Citation Nr: 19147886 Decision Date: 06/19/19 Archive Date: 06/19/19 DOCKET NO. 18-30 846 DATE: June 19, 2019 REMANDED The claim of entitlement to a rating in excess of 10 percent for restless leg syndrome, right lower extremity (RLE), is remanded. The claim of entitlement to a rating in excess of 10 percent for restless leg syndrome, left lower extremity (LLE), is remanded. The claim of entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. The claim of entitlement to a reinstatement of MRM as the Veteran’s dependent for an award of VA benefits is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1974 to July 1980, and from December 1982 to November 1996. His claims come before the Board of Veterans’ Appeals (Board) on appeal of a February 2017 Department of Veterans Affairs (VA) rating decision. Entitlement to a rating in excess of 10 percent for restless leg syndrome, RLE Entitlement to a rating in excess of 10 percent for restless leg syndrome, LLE The Agency of Original Jurisdiction (AOJ) has rated the restless leg syndrome in each of the Veteran’s lower extremities as 10 percent disabling, pursuant to 38 C.F.R. § 4.124a, Diagnostic Code (DC) 8520, based on mild incomplete paralysis of the sciatic nerve. The Veteran seeks ratings in excess of 10 percent for these disabilities. The Veteran has undergone VA examinations of his lower extremities, but the reports of these examinations are inadequate to decide these claims. Treatment records and VA examination reports, considered collectively, suggest that the Veteran’s restless leg syndrome is rated under an incorrect DC. According to treatment records, the Veteran’s sciatic nerve damage (indeed characterized by VA examiners as causing mild incomplete paralysis) is related to a spinal condition, not his restless leg syndrome. Even assuming this were not the case, the Veteran appears to be receiving compensation for the same residuals of the sciatic nerve damage, under both RLE and LLE diagnoses, violating the rule against pyramiding. See 38 C.F.R. § 4.14. Treatment records and VA examination reports confirm the Veteran experiences disabling symptoms of his restless leg syndrome in each of his lower extremities, but the symptoms noted are different than those caused by sciatic nerve damage, more similar to a convulsive tic or other neurological or sleeping condition. A medical professional must consider and discuss this matter before the Board can proceed further in rating the Veteran’s restless leg syndrome. Entitlement to a TDIU The Veteran is claiming entitlement to a TDIU as a component of his increased rating claims. The AOJ has not yet decided this claim in the first instance. Entitlement to a reinstatement of MRM as the Veteran’s dependent for an award of VA benefits In June 2018, the AOJ removed MRM as a dependent on his award of VA benefits. In August 2018, the Veteran filed a Notice Of Disagreement with the action. To date, the RO has not issued a statement of the case in response to the filing, action required under Manlincon v. West, 12 Vet. App. 238 (1999). These matters are REMANDED for the following action: 1. Transfer this case to a VA examiner for an opinion on the nature of the Veteran’s restless leg syndrome. The examiner should review the Veteran’s treatment records and VA examination reports in an effort to determine whether the Veteran’s restless leg syndrome is appropriately rated under DC 8520, governing sciatic nerve damage. Based on the review of the records, and considering each lower extremity separately, the examiner should list all symptoms of the Veteran’s restless leg syndrome. The examiner should discuss whether any of the symptoms listed mirror or are similar to those of a convulsive tic, and, if so, whether they are mild, moderate or severe. The examiner should also discuss whether the symptoms, considered collectively, are more appropriately rated under a neurological or sleeping condition unrelated to sciatic nerve damage. The examiner should specifically offer an opinion as to whether the incomplete paralysis of the Veteran’s sciatic nerve is caused by his restless leg syndrome, or a nonservice-connected spinal condition, as treatment records indicate. If the nerve damage is caused by the Veteran’s restless leg syndrome, not a spinal condition, the examiner should indicate whether the Veteran has different manifestations of the nerve damage in each lower extremity, and, if so, identify such manifestations. 2. Issue a statement of the case addressing the claim of entitlement to a reinstatement of MRM as the Veteran’s dependent for an award of VA benefits. 3. Readjudicate all claims properly prepared for appellate review. In so doing, consider whether the Veteran’s restless leg syndrome is more appropriately rated under DC 8103, which governs convulsive tics, or another DC other than 8520. Also consider the Veteran’s claim of entitlement to a TDIU, a component of his claims for increased ratings. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L.N., 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.