Citation Nr: 18141512 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 16-18 603 DATE: October 10, 2018 REMANDED The claim of entitlement to service connection for a bladder disorder, claimed as a problem with urination, is remanded. The claim of entitlement to an initial compensable rating for residuals of a fracture of the right foot is remanded. The claim of entitlement to an initial compensable rating for residuals of fracture of the left foot is remanded. PRELIMINARY MATTERS In effect, the claims for increased compensable ratings for residuals of fracture of the right foot and the left foot have been on appeal since the claims of service connection were granted in a May 2011 rating decision. At that time, the 0 percent ratings for each foot were assigned. The claim for service connection for issues with urination has been on appeal since that claim was initially denied in a March 2013 rating decision. Hereinafter, that claim will be classified as one for service connection for a bladder disorder, claimed as a problem with urination. Those ratings decisions also addressed numerous other claims, and the Veteran filed a timey notice of disagreement (NOD) and provided testimony regarding all of the claims on appeal at the Regional Office (RO) before a Decision Review Officer (DRO) in June 2015. In addition to the claim of entitlement to service connection for a bladder disorder, claimed as a problem with urination, and the claims for initial compensable ratings for residuals of fractures of the right and left feet, a February 2016 statement of the case (SOC) addressed numerous increased ratings claims (to include the low back, the ankles, radiculopathy of the lower extremities, as well as a claim for entitlement to a total rating based on individual unemployability due to service-connected disabilities (TDIU)). A March 2016 DRO decision promulgated the decisions reached in the above mentioned SOC, to include an increased staged rating for the low back, an increased staged rating for a right ankle disorder, a finding of clear and unmistakable (CUE) error in the assignment of a 10 percent rating for a left ankle disorder, and the grant of a TDIU. The 0 percent ratings in effect for residuals of fracture of the right foot and the left foot were continued. Service connection for a bladder disorder, claimed as a problem with urination, was denied. In his substantive appeal from April 2016, the Veteran expressly limited the issues on appeal to his claim for service connection for a bladder disorder and for initial compensable ratings for residuals of fracture of the right foot and the left foot. Subsequently, in August 2016, the RO erroneously certified the Veteran’s claims for increased ratings (low back, right ankle, left ankle, radiculopathy of the lower extremities) and the claim for a TDIU. Review of the record reflects that the Veteran has not relied to his detriment on the inclusion of those issues on the form certifying the issues to the Board. The Board also find that VA has taken no other actions indicating that those issues remained on appeal beyond their inclusion of the certification form. As a result, the Board finds that the issues of entitlement to increased ratings for the low back, ankles, lower extremities, and for a TDIU, have not been timely appealed to the Board. Those issues will not be addressed any further. See Percy v. Shinseki, 23 Vet. App. 37 (2009). REASONS FOR REMAND The Veteran served on active duty for training from July 31, 2002, to November 15, 2002, and on active duty from July 14, 2006, to September 2, 2009. The claim of entitlement to service connection for a bladder disorder, claimed as a problem with urination, is remanded. The service treatment records (STRs) include at least one notation (in January 2009) that the Veteran rose from his sleep up to 3 times per night to urinate. While no bladder/urinary disorder was noted during service or upon post service examination in 2012, there are reports in the claims file showing that he has been prescribed medication to aid erratic urination. He continues to claim that he has a bladder disorder manifested by urinary problems. Additional examination will be obtained to address whether a bladder/urinary disorder is present, and, if so, whether such is related to service. The claims of entitlement to residuals of a fracture of the right foot and entitlement to residuals of a fracture of the left foot are remanded. In addition to residuals of fractures of the feet, the Veteran is also service-connected for bilateral ankle disorders and for bilateral pes planus. He complains, however, that he suffers from foot problems that are unique to his foot fractures. Additional exam regarding this claim will also be obtained. Updated medical records will also be requested. The matters are REMANDED for the following action: 1. Obtain any VA treatment notes not already of record and associate them with the claims file. Moreover, invite the Veteran to identify any additional medical providers who treated him for his bladder/urinary condition or for his foot disorders. After receiving this information and any necessary releases, contact the named medical providers and obtain copies of the related medical records which are not already in the claims folder. 2. Thereafter, the Agency of Original Jurisdiction (AOJ) should arrange to have the Veteran scheduled for a VA examination to determine the nature and cause of any bladder/urinary disability found to be present. The claims file should be made available to the examiner in conjunction with the examination. For any bladder/urinary disorder found to be present, the examiner is asked to opine whether it is at least as likely as not (defined as a 50 percent or greater probability) etiologically related to his active duty service, to include his documented need to urinate multiple times per night. To that end, the examiner is asked to comment upon the Veteran’s statements (reported, e.g., in an April 2016 statement), that he has an erratic need to void his bladder even with a small volume. The examiner must provide an explanation and rationale for all opinions. If the requested opinion cannot be provided without resort to speculation, the examiner should so state AND explain why an opinion cannot be provided without resort to speculation, to include whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond, given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training). 3. Then, schedule the Veteran an appropriate VA examination to evaluate the current severity of the service-connected residuals of fractures of the feet. The claims file must be made available to the examiner, and the examiner shall indicate in the report that the claims file was reviewed. All necessary tests are to be conducted, including X-rays. The examiner should fully set forth all current complaints, pertinent clinical findings, and diagnoses. A complete medical history should be elicited. The examiner should report all signs and symptoms necessary for evaluating the Veteran’s bilateral foot fracture residuals under the applicable rating criteria. The examiner’s discussion should take into account that the Veteran is already service-connected for bilateral ankle disorders and for bilateral pes planus. In particular, the examiner should state whether the manifestations of the Veteran’s right or left foot fracture residuals can be distinguished from those of the other ankle and flat feet conditions, and, if so, whether the residuals may be described as moderate, moderately severe, or severe. The presence of objective evidence of pain, excess fatigability, incoordination, and weakness should also be noted, as should any additional disability due to these factors. If the examiner is unable to distinguish between the symptoms associated with the service-connected residuals of fractures of the right and left feet with those of the other service-connected disorders of the ankles and flat feet, he or she should state so in the report. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Hal Smith