Citation Nr: 21025606 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 19-31 722 DATE: April 28, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for post-operative thymic carcinoma, including thymectomy and sternotomy (hereinafter malignant thymoma), is remanded. Entitlement to an initial compensable rating for baroreflex failure is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Army from September 1967 to September 1969. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a May 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the Board at a hearing held by the undersigned in January 2021. A transcript of the hearing is of record. In an October 2019 rating decision the Agency of Original Jurisdiction (AOJ) assigned a separate noncompensable rating for baroreflex failure, effective July 1, 2016. As the award of service connection for baroreflex failure was awarded as part of the appeal of the rating assigned for the malignant thymoma, the Board finds that it also has jurisdiction over the rating for baroreflex failure. As such, to afford the Veteran the broadest scope of review, the Veteran’s claim for a higher rating for baroreflex failure is included as an issue in conjunction with this appeal. 1. Entitlement to an initial rating in excess of 10 percent for malignant thymoma is remanded. 2. Entitlement to an initial compensable rating for baroreflex failure is remanded. Evidence indicates that there may be outstanding relevant medical records. A QTC Addendum report added to the file on September 28, 2019 reflects that the Veteran missed his scheduled complete blood count (CBC) appointment scheduled with Quest Diagnostics on September 27, 2019. However, during the January 2021 Board hearing, the Veteran reported that he contacted Quest Diagnostics in September 2019 after receiving notification that he was scheduled to undergo the laboratory test on September 27, 2019. He reported that he contacted Quest Diagnostics to reschedule the blood test because he was going to be unavailable on the scheduled date due to being away for a wedding. He reported that Quest Diagnostics informed him that he could walk in anytime to complete the testing. The Veteran then reported that he went to Quest Diagnostics “two or three days” before the originally scheduled date and underwent the laboratory test. Furthermore, the Veteran reported that he did not remember the exact date because he did not keep a record of the laboratory test. As the record of the September 2019 laboratory test is not in the file, a remand is required to obtain the record. Since the testing was completed by a private diagnostic company, but was completed in furtherance of a VA examination request, it is unclear whether these records would be associated with records from QTC, the contractor who completed the examination, or if they may need to be obtained directly from Quest Diagnostics; thus, both avenues of obtaining these test results have been indicated below. In addition, the Veteran attended a VA examination in May 2020 for an evaluation of his malignant thymoma. However, blood testing was not performed at the May 2020 examination. As such, upon remand, the Veteran should be scheduled for a new VA examination that includes CBC testing.   The matters are REMANDED for the following actions: 1. Take any necessary actions, including coordinating with QTC, to obtain the record of the CBC test results at Quest Diagnostics in Edina, Minnesota in September 2019, that was completed as part of the Veteran’s September 2019 QTC VA Examination. In obtaining the record, the Board notes that the Veteran’s claims file number is not the same as the Veteran’s Social Security Number, so searches should be done using his claims file number and Social Security Number. If the record requested is unavailable, clearly document the claims file to that effect and notify the Veteran of any inability to obtain these records, in accordance with 38 C.F.R. § 3.159(e). 2. If the September 2019 Quest Diagnostics CBC test results are unable to be obtained pursuant to the request in item 1, then ask the Veteran to complete a VA Form 21-4142 for CBC testing done by Quest Diagnostics in Edina, Minnesota in September 2019. Make two requests for the authorized records from Quest Diagnostics unless it is clear after the first request that a second request would be futile. 3. Obtain and associate with the Veteran’s electronic record VA treatment records from March 2020 to the present. If any of the records requested are unavailable, clearly document the claims file to that effect and notify the Veteran of any inability to obtain these records, in accordance with 38 C.F.R. § 3.159(e). 4. After completing the development requested above, schedule the Veteran for an appropriate VA examination(s) (or telehealth interview, if an in-person examination is not feasible) to evaluate the severity of the Veteran’s malignant thymoma and baroreflex failure. The entire claims file should be made available to the examiner in conjunction with this request. CBC testing should be completed, if possible, and all additional testing deemed necessary to rate malignant thymoma and baroreflex failure under the criteria of the rating schedule must be conducted and the results reported in detail. If CBC testing is not completed, the VA examiner should explain why such testing was not completed. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Breitbach, 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.