Citation Nr: 19166385 Decision Date: 08/27/19 Archive Date: 08/27/19 DOCKET NO. 17-51 112 DATE: August 27, 2019 REMANDED Whether the reduction from 100 percent to 10 percent for the evaluation of status post hypothyroidism with radioactive treatment for hyperthyroidism effective September 1, 2016 was correct is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1996 to July 2001, and July 2005 to May 2007. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2016 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO), which reduced the Veteran’s rating for status post hypothyroidism with radioactive iodine treatment for hyperthyroidism from 100 percent to 10 percent, effective September 1, 2016. The Veteran is currently rated under 38 C.F.R. § 4.119, Diagnostic Code 7900 for hyperthyroidism. He underwent VA examinations in October 2015 and March 2017, which noted a current diagnosis of hypothyroidism, which was an update to his prior diagnosis. The RO issued a statement of the case (SOC) in August 2017. However, after the RO issued the August 2017 SOC, the rating criteria for the endocrine system, to include hyper- and hypothyroidism was updated and became effective on December 10, 2017. Under DC 7903 of the new rating criteria, hypothyroidism manifesting as myxedema (cold intolerance, muscular weakness, cardiovascular involvement (including, but not limited to hypotension, bradycardia, and pericardial effusion), and mental disturbance (including, but not limited to dementia, slowing of thought and depression)) warrants a 100 percent rating. Note (1) states that this evaluation shall continue for six months beyond the date that an examining physician has determined crisis stabilization. Thereafter, the residual effects of hypothyroidism shall be rated under the appropriate diagnostic code(s) within the appropriate body system(s) (e.g., eye, digestive, and mental disorders). In addition, hypothyroidism without myxedema warrants a 30 percent rating. Note (2) states that this evaluation shall continue for six months after initial diagnosis. Thereafter, to RO will rate residuals of disease or medical treatment under the most appropriate diagnostic code(s) under the appropriate body system (e.g., eye, digestive, mental disorders). Note (3) states that if eye involvement, such as exophthalmos, corneal ulcer, blurred vision, or diplopia, is also present due to thyroid disease, also separately evaluate under the appropriate diagnostic code(s) in § 4.79, Schedule of Ratings—Eye (such as diplopia (DC 6090) or impairment of central visual acuity (DCs 6061-6066)). Given that the new rating criteria that came into effect after the Veteran’s last VA examination in March 2017 and the August 2017 SOC, the Board finds that a remand is required to evaluate the severity of the Veteran’s hypothyroidism based on the new rating criteria for the endocrine system. See Barr v. Nicholson, 21 Vet. App. 30 (2007) (holding that once VA undertakes the effort to provide an examination or obtain medical opinion, it must ensure that one is provided or obtained that is adequate for the determination being made). In addition, the RO should obtain updated records from the General Leonard Wood Army Community Hospital, Uniformed Service Hospital in Missouri where the Veteran is being treated for his hypothyroidism on an outpatient basis. The matters are REMANDED for the following action: 1. Obtain from the General Leonard Wood Army Community Hospital (and any associated facility(ies)) all outstanding, pertinent records of evaluation and/or treatment of the Veteran, particularly any treatment for his hypothyroidism. 2. Schedule the Veteran for a VA examination to obtain a detailed assessment of the current severity of the Veteran’s hypothyroidism. The claims file must be made available to and reviewed by the examiner. All tests deemed necessary should be conducted and the results reported in detail. The examination should be conducted in accordance with the current disability benefits questionnaire and in accordance with the rating criteria for the endocrine system in effect since December 10, 2017. Kalisse Anderson Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Leifert, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.