Citation Nr: 20002950 Decision Date: 01/14/20 Archive Date: 01/13/20 DOCKET NO. 16-45 785 DATE: January 14, 2020 REMANDED Entitlement to a 100 percent disability rating for service-connected posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from September 1968 to September 1971. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts (Agency of Original Jurisdiction (AOJ)). As an initial matter, the Board notes that at the time the issue of entitlement to an increased disability rating for PTSD was appealed, the issue of entitlement to service connection for tinnitus was also included on the Veteran’s Statement of the Case (SOC). However, while these matters were pending on appeal, the AOJ granted entitlement to service connection for tinnitus in a February 2017 rating decision. This award is effective November 12, 2015 – the date the Veteran first filed his claim. As this represents a complete grant of the Veteran’s claim, this issue is no longer on appeal before the Board. See Grantham v. Brown, 114 F.3d 116 (Fed. Cir. 1997); Barrera v. Gober, 122 F.3d 1030 (Fed. Cir. 1997). The Veteran filed his claim for entitlement to service connection for PTSD in November 2015. Following a VA examination, the AOJ granted service connection in a February 2016 rating decision, awarding the Veteran a 70 percent disability rating for his PTSD based on the frequency, severity, and duration of his symptoms. At that time, the examiner reported that the Veteran suffered from occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care, and conversation. His symptoms included depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, flattened affect, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, suicidal ideation, and impaired impulse control. A review of the record reveals that the Veteran has not received a VA examination since one was performed in February 2017. At that time, the examiner noted that the Veteran’s “symptoms and impairment are more severe now as compared to his last C&P evaluation dated [January 2016].” Still, he records many of the same symptoms as those reflected on the January 2016 examination. Furthermore, the available evidence of record is limited to VA treatment records, the most recent from February 2017. To fully assess the Veteran’s condition and level of impairment due to his PTSD, the Board will remand to obtain a new VA examination and additional, more recent treatment records. The matters are REMANDED for the following action: 1. The AOJ shall associate the Veteran’s most recent outstanding VA medical treatment records with his file, specifically those records from February 2017 to the present pertaining to the Veteran’s PTSD as well as complete records from the Brockton Vet Center. 2. Ask the Veteran to complete a VA Form 21-4142 for any private treatment providers that have treated him for PTSD. Thereafter, obtain and associate with the claims folder any private treatment records identified. 3. Then, afford the Veteran a psychiatric examination to determine the current nature and severity of his PTSD. The examiner should consider the following: • the Veteran’s CAPRI VA treatment records, documenting his PTSD treatment; • the January 2016 VA examination; • the February 2017 VA examination; • the Veteran’s VA Form 9; and • the Veteran’s Notice of Disagreement. 4. Thereafter, readjudicate the claim. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case and an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Victoria A. Narducci, 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.