Citation Nr: 18145504 Decision Date: 10/29/18 Archive Date: 10/29/18 DOCKET NO. 15-00 342A DATE: October 29, 2018 REMANDED The issue of entitlement to service connection for left thumb disability is remanded. The issue of entitlement to service connection for residuals of cold injury to the hands and feet is remanded. The issue of entitlement to an initial rating higher than 50 percent for posttraumatic stress disorder (PTSD) is remanded. The issue of entitlement to an initial rating higher than 10 percent for chronic left ankle sprain is remanded. The issue of entitlement to an initial rating higher than 10 percent for chronic rhinosinusitis is remanded. The issue of entitlement to an initial compensable rating for dental disability is remanded. The issue of entitlement to a compensable rating for chronic urticaria is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1981 to November 1984. She also served on a period of active duty for training between April and August 1987. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of an August 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. In May 2018, the Veteran testified in a hearing convened at the RO before the undersigned Veterans Law Judge. A copy of the transcript of the hearing is included in the record and has been reviewed. 1. The issue of entitlement to service connection for left thumb disability is remanded. 2. The issue of entitlement to service connection for residuals of cold injury to the hands and feet is remanded. During the May 2018 Board hearing, the Veteran detailed her claim that she injured her left thumb during service. She also detailed the way in which she claims to have incurred residuals of cold injury during service. Based on her testimony, she should be provided VA compensation examination into her claims. 3. The issue of entitlement to an initial rating higher than 50 percent for posttraumatic stress disorder (PTSD) is remanded. 4. The issue of entitlement to an initial rating higher than 10 percent for chronic left ankle sprain is remanded. 5. The issue of entitlement to an initial rating higher than 10 percent for chronic rhinosinusitis is remanded. 6. The issue of entitlement to an initial compensable rating for dental disability is remanded. 7. The issue of entitlement to a compensable rating for chronic urticaria is remanded. During the Board hearing, the Veteran also indicated that her service-connected disabilities have worsened since the most recent VA examinations in 2012. She should be provided new examinations of these disabilities. See Green v. Derwinski, 1 Vet. App. 121 (1991). The matters are REMANDED for the following action: 1. Undertake appropriate development to obtain any outstanding records pertinent to the Veteran’s claims to the extent possible. Include in the record any outstanding VA treatment records, the most recent of which are dated in February 2018. All records/responses received must be associated with the electronic claims file. 2. Schedule the Veteran for a VA compensation examination to determine the nature and etiology of any left thumb disorder found on examination. The examiner should review the claims folder, and then respond to the following questions. (a). Does the Veteran have a left thumb disorder? (b). If so, is it at least as likely as not (i.e., probability of 50 percent or greater) that left thumb disability is related to a disease, event, or injury during service? In answering this question, review and consider the service treatment records (STRs), to include the November 1984 separation reports of medical examination and history, and the lay assertions to include testimony before the Board in May 2018. Please support any opinion provided with a full explanation. 3. Schedule the Veteran for a VA compensation examination to determine the nature and etiology of any residuals of cold injury. The examiner should review the claims folder, and then respond to the following questions. (a). Does the Veteran have residuals of cold injury to the hands and feet? (b). If so, is it at least as likely as not (i.e., probability of 50 percent or greater) that residuals of cold injury to the hands and feet are related to a disease, event, or injury during service? In answering this question, review and consider the STRs, to include the November 1984 separation reports of medical examination and history, and the lay assertions to include testimony before the Board in May 2018. Please support any opinion provided with a full explanation. 4. Schedule the Veteran for a VA compensation examination to determine the nature and severity of PTSD. The examiner should also review the claims folder. In a report detailing the nature and severity of PTSD, the examiner should comment on the following: (a). Does PTSD cause deficiencies in most areas of the Veteran’s life, or does the disorder cause total occupational and social impairment? See 38 C.F.R. § 4.130, Diagnostic Code 9411 (2018). (b). Can symptoms associated with other psychiatric disabilities (e.g., anxiety disorder) be differentiated from PTSD? Please support any opinion provided with a full explanation. 5. Schedule the Veteran for a VA compensation examination to determine the nature and severity of left ankle disability. The examiner should also review the claims folder. In a report, the examiner should comment on the following: (a). Does left ankle disability involve ankylosis? (b). Is limited motion in the left ankle “marked.” See 38 C.F.R. § 4.71a, Diagnostic Code 5270-71 (2018). Please support any opinion provided with a full explanation. 6. Schedule the Veteran for a VA compensation examination to determine the nature and severity of rhinosinusitis. The examiner should also review the claims folder. In a report, the examiner should comment on the following: (a). Does rhinosinusitis cause incapacitating episodes which require prolonged (four to six weeks) use of antibiotic treatment (if so, how many per year)? (b). Does rhinosinusitis cause non-incapacitating episodes characterized by headaches, pain, and purulent discharge or crusting (if so, how many per year)? (c). Does rhinosinusitis involve polyps? See 38 C.F.R. § 4.97, Diagnostic Code 6510, 6522 (2018). Please support any opinion provided with a full explanation. 7. Schedule the Veteran for a VA compensation examination to determine the nature and severity of dental disability. The examiner should also review the claims folder. In a report, the examiner should detail any impairment to the mandible, maxilla, or ramus as the result of service-connected dental disability. See 38 C.F.R. § 4.150 (2018). Please support any opinion provided with a full explanation. 8. Schedule the Veteran for a VA compensation examination to determine the nature and severity of urticaria. The examiner should also review the claims folder. In a report, the examiner should comment on the areas of the body affected by this disorder, the percentage of the skin affected, and the medication used to treat the disorder. See 38 C.F.R. § 4.118, Diagnostic Code 7806 (2018). (Continued on the next page)   Please support any opinion provided with a full explanation. G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Christopher McEntee, Counsel