Citation Nr: 21065999 Decision Date: 10/28/21 Archive Date: 10/28/21 DOCKET NO. 15-29 609 DATE: October 28, 2021 REMANDED The claim of entitlement to an initial compensable rating prior to May 20, 2021, and higher than 30 percent thereafter, for residuals of left and right hernia surgery is remanded. The claim of entitlement to a TDIU is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1963 to June 1964. This appeal is from a May 2013 rating decision. The Board last remanded this claim in January 2021. Unfortunately, still further development is required, as discussed below. The Board notes that no informal hearing presentation has been associated with the claims file. However, as the issues are being remanded, there is no prejudice to the Veteran regarding this duty to assist error. 1. The claim of entitlement to an initial compensable rating prior to May 20, 2021, and higher than 30 percent thereafter, is remanded. The Veteran has raised the issue of entitlement to an extraschedular rating for his service-connected hernia. Over the course of the appeal period, he has complained of headaches, nausea, and extreme fatigue, which he relates to his hernia. These symptoms have not been addressed by the VA examiner. The May 2021 VA examiner opined that the Veteran's persistent groin pain limited bending, lifting, and standing. The Veteran was noted to have groin pain and erectile dysfunction. He has service connection for erectile dysfunction, but it is not clear whether the groin pain is part of erectile dysfunction or a symptom of his hernia. On remand, this shall be addressed. On remand, an updated examination shall be conducted that addresses the Veteran's additional symptoms. Thereafter, this claim will be referred to the Director of the Compensation Service for a determination on whether an extraschedular rating is warranted. The Board may not award an extraschedular rating without the issue being considered by the Director first. 2. The claim of entitlement to a TDIU is remanded. The May 2021 VA examiner opined that the Veteran's residual pain from his surgeries make him unable to secure or follow a substantially gainful occupation. Accordingly, this matter is remanded for it to be referred to the Director of the Compensation Service for initial consideration of whether an extraschedular TDIU is warranted. The matters are REMANDED for the following action: 1. Associate updated VA treatment records with the claims file. 2. After completion of the above, schedule the Veteran for an appropriate examination for a report on the current severity of his service-connected residuals of left and right hernia surgery. The examiner is asked to elicit from the Veteran a detailed report on his symptoms. The Veteran has complained of fatigue lasting for up to two days that occurs two or three times a month. He has complained of nausea and headaches associated with his hernia. The May 2021 VA examiner noted he had functional impairment and that persistent groin pain would impact occupational and everyday activities, including difficulty with bending, lifting, and squatting. The examiner is asked to address the above symptoms, and any other symptoms listed by the Veteran, for an opinion on whether they are caused by his service-connected hernia, and if so, the level of impairment they cause. All symptoms are to be supported with explanation. 3. After completion of the above, forward the file to the Director of the Compensation Service for decisions on whether the Veteran is entitled to an extraschedular increased rating for the residuals of his hernia surgery, and whether the Veteran is entitled to an extraschedular TDIU. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Gibson 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.