Citation Nr: 18148036
Decision Date: 11/08/18	Archive Date: 11/06/18

DOCKET NO. 16-40 579
DATE:	November 8, 2018
REMANDED
The issue of entitlement to service connection for chronic renal disease is remanded.
The issue of entitlement to an initial rating higher than 50 percent for posttraumatic stress disorder (PTSD) is remanded.
The issue of entitlement to a total disability rating based on individual unemployability (TDIU) is remanded.  
REASONS FOR REMAND
The Veteran served on active duty between April 1967 and January 1989.         
This matter comes before the Board of Veterans’ Appeals (Board) on appeal of September 2013 and October 2014 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina.  
1. The issue of entitlement to service connection for chronic renal disease is remanded.
The Veteran asserts that he incurred renal disease directly during service and secondarily as the result of service-incurred hypertension.  A July 2013 VA compensation examination report supports his secondary service connection theory by indicating that renal disease is due to hypertension.  Hypertension is not service connected, however.  In fact, a petition to reopen service connection for hypertension is currently pending before the RO.  See 38 C.F.R. §§ 3.156(b), 20.302 (2018).  As the two issues are inextricably intertwined, a decision on the service connection claim for renal disease must be suspended.  The two issues should be decided together.  See Smith v. Gober, 236 F.3d 1370, 1372 (Fed.Cir.2001).
2. The issue of entitlement to an initial rating higher than 50 percent for PTSD is remanded. 
3. The issue of entitlement to a TDIU is remanded.  
The current record is unclear regarding the nature and severity of service-connected PTSD.  The most recent VA compensation examination into PTSD, conducted in September 2015, found mild and transient symptoms, as did a VA examination in October 2014.  Further, VA and private treatment records dated between 2014 and 2018 are largely silent regarding psychiatric disability.  For example, a May 2018 private treatment record indicates that the Veteran denied any depression or anxiety.  But the Veteran submitted into the record two opinions indicating more severe impairment.  An October 2015 letter from the Vet Center described total and permanent impairment from PTSD, while a December 2016 report from a private therapist noted “malignant” PTSD “wrecking every aspect of his life.”  Due to the conflict in the evidence, and to the fact that the Veteran has not undergone VA examination for over three years, a new examination should be conducted.  See Green v. Derwinski, 1 Vet. App. 121 (1991).       
Lastly, the Veteran has asserted, along with his private providers, that PTSD has caused unemployability.  A TDIU claim is therefore on appeal as well.  See Rice v. Shinseki, 22 Vet. App. 447 (2009).
The matters are REMANDED for the following action:
1. Undertake appropriate development to obtain any outstanding records pertinent to the Veteran’s claims to the extent possible.  Include in the record any outstanding VA treatment records, the most recent of which are dated in June 2016.  All records/responses received must be associated with the claims file.  
2. Schedule a VA compensation examination to assess the current nature and severity of PTSD.  The examiner should review the claims folder.  In a report detailing the nature and severity of the disorder, the examiner should also comment on whether PTSD causes social and occupational impairment resulting in deficiencies in most areas of the Veteran’s life, or causes total occupational and social impairment.  See 38 C.F.R. § 4.130, Diagnostic Code 9411 (2018).
3. Readjudicate the service connection claim for renal disease once a decision on the claim to reopen service connection for hypertension is final.  

 
G. A. WASIK
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Christopher McEntee, Counsel