Citation Nr: 20004337 Decision Date: 01/17/20 Archive Date: 01/17/20 DOCKET NO. 19-18 649 DATE: January 17, 2020 REMANDED An increased disability rating greater than 30 percent for posttraumatic stress disorder (PTSD) is remanded. A compensable disability rating for left ear hearing loss is remanded. REASONS FOR REMAND 1. An increased disability rating greater than 30 percent for PTSD is remanded. 2. A compensable disability rating for left ear hearing loss is remanded. A review of the record shows the Veteran has not been examined in conjunction with his PTSD appeal since September 2015 (over four years ago). In his June 2019 substantive appeal the Veteran reported that his PTSD symptoms have increased in severity. Similarly, the Veteran has provided evidence that his left ear hearing loss has worsened, and he has not been afforded a VA audiological examination since April 2007. As capturing the current severity of the disabilities on appeal is crucial to a fair adjudication thereof, remand is necessary. The Board is cognizant that the Veteran missed scheduled VA examinations in December 2018. However, he expressed in his substantive appeal that he was unaware of how to reschedule these appointments and gave assurances that he would miss no further examinations. Given the Veteran’s commitment to attend, the Board finds it appropriate to try to reschedule him for the examinations. However, the Veteran is advised that should he again fail to attend the examinations, the law indicates that the increased ratings claims will be decided on the evidence of record. The matters are REMANDED for the following action: 1. Obtain all updated records (i.e., those not already of record) of VA and adequately identified private treatment the Veteran has received for the disabilities remaining on appeal. 2. Then, arrange for the Veteran to be examined by a psychiatrist or psychologist to determine the current severity of his PTSD. Based on an examination, review of the record, and any tests or studies deemed necessary, the examiner should describe all pertinent symptoms, pathology, and impairment associated with such disability in sufficient detail to allow for application of the pertinent rating criteria. Specifically, the examiner MUST indicate whether the Veteran suffers from total social and occupational impairment. The examiner must also identify, by diagnosis, all psychiatric disability entities found. All diagnostic findings (or lack thereof) must be reconciled with conflicting evidence in the record and, if any documented diagnoses are either not or no longer felt to apply, the examiner must explain why, citing to the pertinent diagnostic criteria. If the Veteran is found to have other psychiatric diagnoses IN ADDITION TO his service-connected disability, the examiner must indicate whether there is clear evidence allowing for differentiation of the symptoms, pathology, or impairment attributable to service-connected and nonservice-connected diagnoses and explain why. If so, the examiner must clearly identify all symptoms and impairment found and attribute them to their appropriate underlying diagnoses. 3. After completion of directive (1.), arrange for an audiological examination to determine the current severity of his left ear hearing loss. Based on an examination, review of the record, and any tests or studies deemed necessary (INCLUDING AUDIOMETRIC STUDIES), the examiner should describe all pathology, symptoms (frequency and severity), and functional impairment associated with left ear hearing loss in sufficient detail to allow for application of the pertinent rating criteria. (Continued on the next page)   The examiner should comment on the impact of left ear hearing loss on the Veteran’s ability to function in an occupational setting, to include (but not limited to) identifying the types of work that would be precluded by such disabilities and those that would remain feasible. All opinions must include a detailed explanation (rationale). (By law, the Board may not rely on any conclusion that is unsupported by a thorough explanation. Providing such an opinion or conclusion will delay processing of the claim and may also require further clarification). VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kyle McKone 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.