Citation Nr: 18159169
Decision Date: 12/18/18	Archive Date: 12/18/18

DOCKET NO. 16-58 048
DATE:	December 18, 2018
REMANDED
A total disability due to individual unemployability (TDIU) is remanded.











REASONS FOR REMAND
The Veteran served on active duty from March 1984 to December 2003.  He also had a period of active duty for training (ACDUTRA) from May 1982 to July 1982.
This case is on appeal from a January 2016 rating decision.
Entitlement to a TDIU.
The Veteran contends he is entitled to a TDIU as a result of the aggregate effect of his service-connected disabilities, including the effects of posttraumatic stress disorder (PTSD), lumbosacral strain, psoriasis, and knee disabilities. 
On a VA Form 21-8940 of record (Veteran’s Application for Increase based on Unemployability), the Veteran reported last working full time in February 2010, and that he became too disabled to work in 2011.
The Veteran’s most recent VA examination in regard to the severity of his PTSD was in August 2015.  During the examination, the Veteran reported that in 2009, he was preparing to leave his job in the maintenance department of a health care provider company due to his problems with his back and arms but the company ceased operations before that.  The VA examiner opined that the Veteran’s current PTSD causes occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation.  
Another VA examination regarding the Veteran’s lumbosacral strain was afforded on the same date.  The examiner noted that the Veteran’s thoracolumbar spine (back) condition impacts his ability to work.
Three other VA examinations were performed in connection with the Veteran’s service connected non-degenerative arthritis, hands and fingers disability and his knee problems.  The examiner opined that as for the non-degenerative arthritis disability, the best work environment for the Veteran would be an indoor facility with minimal sitting, standing, walking and limited need for fine motor skills, including to avoid “lifting objects heavier than 15 lbs.”
Although the VA examinations have addressed the disabilities individually, the Board finds that a remand is warranted for a medical opinion that takes into consideration the aggregate effect of all the Veteran’s service-connected disabilities.
In light of the remand, updated VA treatment records should be obtained.
The matters are REMANDED for the following actions:
1. Obtain updated VA treatment records dated since September 2016.
2. Obtain a VA medical opinion by an appropriate medical professional regarding the aggregate effect of the Veteran’s service-connected disabilities on his employability.  
The Veteran is presently service connected for PTSD, gastroesophageal reflux disease (GERD), lumbar strain with degenerative disc disease, psoriasis, left knee sprain, right 5th finger injury residuals, and psoriatic arthritis of the left hand and right knee.
The Veteran need not to be reexamined unless the VA examiner determines that such an examination is necessary to provide the requested opinion. 
The examiner is asked to provide a full description of the combined effects the service-connected disabilities have on the Veteran’s ability to secure or follow a substantially gainful occupation when considering his educational background and vocational experience, but not his age or nonservice-connected conditions. 
The examiner should discuss the Veteran’s statements which support that he is no longer capable of working as a maintenance employee, his most recent full time employment. 
A complete rationale should be provided for all opinions rendered. 

 
RYAN T. KESSEL
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	William Pagan, Associate Counsel