Citation Nr: 18145088 Decision Date: 10/26/18 Archive Date: 10/26/18 DOCKET NO. 16-31 320 DATE: October 26, 2018 REMANDED Issue of entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1986 to January 1990. This appeal to the Board of Veterans’ Appeals (Board) arose from a March 2014 rating decision issued by the Department of Veterans Affairs (VA). See September 2016 Notice of Disagreement (NOD); June 2016 Statement of the Case (SOC); June 2016 Substantive Appeal (VA Form 9). Issue of entitlement to TDIU is remanded. The Board cannot make a fully-informed decision on the issue of TDIU because no VA examiner has opined on whether pain from the Veteran’s service connected disabilities and medication side effects result in an inability to concentrate that renders the Veteran unemployable. The Veteran submitted a private treatment provider opinion indicating that the Veteran’s pain and side effects of medication limit his concentration, but the opinion is insufficient to warrant granting entitlement to TDIU. The degree of nonservice connected disabilities will be disregarded when making a TDIU determination. See 38 C.F.R. § 416; Blackburn v. Brown, 4 Vet. App. 395, 398 (1993). The July 2014 opinion from LWB, M.D., indicates that the Veteran reports having bilateral knee pain, low back pain, sciatica-type pain, and muscle spasms. Dr. LWB indicates that the combined problems of pain and side effects of Flexeril limit his concentration and that he considers the Veteran 100% disabled. Id. However, the Veteran’s low back and sciatica-type pain are not due to service connected disabilities. See March 2014 Rating decision codesheet; January 2012 VA examination. Dr. LWB’s opinion is unclear on how much the Veteran’s bilateral knee pain affects his concentration, if any. The Board recognizes that the claims file contains VA examiners’ opinions on the functional limitations resulting from the Veteran’s service connected bilateral knee and lower leg conditions and right upper extremity. See November 2012 VA examination; February 2014 VA examination. However, while the November 2012 VA examiner opined the Veteran’s right upper extremity limitations still allow for light and sedentary work, and the February 2014 VA examiner opined the Veteran’s lower extremity limitations still allow for sedentary work, neither opinion specifically address whether the pain and use of medication due to the Veteran’s service connected disabilities limit concentration and render the Veteran unemployable. Accordingly, the Board determines that remand is warranted. The matter is REMANDED for the following action: 1. Ask the Veteran to identify the provider(s) of any evaluations and/or treatment received for his service connected disabilities, to specifically include his bilateral lower extremities and right upper extremity, and provide authorizations for VA to obtain records of any such private treatment. Obtain complete clinical records of all pertinent evaluations and treatment (records of which are not already associated with the claims file) from the providers identified. If any records sought are unavailable, the reason for their unavailability must be noted in the claims file. If a private provider does not respond to VA’s request for the identified records sought, the Veteran must be so notified and reminded that it is ultimately his responsibility to ensure that private treatment records are received. 2. Obtain an addendum opinion from an appropriate medical professional to determine the level of impairment of the Veteran’s service connected disabilities since February 14, 2012, a year prior to when he filed his TDIU claim. If the medical professional determines that it is necessary, schedule the Veteran for a VA examination to determine the level of impairment. Based on a review of the claims file and, if performed, the examination, the medical professional should: (a) Fully describe the functional effects of the Veteran’s combined service connected disabilities on occupation or activities of daily living. The medical professional should specifically address any limitation on concentration from pain or medication due to the Veteran’s service connected disabilities. The medical professional should describe any pertinent complaints, symptoms, and clinical findings. (b) If possible, the medical professional should opine what restrictions are solely due to the Veteran’s service connected disabilities, and what are due to nonservice connected disabilities. 3. Advise the Veteran that he may submit a supplemental medical opinion from a treating physician or any other medical professional that addresses the limitations resulting solely from his service connected disabilities. If such an opinion is provided, the treating physician (or any other medical professional) should set forth in the medical report a fully articulated rationale for the opinion expressed. The report should consider and discuss the Veteran’s medical history and relevant clinical data that apply and may reasonably explain the medical guidance in the study of this case. (Continued on the next page)   4. After the above development has been completed, review the claims file and ensure that all development sought in this remand has been completed. Arrange for any further development indicated by the results of the development requested above if deemed warranted by the Agency of Original Jurisdiction, and re-adjudicate the claim of entitlement to TDIU. DEBORAH W. SINGLETON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Lin, Associate Counsel