Citation Nr: 21071750 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 12-13 256 DATE: December 1, 2021 REMANDED Entitlement to a total rating for compensation purposes based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from January 1965 to January 1977 and from January 1981 to January 1985. Entitlement to a TDIU is remanded. Entitlement to a TDIU requires an accurate assessment of the impairment associated with all of the service-connected disabilities. Service connection has been established for lumbar spine degenerative disc disease rated as 20 percent disabling; left ankle gouty arthritis rated as 20 percent disabling; right ankle gouty arthritis rated as 10 percent disabling; right piriformis syndrome with sciatica and sacroiliac dysfunction rated as 10 percent disabling; hypertensive vascular disease rated as 10 percent disabling; postural hypotension with lightheadedness rated as 10 percent disabling; tinnitus rated as 10 percent disabling; and bilateral hearing loss, degenerative arthritis, hiatal hernia, genitourinary benign growths, and scars rated as noncompensable. The report of an October 2006 evaluation from W. Choisser, M.D., conducted for the Social Security Administration states that the Veteran "cannot sit, stand, or walk for any prolonged period of time because of his ... lumbar spine disc disease as well as ankle pain." The Veteran was last afforded a VA examination which encompassed the service connected gouty arthritis of the ankles and any associated vocational impairment associated with those disabilities in May 2007. VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991). Given the passage of over 14 years since the last VA ankle examination, the Board finds that further ankle evaluation is needed to determine the physical and vocational impairment associated with the right ankle and left ankle gouty arthritis. Clinical documentation dated after August 2021 is not of record. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran's claim. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who treated him for the service connected right ankle gouty arthritis and left ankle gouty arthritis. Make two requests for the authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile. 2. Associate with the record any VA medical records for treatment provided since August 2021 not already of record. 3. Schedule the Veteran for a VA ankle examination conducted by a medical doctor to assist in determining the nature and severity of service-connected right ankle and left ankle gouty arthritis. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Provide ranges of motion for weight-bearing and nonweight-bearing and passive and active motion of and both ankles. The examiner should indicate the degree at which any pain is noted. (Continued on the next page) (b) State whether there is any additional loss of function of the ankles due to painful motion, weakened motion, excess motion, fatigability, incoordination, or on flare up. The examiner should specifically opine as to any additional loss of function due to flare up. (c) Provide an opinion as to the impact of the ankle disabilities on the Veteran's vocational pursuits and whether it is at least as likely as not (50 percent or greater probability) that the Veteran is unable to secure or follow a substantially gainful occupation due to the effects of the ankle disabilities and the other service-connected disabilities. If the Veteran is felt capable of work despite the service-connected disabilities, the examiner should describe what type of work and what accommodations would be necessary due to the service-connected disabilities. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Smith, Associate 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.