Citation Nr: 20007263 Decision Date: 01/28/20 Archive Date: 01/28/20 DOCKET NO. 18-22 292 DATE: January 28, 2020 REMANDED The issue of entitlement to a permanent and total disability rating for lichen planus with squamous cell carcinoma of the mandible is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1960 to November 1960, and from October 1961 to August 1962. This matter is before the Board following his appeal of a February 2016 rating decision. In November 2019, the Veteran and his wife testified before the Board. A transcript of the proceeding is of record. The issue of entitlement to a permanent and total disability rating for lichen planus with squamous cell carcinoma of the mandible is remanded. The Veteran is currently in receipt of a 100 percent disability rating for his service-connected lichen planus with squamous cell carcinoma of the mandible. He seeks a permanent total rating for that disability. Although the Veteran was afforded a VA examination in June 2017 related to his lichen planus with squamous cell carcinoma, that examiner did not address whether the Veteran was permanently and totally disabled due to his disability, nor did the examiner consider all aspects of the Veteran’s disability, to include residuals from a right leg bone graft. In this regard, in an April 2016 statement, a private provider noted that the Veteran had daily pain related to his right leg bone graft and that his condition would not improve. Additionally, since the June 2017 examination, the Veteran has submitted a medical opinion in August 2019 from his private treating provider indicating that the Veteran experienced chronic daily pain and discomfort and difficulty eating; that his future prognosis was uncertain; and, that he would require regular care, follow-up, manufacture of new appliances, and “likely biopsies as he has Stage IV Head and neck cancer.” Given the foregoing, the Board finds that a new examination and opinion are necessary in order to determine whether the Veteran is permanently and totally disabled due to his lichen planus with squamous cell carcinoma with consideration of all the evidence. On remand, updated treatment records should also be obtained. The matters are REMANDED for the following action: 1. Associate with the claims file updated VA and private treatment records related to the Veteran’s lichen planus and squamous cell carcinoma residuals. 2. Then, schedule the Veteran for a VA examination to evaluate the nature and severity of his service-connected lichen planus with squamous cell carcinoma. The examiner should review the claims file. After examining the Veteran and conducting any studies and/or tests deemed necessary, the examiner should fully describe all symptomatology and functional deficits specifically associated with the Veteran’s condition. Specifically, the examiner should offer an opinion as to whether the Veteran is permanently and totally disabled as a result of his lichen planus with squamous cell carcinoma and residuals. In providing the foregoing opinion, the examiner should consider the recurrent nature of the Veteran’s condition, as well as the private medical statements dated or received in April 2016 and August 2019, discussed in the body of the remand above. A complete rationale for the conclusions reached should be provided, as the Board is precluded from making any medical findings. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and whether there is additional evidence that would permit the opinion to be provided. S. C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Fagan 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.