## Facts

- A World War II veteran received service-connected disability ratings in 1949, including 20% for a shoulder wound and 10% for a hand wound.
- Over the years, he repeatedly sought an increased shoulder rating, but the Department of Veterans Affairs (VA) continued the 20% evaluation.
- In 1986, he underwent a total shoulder replacement; VA assigned a temporary 100% rating for one year, then returned the rating to 20%.
- A 1988 VA examination noted limited motion and reduced strength, but VA continued the 20% rating.
- The Board of Veterans’ Appeals remanded for further development; later VA examinations in 1992 reported fair strength, good mobility, and no severe functional impairment.
- The Board denied an increase above 20%, and the veteran appealed.

## Issues

1. In a claim for an increased rating for an already service-connected disability, whether the adjudicator should primarily evaluate the present level of disability.
2. Whether the Board erred in relying on the most recent medical evidence and applying the rating criteria to deny a rating above 20% for the post-replacement shoulder disability.

## Decision

- The court affirmed the Board’s denial of a rating higher than 20% for the shoulder disability.
- The court held that the Board properly focused on the current severity of the disability as shown by contemporaneous medical examinations.
- The court found no clear error in the Board’s factual findings and no misapplication of the rating schedule.

## Legal Principles

- In an increased-rating claim, the present level of disability is of primary concern.
- The disability’s recorded history must be reviewed, but an increased-rating claim turns on current manifestations and functional impairment rather than re-rating earlier periods.
- The Board may assign significant weight to recent medical examinations when assessing current severity under the VA rating schedule.
- On judicial review, Board factfinding is upheld unless clearly erroneous, and the court will affirm where the Board applied the correct law and had evidentiary support.

## Conclusion

The court upheld the 20% shoulder rating, establishing that when a veteran seeks an increased rating, the controlling focus is the current level of disability, informed—but not governed—by historical medical evidence.


Francisco v. Brown, 7 Vet. App. 55 (1994)