Citation Nr: 21015277 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 16-46 710 DATE: March 17, 2021 REMANDED Entitlement to a rating in excess of 70 percent for extremely unfavorable ankylosis status post-fusion of the right (dominant) wrist with ulnar neuropathy and torn ligaments is remanded. Entitlement to an increased rating for post-operative varicose veins of the left lower extremity with associated numbness of the left thigh, rated as 40 percent disabling prior to July 18, 2016 and 20 percent thereafter, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from April 1973 to April 1976, and in the United States Air Force from November 1996 to May 1997 and from April 2001 to June 2002. In addition to the above periods of active duty service, the Veteran has numerous periods of active reserve status in the United States Air Force Reserves. See generally Information Report (rec’d Feb. 5, 2021 ). This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a May 1, 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Denver, Colorado. The Board notes that this rating decision specifically references the Veteran’s claim for increased ratings received on June 29, 2010. As the claims on appeal are before the Board, the claims are rated as such: the right wrist injury, 70 percent disabling throughout the period on appeal, except for periods of temporary total disability from June 6, 2018 until prior to January 17, 2019, see 38 C.F.R. § 4.30; the varicose veins of the left lower extremity, 20 percent disabling prior to April 22, 2013, then 40 percent disabling thereafter until prior to December 27, 2013, then a temporary total disability rating until prior to March 1, 2014, see 38 C.F.R. § 4.30, then back to 40 percent disabling thereafter until July 18, 2016, and then finally back to 20 percent disabling thereafter. For the periods on appeal that the Veteran receives a temporary total disability rating, the Board notes that the Veteran is in receipt of all available benefits on appeal for the respective disorders. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1977). To the extent that higher ratings may be available for the disorders on appeal, the issues remain in appellate status. See AB v. Brown, 6 Vet. App. 35 (1993). Furthermore, while the Board can sometimes infer a claim for total disability due to individual unemployability based upon service-connected disorders (TDIU) out of claims for increased ratings, see Rice v. Shinseki, 22 Vet. App. 447 (2009), the Board concludes that Rice is not appropriate here, as the Veteran testified that his claim for a TDIU is already pending. See Hearing Tr. (Feb. 2, 2021), at Pages 8-9. The Veteran testified before the undersigned Veterans Law Judge at hearing conducted on February 2, 2021. A transcript of the hearing was produced and has since been associated with the claims file for Board review. 1. Entitlement to an increased rating for service-connected extremely unfavorable ankylosis status post-fusion of the right (dominant) wrist with ulnar neuropathy and torn ligaments is remanded. The Veteran’s right wrist disorder is currently rated as 70 percent disabling throughout the period on appeal, except for periods of temporary total disability ratings, 38 C.F.R. § 4.30. The Board notes the Veteran’s testimony that his wrist disorder may render his right (dominant) hand unable to hold a pen for long enough to have legible handwriting, unable to hold anything, and unable to manipulate buttons. See Hearing Tr. (Feb. 2, 2021), at Pages 11-14. Meanwhile, the Board notes that VA examinations of record appear limited to the wrist, see, e.g.: VA Exam ( Jan. 9, 2021 ) (rec’d Jan. 27, 2021). Finally, the Veteran’s private treatment records suggest that the Veteran may have recently suffered an injury postdating the hearing. See Medical Treatment Record ( Feb. 26, 2021 ). Ultimately, for the above-mentioned reasons, the Board determines that a remand is appropriate to ensure that the Veteran’s disorder is developed properly. See Weggerman v. Brown, 5 Vet. App. 281 (1993); Allday v. Brown, 7 Vet. App. 517 (1995); Caffrey v. Brown, 6 Vet. App. 377 (1994); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). 2. Entitlement to an increased rating for service-connected post-operative varicose veins of the left lower extremity with associated numbness of the left thigh is remanded. The Board accepts the Veteran’s contentions that his left leg disorder manifests in an inability to fly on aircraft, which has interfered with his employment. See generally Hearing Tr. (Feb. 2, 2021), at Pages 15-24. Furthermore, the Board notes that after the hearing, the Veteran was diagnosed with mixed reflux with a previously ablated left greater saphenous vein in the left leg. See Medical Treatment Record ( Feb. 24, 2021 ). This symptomatology does not appear to have been contemplated in the most recent examination of record. See VA Exam ( Jan. 9, 2021 ). To properly account for any more recent symptoms not previously examined, see Weggerman v. Brown, supra; Allday v. Brown, supra; Caffrey v. Brown, supra; Snuffer v. Gober, supra, and to consider whether any more appropriate diagnostic codes may apply to the Veteran’s disorder, the Board determines that a remand is warranted for this claim as well. The matters are REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claims on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records and private medical records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and afford them an opportunity to submit any copies in their possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Forward the claims file, including a copy of this remand, the Veteran’s hearing transcript, and all previous VA examinations of record for the Veteran’s extremely unfavorable ankylosis status post-fusion of the right wrist to an appropriate VA examiner. The record, including a complete copy of this remand, must be made available to the examiner, and all indicated tests and studies should be undertaken. The need for further in-person physical examination is left to the discretion of the examiner. The examiner should identify the current nature and severity of all manifestations of the Veteran's right wrist disability. The examiner should indicate whether the Veteran's right wrist disability results in the loss of use of his right hand. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. However, if the requested opinion cannot be provided, the examiner should so state and explain why an opinion cannot be provided. 3. Forward the claims file, including a copy of this remand, the Veteran’s hearing transcript, and all previous VA examinations of record for the Veteran’s post-operative varicose veins of the left lower extremity with associated numbness of the left thigh to an appropriate VA examiner. The record, including a complete copy of this remand, must be made available to the examiner, and all indicated tests and studies should be undertaken. The need for further in-person physical examination is left to the discretion of the examiner. The examiner should identify the current nature and severity of all manifestations of the Veteran's post-operative varicose veins of the left lower extremity. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. However, if the requested opinion cannot be provided, the examiner should so state and explain why an opinion cannot be provided. KRISTY L. ZADORA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael B. Engle, 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.