Citation Nr: 21069050 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 18-50 294 DATE: November 17, 2021 REMANDED Entitlement to a disability rating in excess of 40 percent for varicose veins of the right lower extremity is remanded. Entitlement to a disability rating in excess of 40 percent for varicose veins of the left lower extremity is remanded. Entitlement to a disability rating in excess of 10 percent for residuals of right ulnar nerve transposition with scar is remanded. Entitlement to a disability rating in excess of 10 percent for residuals of left ulnar nerve transposition with scar is remanded. Entitlement to a disability rating in excess of 10 percent for psoriasis with pustular component and folliculitis is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1979 to December 1999. This appeal is before the Board of Veterans' Appeals (Board) from a September 2014 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO) and in June 2021, the Veteran appeared and provided testimony before the undersigned Veterans Law Judge (VLJ) and a transcript of that hearing is associated with the claims file. 1. Bilateral Lower Extremity Varicose Veins 2. Bilateral Upper Extremity Nerve Transposition 3. Psoriasis At the June 2021 Board hearing, the Veteran testified that since his last VA examinations in 2017 and 2019 (1) his service-connected disabilities have worsened, (2) he has received treatment at a private facility, St. Francis Hospital, for his service-connected varicose veins, and (3) he has received treatment at a local Tri-Care facility for his other claimed disabilities. The undersigned VLJ informed the Veteran that this evidence was not of record and the record was held open for ninety days so the Veteran could submit this evidence. Subsequently, the RO submitted an open-ended request for medical records from St. Francis Hospital and only received records from the year 2014. As such, considering the open-ended request and that the Board has not been informed outstanding records remain, the Board finds there are no longer any outstanding records from St. Francis Hospital. However, the Board has yet to receive any Tri-Care records. Specifically, the Veteran testified that he has received treatment at a local Tri-Care facility for his other claimed disabilities since 2019. As such, a remand is required to acquire these records. Additionally, while the Board acknowledges he stated that he does not receive treatment for his varicose veins at Tri-Care, the Board will also remand these claims as well since there could be records affecting the outcome of those increased ratings claims. Accordingly, since Tri-Care records would be in the VA's constructive possession, a remand is necessary to retrieve these records to evaluate the severity of his disabilities during the applicable time period. See Bell v. Derwinski, 2 Vet. App. 611, 613 (1992) (VA medical records are in constructive possession of the agency and must be obtained if the material could be determinative of the claim). Lastly, the Veteran alleged his service-connected disabilities have worsened since his 2017 and 2019 VA examinations and provided lay testimony of his worsening conditions. In cases where the record does not adequately reflect the current state of a veteran's disability, fulfillment of the statutory duty to assist requires a contemporaneous medical examination, particularly if there is no additional evidence that adequately addresses the level of impairment of the disability since the last examination. Allday v. Brown, 7 Vet. App. 517, 526 (1995); Schafrath v. Derwinski, 1 Vet. App. 589 (1991); 38 C.F.R. § 3.327(a). As such, a remand is also required to afford the Veteran VA examinations to determine the current severity of his service-connected disabilities. These matters are remanded for the following actions: 1. Ask the Veteran to identify the outstanding Tri-Care records, obtain such records, and associate them with the claims file. 2. After the above is completed, schedule the Veteran for VA examinations with the appropriate VA examiners to determine the nature and severity of the increased ratings claims on appeal, specifically: (a.) Bilateral varicose veins. (b.) Bilateral upper extremity residuals of ulnar nerve transposition. (c.) Psoriasis with pustular component and folliculitis. 3. After completing the above, take any additional development deemed necessary, and readjudicate the Veteran's claims. [SIGNATURE ON NEXT PAGE] JONATHAN B. KRAMER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Law Clerk, Tyler R. Masters 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.