Citation Nr: 1323388 Decision Date: 07/23/13 Archive Date: 08/01/13 DOCKET NO. 10-17 215 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri THE ISSUE Entitlement to a total disability rating based on individual unemployability due to service connected disabilities (TDIU). REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD J. Chapman, Associate Counsel INTRODUCTION The appellant is a Veteran who served on active duty from December 1963 to December 1965. This matter is before the Board of Veterans' Appeals (Board) on appeal from a November 2009 rating decision by the RO. The appeal is being REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran contends that the combined effects of his service-connected disabilities prevent him from securing and maintaining substantial gainful employment. Total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a Veteran is unable to secure or follow a substantially gainful occupation as a result of service connected disabilities, provided that if there is only one such disability, such disability shall be ratable as 60 percent or more and if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). The Veteran's service-connected disabilities include status post radical prostatectomy, residuals of prostate cancer to include dysuria and incontinence rated 40 percent; diabetes mellitus type 2 rated 20 percent; tinnitus rated 10 percent; peripheral neuropathy of both upper and both lower extremities, each extremity rated 10 percent; malaria rated 0 percent; hearing loss rated 0 percent; and erectile dysfunction rated 0 percent. The combined rating is 70 percent. Thus, he meets the schedular requirements for TDIU. The Veteran was afforded a VA examination in November 2012. The examiner stated that the Veteran's diabetes, peripheral neuropathy, prostate cancer residuals, erectile dysfunction, and tinnitus did not individually impact on his ability to work. As for hearing loss, the examiner opined that "the severity of this hearing loss would make it unlikely to successfully maintain any employment if the employment was dependent on accurate understanding of verbal exchange of information." The examiner provided rationale only for his opinion regarding hearing loss and for the opinions regarding the other service connected disabilities. Specifically, the examiner did not explain why compensably rated peripheral neuropathy (incomplete paralysis) of all four extremities would have no effect on employability to include for someone with the Veteran's long-time work experience as a railroad engineer or discuss the Veteran's allegations that his post-prostatectomy/related incontinence is a factor impacting on occupational functioning. The examiner also did not discuss the combined effect of all of the Veteran's service connected disabilities on his ability to maintain employment. Consequently the examination report is inadequate for rating purposes and a remand to secure a more complete examination with opinion accompanied by adequate rationale is necessary. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Accordingly, the case is REMANDED for the following: 1. The RO should arrange for an examination of the Veteran by an appropriate physician to assess the impact his service connected disabilities (residuals of prostate cancer, type 2 diabetes mellitus, tinnitus, peripheral neuropathy of all four extremities, malaria, hearing loss, and erectile dysfunction), individually and combined, have on his ability to maintain employment. The Veteran's claims file, to include this remand, must be reviewed by the examiner in conjunction with the examination. The examiner should elicit from the Veteran his complete employment history and his complaints regarding the impact of his disabilities on employment, and comment on the restrictions and limitations due to each service-connected disability. The examiner's opinions regarding the impact of the service-connected disabilities on employment must be accompanied by explanation of rationale. The examiner must specifically address the Veteran's own reports regarding the impact of the disabilities on employment. The examiner should offer comment on the types of employment that would be precluded by the service connected disabilities and the types of employment that remain feasible despite the combined effects of the service connected disabilities. The examiner must explain the rationale for all opinions. 2. The RO should then review the record and readjudicate the claim for a TDIU rating. If it remains denied, the RO should issue an appropriate supplemental statement of the case and afford the Veteran and his representative the opportunity to respond. The case should then be returned to the Board, if in order, for further review. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ GEORGE R. SENYK Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).