Citation Nr: 18153770
Decision Date: 11/28/18	Archive Date: 11/28/18

DOCKET NO. 14-44 506
DATE:	November 28, 2018


REMANDED
Entitlement to an initial compensable rating for a kidney condition is remanded.

REASONS FOR REMAND
The Veteran served on active duty from August 1979 to June 1981. This matter comes before the Board on appeal from an April 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).
Entitlement to a compensable rating for a kidney condition. 
The Veteran is diagnosed with reflux nephropathy per VA examination reports dated in March 2017 and March 2017. This condition is not directly included in the rating criteria and therefore, the Veteran’s condition is rated under Diagnostic Code (DC) 7504, Pyelonephritis. This DC instructs the adjudicator to rate as renal dysfunction or urinary tract infection, whichever is predominant.
At the March 2017 VA examination, the Veteran reported experiencing urinary frequency and becoming anxious as a result of the inability to make it to a bathroom in time. The Board finds that this statement requires further development to determine if the Veteran’s condition would be better articulated under a different DC that would consider voiding dysfunction under 38 C.F.R. § 4.115a. 
See 38 C.F.R. § 4.20 (noting that the schedular rating criteria provides for rating by analogy based on similar functions, anatomical location, and symptomatology).
Under the ratings of the genitourinary system—dysfunctions, voiding dysfunction is clarified by rating as urine leakage, frequency, or obstructed voiding. Urine frequency, as mentioned by the Veteran as a symptom of her condition, provides a 10 percent rating for daytime voiding interval between two and three hours, or; awakening to void two times per night. A 20 percent rating is granted for a daytime voiding interval between one and two hours, or; awakening to void three to four times per night. A 40 percent evaluation requires a daytime voiding interval of less than one hour, or; awakening to void five times or more per night. 
The current record contains no evaluation of the Veteran’s urinary frequency and therefore, the Board finds that an examination is needed to evaluate the lay statements of the Veteran regarding urinary frequency. 
The matter is REMANDED for the following actions:
1. Obtain any outstanding treatment records not yet associated with the claims file. 
2. After associating any records from step #1, schedule the Veteran for an in-person examination regarding his service-connected urinary frequency and a kidney condition with an appropriate VA examiner. Review of the claims file should be noted in the examiner’s report. The examiner is to explain the reasons for any opinion offered.  The examiner must consider lay reports from the Veteran along with pertinent medical evidence, including medical literature submitted by her.  If the examiner cannot offer an opinion without resort to speculation, he or she should explain why and state what additional evidence, if any, would be required to offer an opinion. 
The examiner is to identify and describe all current symptomatology related to the Veteran’s claimed urinary frequency, voiding dysfunction symptoms, and any other related, kidney-condition symptoms.
 
Paul Sorisio
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Watkins, Associate Counsel