Citation Nr: 18143547
Decision Date: 10/19/18	Archive Date: 10/19/18

DOCKET NO. 16-35 841
DATE:	October 19, 2018
REMANDED
Entitlement to a rating in excess of 20 percent for hemochromatosis is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the Air Force from June 1985 until his retirement in June 2005.
The Veteran contends that he is entitled to a 100 percent rating for service-connected hemochromatosis.  See May 2015 Notice of Disagreement and May 2016 Informal Conference Report.  The Veteran underwent a VA examination in September 2014 and the examiner stated that the Veteran had incapacitating episodes (defined by a period of acute symptoms severe enough to require bed rest and treatment by a physician) for 6 weeks or more during the past year.  However, review of the claims file revealed no evidence of physician-ordered bed rest or treatment for hemochromatosis, and it is unclear whether the 2014 examiner reviewed the claims file in conjunction with the examination as is required.  See Green v. Derwinski, 1 Vet. App. 121 (1991).  After outstanding treatment records are associated with the claims file, a new VA examination should be scheduled to clarify the severity of the service-connected liver disability.
Moreover, the Veteran maintains that, in addition to fatigue, his service-connected liver disability causes joint pain.  See May 2016 Informal Conference report.  On remand, the examiner should state whether the Veteran’s complaints of joint pain are related to his service-connected liver disability.
The matter is REMANDED for the following actions:
1.  Obtain all outstanding, relevant VA and private treatment records.  If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file.  Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile.  The non-existence or unavailability of such records must be verified and this should be documented for the record.  Required notice must be provided to the Veteran.
2.  Thereafter, schedule the Veteran for a VA examination by an appropriate clinician to determine the current severity of his service-connected hemochromatosis.  The claims file must be made available to and be reviewed by the examiner.  All tests deemed necessary should be conducted and the results reported in detail. 
The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria.  If it is determined that the Veteran experiences incapacitating episodes as a result of his service-connected hemochromatosis, it should be indicated whether these are physician-prescribed.  The examiner should also provide an opinion as to whether the Veteran’s complaints of joint pain are a symptom of service-connected hemochromatosis.
To the extent possible, the examiner should identify the functional impairment due to hemochromatosis alone. 
All opinions must be accompanied by an explanation.  If the examiner opines that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided.
 
A. ISHIZAWAR
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K.R.Fletcher, Counsel