Citation Nr: 18147786 Decision Date: 11/06/18 Archive Date: 11/06/18 DOCKET NO. 16-40 122 DATE: November 6, 2018 REMANDED 1. Entitlement to a disability rating of more than 50 percent for post traumatic stress disorder (PTSD) is remanded. 2. Entitlement to a total disability evaluation based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1962 to September 1965. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Baltimore, Maryland. The Veteran is appealing the March 2015 denial of his claim for an increase in the disability rating assigned to his PTSD. The Veteran’s PTSD was last evaluated by a VA examiner in January 2010 for a prior claim for an increased rating. In February 2015, the Veteran requested a new VA exam. VA scheduled the exam but, according to the case file, the Veteran failed to appear. There is, however, no indication the Veteran was notified that he was scheduled for an exam. Pursuant to 38 C.F.R. § 3.159(c), the VA must provide a medical examination when the record does not contain sufficient competent medical evidence to decide the claim. The Veteran submitted a report of an October 2015 evaluation prepared at his request by clinical psychologist Dr. M.B. The Board finds Dr. M.B.’s evaluation is of limited probative value because, among other deficits, it contains opinions unsupported by facts. See Sklar v. Brown, 5 Vet. App. 140 (1993) (the probative value of a medical opinion may be reduced if the examiner fails to explain the basis for an opinion). For example, Dr. M.B. wrote, without explanation, that the Veteran’s social impairment and daily routine/occupational impairment had increased since October of 2015. He reported that the Veteran was increasingly experiencing impaired judgment without describing any incidents during which the Veteran had evidenced impaired judgement. Finally, Dr. M.B. wrote that the Veteran’s impulse control was increasingly impaired as manifested by outbursts without citing a single example of any outburst. In September of 2015, the Veteran was seen by a VA psychiatrist for a consultation. Dr. N.S. confirmed the PTSD diagnosis but did not offer an opinion as to the Veteran’s current level of occupational and social impairment. Given the length of time since the last VA exam and the limited value of the reports of Drs. M.B. and N.S, the Board finds that the record contains insufficient competent medical evidence to decide the claim. For that reason, the matter must be remanded for a VA examination to assess the current severity of the disability. 38 C.R.S. § 3.159(c). Also, in August 2018, TDIU became an issue in this matter when the Veteran submitted an application stating that his hip condition and PTSD keep him from gainful employment. Pursuant to Rice v. Shinseki, 22 Vet. App. 447, 453-4 (2009), the TDIU claim is part and parcel of his claim for increased rating for PTSD. The Veteran’s claim for TDIU is inextricably intertwined with the claim for increased rating for his PTSD and the results of the requested VA review of that disorder. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Therefore, the Veteran’s claim for TDIU is remanded to the Agency of Original Jurisdiction with his claim for increased rating for PTSD for further examination. These matters are REMANDED for the following action: 1. Obtain all pertinent updated treatment records. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected PTSD. 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 symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to his PTSD alone. The VA examiner should identify any functional limitations caused by the Veteran’s service-connected PTSD and the impact these would have on his ability to work. 3. Conduct any development deemed necessary in these matters. 4. Readjudicate the claim for entitlement to a rating of more than 50 percent for PTSD. (Continued on the next page)   5. Adjudicate the claim for entitlement to TDIU. C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Mucklow, Associate Counsel