Citation Nr: 0822877 Decision Date: 07/09/08 Archive Date: 07/17/08 DOCKET NO. 05-00 868 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUE Entitlement to an initial rating in excess of 10 percent for a bilateral foot fungal condition. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD J. Smith, Associate Counsel INTRODUCTION The veteran served on active duty from August 1951 to June 1959. The veteran's claim comes before the Board of Veterans' Appeals (Board) on appeal from a November 2003 rating decision of the Department of Veterans Affairs' (VA) Regional Office (RO) in St. Petersburg, Florida, that denied the benefit sought on appeal. The RO in Montgomery, Alabama, is now handling the matter. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the veteran if further action is required. REMAND A VA examination is needed to assess the severity of the veteran's bilateral foot fungal condition for VA rating purposes. The last VA examination conducted for this disability was in 2003 and the report does not contain sufficient findings for determining whether the veteran may be rated at the next higher evaluation. The veteran's disability has been rated under Diagnostic Code (DC) 7817. Under that code, a 30 percent rating may be warranted where the evidence shows systemic therapy, such as therapeutic doses of corticosteroids, for a total duration of six weeks or more but not constantly over the past twelve month period. A rating of 60 percent is warranted where there is generalized involvement of the skin without systemic manifestations, and constant or near-constant systemic therapy, such as therapeutic doses of corticosteroids, over the past twelve months. A rating of 100 percent is warranted where there is generalized involvement of the skin plus systemic manifestations, and constant or near-constant systemic therapy, such as therapeutic doses of corticosteroids, over the past twelve months. The VA examination report of October 2003 indicates the veteran's foot fungal condition has been treated with both clobetasol propionate cream and prednisone. These are corticosteroids. See Dorland's Illustrated Medical Dictionary 377, 1500 (30th ed. 2003). However, the report does not indicate the duration of this treatment, such as whether the veteran's condition requires constant or near- constant use of corticosteriods. Additionally, the report indicates the veteran has been hospitalized due to "superinfections" of his feet with Pseudinomas and Morganella, and has required long-standing antibiotic treatment. Thus it is unclear whether there are any systemic manifestations of this disability. An examination is needed to provide findings in accordance with the applicable diagnostic criteria. Accordingly, the case is REMANDED for the following action: Schedule the veteran for a VA examination in order to determine the current severity of his bilateral foot fungal condition. The examiner should identify and completely describe all current symptomatology. The veteran's claims folder must be reviewed by the examiner in conjunction with the examination. Ask the examiner to discuss all findings in terms of the diagnostic codes. The pertinent rating criteria, specifically diagnostic code 7817, must be provided to the examiner. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The veteran is hereby notified that it is his responsibility to report for the examination scheduled in connection with this REMAND and to cooperate in the development of his case. The consequences of failure to report for a VA examination without good cause may include denial of his claim. 38 C.F.R. §§ 3.158, 3.655 (2007). After all of the above actions have been completed readjudicate the veteran's claim. If the claim remains denied, issue to the veteran a supplemental statement of the case, and afford the appropriate period of time within which to respond thereto. 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. 2007). _________________________________________________ J. A. MARKEY Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a 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 decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2004).