Citation Nr: 18143101 Decision Date: 10/18/18 Archive Date: 10/17/18 DOCKET NO. 16-20 143 DATE: October 18, 2018 REMANDED Entitlement to service connection for a neck disability (claimed as herniated discs cervical spine) is remanded. Entitlement to service connection for a back disability (claimed as herniated discs thoracolumbar spine) is remanded. Entitlement to service connection for Parkinson’s disease is remanded. Entitlement to service connection for traumatic brain injury (TBI) is remanded. Entitlement to service connection for an acquired psychiatric disability to include posttraumatic stress disorder (PTSD) 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 service from September 1983 to July 1987. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a November 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. 1. Service Connection – Neck, Back, Parkinson’s Disease, and TBI The Board finds that additional development is required before the remaining claims on appeal are decided. The Board notes that the Veteran has consistently asserted that he injured his head, neck, and back while in service during a fall. In that regard, he stated that he was injured while on active duty in Germany. Furthermore, the Veteran has consistently asserted that he developed tremors and Parkinson’s disease as a result of his head injury during service. Indeed, the Veteran’s service treatment records show that the Veteran was treated for head trauma during active service. In light of the Veteran’s statements, the service treatment records, and his current diagnosis of a neck disability, back disability, Parkinson’s disease, and TBI, the Board concludes that the Veteran should be afforded VA examinations to determine the nature and etiology of any current neck disability, back disability, Parkinson’s disease, and TBI. McLendon v. Nicholson, 20 Vet. App. 79 (2006). 2. Service Connection - Acquired Psychiatric Disability With regard to his claim for service connection for an acquired psychiatric disability, the Board notes that the Veteran was afforded a VA examination in November 2013. At that time, the examiner indicated that the Veteran had a diagnosis of personality disorder not otherwise specified (NOS), depression NOS, and anxiety disorder NOS. The Board finds the November 2013 VA examination is not adequate for adjudication purposes. In this regard, the VA examination did not provide an opinion as to the nature and etiology of the Veteran’s acquired psychiatric disability. Therefore, the Board finds that a new VA examination is warranted to determine the nature and etiology of any current acquired psychiatric disability. McLendon, 20 Vet. App. 79 (2006). 3. 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 the Veteran’s neck disability. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. The examiner should be sure to address the Veteran’s lay statements regarding the onset and continuity of his neck symptoms as well as the Veteran’s contentions of a fall injury during active service. 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 neck disability is etiologically related to service. 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 the Veteran’s back disability. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. The examiner should be sure to address the Veteran’s lay statements regarding the onset and continuity of his back symptoms as well as the Veteran’s contentions of a fall injury during active service. 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 back disability is etiologically related to service. 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 the Veteran’s Parkinson’s disease. The examiner should review the claims file and indicate that review in the report. Any indicated studies should be performed. The examiner should be sure to address the Veteran’s lay statements regarding the onset and continuity of his Parkinson’s disease symptoms as well as the Veteran’s contentions of a fall injury during active service. 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 Parkinson’s disease is etiologically related to service. The rationale for all opinions expressed must be provided. 5. Then, schedule the Veteran for a VA examination to determine the nature and etiology of any currently present TBI disability. The claims file must be made available to, and reviewed by the examiner. Any indicated studies must be performed. Based on the examination results and review of the record, the examiner should first identify all TBI disabilities present during the pendency of the claim and proximate thereto. Once all TBI disabilities have been identified, the examiner should provide the following findings: Does the Veteran have a TBI disability that clearly and unmistakably existed prior to his active service and if so, was that disability clearly and unmistakably NOT aggravated by service? In forming the opinion, the examiner must note that the Veteran’s lay statements alone are not a sufficient basis with which to support a finding that a disability clearly and unmistakably existed prior to service. With regard to any currently present TBI disability determined to NOT clearly and unmistakably exist prior to the Veteran’s active service, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that such disability is etiologically related to the Veteran’s active service. In forming the opinion, the examiner must consider and fully address the Veteran’s lay statements regarding the onset and continuity of his symptoms, and the Veteran’s contentions of a fall injury during active service. The rationale for all opinions expressed must be provided. 6. 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 all identified disabilities, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that 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 rationale for all opinions expressed must be provided. 7. Confirm that the VA examination report and any opinions provided comport with this remand, and undertake any other development found to be warranted. 8. 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. N. RIPPEL Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Mariah N. Sim, Associate Counsel