Citation Nr: 21004861 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 13-21 703A DATE: January 28, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for Lyme disease residuals is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Marine Corps from May 1987 to November 2008. The Veteran initially underwent a VA examination for his Lyme disease in February 2009. At that time, the examiner found that the Veteran’s Lyme disease residuals included arthralgias of the elbows and knees as well as insomnia due to the arthralgias. The Board remanded the claim in May 2015 in order to obtain new VA examinations to determine the current nature and severity of the Veteran’s Lyme disease and any residuals. That exam resulted in findings that Lyme disease was not active or affecting any joints. It did not reconcile these findings with the earlier reported findings. The Board, in a decision dated February 19, 2020, remanded this issue pending a VA examination. A VA examination was scheduled to determine the current level of disability; however, evidence expected from the examination, which might have been material to the outcome of this claim, could not be considered as the Veteran failed to report. The evidence of record as of the August 2020 Supplemental Statement of the Case (SSOC) showed no good cause for the failure to report. Thereafter, however, the Veteran submitted correspondence in September 2020 explaining that illness and apprehensions about possible exposure to COVID-19 as an immunocompromised individual prevented him from attending his C&P examination. He also requested that the exam be scheduled closer to his home. It is noted that outpatient records reveal that he has received some treatment at VA facilities closer to home, and there are possible community based options which may be available. The Board finds that, given the above, and affording the Veteran the benefit of the doubt, good cause has been shown to reschedule the VA examination. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination (or tele-health interview, review of the record, etc., if an in-person examination is not feasible) to ascertain the severity of his service-connected Lyme disease disability. If a facility closer to his home is feasible that should also be considered, to include a community based examination, as appropriate. The examiner should: a) Identify all residuals of the Veteran’s Lyme disease, to include joint pain of the bilateral elbows, knees, hips, right big toe, and insomnia. If the examiner finds that any of the foregoing conditions are not residuals of the Veteran’s Lyme disease, he/she should explain why. A complete rationale must be provided for all opinions expressed. The rationale must consider and discuss the pertinent evidence of record, to include the Veteran’s lay statements. b) For all identified residuals, including those related to the bilateral elbows, hips, knees, and right big toe, the examiner should provide a full description of the residual and report all signs and symptoms necessary for evaluating the residual under the rating criteria. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Omosegbon, Babalakin O. 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.