Citation Nr: 9837870 Decision Date: 12/30/98 Archive Date: 01/05/99 DOCKET NO. 96-39 330 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUES 1. Entitlement to an increased rating for calluses and corns of the feet, currently rated as 10 percent disabling. 2. Entitlement to service connection for a back disorder secondary to service-connected calluses and corns of the feet. 3. Entitlement to service connection for headaches as a residual of head injury in service. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD W. Sampson, Associate Counsel INTRODUCTION The veteran's active military service extended from January 1976 to July 1978. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 1995 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. That rating decision, in part, confirmed and continued a 10 percent rating for calluses and corns of the feet which had been in effect since July 1993. That decision also denied service connection for headaches due to a head injury and a back condition. During the course of the appeal, the veteran modified the claim for a back condition to one of service connection for a back disorder secondary to service connected corns and calluses of the feet. Service connection was denied on a secondary basis in a November 1997 rating decision, and a supplemental statement of the case was issued, also in November 1997. In October 1998, the veteran's representative identified the issue regarding the back as “[e]ntitlement to service connection for degenerative disk disease lumbar spine, as secondary to the service-connected disability of calluses and corns, feet.” The Board will consider the issue more simply as “entitlement to service connection for a back disorder secondary to service-connected calluses and corns of the feet.” CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he should be granted an increased evaluation for his service-connected calluses and corns of the feet. He argues that his bilateral foot disability is more severe than currently evaluated. He further argues that as his calluses and corns have worsened, he has had to walk differently. This, he avers, has caused a back condition which should be service connected secondary to his bilateral foot condition. Finally, he contends that he should be granted service connection for the residuals of head injuries in service. Specifically, he claims that he has headaches which he avers must have been caused by his head injuries in service. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991 & Supp. 1998), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against an increased rating for calluses and corns of the feet, and that the appellant has not met the initial burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claims for service connection for a back disorder, secondary to service- connected calluses and corns of the feet, and headaches as a residual of head injuries during service are well grounded. FINDINGS OF FACT 1. The RO has obtained all relevant evidence necessary for an equitable disposition of the veteran's appeal for an increased rating. 2. The veteran's service-connected foot disability, bilateral calluses and corns of the feet, is manifested by calluses on both feet, neatly trimmed, only minimal pain on deep palpation, complaints of difficulty walking, use of molds for his shoes and no more than definite tenderness. 3. There is no medical opinion or other competent evidence linking a back disorder to a service connected disability. 4. The veteran has not presented a plausible claim for service connection for a back disorder, secondary to service- connected calluses and corns of the feet. 5. The veteran has presented no medical evidence of a link or nexus between his headaches and a head injury in service. The earliest medical evidence of headaches is in July 1994, more than 15 years following his active service. 6. The veteran has not presented a plausible claim for service connection for headaches as a residual of a head injury in service. CONCLUSIONS OF LAW 1. The criteria for a rating in excess of 10 percent for corns and calluses of the feet have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. Part 4, including § 4.7 and Diagnostic Codes 5278 (1998). 2. The appellant has not presented a well-grounded claim for service connection for a back disorder as secondary to service-connected calluses and corns of the feet, and therefore there is no statutory duty to assist the appellant in developing facts pertinent to this claim. 38 U.S.C.A. §§ 101(16), 1131, 5107(a) (West 1991); 38 C.F.R. §§ 3.303(b), 3.310(a) (1998). 3. The appellant has not presented a well-grounded claim for service connection for headaches as a residual of head injury in service, and therefore there is no statutory duty to assist the appellant in developing facts pertinent to this claim. 38 U.S.C.A. §§ 101(16), 1131, 5107(a) (West 1991); 38 C.F.R. § 3.303(b) (1998). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. An Increased Rating for Calluses and Corns of the Feet Preliminary Matters The veteran's claim for an increased rating is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, he has presented a claim which is plausible. His assertion that his service-connected calluses and corns of the feet has increased in severity is plausible. See Proscelle v. Derwinski, 2 Vet. App. 629, 632 (1992) (where a veteran asserted that his condition had worsened since the last time his claim for an increased disability evaluation for a service-connected disorder had been considered by VA, he established a well grounded claim for an increased rating). All relevant facts have been properly developed and no further assistance to the veteran is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107(a). Service-connected disabilities are rated in accordance with VA’s Schedule for Rating Disabilities, 38 C.F.R. Part 4 (1998) (Schedule), which are based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4 (1998). The disability ratings evaluate the ability of the body to function as a whole under the ordinary conditions of daily life including employment. Evaluations are based on the amount of functional impairment; that is, the lack of usefulness of the rated part or system in self support of the individual. 38 C.F.R. § 4.10 (1998). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for the higher rating. 38 C.F.R. § 4.7 (1998). When a disability is encountered that is not listed in the rating schedule it is permissible to rate under a closely related disease or injury in which the functions affected, the anatomical location and the symptomatology are closely analogous. 38 C.F.R. § 4.20 (1998). In considering the severity of a disability it is essential to trace the medical history of the veteran. 38 C.F.R. §§ 4.1, 4.2 (1998), Peyton v. Derwinski, 1 Vet. App. 282 (1991). While the regulations require review of the recorded history of a disability by the adjudicator to ensure a more accurate evaluation, the regulations do not give past medical reports precedence over the current medical findings. Where an increase in the disability rating is at issue, the present level of the veteran's disability is the primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Factual Background The service medical records show that the veteran complained of corns on both feet during service. A February 1976 record shows callous building across the plantar surface of the metatarsals on both feet, medial hallux bilaterally, and an interdigital soft corn between the right fourth and fifth toes. On a September 1993 VA examination, the veteran complained of frequent pain on the bottom of his feet and calluses which he trimmed himself about twice a month. He also had discomfort between his fourth and fifth toes on his left foot, apparently corns between the toes which he also trimmed about twice a month. Examination of the feet revealed moderately severe pes planus bilaterally. He seemed to walk without difficulty. There was a scar on the fifth toe of the right foot, evidence of past surgery. There was some irritation between the fourth and fifth tows of the left foot, apparently where he had a corn that he had worked on. No calluses were seen on either foot. The diagnoses were (1) pes planus bilaterally, moderately severe; (2) a problem with calluses on both feet and a corn between the fourth and fifth toe of his left foot, and (3) status post surgery of the right fifth toe. An October 1993 RO decision granted service connection for calluses and corns of the feet based on complaints of pain in both feet. Service connection was denied, however, for pes planus, residuals of surgery to the right little toe and plantar warts. On an August 1994 VA skin examination, the veteran complained of rough calluses on his feet that impaired his walking. He also complained of fissures between the fourth and fifth digits of both feet that were sore and had been previously treated by Mycelex cream. He indicated that both conditions had been with him for the past eighteen years. The diagnoses were punctate keratoderma on the soles extenuated with subsequent callosity formation, tinea pedis macerated type between the fourth and fifth digits of the feet bilaterally, and onychomycosis. In a July 1996 personal hearing, the veteran testified that he could only walk about two blocks before his feet started to bother him. He also stated that he had been having problems with the little toe on his right foot and because of persistent pain in that toe it was scheduled to be removed in October. Molds of his feet had been made by his private doctor which fit around the corns and calluses and allowed him to walk with less pain. His frequency of podiatry appointments was approximately every three weeks. On a May 1997 VA examination, apparently by a dermatologist who identified himself as being on staff at the VA dermatology clinic, the veteran stated that his feet did not cause a lot of pain unless the calluses got big. He described his feet as doing well currently since his doctor had been working on them. On examination, the skin of his feet was noted to be mildly scaly. Overlying the first and fifth metatarsal heads bilaterally, he was noted to have a callus. The right seemed to be more of a clavus with some invagination of keratotic debris. There was some minimal amount of pain on deep palpation to this lesion; the remainder seemed to be relatively pain free. He also had a callus on his left fifth digit medially, which abraded the left fourth digit laterally on ambulation. On orthopedic examination performed the same day, the veteran stated that in his opinion his feet made his back hurt. Examination of the feet revealed a surgically webbed fourth and fifth toe on the right. He had calluses which were neatly trimmed. They were bilaterally symmetrical in that both feet showed a callosity on the plantar aspect of the head of the fifth metatarsal and the head of the first metatarsal. These calluses were not overly large and were not over grown at the present time. There was an over grown soft tissue callus at the proximal phalangeal level of both great toes medially. In between the fourth and fifth toe on the left foot was a clivus or soft corn. Analysis The veteran's bilateral foot disability is currently rated under Diagnostic Code 5278 for claw foot as the most closely analogous disability. Under Diagnostic Code 5278 a 10 percent evaluation is warranted for unilateral or bilateral claw foot where the great toe is dorsiflexed, where there is some limitation of motion of dorsiflexion at the ankle, and where there is definite tenderness under the metatarsal heads. A 30 percent evaluation is warranted for bilateral claw foot where all toes are tending to dorsiflexion, where there is limitation of dorsiflexion at the ankle to right angle, where there is shortened plantar fasciae, and where there is marked tenderness under the metatarsal heads. A 50 percent evaluation requires marked contraction of plantar fasciae with dropped forefoot, all toes hammertoes, very painful callosities, and marked varus deformity. On the veteran's most recent VA examinations, he had calluses overlying the first and fifth metatarsal heads bilaterally, a soft callus in between the fourth and fifth toe on the left foot, and a callus on his left fifth digit medially which abraded the left fourth digit laterally on ambulation. His calluses were kept neatly trimmed. By his own description he was doing well and was not in a lot of pain unless the calluses became large. He had only minimal pain on deep palpation of one of his calluses, but the remainder were relatively pain free. Although he testified that he could only walk two blocks before his feet started bothering him, and he had been fitted for molds for his shoes which fit around the corns and alleviated some of the pain, he appeared to be primarily bothered by problems with the little toe on his right foot which was scheduled to be removed. To obtain a higher rating under Diagnostic Code 5278, the veteran would have to show pain more nearly approximating the term “marked tenderness under metatarsal heads” rather than “definite tenderness under metatarsal heads.” The Board finds that because his calluses and corns are kept neatly trimmed, and currently do not cause him a lot of pain, he is more appropriately compensated under the 10 percent level of disability which contemplates “definite” rather than “marked” tenderness. Because the veteran is being rated by analogy under this diagnostic code, the other criteria relating to dorsiflexion of the toes and shortened planter fascia are not applicable. The Board has considered other disabilities of the foot under which the veteran may also be rated. However, to obtain a higher rating under those codes, his calluses and corns would have to more nearly approximate flat foot, malunion or nonunion of the tarsal or metatarsal bones, or a disability described as another foot injury. 38 C.F.R. § 4.71a, Diagnostic Codes 5276, 5283, 5284 (1998). There is no more appropriate disability under which the veteran's corns and calluses may be rated. The Board notes that he has specifically not been service connected for either flat foot, or the residuals of his toe surgery. As such, the preponderance of the evidence is against a higher rating for the veteran's service connected calluses and corns of the feet. II. Service Connection for a Back Disorder and Headaches A. Preliminary Matters Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. §§ 101(16), 1131 (West 1991); 38 C.F.R. §§ 3.303, 3.304 (1998). The law provides that “a person who submits a claim for benefits under a law administered by the Secretary shall have the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded.” 38 U.S.C.A. § 5107(a) (West 1991). Establishing a well grounded claim for service connection for a particular disability requires more than an allegation that the disability had its onset in service or is service-connected; it requires evidence relevant to the requirements for service connection and of sufficient weight to make the claim plausible and capable of substantiation. See Franko v. Brown, 4 Vet. App. 502, 505 (1993); Tirpak v. Derwinski, 2 Vet. App. 609, 610 (1992); Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). The three elements of a “well grounded” claim are: (1) evidence of a current disability as provided by a medical diagnosis; (2) evidence of incurrence or aggravation of a disease or injury in service as provided by either lay or medical evidence, as the situation dictates; and, (3) a nexus, or link, between the inservice disease or injury and the current disability as provided by competent medical evidence. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1997); see also 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1998). Generally, competent medical evidence is required to meet each of the three elements. However, for the second element the kind of evidence needed to make a claim well grounded depends upon the types of issues presented by a claim. Grottveit v. Brown, 5 Vet. App. 91, 92-93 (1993). For some factual issues, such as the occurrence of an injury, competent lay evidence may be sufficient. However, where the claim involves issues of medical fact, such as medical causation or medical diagnoses, competent medical evidence is required. Id. at 93. Lay evidence is also acceptable to show incurrence in service if the veteran was engaged in combat and the evidence is consistent with the circumstances, conditions and hardships of such service, even though there is no official record of such incurrence. 38 U.S.C.A. § 1154 (West 1991); 38 C.F.R. § 3.304(d) (1998). Service connection may also be granted for a disability which is proximately due to and the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a) (1998). A claim for secondary service connection, like all claims, must be well grounded. 38 U.S.C.A. § 5107(a); Proscelle v. Derwinski, 2 Vet. App. 629, 633 (1992). Similar to the Caluza analysis above, the veteran must provide evidence of (1) a current disability, and (2) a link or nexus between the current disability and a service connected disability, as shown by competent lay or medical evidence as the situation warrants. See Locher v. Brown, 9 Vet. App. 535 (1997), Reiber v. Brown, 7 Vet. App. 513, 516 (1995). Where the determinative issue involves medical causation or a medical diagnosis, competent medical evidence to the effect that the claim is plausible or possible is required. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). The Board finds that medical evidence is needed to provide a link between any current diagnosis of a back disorder, and the veteran's service-connected calluses and corns of the feet. B. Secondary Service Connection for a Back Disorder Factual Background A private medical record from July 1979 shows a complaint of pain in the low back of three weeks duration, aggravated by straining. There was pain noted in the left sacroiliac joint. In June 1990, the veteran complained of pain in the right low back and right hip which began the previous Thursday. He gave no history of injury. On examination, most of the pain was noted to be in the right sacroiliac joint. In October 1994, the veteran was provided a VA spine examination. He indicated the onset of back pain while he was in the service, but was unable to recall whether he actually sought medical attention for a back condition at that time. He indicated recurrent episodes of lower back pain exacerbated by walking long distances or strenuous physical activities such as mowing the lawn. His last significant episode of pain was approximately a week ago. He was doing well at the present time. There was no radiation to the lower extremities. On physical examination, he walked with an unremarkable gait, without spasms or tenderness and was able to squat and arise again. The impression was low back syndrome, intermittently symptomatic of uncertain etiology. In October 1994, the veteran underwent a VA miscellaneous neurological disorders examination. He reported problems with low back pain that he described as a chronic pain for the last fifteen to twenty years. He stated that it was worse in certain positions such as walking and bending. Overall, he attributed his back problems to his foot problems. and noted a recent improvement in his back pain with new shoes. There was no pain to direct palpation of the neck or back. The impression was chronic low back pain. The examiner wrote: “This appears to be more consistent with low back strain without any history of examination findings suggestive of a radiculopathy.” In a July 1996 personal hearing, the veteran testified that because of the corns and calluses on his feet his gait was affected. He also stated that he had had molds made of the bottom of his feet by his private doctor which fit around the corns and calluses and he could therefore walk with less pain. On a May 1997 VA examination, apparently by a dermatologist who identified himself as being on staff at the VA dermatology clinic, the veteran stated that he thought the calluses on his feet were causing some of his back pain, because he has had to change the way he walks. On physical examination, he had a callus on his left fifth digit medially, which abraded the left fourth digit laterally on ambulation. On observation, he favored his left leg on ambulation. The impression was of painful callosities of the feet, “a possible contributory factor to low back pain.” The examiner also commented that a full orthopedic evaluation needed to be undertaken to rule out the possibility of leg length discrepancy as a possible contributing factor to his lower back pain. Although the examiner noted that the claims file had not been made available for review prior to the examination, he indicated that “[t]he callosities and their relation to his [back] pain would unlikely be clarified by review of his old chart. . . .” On orthopedic examination performed the same day, the veteran stated that in his opinion his feet made his back hurt. On physical examination, he stood with a drop in his right pelvis which required 5/8 of an inch to elevate him to a level position. Examination of the feet revealed a surgically webbed fourth and fifth toe on the right. He had calluses which were neatly trimmed. They were bilaterally symmetrical in that both feet showed a callosity on the plantar aspect of the head of the fifth metatarsal and the head of the first metatarsal. These calluses were not overly large and were not over grown at the present time. There was an overgrown soft tissue callus at the proximal phalangeal level of both great toes medially. In between the fourth and fifth toe on the left foot was a clivus or soft corn. X-ray examination of the back showed degenerative discopathy. The examiner stated that “In my opinion, this patient’s back condition is not related to his foot condition.” Analysis The veteran has not submitted a well-grounded claim for service connection for a back disorder secondary to his service-connected bilateral calluses and corns of the feet. No medical evidence has been presented of a link or nexus between his back disorder, and his service-connected foot disability. In fact, a VA medical opinion specifically disputes any such link noting that “this patient’s back condition is not related to his foot condition.” Although a VA dermatologist stated that the veteran's callosities of the feet were “a possible contributory factor to low back pain,” this was clearly contradicted by the subsequent orthopedic evaluation. The Board notes that when a doctor’s opinion is expressed in terms of “may or may not” it is not sufficient to establish a well grounded claim. Tirpak v. Derwinski, 2 Vet. App. 609 (1992). The Board finds that the term “possible” in describing the link between the veteran's back disability and his service-connected bilateral calluses and corns of the feet is the functional equivalent of “may or may not,” and therefore can not serve to well ground the claim. Nor is there any evidence of an increase in the veteran's back disability which may be attributable to his service-connected bilateral corns and calluses. See Allen v. Brown, 7 Vet. App. 439 (1995). The only evidence of a link between the veteran’s back disorder and his service-connected foot disability consists of the veteran's own testimony. However, the veteran’s statements are not competent evidence to establish either a current disability, or the etiology of his disorder. The veteran is not competent to make a determination that his back disability is the result of his service connected foot disability rather than his other nonservice connected disabilities such as his flat feet, residuals of surgery to one toe, or a possible shortening of one leg. See Espiritu, 2 Vet. App. at 495; Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). C. Service Connection for Headaches Factual Background In October 1976 the veteran complained of a severe headache with continuous pain. On physical examination, both ears showed signs of otitis media. In November 1976, a four inch laceration to the scalp was closed with seven stitches. Two days later, he complained of a headache which the treatment record notes “may be due to sutures in top of head.” On examination, the veteran was found to have severe left otitis media with a bulging ear drum. In December 1977, a treatment record notes that the veteran had been attacked the previous evening and hit with a brick behind the left ear. He was now complaining of a throbbing headache to the area. The impression was laceration of the left parietal area. There was no internal injury evident. The veteran was hospitalized from February to March 1978 with a diagnosis of habitual excessive drinking. Although he was released on Antabuse with a warning not to take alcohol, a sick call record shows that on the very day of his release he was treated for an injury to the left side of his head when he was climbing up some steps and fell on his face. He had been drinking. No abnormality of the head, or any complaint of headaches was noted on the July 1978 separation examination. A July 1994 neurology clinic note shows that the veteran complained of headaches for about one year since being sober. He described headaches in the back of his head which feel like a “cramp” and “tight,” with no precipitating causes. These had been almost daily but were now three or four times a week. No abnormalities were noted on neurological examination. The impression was of chronic headaches not relieved by NSAIDs or muscled relaxors. An August 1994 treatment record shows treatment for diabetes, including a complaint of chronic headaches noted to be in the occipital region. No diagnosis was rendered regarding the headaches. In October 1994, the veteran underwent a VA miscellaneous neurological disorders examination. He related a head injury in 1977 during active service, hitting his head on the top of a doorway of a ship. He subsequently had a head laceration and received some sutures but was not hospitalized. The examiner noted the following history: In approximately 1992 he began experiencing headaches that he describes as a throbbing sensation over the left posterior aspect of his head, that would be exacerbated by turning his head and diminished with sleep. He states these headaches now occur about three to four times a week and are less in frequency from their previous daily occurrence. The veteran stated that his headaches had probably been with him all along but he most likely only began noticing them in 1992 after he began “clearing up” from his previous history of substance abuse. The impression was mixed headaches disorder. The examiner noted: “The patient’s history is most suggestive of mixed headaches disorder with some features characteristic of migraine headaches and some of a tension headache.” Analysis In this case, the veteran is claiming that as a result of head injuries he sustained during his service, he now has headaches. The veteran has met the first of the three requirements for a well grounded claim, that of a current disability. Caluza v. Brown, 7 Vet.App. 498, 505 (1995); Brammer v. Derwinski, 3 Vet.App. 223, 225 (1992). He was diagnosed on VA examination with mixed headaches disorder. The service medical records clearly show several head injuries during service. The only remaining element of a well-grounded claim is that of a nexus or link between his current diagnosis and the claimed injury in service. The Board concludes that there is no medical evidence of a link or nexus between his current diagnosis of headaches and his active service. Although the medical records repeat his history in which he contends that his headaches were incurred as a result of injury in service, it is clear that this only represents the veteran's history as related to the examiner. The Board notes that a bare transcription of a lay history is not transformed into competent medical evidence merely because the transcriber happens to be a medical professional. LeShore v. Brown, 8 Vet. App. 406 (1995). Thus, any conclusion based on the veteran's history, unenhanced by clinical evaluation and findings to support the diagnosis is invalid. Moreover, by the veteran's own statements as provided to the examiner in his October 1994 VA examination, he was unable to state with certainty that he had had headaches prior to 1992, noting that his headaches had “probably” been with him all along but he “most likely” only began noticing them in 1992 after he began clearing up from his substance abuse. Without medical evidence of a link between the veteran's current diagnoses and his active service, the only remaining evidence of such a link is the veteran's own statements and testimony. The veteran’s sworn testimony and other statements are not competent evidence to establish the etiology of his disorder. Medical diagnosis and causation involve questions that are beyond the range of common experience and common knowledge and require the special knowledge and experience of a trained physician. Because he is not a physician, the veteran is not competent to make a determination that his headaches are the result of injury over two decades ago rather than the result of intercurrent causes such as his long history of alcohol and substance abuse, or his diagnosis of diabetes. See Espiritu, 2 Vet. App. at 495; Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). The Board particularly notes that the medical evidence shows that the veteran did not begin to complain of a chronic headache problem until approximately 1992. D. Conclusion The veteran does not meet the requirement of a link or nexus between his back disorder and his service-connected calluses and corns of the feet. Nor does he meet the requirement of a link or nexus between his headaches and head injury shown in service. See Caluza, 7 Vet. App. at 506. See also Dean v. Brown, 8 Vet. App. 449, 455 (1995); Slater v. Brown, 9 Vet. App. 240 (1997). The Board has thoroughly reviewed the claims file, but finds no evidence of plausible claims for service connection for a back disorder secondary to service-connected calluses and corns of the feet, or headaches as a residual of head injury in service. Since the veteran has not met his burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded, it must be denied. See Boeck v. Brown, 6 Vet. App. 14, 17 (1993) (if a claim is not well-grounded, the Board does not have jurisdiction to adjudicate it). Where a claim is not well grounded, VA does not have a statutory duty to assist a claimant in developing facts pertinent to the claim, but VA may be obligated under 38 U.S.C.A. § 5103(a) to advise a claimant of evidence needed to complete his application. This obligation depends on the particular facts of the case and the extent to which the Secretary has advised the claimant of the evidence necessary to be submitted with a VA benefits claim. Robinette v. Brown, 8 Vet. App. 69, 78 (1995). Here, unlike the situation in Robinette, the veteran has not put the VA on notice of the existence of any specific, particular piece of evidence that, if submitted, could make his claims well grounded. See also Epps v. Gober, No. 97-7014 (Fed Cir. October 7, 1997); Epps v. Brown, 9 Vet. App. 341 (1997). Accordingly, the Board concludes that VA did not fail to meet its obligations under 38 U.S.C.A. § 5103(a) (West 1991). Regulations affording the appellant the benefit of the doubt, as provided by 38 U.S.C.A. § 5107(b) and 38 C.F.R. § 3.102, do not apply where the appellant has not submitted a well- grounded claim. Holmes v. Brown, 10 Vet. App. 38 (1997). Finally, the appellant’s representative “requests that the Board determine whether the RO followed the M21-1 substantive rules requiring that full development of all claims be undertaken prior to the well grounded determination.” As such, he essentially contends that VA has expanded its duty to assist the claimant by certain provisions in VA ADJUDICATION PROCEDURE MANUAL M21-1 (M21-1) and that the case should be remanded on the ground that VA has extended the duty to assist to claims that are not well grounded. M21-1, Part III, 1.03(a) and Part VI, 2.10(f). The Board, however, notes that it is specifically not bound by VA manuals, circulars, or other administrative issues. Tobler v. Derwinski, 2 Vet.App. 8, 14 (1991). Moreover, the cited provisions of M21-1 have not been promulgated pursuant to the regulatory requirements of 38 C.F.R. § 1.12 (1998). The representative has not cited to a court decision that holds that the cited portions of M21-1 are substantive rules. Consequently, the Board finds no basis upon which to comply with the representative’s request in this regard. ORDER An increased rating for corns and calluses of the feet is denied. Because it is not well grounded, the veteran's claim for service connection for a back disorder, secondary to a service-connected bilateral foot disability, is denied. Because it is not well grounded, the veteran's claim for service connection for residuals of a head injury is denied. BETTINA S. CALLAWAY Member, Board of Veterans' Appeals NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991 & Supp. 1998), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals. - 2 -