Citation Nr: 18157942 Decision Date: 12/13/18 Archive Date: 12/13/18 DOCKET NO. 15-23 106A DATE: December 13, 2018 REMANDED Entitlement to an initial rating in excess of 60 percent for service connected coronary artery disease (CAD) prior to November 17, 2014, and in excess of 10 percent thereafter is remanded. Entitlement to total disability based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from August 1967 to September 1969. In July 2018, the Veteran and his spouse testified at a Board hearing. The transcript is of record. The Board notes that in this case, there was no reduction, but rather the Regional Office granted staged rating for its initial grant of service connection for CAD. Because this staged rating did not result in a reduction or discontinuance of compensation payments that were already being made, this does not constitute a reduction in compensation, and the process specified in 38 C.F.R. § 3.105 (e) (2017) was not required. See O'Connell v. Nicolson, 21 Vet. App. 89, 93 (2007); Hamer v. Shinseki, 24 Vet. App. 58, 61-62 (2010). In the case of Rice v. Shinseki, 22 Vet. App. 447, 455 (2009), the United States Court of Appeals for Veterans Claims (Court) held that a claim for a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is part and parcel of an increased rating claim when such claim is raised by the record. I. Increased Rating and TDIU The Veteran last underwent a VA examination in November 2014 for his CAD. At the hearing in July 2018, the Veteran testified that his symptoms have increased since his last VA examination. Based on the contention that his symptoms worsened, a new VA examination is warranted to determine the current severity of the Veteran’s CAD. The Veteran's entitlement to a TDIU is inextricably intertwined with the entitlement to an increased rating for CAD claim on appeal. Therefore, the Board finds that the claim for a TDIU must be remanded as well. See Harris v. Derwinski, 1 Vet. App. 180 (1991) (issues are inextricably intertwined when a decision on one issue would have a significant impact on another issue). The matter is REMANDED for the following action: 1. Obtain updated VA and/or private treatment records to the extent possible. If such records are unavailable, the Veteran’s claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 2. Schedule the Veteran for a VA medical examination to determine the current severity of his service-connected CAD. The electronic claims file, to include a copy of this remand, must be reviewed in conjunction with the examination. Any appropriate evaluations, studies, and testing deemed necessary by the examiner should be conducted, and the results included in the examination report. The examiner should consider and address the testimony and any lay statements of record. If there is a medical basis to support or doubt the history provided, the examiner should provide a fully reasoned explanation. The examiner must also provide an assessment of the Veteran’s functional limitations due to his CAD as it may relate to his ability to function in a work setting and to perform work tasks. However, the examiner should refrain from commenting on the Veteran’s employability. A complete rationale should be given for all opinions and conclusions rendered. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 3. Finally, readjudicate the appeal. If the benefits sought on appeal remain denied, issue a supplemental statement of the case and return the case to the Board. G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. A. Prinsen, Associate Counsel