Citation Nr: 18151708
Decision Date: 11/20/18	Archive Date: 11/19/18

DOCKET NO. 11-29 880
DATE:	November 20, 2018
REMANDED
Entitlement to a rating for fibromyalgia higher than 20 percent prior to March 18, 2016 and higher than 40 percent beginning on this date is remanded.
(The appeals for higher ratings for bilateral lower extremity peripheral vascular disease and a left hip disability will be addressed in a separate decision.)
REASONS FOR REMAND
The Veteran served on active duty from July 1979 to May 2000.
This appeal to the Board of Veterans’ Appeals (Board) is from a September 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
This claim was remanded in July 2015 for further development.
1. Entitlement to ratings for fibromyalgia higher than 20 percent prior to March 18, 2016 and higher than 40 percent beginning on this date is remanded.
An examination is needed to obtain a clearer past and present picture of the severity of the disability.
The March 2016 VA examiner did not adequately address the symptoms associated with the Veteran’s fibromyalgia.  The clinician noted the findings, signs, and symptoms associated with fibromyalgia but did not discuss them all, as requested in the report.  It would also be helpful if the examiner provided retrospective opinions as to the severity of the Veteran’s fibromyalgia during the appeal, particularly since the February 2012 VA examiner did not have all pertinent records available to review.  
The March 2016 VA examination report also notes that the Veteran is treated at Carolina and Rheumatology & Neurology for this disability, so these records should be obtained.
The matter is REMANDED for the following action:
1. Ask the Veteran to complete a VA Form 21-4142 for Carolina Rheumatology & Neurology.  Make two requests for the authorized records from this facility, unless it is clear after the first request that a second request would be futile.
2. Obtain and associate with the claims file ongoing VA treatment records since October 2017.
3. After all the above development is completed, schedule the Veteran for a VA examination to determine the severity of his fibromyalgia.  The claims file must be made available to and reviewed by the clinician.  
a)	Elicit a history from the Veteran concerning his fibromyalgia and complete any necessary tests or studies to determine the severity of the disability.
b)	Report all complaints, symptoms, and clinical findings in detail, to include providing complete explanations of responses where indicated.
c)	Based on the examination and a review of all available records, indicate and discuss whether there has been any change in the severity or symptomatology of the Veteran’s fibromyalgia as follows:
•	since his last VA examination in March 2016,
•	between his VA examination in February 2012 and March 2016, and
•	from June 2010 to February 2012 and compared with the findings of the February 2012 VA examination. 
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d)	An explanation of all opinions and conclusions should be provided.  If the examiner is not able to answer any of the above without resort to speculation, he/she should explain why.
 
S. HENEKS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Bredehorst