Citation Nr: 21075261 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 18-29 540 DATE: December 20, 2021 REMANDED Entitlement to an initial rating higher than 60 percent for nephropathy is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from February 1970 to November 1971. This matter comes before the Board of Veterans' Appeals (BVA or Board) from April 2014 and April 2015 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran requested a hearing before the Board. The requested hearing was conducted in September 2021 by the undersigned Veterans Law Judge. A transcript is associated with the claims file. 1. Entitlement to an initial rating higher than 60 percent for nephropathy. The Veteran seeks entitlement to an initial rating higher than 60 percent for his nephropathy. During the September 2021 Board hearing, the Veteran testified that he experiences fatigue, weakness, urinary frequency, and nosebleeds from exertion, as a result of his nephropathy. The Board notes the Veteran was last afforded a VA examination for his nephropathy in July 2018, more than three years ago. The Board finds that there is insufficient contemporaneous evidence of record to evaluate the Veteran's disability. Thus, an updated VA examination is needed to fully and fairly evaluate the Veteran's claim for an increased disability rating. See Allday v. Brown, 7 Vet. App. 517, 526 (1995) (where the record does not adequately reveal current state of claimant's disability, fulfillment of statutory duty to assist requires a contemporaneous medical examination). On remand, the Veteran should be afforded a VA examination to determine the current severity of his nephropathy. 2. Entitlement to a TDIU. The Veteran seeks entitlement to a TDIU. He asserts he is not able to work due to his service-connected disabilities. He is currently service connected for nephropathy, bilateral tinnitus, diabetes mellitus, type 2, ischemic heart disease, and bilateral hearing loss. The Veteran testified during the September 2021 Board hearing that he experiences burning and numbness in his feet and legs that affect his ability to walk, stand and sit. Although the Veteran is currently service connected for diabetes, he is not service connected for neuropathy. The Veteran also testified that he experiences various symptoms such as weakness, fatigue, difficulty walking and falling, that he attributes to his service-connected disabilities. Importantly, the Veteran has not been afforded VA examinations to determine the current severity of his disabilities in many years. For example, the most recent VA examinations for his bilateral hearing loss, tinnitus and ischemic heart disease were in December 2016, more than five years ago. His most recent VA examination for diabetes was in April 2014, more than seven years ago. Thus, updated VA examinations are needed to fully and fairly evaluate the Veteran's claim for a TDIU. See Allday v. Brown, 7 Vet. App. 517, 526 (1995) (where the record does not adequately reveal current state of claimant's disability, fulfillment of statutory duty to assist requires a contemporaneous medical examination). On remand, the Veteran should be afforded VA examinations to determine the current severity of his disabilities and to determine if he has neuropathy as secondary to his diabetes. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all updated treatment records. 2. Afford the Veteran a VA examination to determine the current severity of his nephropathy (kidney disability). All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The examiner should identify and completely describe all current symptomatology. The examiner should provide a detailed review of the Veteran's current complaints, as well as findings as to the nature, extent, and severity of symptoms caused by the Veteran's disability. The examiner should note the Veteran's complaints regarding the impact of his nephropathy on employment. The examiner should identify all limitations or functional impairment caused by his nephropathy. 3. Afford the Veteran a VA examination to determine the current severity of his bilateral hearing loss and tinnitus. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The examiner should identify and completely describe all current symptomatology. The examiner should provide a detailed review of the Veteran's current complaints, as well as findings as to the nature, extent, and severity of symptoms caused by the Veteran's disability. The examiner should note the Veteran's complaints regarding the impact of his bilateral hearing loss and tinnitus on employment. The examiner should identify all limitations or functional impairment caused by his bilateral hearing loss and tinnitus. 4. Afford the Veteran a VA examination to determine the current severity of his ischemic heart disease. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The examiner should identify and completely describe all current symptomatology. The examiner should provide a detailed review of the Veteran's current complaints, as well as findings as to the nature, extent, and severity of symptoms caused by the Veteran's disability. The examiner should note the Veteran's complaints regarding the impact of his ischemic heart disease on employment. The examiner should identify all limitations or functional impairment caused by his ischemic heart disease. 5. Afford the Veteran a VA examination to determine the current severity of his diabetes. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail, to include neurological testing to determine if the Veteran has neuropathy as secondary to his diabetes. The examiner should identify and completely describe all current symptomatology. The examiner should provide a detailed review of the Veteran's current complaints, as well as findings as to the nature, extent, and severity of symptoms caused by the Veteran's disability. The examiner should note the Veteran's complaints regarding the impact of his diabetes on employment. The examiner should identify all limitations or functional impairment caused by his diabetes. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Andersen, 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.