Citation Nr: 1324130 Decision Date: 07/29/13 Archive Date: 08/07/13 DOCKET NO. 12-20 835A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to a compensable evaluation for residuals of filariasis, claimed as bilateral leg and groin disabilities. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD S. Mishalanie, Counsel INTRODUCTION The Veteran served on active duty from October 1940 to April 1947. This matter initially came before the Board of Veterans' Appeals (Board) on appeal from a rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In March 2013, the Board remanded the claim for additional development. The Board notes that, in addition to the paper claims file, there is a Virtual VA electronic claims file associated with the Veteran's claim. The Virtual VA file has been reviewed in conjunction with the disposition of the issue on appeal. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). 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 Unfortunately, the Board's review of the claims file reveals that further RO action is warranted, even though such action will, regrettably, further delay an appellate decision on the claim. A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In March 2013, the Board remanded the claim to afford the Veteran a VA examination to clarify whether he has any current residuals of filariasis. As noted in the remand, VA examinations conducted in July and December 2010 indicated that the Veteran had swelling in his legs, but it was unclear if this was a residual of filariasis or his history of chronic venous insufficiency, a nonservice-connected condition. The VA examiner was directed to identify all residuals of filariasis and specifically state whether the leg edema noted during the July and December 2010 VA examinations was a residual of filariasis. A VA knee and lower leg examination was conducted in May 2013. The examiner indicated that the examination was normal and there was no objective evidence of venous insufficiency found. The examination focused mostly on the knee joints and there were no specific findings as to whether the Veteran had edema of the legs. As the Veteran's representative pointed out his July 2013 brief, a lymphatic examination may have been more appropriate. Furthermore, the examiner did not address previous findings of edema and did not provide an opinion as to whether the leg edema noted during the July and December 2010 VA examinations was a residual of filariasis. For these reasons, the examination was inadequate. The Board emphasizes that even if the Veteran's most recent examination is normal and no residuals are found, he may be entitled to a staged rating if it is determined that the previously noted edema is a residual of filariasis. See Hart v. Mansfield, 21 Vet. App. 505, 511 (2007); see also, McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Accordingly, the case is REMANDED for the following actions: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested.) 1. The Veteran must be afforded appropriate VA examinations to determine the nature and extent of the residuals of filariasis, if any. This should include a lymphatic examination, but may also require vascular and genitourinary examinations if the examiner determines they are necessary. The claims folder is to be made available to the examiner to review. The examiner should identify all residuals of filariasis and specifically state whether the leg edema noted during the July and December 2010 VA examinations is a residual of filariasis. Even if no current residuals are found and the Veteran does not have leg edema, the examiner must render an opinion as to whether past findings of edema were a residual of filariasis. In rendering this opinion, the examiner should consider and discuss the Veteran's diagnosis of chronic venous insufficiency. The discussion should include whether this insufficiency is a manifestation or the result of or related to the service connected disorder at issue. A complete rationale for any opinion offered must be provided. 2. After the development requested has been completed, the RO must review the examination report to ensure that it is in complete compliance with the directives of this REMAND. If any report is deficient in any manner, the RO must implement corrective procedures at once. 3. After completion of the above and any additional development deemed necessary, the issue on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished an appropriate supplemental statement of the case and be afforded the opportunity to respond. 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). _________________________________________________ MICHAEL D. LYON 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).