Citation Nr: 22014552
Decision Date: 03/14/22	Archive Date: 03/14/22

DOCKET NO. 17-48 708
DATE: March 14, 2022

REMANDED

The claim for a rating for Reiter's syndrome in excess of 10 percent is remanded.

REASONS FOR REMAND

The Veteran honorably served on active duty from July 1972 to July 1974. In a May 2015 rating decision, the Regional Office (RO) denied a non-initial rating increase for Reiter's syndrome evaluated at 10 percent under Diagnostic Code (DC) 5003-6018-7512. The Veteran appealed. In October 2021, he testified at a Board hearing, a transcript of which is of record.

At the outset, the Board notes a December 1974 rating decision noted that the Veteran had been diagnosed with Reiter's syndrome in service and continued to demonstrate pain in his low back pain, right ankle, right knee, and the third and fifth fingers of his left hand also showing some fusiform dilatation of the proximal interphalangeal joints following service.

Of note here is a November 2021 VA examination report reflecting an examiner's explanation that Reiter's syndrome first begins with a great deal of swelling and pain in the affected joints. Joint involvement is usually asymmetric (meaning it affects different joints on opposite sides of the body) and confined to a small number of joints. Often the spine sacroiliac joints and large joints of the legs are involved. A few small joints in the toes or fingers also may be affected. In addition, people with Reiter's syndrome may experience inflammation in areas where tendons connect to bones as in the heels. The joint involvement of Reiter's syndrome tends to follow one of two courses. A small percentage of people have continuing joint involvement that is constant. Most people have periodic attacks of arthritis that last from three to six months.

The October 2021 hearing transcript reflects the Veteran's statement that ever since having been diagnosed with Reiter's syndrome, this progressively debilitating disease has affected multiple parts of his body, to include his back, neck, knees, ankles, wrists, urethra, and eyes. 

Following a number of claims and rating actions between his May 2015 claim and present, the Veteran has been granted service connection for additional disabilities secondary to his Reiter's syndrome, to include psychiatric disorder, bilateral knees, low back, and neck disabilities. Unfortunately, in lieu of taking piecemeal approach, at no given point has the Veteran been afforded a comprehensive evaluation of the holistic impact of his Reiter's syndrome, which the Board finds is appropriate in this case to properly rate this disability.

At his hearing, the Veteran further indicated that he is unable to maintain a gainful employment, due to systemic flare-ups of this disease, which reasonably raised an issue of total disability based on individual unemployability (TDIU) rating under Rice v. Shinseki, 22 Vet. App. 447 (2009), but has not been previously considered by the RO.

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Accordingly, the matters are REMANDED for the following action:

1. Schedule the Veteran for a comprehensive medical examination of his Reiter's syndrome, to include any primary effects and any secondary disabilities.  The examiner should identify all joints/anatomical areas that either are, or have been, impacted by the Veteran's Reiter's syndrome since March 2017.

2. Then, readjudicate the claim, to include consideration of a TDIU.

 

 

MATTHEW W. BLACKWELDER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Alex Bardin, 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.