Citation Nr: 21062757 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 16-61 183 DATE: October 12, 2021 REMANDED Entitlement to an effective date earlier than November 28, 2016, for the grant of special monthly compensation (SMC) at the rate under 38 U.S.C. § 1114(r)(1) (R-1 level) is remanded. INTRODUCTION The Veteran served on active duty from July 1967 to June 1970. In January 2021, the United States Court of Appeals for Veterans Claims (Court) granted a joint motion for remand and returned the above-noted issue to the Board for action consistent with the joint motion. REASONS FOR REMAND In the January 2021 joint motion for remand, the parties agreed an April 2020 Board decision, which denied the above-noted claim, failed to appropriately consider whether the evidence prior to November 28, 2016 established the Veteran's service-connected disabilitiesother than his service-connected heart disabilitymay have entitled him to the higher-level SMC he seeks. Following the January 2021 joint motion, the Veteran's representative provided a medical opinion from a private physician in August 2021. In sum, the physician concluded the Veteran had more likely than not experienced a loss of use of his left upper and lower extremities since December 2011 and had also more likely than not required the aid and attendance of another to complete daily activities since December 2011. However, the physician acknowledged in his report that he had never previously examined this Veteran, and curiously then cited to evidence dated much later in time than December 2011 to support his medical conclusions. For these reasons, the Board finds a retrospective medical opinion addressing these matters would be helpful in addressing the Veteran's claim. Accordingly, this case is REMANDED for the following actions: Obtain a retrospective medical opinion from a VA examiner, with sufficient experience and expertise, to address the functional effects caused by the Veteran's service-connected disabilities prior to November 28, 2016. The electronic records should be made available to and reviewed by the examiner. Following a review of all pertinent evidence and information the examiner is asked to address the following questions: a) At any time prior to November 28, 2016, does the evidence indicate the Veteran's service-connected bilateral lower extremity disabilities were of such severity as to cause a loss of function with respect to activities such as balance or propulsion such that he would have been equally well served by amputation with suitable prosthetic appliance? i. If so, please provide the date upon which his functional abilities were so impaired. ii. If not, please explain why. (Please note, the term "equally well served by amputation" does not mean an amputation was medically indicated; rather, in plain terms, the examiner is asked whether a person who had undergone bilateral amputations, and obtained suitably functioning prosthetics, could ambulate as well or better than this Veteran could given his service-connected bilateral lower extremity impairments at any time prior to November 28, 2016). b) At any time prior to November 28, 2016, did the Veteran's service-connected disabilitiesother than his service-connected right upper and right lower extremity disabilitiespreclude him from being able to tend to his activities of daily living (ADLs)? i. If so, please provide the date upon which his ability to tend to his ADLs were sufficiently impaired as to require the assistance of another. ii. If not, please explain why. (In this respect, the examiner is asked to provide concrete examples of how the Veteran's service-connected disabilities, both alone and in concert, impacted upon his ability to bath, shower, dress, eat/prepare meals, toilet, transfer, and ambulate within his home and living area prior to November 28, 2016). The examiner must discuss and consider the Veteran's competent and credible lay statements as they relate to his reported functional impairments. If the examiner determines any of the above-requested retrospective opinions are not possible, or would be speculative, the examiner must state whether this 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). T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Fraser, 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.