Citation Nr: 21074976 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 16-27 219 DATE: December 16, 2021 ORDER The claim for a separate grant of service connection and disability rating for pulmonary fibrosis is denied. The claim for a separate grant of service connection and disability rating for rheumatoid lung disease is denied. The claim for a separate grant of service connection and disability rating for mediastinal nodes is denied. FINDINGS OF FACT 1. The Veteran has been granted service connection for interstitial lung disease, pulmonary fibrosis, and rheumatoid lung disease, with associative mediastinal lymphadenopathy (herein lung disease). 2. The symptoms associated with pulmonary fibrosis, rheumatoid lung disease, and mediastinal lymphadenopathy are fully compensated by his rating for lung disease. 3. A separate rating under the diagnostic criteria for pulmonary fibrosis, rheumatoid lung disease, and/or mediastinal lymphadenopathy for the same symptoms in the same body part would violate the Rule Against Pyramiding. CONCLUSIONS OF LAW 1. The criteria for service connection for pulmonary fibrosis are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 4.14, 4.97, Diagnostic code 6825. 2. The criteria for service connection for rheumatoid lung disease are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 4.14, 4.97, Diagnostic code 6825. 3. The criteria for service connection for mediastinal nodes are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 4.14, 4.97, Diagnostic code 6825. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1967 to September 1969. The claim was remanded by the Board in a May 2021 for additional development. As discussed below, service connection has been granted for the above claimed disabilities and a separate grant and disability rating for each disability cannot be awarded. Service Connection 1. Entitlement to service connection for pulmonary fibrosis 2. Entitlement to service connection for rheumatoid lung disease 3. Entitlement to service connection for mediastinal nodes A July 2021 rating decision granted service connection for the Veteran's lung disease, specifically described as interstitial disease, pulmonary fibrosis, and rheumatoid lung disease, with associative mediastinal lymphadenopathy under Diagnostic Code 6825 for diffuse interstitial fibrosis or interstitial lung disease. The symptomatology contemplated by this Diagnostic Code includes difficulty breathing, decreased lung capacity, and cardiopulmonary limitations, the same symptoms that manifest as a result of rheumatoid lung disease and mediastinal lymphadenopathy. Under the anti-pyramiding provision of 38 C.F.R. § 4.14, the evaluation of the "same disability" or, more appropriately in this case, the "same manifestation" under various diagnoses is to be avoided. For purposes of determining whether the Veteran is entitled to separate ratings for different problems or residuals of an injury, such that separate evaluations do not violate the prohibition against pyramiding, the critical element is that none of the symptomatology for any one of the conditions is duplicative of or overlapping with the symptomatology of the other two conditions. Esteban v. Brown, 6 Vet. App. 259 (1994). Providing multiple ratings under Diagnostic Code 6825 for the same symptoms in the same body part constitutes pyramiding. As such, the Board will not provide a separate grant of service connection and separate ratings for pulmonary fibrosis, rheumatoid lung disease, and mediastinal lymphadenopathy as to do so would violate the Rule Against Pyramiding by compensating the Veteran two or three times for the same symptoms. 38 C.F.R. § 4.14. (Continued on the next page) As service connection has already been granted for all three of the Veteran's claimed lung diseases and as separate ratings would result in prohibited pyramiding, the Board finds that the claim for separate service connection and ratings for pulmonary fibrosis, rheumatoid lung disease, and mediastinal lymphadenopathy must be denied. In arriving at the decision to deny the claim, the Board has considered the applicability of the benefit-of-the-doubt rule enunciated in 38 U.S.C. § 5107(b). However, as there is not an approximate balance of evidence, that rule is not applicable in this case. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001). Cynthia M. Bruce Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. B., 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.