Citation Nr: 1304232 Decision Date: 02/06/13 Archive Date: 02/19/13 DOCKET NO. 12-13 372 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Lincoln, Nebraska THE ISSUES 1. Entitlement to an initial evaluation in excess of 20 percent for right foot cold injury residuals and chronic onychomyosis of the toenails from July 15, 2011. 2. Entitlement to an initial evaluation in excess of 20 percent for left foot cold injury residuals and chronic onychomyosis of the toenails from July 15, 2011. REPRESENTATION Appellant represented by: John Berry, Attorney ATTORNEY FOR THE BOARD G. Slovick, Associate Counsel INTRODUCTION Pursuant to 38 C.F.R. §20.900(c), the appeal has been advanced on the Board's docket. The Veteran served on active duty from November 1951 to October 1953. This matter is before the Board of Veterans' Appeals (Board) on appeal of a rating decision in November 2011 of a Department of Veterans Affairs (VA) Regional Office (RO) which denied a disability evaluation in excess of 20 percent for right and left foot cold injury residuals and onychomyosis. The appeal is REMANDED to the Department of Veterans Affairs Regional Office. VA will notify the appellant if further action is required. REMAND In November 2011, a VA examiner completed a disability benefits questionnaire in order to determine the severity of the Veteran's right and left foot cold injury residuals with onychomyosis. The disability benefits questionnaire report reveals the Veteran had cold sensitivity and nail abnormalities of the feet bilaterally. The report's instructions noted that diagnoses of subarticular punched out lesions or osteoarthritis must be confirmed by x-ray. The examiner noted that there were no x-rays available and it appears that no x-rays of the feet were taken following the completion of the questionnaire. A maximum rating of 30 percent rating is assigned for arthralgia or other pain, numbness, or cold sensitivity plus two or more of the following: tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, or X-ray abnormalities (osteoporosis, subarticular punched out lesions or osteoarthritis). The Veteran clearly has nail abnormalities as evidenced by his onychomycosis; however, because no x-rays were available, it is unclear whether the Veteran has symptoms which might make him eligible for the higher, 30 percent schedular disability rating. The VA examination is inadequate, and the issues must be remanded. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The RO should obtain any and all contemporary VA and private treatment records pertaining to the Veteran's right and left feet not already in the claims file. See 38 C.F.R. § 3.159. Accordingly, the case is REMANDED for the following action: 1. Obtain and associate with the claims file all relevant treatment records from the VA Nebraska-Western Iowa Health System dated after April 24, 2012. If the search for such records proves unsuccessful, this must be documented in the claims file and the Veteran must be informed of this fact. 2. Schedule the Veteran for x-rays to confirm or refute the presence of subarticular punched out lesions or osteoarthritis. Then, when the x-ray results are available, afford the Veteran a VA examination to determine the nature and severity of the Veteran's cold injury residuals and onychomyosis of the right and left foot. The entire claims file (i.e. the paper claims file and any medical records contained in Virtual VA, CAPRI, and AMIE) must be reviewed by the examiner in conjunction with the examination. If the examiner does not have access to Virtual VA, any relevant treatment records contained in Virtual VA file that are not available on CAPRI or AMIE must be printed and associated with the paper claims file so they can be available to the examiner for review. The examiner is specifically to comment upon any findings of tissue loss, nail abnormalities, color changes, locally impaired sensation, hyperhidrosis, or X-ray abnormalities (osteoporosis, subarticular punched out lesions or osteoarthritis). 3. Review the claims file to ensure that all of the foregoing development has been completed, and arrange for any additional development indicated. Then readjudicate the issues on appeal. If either benefit remains denied, issue an appropriate supplemental statement of the case and provide the Veteran and his representative an appropriate period of time to respond. The case is to then be returned to the Board for further appellate review. The appellant has the right to submit additional evidence and argument on the 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. 2012). _________________________________________________ RONALD W. SCHOLZ 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) (2012).