Citation Nr: 18145663 Decision Date: 10/29/18 Archive Date: 10/29/18 DOCKET NO. 13-06 566 DATE: October 29, 2018 REMANDED Entitlement to a compensable disability rating for status-post repair of a left inguinal hernia is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1973 to March 1977. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a February 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. The Veteran requested a Board hearing before a Veterans Law Judge at the local RO on his March 2013 VA Form 9. A hearing was scheduled in March 2015, but the Veteran did not appear. The Board concludes that the Veteran has withdrawn his request for a Board hearing. In a September 2017 decision, the Board denied entitlement to a compensable rating for status-post repair of a left inguinal hernia, finding that “the Veteran does not have a recurrent hernia, nor does he have a hernia that is well supported by a truss or belt. In fact, there is no evidence of an inguinal hernia at all.” The Veteran appealed that denial to the United States Court of Appeals for Veterans Claims (Court), and in response to a Joint Motion for Partial Remand, the Court vacated and remanded the Veteran’s claim in June 2018. In the Joint Motion for Partial Remand, the parties agreed that the Board erred when it failed to address whether the Veteran is entitled to an extraschedular rating given the neurological symptoms caused by his status-post repair hernia. The parties further agreed that the Board erred when it failed to consider whether the Veteran is entitled to a separate rating for his neurological symptoms. Although the Board regrets the additional delay, a remand is required for further development and adjudicative action. The Board also notes that three additional issues that were remanded by the Board for further development in June 2018 have not yet been recertified to the Board, and will not, therefore, be addressed at this time. Entitlement to a compensable disability rating for status-post repair of a left inguinal hernia is remanded. In a May 2013 visit with a private examiner, the Veteran asserted that pain he experiences as a result of his service-connected left inguinal hernia disability has increased in severity in the form of affecting his nerves. The private examiner noted that the Veteran’s 2011 hernia repair still leads to pain on the inside of his thigh, numbness, tingling, “almost abolished” deep tendon reflexes and “some hypethesia with allodynia on the distribution of the ilioinguinal and iliohypogastric nerves”. The Board fidns that the Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and neurological manifestations of the Veteran’s impaired nerves. A review of the record reflects that the Veteran was afforded a VA Examination in August 2013; however, that examination report did not include an opinion on the etiology of the Veteran’s neurological symptoms. Therefore, on remand, the Veteran should be afforded a VA examination in which the examiner should consider neurological manifestations to include, as stated above, the pain on the inside of his thigh, numbness, tingling, “almost abolished” deep tendon reflexes and “some hype[res]thesia with allodynia on the distribution of the ilioinguinal and iliohypogastric nerves”. Only then can the Board determine whether the Veteran is entitled to a separate rating or extraschedular rating for the neurological symptoms that stem from his service-connected left inguinal hernia. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate medical professional to determine the current severity of the Veteran’s service-connected left inguinal hernia, to specifically include a neurological examination of the Veteran’s impaired nerves and neurological manifestations. The medical professional should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability, including obtaining from the Veteran information regarding the severity, frequency, and duration of symptoms as well as the specific nerves that are affected. The examiner must attempt to distinguish between any neurological impairment due to the service-connected hernia and any such impairment due to nonservice-connected sources. A complete rationale should be provided for all opinions given. If the medical professional is unable to provide this opinion without resorting to speculation, he or she must indicate why this is so. (Continued on the next page)   2. If the medical professional determines that neurological manifestations attributable to the hernia are present, the RO should then determine whether extraschedular rating is warranted. If warranted, the Veteran’s file should then be referred to the Director of Compensation Services for an opinion on an extraschedular rating. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K.Smith, Law Clerk