Citation Nr: 20008076 Decision Date: 01/30/20 Archive Date: 01/30/20 DOCKET NO. 16-17 554 DATE: January 30, 2020 REMANDED Entitlement to service connection for a back disability is remanded. Entitlement to service connection for a left shoulder disability is remanded. Entitlement to service connection for a lung condition, claimed as residuals of pneumonia and to include obstructive sleep apnea is remanded. Entitlement to a total disability rating based on individual unemployability as a result of service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran had active duty military service from January 1977 to February 1980. Entitlement to service connection for a back disability Entitlement to service connection for a left shoulder disability Entitlement to service connection for a lung condition, claimed as residuals of pneumonia and to include obstructive sleep apnea Entitlement to TDIU These matters were previously before the Board in December 2019. At that time, these claims were remanded for additional development, to include VA examinations and opinions. In January 2020, these matters were returned to the Board without any additional action being taken with respect to these claims. This is a clear violation of the Board’s instructions and the claims must again be remanded. Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: 1. Ask the appropriate federal records custodian to obtain and provide copies of any outstanding service treatment records, specifically hospital treatment records for the period of May 1977 when the Veteran was treated for pneumonia. In the event that additional records cannot be obtained, the Veteran and his attorney should be so advised in accordance with 38 C.F.R. § 3.159 (e). 2. Then, provide the Veteran with an updated VA examination with respect to his claim of service connection for a respiratory disability, to include asthma and sleep apnea. Specifically, the examiner should obtain a complete history of the Veteran’s respiratory symptoms, his diagnosis with and treatment for asthma, and his use of tobacco products. Then the VA examiner should offer an opinion as to whether the Veteran has a current respiratory disability which is at least as likely as not (probability 50 percent or greater) the result of the pneumonia the Veteran experienced in service or that is otherwise is related to service. In rendering this opinion, the VA examiner should discuss the July 2019 private medical opinion and the Veteran’s testimony at the June 2019 Board hearing that he was told a collapsed lung or atelectasis could result in decreased lung capacity. The VA examiner should provide a statement of the reasons or rationale for the opinions provided, to include citations to any specifically relevant evidence in the record and any pertinent medical research or literature. 3. Then provide the Veteran with an appropriate VA examination to address his claim of service connection for a back disability, to include as secondary to bilateral pes planus, ankle, and knee disabilities. The examiner should obtain a complete history of back symptoms, to include any information possible on a back injury in service. The examiner should offer an opinion as to whether it is at least as likely as not (probability 50 percent or greater) that any back disability had its onset in service. If that opinion is negative, the examiner should offer an opinion as to whether any such back disability was at least as likely as not (probability 50 percent or greater) caused or aggravated by any service-connected disabilities, to include bilateral pes planus, bilateral ankle disabilities, bilateral knee disabilities, and/or any combination of the above. If aggravation is found, the examiner should attempt to identify the baseline level of disability prior to such aggravation. The examiner should provide a statement of the reasons or rationale for all opinions provided, to include citations to any relevant evidence of record and any pertinent medical research or literature. 4. Then provide the Veteran with an appropriate VA examination regarding his claim of service connection for a left shoulder disability. The examiner should obtain a complete history of his left shoulder symptoms, to include any injury incurred in service and the impact of carrying heavy loads in service. The examiner should then offer an opinion as to whether it is at least as likely as not (probability 50 percent or greater) that his left shoulder disability had its onset in service or is otherwise the result of service. In offering this opinion, the examiner should specifically address the lapse of time between the Veteran’s separation from service and his first reported observation of symptoms. The examiner should also address the July 2019 private medical opinion. The examiner should provide a statement of the reasons or rationale for all opinions provided, to include citations to any relevant evidence of record and any pertinent medical research or literature. 5. Thereafter, the claim of entitlement to TDIU should be addressed, to include consideration of referral to the Director of Compensation Services for extraschedular TDIU for the period prior to October 28, 2016, and consideration of the most appropriate effective date for any award that may be granted. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Cheryl E. Handy 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.