Citation Nr: 18129059 Decision Date: 08/23/18 Archive Date: 08/23/18 DOCKET NO. 14-26 881 DATE: August 23, 2018 REMANDED Entitlement to a rating in excess of 20 percent disabling for peripheral neuropathy of the left lower extremity involving the thigh is remanded. Entitlement to a total disability rating for individual unemployability due to service connected disability (TDIU) as part of the increased rating claim on appeal is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1963 to November 1966. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned in a videoconference hearing at the RO in January 2018; a transcript is of record. In his September 2012 notice of disagreement (NOD) and January 2018 Board hearing the Veteran stated that he had to retire from his post office job due at least in part to his left lower extremity disability. This statement raised a claim for TDIU, which is under the Board’s jurisdiction as part and parcel of the increased rating claim for the underlying disability. Rice v. Shinseki, 22 Vet. App. 447 (2009). 1. Entitlement to a rating in excess of 20 percent disabling for peripheral neuropathy is remanded. Regarding the claim for an increased rating and the intertwined TDIU claim, the Veteran is noted to have last been provided an examination addressing the severity of his service connected neuropathy of the left lower extremity in December 2011 over six years ago. His January 2018 hearing testimony detailed symptoms including left foot swelling, an inability to stand for long, and currently treating for this neuropathy by multiple VA doctors. This testimony indicates that this service-connected disability is more severely disabling than reflected in the currently assigned rating, and in light of the amount of time since his last examination for these disabilities and the possible increase in severity since last examination, reexamination is needed to fully and fairly evaluate the conditions on appeal. See Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007), citing Caluza v. Brown, 7 Vet. App. 498, 505 -06 (1998) (“Where the record does not adequately reveal the current state of the claimant’s disability... the fulfillment of the statutory duty to assist requires a thorough and contemporaneous medical examination.”). See also Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994) (wherein the Court determined the Board should have ordered a contemporaneous examination of the Veteran because a 23-month old examination was too remote in time to adequately support the decision in an appeal for an increased rating); VAOPGCPREC 11-95 (1995). Additionally, it appears that additional remain outstanding. At his January 2018 hearing, it was agreed that the record would be held until February 2018 to afford the Veteran opportunity to submit VA treatment records pertinent to this claim, as VA records after 2014 had not been associated with the file at the time. Subsequent VA records obtained from the Veteran and associated with the claims file in February 2018 are noted to address other medical issues not clearly related to the left lower extremity. At his hearing, the Veteran testified that he was receiving current treatment and medications from multiple medical doctors for the left lower extremity neuropathy and indicated he had upcoming appointments for this disability. 2. TDIU claim on appeal is remanded. As noted the TDIU claim has been raised as part and parcel of the increased rating claim and is intertwined with this claim. Hence this matter must be remanded. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from May 2014 to the present. (Continued on the next page)   2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected peripheral neuropathy of the left lower extremity involving the thigh. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to peripheral neuropathy of the left lower extremity alone and discuss the effect of this disability on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Eckart, Counsel