Citation Nr: 1322742 Decision Date: 07/17/13 Archive Date: 07/24/13 DOCKET NO. 11-08 615 ) DATE ) ) On appeal from the Department of Veterans Affairs Medical and Regional Office Center in Wichita, Kansas THE ISSUES 1. Entitlement to disability rating in excess of 10 percent for hypertension. 2. Entitlement to a compensable disability rating for diabetic neuropathy, left upper extremity. 3. Entitlement to a compensable disability rating for diabetic neuropathy, right upper extremity, prior to December 4, 2009, and in excess of 10 percent from December 4, 2009, forward. 4. Entitlement to service connection for sinus bradycardia, to include as secondary to service-connected diabetes mellitus. 5. Entitlement to service connection for bilateral carpal tunnel syndrome, to include as secondary to service-connected diabetes mellitus. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD M. Sopko, Associate Counsel INTRODUCTION The Veteran had active military service from July 1967 to July 1969. This appeal to the Board of Veterans' Appeals (Board) is from a rating decision(s) of the Department of Veterans Affairs (VA) Regional Office (RO) in Wichita, Kansas. In July 2008, the RO awarded service connection for hypertension and bilateral diabetic neuropathy of the upper extremities, each rated as noncompensable, effective from March 28, 2008. The Veteran was notified of this decision and of his appellate rights by letter dated July 17, 2008. In August 2008, the Veteran submitted a statement requesting "a claim for increase of benefit." Additional VA treatment records were received, and in January 2009 the RO denied the claims for increased ratings. The Veteran was notified of this decision and of his appellate rights by letter dated January 12, 2009. In August 2009, the Veteran submitted a notice of disagreement (NOD) with the January 2009 rating decision. In an August 2010 rating decision, the RO increased the Veteran's rating for neuropathy in his right upper extremity to 10 percent disabling, effective from December 4, 2009. The RO issued a statement of the case (SOC) on August 10, 2010. In a January 2011 rating decision, the RO increased the Veteran's rating for hypertension to 10 percent disabling, effective from March 28, 2008. The RO also issued a supplemental statement of the case (SSOC) in January 2011. In March 2011, the Veteran submitted a substantive appeal (VA Form 9) addressing only the claims for increased ratings for peripheral neuropathy of the upper extremities. His representative submitted a VA Form 646 later that month which also addressed the claim for an increased rating for hypertension. The RO certified all three issues to the Board, and the Board accepts them as on appeal. In the January 2009 rating decision, the RO also denied entitlement to service connection for sinus bradycardia, an optic nerve condition, and bilateral carpal tunnel syndrome. The Veteran submitted a notice of disagreement with the RO's denial of these claims in August 2009. In October 2011, the RO awarded service connection for cataracts (claimed as an optic nerve condition), thereby resolving this claim. As discussed below, however, the Veteran has not yet been provided an SOC as to the claims for service connection for sinus bradycardia and bilateral carpal tunnel syndrome. A review of the Virtual VA paperless claims processing system has been conducted. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Board finds that additional development is required before the Veteran's appeal can be adjudicated. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran's claims so that he is afforded every possible consideration. An October 2011 rating decision is contained in the Veteran's Virtual VA file. This rating decision reveals the Veteran had three VA examinations in May 2011, the reports of which are not included in either Virtual VA or the claims file. Records generated by VA facilities that may impact the adjudication of a claim are considered constructively in the possession of VA adjudicators during the consideration of a claim, regardless of whether those records are physically in the claims files. Dunn v. West, 11 Vet. App. 462, 466-67 (1998); Bell v. Derwinski, 2 Vet. App. 611, 613 (1992). Therefore, on remand the AMC should obtain these VA examination reports as well as any unassociated VA treatment records, as set forth below. As the case must be remanded, the Veteran should also be afforded a current VA examination of his diabetic neuropathy of his upper extremities and hypertension. As noted above, in the January 2009 rating decision the RO denied entitlement to service connection for sinus bradycardia and bilateral carpal tunnel syndrome. The Veteran submitted a notice of disagreement with the RO's denial of these claims in August 2009. However, the Veteran has not yet been provided an SOC as to these claims. See Manlincon v. West, 12 Vet. App. 238 (1999). This should be accomplished on remand. Accordingly, the case is REMANDED for the following action: 1. Issue a statement of the case on the issues of service connection for sinus bradycardia, to include as secondary to service-connected diabetes mellitus, and service connection for bilateral carpal tunnel syndrome, to include as secondary to service-connected diabetes mellitus. The Veteran should be advised of the need to file a substantive appeal following the issuance of the statement of the case if he wishes to complete an appeal as to these issues. 2. Make arrangements to obtain the Veteran's complete treatment records from the Kansas City VA Medical Center and Paola Community Based Outpatient Clinic, dated since January 2010. In particular, make arrangements to obtain the three VA examination reports from May 2011 referenced in the October 2011 rating decision. 3. Thereafter, schedule the Veteran for a VA examination(s) of his diabetic neuropathy of his upper extremities and hypertension. The claims file should be made available to and reviewed by the examiner. All indicated tests should be completed. The examiner should identify and describe the current severity and all manifestations attributable to the Veteran's service-connected peripheral neuropathy of the upper extremities. The specific nerve(s) affected should be specified, together with the degree of paralysis caused by service-connected disability. The examiner should also determine the current severity of the Veteran's hypertension. The examiner should record the Veteran's blood pressure readings. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. 4. Then, review the medical examination report(s) obtained to ensure that the remand directives have been accomplished, and return the case to the examiner(s) if all questions posed are not answered. 5. Finally, readjudicate the Veteran's claims for higher ratings for hypertension and diabetic neuropathy of the upper extremities. If the claims remain denied, provide the Veteran with a supplemental statement of the case and allow an appropriate time for response. 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. 2012). _________________________________________________ P.M. DILORENZO 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).