Citation Nr: 21003551 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 15-11 594 DATE: January 21, 2021 REMANDED Entitlement to a disability rating in excess of 20 percent for diabetes mellitus type II (DM) is remanded. Entitlement to an initial disability rating in excess of 10 percent for peripheral neuropathy (PN) of the right lower extremity is remanded. Entitlement to an initial disability rating in excess of 10 percent for PN of the left lower extremity is remanded. Entitlement to a total disability due to individual unemployability due to service-connected disabilities (TDIU) for the period prior to October 31, 2016 is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to May 1970. These matters are on appeal of a February 2015 rating decision. In August 2018, a hearing was held before the undersigned. A transcript of the hearing is of record.   In February 2019, the Board denied the Veteran’s claim for an increased disability rating for DM, while remanding the claims for increased disability ratings for PN of the right and left lower extremities for additional development. The Veteran appealed the February 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). In October 2019, the Court granted a Joint Motion for Remand (JMR) by the Veteran’s representative and the VA General Counsel, which included the raised issue of entitlement to a TDIU prior to October 31, 2016. The Board again remanded the appeal for further development in April 2020. Unfortunately, the claims must again be remanded for additional development. Initially, the record, including an October 2018 VA examination report, reflects that the Veteran was granted Social Security Administration (SSA) disability benefits in 2014. SSA records are constructively of record, and the Board is obligated to obtain them when there is a reasonable possibility that they could help the appellant substantiate a claim for VA benefits. Golz v. Shinseki, 590 F.3d 1317 (Fed. Cir. 2010). It is unclear from the record for what disability or disabilities the Veteran is receiving SSA benefits, and SSA records could shed additional light on the Veteran’s claims. As such, an attempt should be made to obtain any available SSA determination and any available medical records on which the determination was based. The record also reflects the Veteran receives VA treatment; thus, updated VA treatment records should be associated with the claims file. Regarding the Veteran’s appeal for an increased disability rating for DM, in April 2020, the Board remanded the Veteran’s claim to obtain an updated VA examination to assess the current severity of the Veteran’s DM. The remand further directed that the examiner providing the assessment address the statement in an April 2019 Disability Benefits Questionnaire that the Veteran required regulation of his activities as part of the medical management of his diabetes. The remand noted that the explanation for this statement was that the Veteran could no longer work as a tile installer due to his erratic blood sugars and that neuropathy in his feet made his line of work and physical activities dangerous. It was unclear from this explanation whether any regulation of activities was solely due to the Veteran’s DM and not also due in part to his diabetic PN. Once VA undertakes the effort to provide a medical examination or opinion, it must provide an adequate one. Barr v. Nicholson, 21 Vet. App. 303 (2007). The Board finds that there has not been substantial compliance with the April 2020 remand directives. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that where the remand orders of the Board are not substantially complied with, the Board errs as a matter of law when it fails to ensure substantial compliance). Although the Veteran was afforded a VA examination in August 2020 that indicated the Veteran did not require regulation of activities as part of his medical management, the examiner did not address the statement in the earlier April 2019 evaluation as directed. On remand, after any available SSA records and outstanding VA treatment records have been obtained, an addendum medical opinion should be obtained that addresses the relevant statement in the April 2019 Disability Benefits Questionnaire. As the issues being remanded in this appeal could have a direct impact on whether entitlement to TDIU prior to October 31, 2016, is warranted, the issues are inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180 (1991). As such, adjudication of the TDIU claim must be deferred pending resolution of these claims. The Board notes that presently the Veteran does not meet the schedular criteria for TDIU pursuant to 38 C.F.R. § 4.16(a) prior to October 31, 2016. The matters are REMANDED for the following action: 1. Obtain the Veteran’s records from the SSA, including any decisions and/or determinations, and all supporting medical documentation utilized in rendering any decision or determination. Document all requests for information as well as all responses in the claims file. 2. Obtain the Veteran’s VA treatment records from March 2020 to the present.   3. After obtaining any additional records, forward the Veteran’s claims file to an examiner for completion of an addendum opinion. If deemed necessary, the examiner should complete an examination (including via telehealth interview) of the Veteran and provide an assessment of the severity of the Veteran’s DM that provides a full description of the disability and reports all signs and symptoms necessary for evaluating his DM under the rating criteria. The examiner must consider and address the statement in the April 2019 Disability Benefits Questionnaire that the Veteran requires regulation of his activities as part of the medical management of his DM. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 4. After completing the above development and after, or contemporaneously, readjudicating the claims for a higher disability rating for DM and higher initial disability ratings for PN of the right lower and left lower extremities, readjudicate the inextricably intertwined issue of entitlement to TDIU for the period prior to October 31, 2016, including, if the Veteran’s disabilities   during this period do not meet the schedular criteria under 38 C.F.R. § 4.16(a), consideration of whether extraschedular referral of TDIU under § 4.16(b) is warranted. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. J. Wells-Green 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.