Citation Nr: 18152152 Decision Date: 11/21/18 Archive Date: 11/21/18 DOCKET NO. 15-27 695 DATE: November 21, 2018 REMANDED ISSUES Entitlement to an initial rating in excess of 10 percent for left knee chondromalacia is remanded. Entitlement to an initial rating in excess of 10 percent for lumbar spine degenerative arthritis is remanded. Entitlement to an initial rating in excess of 10 percent for coronary artery disease (CAD) is remanded. Entitlement to an initial compensable rating for hypertension is remanded. Entitlement to an initial rating in excess of 10 percent for gastroesophageal reflux (GERD) with small sliding hiatal hernia is remanded. Entitlement to an initial compensable rating for a left ovarian cyst, status post left salpingectomy is remanded. Entitlement to an initial rating in excess of 10 percent for anxiety disorder NOS is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1991 to May 2011. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2011 rating decision by the Winston-Salem, North Carolina, Regional Office (RO) of the Department of Veterans Affairs (VA). 1. Entitlement to an initial rating in excess of 10 percent for left knee chondromalacia is remanded. 2. Entitlement to an initial rating in excess of 10 percent for lumbar spine degenerative arthritis is remanded. 3. Entitlement to an initial rating in excess of 10 percent for CAD is remanded. 4. Entitlement to an initial compensable rating for hypertension is remanded. 5. Entitlement to an initial rating in excess of 10 percent for GERD with small sliding hiatal hernia is remanded. 6. Entitlement to an initial compensable rating for a left ovarian cyst, status post left salpingectomy is remanded. 7. Entitlement to an initial rating in excess of 10 percent for anxiety disorder NOS is remanded. The Veteran seeks increased initial ratings for the above listed service-connected disabilities. Sh was last afforded a VA examination for these conditions in January 2011. In a November 2018 Brief, the Veteran, by way of his representative, asserts a worsening of his service-connected disabilities since initial examination. The most recent treatment medical evidence of record is dated in 2013. A Remand is thereby deemed necessary to obtain all outstanding treatment medical records as well as to conduct new VA examinations. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records since 2013. Contact the Veteran to determine whether there are any additional relevant private treatment records and obtain any necessary authorizations for such records. 2. Schedule the Veteran for a VA examination to determine the current nature and severity of her low back, and left knee disabilities. The claims file, including this remand, should be reviewed by the examiner and such review should be noted in the examination report. For all joint examinations: (a.) Complete range of motion testing should be accomplished and the examiner should note the point at which there is pain on motion, if any. Active and passive range of motion testing as well as weight-bearing and non-weight-bearing testing must be conducted if applicable. If possible, the examiner should indicate how far back (i.e., one year, two years, etc.) these results would apply. Further, if any test is not deemed warranted, such should be identified and explained. (b.) The examiner should also note any additional loss of function with repetition due to factors such as pain, weakness, fatigability, and pain on movement. The extent of additional limitation should be expressed in degrees. (c.) If flare-ups are reported, the examiner must express an opinion on whether the flare-ups are associated with additional functional loss. If so, he or she should estimate the degree of lost motion during such flare-ups. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. (d.) The examiner should determine whether there are any associated objective neurological abnormalities related to the Veteran’s low back disability, including radiculopathy or IVDS. 3. Schedule the Veteran for a VA examination to evaluate the current severity and manifestations of her coronary artery disease. The entire claims file should be made available to, and be reviewed by, the VA examiner. All appropriate tests, studies, and consultation, to include exercise stress test should be accomplished and all clinical findings and results of exercise stress test should be reported in detail. 4. Schedule the Veteran for a VA gynecological examination by an appropriate medical profession to address the current nature and severity of the Veteran’s service-connected left ovarian cyst, status post left salpingectomy. Schedule the Veteran for VA examination by an appropriate medical professional to address the nature and severity of the Veteran’s hypertension. Following a review of the claims file and medical history, the VA examiner must document the current blood pressure readings, the predominant diastolic and systolic pressures discernable from the treatment records, and indicate whether the Veteran’s hypertension requires continuous medication for control. 5. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected GERD with small sliding hiatal hernia. 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. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. 6. Schedule the Veteran for a VA examination to evaluate the current severity and manifestations of her psychiatric disorder. The entire claims file should be made available to, and be reviewed by, the VA psychologist or psychiatrist. All appropriate tests, studies, and consultation should be accomplished and all clinical findings should be reported in detail with a full description of the Veteran’s psychiatric disorder, including the level of social and occupational impairment attributable to the Veteran’s psychiatric disorder. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. L. Burroughs, Associate Counsel