Citation Nr: 18149914
Decision Date: 11/14/18	Archive Date: 11/14/18

DOCKET NO. 15-00 037
DATE:	November 14, 2018
REMANDED
Entitlement to an increased rating for rheumatoid arthritis, currently rated 20 percent, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from September 1998 to September 2001.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 
Entitlement to an increased rating higher than 20 percent for rheumatoid arthritis is remanded.
While the Board regrets the delay, pursuant to the duty to assist, additional development is needed with respect to the Veteran's claim. When a claimant asserts that the severity of a disability has increased since the most recent rating examination, an additional examination is appropriate. Snuffer v. Gober, 10 Vet. App. 400 (1997).  During the Veteran’s November 2017 VA rheumatology follow-up treatment, the Veteran reported that he has progressively worsening bilateral hand deformity.  The Veteran’s VA rheumatology department records from February 2018 to March 2018 show that the Veteran has sought regular treatment for his arthritis, which may indicate that the Veteran’s disability is worsening.  In the September 2018 Informal Hearing Presentation brief, the Veteran’s Representative noted that it had been a decade since the Veteran’s last VA exam and requested a new examination to determine whether there have been changes in the severity of the Veteran’s arthritis.  
Accordingly, the case is REMANDED for the following action:
1. Schedule the Veteran for an appropriate VA examination to determine the extent, severity and manifestations of his service-connected rheumatoid arthritis. The claims file must be made available to the examiner for review in conjunction with the examination. All necessary testing must be completed. All clinical manifestations of the service-connected hypertension, and associated functional impairment, must be reported in detail. Associate a copy of the examination report with the claims file.
The examiner should provide a complete rationale for all opinions expressed. If the examiner cannot provide the requested information without resorting to speculation, then the examiner should provide an explanation and rationale for why such information could not be provided.
2. Thereafter, the AOJ should readjudicate the issue on appeal. If the benefit sought on appeal remains denied, the Veteran and his representative should be provided with a supplemental statement of the case and allowed an 
 
appropriate period for response. The case should then be returned to the Board for further consideration, if otherwise in order.
 
U. R. POWELL
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	S.E. Leary,  Associate Counsel