Citation Nr: 18144192 Decision Date: 10/24/18 Archive Date: 10/23/18 DOCKET NO. 13-34 234 DATE: October 24, 2018 REMANDED Entitlement to service connection for right shoulder pain, claimed as secondary to a service connected thoracic spine disability, is remanded. Entitlement to service connection for right arm pain, claimed as secondary to a service connected thoracic spine disability, is remanded. Entitlement to a rating greater than 10 percent for Bell's palsy is remanded. REASONS FOR REMAND The appellant served on active duty in the United States Air Force from March 1966 to March 1987. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2011 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for right shoulder pain and right arm pain, as secondary to a thoracolumbar disability, and which denied a rating greater than 10 percent for Bell’s palsy. As a preliminary matter, the Board notes that the appellant’s representative has indicated that he believes the Board erred in denying entitlement to service connection for Alzheimer’s disease in a November 2017 Board decision. In a September 2018 Informal Hearing Presentation, the appellant’s representative stated that the Board should re-adjudicate the issue of the denial of service connection for Alzheimer’s disease. The record currently available to the Board, however, contains no indication that the appellant appealed the Board’s November 2017 decision within 120 days after the date on which notice of the decision was mailed. See 38 U.S.C. § 7266. Thus, the decision is final. The Board may reconsider a prior decision upon receipt of a motion for reconsideration which meets the criteria set forth at 38 C.F.R. § 20.1000. Alternatively, an appellant may seek revision of a prior Board decision on the grounds of clear and unmistakable error. See 38 C.F.R. § 20.1405. If the appellant wishes to seek reconsideration or revision of that decision, a motion should be filed with the Board in accordance with the applicable regulations. 1. Entitlement to service connection for right shoulder pain, claimed as secondary to a thoracic spine disability, is remanded. The appellant contends that his right shoulder pain is caused by, or proximately due, to his service-connected thoracolumbar disability. This claim was previously remanded by the Board to obtain a medical examination and opinion regarding the nature and etiology of the appellant’s claimed disability. The appellant was scheduled for a VA examination on January 9, 2018 in compliance with the Board’s prior remand; however, the appellant failed to appear for the examination. Subsequently, the appellant’s representative submitted a brief in support of the claim which indicates the appellant has advanced Alzheimer’s disease, and asserts that he is incapable of managing his own appointments, as evidenced by the June 2015 appointment of a legal guardian. The Board finds that good cause has been demonstrated for the appellant’s failure to appear and finds that remand is appropriate to obtain an adequate examination that addresses this issue of entitlement to service connection. 38 C.F.R. § 3.655. In scheduling the appellant for an examination, the RO should coordinate with the appellant’s appointed guardian and his representative. 2. Entitlement to service connection for right arm pain, claimed as secondary to a service connected thoracic spine disability is remanded. The appellant contends his right arm pain, is caused by, or proximately due, to his service connected thoracolumbar disability. This claim was previously remanded by the Board to obtain a medical examination and opinion for the appellant regarding the nature and etiology of the appellant’s claimed disability. The appellant was scheduled for a VA examination on January 9, 2018 in compliance with the Board’s prior remand; however, the appellant failed to appear for the examination. Subsequently, the appellant’s representative submitted a brief in support of the claim which indicates the appellant has advanced Alzheimer’s disease, and asserts that he is incapable of managing his own appointments, as evidence by the June 2015 appointment of a legal guardian. The Board finds that good cause has been demonstrated for the appellant’s failure to appear and finds that remand is appropriate to obtain an adequate examination that addresses this issue of entitlement to service connection. 38 C.F.R. § 3.655. In scheduling the appellant for an examination, the RO should coordinate with the appellant’s appointed guardian and his representative. 3. Entitlement to a rating greater than 10 percent for Bell's palsy is remanded. The appellant contends that his service connected Bell’s palsy is more disabling than currently rated. This claim was previously remanded by the Board to obtain a medical examination and opinion for the appellant regarding the nature and severity of this service connected disability. The appellant was scheduled for a VA examination on January 9, 2018 in compliance with the Board’s prior remand; however, the appellant failed to appear for the examination. Subsequently, the appellant’s representative submitted a brief in support of the claim which indicates the appellant has advanced Alzheimer’s disease, and asserts that he is incapable of managing his own appointments, as evidence by the June 2015 appointment of a legal guardian. The Board finds that good cause has been demonstrated for the appellant’s failure to appear and finds that remand is appropriate to obtain an adequate examination that addresses this issue of entitlement to service connection. 38 C.F.R. § 3.655. In scheduling the appellant for an examination, the RO should coordinate with the appellant’s appointed guardian and his representative. The matters are REMANDED for the following action: 1. Schedule the appellant for an examination by an appropriate clinician to determine the nature and etiology of any right shoulder or right arm disabilities, which manifest with pain. The examiner must opine: (a) whether it is at least as likely as not that any current right shoulder or arm disability is at least as likely as not related to an in-service injury or disease, and (b) whether it is at least as likely as not that any current right shoulder or arm disability proximately due to a service-connected disability, to include the appellant’s thoracolumbar disability, or aggravated beyond their natural progression by a service-connected disability. 2. Schedule the appellant for an examination by an appropriate clinician to determine the current severity of his service-connected Bell’s palsy. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the appellant’s disability under the rating criteria.   3. The RO should coordinate the scheduling of these examinations with the appellant’s appointed legal guardian, with the assistance of his representative if necessary, as the appellant has advanced Alzheimer’s disease and it has been asserted that this condition causes an impediment to his ability to remember and keep appointments. K. Conner Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Kleponis, Associate Counsel