Citation Nr: 21061348 Decision Date: 10/01/21 Archive Date: 10/01/21 DOCKET NO. 15-13 237 DATE: October 1, 2021 REMANDED Entitlement to an increased initial rating for posttraumatic stress disorder (PTSD), rated as 50 percent prior to April 2, 2014 and as 70 percent, thereafter, is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU), prior to January 29, 2010, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1965 to November 1967. This matter is before the Board of Veterans' Appeals (Board) on appeal of July 2011, April 2014, and September 2020 rating decisions of a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran testified before the undersigned at a hearing in October 2015. In January 2020 and December 2020,, the Board remanded the claims for additional development. They are now returned for continued appellate review. In September 2020, a rating decision allowed service connection for bilateral hearing loss. As this represents a complete grant of the benefit sought, the issue is no longer in appellate status. In November 2020, the Veteran submitted a VA form 10182 to appeal the September 2020 rating decision, including the issue of an increased rating for PTSD, under the system created by the Appeals Modernization Act (AMA). The September 2020 rating decision represents an interim determination in the appeal of the initial rating assigned for PTSD. The rating decision, as to this issue, is not subject to appeal under the AMA. The Veteran did not submit a request to "opt-in" to the AMA system following the September 2020 Supplemental Statement of the Case which addressed entitlement to an increased initial rating for PTSD. Thus, this issue remains on appeal within VA's legacy appeal system. Under the holding in Rice v. Shinseki, 22 Vet. App. 447 (2009), the issue of entitlement to a TDIU is raised by the record and associated with the continuing appeal for an increased initial rating for PTSD. It is also addressed below. 1. Entitlement to an increased initial rating for posttraumatic stress disorder (PTSD), rated as 50 percent prior to April 2, 2014 and as 70 percent, thereafter, is remanded. The issue before the Board is whether an increased rating for PTSD is warranted over the appeal period. Unfortunately, VA treatment records, relevant to this issue, may be outstanding. In April 2014, a VA PTSD examiner documented the Veteran's mental health history included being followed by a VA prescriber. The prescriber is identified as W. H., a clinical nurse specialist. The April 2014 examiner referred to and quoted from W. H.'s December 15, 2013 treatment notes. Other VA treatment records include a June 2013 phone call to schedule a July 2013 appointment with W. H., March 2013 prescriptions prescribed by W. H., and a "problem list " with psychiatric diagnoses by W. H. Unfortunately, there are no VA treatment records from W. H. included in the claims file. VA's duty to assist requires efforts to ensure all available VA treatment records have been obtained and associated with the claims file. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c); see also Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016). The outstanding VA treatment records from W. H. have potential relevance to the issue on appeal. 2. Entitlement to a total disability rating based on individual unemployability (TDIU), prior to January 29, 2010, is remanded. Where a decision on one issue would have a "significant impact" upon another, and that impact in turn could render any appellate review on the other claim meaningless and a waste of judicial resources, the two claims are inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The issue of entitlement to TDIU, prior to January 29, 2010 remains intertwined with the claim seeking an increased initial rating for PTSD. The matters are REMANDED for the following action: Obtain all outstanding VA treatment records for the Veteran. These records should include all records and notes from W. H., a VA clinical nurse specialist who appears to have treated the Veteran for some period, including in 2013 and 2014. If no records from W. H. are obtained, document the file as to this finding and describe all efforts made to obtain outstanding records. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jeanne Celtnieks 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.