Citation Nr: 21008899 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 18-07 497 DATE: February 18, 2021 REMANDED From November 17, 2014, an initial rating in excess of 10 percent for varicose veins in the lower left extremity is remanded. From November 17, 2014, an initial rating in excess of 10 percent for varicose veins in the lower right extremity is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from August 1972 to May 1992. These matters are on appeal from a February 2015 rating decision issued by the Regional Office (RO) in St. Petersburg, Florida. In April 2019, the Board granted service connection for bilateral hearing loss, tinnitus and hypertension and denied initial ratings in excess of 10 percent for left and right lower extremity varicose veins. The Veteran appealed to the United States Court of Appeals for Veterans Claims. Pursuant to a Joint Motion for Partial Remand (Joint Motion), an April 2020 Court Order vacated the portion of the Board’s April 2019 decision which denied increased initial ratings for varicose veins of each lower extremity and remanded the claims for action consistent with the Joint Motion. The Court Order dismissed the appeal as to the remaining issues. As noted in the Joint Motion, a December 2017 VA examination report notes that the Veteran’s pain was relieved by elevation of the extremity and compression hosiery; however, in a subsequent January 2018 statement, the Veteran reported no relief from elevating his legs. The January 2018 statement also includes the Veteran’s observation that, “[b]y the end of the day, the swelling is so bad that it leaves imprints of my fingers when I touch it” and his “legs are discolored all over, especially down by [his] ankles, with patches of brown and dark red. The hair has even stopped growing on most of the discolored areas of [his] leg.” As the record suggests they Veteran’s service-connected varicose veins have increased in severity since the last examination, the Board finds that an updated examination is necessary. The matters are REMANDED for the following action: 1. Please secure for the record copies of complete updated clinical records (any not already of record) of all VA and/or private treatment the Veteran has received for his varicose vein disability. 2. After the development sought in paragraph 1 is completed, please schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) and medical opinion to determine the nature and severity of his service-connected bilateral varicose veins. All indicated tests should be performed. After interview and examination of the Veteran and review of his claims file, the examiner is requested to delineate all symptomatology associated with, and the current severity of, his varicose veins. a. The examiner should provide an opinion as to whether the Veteran is able to obtain relief by elevating his legs in light of the Veteran’s January 2018 statement reporting that he experiences no relief from elevating his legs. b. The examiner should provide an opinion as to whether two reports (over a period of 8 months) characterizing the Veteran’s edema as “significant” or “chronic” (even if mild) reasonably equate to a finding of “persistent” edema. A full rationale is to be provided for all stated medical opinions. If an opinion cannot be made, including without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kshama Hughes 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.