Citation Nr: A21019587 Decision Date: 12/08/21 Archive Date: 12/08/21 DOCKET NO. 201009-111941 DATE: December 8, 2021 ORDER Entitlement to an initial evaluation of 20 percent, but no higher, for bilateral dry eyes is granted. Entitlement to an effective date prior to February 11, 2020 for the grant of service connection for bilateral dry eyes as secondary to service-connected bilateral pterygium with corneal scar is denied. FINDINGS OF FACT 1. For the entire period on appeal, the Veteran's service-connected dry eye syndrome has been manifested by a disorder of the lacrimal apparatus, specifically dry eye, bilaterally. 2. The earliest date of receipt for claims of entitlement to service connection for bilateral dry eyes is February 11, 2020. CONCLUSIONS OF LAW 1. The criteria for a 20 percent initial evaluation, but no higher, for bilateral dry eyes have been met for the entire period on appeal. 38 U.S.C. § 1155; 38 C.F.R. § 4.79, Diagnostic Code 6099-6025. 2. The criteria for an effective date prior to February 11, 2020, for the grant of service connection for bilateral dry eyes, have not been met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 2007 to August 2012. The rating decision on appeal was issued in October 2020 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the October 2020 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Increased Rating Disability evaluations are determined by the application of VA's Schedule for Rating Disabilities, which is based on average impairment of earning capacity. 38 U.S.C.A. § 1155 ; 38 C.F.R. Part 4. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the veteran. 38 C.F.R. § 4.3. The Veteran's entire history is reviewed when making disability evaluations. See generally 38 C.F.R. § 4.1 ; Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where the question for consideration is the propriety of the initial evaluation assigned, evaluation of the medical evidence since the grant of service connection and consideration of the appropriateness of a "staged rating" (assignment of different ratings for distinct periods of time, based on the facts found) is required. See Fenderson v. West, 12 Vet. App. 119, 126 (1999). 1. Initial compensable rating for bilateral dry eyes The Veteran's bilateral dry eyes are currently rated noncompensable under Diagnostic Code 6099-6025. Hyphenated Diagnostic Codes are used when a rating under one Diagnostic Code requires use of an additional Diagnostic Code to identify the basis for the evaluation assigned. See 38 C.F.R. § 4.27. When an unlisted condition is encountered, it is permissible to rate under a closely related disease or injury in which not only the functions affected, but the anatomical localization and symptomatology are closely analogous. See 38 C.F.R. § 4.20. Under Diagnostic Code 6025, Disorders of the lacrimal apparatus (epiphora, dacryocysistis, etc.), a 20 percent rating is warranted for bilateral involvement and a 10 percent rating is warranted for unilateral involvement. Prior VA examinations had shown only pterygium with a corneal scar. This is rated under the General Rating Formula for Diseases of the Eye. See 38 C.F.R. § 4.79, Diagnostic Code 6034. In order to receive a compensable rating, there must be documented incapacitating episodes requiring at least one but less than 3 treatment visits for an eye condition in the past 12 months. Id. The Veteran is already rated for this issue separately and it is not on appeal (see also earlier effective date section below). Here, the Veteran has a diagnosis of bilateral dry eyes as shown in a July 2020 private treatment record. Therefore, a 20 percent rating is warranted. The Board also finds the preponderance of evidence is against a finding that there is any other applicable diagnostic code in the rating schedule for diseases of the eye that would result in a higher rating for his bilateral dry eyes. As previously noted, the medical evidence of record indicates the Veteran's disability is a bilateral disorder of the lacrimal apparatus; therefore, Diagnostic Code 6025 is the most closely related diagnostic code based not only on the functions affected, but also the anatomical localization and symptomatology of the Veteran's disability. VA examination reports show the Veteran's bilateral dry eye does not cause compensable loss of visual acuity or impairment of visual fields or muscle function. As the Veteran is entitled to the highest rating available under the most analogous diagnostic code, an initial rating in excess of 20 percent for bilateral dry eyes must be denied. Earlier Effective Date 2. Effective date prior to February 11, 2020 for the grant of service connection for bilateral dry eyes Generally, the effective date of an evaluation and award of pension, compensation or dependency and indemnity compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. As awards of secondary service connection are not awards of increased compensation within the meaning of the statute, the effective date can be no earlier than the date of the claim for service connection on a secondary basis. Ellington v. Nicholson, 22 Vet. App. 141, 145 (2007) (finding that the effective date for a grant of service connection for diabetes and hypertension as secondary to leukemia was the date of the claim for secondary service connection, not the date of the claim of service connection for leukemia), aff'd sub nom. Ellington v. Peake, 541 F.3d 1364 (Fed. Cir. 2008); Ross v. Peake, 21 Vet. App. 528, 532-33 (2008) (holding that the effective date for a grant of secondary service connection for depression with anxiety was the date of the secondary service connection claim, not the date of the claim for service connection for the primary heart condition). The Veteran's claim of service connection for bilateral dry eyes as secondary to bilateral pterygium with corneal scar of the right eye was received on February 11, 2020. In the application, the Veteran reported that the February 2020 examiner told him that his dry eye syndrome was caused by the service-connected disability. In support of his claim, the Veteran submitted a July 2020 private treatment record showing a diagnosis of bilateral dry eyes. The evidence associated with the claims file prior to this submission, to include the February 2020 VA examination, does not show a diagnosis of dry eyes. Therefore, the effective date for the grant of service connection for bilateral dry eyes cannot be earlier than February 11, 2020. The claim is denied. Emily Tamlyn Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Y. Taylor 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.