Citation Nr: 21004844 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 16-53 671A DATE: January 28, 2021 REMANDED Entitlement to a disability rating in excess of 30 percent for the service-connected hiatal hernia with gastroesophageal reflux disease (GERD) is remanded. Entitlement to a compensable disability rating for the service-connected scars of the anterior trunk associated with hiatal hernia with GERD is remanded. Entitlement to a disability rating in excess of 10 percent for the service-connected surgical scar due to diaphragmatic hernia repair and thoracotomy is remanded. Entitlement to a compensable rating for the service-connected posterior trunk scar is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disability (TDIU) is remanded. Entitlement to special monthly compensation (SMC) based on aid and attendance (A&A) or housebound status is remanded. REASONS FOR REMAND The Veteran had active service from August 1979 to August 1999. The Veteran testified via live video conference at a hearing before the undersigned Veterans Law Judge (VLJ) in April 2020. These matters were previously before the Board of Veterans’ Appeals (Board) in July 2020. After a complete and thorough review of the evidence of record, the Board finds that, unfortunately, another remand of this appeal is necessary. The Board sincerely regrets the additional delay associated with this remand but finds that a remand is necessary to ensure that the Veteran is accorded full compliance with VA’s statutory duty to assist. Entitlement to a disability rating in excess of 30 percent for the service-connected hiatal hernia with GERD The medical evidence of record indicates that there may be symptoms or conditions associated with his hiatal hernia with GERD that have not been addressed, particularly in the most recent VA examination in August 2020. In particular, VA treatment records from November 2011 indicate the Veteran suffering incidents of hypoglycemia that were or are possibly related to his hiatal hernia condition. An additional examination is required to investigate this symptom, if present, and to determine whether this condition or symptom is related to his hiatal hernia. Entitlement to a compensable disability rating for service-connected scars of the anterior trunk Entitlement to a disability rating in excess of 10 percent for the service-connected surgical scar due to diaphragmatic hernia repair and thoracotomy Entitlement to a compensable disability rating for the service-connected scar of the posterior trunk Unfortunately, the Board finds that the September 2020 VA examinations of the Veteran’s scars are not adequate. The scars of the Veteran’s anterior trunk are not described on the examination reports. Consequently, another scar examination is required, and all of the claims for increased ratings for the service-connected scar conditions must be remanded as the evidence obtained will affect the adjudication of these service-connected conditions. Entitlement to a TDIU Entitlement to SMC based on A&A or housebound status Finally, because a decision on the remanded issues of entitlement to increased ratings for service-connected hiatal hernia with GERD and associated scar conditions could significantly impact a decision on the issues of entitlement to TDIU and SMC, these issues are inextricably intertwined. A remand of the claims for entitlement to TDIU and SMC are, thus, required. Accordingly, this appeal is REMANDED for the following actions: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected hiatal hernia with GERD. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating this disability under the rating criteria. The examiner’s attention is directed to the November 2011 VA treatment records, and similar records, documenting hypoglycemia that was suspected to be associated with the Veteran’s hiatal hernia and GERD. An appropriate examination should include an examination of this symptom, and an opinion as to whether this symptom is at least as likely as not related to his hiatal hernia with GERD is required. 2. Also, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected anterior trunk scars, posterior scar, and service-connected painful surgical scar. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. All of the Veteran’s scars should be described by an adequate examination. 3. After the above development—as well as any additionally indicated development—has been completed, readjudicate the issues on appeal, as are listed on the title page of this Remand. If the benefits sought are not granted to the Veteran’s satisfaction, send the Veteran and his attorney a Supplemental Statement of the Case and provide them an opportunity to respond. If necessary, return the case to the Board for further appellate review. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Steven H. Johnston, 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.