Citation Nr: 21040448 Decision Date: 07/03/21 Archive Date: 07/03/21 DOCKET NO. 15-20 001 DATE: July 3, 2021 REMANDED Entitlement to an increased rating in excess of 60 percent for hypertensive nephrosclerosis status post kidney transplant is remanded. REASONS FOR REMAND The Veteran served in the United States Navy from August 1987to August 1997. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision from the St. Petersburg, Florida Regional Office (RO) for the Department of Veterans Affairs (VA). In November 2018, the Veteran testified at a video conference hearing in St. Petersburg, Florida before the undersigned Veterans Law Judge. A copy of the hearing transcript has been associated with the electronic claims file. In March 2019, the Board remanded the Veteran's claim for additional development. The claim has since been returned to the Board for further appellate action. The Board is satisfied there was substantial compliance with its remand orders. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998). Although the Board regrets the additional delay, another remand is required in this case to ensure that there is a complete record upon which to decide the issue of increased rating for a kidney disability, so that the Veteran is afforded every possible consideration. Hypertensive nephrosclerosis status post kidney transplant. The Veteran contends he is entitled to a higher disability rating for his hypertensive nephrosclerosis status post kidney transplant, currently rated at 60 percent disabling. The Veteran underwent a VA examination for his kidney condition in April 2013. From this, the examiner opined that while the Veteran had some weight loss and chronic diarrhea of unclear etiology, the Veteran had been stable for years and would not be considered to have generalized poor health characterized by lethargy, weakness, anorexia, weight loss, or limitation of exertion. However, in his November 2018 Board hearing testimony, the Veteran claimed that his symptoms had worsened. The Board remanded the issue in March 2019 for additional development: to request VA and private treatment records and an updated VA examination to assess the Veteran's current disability level. An examination was completed in September 2020 and is of record; however, no new private treatment records were obtained. In a September 2008 VA 21-4138 Statement in Support of Claim, the Veteran said his wife had him visit the family doctor, Dr. C, when he started having dizzy spells a year after service. His family doctor referred him to a kidney specialist, Dr. S. Those records were subsequently added to the file in September 2008. In April 2020, the RO sent the Veteran VA Forms 21-4142, Authorization to Disclose Information to the Department of Veterans Affairs (VA), asked him complete and return the forms, and to submit any relevant treatment records he had in his possession. The RO sent the forms because they say the Veteran indicated that he received treatment from private providers. At the November 2018 Board hearing, the Veteran testified that his VA nephrologist had left, and he was looking for a new nephrologist. In CAPRI notes from October 2018, the VA referred him back to the Mayo Clinic for a nephrologist. No new private treatment notes have been added to the record since the referral. The case has since returned to the Board. VA's duty to assist in developing the facts and evidence pertinent to a Veteran's claim is not a one-way street, and it is the responsibility of Veterans to cooperate with VA regarding development. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). This is especially true in matters relating to private records, to which VA has no access or knowledge without the Veteran's cooperation. Given the Veteran was referred to a private nephrologist, maintains the condition has worsened, and there may be pertinent recent medical treatment records not of record which might affect the outcome of the claim, one last attempt will be made to obtain these records. The matter is REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for all outstanding medical treatment records related to his kidney disability, including any records at Mayo Clinic. Make two requests for the authorized records from treatment provider(s) identified by the Veteran unless it is clear after the first request that a second request would be futile. If additional authorizations are required by the identified provider(s), the forms should be forwarded to the Veteran for completion. (Continued on the next page) 2. Add all obtained private records to the claims file. Associate with the record any VA clinical notes not already of record pertaining to treatment of the Veteran since March 2020. H. SEESEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Black, 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.