Citation Nr: 21068239 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 14-12 592 DATE: November 9, 2021 ORDER Entitlement to a disability rating greater than 10 percent for hypertension is denied. REMANDED Entitlement to a disability rating greater than 10 percent prior to June 7, 2014, and greater than 20 percent thereafter, for diabetic polyneuropathy of the right lower extremity is remanded. Entitlement to a disability rating greater than 10 percent prior to June 7, 2014, and greater than 20 percent thereafter, for diabetic polyneuropathy of the left lower extremity is remanded. FINDING OF FACT The record evidence shows that the Veteran's service-connected hypertension requires, at most, continuous medication for control. CONCLUSION OF LAW The criteria for a disability rating greater than 10 percent for hypertension have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.104, Diagnostic Code (DC) 7101 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from May 1970 to September 1974, including in combat in the Republic of Vietnam. This appeal comes before the Board of Veterans' Appeals (Board) on appeal from a February 2013 rating decision which denied, in pertinent part, the currently appealed claims. In a May 2015 rating decision, the Agency of Original Jurisdiction (AOJ) assigned higher 20 percent ratings effective June 7, 2014, for the Veteran's service-connected diabetic polyneuropathy of the right lower extremity and of the left lower extremity. In July 2021, the Board remanded the currently appealed claims to the AOJ for additional development. A review of the claims file shows that there has been substantial compliance with the Board's remand directives. The Board directed that the AOJ schedule the Veteran for an updated examination to determine the current nature and severity of his service-connected hypertension and promulgate a Supplemental Statement of the Case (SSOC) on all of the currently appealed claims. The requested examination occurred in July 2021. And the AOJ promulgated an SSOC on all of the currently appealed claims in August 2021. See Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141 (1999) (holding that another remand is not required under Stegall where the Board's remand instructions were substantially complied with), aff'd, Dyment v. Principi, 287 F.3d 1377 (2002). 1. Entitlement to a disability rating greater than 10 percent for hypertension The Board finds that the preponderance of the evidence is against granting the Veteran's claim of entitlement to a disability rating greater than 10 percent for hypertension. He essentially contends that this disability is more disabling than currently evaluated. The record evidence does not support his assertions. It shows instead that this disability requires, at most, continuous medication for control (i.e., a 10 percent rating under DC 7101). See 38 C.F.R. § 4.104, DC 7101 (2020). For example, the Veteran's voluminous post-service VA outpatient treatment records show ongoing complaints of and treatment for hypertension which was treated with medication. On VA hypertension Disability Benefits Questionnaire (DBQ) in July 2021, the Veteran reported taking his anti-hypertensive medications as prescribed and his blood pressure "remains elevated." The VA examiner reviewed the Veteran's electronic claims file, including service treatment records and post-service VA treatment records. His treatment plan included taking continuous medication for hypertension (Amlodipine Besylate 10 milligrams daily). He did not have a history of diastolic blood pressure elevation to predominantly 100 or more. His blood pressure was 152/98, 162/92, and 152/98. He had no other pertinent physical findings, complications, conditions, signs, or symptoms related to hypertension. The diagnosis was hypertension. Contrary to the Veteran's lay assertions, the record evidence shows that his service-connected hypertension requires, at most, continuous medication for control. The July 2021 VA hypertension DBQ specifically found that the treatment plan for the Veteran's hypertension included taking continuous medication for it. This supports the 10 percent rating currently assigned for the service-connected hypertension under DC 7101. Id. There is no indication that the Veteran's diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more as is required for a 20 percent rating for hypertension under DC 7101. Id. The July 2021 VA hypertension DBQ found no history of diastolic blood pressure elevation to predominantly 100 or more. He otherwise has not identified or submitted any evidence demonstrating his entitlement to a disability rating greater than 10 percent for his service-connected hypertension. In summary, the Board finds that the criteria for a disability rating greater than 10 percent for hypertension have not been met. REASONS FOR REMAND Entitlement to disability ratings greater than 10 percent prior to June 7, 2014, and greater than 20 percent thereafter, for diabetic polyneuropathy of the right lower extremity and for diabetic polyneuropathy of the left lower extremity is remanded. The Veteran also contends that his service-connected diabetic polyneuropathy of the right lower extremity and of the left lower extremity are more disabling than currently evaluated. The Board acknowledges that these claims were remanded in July 2021. Having reviewed the record evidence, and although the Board is reluctant to contribute to "the hamster-wheel reputation of Veterans law" by remanding these claims again, additional development is required before the underlying claims can be adjudicated on the merits. Cf. Coburn v. Nicholson, 19 Vet. App. 427, 434 (2006) (Lance, J., dissenting) (finding that repeated remands "perpetuate the hamster-wheel reputation of Veterans law"). A review of the record evidence shows that the Veteran's most recent VA examination for these disabilities occurred in April 2017, more than 4 years ago. The Court has held that when a Veteran alleges that his service-connected disability has worsened since he was examined previously, a new examination may be required to evaluate the current degree of impairment. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); but see Palczewski v. Nicholson, 21 Vet. App. 174, 182 (2007) (finding "mere passage of time" does not render old examination inadequate). Given the Veteran's contentions, and given the length of time which has elapsed since his most recent VA examination in April 2017, the Board finds that, on remand, he should be scheduled for an updated VA examination to determine the current nature and severity of his service-connected diabetic polyneuropathy of the right lower extremity and of the left lower extremity. The matters are REMANDED for the following action: Schedule the Veteran for updated examination to determine the current nature and severity of his service-connected diabetic polyneuropathy of the right lower extremity and service-connected diabetic polyneuropathy of the left lower extremity. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael T. Osborne, 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.