Citation Nr: 1103101 Decision Date: 01/25/11 Archive Date: 02/01/11 DOCKET NO. 07-32 372 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to a compensable rating for appendectomy with postoperative history of adhesions and bladder dysfunction. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD A. Fagan, Associate Counsel INTRODUCTION The Veteran served on active duty from June 1943 to March 1946, as shown on his separation form. The Veteran also claims additional active service. This appeal comes before the Board of Veterans' Appeals (Board) from a May 2007 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina. However, the RO in Atlanta, Georgia, currently has jurisdiction over the Veteran's claim. The issues of entitlement to service connection for a hip disability and a back disability have been raised by the record, but have not been adjudicated by the Agency of Original Jurisdiction (AOJ). Therefore, the Board does not have jurisdiction, and those claims are referred to the AOJ for appropriate action. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2010). 38 U.S.C.A. § 7107(a)(2) (West 2002). The appeal is REMANDED to the RO via the Appeals Management Center in Washington, D.C. REMAND Although the Board regrets the delay, additional development is needed prior to further disposition of the Veteran's claim. The Veteran has expressed disagreement with the assignment of a 0 percent rating for his service-connected appendectomy residuals, which include an adhesion scar and bladder dysfunction. Although most of the evidence submitted by the Veteran throughout the course of this appeal pertains to disabilities not currently on appeal, he did indicate in an attachment to his October 2007 substantive appeal that he takes medication every evening for bladder dysfunction and that, without that medication, he cannot contain his urine. A review of the record shows that the Veteran was most recently afforded a VA QTC examination in September 2007, at which time the Veteran reported no urination problems at night, no urinary incontinence, and no limitations due to his bladder dysfunction. VA's duty to assist includes a duty to provide a medical examination or obtain a medical opinion where it is necessary to make a decision on the claim. 38 U.S.C.A. § 5103A(d) (West 2002); 38 C.F.R. § 3.159(c)(4) (2010); Robinette v. Brown, 8 Vet. App. 69 (1995). When available evidence is too old for an adequate evaluation of the Veteran's current condition, VA's duty to assist includes providing a new examination. Weggenmann v. Brown, 5 Vet. App. 281 (1993). Here, the Veteran's last VA examination is somewhat stale and he has provided lay evidence of a worsening condition since the date of the last examination. Specifically, the Veteran has indicated that he is incontinent without medication. Because there may have been a significant change in the Veteran's condition, the Board finds that he should be afforded a new examination. Additionally, the Board finds that a new examination is warranted on the basis that the September 2007 QTC examiner's report contained insufficient detail. 38 C.F.R. § 4.2 (2010). The examiner failed to discuss the presence and nature of any adhesions, and whether the Veteran's bladder dysfunction required the use of absorbent materials, which could support entitlement to a higher rating. The Board also observes that there is no indication that the Veteran's claims file was reviewed at the time of the September 2007 examination. To ensure a thorough examination and evaluation, the Veteran's disability must be viewed in relation to its history. 38 C.F.R. § 4.1 (2010). Therefore, on remand, the Veteran should be afforded a new VA examination that includes a review of the claims folder and addresses all relevant rating criteria. Finally, it appears that there are outstanding medical records. In an attachment to his October 2007 substantive appeal, the Veteran indicated that he was being prescribed medication for his bladder dysfunction. However, there are no treatment records in the claims file relating to this disability. On remand, VA should clarify whether the Veteran is receiving treatment from a VA physician or a private physician for his appendectomy residuals, and take the necessary steps to obtain those records. Accordingly, the case is REMANDED for the following action: This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2010). Expedited handling is requested. 1. After obtaining the necessary authorization from the Veteran, obtain and associate with the claims folder any private medical records dated since May 2005 from any private medical provider who treated him for his service-connected appendectomy residuals, to include bladder dysfunction and adhesion scars. All attempts to secure those records must be documented in the claims folder. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or are unavailable. Then, notify the Veteran and associate the notice in the record. 2. Obtain and associate with the claims folder all medical records from any VA Medical Center where the Veteran received treatment from May 2005 to the present. 3. After obtaining the above records, schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected appendectomy residuals. The examiner should comment on the presence and nature of any adhesions and scars. The examiner should state whether the use of absorbent materials is required for bladder incontinence, and, if so, how often the materials must be changed. The examiner should also describe the severity of urinary frequency or incontinence during the daytime and frequency or incontinence during the night. The claims folder should be reviewed by the examiner and that review should be indicated in the examination report. The rationale for all opinions should be provided. 4. Then, readjudicate the claim. If the benefit sought on appeal remains denied, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. 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 or the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2010). _________________________________________________ Harvey P. Roberts 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) (2010).