Citation Nr: 18159276 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 15-03 002 DATE: December 19, 2018 REMANDED Entitlement to service connection for a left eye disorder is remanded. Entitlement to service connection for a right eye disorder is remanded. Entitlement to a rating in excess of 10 percent for hypertension is remanded. Entitlement to a compensable rating for hemorrhoids is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty September 1976 to September 1998. In his January 2015 and October 2017 substantive appeals (VA Form 9s), the Veteran indicated that he wanted a Board hearing. Thereafter, he was scheduled for hearing before the Board. However, prior to his hearing date, he withdrew his request for a Board hearing. See November 2018 Statement in Support of Claim. Thus, the hearing request is considered withdrawn. 38 C.F.R. § 20.704(e). Regarding the claim of entitlement to TDIU, the Board acknowledges that the Agency of Original Jurisdiction (AOJ) limited the issue to the period prior to November 22, 2016, because from that date, the Veteran is in receipt of a combined 100 percent schedular rating for his service-connected disabilities. However, the United States Court of Appeals for Veterans Claims (Court) has held that an award of a 100 percent schedular rating does not necessarily render the Veteran’s claim for TDIU moot. See Bradley v. Peake, 22 Vet. App. 280 (2008). Accordingly, the Board finds that entitlement to a TDIU for the entire appeal period – both prior to November 22, 2016, and after that date – remains on appeal despite the existence of a combined schedular total rating effective that day because the Veteran may be entitled to special monthly compensation (SMC) under 38 U.S.C. § 1114(s). Id. at 294. Significantly, the record reflects that from November 22, 2016, the Veteran is in receipt of a 70 percent rating for his service-connected PTSD and he also previously contended that his physical disabilities (bilateral knees, right shoulder, low back, and Bell’s palsy) prevented him from working. See September 2012 VA Form 21-0820. VA has a well-established duty to maximize a Veteran’s benefits. See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011); AB v. Brown, 6 Vet. App. 35, 38 (1993). Thus, the TDIU issue has been recharacterized as is listed above. 1. Entitlement to service connection for a left eye disorder is remanded. In March 2017, the Veteran underwent a VA examination to evaluate his left eye disorder. The VA examiner diagnosed bilateral glaucoma/cataracts and opined that the Veteran’s left eye disorder was not at least as likely as not proximately due to or the result of Bell’s Palsy. The examiner explained that the Veteran did not currently have Bell’s Palsy affecting the left eye/side of face. Nevertheless, the Board finds this VA examination insufficient for rating purposes. In pertinent part, the VA examiner failed to reconcile his findings with the pertinent service treatment records, which show that left eye problems began in-service during the time that he had Bell’s Palsy. Moreover, during the appeal period, the Veteran has been diagnosed with additional left eye disorders, to include left eye canaliculitis. However, the examiner failed to address the additional diagnoses. As such, a new VA examination must be provided consistent with the directives herein. See Barr v. Nicholson, 21 Vet. App. 303 (2007). 2. Entitlement to service connection for a right eye disorder is remanded. In December 2014, the Veteran underwent a VA examination to evaluate his right eye disorder. After evaluation of the Veteran, the examiner diagnosed bilateral cataracts/glaucoma and left eye canaliculitis and opined that the Veteran’s dry eye syndrome of the right eye was not caused by or a result of Bell’s Palsy or military service. However, the VA examiner did not address the etiology of the Veteran’s cataracts/glaucoma and failed to render a secondary service connection aggravation opinion. Accordingly, the Board finds that a new VA examination must be provided. 3. Entitlement to increased ratings for hypertension and hemorrhoids are remanded. The Veteran was last afforded VA examinations to assess his service-connected hypertension and hemorrhoids in June 2014. Subsequent to these evaluations, the Veteran has reported worsening symptoms consisting of increased blood pressure and burning and flaring of his hemorrhoids. See February 2018 DRO Hearing Testimony. Accordingly, the Board finds that VA’s duty to assist necessitates that these claims be remanded to schedule new VA examinations. The Board acknowledges that in July 2015 the Veteran was scheduled for a VA examination regarding his hemorrhoids. However, no examination was conducted because the Veteran had recently underwent surgery. 4. Entitlement to a TDIU. Consideration of entitlement to a TDIU is dependent upon the impact of the Veteran’s service-connected disabilities on his ability to obtain or retain substantially gainful employment. Accordingly, the matter of a TDIU is inextricably intertwined with the Veteran’s increased rating and service-connection claims remanded herein. Harris v. Derwinski, 1 Vet. App. 180 (1991). Remand of the inextricably intertwined TDIU claim is, thus, also required. The matters are REMANDED for the following actions: 1. Make reasonable efforts to obtain any outstanding and relevant VA or private treatment records. With the Veteran’s assistance, if necessary, obtain copies of any pertinent records and add them to the claims file. If VA attempts to obtain any outstanding records which are unavailable, the Veteran should be notified in accordance with 38 C.F.R. § 3.159(e). 2. After the above records request has been completed, schedule the Veteran for a VA examination with an appropriate examiner to determine the nature and etiology of his left and right eye disorders. The examiner must review pertinent documents in the Veteran’s claims file in conjunction with the examination. All indicated studies should be completed. All findings must be fully reported. a) After considering the pertinent information in the record, the examiner should provide a diagnosis for all current left and/or right eye disorders. b) For each diagnosis rendered, the examiner must provide an opinion as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that the diagnosed disorder had its onset in, or is otherwise related to, the Veteran’s active duty service. c) For each diagnosis rendered, the examiner must also provide an opinion regarding whether it is at least as likely as not (i.e., 50 percent probability or greater) that the diagnosed disorder was caused or aggravated by his service-connected Bell’s Palsy. Aggravation in this context is defined as any increase in disability. In rendering the above opinions, the VA examiner is instructed to specifically consider and discuss the Veteran’s service treatment records regarding his left eye problems. The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 3. After the above records request has been completed, schedule the Veteran for an appropriate VA examination to ascertain the nature and current severity of his service-connected hypertension. The claims folder and a copy of this remand must be made available to the examiner for review in conjunction with the examination. All indicated testing must be conducted and all pertinent symptomatology and findings must be reported in detail. The examiner should determine the functional impairment, if any, due to the hypertension and how they affect and limit the Veteran’s employment. 4. After the above records request has been completed, schedule the Veteran for an appropriate VA examination to ascertain the nature and current severity of his service-connected hemorrhoids. The claims folder and a copy of this remand must be made available to the examiner for review in conjunction with the examination. All indicated testing must be conducted and all pertinent symptomatology and findings must be reported in detail. The examiner should determine whether the Veteran’s hemorrhoids are mild or moderate; large or thrombotic, irreducible, with excessive redundant tissue, evidencing frequent recurrences; or, with persistent bleeding and with secondary anemia, or with fissures. The examiner should also determine the functional impairment due to the hemorrhoids and how they affect and limit the Veteran’s employment. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. E. Metzner, Associate Counsel