Citation Nr: 21031925 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 17-50 901 DATE: May 25, 2021 REMANDED Entitlement to an increased rating in excess of 30 percent for a kidney transplant with residual surgical scars is remanded. Entitlement to an increased rating in excess of 10 percent for hyperparathyroidism is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from July 2001 to February 2007 with service in Southwest Asia. These matters come before the Board of Veterans' Appeals (Board) on appeal from March 2015 and February 2015 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a March 2021 Board video conference hearing. A transcript of the hearing has been associated with the claims file. 1. Entitlement to an increased rating in excess of 30 percent for a kidney transplant with residual surgical scars 2. Entitlement to an increased rating in excess of 10 percent for hyperparathyroidism The Veteran contends that an increased rating is warranted for his service connected kidney transplant with residual surgical scars and his hyperparathyroidism. The Board finds that a remand is warranted for additional development. First, evidence indicates that there may be outstanding relevant VA treatment records. During the March 2021 hearing, the Veteran reported that he has continued to receive VA treatment at the Portland VA Medical Center (VAMC), Prescott VAMC and Phoenix VAMC. Any VA treatment records are within VA's constructive possession and are considered potentially relevant to the issues on appeal. A remand is required to allow VA to obtain them. Next, at the March 2021 hearing the Veteran identified relevant outstanding private treatment records. A remand is required to allow VA to obtain authorization and request any outstanding private treatment records. Then, a March 2021 record indicates that there may be outstanding and relevant Social Security Administration (SSA) records during the period on appeal. A remand is required to allow VA to request these records. Further, in March 2021 testimony, the Veteran asserted that his kidney transplant with residual surgical scars and his hyperparathyroidism have increased in severity since the Veteran was last examined by VA. The Veteran testified to joint pain and weakness and muscle weakness with difficulty going up flights of stairs and feeling fatigued after a day of work. Additionally, the Veteran reported symptoms of anxiety and feelings of nervousness since his kidney transplant. Further, the Veteran reported an increased sensitivity to foods, and that he has to be very careful with what he eats and that he experiences ongoing gastrointestinal issues, a sensitive stomach and diarrhea at times. He also identified an upper arm fistula as a residual of the kidney transplant surgery. The Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and all manifestations of his kidney transplant with residual surgical scars and his hyperparathyroidism. As such a remand is warranted for an updated VA examination. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from August 2017 forward from the Prescott VAMC, Portland VAMC and Phoenix VAMC. 2. Ask the Veteran to identify and authorize for release any outstanding private treatment records and complete a VA Form 21-4142 for any outstanding private treatment records. Make two requests for any identified and authorized for release records unless it is clear after the first request that a second request would be futile. 3. Obtain the Veteran's federal records from the Social Security Administration (SSA). Document all requests for information as well as all responses in the claims file. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected kidney transplant with residual surgical scars and his hyperparathyroidism. The examiner should provide a full description of the disabilities and report all signs and symptoms necessary for evaluating the Veteran's disabilities under all applicable rating criteria. Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Attention is invited to the Veteran's March 2021 testimony noting joint pain, weakness and muscle weakness with difficulty going up flights of stairs and feeling fatigued after a day of work. Additionally, the Veteran reported symptoms of anxiety and feelings of nervousness since his kidney transplant. Further, the Veteran reported an increased sensitivity to foods, and that he has to be very careful with what he eats and that he experiences ongoing gastrointestinal issues, a sensitive stomach and diarrhea at times. Further, the Veteran testified to having a fistula on his left arm which is related to his kidney transplant and that this scar is painful and tender. The examiner should evaluate the Veteran's left arm fistula and discuss whether such is a painful and/or tender scar, and evaluate under 38 C.F.R. § 4.118. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.R. Kardian, 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.