Citation Nr: 21002882 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 14-02 196 DATE: January 19, 2021 REMANDED Entitlement to an initial disability rating for sarcoidosis in excess of 30 percent before July 2, 2012, in excess of 10 percent between July 2, 2012 and October 16, 2018, and in excess of 30 percent thereafter is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1980 to September 1980 and from September 1990 to August 1991. He also had service in the United States Army Reserve and the Army National Guard. His decorations include the Southwest Asia Service Medal. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a July 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran was scheduled to appear for a hearing before the Board in April 2017. He failed to appear for his hearing. The Veteran has provided no explanation for his failure to report and has not since requested that the hearing be rescheduled. His hearing request, therefore, is deemed withdrawn. See 38 C.F.R. § 20.704(d). In October 2017, March 2019, and June 2020, the Board remanded the Veteran’s claim for additional development. The case is once again before the Board. 1. Entitlement to an initial disability rating for sarcoidosis in excess of 30 percent before July 2, 2012, in excess of 10 percent between July 2, 2012 and October 16, 2018, and in excess of 30 percent thereafter is remanded. The Board regrets the delay associated with this remand, especially considering that this matter was the subject of three previous remands. However, another remand is necessary to ensure that the Veteran is afforded full compliance with the statutory duty to assist. The Veteran’s service-connected sarcoidosis may be rated under Diagnostic Code (DC) 6846, or alternatively under DC 6600, which applies to symptoms of chronic bronchitis. See 38 C.F.R. § 4.97, DC 6846 (“Or rate active disease or residuals as chronic bronchitis (DC 6600).”). Under DC 6600, a 100 percent disability rating is warranted when, as relevant here, the Veteran’s sarcoidosis results in a cardiopulmonary complication like pulmonary hypertension. Id., DC 6600. Review of the record reveals that may be the case here. In January 2013, the Veteran underwent a chest CT (computed tomography) scan. The radiologist found that the Veteran’s main pulmonary arteries were enlarged, suggesting pulmonary artery hypertension. The next month, the Veteran’s VA pulmonologist diagnosed him with Stage IV sarcoidosis with airway involvement and possible pulmonary hypertension. Roughly six-and-a-half years later, the Veteran underwent another chest CT scan. As before, the VA doctor found evidence of pulmonary hypertension with dilation of the main pulmonary artery. And he specifically noted that it was likely related to the Veteran’s chronic lung disease. Unfortunately, the October 2018 VA examiner did not perform diagnostic testing to determine if the Veteran’s respiratory condition caused pulmonary hypertension despite it being indicated by his medical records. As such, the examination is inadequate for rating purposes, and remand is necessary to obtain another. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). 2. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected sarcoidosis is remanded. Because a decision on the Veteran’s initial rating claim could significantly impact a decision on his TDIU claim, the issues are inextricably intertwined. As such, a remand of both is required. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Finally, as the case is being remanded for additional development, any outstanding VA treatment records should be associated with the claims file. See Bell v. Derwinski, 2 Vet. App. 611, 613 (1992) (per curiam). The matter is REMANDED for the following action: 1. Obtain all outstanding VA treatment records and associate them with the claims file. 2. Then, schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected sarcoidosis. The claims file should be made available to and reviewed by the examiner. An echocardiogram or cardiac catheterization must be performed to determine whether the Veteran’s sarcoidosis caused pulmonary hypertension. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Canedy, Associate 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.