Citation Nr: 18147804 Decision Date: 11/06/18 Archive Date: 11/06/18 DOCKET NO. 13-16 255 DATE: November 6, 2018 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected bilateral foot calluses is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1979 to June 1979, with additional service in the Army Reserves. The Board issued a decision in August 2017 denying the Veteran’s claims. The Veteran then appealed to the United States Court of Appeals for Veterans Claims (Court) and the parties filed a Joint Motion for Partial Remand (JMPR) in April 2018. Thereafter, in April 2018, the Court issued an Order granting the JMPR and remanding the matters for action consistent with the terms of the JMPR. 1. Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected bilateral foot calluses is remanded. The parties to the April 2018 JMPR agreed that VA erred in failing to ensure that the Veteran’s VA examination was adequate. Specifically, an April 2016 VA examiner opined that the Veteran’s psychiatric disorder was less likely than not proximately due to or the result of the Veteran’s service connected condition. The examiner reasoned that there were multiple stressors that could have contributed to the Veteran’s depressive symptoms “including chronic heroin use, homelessness, unemployment, chronic foot pain, and diabetes. In addition, he had multiple conditions that could have caused foot pain including callouses, chronic plantar fascitis, and diabetic neuropathy”. However, in providing this opinion, the VA examiner did not address aggravation of any psychiatric disorder by the Veteran’s service-connected foot disabilities. A medical opinion regarding secondary service connection must address both causation and aggravation. See El Amin v. Shinseki, 26 Vet. App. 140 (2013). The absence of an opinion addressing aggravation renders the examination inadequate for adjudication purposes. Therefore, a remand is necessary to obtain a medical opinion addressing aggravation and to readjudicate the claim on appeal pursuant to the April 2018 JMR directives. 2. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. The claim for entitlement to a TDIU is inextricably intertwined with the claim for service connection that is remanded herein. See Tyrues v. Shinseki, 23 Vet. App. 166, 177 (2009) (en banc) (explaining that claims are inextricably intertwined where the adjudication of one claim could have a significant impact on the adjudication of another claim). As such, consideration of the Veteran's TDIU claim must be deferred pending the outcome of such claim. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (where a claim is inextricably intertwined with another claim, the claims must be adjudicated together in order to enter a final decision on the matter). The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records dated to the present. 2. Ask the Veteran to complete a VA Form 21-4142 for any outstanding private treatment records. Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. 3. Return the file to the April 2016 VA examiner for an addendum opinion. If that examiner is unavailable, the opinion should be provided by another examiner. An examination should be scheduled. The claims file, JMPR, and a copy of this remand, must be reviewed by the examiner. Following review of the file, and the requested examination, the examiner is to address the following, providing a complete rationale for any opinion offered: (a.) If any acquired psychiatric disorders are diagnosed, the examiner must opine whether each diagnosed disorder is at least as likely as not related to an in-service injury, event, or disease, to specifically include, but not limited to, the Veteran’s service-connected bilateral foot disabilities. (b.) The examiner is asked to specifically discuss whether any diagnosed psychiatric disorder was aggravated beyond a natural progression by the Veteran’s bilateral foot disabilities. In so doing, the examiner should discuss the private medical opinion from Dr. Uzzell. (Continued on the next page)   4. Subsequently, readjudicate the issues on appeal and, if any benefit remains denied, provide the Veteran and his representative, if any, with an appropriate SSOC prior to returning the appeal to the Board. JEBBY RASPUTNIS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Smith-Jennings, Associate Counsel