Citation Nr: 21029353 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 16-24 910A DATE: May 13, 2021 ORDER A compensable rating for maxillary sinusitis is denied. A compensable rating for anal/perianal fistula is denied. FINDINGS OF FACT 1. The Veteran had active duty from December 2003 to May 2014. 2. Sinusitis has been manifested by subjective complaints of headaches, pain, tenderness, and purulent discharge causing incapacitating episodes; objective findings include no evidence of incapacitating episodes of sinusitis. 3. Anal fissure has been manifested by subjective complaints of rectal bleeding and hemorrhoids; objective findings include no evidence of slight constant or occasional moderate leakage. CONCLUSIONS OF LAW 1. The criteria for a compensable rating for maxillary sinusitis have not been met. 38 U.S.C. §§ 1110, 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.130, Diagnostic Code (DC) 6513 (2020). 2. The criteria for a compensable rating for anal/perianal fistula have not been met. 38 U.S.C. §§ 1110, 1155, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.130, DC 7335 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. §§ 4.1. Separate diagnostic codes identify the various disabilities. Sinusitis The Veteran has been rated noncompensable under DC 6513 for sinusitis. Under DC 6513, a 10 percent rating is warranted when the objective medical evidence shows: one or two incapacitating episodes per year of sinusitis requiring prolonged (lasting four to six weeks) antibiotic treatment, or; three to six non-incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting. However, the medical evidence does not show one or two incapacitating episodes per year of sinusitis requiring prolonged antibiotic treatment or three to six non incapacitating episodes per year of sinusitis characterized by headaches, pain, and purulent discharge or crusting. Specifically, in an October 2014 VA examination, the Veteran complained of difficulty breathing at night. Upon examination, the examiner marked that the Veteran experienced headaches, pain, tenderness, and purulent discharge; however, the examiner marked that the Veteran did not experience incapacitating episodes due to these symptoms. Further, the examiner noted that the Veteran did not experience one or two incapacitating episodes of sinusitis requiring prolonged antibiotic treatment. Further, in a March 2018 clinical record, the Veteran reported three episodes of postnasal drip occurring in the last six months; however, he denied pain or purulent discharge. In addition, in a May 2019 clinical record, he reported having congestion every two to four months; however, he did not state that this congestion resulted in incapacitating episodes. In a July 2019 VA examination, the Veteran denied facial pain or pressure. Upon examination, the examiner did not mark that the Veteran experienced incapacitating episodes of sinusitis. As to the lay evidence, in the May 2016 Appeal to the Board, the Veteran reported being on his fourth incapacitating episode that year and experiencing symptoms such as headaches, pain, and purulent discharge. Further, in a June 2017 statement, he explained that he experienced 11 incapacitating episodes that year. In addition, in an August 2020 statement, he reported experiencing seven incapacitating episodes in 2019. The Veteran's wife also stated that he experienced episodes of sinusitis six to eight times a year and had symptoms such as headaches, sinus pain, and mucus discharge. Based on the above, the evidence does not support a compensable rating for sinusitis. Specifically, the medical evidence did not show that the Veteran experienced one or two incapacitating episodes per year of sinusitis requiring prolonged antibiotic treatment. Further, while he reported headaches, pain, and purulent discharge in VA examinations and in clinical records, he denied that these symptoms caused incapacitating episodes. Further, while the Veteran has submitted lay statements indicating that he has experienced incapacitating episodes due to sinusitis, his statements are assigned less probative weight. Specifically, in 2019, he reported having seven incapacitating episodes; however, at the July 2019 VA examination, he did not report any incapacitating episodes due to symptoms of sinusitis. Therefore, more probative weight is assigned to the VA examinations than his statements. In sum, the medical evidence does not support a compensable rating for sinusitis. Anal Fissure The Veteran has been rated noncompensable under DC 7335 for anal fissure. Under DC 7335, a 10 percent rating is warranted when the objective medical evidence shows constant slight or occasional moderate leakage. However, the medical evidence does not show constant slight or occasional moderate leakage. Specifically, in an October 2014 VA examination, the Veteran acknowledged occasional rectal bleeding and hemorrhoids; however, at the time of this examination, he denied experiencing these symptoms. Upon examination, there was no evidence of constant slight or occasional moderate leakage. While he reported pain, no anal fissures were noted. Further, in a July 2019 VA examination, the Veteran complained of pain with defecation and a slight amount of blood on toilet paper; however, upon examination, the colonoscopy was normal and there was no evidence of constant slight or occasional moderate leakage. In the May 2016 Appeal to the Board, the Veteran reported rectal bleeding occurring daily. Further, in an August 2020 statement, he explained that a tear in the anus caused severe pain, bleeding, and constant slight leakage. Based on the above, the evidence does not support a compensable rating for anal fissures. Specifically, the medical evidence did not show evidence of constant slight or occasional moderate leakage. Clinical records do not contradict these findings. While the Veteran has submitted statements indicating that he has experienced constant slight leakage, his statements are assigned less probative weight. Specifically, at the July 2019 VA examination, he did not report experiencing constant slight leakage. Therefore, more probative weight is assigned to the VA examinations than his statements. In sum, the medical evidence does not support a compensable rating for anal fissures. The Board has also considered the Veteran's lay statements that his disabilities are worse. While he is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability of these disorders according to the appropriate diagnostic codes. Such competent evidence concerning the nature and extent of the Veteran's disabilities has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings directly address the criteria under which these disabilities are evaluated. Moreover, as the examiners have the requisite medical expertise to render medical opinions regarding the degree of impairment caused by these disabilities and had sufficient facts and data on which to base the conclusion, the Board affords the medical opinions great probative value. As such, these records are more probative than the Veteran's subjective complaints of increased symptomatology. In sum, after a careful review of the evidence of record, the benefit of the doubt rule is not applicable, and the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Ragofsky, Attorney Advisor 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.