Citation Nr: 18148702
Decision Date: 11/08/18	Archive Date: 11/07/18

DOCKET NO. 15-07 380
DATE:	November 8, 2018
REMANDED
Entitlement to a rating in excess of 50 percent for posttraumatic stress disorder (PTSD) is remanded.
REASONS FOR REMAND
The Veteran served on active duty from April 1965 to April 1967. 
These matters come to the Board of Veterans’ Appeals (Board) on appeal from an April 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
The Veteran initially requested a hearing, but withdrew his request in correspondence received in April 2016.
Remanded Issue
The Veteran’s last VA PTSD examination was in April 2014. Despite the contentions of the Veteran’s representative in her October 2018 written brief presentation, the Board is not required to direct a new examination simply due to the passage of time. However, a new examination is appropriate when the claimant asserts that the disability in question has undergone an increase in severity since the time of the last examination. See Palczewski v. Nicholson, 21 Vet. App 174, 181 (2007); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); see also Bolton v. Brown, 8 Vet. App. 185, 191 (1995). (VA must provide a new examination where a veteran claims the disability is worse than when originally rated and the available evidence is too old to adequately evaluate the current severity); Caffrey v. Brown, 6 Vet. App. 377, 381 (1995). 
There is evidence suggestive of worsening symptomatology, including since that last VA examination. VA mental health records subsequent to the April 2014 VA examination indicate worsening psychiatric symptoms, such as memory loss, decreased insight, and increasing depressive symptoms. In addition, the Veteran was diagnosed with a major neurocognitive disorder, assessed as severely impaired.
Thus, after considering the medical evidence indicating that the Veteran’s psychiatric symptoms have worsened, and in light of the amount of time since the last VA examination and the possible increase in severity of this disability, re-examination is needed.
The matter is REMANDED for the following action:
1. Obtain all outstanding treatment records if relevant to the claim.
 2. After receiving all additional treatment records, schedule the Veteran for a VA examination to reassess the severity of his PTSD. His claims file, including a complete copy of this remand, must be made available to the examiner in conjunction with the examination. All pertinent symptoms and findings must be reported in detail. The examiner should indicate all symptomatology associated with the Veteran’s PTSD. The examiner should also address all functional impairment caused by 
 
this disability. All findings must be reported in detail and all opinions accompanied by supporting rationale.
 
M. H. HAWLEY
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. Norwood, Associate Counsel