Citation Nr: 18141571
Decision Date: 10/11/18	Archive Date: 10/10/18

DOCKET NO. 16-24 490A
DATE:	October 11, 2018
REMANDED
Entitlement to an evaluation in excess of 50 percent for depressive disorder 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 December 1998 to October 2000. 
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2015 rating decision by the Department of Veterans Affairs (VA). 
Entitlement to an evaluation in excess of 50 percent for depressive disorder and TDIU are remanded. 
The Veteran stated that he received on-going treatment with his private psychiatrist, see September 2015 notice of disagreement, but updated records have not been sought. Because the Veteran will be undergoing VA examinations to determine the functional impairment of his spine and neck disabilities, see below, updated private treatment records and a new VA psychological examination should be obtained on remand. 
The Veteran has previously indicated that his service-connected bilateral pes planus, spine disability, and neck disability prevent him from securing or following substantially gainful employment. See March 2014 VA Form 21-8940, Application for Increased Compensation Based on Unemployability. VA examinations to determine the level of functional impairment the Veteran’s spine and neck disabilities have not been completed during the appeal period. Thus, remand is necessary to determine the current level of functional impairment caused by these disabilities.
The matters are REMANDED for the following action:
1. The AOJ should obtain, if possible, records of all private evaluations and treatment the Veteran has received for his psychological disorder. The Veteran must assist in the matter by identifying his private healthcare providers and by submitting releases for VA to obtain any private records identified.
If any private records identified are not received pursuant to the AOJ’s request, the Veteran should be so notified and advised that it is ultimately his responsibility to ensure that any available private records are received.
2. After the above development is completed, the AOJ should arrange for an examination of the Veteran to assess the current severity of his service-connected depressive disorder. The examiner must review the entire record (including this remand) in conjunction with the examination and note such review was conducted. The examiner should provide a full description of the disability and report all signs and symptoms associated with the Veteran’s disorder.
3. After the development in the first instruction is completed, the AOJ should arrange for an orthopedic examination of the Veteran to assess the current severity of his service-connected spine and neck disabilities. The examiner must review the entire record in conjunction with the examination and note such review was conducted. Any associated impairment of function should be described in detail. All indicated tests or studies should be completed.
Range of motion measurements should be included for active and passive motion, and weight-bearing and non-weight-bearing circumstances. If pain is noted, the point in the range of motion at which pain starts should be clearly noted.
If feasible, the examiner should assess the additional functional impairment on repeated use or during flare-ups in terms of the degree of additional range of motion loss, using lay observations specifically elicited from the Veteran. If not feasible, the examiner should provide a detailed explanation and rationale for why such could not be accomplished. Specifically, if the medical professional cannot provide an opinion without resorting to mere speculation, he or she must provide a complete explanation for why an opinion cannot be rendered; a rationale based on the fact that the Veteran is not having a flare-up at the time of the examination will not be deemed adequate.




4. If upon completion of the above action the issues remain denied, the case should be returned to the Board after compliance with appellate procedures.
 
E. I. VELEZ
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Sandler, Associate Counsel