Citation Nr: 21066098 Decision Date: 10/28/21 Archive Date: 10/28/21 DOCKET NO. 16-08 784 DATE: October 28, 2021 REMANDED Entitlement to service connection for chronic angina is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for nerve disability of the left upper extremity is remanded. Entitlement to service connection for nerve disability of right upper extremity is remanded. Entitlement to total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 decision. The Veteran presented testimony before the Board in March 2019. The Board remanded these issues in December 2019 for further development. In January 2021, the Regional Office (RO) granted service connection for prostate cancer and dysphagia. In April 2021, the RO granted service connection for coronary artery disease (CAD). Consequently, there no longer remains claims controversy. The Board notes the Veteran is in receipt of a 100 percent disability rating for prostate cancer from May 2, 2014. Although TDIU is now moot with regard to whether it may be awarded for prostate cancer from May 2, 2014, VA must still consider whether TDIU is warranted based on any combination of the remaining service-connected disabilities. In addition, VA must also consider whether increased compensation benefits may be payable as special monthly compensation (SMC) at the housebound rate under 38 U.S.C. § 1114 (s). See Buie v. Shinseki, 24 Vet. App. 242, 250 (2011); Bradley v. Peake, 22 Vet. App. 280, 294 (2008). Specifically, SMC benefits under 38 U.S.C. § 1114 (s) are to be accorded when a veteran becomes eligible without need for a separate claim. See Bradley, 22 Vet. App. at 294. Entitlement to service connection for chronic angina, hypertension, and nerve disability of the bilateral upper extremities; Entitlement to TDIU Unfortunately, there has not been substantial compliance with the Board's previous remand directives regarding clarifying the Veteran's periods of active duty service with Air Force Reserves between 1999 and 2012 and obtain the specific dates of active and inactive duty training from 1999 to 2012. The RO was also to obtain a copy of Page 5 of the points summary prepared November 5, 2012, which contains the summary for the period between June 2009 and January 2012. In a July 2020 Deferred Rating Decision, the RO indicated that the Veteran's service dates still needed to be properly verified and the necessary records requested, to include the missing points summary page. The Board notes that duplicate records were received by Defense Personnel Records Information Retrieval System (DPRIS) in August 2020. The periods of ADT and IDT still have not been verified nor have the dates of active service as the RO still lists conflicting dates in decisions dated in January and April 2021. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board remanded the claims for service connection for chronic angina, hypertension and nerve disability of the bilateral upper extremities for a VA opinion to determine the nature and etiology of the claimed disabilities. The requested examinations were conducted in July 2020; however, the Board cannot make a fully-informed decision on these issues because the examination opinions are inadequate. With regard to the claims for hypertension and nerve disability of the bilateral upper extremities, the examiner failed to provide an opinion on whether the claimed disabilities were directly related to the Veteran's military service. Further, while the examiner indicated the claimed disabiblities were not caused by the now service-connected CAD, failed to answer whether the conditions were in fact aggravated by the CAD. The Board notes the RO attempted to cure the defect and obtain addendum opinions, but the December 2020 addendum opinion simply reiterated the prior opinions. As such, further addendum is necessary. With regard to the claim for chronic angina, the Board notes the July 2020 VA examiner indicated that there has been no recurrence of angina symtoms since the Veteran's 2014 catherization. The Board finds that clarification is necessary to determine whether angina identified prior to the catherization (from 2012 to 2014) was a separately diagnosed disability related to service or a service-connected disablity or a symptom of the now service-connected CAD. Consequently, an addendum opinion must be sought. Finally, because a decision on the claims for service connection for hypertension and nerve disability of the bilateral upper extremity could significantly impact a decision on the issue of TDIU, the issues are inextricably intertwined. A remand of the claim for TDIU is also required. The matters are REMANDED for the following action: 1. Contact the appropriate record depository, to include the Air Reserve Personnel Center, to clarify the Veteran's periods of active duty service with the Air Force Reserves between 1999 and 2012. In addition, obtain the specific dates of active duty training (ADT) and inactive duty training (IDT) dates of the Veteran in the Air Force Reserves from 1999 to 2012. Please note, simply providing copies of military personnel records and/or points credit summaries are not sufficient to satisfy this request. Document all requests for information as well as all responses in the claims file. Thereafter, the RO is to compile the specific dates requested above (active service, ADT, and IDT) in a single memorandum for the record. 2. Obtain a copy of page 5 of the points summary prepared November 5, 2012, which contains the summary for the period between June 2009 and January 2012. Document all requests for information as well as all responses in the claim file. 3. Once completed, obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's hypertension and/or bilateral ulnar tunnel syndrome at least as likely as not began during active service, manifested within a year after discharge from service (dates to be provided), or was noted during service with continuity of the same symptomatology since service? In the alternative, the examiner must indicate whether hypertension and/or bilateral ulnar tunnel syndrome at least as likely as not was aggravated beyond its natural progression by the service-connected CAD. In providing the requested opinion, consider the Veteran's description of his/her in-service injury and symptoms as well as his post-service symptoms. The examiner must provide the complete rationale for all opinions expressed. 4. Obtain an addendum opinion from an appropriate clinician regarding whether chronic angina identified between 2012 and 2014 was a separate disability from the service-connected CAD and if so, whether it at least as likely as not was related to service and/or proximately due to, the result of, or aggravated by (beyond the natural progression) by service-connected disability. In the alternate, the examiner must indicate whether angina was a symptom/manifestation of CAD resolved by catherization without reoccurrence since 2014? Provide a rationale to support the opinion(s). 5. Thereafter, the claims must be readjudicated. The RO must consider whether TDIU is warranted based on any combination of the remaining service-connected disabilities other than prostate cancer. In addition, VA must also consider whether increased compensation benefits may be payable as SMC at the housebound rate under 38 U.S.C. § 1114 (s). If upon completion of the above action the claims remain denied, the matters must be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. L. Wallin, 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.