Citation Nr: 18146314 Decision Date: 10/31/18 Archive Date: 10/31/18 DOCKET NO. 16-30 494 DATE: October 31, 2018 REMANDED Entitlement to increased rating in excess of 10 percent for a low back disability is remanded. Entitlement to increased rating in excess of 10 percent for a right knee retropatellar syndrome is remanded. Entitlement to increased rating in excess of 10 percent for a left knee retropatellar syndrome is remanded. Entitlement to increased rating in excess of 10 percent for a right foot disability is remanded. Entitlement to a total rating based on individual unemployability (TDIU) due to service-connected disabilities, is remanded. REASONS FOR REMAND Although the Board regrets the delay, remand is warranted. During the course of the appeal, the Veteran identified outstanding VA treatment records and VA has uploaded treatment records to the file that have not been reviewed by the RO. In addition, the Veteran was last afforded a VA examination in May 2015, but he stated in a June 2016 substantive appeal that his disabilities had worsened. Remand is needed to associate pertinent outstanding records with the claims file and for VA to afford the Veteran new VA examinations to determine the current severity of his disabilities. As the Veteran has claimed entitlement to a TDIU as the result of his service-connected disabilities, TDIU has been raised by the record and is part of the current appeal, but it is also inextricably intertwined with the issues being remanded such that it also must be remanded. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Ensure that all outstanding VA treatment records dated to the present are associated with the claims file. 2. Ask the Veteran to complete a VA Form 21-4142 for any pertinent outstanding private treatment records. Make two requests for any authorized records, unless it is clear after the first request that a second request would be futile. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected low back disability. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to the back disability alone and discuss the effect of the Veteran’s back disability on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner does not have the knowledge or training. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected knee disabilities. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to the knee disabilities alone and discuss the effect of the Veteran’s knee disabilities on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner does not have the knowledge or training. 5. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected right foot disability. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to the right foot disability alone and discuss the effect of the Veteran’s right foot disability on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner does not have the knowledge or training. 6. Then, readjudicate the claims on appeal, to include entitlement to a TDIU. JEBBY RASPUTNIS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Yaffe, Associate Counsel