Citation Nr: 1329300 Decision Date: 09/12/13 Archive Date: 09/20/13 DOCKET NO. 04-09 333 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUE Entitlement to an initial rating in excess of 10 percent for hallux valgus, left foot. (The issues of entitlement to service connection for right foot hallux valgus, to include as secondary to service- connected left foot hallux valgus, entitlement to service connection for a cervical spine disability, entitlement to vocational rehabilitation training benefits under the provisions of Chapter 31 of Title 38 of the United States Code, and entitlement to reimbursement of unauthorized medical expenses incurred at Methodist North Surgery Center on August 7, 2006 for service-connected left foot hallux valgus area are the subjects of separate decisions of the Board). REPRESENTATION Appellant represented by: Michael Viterna, Attorney WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD L. A. Rein, Counsel INTRODUCTION The Veteran had active service from April 1982 to November 1986. Thereafter, he served in the Naval Reserves until 1996. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a November 2003 decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. In March 2008, the Veteran testified during a hearing before the undersigned Veterans Law Judge at the RO; a transcript of that hearing is of record. In February 2009, the Board remanded this matter for additional development. The appeal is REMANDED to the Department of Veterans Affairs Regional Office. VA will notify the appellant if further action is required. REMAND In February 2009, the Board remanded this matter for a new VA examination to determine the current severity of the Veteran's service-connected left foot disability. In May 2010, the Veteran underwent a VA examination that addressed the current severity of his service-connected left foot disability. Subsequently, the Veteran was afforded additional VA examinations in July 2011 and August 2011; however, these examinations did not provide findings necessary to rate the Veteran's service-connected left foot disability under the appropriate rating criteria. Significantly, moreover, a December 2011 VA medical record shows that the Veteran underwent surgery on his left foot. Furthermore, in a June 2012 letter, the Veteran stated that he still has pain in his left foot due to the presence of a screw implanted during surgery. The foregoing statements and VA treatment records indicate a worsening of the service-connected left foot disability since the most recent May 2010 VA examination. Therefore, to ensure that the record has evidence of the current severity of the Veteran's service-connected left foot disability, a more contemporaneous examination is warranted. Green v. Derwinski, 1 Vet. App. 121 (1991); Caffrey v. Brown, 6 Vet. App. 377 (1994). Although VA medical records dated through December 27, 2011 have been associated with the claims file and those from December 28, 2011 to June 4, 2012 have been associated with the Virtual VA electronic claims file, VA medical records dated from June 4, 2012 to the present are not included. These treatment records must be associated with the claims file or Virtual VA. Bell v. Derwinski, 2 Vet. App. 611 (1992). Accordingly, the case is REMANDED for the following actions: 1. Obtain and associate copies of the Veteran's VA medical records dated from June 4, 2012 to the present, with the claims folder or Virtual VA. 2. After the above development has been completed, schedule the Veteran for a VA examination to determine the current nature and severity of his service- connected hallux valgus, left foot disability. The claims folder must be reviewed by the examiner, and the review should be noted in the report. The VA examiner should specifically address the following: (a) Set forth all current complaints, findings, and diagnoses pertaining to the Veteran's service-connected hallux valgus, left foot. (b) Conduct all necessary tests, to include X-rays, and range-of-motion and repetitive motion studies. All ranges of motion should be expressed in degrees. (c) Describe any functional limitation due to pain, weakened movement, excess fatigability, pain with use, or incoordination. Additional limitation of motion during flare-ups and following repetitive use due to limited motion, excess motion, fatigability, weakened motion, incoordination, or painful motion should be noted. If the Veteran describes flare-ups of pain, the examiner must offer an opinion as to whether there would be additional limits on functional ability during flare-ups. All losses of function due to problems such as pain should be equated to additional degrees of limitation of flexion and extension beyond that shown clinically. (d) Discuss whether any left foot disability is productive of any additional functional impairment. (e) State what impact, if any, the Veteran's service-connected left foot disability has on his occupational functioning and daily living. The examiner should provide a rationale for any opinion expressed and reconcile that opinion with all pertinent evidence of record, including all relevant VA medical records and any lay evidence suggesting that Veteran's service- connected hallux valgus, left foot problems are worse than shown on his prior examinations. 3. Then, readjudicate the claim. If the decision remains adverse to the Veteran, 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 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). _________________________________________________ F. JUDGE FLOWERS 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).