Citation Nr: 18152517 Decision Date: 11/23/18 Archive Date: 11/23/18 DOCKET NO. 1534037 DATE: November 23, 2018 REMANDED Entitlement to an initial rating higher than 30 percent for service-connected tension headaches is remanded. Entitlement to a total rating based on individual employability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from February 8, 1978 to February 7, 1981. These matters are before the Board of Veterans’ Appeals (Board) on appeal of an October 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. The Board notes that jurisdiction now rests with the Lincoln, Nebraska RO. Although the Board regrets the additional delay, a remand is required for further development and adjudicative action. 1. Entitlement to an initial rating higher than 30 percent for service-connected tension headaches is remanded. Here, the Veteran seeks increased compensation for his service-connected headaches, which he alleges manifest in symptoms that include seizures. The Veteran has asserted that his seizures originate from the same area of his head as his headaches, which result from an injury that he incurred in-service. See October 2015 Lay Statement. He also stipulates that his headaches occur at least weekly, not monthly as is stated on the Statement of the Case (SOC). See VA Form 9. He claims to experience “spells of sharp tingling pain from right posterior head region then blurring vision then [loss of consciousness], eyes open, [and] head movements”. See July 2018 VA Treatment Records. A review of the record reflects that the Veteran was afforded a Compensation and Pension Examination in September 2013; however, that examination report did not include an opinion on the etiology of the Veteran’s seizures. Further, the Veteran asserts that his seizures “are happening more frequently”. See April 2015 Lay Statement. Therefore, on remand, the Veteran should be afforded a VA examination in which the examiner should consider his seizure manifestations to include, as stated above, the pain on the right side of his head, tingling, blurring vision and head movements. The Board notes that the Veteran has presented a separate claim for the possibility of his seizures being service-connected which is currently at the Regional Office. However, the Board has concluded that a new VA examination is necessary which may address both claims. Only then can the Board determine whether the Veteran is entitled to a separate rating for the seizure symptoms that may stem from his service-connected headaches. 2. Entitlement to a TDIU due to his service-connected headaches is remanded. Additionally, the Court has held that a claim for a TDIU, either expressly raised by a Veteran or reasonably raised by the record, involves an attempt to obtain an appropriate rating for a disability and is part of the claim for an increased rating. Rice v. Shinseki, 22 Vet. App. 447 (2009). Here, the Veteran has asserted that he “couldn’t work if [he] wanted to] because his condition means that he “can’t concentrate on a task with [his] head pounding”. See April 2015 Lay Statement. The Board recognizes that the Veteran submitted a VA Form 21-8940 in July 2014, however, entitlement to a TDIU has been raised as part and parcel of the Veteran’s disagreement with the initial rating assigned for his headaches. Accordingly, the Board concludes that a claim for TDIU has been raised. The Board’s directive regarding the initial increased rating claim being remanded could potentially have an impact regarding the TDIU issue; therefore, the issue of a TDIU is inexplicably intertwined with the issue being remanded and adjudication of TDIU must be deferred pending the proposed development. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (the adjudication of claims that are inextricably intertwined is based upon the recognition that claims related to each other should not be subject to piecemeal decision-making or appellate litigation). The Board acknowledges that the Veteran may be incarcerated in Texas with a projected release date of October 22, 2019. See Texas Department of Criminal Justice Offender Information Search. Nevertheless, incarcerated veterans are entitled to the same care and consideration given to their fellow Veterans. Bolton v. Brown, 8 Vet. App. 185, 191 (1995). The Court has cautioned those who adjudicate claims of incarcerated veterans to be certain that VA tailors its assistance to the peculiar circumstances of confinement. Id. The matters are REMANDED for the following action: 1. Contact the Veteran’s incarcerating facility to determine whether a VA examination is possible and, if so, whether the Veteran should be escorted to a VA medical facility or examined at the prison by VHA personnel, prison medical providers at VA expense, or fee-based providers contracted by VHA. All efforts to arrange for examination must be documented in the claims file. 2. If examination is possible, schedule the Veteran for an examination by an appropriate medical professional to determine the current severity of the Veteran’s service-connected headaches, to specifically include an examination of the Veteran’s claimed seizure manifestations. The medical professional should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability, including obtaining from the Veteran information regarding the severity, frequency, and duration of symptoms. The examiner must attempt to distinguish between any impairment due to the service-connected headaches and any such impairment due to nonservice-connected sources. If a seizure disorder is found, the examiner must clarify whether it was caused or aggravated by the service-connected headache disorder. A complete rationale should be provided for all opinions given. If the medical professional is unable to provide this opinion without resorting to speculation, he or she must indicate why this is so. (Continued on the next page)   3. Then, the Veteran’s claim must be readjudicated. If the benefit sought on appeal is not granted to the Veteran’s satisfaction, the Veteran and his representative must be provided a Supplemental Statement of the Case and be given an adequate opportunity to respond. Thereafter, the case should be returned to the Board for further appellate action. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K.Smith, Law Clerk