Citation Nr: 21061659 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 18-17 610 DATE: October 4, 2021 REMANDED Entitlement to a rating in excess of 50 percent for major depressive disorder with eating disorder and attention deficit hyperactive disorder is remanded. Entitlement to a total rating based on individual unemployability due to service connected disability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from November 1999 to September 2014. These matters come to the Board of Veterans' Appeals (Board) on appeal from a May 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). Jurisdiction of this appeal is currently with the RO in Winston-Salem, North Carolina. The Veteran testified at a virtual video conference hearing before the undersigned Veterans Law Judge (VLJ) of the Board in July 2021. A transcript of the hearing has been associated with the claims file. Increased Rating Major Depressive Disorder The Veteran was most recently afforded a VA examination for his major depressive disorder in March 2017. Subsequently, in continuing post-treatment records, lay statements submitted, and Board hearing testimony, it was indicated that the Veteran's major depressive disorder symptoms had worsened since his VA examination. Specifically, the Veteran reported psychiatric symptoms that manifested in an inability to maintain and follow substantially gainful employment, marital stress, and decreased concentration and ability to focus. As the above evidence indicates a possible worsening of that the Veteran's major depressive disorder since his last VA examination, an additional examination should be afforded to determine the current level of severity of his disability. See Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994); VAOPGCPREC 11-95 (1995). Entitlement to a TDIU Regarding the TDIU issue, the Board notes that the issue of entitlement to a TDIU is inextricably intertwined with the claim remanded herein. Harris v. Derwinski, 2 Vet. App. 180, 183 (1991). Hence, a determination on the claim for TDIU should be deferred pending final disposition of the claim of entitlement to an increased rating for major depressive disorder. The matters are REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claims on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative and afford him an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Following the receipt of outstanding records, schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected major depressive disorder. The record, to include a copy of this Remand, should be made available to the examiner, and all indicated tests should be conducted. The examiner should identify the nature and severity of all current manifestations of the Veteran's service-connected major depressive disorder. The examiner must reconcile any conflicting medical evidence of record. The examiner must be sure to address the Veteran's lay statements and contentions regarding his psychiatric symptoms and their impact on occupational and social functioning. A clear rationale for all opinions must be provided, and a discussion of the facts and medical principles involved would be of considerable assistance. If the examiner opines that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. A rationale should be provided for any opinion offered. If it is not possible to provide a specific opinion regarding the above questions, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mariah N. Sim, 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.