Citation Nr: 21020987 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 18-41 155 DATE: April 8, 2021 ORDER Entitlement to an initial compensable disability rating for a deviated nasal septum is denied. REMANDED Entitlement to an initial disability rating in excess of 30 percent for posttraumatic stress disorder (PTSD) is remanded. FINDING OF FACT The evidence does not demonstrate that the Veteran’s deviated nasal septum causes 50-percent obstruction of the nasal passage on both sides or complete obstruction on one side. CONCLUSION OF LAW The criteria for entitlement to an initial compensable disability rating for a deviated nasal septum have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.97, Diagnostic Code 6502. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 2003 to January 2015, to include service in Afghanistan and Southwest Asia. He was awarded two Combat Action Ribbons and a Navy and Marine Corps Commendation Medal with combat “V,” among other decorations. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a May 2015 decision by a Department of Veterans Affairs (VA) regional office. In November 2020, the Veteran testified before the undersigned Veterans Law Judge. 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. The evidentiary record does not reasonably raise the prospect that the Veteran’s disability is not and cannot be adequately rated under the Rating Schedule. In that regard, the Veteran is currently assigned a noncompensable disability rating pursuant to 38 C.F.R. § 4.97, Diagnostic Code 6502, for deviation of the nasal septum. See Copeland v. McDonald, 27 Vet. App. 333, 338 (2015) (when a condition is specifically listed in the Rating Schedule, it may not be rated by analogy). This claim stems from the Veteran’s service connection claim, which he initiated in September 2014 while he was still on active duty; service connection has been awarded effective January 2, 2015, the day after he was discharged from active duty. Pursuant to 38 C.F.R. § 4.97, Diagnostic Code 6502, a maximum 10 percent rating is warranted for traumatic deviation of the nasal septum with 50-percent obstruction of the nasal passage on both sides or complete obstruction on one side. Although the schedular criteria do not specifically provide for a noncompensable rating, the Board notes that a 0 percent rating is assigned when the requirements for a compensable evaluation are not met pursuant to 38 C.F.R. § 4.31. The Veteran underwent VA examination in March 2015. The examination evaluated the Veteran’s deviated septum as well as his service-connected allergic rhinitis. The examiner opined that there is greater than 50 percent obstruction of the nasal passage on both sides due to rhinitis, but that there was not at least 50 percent obstruction of the nasal passage on both sides due to traumatic septal deviation. The examiner also found that neither side was completely obstructed due to traumatic septal deviation. There were no scars, nor was there evidence of loss of part of the nose exposing the nasal passage, causing loss of part of an ala, or causing obvious disfigurement. The examiner noted that there were no other significant diagnostic findings, nor were there any other pertinent physical findings, complications, conditions, signs or symptoms related to the deviated nasal septum. Treatment records do not reflect findings in conflict with those noted upon examination. During his November 2020 hearing, the Veteran reported that his deviated septum causes a primary snoring issue, and that he had undergone a sleep study but had not been diagnosed with sleep apnea. He further reported that his deviated septum caused his nose to appear crooked, and that his appearance aggravated his mental health symptoms. Upon review, the Board finds that the criteria for a compensable rating for deviated nasal septum have not been met. In that regard, the evidence does not demonstrate that the Veteran has 50-percent obstruction of the nasal passages on both sides or complete obstruction on one side due to his deviated septum. The Board notes the Veteran’s confusion, expressed during the November 2020 hearing, regarding the fact that he was assigned a 10 percent rating for allergic rhinitis based upon a finding that he has a greater than 50-percent obstruction of the nasal passage on both sides. However, the March 2015 VA examiner specifically opined that the 50-percent obstruction was due to rhinitis, while finding that the Veteran did not have a 50-obstruction due to deviated septum. Accordingly, the Board does not find that the assignment of a 10 percent rating for allergic rhinitis is in conflict with the assignment of a noncompensable rating for deviated septum. In any event, the assignment of multiple disability ratings for the same symptoms is prohibited by the Rating Schedule; as such, the Veteran cannot be compensated twice for obstruction of the nasal passages. 38 C.F.R. § 4.14. The Board notes the Veteran’s contentions, raised during his hearing, that he should be assigned an increased or separate rating to compensate for the change in his physical appearance caused by the deviated septum. While the Board is sympathetic to the Veteran’s concerns, disability ratings may only be assigned for disabling manifestations of a condition, and are designed to compensate for a reduction in the ability to “function under the ordinary conditions of daily life including employment.” 38 C.F.R. § 4.10. Evaluations are “based upon lack of usefulness.” Id. The evidence does not suggest, and the Veteran has not alleged, that the appearance of his nose results in functional impairment. Furthermore, the March 2015 VA examiner specifically noted no scars or loss of the nose causing disfigurement, as well as no other pertinent findings. Accordingly, the Board finds an increased rating cannot be awarded based on the appearance of his nose. To the extent that the Veteran contends the appearance of his nose causes him distress and that his deviated septum causes him to snore, the Board notes that the Veteran is in receipt of service connection for a psychiatric disability. The rating assigned for this disability accounts for mental health symptoms and sleep impairment. To the extent that the Veteran asserts that his deviated septum causes a primary snoring disability with disabling effects, the Board advises him to consider filing a claim for secondary service connection. 38 C.F.R. § 3.310. In that regard, the evidence of record does not show that the Veteran’s deviated septum manifests in snoring that is in any way compensable under the rating schedule. Finally, the Board notes that the Veteran also complained of an orbital fracture and allergies during his hearing; these conditions are service connected and have been assigned separate ratings. As the evidence does not demonstrate that the criteria for a compensable or separate disability rating have been met, the claim for entitlement to a compensable initial rating for a deviated nasal septum must be denied. REASONS FOR REMAND While further delay is regrettable, the Board finds remand is necessary before a decision may be rendered with respect to the Veteran’s claim for entitlement to an initial disability rating in excess of 30 percent for PTSD. In that regard, during his November 2020 hearing, the Veteran testified that his symptoms had worsened since he was last evaluated in March 2015. Accordingly, remand is warranted so that a new VA examination may be obtained to assess the severity of his PTSD. Updated VA treatment records, as well as any identified relevant private treatment records, should be obtained and associated with the file. The matters are REMANDED for the following actions: 1. Ask the Veteran to identify all outstanding treatment records relevant to his PTSD 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. (Continued on the next page.) 2. After records development is completed, schedule the Veteran for a VA PTSD examination to determine the current symptoms, level of severity, and functional impairment associated with his PTSD. The claims file should be reviewed by the examiner. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. D. Bruce, 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.