Citation Nr: 21015852 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 16-47 884 DATE: March 18, 2021 ORDER Entitlement to a rating higher than 0 percent for residuals of bilateral chalazion excisions is denied. FINDING OF FACT Residuals of bilateral chalazion excision have not manifested in any symptoms, including disfigurement or visual impairment. CONCLUSION OF LAW The criteria for a compensable rating for residuals of bilateral chalazion excision are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.7, 4.79, Diagnostic Codes 6015-7800. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1980 to August 1982. In August 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A hearing transcript is of record. In December 2019, the Board remanded the case for further development. Increased Rating Disability ratings are determined by the application of VA’s Schedule for Rating Disabilities, which is based on average impairment of earning capacity resulting from a service-connected disability. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Where there is a question as to which of two ratings 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 to be considered when assigning disability ratings. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). A claimant may experience multiple distinct degrees of disability that may result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505 (2007). The following analysis is undertaken with consideration of the possibility that different ratings may be warranted for different time periods. The rating of the same disability under various diagnoses is to be avoided. 38 C.F.R. § 4.14. That does not preclude the assignment of separate ratings for separate and distinct symptomatology where none of the symptomatology justifying a rating under one diagnostic code is duplicative of or overlapping with the symptomatology justifying a rating under another diagnostic code. Esteban v. Brown, 6 Vet. App. 259 (1994). 1. Entitlement to a rating higher than 0 percent for residuals of bilateral chalazion excisions During the pendency of the appeal, VA issued a final rule revising the portion of the VA Schedule for Rating Disabilities that addresses the organs of special sense and the schedule of ratings for eye disabilities. 83 Fed. Reg. 15,316 (Apr. 10, 2018). The final rule went into effect May 13, 2018. Where there is a change in the rating criteria during the appeal period, the Board will consider the claim using both the former and revised schedular rating criteria, although an increased rating based on the revised criteria cannot predate the effective date of the amendments. The amendment altered the scope of disability specifically addressed. Under the former criteria, Diagnostic Code 6015 addressed benign neoplasms of the eyeball and adnexa. Under the revised criteria, Diagnostic Code 6015 addresses benign neoplasms of the eye, orbit and adnexa (excluding skin). There were no other substantive changes. Both the former and revised criteria instruct to separately rate visual and nonvisual impairment, such as disfigurement (Diagnostic Code 7800), and combine ratings. With regard to visual impairment, the May 2018 amendments made no substantive changes to how visual acuity is rated. With regard to visual field and muscle function examinations, the use of a Goldmann chart is no longer required. There are otherwise no substantive changes to how those types of visual impairment are rated. The rating of visual impairment is based on impairment of visual acuity, excluding developmental errors of refraction; visual field; and muscle function. 38 C.F.R. § 4.75(a). To determine the rating for visual impairment when both decreased visual acuity and visual field defect are present in one or both eyes and are service-connected, visual acuity and visual field defects are rated separately, and then combined under the provisions of 38 C.F.R. § 4.25. The rating of visual acuity is based on corrected distance vision with central fixation. 38 C.F.R. § 4.76(b)(1). The measurements for each eye are applied to the table for Impairment of Central Visual Acuity. Subject to the provisions of 38 C.F.R. § 3.383(a), if visual impairment of only one eye is service-connected, the visual acuity of the other eye will be considered to be 20/40 for purposes of rating the service-connected visual impairment. 38 C.F.R. § 4.75(c). Diagnostic Code 6066 provides ratings where vision in one eye (the poorer eye) is 10/200 or better. Where the visual acuity in both eyes is 20/40, a 0 percent rating is warranted. Where the visual acuity in the poorer eye is 20/50, a 10 percent rating is warranted where vision in the other eye is either 20/50 or 20/40. At a June 2018 VA examination, the Veteran did not report any current symptoms. Corrected distance measured 20/40 bilaterally. The external eye examination showed the eyelids were status post chalazion excision. Although the Veteran had a visual field defect and there was a contraction of the visual field in both eyes, the chalazion excision did not result in the visual field defect. The examiner noted a generalized reduction of sensitivity in both eyes. Also, the Veteran had difficulty following instructions during testing. The reliability of the visual field testing results was questionable, and no diagnosis for the visual defect could be provided. There was no scarring or disfigurement. At the August 2019 Board hearing, the Veteran reported decreased visual acuity and eye pain when he could not focus. The Veteran believed the service-connected eyelid disability caused the visual disturbance. At a February 2020 VA examination, the Veteran reported difficulty with near and far distances, even with glasses. Corrected distance measured 20/40 bilaterally. The external eye examination showed a papilloma on the left upper eyelid. The Veteran had a visual field defect, and a contraction of the visual field in both eyes. The chalazion excision did not result in decreased visual acuity or other visual impairment. There was no scarring or disfigurement or incapacitating episodes. In regard to the Veteran’s statements of eye pain decreased visual acuity, the examiner diagnosed bilateral low-tension glaucoma and age-related nuclear cataracts. Both disabilities caused a decrease in visual acuity. The glaucoma caused optic nerve cupping and visual field loss. The cataracts manifest with a clouding of the natural lens in his eye that is typically related to age. That resulted in decreased in vision and glare. Although the Veteran had additional eye diagnoses, the examiner explained that the disabilities were not related to the service-connected residuals of chalazion excision. The evidence did not indicate any residual scarring or visual impairment related to the bilateral incision and drainage of the chalazion during service. Therefore, the eye pain was less likely than not related to the service-connected residuals of the chalazion excision. The current visual impairment was found to be less likely than not related to the service-connected residuals of the chalazion excision. VA treatment records show complaints eye pain and difficulty reading fine print. In 2012, there was an upper eyelid chalazion. The Veteran reported bilateral upper eyelid lesions that resolved spontaneously. The records do not indicate current symptoms from the chalazion excision. (Continued on the next page)   After review of the record, the Board finds that the preponderance of the evidence is against a finding that the bilateral eye disability warrants a compensable rating. The Board notes that the bilateral eye disability is not specifically listed in the rating criteria. However, both VA examiners explicitly found that the status post chalazion excision is not visually impairing or disfiguring, and therefore did not manifest in any visual symptoms. The Veteran has other nonservice-connected bilateral eye conditions that are visually significant. However, the examiner specifically opined that those other eye disorders were unrelated to the service-connected bilateral eye disability. Notably, the Veteran has glaucoma and cataracts that cause decreased visual acuity and glare. The Board acknowledges the Veteran’s statements regarding eye symptoms and resultant difficulties with near vision and eye strain. However, the preponderance of the evidence, including both VA examination reports, supports a finding that the service-connected bilateral eye disability is not visually significant and does not manifest in any symptoms of disfigurement or visual decrease. The Veteran has not provided any additional evidence indicating that the bilateral eye disability warrants a compensable rating. Accordingly, the Board finds that the preponderance of the evidence is against a finding that the service-connected bilateral eye disability warrants a compensable rating. Therefore, the claim for increased rating must be denied. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Kass, 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.