Citation Nr: 21062765 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-36 877 DATE: October 12, 2021 REMANDED Service connection for tinnitus is remanded. Service connection for hemorrhoids is remanded. A rating higher than 30 percent for posttraumatic stress disorder (PTSD) is remanded. A rating higher than 10 percent for lumbar strain is remanded. A rating higher than 10 percent for allergic rhinitis is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1987 to May 1988. Tinnitus Hemorrhoids The Veteran has sought service connection for tinnitus and hemorrhoids. After review of the record, the Board finds that the VA examination provided to the Veteran regarding her tinnitus in 2013 is inadequate for adjudication purposes as the examiner did not note or consider the Veteran's in-service documented ear infections. As such, a new examination is warranted. As to the Veteran's claim for service connection for hemorrhoids, upon review of the record, the Board notes that no examination regarding the Veteran's hemorrhoids has been conducted; remand is necessary as the low threshold for obtaining such an examination and medical opinion has been surpassed in this case. See 38U.S.C. §5103A (d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). PTSD Lumbar Strain Allergic Rhinitis The Veteran was last afforded VA examinations regarding the severity of her conditions in 2013. New examinations are warranted. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of her tinnitus. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's tinnitus was incurred in, or due to, the Veteran's service. The examiner is specifically asked to address the Veteran's service treatment records which document in-service ear infections. The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of her hemorrhoids. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's hemorrhoids were incurred in, or due to, the Veteran's service. The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of her service-connected PTSD. 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. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to PTSD. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of her lumbar spine disability. 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. In so doing, the examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran's statements. If it is not possible to provide a specific measurement without speculation, 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). 5. Schedule the Veteran for an appropriate VA examination to determine the current severity of her service-connected allergic rhinitis. The claims file should be made available to the examiner and reviewed in conjunction with the examination. All necessary tests and studies should be conducted. (Continued on the next page) The examiner should describe in detail all manifestations of the condition, to include nasal passage obstruction and/or polyps. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.