Citation Nr: 20022497 Decision Date: 04/01/20 Archive Date: 04/01/20 DOCKET NO. 14-32 235A DATE: April 1, 2020 REMANDED The issue of entitlement to special monthly compensation based on the need for regular aid and attendance or at the housebound rate is remanded. REASONS FOR REMAND The Veteran had active service from February 1966 to January 1968. The issue of entitlement to special monthly compensation based on the need for regular aid and attendance or at the housebound rate is remanded. Special monthly compensation is warranted when a veteran, as the result of service connected disability, is so helpless as to be in need of the regular aid and attendance of another individual. A veteran may receive special monthly compensation at the housebound rate if he has a service-connected disability evaluated at 100 percent disabling and has either additional service connected disability or disabilities independently ratable at 60 percent which are separate and distinct from the 100 percent service connected disability and involving different anatomical segments or bodily systems or is permanently housebound by reason of service connected disability or disabilities. Permanently housebound is defined as “substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime.” 38 U.S.C. § 1114; 38 C.F.R. § 3.350. In a November 2019 written statement, the Veteran stated that he and his treating physician felt that he was experiencing a reoccurrence of the service-connected chronic lymphocytic leukemia and additional associated pulmonary and cardiac disability. Clinical documentation of the cited reoccurrence of the service-connected chronic lymphocytic leukemia is not of record. Clinical documentation dated after October 2019 is not of record. The Department of Veterans Affairs (VA) should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran’s claim. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The report of an August 2019 VA examination for housebound status or permanent need for regular aid and attendance states that the chronic lymphocytic leukemia was in remission and the Veteran was not housebound. The VA physician noted that “a medical opinion was not requested” and did not determine whether or not the service-connected disabilities made the Veteran in need of regular aid and attendance of another person in performing the activities of daily living. VA’s duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121 (1991). When VA obtains an evaluation, the evaluation must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Because of the deficiencies in the examination report and the Veteran’s assertion that the chronic lymphocytic leukemia is now active, the Board finds that further VA evaluation is need. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who has treated him for chronic lymphocytic leukemia and the other service-connected disabilities. Make two requests for the authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran’s VA treatment records dated after October 2019. 3. Schedule the Veteran for a VA examination for Housebound Status or Permanent Need for Regular Aid and Attendance. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should state whether it is at least as likely as not (50 percent or greater probability) that due to the service-connected disabiliteis the Veteran is substantially confined as a direct result of service-connected disabilities to his dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas, and it is reasonably certain that the disabilities and resultant confinement will continue throughout his lifetime. The examiner should also opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran needs the aid and attendance of another person due to the service-connected disabilities. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. T. Hutcheson, 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.