Citation Nr: 18161253 Decision Date: 12/31/18 Archive Date: 12/31/18 DOCKET NO. 16-48 918 DATE: December 31, 2018 REMANDED Entitlement to an increased rating in excess of 50 percent disabling for an acquired psychiatric disorder is remanded. Entitlement to a total disability rating by reason of individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1976 to March 1978. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a May 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Washington, District of Columbia. Jurisdiction of the Veteran’s claim was subsequently transferred to the RO in Cleveland, Ohio. In a September 2016 rating decision, the RO awarded an increased 50 percent disability rating for an acquired psychiatric disorder for the entire period on appeal. As this is not the maximum disability rating possible, the appeal remains in appellate status and is properly before the Board. AB v. Brown, 6 Vet. App. 35 (1993). 1. Entitlement to an increased rating in excess of 50 percent disabling for an acquired psychiatric disorder is remanded. First, remand is required to attempt to obtain private medical records. VA has a duty to assist claimants to obtain evidence needed to substantiate a claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). This includes making reasonable efforts to obtain relevant private medical records. 38 C.F.R. § 3.159(c)(1). The record reflects the Veteran received mental health treatment from a private psychiatrist (Dr. M. R.) until approximately August 2015. Unfortunately, these records do not appear to have been associated with the record. Remand to attempt to obtain these records is thus warranted. Additionally, the record reflects multiple periods of confinement at various correctional institutions. The record reflects the Veteran received mental health treatment while incarcerated. Most recently, the Veteran was incarcerated from December 2017 to April 2018, at which time he was transferred to court-ordered in-patient psychiatric treatment. Unfortunately, these records do not appear to have been associated with the record. Given that such records may have a bearing on the case, remand to attempt to obtain these records is warranted. Further, remand is required for a current VA examination. When a claimant asserts, or the evidence shows, that the severity of a disability has increased since the most recent rating examination, an additional examination is appropriate. VAOPGCPREC 11-95 (April 7, 1995); Snuffer v. Gober, 10 Vet. App. 400 (1997). Passage of time alone, without an allegation of worsening, does not warrant a new examination. Palczewski v. Nicholson, 21 Vet. App. 174 (2007). A VA examination dated in early-November 2015 is the most recent examination of record. A review of the record since that examination reflects a discernable worsening of the Veteran’s symptoms. For instance, VA medical treatment records dated in April 2018 reflect a history of two separate suicide attempts in late-November 2015 (Veteran attempted to overdose on pills) and December 2015 (Veteran attempted to hang himself in jail). In a statement dated in July 2018, the Veteran indicated, in pertinent part, that he has been admitted to four (4) different facilities since September 2017. Lastly, an October 2018 rating decision by the RO found that the Veteran lacks the mental capacity to control and/or manage his own financial affairs. Given the evidence of worsening, the Board finds a remand is necessary to provide the Veteran with an additional examination. 2. Entitlement to TDIU is remanded. To the extent the Veteran is claiming that his service-connected acquired psychiatric disorder causes an inability to work, the claims are inextricably intertwined and TDIU must be remanded. See Harris v. Derwinski, 1 Vet. App. 180 (1991) (two issues are “inextricably intertwined” when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issue has been rendered). The matters are REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and his attorney. 2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Specifically, the Veteran should be asked to submit authorizations to obtain records from private psychiatrist Dr. M.R. and any institutions of confinement where he was treated. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his attorney. 3. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the severity of the service-connected acquired psychiatric disorder. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. The relevant Disability Benefits Questionnaire must be utilized. An explanation for all opinions expressed must be provided. The examiner must document the current symptomatology described by the Veteran and the severity, frequency, and duration at which such symptoms manifest. 4. Notify the Veteran that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claims, and that the consequences for failure to report for a VA examination without good cause may include denial of the claims. 38 C.F.R. §§ 3.158, 3.655 (2017). In the event that the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. Lindsey M. Connor Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Kalolwala, Associate Counsel