Citation Nr: 21063612 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 18-30 125 DATE: October 14, 2021 REMANDED Entitlement to an increased rating for depressive disorder, rated 50 percent disabling, is remanded. Entitlement to an increased rating for diabetic neuropathy of the left lower extremity affecting the femoral nerve, rated 10 percent disabling, is remanded. Entitlement to an increased rating for diabetic neuropathy of the left lower extremity affecting the sciatic nerve, rated 10 percent disabling, is remanded. Entitlement to an increased rating for diabetic neuropathy of the right lower extremity affecting the femoral nerve, rated 10 percent disabling, is remanded. Entitlement to an increased rating for diabetic neuropathy of the right lower extremity affecting the sciatic nerve, rated 10 percent disabling, is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1984 to March 1985 and from November 1990 to May 1991. The Department of Veterans Affairs is grateful for his service. 1. Entitlement to an increased rating for depressive disorder, rated 50 percent disabling, is remanded. At the October 2021 hearing before the undersigned, the Veteran testified to worsening depression since his last examination in May 2018 and in particular over the last year. Accordingly, remand for a new examination is warranted. The duty to conduct a contemporaneous examination is triggered when the evidence indicates that there has been a material change in disability or that the currently assigned disability rating may be incorrect. Caffrey v. Brown, 6 Vet. App. 377, 381 (1994). 2. Entitlement to an increased rating for diabetic neuropathy of the left lower extremity affecting the femoral nerve, rated 10 percent disabling, is remanded. 3. Entitlement to an increased rating for diabetic neuropathy of the left lower extremity affecting the sciatic nerve, rated 10 percent disabling, is remanded. 4. Entitlement to an increased rating for diabetic neuropathy of the right lower extremity affecting the femoral nerve, rated 10 percent disabling, is remanded. 5. Entitlement to an increased rating for diabetic neuropathy of the right lower extremity affecting the sciatic nerve, rated 10 percent disabling, is remanded. At the October 2021 hearing before the undersigned, the Veteran testified to worsening peripheral neuropathy in the lower extremities since his last examination in April 2018, with increased weakness, pain, and numbness. Accordingly, remand is warranted for a new examination. Id. 6. Entitlement to a TDIU is remanded. The Veteran's claim for TDIU is inextricably intertwined with the other claims the subject of appeal, and hence it must also be remanded. The Court has held that a claim which is inextricably intertwined with another claim which remains undecided and pending before the VA must be adjudicated prior to a final order on the pending claim, so as to avoid piecemeal adjudication. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following actions: 1. Obtain and associate with the claims file any outstanding VA and relevant private treatment records, with the Veteran's assistance and authorization, as appropriate. If any records cannot be obtained, the Veteran should be informed. 2. Thereafter, obtain a VA examination to address the nature and severity of the Veteran's service-connected depression. The claims file including a copy of this remand should be provided to the examiner, and these should be carefully reviewed. Any necessary tests or studies should be performed. The examiner should be advised that the examination is necessary due to the Veteran's October 2021 testimony that his depression has worsened since his last examination in May 2018. The examiner must also document and consider the Veteran's own statements regarding his disability, since a layperson is competent to address symptoms as experienced and his recollections of past history and treatment. If the examiner has reason based on other evidence of record or medical knowledge to question the Veteran's self-reported history, the examiner should so state and provide a complete explanation why this is so. The examiner should also address the effect of the Veteran's depression on any occupational functioning and activities of daily living. If it is not possible to provide a specific finding 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). 3. Obtain a VA examination to address the nature and severity of the Veteran's service-connected diabetic peripheral neuropathy affecting each lower extremity. The claims file including a copy of this remand should be provided to the examiner, and these should be carefully reviewed. Any necessary tests or studies should be performed. The examiner should be advised that the examination is necessary due to the Veteran's October 2021 testimony that his peripheral neuropathy has worsened in each lower extremity since his last examination in April 2018. The examiner should, to the extent feasible, provide separate findings for the nature and severity of diabetic neuropathy of the enervated parts from the sciatic nerve, and separately, from the femoral nerve, for each lower extremity. The examiner must also document and consider the Veteran's own statements regarding his disability, since a layperson is competent to address symptoms as experienced and his recollections of past history and treatment. If the examiner has reason based on other evidence of record or medical knowledge to question the Veteran's self-reported history, the examiner should so state and provide a complete explanation why this is so. The examiner should also address the effect of the Veteran's diabetic neuropathy affecting the sciatic nerve and the femoral nerve for each lower extremity, on any occupational functioning and activities of daily living. If it is not possible to provide a specific finding 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). 4. Thereafter, readjudicate the appealed claims. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Schechter 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.