Citation Nr: 21012061 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 20-19 530 DATE: March 3, 2021 REMANDED Entitlement to a compensable rating for non-Hodgkin's lymphoma (inactive) with anemia is remanded. REASONS FOR REMAND The Veteran had active duty service from March 1964 to September 1964. This matter is on appeal to the Board of Veterans’ Appeals (Board) from a decision of the Agency of Original Jurisdiction (AOJ) dated in April 2017, which, in pertinent part, granted service connection for non-Hodgkin’s lymphoma and assigned a 0 percent rating, effective February 16, 2017. The Veteran testified at an AOJ Decision Review Officer (DRO) hearing at the AOJ in June 2018. A transcript of that hearing is of record. The Board remanded the case for additional development in September 2020. For the reasons described below, the case must be remanded again. 1. Entitlement to a compensable rating for non-Hodgkin's lymphoma (inactive) with anemia is remanded. The Board remanded the case so that a VA examination could be provided to address the present severity of the Veteran’s non-Hodgkin’s lymphoma with anemia. A medical examination was subsequently provided in January 2021 but not all of the questions directed in the remand were answered. First, the examiner cited to hemoglobin studies that were performed in July 2018. The examiner noted that a phone interview was conducted, and that the Veteran related that he had not had any VA treatment since July 2018 but had instead been seen by a private doctor, Dr. Benjamin Smith, from Bronson Internal Medicine & Rheumatology. It was noted that Dr. Smith had told him that laboratory readings conducted in the fall of 2020 were good. These private treatment records do not appear in the file. In order to assess the present severity of the hemoglobin readings for a potential increased rating of 10 percent under 38 C.F.R. § 4.117, Diagnostic Code 7700 (effective prior to December 8, 2018), a current clinical evaluation needs to be performed. If possible, the laboratory findings by Dr. Smith in 2020 should be obtained, as well. Second, the examiner noted that the Veteran required continuous treatment with oral supplementation for his anemia in the form of a multi-vitamin with iron. Iron deficiency anemia that requires continuous treatment with oral supplementation warrants the next higher 10 percent rating under 38 C.F.R. § 4.117, Diagnostic Code 7720 (effective December 8, 2018). However, later in the report, the examiner checked the box for requiring treatment only by dietary modification and did not check the box for requiring continuous treatment with oral supplementation. This discrepancy should be resolved on remand, as well. Finally, the VA examination notes that the Veteran sees a civilian provider for his healthcare, namely, Dr. Benjamin Smith, from Bronson Internal Medicine & Rheumatology. It was noted in the report that Dr. Smith was going to retire soon. Thus, the Veteran should be given the opportunity to authorize VA to obtain and/ or submit the private treatment records. The matters are REMANDED for the following action: 1. Ask the Veteran to either submit, or identify any relevant outstanding private treatment records and submit the authorization for VA to request these records, including any records from Bronson Internal Medicine & Rheumatology, from his primary care provider, Dr. Benjamin Smith. Specifically any laboratory reports that were provided in the fall of 2020 should be added to the Veteran’s file. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his non-Hodgkin’s lymphoma with anemia. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria, (under Diagnostic Code 7700, in effect prior to December 8, 2018, and Diagnostic Code 7720, thereafter) under 38 C.F.R. § 4.117. In addition to other symptoms, the examiner should specifically address the following: (a.) Updated hemoglobin studies should be performed (i.e., since July 2018). (b.) Address whether the Veteran has weakness, easy fatigability or headaches due to his anemia. (c.) Address whether the Veteran’s anemia has required an intravenous iron infusion at least one time in the last 12 months. (Continued on the next page)   (d.) The examiner also should clarify whether the iron deficiency anemia requires continuous treatment with oral supplementation. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Sarah B. Richmond, 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.