Citation Nr: 18151191
Decision Date: 11/16/18	Archive Date: 11/16/18

DOCKET NO. 13-28 224
DATE:	November 16, 2018
REMANDED
Entitlement to a compensable rating for right inguinal hernia, P.O. is remanded.
Entitlement to a compensable rating for left inguinal hernia, P.O., is remanded.
Entitlement to service connection for carpal tunnel syndrome of the bilateral lower extremities is remanded.
Entitlement to service connection for sleep apnea, to include as secondary to service-connected posttraumatic stress disorder (PTSD) is remanded.
Entitlement to service connection for peripheral neuropathy of the right arm with numbness, to include as due to herbicide exposure or carpal tunnel syndrome, is remanded.
Entitlement to a compensable rating for bilateral hearing loss is remanded.
Entitlement to a rating in excess of 10 percent for tinea versicolor is remanded.
Entitlement to a compensable rating for a maculopapular rash on the back and chest is remanded.
Entitlement to an initial rating in excess of 30 percent for PTSD is remanded.
Entitlement to a total disability rating for individual unemployability (TDIU) is remanded.
REASONS FOR REMAND
The Veteran served honorably in the United States Marine Corps from February 1965 to February 1969.
1. Entitlement to a compensable rating for right inguinal hernia, P.O.
2. Entitlement to a compensable rating for left inguinal hernia, P.O.
3. Entitlement to service connection for carpal tunnel syndrome of the bilateral lower extremities 
4. Entitlement to service connection for sleep apnea, to include as secondary to service-connected PTSD
Due to the similar dispositions for the claims on appeal, the Board will address them in a common discussion below.
In an April 2012 rating decision, the Agency of Original Jurisdiction (AOJ) denied claims for compensable ratings for service-connected right and left inguinal hernias, P.O., as well as for service connection for carpal tunnel syndrome of the bilateral lower extremities and sleep apnea.  In a May 2012 rating decision, the AOJ continued these denials.   In May 2012, the Veteran timely expressed disagreement with the rating decision for these specified issues; however, the AOJ has yet to issue a Statement of the Case (SOC).  Where VA fails to furnish a claimant with an SOC in accordance with statutory or regulatory requirements, then the appropriate remedy is for the Board to remand the matter to the AOJ in order to issue an SOC.  See Manlincon v. West, 12 Vet. App. 238, 240-41 (1999).
5. Entitlement to service connection for peripheral neuropathy of the right arm with numbness, to include as due to herbicide exposure or carpal tunnel syndrome
The Veteran asserts his right arm condition is related to his duties performed during active service, to include herbicide exposure, or in the alternative related to his carpal tunnel syndrome. The current treatment records show the Veteran has been treated for carpal tunnel syndrome with probable ulnar neuropathy of the right arm and with neuropathy of the upper extremities.  See VA medical center records dated March 2016.  Additionally, review of the Veteran’s service personnel records documents his service in Vietnam during his period of active service from 1965 to 1969, thus the Board finds the Veteran is presumed to have herbicide exposure therein.  See 38 C.F.R. § 3.307(a)(6)(i) (2018).
Due to the Veteran’s assertions of a right arm condition, as well as the lack of conclusive medical records, the Board believes further development including a medical examination with an opinion based on full consideration of the Veteran’s documented medical history and assertions, and supported by clearly stated rationale, would be helpful in resolving this claim on appeal.  See 38 U.S.C. § 5103A (2012); 38 C.F.R. §§ 3.159, 3.303 (2018); McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006).
6. Entitlement to a compensable rating for bilateral hearing loss
7. Entitlement to a rating in excess of 10 percent for tinea versicolor
8. Entitlement to a compensable rating for a maculopapular rash on the back and chest
9. Entitlement to an initial rating in excess of 30 percent for PTSD
During the course of the appeal, the Veteran was last afforded VA examinations for his service-connected bilateral hearing loss in October 2011, for his service-connected tinea versicolor and maculopapular rash on the back and chest in September 2013, and for his service-connected PTSD in October 2011.  The Veteran indicated in his September 2013 appeal to the Board that these service-connected disabilities have all worsened since he was last evaluated.  In light of such evidence, additional development is needed to properly adjudicate these issues on appeal.  See 38 U.S.C. § 5103A(a); 38 C.F.R. § 3.159; Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).
10. Entitlement to TDIU
While the Board remands the issues of entitlement to higher ratings for service-connected bilateral hearing loss, tinea versicolor, maculopapular rash of the back and chest, and PTSD for additional evidentiary development, as discussed above, those decisions may impact this claim for TDIU.  As such, these issues are inextricably intertwined.  See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).
The matters are REMANDED for the following actions:
1. Issue a SOC addressing the issues of entitlement to compensable ratings for right and left inguinal hernias, P.O., service connection for carpal tunnel syndrome of the bilateral lower extremities, and service connection for sleep apnea, to include as secondary to service-connected PTSD.  A timely perfected appeal must be filed to vest the Board with appellate jurisdiction over the claim.  Otherwise the appeal may be closed by the AOJ.
2. Contact the Veteran and request that he identify any private treatment facilities or providers for his peripheral neuropathy of the right arm, bilateral hearing loss, tinea versicolor, maculopapular rash, and/or PTSD and provide him with the appropriate release forms.
Then, if he provides the required information, make appropriate efforts to obtain any outstanding records so authorized for release from any facility identified by the Veteran, to include the Montezuma Hearing Clinic, Inc. with Dr. Lucia Story as identified in a March 2018 private audiologic report.   
If these records cannot be located, the AOJ must specifically document the attempts made to locate them and notify the Veteran.
3. Obtain and associate with the claims file (a) any outstanding VA treatment records dated since January 2018 and (b) any outstanding treatment records from the Farmington Vet Center.  If these records cannot be located or do not exist, it must specifically document the attempts that were made to locate them and the Veteran must be notified.
4. Then, schedule the Veteran for an examination with an appropriate clinician for his peripheral neuropathy of the right arm with numbness.  The claims folder should be made available and reviewed by the examiner, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated.  All indicated studies should be performed and all findings should be reported in detail. 
The examiner is requested to provide the following information:
(a.) The examiner should identify any current diagnosis for neurological impairment of the right upper extremity.
(b.) If so, provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s current diagnosis began during active service or is related to an incident of service, to include herbicide exposure therein.
The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report.  If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 
5. Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of his service-connected bilateral hearing loss.  The entire claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated. 
Although an independent review of the claims file is required, the Board calls the examiner’s attention to the following: 
The Veteran’s statement in September 2013 regarding worsening symptoms
The examiner must provide all findings, along with a complete rationale for any opinions provided.
6. Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of his service-connected tinea versicolor and service-connected maculopapular rash of the back and chest.  The entire claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated.
Although an independent review of the claims file is required, the Board calls the examiner’s attention to the following: 
The Veteran’s statement in September 2013 regarding worsening symptoms
The examiner must provide all findings, along with a complete rationale for any opinions provided.
7. Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of his service-connected PTSD.  The entire claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated.
Although an independent review of the claims file is required, the Board calls the examiner’s attention to the following: 
The Veteran’s statement in September 2013 regarding worsening symptoms
The examiner must provide all findings, along with a complete rationale for any opinions provided.
8. Then, review the examination reports and medical opinions to ensure that the requested information was provided.  If any report or opinion is deficient in any manner, the AOJ must implement corrective procedures.
9. Then, readjudicate the issues of entitlement to service connection for peripheral neuropathy of the right arm with numbness, higher ratings for bilateral hearing loss, tinea versicolor, maculopapular rash of the back and chest, and PTSD, as well as TDIU.  If any decision is adverse to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response.  Then, return the case to the Board.
 
T. Blake Carter
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Laura A. Crawford, Associate Counsel