Citation Nr: 22053262 Decision Date: 09/20/22 Archive Date: 09/20/22 DOCKET NO. 18-29 540 DATE: September 20, 2022 REMANDED Entitlement to an initial rating higher than 60 percent for nephropathy is remanded. REASONS FOR REMAND The Veteran had active service from February 1970 to November 1971. This matter comes before the Board of Veterans' Appeals (BVA or Board) from April 2014 and April 2015 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran requested a hearing before the Board. The requested hearing was conducted in September 2021 by the undersigned Veterans Law Judge. A transcript is associated with the claims file. In December 2021, the Board remanded this appeal, including the issue of entitlement to a total disability rating based on individual unemployability (TDIU). In a June 2022 rating decision, the RO granted entitlement to a TDIU, effective October 2017, the entire period on appeal. As such, the issue of entitlement to a TDIU is no longer before the Board. Entitlement to an initial rating higher than 60 percent for nephropathy. Service connection for nephropathy was granted in an April 2014 rating decision, at which time a 60 percent rating was assigned, effective October 2017. The Veteran disagrees with the rating assigned. The Veteran testified during the September 2021 Board hearing that he experiences increased urinary frequency due to his kidney disability and that he suffers from nosebleeds as a result of overexertion from walking back and forth to the bathroom frequently. The Veteran was afforded a VA examination in May 2022; however, the Veteran's reported symptoms of increased urinary frequency and nosebleeds were not discussed or noted. The Board finds a remand is necessary to obtain an addendum opinion regarding whether the Veteran's reported symptoms of increased urinary frequency and nosebleeds are manifestations of his service-connected nephropathy in order to determine the current severity and appropriately evaluate all related symptoms. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all updated treatment records. 2. Obtain an addendum opinion for the Veteran's nephropathy. The claims folder must be provided to the examiner for review. The examiner must state in the examination report that the claims folder has been reviewed. After a review of the record, the examiner should opine as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that: a) the Veteran's increased urinary frequency is a manifestation of his service-connected nephropathy; b) the Veteran's nosebleeds, reported to be a result of overexertion from going back and forth to the bathroom, are a manifestation of his service-connected nephropathy. In providing these opinions, the examiner should consider/comment on the Veteran's testimony during the December 2021 Board hearing, wherein he reported increased urinary frequency and that overexertion traveling to the bathroom caused nosebleeds. A detailed explanation (rationale) is requested for all opinions provided, citing to supporting clinical data and/or medical literature, as appropriate. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Andersen, 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.