Entitlement to an initial increased rating for service-connected monoclonal B-cell lymphocytosis (MBL) with chronic lymphocytic leukemia (CLL) immunophenotype (MBL with CLL) is remanded.

Citation Nr: A26069930 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 260420-649239 DATE: July 30, 2026 REMANDED Entitlement to an initial increased rating for service-connected monoclonal B-cell lymphocytosis (MBL) with chronic lymphocytic leukemia (CLL) immunophenotype (MBL with CLL) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from September 1972 to August 1976. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a March 2026 Higher-Level Review (HLR) decision issued by a Department of Veterans Affairs (VA) regional office, an agency of original jurisdiction (AOJ). In February 2026, the Veteran submitted a VA Form 20-0996, Decision Review Request: HLR, and requested review of a February 2026 decision that awarded service connection for MBL with CLL and assigned an initial noncompensable (zero percent) rating, effective August 10, 2022. In March 2026, the AOJ issued the HLR decision on appeal, which considered the evidence of record at the time of the prior February 2026 decision. VA received the Veteran's VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in April 2026. The Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the February 2026 decision, which was subsequently subject to HLR. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. However, because the Board is remanding the claim, any evidence the Board could not consider will be considered by the AOJ in the readjudication of the claim. 38 C.F.R. § 3.103(c)(2)(ii). This appeal has been advanced on the Board's docket. 38 C.F.R. § 20.800(c). Entitlement to an initial increased rating for MBL with CLL The Veteran, through his attorney, contends that VA examiners all agree that the Veteran's MBL with CLL is active, which is one of the two requirements under Diagnostic Code (DC) 7703 for a 100 percent rating. The attorney further notes that none of the VA examiners has indicated that the Veteran's MBL with CLL is in remission or that there has been a cessation of the malignant process. See Attachment to April 2026 VA Form 10182. DC 7703 for leukemia directs that when there is active disease or during a treatment phase it is to be rated as 100 percent disabling, otherwise residuals are to be rated under the appropriate DC; and CLL or MBL that is asymptomatic, Rai Stage 0, is noncompensable. 38 C.F.R. § 4.117, DC 7703. October 2023, December 2023, and December 2025 VA Hematologic Examination Reports show that the Veteran's MBL with CLL was active. The December 2023 and December 2025 VA examiners indicated that the Veteran's MBL with CLL was active, asymptomatic, Rai Stage 0. None of the examiners found any functional impact. See December 2025, December 2023, and October 2023 VA Hematologic Examination Reports. However, in January 2024, the Veteran submitted the necessary authorizations to obtain treatment records from private providers, including Lexington Medical Center (LMC). See January 2024 VA Forms 21-4142 and 21-414a. VA received notice from a third-party records provider on behalf of LMC that there was an issue with the records request, and which requested additional information and provided an LMC-specific authorization. See August 2024, July 2024, June 2024, and May 2024 Medical Treatment Records - Non-Government Facility and July 2024 and June 2024 Third Party Release of Information. There is nothing of record to indicate that VA followed up with the third-party provider, requested the identified records again, notified the Veteran of the problem with obtaining these identified records, or afforded the Veteran the opportunity to resolve the issue or submit the records himself, before the issuance of the February 2026 rating decision, which the Board finds is a pre-decisional duty-to-assist error. See 38 C.F.R. §§ 3.159(c)(1), 20.802(a). Remand is therefore necessary to afford the AOJ an opportunity to obtain relevant, outstanding private treatment records. VA must notify the Veteran if it is unable to obtain any identified private treatment records and documentation of that notice should be evident in the claims record. See 38 C.F.R. § 3.159(e)(1). The matter is REMANDED for the following action: (Continued on the next page) ? The Veteran should be afforded the opportunity to submit any relevant, outstanding private treatment records, particularly those from Lexington Medical Center, or in the alternative, provide a release(s) so that VA can attempt to obtain those records. If the Veteran submits the appropriate release(s) to obtain any records, all efforts to obtain the records should be documented in the claims file. If any identified records cannot be obtained and further attempts would be futile, such should be noted in the claims file and the Veteran should be notified so that he can try to obtain those records. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Battaile 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.