Citation Nr: 21004319 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 12-17 082 DATE: January 26, 2021 REMANDED Entitlement to a total disability rating based on individual unemployability (TDIU) for the period prior to May 17, 2017 is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1990 to August 1995. The Veteran testified at a hearing held before the undersigned Veterans Law Judge in August 2015. A transcript of the hearing is of record. This matter has a lengthy procedural history that has been discussed in detail in prior decisions that are incorporated herein by reference. Most recently, it was before the Board in August 2020 at which time it was remanded for additional development, to specifically include obtaining a supplemental VA medical opinion regarding the Veteran’s service-connected headache condition as well as the overall impact of the Veteran’s service-connected disabilities on her employability. The claim has now been returned to the Board for appellate review. As an initial matter, the Board notes that on remand, TDIU was granted effective May 17, 2017. Accordingly, the Board has recharacterized the issue on appeal as entitlement to a TDIU prior to May 17, 2017. Unfortunately, the Board remains unable to determine the collective impact of the Veteran’s then-service-connected disabilities as the VA medical opinions obtained in October of 2020 in order to comply with the most recent Board remand do not address the collective impact of the Veteran’s service-connected conditions as instructed by the Board. Further, despite being instructed to address the Veteran’s ability to function in an occupational environment for the period from December 2008 through the present, the examiner made statements such as “review of the c-file has not shown evaluation for or treatments regarding the SC [gynecological] condition within the last 24 months” and “review of the last 2 years did not show recent hospital admission or urgent evaluation for an asthma exacerbation”. It is unclear why only a two year period was considered by this examiner in lieu of the Board’s instructions. This unfortunately means that the opinions offered were based on evidence that clearly does not include the entirety of the period on appeal. Lastly, many of the opinions offered are mere conclusions and lack rationale altogether. Based on the foregoing, the Board finds that an additional remand is necessary. The matter is REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician, who should be a different medical professional than any of the clinicians who have offered any opinion already of record. The entire claims file, including a complete copy of this remand, should be made available to and be reviewed by the clinician, and it should be confirmed that such records were available for review. Following a review of the evidence of record, to include the Veteran’s lay statements, the clinician should address: (a.) The combined effect of the Veteran’s service-connected disabilities on her ability to engage in any type of full-time employment for the period from December 2008 to May 17, 2017. The clinician should elicit and set forth the pertinent facts regarding the Veteran’s medical history, education and employment history, day-to-day functioning, and industrial capacity. He or she should address the Veteran’s ability to function in an occupational environment. The clinician is advised that being unemployed during the period on appeal is not equivalent to being unemployable for VA purposes. In responding to these inquiries, any side effects the Veteran experienced from medications for the service-connected disabilities should be considered. If the evidence demonstrates that the Veteran experienced varying levels of impairment at different points during the appeal period, the clinician should so state and provide the basis for such conclusion.  (Continued on the next page)   The clinician must provide a comprehensive report, including complete rationales for all conclusions reached. If the clinician is unable to provide any of the requested information without resorting to speculation, he or she should so state, and further explain why it is not feasible to provide a medical opinion.  2. Thereafter, readjudicate the claim. If the benefits sought on appeal remain denied, issue a supplemental statement of the case to the Veteran and her representative. Then return the appeal to the Board for further appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Smith, 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.