.R. § 4.71a, DC 5228. In determining disability ratings, DC 5228 makes no differentiation between the major and minor hands. When evaluating disabilities that are based on limited motion, it is necessary to consider both the schedular criteria and any functional loss due to flare-ups of pain, fatigability, incoordination, pain on movement, and weakness. DeLuca v. Brown, 8 Vet. App. 202 (1995). Pain on movement, swelling, deformity, or atrophy of disuse are relevant factors in regard to joint disability. 38 C.F.R. § 4.45. Painful, unstable, or malaligned joints, due to a healed injury, are entitled to at least the minimal compensable rating for the joint. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011) (applying § 4.59 in non-arthritis contexts). The Veteran reports pain, swelling, and limited grip strength of his left hand, worse with activity and with inclement or cold weather. See April 2014 VA examination; January 2017 substantive appeal. The three VA examinations of record April 2014, October 2017, and April 2021 show no limitation in his range of motion or gap between the thumb pad and fingers. April 2014 and April 2021 x-rays were normal. However, the Veteran reports pain with use and during inclement weather, which is consistent with the VA examinations of record. For example, the April 2014 VA examiner opined that during flare ups and after heavy physical activities the Veteran will likely have more pain, stiffness and mild limitation in range of motion. However, the examiner was unable to provide degree of additional range of motion loss because this will depend on the severity of the flare-up and the amount of effort done, so, it would be mere speculation to estimate that in degrees. In short, while there is no evidence of arthritis in the left hand, or a gap between the thumb pad and the fingers, the Veteran competently and credibly reports flare-ups of pain, swelling, and decreased grip strength after repeated use and during inclement weather. Accordingly, resolving reasonable doubt in favor of the Veteran, the Board finds that the Veteran's left hand sprain is consistent with a 10 percent rating based on painful motion for the entire period on appeal. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). The Board notes that the RO increased the Veteran's rating to 10 percent effective May 2017. However, upon review of the record, the Board finds no evidence suggesting the Veteran's condition worsened in May 2017. Indeed, the evidence indicates that, the Veteran has experienced painful motion throughout the appellate period. Thus, the Board awards a 10 percent rating for the entire appellate period, that is, effective June 25, 2013. However, the preponderance of the evidence is against awarding a higher rating of 20 percent under DC 5228 because there is no evidence of a gap of more than two inches (5.1 cm) between the thumb pad and the fingers. To the extent that the Veteran contends entitlement to higher ratings, the preponderance of the evidence is against the claim; there is no reasonable doubt to be resolved; and any further increased rating is not warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, supra. Nathaniel J. Doan Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.L. Blevins, 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.