Citation Nr: 21003376 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 08-12 838 DATE: January 21, 2021 REMANDED Entitlement to a disability rating greater than 30 percent for sarcoidosis is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1990 to August 1992. This case come before the Board of Veterans’ Appeals (Board) on appeal from an October 2006 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO), which, inter alia, denied the Veteran’s claim for a disability rating greater than 30 percent for his service-connected sarcoidosis. Most recently in May 2017, these matters were remanded by the Board to the agency of original jurisdiction (AOJ), for additional development. Pursuant to the Board remand, the Veteran underwent a VA respiratory conditions examination in August 2017. The VA examiner noted the Veteran’s diagnosed sarcoidosis, and stated that his symptoms included decreased mobility, shortness of breath, night sweats, and burning in his legs and arms. The examiner remarked that the Veteran’s respiratory condition required the use of Flovent when a flare-up occurred, but did not require the use of oral bronchodilators, antibiotics, or outpatient oxygen therapy. Pursuant to the Board’s remand directives, the examiner also addressed the Veteran’s lay statements regarding the severity of his sarcoidosis symptoms- in particular, the Veteran’s statements attributing his symptoms of bowel and bladder incontinence, numbness and burning of the extremities, or fatigue to sarcoidosis. The examiner opined that “there is no medical evidence to support the Veteran’s claims of bowel and bladder incontinence, numbness and burning of extremities,” but acknowledged that the Veteran’s current fatigue symptoms were related to his sarcoidosis. However, the Board finds that the examiner’s findings are inconsistent with the Veteran’s medical history. Specifically, the Veteran’s December 2008 medical treatment records from Scott Air Force Base (AFB) note that his bowel and bladder incontinence may represent spinal cord compression since he has a history of sarcoidosis. Thus, because the examiner’s conclusions were not based on an accurate factual premise, the Board finds that it is not probative. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993). As such, the Board finds that substantial compliance with the May 2017 remand directives has not been achieved. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In addition, the Veteran’s entitlement to a TDIU is inextricably intertwined with his increased rating claim for sarcoidosis; therefore, the TDIU claim must be remanded with it. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Provide the Veteran appropriate notice as to the claim for entitlement to a TDIU and ask that he complete an application for TDIU. Allow him a reasonable opportunity to respond. 2. Schedule the Veteran for a VA examination, preferably with a pulmonologist, to determine the current severity of his service-connected sarcoidosis with subjective complaints of fibromyalgia and polyneuropathy. The examiner is requested to delineate all symptomology associated with and the current severity of this disability, as well as all functional limitations that are a result of this disability. All necessary diagnostic testing and evaluation should be performed, and all clinical findings reported in detail, to include the results of pulmonary function testing. 3. The examiner should specifically comment on the Veteran’s lay statements regarding the severity of his symptoms of sarcoidosis, and in particular address his statements attributing his symptoms of bowel and bladder incontinence, numbness and burning of the extremities, or fatigue to sarcoidosis. See November 2005 VA Fibromyalgia Examination; September 2007 VA Pulmonary Consultation; October 2007 VA Endocrine Examination (finding that the Veteran reported fatigue and shortness of breath upon exertion); December 2008 Scott AFB Treatment Records (finding that bowel and bladder incontinence may represent spinal cord compression since the Veteran has a history of sarcoidoses); March 2010 Barnes Jewish Hospital Treatment Records (noting the Veteran’s diagnosed cervical spondylosis, C3-C4, with spinal cord compression and early myelopathy). 4. After the above development and any other development deemed necessary is completed, readjudicate the Veteran’s increased-rating claim and adjudicate entitlement to a TDIU. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Kovacs, 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.