Citation Nr: 21064295 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 17-45 974 DATE: October 19, 2021 REMANDED Entitlement to an increased rating in excess of 30 percent for ischemic heart disease (IHD) is remanded. Entitlement to an increased rating in excess of 20 percent for diabetes mellitus, type II (DM) is remanded. Entitlement to a separate an increased rating in excess of 10 percent for residuals of a stroke, prior to July 3, 2014, is remanded. REASONS FOR REMAND The Veteran served on active service in the United States Marine Corps from May 1966 to April 1969. By way of procedural history, the Veteran's claims for IHD, DM, and residuals of a stroke comes from a rating decision issued in February 2014, which denied the Veteran's claim for increased rating for his IHD and DM, and granted service connection for stroke, to include residuals. The Veteran filed a timely Notice of Disagreement (NOD) and a statement of the case (SOC) was issued August 2017, denying all three claims. In August 2017, the Veteran filed a timely substantive appeal (VA Form 9), requesting a hearing and contesting the denial of all his previously open claims; this Board has interpreted this as a substantive appeal for also the claims noted herein. In July 2020, the Veteran provided testimony at a Board hearing before the undersigned Veteran Law Judge (VLJ). 1. Entitlement to an increased rating in excess of 30 percent for ischemic heart disease is remanded. 2. Entitlement to an increased rating in excess of 20 percent for diabetes mellitus, type II, is remanded. 3. Entitlement to an increased rating in excess of 10 percent for residuals of a stroke, from July 1, 2013, to July 3, 2014 is remanded. With regards to the Veteran's claims for increased rating, the Veteran was last afforded VA examinations in March 2018. Although VA examinations do not necessarily expire or go stale due to the mere passage of time, adequate examinations must sufficiently evaluate the Veteran's current disability picture. Barr v. Nicholson, 21 Vet. App. 303 (2007). However, claims of a worsening condition regarding the Veteran's claimed conditions have been set forth by the Veteran since those examinations. Specifically, during testimony before the undersigned, the Veteran explicitly expressed that his disabilities had become worse. When available evidence is too old for an adequate evaluation of the current condition, VA's duty to assist includes providing a more current examination. Weggenmann v. Brown, 5 Vet. App. 281 (1993). The Board finds that not only are the last examinations remote, but the examinations appear to no longer indicate the Veteran's current level of disability. Consequently, after all outstanding medical records are associated with the claims file, more contemporaneous examinations are needed to rate the Veteran's claims for increased ratings IHD, DM, and stroke. Allday v. Brown, 7 Vet. App. 517 (1995); Caffrey v. Brown, 6 Vet. App. 377 (1994); Snuffer v. Gober, 10 Vet. App. 400 (1997). The Board additionally points out that in addition to claims of worsening conditions by the Veteran during his hearing, he also notes that there remain outstanding private treatment records not associated with the claims file. As such, remand is also required for the VA to attempt to acquire this additional medical evidence noted by the Veteran. The matters are REMANDED for the following action: 1. Obtain all VA treatment medical records not already of record. 2. After obtaining appropriate authorization, obtain any private treatment records identified by the Veteran that are not already of record. 3. Schedule the Veteran for examination to determine the current nature and severity of his service-connected IHD. The claims file must be made available to and reviewed by the examiner. All necessary studies and tests must be performed, the results of which reported in full. The RO must ensure that the examination report includes all information and findings necessary to rate the disability. 4. Schedule the Veteran for examination to determine the current nature and severity of his service-connected DM. The claims file must be made available to and reviewed by the examiner. All necessary studies and tests must be performed, the results of which reported in full. The RO must ensure that the examination report includes all information and findings necessary to rate the disability. 5. Provide the Veteran's claims file to a VA medical examiner with the appropriate expertise with regards to strokes. The examiner is asked to make a retroactive opinion regarding the period prior to July 3, 2014, and opine upon any evidence regarding the existence of any diagnosable or quantifiable residuals of the Veteran's stroke, to include issue with speech, taste, smell, or sight. To this end, the examiner is explicitly as to state whether it is as likely as not (more than 50 percent) that these residuals disabilities existed prior to July 3, 2014, to include directly after the Veteran's stroke event. The examiner must explicitly note review of the relevant treatment and medical evidence of record for that time, and must show consideration of the Veteran's lay statements, to especially include those made by the Veteran during his hearing testimony regarding developing double vision and slowed speech. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ziheng Zhu, 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.