Citation Nr: 21074035 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 17-36 227 DATE: December 14, 2021 REMANDED Entitlement to an increased rating for right lower extremity peripheral neuropathy, rated as 40 percent disabling prior to May 12, 2017, 60 percent disabling from May 12, 2017 and 40 percent disabling from December 14, 2017, is remanded. Entitlement to an increased rating for left lower extremity peripheral neuropathy, rated as 40 percent disabling prior to May 12, 2017, 60 percent from May 12, 2017 and 40 percent disabling from December 14, 2017 is remanded. Entitlement to an increased rating for right lower extremity peripheral neuropathy of the femoral nerve, rated as 30 percent disabling from December 14, 2017 is remanded. Entitlement to an increased rating for left lower extremity peripheral neuropathy of the femoral nerve, rated as 30 percent disabling from December 14, 2017 is remanded. Entitlement to an increased rating for diabetes mellitus with erectile dysfunction and aggravation of eye disabilities, currently assigned a 10 percent evaluation prior to August 12, 2013 and 20 percent thereafter, is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disability (TDIU) is remanded. Entitlement to an effective date earlier than February 26, 2017 for the grant of eligibility to Dependents' Educational Assistance is remanded. REASONS FOR REMAND The Veteran had active duty from June 1968 to June 1988. This matter comes before the Board of Veterans' Appeals (Board) from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This case was previously before the Board in April 2019. The Board finds that the issue of entitlement to TDIU continues to be before the Board as an inferred claim as the Veteran claims that he is unable to work due to his peripheral neuropathy disabilities. See Veteran's Application for Increased Compensation based on Unemployability dated in September 2017. 1. Entitlement to an increased rating for right lower extremity peripheral neuropathy, rated as 40 percent disabling prior to May 12, 2017, 60 percent disabling from May 12, 2017 and 40 percent disabling from December 14, 2017, is remanded. 2. Entitlement to an increased rating for left lower extremity peripheral neuropathy, rated as 40 percent disabling prior to May 12, 2017, 60 percent from May 12, 2017 and 40 percent disabling from December 14, 2017 is remanded. 3. Entitlement to an increased rating for right lower extremity peripheral neuropathy of the femoral nerve, rated as 30 percent disabling from December 14, 2017 is remanded. 4. Entitlement to an increased rating for left lower extremity peripheral neuropathy of the femoral nerve, rated as 30 percent disabling from December 14, 2017 is remanded. The Veteran received a Diabetic Sensory-Motor Peripheral Neuropathy Disability Benefits Questionnaire (DBQ) in November 2019 pursuant to the Board's April 2019 remand directives. The examiner did not find that the Veteran had a diagnosis of diabetic peripheral neuropathy. Although the examiner evaluated the Veteran's nerve disabilities, the examiner did not provide the severity of these disabilities. The examiner determined that the Veteran instead had polyneuropathy and the exact etiology of the neurological symptoms could not be determine based on medical record review and available diagnostic testing in the clinic. For these reasons, the Board finds that the Veteran should be afforded a neurological examination that will provide the diagnosis of his nerve disability and the severity. 5. Entitlement to an increased rating for diabetes mellitus with erectile dysfunction and aggravation of an eye disabilities, currently assigned a 10 percent evaluation prior to August 12, 2013 and 20 percent thereafter, is remanded. Since the most recent December 2017 Diabetes Mellitus Disability Benefits Questionnaire (DBQ), the record indicates that the Veteran's diabetes has worsened, and he is now receiving insulin injections for his diabetes. A remand is needed to ascertain the current severity of his diabetes. 6. Entitlement to a total disability rating based on individual unemployability due to service-connected disability (TDIU) is remanded. 7. Entitlement to an effective date earlier than February 26, 2017 for the grant of eligibility to Dependents' Educational Assistance is remanded. The issues of entitlement to a TDIU and DEA eligibility cannot be resolved until the matter involving increased ratings for diabetes mellitus has been adjudicated. The Board finds that the Veteran's claims are inextricably intertwined, and therefore will be addressed together. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected diabetes mellitus. 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's attention is directed to the Veteran's treatment records showing the use of insulin for his diabetes mellitus. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected peripheral neuropathy of the lower extremities and femoral nerve disability of the lower extremities. 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 should also note whether any nerve disability is secondary to his diabetes. In so doing, the examiner must test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing. 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). 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 at all 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). 3. Readjudicate the Veteran's claims, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, he and his attorney should be furnished a supplemental statement of the case and afforded an appropriate period of time within which to respond thereto. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Tahirih S. Samadani, 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.