Citation Nr: 21014418 Decision Date: 03/12/21 Archive Date: 03/12/21 DOCKET NO. 16-49 445 DATE: March 12, 2021 REMANDED Entitlement to an initial disability rating in excess of 10 percent for service-connected familial Mediterranean fever (FMF), is remanded. REASONS FOR REMAND The Veteran served on active duty in the Marine Corps Reserves from October 1991 to September 1992 and in the Air National Guard from November 2001 to September 2003. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing conducted by the undersigned Veterans Law Judge in December 2020. A transcript of the hearing has been associated with the claims file. Entitlement to an increased disability rating for FMF is remanded. The Veteran contends that his disability is more analogous to Lupus and that a higher rating is warranted given his symptomology. The Board observes that FMF is not listed under any of the diagnostic codes in the VA Schedule for Rating Disabilities (Rating Schedule). When an unlisted condition such as FMF is encountered, it is permissible to rate under a closely related disease or injury in which not only the functions affected, but also the anatomical localization and symptomatology are closely analogous. 38 C.F.R. § 4.20. In this case, the Veteran’s FMF has been rated by analogy under the Diagnostic Code for Chronic Fatigue Syndrome. See 38 C.F.R. § 4.88b, Diagnostic Code 6354. The Veteran was last provided a VA examination for his FMF in September 2013 in order to obtain a medical opinion regarding service connection. An addendum opinion was obtained in April 2015, but an examination was not performed at that time. The record does not contain any ongoing treatment records related to the Veteran’s FMF since the 2015 opinion. Significantly, in a January 2021 statement, the Veteran’s spouse reported that his symptoms had been worsening. As there is evidence that the Veteran’s disability picture has changed since his last examination, the Board finds that a new examination is needed to fully and fairly evaluate his claim. See Snuffer v. Gober, 10 Vet. App. 400, 402-03 (1997). The matters are REMANDED for the following action: 1. Obtain and associate with the Veteran’s claims file any outstanding VA treatment records related to the Veteran’s claims on appeal. 2. Schedule an appropriate VA examination to determine the current nature and severity of the Veteran’s service-connected FMF. 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 diagnostic codes for Lupus and Chronic Fatigue Syndrome (DCs 6350, 6354). 3. After undertaking any additional development deemed appropriate and giving the Veteran full opportunity to supplement the record, readjudicate the issue on appeal to include consideration of alternate diagnostic codes relating to autoimmune diseases in light of any additional evidence added to the record and assign the appropriate rating criteria based on the Veteran’s disability symptomology. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.V. Palatt, Associate 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.