Citation Nr: 21015759 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 15-12 562 DATE: March 18, 2021 ORDER Service connection for a right shoulder disorder is denied. Service connection for sleep apnea is denied. A 10 percent rating for callosities of both feet is granted. A compensable rating for postoperative right inguinal hernia is denied. An initial compensable rating for residual hernia scar is denied. An initial compensable rating for allergies is denied. REMANDED Service connection for a lung disorder is remanded. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that a right shoulder disorder began during active service, or is otherwise related to an in-service injury, event, or disease. 2. The Veteran’s sleep apnea is not secondary to service-connected allergies, and is not otherwise related to an in-service injury, event, or disease. 3. For the period on appeal, the Veteran’s callosities of both feet are manifested by moderate symptoms, but not moderately severe symptoms. 4. For the period on appeal, the Veteran’s right inguinal hernia does not result in protrusion or necessitate the use of a truss or belt for support. 5. For the period on appeal, the Veteran’s residual hernia scar has been manifested by a scar that affects the right inguinal hernia region and covers an area less than 6 square inches; however, it has not been unstable, painful, or associated with underlying soft tissue damage; and the scar associated with the no underlying soft tissue damage is less than 144 square inches. 6. For the period on appeal, the Veteran’s allergies are manifested by runny nose, stuffiness, congestion, itchy eyes and itchy nose; however, symptoms did not more nearly approximate greater than 50 percent obstruction of nasal passage on both side, complete obstruction on one side, or polyps. CONCLUSIONS OF LAW 1. The criteria for service connection for a right shoulder disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for sleep apnea are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 3. The criteria for a disability rating of 10 percent for callosities of both feet are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, Diagnostic Code (DC) 7819-5284. 4. The criteria for a compensable rating for right inguinal hernia are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.114, DC 7338. 5. The criteria for an initial compensable rating for residual hernia scar are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.118, DC 7338-7805. 6. The criteria for an initial compensable rating for allergies are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.97, DC 6522. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from October 1974 to October 1977. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO). In September 2020, the Board remanded the matters to the Agency of Original Jurisdiction (AOJ) for additional development and have since returned for further appellate review. Service Connection Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). A disability that is proximately due to, the result of, or aggravated by a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310. Right Shoulder The Veteran contends that his right shoulder condition is due to his daily duties as a ship serviceman such as pulling lines, tying up the ship, painting, and various other manual labor duties using physical strength. See April 2018 Statement in Support of Claim. He also alleges that his right shoulder condition is due to an injury sustained while on active duty. See September 2013 Notice of Disagreement. The Veteran has a current right shoulder disability. For example, at his October 2012 and April 2017 VA examinations he was diagnosed with right shoulder condition and other specific joint derangement of the right shoulder, respectively. See also August 2020 VA Examination Report. Thus, the remaining question is whether the current right shoulder disability is related to service. Service treatment records show no complaints, diagnosis, or treatment related to a right shoulder disability. As the Veteran reported other ailments during service, and right shoulder problems are the type that a reasonable person would report, if the Veteran was experiencing problems with his right shoulder during service the Board would expect that he would have reported these problems to medical professionals. During the October 1977 separation examination, evaluation of the upper extremity was normal. In a corresponding report of medical history, the Veteran specifically denied having had painful or trick shoulder. If right shoulder injury or pain was present during service, the Board would expect the Veteran would have responded “yes” when asked about painful shoulder at separation because a reasonable person would have interpreted the question to include symptoms of shoulder pain. Moreover, the Veteran responded affirmatively when asked whether he had other conditions at separation and the Board would thus expect the Veteran to have also responded affirmatively to having right shoulder injury or pain. In a January 2013 VA medical opinion, the examiner opined that the Veteran’s right shoulder condition is less likely as not related to military. In support of this conclusion, the examiner explained that upon review of the Veteran’s service treatment records, there is no report of a shoulder condition. The Board finds this opinion highly probative as it was made by a medical professional with consideration of the specific facts in this case. The opinion is also supported by other evidence of record. For example, the Veteran specifically denied having any shoulder pain at his separation. There is no medical opinion or competent and credible evidence in significant conflict with the VA medical opinion. The Board has considered the Veteran’s statements, to include his assertions that his symptoms began during service. As the Veteran is not shown to have medical education or experience, he is a lay person and is competent to report (1) symptoms that are observable to a layperson, e.g., shoulder pain; (2) symptoms at the time supporting a later diagnosis by a medical professional; or (3) a contemporaneous medical diagnosis. See Davidson v. Shinseki, 581 F.3d 1313 (2009). The Veteran is not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, his lay assertions do not constitute evidence upon which service connection can be granted. Further, while the Veteran contends that he sustained a shoulder injury during service, his service treatment records is absent of a shoulder injury. Indeed, the Veteran specifically denied experiencing any shoulder pain during his separation. In any event, the Board ultimately assigns greater probative weight to the medical evidence of record, to include the opinion rendered by a trained medical professional based on a review of the record and reasonably drawn conclusion with supportive rationale. For the above reasons, the preponderance of the evidence is against the claim and service connection is denied. Sleep Apnea The Veteran contends that his sleep apnea is secondary to his service-connected allergies. See December 2020 Correspondence. The Veteran has a current sleep apnea disability. For example, at his July 2020 VA examination he was diagnosed with obstructive sleep apnea. Thus, the remaining question is whether the current sleep apnea disability is related to service or service-connected allergies. Service treatment records show no complaints, diagnosis, or treatment related to a sleep apnea disability. As the Veteran reported other ailments during service, and sleeping problems are the type that a reasonable person would report, if the Veteran was experiencing problems with sleep during service the Board would expect that he would have reported these problems to medical professionals. During the October 1977 separation examination, there was no report of sleep problems. In a corresponding report of medical history, the Veteran specifically denied having had frequent trouble sleeping. If trouble sleeping was present during service, the Board would expect the Veteran would have responded “yes” when asked if he had frequent trouble sleeping at separation because a reasonable person would have interpreted the question to include symptoms of sleeping problems. Moreover, the Veteran responded affirmatively when asked whether he had other conditions at separation and the Board would thus expect the Veteran to have also responded affirmatively to having frequent trouble sleeping. The Veteran presented for a VA examination in September 2014, at which time he was interviewed by the examiner who also reviewed the pertinent medical history and performed an examination. The examiner noted that the Veteran has 6 known risk factors for sleep apnea including being a male, 60 years old, 30 year former smoker with chronic obstructive pulmonary disease (COPD), allergies, hypertension, and diabetes mellitus. The examiner noted that according to research from Mayo Clinic, certain factors risk a person to have sleep apnea such as being overweight, having narrower neck circumference, and depending on factors such as gender, age, family history, race, alcohol use, smoking history, and nasal congestion such as having allergies. The examiner indicated that similar findings were also found in research from the National Institute of Health. In the Veteran’s case, the examiner noted that while the Veteran’s seasonal allergy is a risk factor, he also has 5 other risk factors for sleep apnea that are not service connected. The examiner further noted that while there is no precise way of determining what caused the Veteran’s sleep apnea without speculation, it is not likely that the Veteran’s seasonal allergies are greater than 50 percent responsible. Thus, the examiner opined that the Veteran’s sleep apnea is not at least as likely as not due to, caused by, or incurred in military service. The Board finds this opinion highly probative as it was made by a medical professional with consideration of the specific facts in this case and after examination of the Veteran. The opinion is also supported by other evidence of record. In a March 2015, the Veteran submitted a private medical opinion by Dr. R.M. In the opinion, Dr. R.M. noted that the Veteran was diagnosed with sleep apnea, a condition where intermittently the upper airway collapsed while sleeping causing oxygen levels to drop. Dr. R.M. indicated that the Veteran also had generalized stress response with an increase in blood pressure, blood sugar, and heart rate. Over time, Dr. R.M. noted that the latter symptoms can lead to diabetes, heart disease, high blood pressure, and stroke. Dr. R.M. explained that allergic rhinitis is connected with sleep apnea based on the fact that it can worsen the severity of sleep apnea. Dr. R.M. noted that a review of the November 2013 sleep study revealed that the Veteran had severe sleep apnea and certainly the presence of allergic rhinitis contributes to this severity. In February 2017, a VA medical opinion was provided by an examiner who also reviewed the pertinent medical history. The examiner opined that the claimed condition, which clearly and unmistakably existed prior to service, was not aggravated beyond its natural progression by an in-service event, injury, or illness. In support of this conclusion, the examiner explained that the Veteran was diagnosed with obstructive sleep apnea in November 2013. The examiner disagreed with the March 2015 private medical opinion by Dr. R.M. noting that the rationale was inadequate as it was based on speculation and not objective medical record evidence. The examiner further opined that the Veteran’s sleep apnea is less likely than not permanently aggravated beyond its natural progression by his service-connected allergic rhinitis. In support, the examiner explained that there was no evidence to support secondary service connection. The examiner noted that the Veteran’s allergic rhinitis is well controlled on current medical therapy and therefore there is not mechanism of action for permanent aggravation. The Board finds this opinion highly probative as it was made by a medical professional with consideration of the specific facts in this case and after examination of the Veteran. The opinion is also supported by other evidence of record. The Veteran presented for a VA examination in October 2020, at which time he was interviewed by the examiner who also reviewed the pertinent medical history and performed an examination. The examiner opined that the condition claimed is less likely than not proximately due to or the result of the Veteran’s service-connected disabilities. The examiner also opined that the Veteran’s sleep apnea is less likely than not aggravated beyond its natural progression by his current service-connected disabilities. In support of this conclusion, the examiner explained that there is no nexus found in the current medical literature reviewed that showed that the Veteran’s service-connected chronic prostatitis, residual hernia scar, callosities of both feet, right inguinal hernia, hepatitis, and allergies caused the anatomical condition responsible for sleep apnea. The examiner noted that the Veteran’s sleep apnea which is due to an anatomical abnormality in which there is an increase in tissue around the airway, mostly due to overweight, collapse during sleep causing snoring and apnea. The examiner indicated that obesity is a major risk factor for the development of sleep apnea and there is evidence that the Veteran’s sleep apnea was an overweight condition. The examiner noted that after discharge from service, there was no significant change in weight until 2010, and then 2013 where the Veteran gained about 12 pounds. Thus, the examiner opined that it is not at least as likely as not that his sleep apnea was caused and aggravated by his overweight condition. The Board finds this opinion highly probative as it was made by a medical professional with consideration of the specific facts in this case and after examination of the Veteran. The opinion is also supported by other evidence of record. Upon review of the evidence, the Board finds that the probative evidence of record does not support secondary service connection for sleep apnea. The Board acknowledges the March 2015 private medical opinion by Dr. R.M. but gives it less probative weight. While Dr. R.M. points to the severity of the Veteran’s sleep apnea as a certainly due to his service-connected allergies, the February 2017 VA examiner opined that the Veteran’s allergies were well controlled by medication and thus, negating any aggravation. The latter examiner opined that Dr. R.M.’s opinion was based on speculation, and not based on objective medical evidence. Additionally, the September 2014 VA examiner explained that the Veteran’s allergies is just one of several factors that could contribute to his sleep apnea. Of note, the October 2020 VA examiner examined the Veteran and reviewed the record and concluded that the anatomical reasoning for the Veteran’s sleep apnea is primarily the result of weight and not his allergies. The Board has considered the Veteran’s statements, to include his assertions that his sleep apnea is due to his active duty to service or his service-connected allergies. As the Veteran is not shown to have medical education or experience, he is a lay person and is competent to report (1) symptoms that are observable to a layperson, e.g., difficulty sleeping; (2) symptoms at the time supporting a later diagnosis by a medical professional; or (3) a contemporaneous medical diagnosis. See Davidson v. Shinseki, 581 F.3d 1313 (2009). The Veteran is not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, his lay assertions do not constitute evidence upon which service connection can be granted. Notably, the evidence is absent any indication of trouble sleeping during service, and the probative medical evidence does not support secondary service connection based on causation or aggravation. In any event, the Board ultimately assigns greater probative weight to the medical evidence of record, to include the opinion rendered by a trained medical professional based on appropriate diagnostic testing and reasonably drawn conclusions with supportive rationale. For the above reasons, the preponderance of the evidence is against the claim and service connection is denied. Increased Rating Disability ratings are determined by evaluating the extent to which a Veteran’s service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Different ratings may be assigned for different periods of time for the same disorder if the facts show distinct time periods with different levels of disability. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. See 38 C.F.R. § 4.3. When evaluating musculoskeletal disabilities based on limitation of motion, 38 C.F.R. § 4.40 requires consideration of functional loss caused by pain or other factors listed in that section that could occur during flare-ups or after repeated use and, therefore, not be reflected on range-of-motion testing. 38 C.F.R. § 4.45 requires consideration also be given to less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, and pain on movement. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Nonetheless, even when the background factors listed in § 4.40 or 4.45 are relevant when evaluating a disability, the rating is assigned based on the extent to which motion is limited, pursuant to 38 C.F.R. § 4.71a (musculoskeletal system) or § 4.73 (muscle injury); a separate or higher rating under § 4.40 or 4.45 itself is not appropriate. See Thompson v. McDonald, 815 F.3d 781, 785 (Fed. Cir. 2016) (“[I]t is clear that the guidance of § 4.40 is intended to be used in understanding the nature of the veteran’s disability, after which a rating is determined based on the § 4.71a [or 4.73] criteria.”). Callosities of Both Feet The Veteran’s service-connected callosities of both feet is rated noncompensable under Diagnostic Code 7819-5284. 38 C.F.R. § 4.71a. Hyphenated diagnostic codes are used when rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned. 38 C.F.R. § 4.27. The additional code is shown after the hyphen. Id. Diagnostic Code 7819 is for benign skin neoplasms. Disorders under this diagnostic code may be rated under disfigurement to the head, face or neck (not applicable here) or based on scars or as impairment of function. His October 2020 skin VA examination did not show evidence of scarring. In this case, the Veteran has no scarring due to his calluses, so his condition is best rated as impairment of function of the foot. Under Diagnostic Code 5284, for other foot injuries, a 10 percent rating is warranted for moderate other foot injuries. A 20 percent rating is warranted for moderately severe other foot injuries. A 30 percent rating is warranted for severe other foot injuries. A Note to Diagnostic Code 5284 instructs that with actual loss of use of the foot rate as a maximum 40 percent. 38 C.F.R. § 4.71a, Diagnostic Code 5284. The Board notes that “Mild,” as relevant to a physical condition, is defined as “not severe” or temperate; with “Temperate” being defined as “keeping or held within limits” and “not extreme or excessive.” Merriam-Webster’s Dictionary (merriam-webster.com/dictionary, accessed February 10, 2021). “Moderate” is defined as “tending toward the mean or average amount,” “not violent, severe, or intense,” and “limited in scope or effect.” Id. “Severe” is defined as “very painful or harmful” or “of a great degree.” Id. Turning to the evidence, the Veteran was afforded a VA examination in October 2012. The examiner noted that the Veteran had hammer toes in the third and fourth toe of the left feet. The Veteran also had hallux valgus with mild or moderate symptoms of both feet. There was no surgery or scars noted. The examiner reported no showing of Morton’s neuroma, hallux rigidus, pes cavus, malunion or nonunion, other foot injuries, or bilateral weak foot. The Veteran was afforded another VA examination in October 2020. The Veteran report continuing to have pain in both feet callosities rated as 8 out of 10, mostly in the right foot. He uses shoe inserts constantly and takes medication for relief. He reported no flare-ups and described functional loss as pain in both of his feet callosities with impairment in prolonged walking and climbing stairs. The examiner noted that the Veteran has pain on use of the feet and pain accentuated on use. There was no pain on manipulation of the feet, indication of swelling, or characteristic callouses. While using arch supports, the examiner noted that the symptoms of both feet are not relieved. The examiner indicated that the Veteran does not have other foot injuries and does not have functional loss for the left and right lower extremity attributable to the callosities of both feet. The Veteran constantly uses shoe inserts for pain from his feet callosities. The examiner also noted that the Veteran’s feet callosities is non tender at palpation. At the end of the examination, the examiner remarked that the Veteran does not have a diagnosis of pes planus, and that the pain noted above was merely a description of the pain experienced by the Veteran. Upon consideration of the record, the Board finds that the probative evidence supports the award of a compensable rating for callosities of both feet. Under Diagnostic Code 5284, 10 percent rating is warranted for moderate other foot injuries. Here, the evidence show that the Veteran has reported experienced pain in his feet that appears to be moderate in severity. For instance, during the October 2012 VA examination, the Veteran reported having mild to moderate symptoms of his hallux valgus. A separate rating for hallux valgus under Diagnostic Code 5280 is not warranted as there is no showing of severe injury necessary for a compensable rating. Rather, such symptoms are supportive of the Veteran’s report of moderate symptoms. Additionally, during the October 2020 VA examination, the Veteran reported functional loss described as difficulty with prolonged walking and climbing stairs with symptoms not relieved even while using arch supports. With regard to a 30 percent under Diagnostic Code 5284, the evidence does not show symptoms that are moderately severe to warrant a higher rating. Additionally, the Board acknowledges the reports of pes planus and hammer toe but finds that separate ratings are not applicable. A separate rating under Diagnostic Code 5284 for flatfeet is not warranted as the October 2020 examiner specifically found that the Veteran does not have a diagnosis for pes planus. Regarding hammer toe noted in the October 2012 VA examination, a separate compensable rating for hammer toe is not warranted as the evidence of record is against a finding that the service-connected callosities of both feet and hammer toe have distinct manifestations from those that are already being compensated. See 38 C.F.R. § 4.14. Accordingly, for the duration of the appeal period, the Board finds that the evidence supports a compensable rating for service-connected callosities of both feet. 38 C.F.R. §§ 4.3, 4.71a, Diagnostic Code 7819-5284. Right Inguinal Hernia The Veteran’s service-connected right inguinal hernia is rated noncompensable under Diagnostic Code 7338 for inguinal hernia. 38 C.F.R. § 4.114. Under Diagnostic Code 7338, a noncompensable rating is provided for a small, reducible, or without true hernia protrusion, or a hernia that has not been operated but remediable. A 10 percent rating is provided for post-operative recurrent inguinal hernia that is readily reducible and is well-supported by a truss or belt. A 30 percent rating is provided for a post-operative recurrent or unoperated irremediable small inguinal hernia that is not well-supported by a truss or is not readily reducible. A 60 percent rating is provided for a large inguinal hernia that is postoperative, recurrent, is not well-supported under ordinary conditions, and is not readily reducible, when considered inoperable. A Note to Diagnostic Code 7338 provides that 10 percent is to be added for bilateral involvement, provided the second hernia is compensable. This means that the more severely disabling hernia is to be rated, and 10 percent, only, is added for the second hernia, if the second hernia is of compensable degree. The Veteran was afforded a VA examination in October 2012 for hernia. There was no indication of reoccurrence. The examiner noted that the Veteran had a right inguinal hernia surgery performed in 1974. Upon examination, no hernia was detected on the right side and no indication for a supporting belt. The examiner noted no residuals or complaints for right inguinal hernia. The Veteran was afforded another VA examination in October 2020 for hernia. The Veteran reported continuing to have sharp pain in the right inguinal area rated 8 out of 10 and took medication for relief. He reported his right inguinal hernia pain sometimes impairs his ability to do prolonged walking and lifting. Upon physical examination, it was noted that the Veteran had a right inguinal hernia surgery during service and currently, there was no hernia detected or indication for a supporting belt. Based on the foregoing, the Board finds that the evidence does not support a compensable rating for right inguinal hernia as there no indication of post-operative recurrent inguinal hernia that is readily reducible and is well-supported by a trust or belt. 38 C.F.R. § 4.114. Rather, the evidence supports the continuation of the noncompensable rating. Accordingly, as the criteria for a higher rating for service-connected right inguinal hernia is not met, the claim of increased rating must be denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Residual Hernia Scar By way of history, in May 2012, the Veteran filed a claim seeking a higher rating for his service-connected right inguinal hernia. A December 2012 rating decision awarded a separate noncompensable rating for residual hernia scar effective May 2012, the date of claim. The Veteran appealed the decision seeking a higher rating, and the issue is now before the Board. During the appeal period, the Veteran’s residual hernia scar has been rated noncompensable under Diagnostic Code 7338-7805. 38 C.F.R. § 4.118. Hyphenated diagnostic codes are used when rating under one diagnostic code requires use of an additional diagnostic code to identify the basis for the evaluation assigned. 38 C.F.R. § 4.27. The additional code is shown after the hyphen. Id. The diagnostic code relating to right inguinal hernia is noted above. Diagnostic Codes 7800 to 7805 pertain to scars. 38 C.F.R. § 4.118. The Board notes that the schedule of ratings for the skin were amended effective August 13, 2018 (see 83 Fed. Reg. 32,592 (July 13, 2018)). Since the Veteran’s claim was received prior the effective date of the amendments, the Board will consider whether either the old or new rating criteria is more favorable to the Veteran. Diagnostic Codes 7800 to 7805 pertain to scars. 38 C.F.R. § 4.118. The Schedule of ratings for the skin were amended effective August 13, 2018. See 83 Fed. Reg. 32,592 (July 13, 2018). Prior to August 13, 2018, the Board will consider the old version of the diagnostic codes only (old code); however, for the period beginning August 13, 2018 the Board will consider both the old and amended version (amended code) of the diagnostic codes and rate based on whichever is most favorable to the Veteran. Diagnostic Code 7800 deals with scars and disfigurement of the head, face, or neck and was not revised by the recent regulatory amendments. A 10 percent rating is assigned with one characteristic of disfigurement. A 30 percent rating is assigned with visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with two or three characteristics of disfigurement. A 50 percent rating is assigned with visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features, or; with four or five characteristics of disfigurement. An 80 percent rating is assigned with visible or palpable tissue loss and either gross distortion or asymmetry of three or more features or paired sets of features, or; with six or more characteristics of disfigurement. Characteristics of disfigurement include: Scar 5 or more inches (13 or more cm.) in length; Scar at least one-quarter inch (0.6 cm.) wide at widest part; Surface contour of scar elevated or depressed on palpation; Scar adherent to underlying tissue; Skin hypo-or hyper-pigmented in an area exceeding six square inches (39 sq. cm.); Skin texture abnormal (irregular, atrophic, shiny, scaly, etc.) in an area exceeding six square inches (39 sq. cm.); Underlying soft tissue missing in an area exceeding six square inches (39 sq. cm.); and, Skin indurated and inflexible in an area exceeding six square inches (39 sq. cm.). Diagnostic Code 7801 provides for a 10 percent disability evaluation for a scar that is not of the head, face, or neck, that is deep and nonlinear (old code) or associated with underlying soft tissue damage (amended code), and that has an area of at least 6 square inches (39 sq. cm.). Higher ratings are available if larger areas are affected. Under the old code, a “deep scar” is defined as one associated with underlying soft tissue damage. The old and amended codes also differ regarding instructions for totalling the area affected when there is more than one qualifying scar. Diagnostic Code 7802 provides for a 10 percent disability evaluation for a scar not of the head, face, or neck, that is superficial and nonlinear (old code) or not associated with underlying soft tissue damage (amended code) and which covers an area of at least 144 square inches (929 sq. cm.) or more. No higher ratings are available under either version of this code. Under the old code, a “superficial scar” is defined as one not associated with underlying soft tissue damage. The old and amended codes also differ regarding instructions for totalling the area affected when there is more than one qualifying scar. Diagnostic Code 7804 provides for a 10 percent disability evaluation for one or two scars that are unstable or painful. A 20 percent disability evaluation is assigned where there are three or four scars that are unstable or painful. A 30 percent disability evaluation is assigned where there are five or more scars that are unstable or painful. An unstable scar is one where there is frequent loss of skin covering over the scar. If one or more scars are both unstable and painful 10 percent is added to the evaluation. Under the new and amended codes, pursuant to Diagnostic Code 7805, a scar may be rated on any disabling effect(s) not considered as part of Diagnostic Codes 7800 to 7804. Considering the evidence, the Veteran was afforded a VA examination in October 2012 for hernia. Regarding the hernia scar, the examiner indicated that the Veteran had a 6 centimeters scar in the right groin area and 1/4 centimeters wide. The scar was well-healed, nontender, and had good texture and adherence. There were no keloids, elevations, depression, scaliness, hernias, redness, inflammation, infection, underlying soft tissue, or limitation of the scar. The Veteran was afforded another VA examination in October 2020 for his scar. The examiner noted that the Veteran had scars on the trunk or extremities, but not on the head, face, or neck. The Veteran reported that the scar on the right inguinal area was not painful. With the trunk or extremities, there were no painful scars, unstable scars with frequent loss of covering of skin, or scars due to burns. The examiner indicated that the scar was 5 centimeters long and 0.3 centimeters width. The examiner also indicated that the scars without underlying tissue damage was approximately 1.5 square centimeters, and there were no scars with underlying tissue damage found. Based on the foregoing, the Board finds that the Veteran is not entitled to a compensable evaluation for residual hernia scar. The evidence shows that the Veteran had a scar in the right inguinal region, and there were no scars on the head, face, or neck. Further, there was no evidence showing scars with underlying soft tissue damage. The evidence shows scar not associated with underlying soft tissue damage; however, the size was limited to 1.5 square centimeters and not sufficient to warrant a compensable rating under Diagnostic Code 7802. Examination findings also does not show that the scar was painful or unstable necessary for a compensable rating under Diagnostic Code 7804. Accordingly, upon consideration of the evidence above, the Board finds that a compensable rating for service-connected residual hernia scar under Diagnostic Code 7338-7805 is not warranted, and the claim for an initial increased rating is denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. Allergies By way of history, in April 2012, the Veteran filed a service connection claim for allergies. An August 2013 rating decision awarded service connection for allergies effective April 2012, the date of claim. The Veteran appealed the decision seeking a higher rating, and the issue is now before the Board. During the appeal period, the Veteran’s allergies has been rated noncompensable under Diagnostic Code 6522, for allergic or vasomotor rhinitis. 38 C.F.R. § 4.97. A compensable rating of 10 percent is warranted for allergic rhinitis without polyps, but with greater than 50 percent obstruction of nasal passage on both side or complete obstruction on one side. A 30 percent rating is warranted for allergic rhinitis with polyps. Turning to the evidence, the Veteran was afforded a VA examination in October 2012. The Veteran complained of rhinitis and constant stuffiness in both sides of the nose. He uses nasal spray for relief. On examination, the examiner noted that there was no greater than 50 percent obstruction of the nasal passage of both sides, complete obstruction on one side, permanent hypertrophy of the nasal turbinates, nasal polyps, or other granulomatous conditions. The Veteran was afforded another VA examination in October 2020. He reported continuing to have daily allergy symptoms with runny nose, congestion, and itchy eyes and nose. He continued to take medication for relief. On examination, the examiner noted that there was no greater than 50 percent obstruction of the nasal passage of both sides, complete obstruction on the left or right side, permanent hypertrophy of the nasal turbinates, nasal polyps, or other granulomatous conditions. Upon review of the record, the Board finds that the probative evidence does not support an initial compensable rating for service-connected allergies. As noted on examination, the Veteran did not have greater than 50 percent obstruction of the nasal passage of both sides, complete obstruction of the left or right side, or nasal polyps. Accordingly, for the duration of the appeal period, the Board finds that an initial compensable rating for service-connected allergies is not warranted and claim of initial increased rating is denied. 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7.   REASONS FOR REMAND Lung disorder While the Board regrets additional delay, a remand is necessary prior to final adjudication for the claim of service connection for a lung disorder. While the October 2020 VA medical opinion addressed asbestosis, the examiner did not address whether the Veteran’s lung disorder was due to fumes from paint or munitions, issues noted in the September 2020 Board remand. Furthermore, the examiner did not address relevant in-service reports by the Veteran. In this regard, the Veteran was assessed with upper respiratory infection in January 1975 and February 1975. He also received a diagnosis of upper respiratory infection in May 1977. In the October 1977 report of medical history held at separation, the Veteran specifically reported having pain or pressure in his chest. Based on the foregoing, the Board finds that an additional VA medical opinion is necessary. The matter is REMANDED for the following action: 1. Ask the Veteran to identify all outstanding treatment records relevant to his lung disorder claim. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. 2. After records development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the current lung disorder onset during service or is otherwise related to an in-service injury, event, or disease, to include as due to fumes from paint or munitions. In offering the opinion, the examiner should consider the January 1975 and February 1975 report of upper respiratory infection. The examiner should also consider the May 1977 diagnosis of upper respiratory infection, and the October 1977 report of medical history held at separation, where the Veteran specifically reported having pain or pressure in his chest. The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is required. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Mathew 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.