Citation Nr: 20005402 Decision Date: 01/23/20 Archive Date: 01/22/20 DOCKET NO. 10-28 152 DATE: January 23, 2020 REMANDED Entitlement to a rating in excess of 10 percent, prior to January 20, 2010, in excess of 30 percent, prior to September 22, 2015, and in excess of 60 percent thereafter, for cardiomegaly, is remanded. Entitlement to service connection for prostate cancer, to include as secondary to service-connected prostatitis, is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from November 1971 to March 1989 and from September 1989 to September 1992. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a March 2009 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In the March 2009 rating decision, the RO granted the Veteran’s claim for entitlement to service connection for cardiomegaly and assigned a 10 percent rating, effective April 1, 2008. In April 2009, the Veteran filed a Notice of Disagreement (NOD) with the assigned rating. In a February 2010 rating decision, the RO assigned a 30 percent rating, effective January 20, 2010. In an October 2016 rating decision, the RO assigned a 60 percent rating, effective September 22, 2015. As these increases do not represent the maximum benefit allowed, they are considered only a partial grant of the benefit sought on appeal; therefore, the claim for entitlement to an increased rating for cardiomegaly is still on appeal. All matters are remanded. In December 2017, the Board remanded the matters to obtain VA examinations. In that regard, the Board requested an examination to determine the current severity of the Veteran’s cardiomegaly. The Board also requested an examination to determine the etiology of the Veteran’s prostate cancer. The Board remanded the claim for entitlement to TDIU as inextricably intertwined with the remanded matters. In a June 2018 report, the VA examiners noted that the Veteran failed to appear for the VA examinations. However, in a January 2019 Report of General Information, the Veteran called to request the status of his appeal. The RO representative informed him of the missed examinations in June 2018. It was noted that the Veteran should be rescheduled for the missed examinations. In May 2018, it is noted that the Veteran again failed to appear for the scheduled examinations. However, there is no evidence of the notice sent to the Veteran informing him of the examinations. Further, there is evidence that the Veteran, who resides in Ohio and Virginia, requested that the Ohio RO handle his appeal because he was currently living at the Ohio address. There is a question as to whether the Veteran was properly informed of his scheduled VA examinations at his current address. Therefore, the Board finds that a remand is necessary to afford the VA examinations requested in the December 2017 Board remand. As it appears that the Veteran receives regular treatment at a VA facility, on remand, up to date VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain the Veteran’s up to date VA treatment records from all facilities where the Veteran has received treatment, which include but is not limited to the VA Medical Centers in Hampton, Virginia and Cincinnati, Ohio. 2. Verify the Veteran’s current mailing address (a September 2019 Report of General Information indicates that the Veteran is currently residing at his Ohio residence) and then schedule the Veteran for a VA examination to determine the etiology of his prostate cancer. A copy of the letter notifying the Veteran of the scheduled appointment should be associated with the electronic claims folder. The electronic claims folder, including a copy of this remand, must be made available to the examiner for review prior to the examination. All indicated tests must be performed all findings reported in detail. The examiner is requested to provide an opinion on the following: Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s prostate cancer was incurred in or is otherwise related to active service. Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s prostate cancer was caused by his service-connected prostatitis. Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s prostate cancer was aggravated by his service-connected prostatitis. If aggravation is found, the examiner should provide the baseline manifestations prior to aggravation and any increased manifestations as a result of the service-connected prostatitis. The examiner is requested to address the articles the Veteran submitted which purport to show a relationship between prostatitis and prostate cancer. A complete rationale for all opinions reached must be provided. 2. Verify the Veteran’s current mailing address (a September 2019 Report of General Information indicates that the Veteran is currently residing at his Ohio residence) and then schedule the Veteran for a VA examination to determine the current severity of his cardiomegaly. The examination must include a stress test to determine the Veteran’s METs, unless the examiner determines that a stress test is medically contraindicated due to the Veteran’s physical limitations or other valid reasons. If such a test is medically contraindicated, a full explanation must be given. The examiner should also comment on the Veteran’s ability to work based on his cardiomegaly symptoms. A complete rationale for all opinions reached must be provided. (Continued on next page.) 3. After ensuring that the requested actions are completed, and undertaking any additional development action that is deemed warranted, adjudicate the claims on the merits, including the inextricably intertwined claim of entitlement to TDIU. If the benefits sought are not fully granted, furnish the Veteran a supplemental statement of the case (SSOC), before the electronic claims file is returned to the Board, if otherwise in order. Michael A. Pappas Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Baskerville 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.