Citation Nr: 20023529
Decision Date: 04/06/20	Archive Date: 04/06/20

DOCKET NO. 17-16 436
DATE: April 6, 2020

REMANDED

Entitlement to increased ratings for the service-connected Ehlers-Danlos syndrome, currently rating as 10 percent disabling based on right knee manifestations and 10 percent disabling on left knee manifestations.

REASONS FOR REMAND

The Veteran had active service in the United States Air Force from July 2008 to January 2009. 

This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio.

The Veteran testified during a February 2020 videoconference hearing before the undersigned Veterans Law Judge. A transcript is included in the electronic claims file.

1. Entitlement to increased ratings for the service-connected Ehlers-Danlos syndrome, currently rating as 10 percent disabling based on right knee manifestations and 10 percent disabling on left knee manifestations.

Although currently rated based on knee manifestations, the underlying syndrome is service-connected.  Further in this regard, the VA medical opinion relied upon in granting service connection generally provided that the syndrome was related to service.  The Veteran’s contentions is more generally that his Ehlers-Danlos syndrome is not properly rated.  

The Veteran’s symptoms have been diagnosed broadly as Ehlers-Danlos syndrome and were service-connected as Ehlers-Danlos syndrome of the left and right knees following a September 2012 VA examination. He contends that his Ehlers-Danlos syndrome affects all of his joints, not just his service-connected knees, and that his rating should encompass the entire disease process.  The Board again reiterates that it is the disease process that is service-connected.  The Board notes that the Veteran’s disabilities are currently service-connected under Diagnostic Code 5299-5260, but that it is permissible to switch diagnostic codes to reflect more accurately a claimant’s current symptoms. See Read v. Shinseki, 651 F. 3d 1296 (Fed. Cir. 2011).  Therefore, the RO is asked to consider all applicable diagnostic codes to determine which is/are the most appropriate for the Veteran’s disability. 

It does not appear from the record that the Veteran has been afforded a comprehensive VA examination that addressed all of the effects of his Ehlers-Danlos syndrome, including under other potentially applicable diagnostic codes, and addresses whether his Ehlers-Danlos syndrome is an active disease process. On this basis, remand is warranted.

The matters are REMANDED for the following action:

1. Update VA treatment records.

2. Thereafter, schedule the Veteran for an examination with an appropriately qualified clinician to determine the current severity of his Ehlers-Danlos syndrome, to include whether his Ehlers-Danlos syndrome is an active disease process and, if so, the residual limitation of motion/ankylosis of the affected joints in appellate status. 

The examiner should consider and discuss all pertinent medical evidence of record as well as all lay assertions regarding symptomatology.  The report should document all manifestations of the Ehlers-Danlos syndrome and the severity thereof.  

 

Nathaniel J. Doan

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	K. Thompson, Associate 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.