Citation Nr: 20073976 Decision Date: 11/18/20 Archive Date: 11/18/20 DOCKET NO. 19-17 357 DATE: November 18, 2020 ORDER New and material evidence has been received to reopen the claim for service connection for left leg varicose veins; to this extent, the appeal is granted. REMANDED Entitlement to service connection for sinus congestion is remanded. Entitlement to service connection for residuals of right shoulder pain is remanded. Entitlement to service connection for a left shoulder disorder is remanded. Entitlement to service connection for generalized neuralgia, also claimed as muscle/joint pain/flu-like symptoms, is remanded. Entitlement to service connection for bleeding gums is remanded. Entitlement to service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD), is remanded. Entitlement to service connection for pseudofolliculitis barbae is remanded. Entitlement to service connection for residuals of a left ankle disorder is remanded. Entitlement to service connection for allergic rhinitis is remanded. Entitlement to service connection for left leg varicose veins is remanded. Entitlement to a compensable rating for left varicocele disability is remanded. FINDING OF FACT A November 2007 final unappealed rating decision denied service connection for left leg varicose veins; evidence received since that decision relates to unestablished facts necessary to substantiate the claim. CONCLUSION OF LAW New and material evidence has been received, and the claim of entitlement to service connection for left leg varicose vein is reopened. 38 U.S.C. §§ 5108, 7105(c); 38 C.F.R. § 3.156. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service from May 1991 to August 1998, and from January 2003 to May 2003. These matters are before the Board of Veterans’ Appeal (Board) from an August 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office. On a June 2019 VA Form 9, the Veteran requested a Board hearing. In a March 2020 letter, the Veteran withdrew his request for a Board hearing. New and Material Evidence Since the November 2007 rating decision became final for the claim of service connection for left leg varicose veins, additional evidence has been associated with the Veteran's claims file. The evidence includes the Veteran’s July 2015 statement that his varicose veins started in 1992 and became more prominent when he separated from active duty. He also submitted photographs showing varicose veins of his left leg. Statements by the Veteran’s father and his sister attesting that they began noticing the Veteran’s varicose veins around 1993 have also been associated with the record. In addition, a June 2020 independent medical nexus opinion addendum by C.N.B., M.D. that addresses the possible cause of the Veteran’s varicose veins has been associated with the claims file since the last final November 2007 rating decision. The evidence is presumed to be credible. This evidence is "new and material" in that it was not before agency decision makers at the time of the November 2007 rating decision that denied service connection for left leg varicose veins on the basis that there was no evidence that left leg varicose veins either occurred in or were caused by service. It is not cumulative of evidence previously of record and addresses the question of whether there is a currently diagnosed disability that relates to unestablished facts necessary to substantiate the claim. This evidence raises a reasonable possibility of substantiating the claim. See Shade v. Shinseki, 24 Vet. App. 110, 117 (2010). Accordingly, the criteria for reopening the service connection claim for left leg varicose veins are met, and to this extent only the appeal is granted. See 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a). The underlying service connection claim will be addressed de novo on remand. REASONS FOR REMAND Additional relevant lay and medical evidence has been added to the Veteran’s record since the issuance of the statement of the case (SOC) in May 2019. The additional evidence has not been reviewed by the RO. In correspondence dated in June 2020, the Veteran’s attorney stated that the Veteran does not waive his rights to RO review. In light of the newly received evidence, specifically including the lay contentions contained therein and the June 2020 opinion of Dr. C.N.B., the Board finds that additional VA examinations are warranted in this case, as the existing examination reports of record do not adequately address the issues on appeal. 38 C.F.R. § 3.159(c)(4). The matters are REMANDED for the following action: 1. Afford the Veteran a VA medical examination (or multiple examinations, if deemed necessary) addressing his service-connected left varicocele and his claimed allergic rhinitis, bleeding gums, sinus congestion, left ankle disorder, generalized neuralgia, residuals of right shoulder pain, pseudofolliculitis barbae, left shoulder disorder, and varicose veins of the left leg. The entire claims file, specifically the lay and medical evidence received in June 2020, must be reviewed by the examiner. The examiner must address all current symptoms and severity of the service-connected varicocele. With regard to the claimed allergic rhinitis, bleeding gums, sinus congestion, left ankle disorder, generalized neuralgia, residuals of right shoulder pain, pseudofolliculitis barbae, left shoulder disorder, and varicose veins of the left leg, the examiner should provide opinions as to whether it is at least as likely as not (a 50 percent or greater probability) that each such disorder is etiologically related to service. If any disorder is found to not be present, this must be explained. All opinions must be supported by a rationale. 2. The Veteran must be afforded a VA mental health examination, with a psychiatrist or psychologist, to address the claimed psychiatric disorder. The entire claims file must be reviewed by the examiner, with particular attention to the lay and medical evidence received in June 2020. If PTSD is diagnosed, the examiner must address all stressful in-service incidents upon which this diagnosis is predicated. For any other psychiatric disorder (or disorders) diagnosed, the examiner must provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that such disorder is etiologically related to service. All opinions must be supported by a rationale. 3. After reviewing the newly received evidence and conducting any additional development deemed necessary, readjudicate the 11 issues on appeal with consideration of all additional evidence submitted since the May 2019 SOC and/or additional evidence obtained. If any benefit sought remains denied, furnish the Veteran and his representative with an SSOC and afford the appropriate time to respond before returning the case to the Board. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Young, 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.