Citation Nr: 20002117 Decision Date: 01/10/20 Archive Date: 01/09/20 DOCKET NO. 17-18 293 DATE: January 10, 2020 REMANDED Service connection for left hand condition is remanded. Service connection for right hand and wrist condition, status post right wrist surgery, is remanded. Service connection for a left shoulder condition is remanded. Service connection for a right shoulder condition is remanded. Service connection for a neck condition is remanded. Entitlement to an initial evaluation for posttraumatic stress disorder (PTSD) in excess of 30 percent prior to June 5, 2013; and 50 percent thereafter, is remanded. Entitlement to a total rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1967 to December 1970. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). A hearing was held before the undersigned Veterans Law Judge in August 2019. A copy of the hearing transcript has been associated with the file. At the August 2019 hearing, the Veteran, by his representative, indicated that he wished to combine the right-hand arthritis and right wrist surgery claims. As such, these issues have been consolidated into one issue. 1. Service connection for a left-hand condition is remanded. 2. Service connection for a right-hand and wrist condition, status post right wrist surgery is remanded. 3. Service connection for a left shoulder condition is remanded. 4. Service connection for a right shoulder condition is remanded. 5. Service connection for a neck condition is remanded. The Veteran asserts that his left shoulder, right shoulder, left hand, right hand and wrist (status post wrist surgery), and neck disabilities are related to heavy lifting in service. The Board observes that his military occupational specialty was storage specialist. He testified at his recent hearing that he has had pain in his joints since service. He also testified that a truck bed canopy fell and nicked his back while in Vietnam. See August 2019 Board hearing. In a written statement from August 2013, the Veteran also reported his post-service employment at WAWA involved heavy lifting. Alternatively, the Veteran asserts that these disabilities are secondary to service-connected posttraumatic stress disorder (PTSD). See August 2019 Board hearing. In his notice of disagreement, the Veteran reported that during his coping skills for PTSD program at VA he learned that the constant stress inherent in his PTSD causes chemical problems related to his disabilities and PTSD flare-ups aggravate his muscle and joint pain. The Veteran has not been afforded a VA examination for his claimed disabilities. Upon remand, one should be provided. See McClendon v. Nicholson, 20 Vet. App. 79 (2006). 6. Entitlement to an initial evaluation for PTSD in excess of 30 percent prior to June 5, 2013; and 50 percent thereafter, is remanded. At the August 2019 Board hearing, the Veteran asserts that his PTSD is severe and has a severe impact on his social and occupational functioning. His representative testified that the Veteran’s treating psychiatrist has determined his PTSD is severe, and is permanently and totaling disabling. As such, a new VA examination to assess the current severity of this disability is necessary. Further, review of the file reflects there are outstanding VA medical records that must be obtained. 7. Entitlement to TDIU is remanded. The Veteran’s claim for individual unemployability is based on the impairment from the disabilities of his right shoulder, right hand, and left hand. See February 2016 VA 21-8940. In addition, the Veteran asserts that his service-connected PTSD results in difficulty maintaining and establishing effective work relationship, especially trusting co-workers. See September 2011 correspondence. As the claim for an increased rating for PTSD and service connection for his shoulder and bilateral hands are being remanded for further development, the Board will defer adjudication of the intertwined issue of entitlement to a TDIU. See Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records since October 2018. 2. Ask the Veteran to complete a VA Form 21-4142 for physician(s)/facility(ies). Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 3. Schedule the Veteran for a VA examination to evaluate the nature and etiology of his neck, right shoulder, left shoulder, right-hand and wrist (status post right wrist surgery), and left-hand conditions. The claims file and this remand must be reviewed by the examiner. All appropriate diagnostic testing must be conducted. a) For all relevant diagnoses, the examiner is to provide an opinion as to whether it is at least as likely as not that such current disability had onset in service, or is otherwise related to his active service to include the Veteran’s credible testimony that his military occupational specialty involved heavy lifting and he experienced some joint/muscle pain since discharge, and that a truck canopy nicked his back. b) If no diagnosis is found, the examiner should reconcile this with any prior diagnosis in the record since the claim was filed. The examiner must then opine as to whether the Veteran has pain that causes a functional impairment of earning capacity. c) If any diagnosis of arthritis is found, the examiner is to indicate whether it is at least as likely as not such had onset within one year of service discharge. d) For any current clinical diagnosis (or pain in a joint that with pain that causes a functional impairment of earning capacity), the examiner is to indicate whether it is at least as likely as not whether such disability is proximately due to OR aggravated beyond its natural progression by the service-connected PTSD. The examiner should consider the Veteran’s contentions regarding the stress produced by PTSD aggravates muscle and joint pain. A fully-explained rationale for all of the requested opinions should be provided. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his PTSD. 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 symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to his service-connected PTSD alone. 5. After the foregoing development, readjudicate the claim for TDIU. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Vuong, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.