Citation Nr: 18152788 Decision Date: 11/27/18 Archive Date: 11/26/18 DOCKET NO. 16-64 006 DATE: November 27, 2018 ORDER Entitlement to an initial 30 percent rating, but no higher, for nephrolithiasis status post lithotripsy and nephrolithotomy is granted. FINDING OF FACT The Veteran’s nephrolithiasis manifests in recurrent stone formation that necessitates drug and diet therapy. CONCLUSION OF LAW For the entire appeal period, the criteria for a 30 percent rating, but no higher, for nephrolithiasis have been met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.115b, Diagnostic Code 7508. REASONS AND BASES FOR FINDING AND CONCLUSION Disability evaluations are assigned based on the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10. Ratings may be staged for periods in which the severity of the disability warrants different disability ratings. See Hart v. Mansfield, 21 Vet. App. 505, 509-510 (2007). The veteran will be given the benefit of the doubt as to any issue material to the determination of a matter when there is an approximate balance of positive and negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The Veteran’s nephrolithiasis has been assigned a noncompensable rating under 38 C.F.R. § 4.115b, Diagnostic Code (DC) 7508. Under DC 7508, nephrolithiasis is rated as hydronephrosis except when there are recurring stone formations that require one or more of the following: diet therapy, drug therapy, and/or invasive or non-invasive procedures more than 2 times a year; in which case a 30 percent evaluation will be assigned. The Veteran was afforded a VA examination in October 2014. The examiner noted the Veteran was diagnosed with nephrolithiasis but his September 2014 renal ultrasound was negative for kidney stones. It was noted the Veteran limits foods high in iron and takes Allopurinol and Urocit K for treatment of his recurrent kidney stones. In VA examination reports for the kidneys in August 2015, it was noted that the Veteran has had no problems or recurrent stones since his last examination in 2014. It was also noted that although his treatment plan includes taking continuous medication he is no longer taking his medication, and that invasive or non-invasive procedures occurred between 0 and 1 time per year. In his October 2016 Form 9, the Veteran contends that the August 2015 VA examiner was incorrect in stating that his treatment plan does not include taking continuous medication. The Veteran stated that he briefly stopped taking Allopurinol while he and his wife were trying to conceive a child as they experienced previous miscarriages when he was on the medication but has since continued its use. A December 2017 VA treatment record notes that the Veteran had multiple kidney stones and was taking Allopurinol and potassium citrate to prevent stone formation. See May 2018 CAPRI pg. 16. After reviewing the evidence, the Board finds that a 30 percent rating, the maximum available rating under 38 C.F.R. § 4.115b, DC 7508, is warranted for the entire period under review. While the August 2015 VA examination states that the Veteran stopped taking his medication, the Veteran contends his condition required constant drug therapy and only stopped taking the medication for a short period of time and then continued its use. VA treatment records support the Veteran’s contention as they show that the Veteran stopped his medication but then continued its use in 2017, after the birth of his child. Further, the October 2014 VA examination report shows the Veteran required drug therapy and diet therapy to treat his kidney stone and a December 2017 treatment record shows the formation of multiple kidney stones and the use of medication to prevent stone formation. As the Veteran requires the continuous drug therapy to treat kidney stone formation, and has recurrent stone formation, a 30 percent rating, but no higher, is warranted for the Veteran’s nephrolithiasis. As the Veteran’s kidney stones result in recurrent stone formation necessitating drug therapy, evaluation of the disability as hydronephrosis need not be considered. A rating higher than 30 percent is not available under the rating criteria for hydronephrosis in any event. 38 C.F.R. § 4.115b, DC 7508, DC 7509. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Brandt