Citation Nr: 18140606 Decision Date: 10/03/18 Archive Date: 10/03/18 DOCKET NO. 15-46 394 DATE: October 3, 2018 REMANDED Entitlement to a rating in excess of 30 percent for posttraumatic stress disorder (PTSD) prior to March 9, 2012, and in excess of 50 percent thereafter is remanded. Entitlement to a rating in excess of 10 percent for status post bullet wound to the chest with myofascial pain syndrome and right anterior chest defect is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1976 to September 1979. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in New York, New York. 1. PTSD The Veteran was afforded a VA PTSD examination in April 2012, and at that time, the VA examiner noted there was occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily with normal routine behavior, self-care, and conversation. However, in October 2015, a private psychologist noted that the Veteran showed serious emotional symptoms, and his Beck Anxiety Inventory (BAI) score of 39 suggested severe anxiety symptoms. Due to the more than five years since the prior VA examination, the Board finds that there is a potential worsening of the Veteran’s PTSD. Thus, the Veteran should be afforded a new VA examination to assess the current nature and severity of his disability. See Snuffer v. Gober, 10 Vet. App. 400 (1997). 2. Bullet Wound In a September 2013 rating decision, the RO continued the 10 percent evaluation for the Veteran’s status post bullet wound of the chest with pain under Diagnostic Code 6843. It also granted service connection with a noncompensable evaluation for status post bullet wound with myofascial pain syndrome under Diagnostic Code 5321. The RO combined the two disabilities under one evaluation in the October 2015 Statement of the Case (SOC) with a 10 percent evaluation. The Veteran’s last VA examination for his respiratory condition was in April 2012, and the last VA examination for his muscle injury was in March 2013. Due to the more than five years since the prior VA examination, the Board finds that there is a potential worsening of the Veteran’s PTSD. Thus, the Veteran should be afforded a new VA examination to assess the current nature and severity of his disability. See Snuffer v. Gober, 10 Vet. App. 400 (1997). 3. TDIU With respect to the Veteran’s assertion that he is unable to work due to his claimed service-connected disabilities, the Board concludes that further development and adjudication of the Veteran’s claims may provide evidence in support of his claim for TDIU. The Board has therefore concluded that it would be inappropriate at this juncture to enter a final determination on that issue. See Henderson v. West, 12 Vet. App. 11 (1998), citing Harris v. Derwinski, 1 Vet. App. 180 (1991) (where a decision on one issue would have a “significant impact” upon another, and that impact in turn could render any review of the decision on the other claim meaningless and a waste of appellate resources, the claims are inextricably intertwined). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the current severity of service-connected PTSD. The claims file must be made available to the examiner and any indicated diagnostic tests and studies must be accomplished. The examiner is also asked to provide a functional assessment of the Veteran’s service-connected PTSD and his ability to secure or follow a substantially gainful employment consistent with his education and occupational experience, and without consideration of his age or nonservice-connected disabilities. 2. Schedule the Veteran for VA examinations to determine the current severity of service-connected bullet wound to the chest with myofascial pain syndrome. The Board notes that the Veteran must receive an examination to determine the effects of both his muscle injury and his respiratory injury. The claims file must be made available to the examiner and any indicated diagnostic tests and studies must be accomplished. The examiner is also asked to provide a functional assessment of the Veteran’s service-connected bullet wound to the chest with myofascial pain syndrome and his ability to secure or follow a substantially gainful employment consistent with his education and occupational experience, and without consideration of his age or nonservice-connected disabilities. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Daniels, Associate Counsel