Citation Nr: 18101652 Decision Date: 05/08/18 Archive Date: 05/08/18 DOCKET NO. 13-28 583A DATE: May 8, 2018 ISSUES DECIDED: 0 ISSUES REMANDED: 2 REMANDED ISSUES Although the Board sincerely regrets the additional delay, the Veteran’s claims must be remanded for additional development. 1. Entitlement to a disability rating in excess of 30 percent for post-traumatic stress disorder (PTSD) is remanded. VA’s duty to assist includes obtaining a medical examination when it is necessary to make a decision on a claim. See 38 U.S.C. § 5103A(d) (2012). Furthermore, when VA undertakes to provide an examination, it must ensure that it is adequate. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Here, the Veteran was provided VA examinations in November 2011 and August 2013. However, in his February 2017 testimony before the Board, the Veteran alleged that his symptoms have worsened. Specifically, he stated for the first time that he experiences panic attacks 2 or 3 times per week and that they last for 30 minutes to an hour. In addition, he reported that he sleeps 2 to 3 hours per night, as opposed to 4 to 5 hours that he reported in treatment records up to 2013. Based on this, a remand is warranted for a new examination to fully evaluate the Veteran’s claim. See Caffrey v. Brown, 6 Vet. App. 377 (1994); Snuffer v. Gober, 10 Vet. App. 400 (1997). 2. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. The Veteran brought a claim for TDIU in November 2011 that was denied in an August 2013 rating decision that the Veteran did not appeal. Later, in the Veteran’s October 2013 substantive appeal to the Board (VA Form 9) regarding his claim for an increased rating for PTSD, the Veteran’s representative asserted that the Veteran is entitled to TDIU and he cited medical evidence indicating that the Veteran is unable to work. At his hearing in February 2017 regarding his PTSD appeal, the Veteran discussed his difficulties maintaining substantially gainful employment. When evidence of unemployability is submitted during the course of an appeal from an assigned disability rating, a claim for TDIU will be considered part of the claim for benefits for the underlying disability. Rice v. Shinseki, 22 Vet. App. 447 (2009). However, consideration of entitlement to TDIU depends, in part, on the impact that the Veteran’s PTSD has on his ability to obtain or retain substantially gainful employment. Accordingly, the matter of TDIU is inextricably intertwined with the claim remanded herein. Harris v. Derwinski, 1 Vet. App. 180 (1991). Remand of the TDIU claim is therefore required. Moreover, as the Veteran’s previous claim for TDIU became final, the present claim for TDIU has not been adjudicated in the first instance. On remand, the Veteran should be given the opportunity to complete a VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability, and the RO should provide notice and initial adjudication. The matters are REMANDED for the following action: 1. Obtain copies of any outstanding VA treatment records pertaining to the Veteran’s service-connected disabilities and associate them with the claims file. 2. Send the Veteran proper notice under 38 U.S.C. § 5103(a) and 38 C.F.R. § 3.159(b) (2017) that advises him what is needed to substantiate a claim for TDIU. Give the Veteran an opportunity to complete a VA Form 21-8940. When the application is completed and returned, verify the nature of the Veteran’s employment history, work schedule, and income consistent with the procedures outlined in the M-21 VA Adjudication Procedure Manual. 3. After completion of the above development, the Veteran should be afforded an updated VA psychiatric examination to address the current severity of his service-connected PTSD. All indicated studies or testing should be conducted. The VA examiner should specifically address the extent of functional impairment caused by the Veteran’s service-connected PTSD. 4. Then, obtain a VA examination and opinion to address the collective impact of all of the Veteran’s service-connected disabilities on his employability. The examiner should consider and discuss the functional effects resulting from all of the Veteran’s service-connected disabilities (i.e., considered jointly) that could impact either daily living or industrial capacity. The examination report must include a complete rationale for all opinions and conclusions reached. K. PARAKKAL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Freda J. F. Carmack, Associate Counsel