Rheumatoid arthritis decisions — 2010

The Board has determined that the Veteran's request for a spare motorized wheelchair is denied as there is no unusual circumstance to justify one.

The Veteran's heart disability is not manifested by more than one episode of acute congestive heart failure; a workload of greater than three METs but not greater than five METs resulting in dyspnea, fatigue, angina, dizziness or syncope; or left ventricular dysfunction with an ejection fraction of 30 to 50 percent. As such, the Veteran's claim for an increased rating for rheumatoid heart disease with mitral insufficiency is denied.

The Veteran's service-connected lupus, rheumatoid arthritis, and osteopenia have been evaluated based on their combined effect. The claims for higher initial ratings for various joints are denied as the evidence does not meet the criteria for a higher rating at any point during the appeal period.

The Board found that the Veteran's spinal disease and arthritis of multiple joints did not manifest within one year after service, and there is no evidence linking these conditions to his military service.

The Board denied the Veteran's claims for service connection for various conditions, including a head injury, right ear injury, blurred vision and inability to walk, rheumatoid arthritis, right knee disability, cardiovascular disability (including heart valve replacement), and bilateral hearing loss. The claim of service connection for compensation benefits under 38 U.S.C. § 1151 due to cardiac catheterizations was also denied.

The Veteran's claims for earlier effective dates for service connection have been denied as the earliest date of receipt of a claim is December 22, 1998.

The Veteran's claim for reimbursement of medical expenses incurred at St. Mary Medical Center from February 13, 2005 to February 15, 2005 is denied as the services were not rendered in a 'medical emergency' and VA facilities were feasibly available.

The Board has determined that the Veteran's claimed disabilities were not incurred or aggravated during active service and are not shown to have developed as a result of an established event, injury, or disease during active service. The claims for service connection are therefore denied.

The Board found that the Veteran's orthopedic conditions, including rheumatoid arthritis and osteopenia, are not related to his active service or exposure to ionizing radiation. The claim was denied.

The Veteran's appeal is remanded for additional development, including updated VA examinations to assess the current severity of his service-connected rheumatoid arthritis of the right knee, diffuse arthritis of the bilateral feet, and diffuse ankylosis of the thoracolumbar spine with sclerosis of both sacroiliac joints.

The Veteran's claim for a compensable rating for rheumatoid arthritis, multiple joints was denied as there is no evidence of the condition. The issues of service connection for bilateral shoulder disability, right hip disability, left hip disability (status-post hip replacement), and lumbar spine disability are addressed in the REMAND portion of this decision.

The Board has decided that the Veteran's claim of service connection for rheumatoid arthritis should be remanded to obtain additional VA treatment records and a medical examination.

The Veteran's claims for an increased rating for schizophrenia and TDIU are being remanded due to the need for additional medical examination.

The Veteran's service-connected disabilities do not preclude him from participating in substantially gainful employment.

The Board has determined that the Veteran's rheumatoid arthritis of the right hand and wrist is service-connected, as it was caused by an in-service injury.

The Veteran has withdrawn his appeal, and the Board does not have jurisdiction to consider the claims.

The Veteran's claim for increased evaluations for his service-connected rheumatoid arthritis was denied. The effective date of the deconstructed ratings remains March 31, 2007.

The Board has determined that the Veteran's polyarthritis/rheumatoid arthritis is related to his service-connected prostate cancer, and thus grants the claim for service connection.

The Veteran's appeal is remanded for additional development, including a VA examination of his lumbar spine disability and consideration of his claims for service connection and TDIU.

The Board has decided to remand the case for additional development, including obtaining a VA examination and medical nexus opinion regarding the Veteran's claimed disabilities related to exposure to cold weather during service.