Citation Nr: 18159613
Decision Date: 12/19/18	Archive Date: 12/19/18

DOCKET NO. 10-43 036
DATE:	December 19, 2018
REMANDED
Entitlement to a rating in excess of 20 percent for lymphedema in the upper left extremity, to include on an extraschedular basis, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from July 1989 to November 2003.  This matter comes before the Board of Veterans’ Appeals (Board) from a September 2008 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas.
In July 2015, the Veteran testified before a Veterans Law Judge.  However, the Veterans Law Judge who conducted the July 2015 hearing is no longer employed by the Board.  The Veteran appeared before the undersigned at a hearing in July 2018.  A transcript of that hearing has been associated with the record.  
In November 2015, the Board remanded this case for additional development.  In December 2016, the Board granted a 20 percent rating for the entire appeal period.  
The Veteran appealed the December 2016 Board decision to the United States Court of Appeals for Veterans Claims.  In November 2017, the Court granted a Joint Motion for Remand filed by representatives for both parties, remanding the claim for an adequate statement of reasons and bases for denying an increased rating on both a schedular and extraschedular bases. 
In June 2018, the Veteran testified before the undersigned Veterans Law Judge.   A transcript of the hearing has been associated with the record.
The Veteran underwent a VA examination in January 2016.  Since that examination, private treatment records suggest an increased severity of the service-connected lymphedema in the upper left extremity.  Specifically, the Veteran’s representative submitted private treatment records showing new measurements of the Veteran’s arm circumference, which had increased since the January 2016 examination.  A remand is necessary to evaluate the current severity of lymphedema.  
The matter is REMANDED for the following action:
1. Obtain all pertinent VA and private medical records not yet associated with the appellate record, and associate them with the record.  This request should specifically include records from Baptist Health System Health Link and MD Anderson Center.
2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of her service-connected lymphedema of the left upper extremity.  The examiner must review the claims file and should note that review in the report.  All indicated tests and studies should be accomplished, and all clinical findings must be reported in detail.  The examiner must address the November 2017 treatment notes showing the Veteran’s arm circumference measurements.  The examiner should provide a full description of the disability and report all signs and symptoms, with particular attention to edema, stasis pigmentation, eczema, and ulceration.  Any discoloration, rashes, and cellulitis should be noted.  The examiner should identify any symptoms and functional impairments due to lymphedema in the left upper extremity alone and discuss the effect of the Veteran’s disability on any occupational functioning and activities of daily living. 
 
Harvey P. Roberts
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. Kass, Associate Counsel