Citation Nr: 1328369 Decision Date: 09/05/13 Archive Date: 09/16/13 DOCKET NO. 09-07 263 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Jackson, Mississippi THE ISSUE Entitlement to a compensable disability rating for hemorrhoids. REPRESENTATION Appellant represented by: Kathy A. Lieberman, Attorney at Law WITNESS AT HEARINGS ON APPEAL The Veteran ATTORNEY FOR THE BOARD C. Fetty, Counsel INTRODUCTION The Veteran had active military service from February 1973 to February 1977, and from February 1982 to July 1982. This appeal comes before the Board of Veterans' Appeals (Board) from an April 2008 rating decision of the Department of Veterans Affairs (VA), Regional Office (RO) in Jackson, Mississippi. The case was most recently before the Board in February 2012 when the Board denied a compensable disability rating for hemorrhoids. At that time, the Board also remanded the issues of entitlement to an increased rating for left varicocele, currently evaluated as 10 percent disabling, and entitlement to a total rating based on individual unemployability due to service-connected disabilities (TDIU). Thereafter, the Veteran appealed the Board's February 2012 decision to the United States Court of Appeals for Veterans Claims (Court). In November 2012, the Veteran's representative and VA's General Counsel agreed to a Joint Motion for Partial Remand (JMR) of the Board's February 2012 decision as the denial of the hemorrhoids claim was not supported with an adequate statement of reasons and bases. The left varicocele and TDIU claims were to be left untouched as they were remanded by the Board and not before the Court. In a November 2012 Order, the Court granted the JMR and remanded the hemorrhoids claim to the Board for action consistent with the terms of the joint motion. The appeal is REMANDED to the RO. VA will notify the appellant if further action is required. REMAND The November 2012 JMR found that the Board failed to consider a potentially applicable diagnostic code and to adequately explain why an extraschedular rating pursuant to 38 C.F.R. § 3.321(b)(1) was not warranted. In order to adequately address these aspects, the Board finds that the claim must be remanded to afford the Veteran another VA examination. In July 2013, the Veteran's representative indicated that the Veteran's symptoms may have worsened since the most recent VA examination from May 2010. Thus, a new VA examination is warranted on remand. As noted in the introduction, the Board also remanded the issues of entitlement to an increased rating for left varicocele, currently evaluated as 10 percent disabling, and entitlement to a TDIU, in the February 2012 decision. It does not appear from the record that the additional development and consideration requested in the remand has been substantially completed. Therefore, the development set forth in the February 2012 remand should also be completed even though the issues are not currently listed on the title page. Accordingly, the case is REMANDED for the following actions: 1. Afford the Veteran a VA examination to determine the nature and severity of all hemorrhoid and related symptoms. The claims files and any pertinent evidence contained in Virtual VA that is not contained in the claims files should be made available to and reviewed by the examiner. The examiner should provide all information required for rating purposes for service-connected hemorrhoids, including whether the hemorrhoids: are external or internal; are small or large; result in persistent bleeding; result in secondary anemia; are with fissures; are thrombotic; are irreducible; have excessive redundant tissue; are frequently recurrent; are mild; are moderate. Additionally, the examiner must address whether any identified leakage is a result of the Veteran's hemorrhoids. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached. 2. Complete the development set forth in the Board's February 2012 remand for the issues of entitlement to an increased rating for left varicocele, currently evaluated as 10 percent disabling, and entitlement to a TDIU. 3. Undertake any other development determined to be warranted. 4. Consider whether a referral is warranted for an extraschedular rating pursuant to 38 C.F.R. § 3.321(b)(1). 5. Finally, re-adjudicate the issues on appeal. If any benefit sought is not granted, furnish the Veteran and his representative with a supplemental statement of the case and afford them an opportunity to respond before the record is returned to the Board for further review. The Veteran has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This case must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by the Court for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2013). _________________________________________________ RYAN T. KESSEL Acting Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board is appealable to the Court. 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) (2013).