Citation Nr: 18152766 Decision Date: 11/27/18 Archive Date: 11/26/18 DOCKET NO. 16-07 229 DATE: November 27, 2018 REMANDED Entitlement to a rating in excess of 10 percent for right lower varicose veins is remanded. Entitlement to a rating in excess of 10 percent for right lower varicose veins is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served in the United States Army from August 1996 to August 2000. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina, which granted the Veteran’s claim for pain disorder and denied the Veteran’s claims for an increased rating for his bilateral lower extremity varicose vein disability, bilateral orchialgia, scars of the abdominal quadrant and left lower extremity, and declined to reopen the Veteran’s claim for service connection for a neck injury and for a hiatal hernia. On the Veteran’s January 2016 VA Form 9, he limited his appeal to the issues reflected above. The Veteran previously testified before a Decision Review Officer in June 2015 and a transcript of that hearing is associated with the record. The Veteran thereafter requested a videoconference hearing on his January 2016 VA Form 9, however, the Veteran did not appear for his scheduled hearing and did not provide good cause for his failure to appear and therefore, the request is deemed withdrawn. While the Board sincerely regrets further delay, additional development is required before the Veteran’s claims may be adjudicated on the merits. 1. Entitlement to a rating in excess of 10 percent for right lower varicose veins is remanded. 2. Entitlement to a rating in excess of 10 percent for right lower varicose veins is remanded. The Veteran was most recently provided with a VA examination in connection with his claim in March 2013. The Board finds that since the most recent VA examination, the evidence of record indicates that the Veteran’s bilateral lower varicose vein disability has increased in severity. Specifically, the Board notes that private treatment records dated December 2014 indicate that the Veteran’s varicose vein symptoms have gotten “worse over the past year.” The private treatment records further note that the Veteran’s symptoms include pain, swelling, and edema of the lower varicose veins that are “interfering with activities of daily living despise three months of daily conservative therapy.” See, post-service treatment records dated December 2014. Based on the most recent medical evidence of record regarding the worsening of the Veteran’s bilateral lower varicose vein disability, VA is required to afford the Veteran with a contemporaneous VA examination to assess the current nature, extent, and severity of his service-connected bilateral lower varicose vein disability as the Veteran’s most recent VA examination may no longer reflect an accurate picture of the Veteran’s disability. Snuffer v. Gober, 10 Vet. App. 400 (1997). 3. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. Finally, with respect to the Veteran’s claim for entitlement to a TDIU, the Board notes that this claim is also inextricably intertwined with his increased rating claims that remain appeal. Accordingly, the Board will therefore defer any action with respect to this claim until the completion of the development noted above. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Obtain any outstanding VA and private treatment records and associate them with the Veteran’s claims file. 2. Following the receipt of any outstanding records, schedule the Veteran for a VA examination with the appropriate medical personnel in order to determine the current severity of his bilateral lower varicose vein disability. The Veteran’s entire claims file, to include a copy of this remand, should be provided to the examiner. Following a complete review of the record, the examiner is asked to provide the following opinion: Determine the current level of severity of the Veteran’s varicose vein disability for each of the lower extremities. All opinions provided must be supported by a complete rationale. If the examiner must resort to speculation for any of the requested opinions, an explanation as to why this is so is required. 3. Send the Veteran a new VA Form 21-8940 Veteran’s Application for Increased Compensation Based on Unemployability to substantiate the claim of TDIU. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Daugherty, Associate Counsel