Citation Nr: 0609647 Decision Date: 04/03/06 Archive Date: 04/13/06 DOCKET NO. 03-00 068 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to an initial compensable evaluation for service- connected residuals of mycoplasma infection. WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD A. J. Turnipseed, Associate Counsel INTRODUCTION The veteran had active service from October 1968 to August 1970 and from March 1971 to June 1993. This matter comes before the Board of Veterans' Appeals (Board) from a July 2001 rating decision of the above Department of Veterans Affairs (VA) Regional Office (RO), which granted service connection for residual mycoplasma infection, and assigned a noncompensable rating, effective December 30, 1999. The veteran testified at a Travel Board hearing at the RO before the undersigned Veterans Law Judge in January 2006. In June 2003, the veteran was previously afforded a hearing at the RO before another Veterans Law Judge, who is now retired. The transcripts from those hearings are associated with the claims file. This case was previously before the Board in March 2004 and July 2005, but the Board determined that additional development was necessary and directed the RO to complete such development. Additional development has been conducted and the claim is now properly before the Board for appellate review. Unfortunately, further development is necessary before this claim can be adjudicated on the merits. Accordingly, the appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will provide notification when further action is required on the part of the veteran. REMAND Service connection for residuals of mycoplasma infection was established in July 2001; a noncompensable rating was assigned under Diagnostic Code (DC) 6899-6826, effective from December 1999. Mycoplasma infection is not listed on the Rating Schedule, and the RO assigned DC 6899-6826 pursuant to 38 C.F.R. § 4.27, which provides that unlisted disabilities requiring rating by analogy will be coded as the first two numbers of the most closely related body part and "99." See 38 C.F.R. § 4.20 (2005). The RO determined that the most closely analogous diagnostic code is DC 6826, for desquamative interstitial pneumonitis. DC 6826 is evaluated under a general rating formula for interstitial lung disease, which provides that a 10 percent evaluation is warranted where forced vital capacity (FVC) is 75 to 80 percent of predicted value, or diffusion capacity of the lung for carbon monoxide by the single breath method (DLCO (SB)) is 66 to 80 percent of predicted value. A 30 percent evaluation is warranted where FVC is 65 to 74 percent predicted or DLCO (SB) is 56to 65 percent predicted. A 60 percent evaluation is warranted where FVC is 50 to 64 percent predicted, or DLCO (SB) is 40 to 55 percent predicted, or maximum exercise capacity is 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation. A 100 percent evaluation is warranted where FVC is less than 50 percent predicted, or DLCO (SB) is less than 40 percent predicted, or maximum exercise capacity is less than 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, cor pulmonale, or pulmonary hypertension, or requires outpatient oxygen treatment. The evidentiary record contains one private pulmonary function test (PFT) dated April 2002. However, the April 2002 PFT report is not adequate for rating purposes. In particular, the PFT report does not show the veteran's FVC in terms of the percentage of predicted value, and does not indicate whether the results reported are after bronchodilator administration. See 61 Fed. Reg. 46,720 (Sept. 5, 1996) (to the effect that, under VA's rating procedures, the post-bronchodilator value provides the ideal estimate of the veteran's best possible functioning and assures consistent evaluations). The Board notes the veteran has not been afforded a VA examination in conjunction with his claim for an increased rating for service-connected residuals of mycoplasma infection. The Board also notes the veteran was found to be positive for a mycoplasma infection in December 1999, and that he has complained of shortness of breath, fatigue, and chest pains since he was separated from service. However, it is not clear whether these symptoms are associated with the residuals of mycoplasma infection. Based upon the foregoing, the Board finds that a new examination is necessary to adequately assess the severity of the veteran's disability due to service-connected residuals of mycoplasma infection. See 38 C.F.R. § 3.159(c)(4) (2005). Accordingly, the case is REMANDED for the following action: 1. The veteran should be afforded a VA pulmonary examination to determine the current level of impairment due to service-connected residuals of mycoplasma infection, to include interstitial lung disease. All indicated tests and studies, including pulmonary function testing, should be conducted and all findings described in detail. The claims file must be made available to the examiner for review, and the examination report should reflect that such review is accomplished. a. The examiner should be requested to record pertinent medical complaints, symptoms, and clinical findings associated with service-connected residuals of mycoplasma infection. b. The PFT report must include FVC percent predicted and DLCO (SB) percent predicted after bronchodilator administration. 2. Thereafter, the issue on appeal should be readjudicated. If the benefit sought on appeal is not granted to the veteran's satisfaction, the veteran should be provided with a supplemental statement of the case and afforded the appropriate opportunity to respond thereto. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. The Board intimates no opinion as to the ultimate outcome of this case. The veteran need take no action unless otherwise informed. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2005). _________________________ ANDREW J. MULLEN Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a final decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a final decision of the Board on the merits of the appeal. 38 C.F.R. § 20.1100(b) (2005).