Citation Nr: 18139839 Decision Date: 10/01/18 Archive Date: 10/01/18 DOCKET NO. 14-27 485 DATE: October 1, 2018 REMANDED Entitlement to service connection for a right shoulder disability is remanded. Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for a neck disability is remanded. Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD) and depression, is remanded. Entitlement to service connection for sleep apnea, to include as secondary to an acquired psychiatric disability, is remanded. Entitlement to service connection for alcohol abuse, to include as secondary to an acquired psychiatric disability, is remanded. Entitlement to a total rating based on individual unemployability due to service connected disability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active military service from March 2002 to July 2002, January 2004 to April 2005, and again from June 2008 to July 2009. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from May 2001 and September 2014 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Chicago, Illinois. This case was previously before the Board in January 2017, at which time the Board denied the Veteran’s claims on appeal. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In a March 2018 Memorandum Decision, the Court vacated the Board’s January 2017 decision and remanded the case to the Board for action consistent with the Memorandum Decision. The Board finds that additional development is required before the Veteran’s claims on appeal are decided. 1. Service Connection – Shoulder, Neck, and Back Disabilities A review of the record shows that VA medical opinions were obtained in conjunction with the Veteran’s claims for entitlement to service connection for right and left shoulder, neck, and back disabilities in March 2014. However, a review of those medical opinions show that they are inadequate for adjudication purposes. In this regard, the VA examiners found the Veteran’s right and left shoulder, neck, and back disabilities were not etiologically related to his active service. Specifically, the examiners stated that there was “no evidence of any connection. There is no clearly documented continuum of care from service until now.” However, the examiners contradicted their own statements that the Veteran was first diagnosed with musculoskeletal strains the year he separated from service, and failed to adequately address the post-service medical evidence indicating continuing treatment for shoulder, neck, and back pain. Moreover, the examiners failed to adequately address the Veteran’s lay statements on continuing symptomatology during and since active service. Thus, the Board finds that the Veteran should be afforded new VA examinations to determine the nature and etiology of any current shoulder, neck, and back disabilities. 2. Service Connection – Acquired Psychiatric Disability A review of the record shows that the Veteran failed to appear for his March 2016 VA psychiatric examination. The RO and Board subsequently adjudicated the Veteran’s claim for entitlement to service connection for an acquired psychiatric disability based on the evidence of record. However, the Board failed to adequately provide analysis as to whether it could be presumed, based on the evidence of record, that the Veteran had been properly notified of the time, date, and place of the examination. Thus, the Board finds that the Veteran should be afforded another VA examination to determine the nature and etiology of any currently present acquired psychiatric disorder. 3. Service Connection – Sleep Apnea and Alcohol Abuse Regarding the issues of service connection for sleep apnea and alcohol abuse, the Board notes that these issues are inextricably intertwined with the claim of entitlement to service connection for an acquired psychiatric disability remanded herein. Harris v. Derwinski, 2 Vet. App. 180, 183 (1991). Hence, a determination on the claims of entitlement to service connection for sleep apnea and alcohol abuse, secondary to an acquired psychiatric disability, should be deferred pending final dispositions of the claim of entitlement to service connection for an acquired psychiatric disability. 4. TDIU Regarding the TDIU issue, the Board notes that the issue of entitlement to a TDIU is inextricably intertwined with the claims remanded herein. Harris v. Derwinski, 2 Vet. App. 180, 183 (1991). Hence, a determination on the claim for TDIU should be deferred pending final dispositions of the claims currently on appeal. The matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, schedule the Veteran for a VA examination by an examiner with sufficient expertise to determine the nature and etiology of any currently present right and left shoulder disabilities. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. Based upon the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any currently present right and/or left shoulder disability had its onset during active service, or is otherwise etiologically related to service. In forming the opinion, the examiner must consider the Veteran’s statements regarding onset and continuity of his symptoms. The rationale for all opinions expressed must be provided. 3. Then, schedule the Veteran for a VA examination by an examiner with sufficient expertise to determine the nature and etiology of any currently present neck disability. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. Based upon the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any currently present neck disability had its onset during active service, or is otherwise etiologically related to service. In forming the opinion, the examiner must consider the Veteran’s statements regarding onset and continuity of his symptoms. The rationale for all opinions expressed must be provided. 4. Then, schedule the Veteran for a VA examination by an examiner with sufficient expertise to determine the nature and etiology of any currently present low back disability. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. Based upon the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any currently present low back disability had its onset during active service, or is otherwise etiologically related to service. In forming the opinion, the examiner must consider the Veteran’s statements regarding onset and continuity of his symptoms. The rationale for all opinions expressed must be provided. 5. Then, schedule the Veteran for a VA examination with a psychologist or psychiatrist to determine the nature and etiology of any currently present psychiatric disability. The claims file must be made available to, and reviewed by the examiner. All indicated tests and studies must be performed. Based on the examination results and review of the record, the examiner should first identify all psychiatric disabilities present during the pendency of the claim, and proximate thereto. Then, for each psychiatric disability identified, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any such disability had its onset during active service, or is otherwise etiologically related to such service. In forming the opinion, the examiner must consider the Veteran’s statements regarding the onset and continuity of his psychiatric symptoms. The examiner must specifically address the Veteran’s statements regarding exposure to combat during deployment, as well as witnessing deaths of his fellow servicemembers. The rationale for all opinions expressed must be provided. 6. Confirm that the VA examination reports and any opinions provided comport with this remand, and undertake any other development found to be warranted, to include scheduling the Veteran for any necessary VA examinations to address his secondary service connection claims for sleep apnea and alcohol abuse. 7. Then, readjudicate the remaining issue on appeal. If the decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Mariah N. Sim, Associate Counsel