Citation Nr: 21074825 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 17-48 191 DATE: December 16, 2021 ORDER Entitlement to service connection for bilateral hearing loss has been withdrawn. Entitlement to service connection for hypertension has been withdrawn. Entitlement to service connection for dermatophytosis, characterized as brittle nails has been withdrawn. Entitlement to service connection for a skin disorder, claimed as chloracne, has been withdrawn. REMANDED Entitlement to an initial rating in excess of 50 percent for an acquired psychiatric disorder, characterized as Posttraumatic Stress Disorder (PTSD) and major depressive disorder, is remanded. Entitlement to service connection for stroke residuals, to include as secondary to service-connected diabetes mellitus, type II, and/or an acquired psychiatric disorder, is remanded. Entitlement to a total disability rating based on individual unemployment (TDIU) is remanded. FINDING OF FACT In a March 1, 2021 statement submitted by the Veteran, through his attorney, the Veteran expressed his desire to withdraw his claims for entitlement to service connection for: bilateral hearing loss; hypertension; dermatophytosis, characterized as brittle nails; and a skin disorder, claimed as chloracne. CONCLUSIONS OF LAW 1. The criteria for withdrawal of entitlement to service connection for bilateral hearing loss by the Veteran have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 2. The criteria for withdrawal of entitlement to service connection for hypertension by the Veteran have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 3. The criteria for withdrawal of entitlement to service connection for dermatophytosis, characterized as brittle nails by the Veteran have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 4. The criteria for withdrawal of entitlement to service connection for a skin disorder, claimed as chloracne, by the Veteran have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1966 to November 1970. These matters come before the Board of Veterans' Appeals (Board) subject to a merged appeal. The issues of service connection of bilateral hearing loss, hypertension, dermatophytosis, and a skin disorder come before the Board on appeal from an August 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). They return to the Board following the issuance of an August 2019 remand order which directed the RO to undertake additional development. Also included as part of that prior Board remand was a claim of service connection for a left arm disorder, which was subsequently granted and is no longer part of this appeal. The claims for an increased disability rating for a psychiatric disability and service connection for residuals of a stroke come before the Board on appeal from a July 2016 rating decision, the appeal of which was perfected to the Board in December 2019. The Board notes that the Veteran has not explicitly claimed entitlement to TDIU, however, the evidence of record implies that the Veteran's disabilities, particularly his PTSD, may render him unemployable. As such, it has been included as part and parcel of the increased rating claim. Rice v. Shinseki, 22 Vet. App. 447 (2009). Withdrawal 1. Entitlement to service connection for bilateral hearing loss 2. Entitlement to service connection for hypertension 3. Entitlement to service connection for dermatophytosis, characterized as brittle nails 4. Entitlement to service connection for a skin disorder, claimed as chloracne, The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 19.55. Withdrawal may be made by the appellant or by his or her authorized representative. Id. In a March 2021 statement submitted through his attorney, the Veteran requested that his claims for entitlement to service connection for: bilateral hearing loss; hypertension; dermatophytosis, characterized as brittle nails; and a skin disorder, claimed as chloracne. Hence, here remains no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeal and it is dismissed REASONS FOR REMAND 1. An initial rating in excess of 50 percent for an acquired psychiatric disorder, characterized as Posttraumatic Stress Disorder (PTSD) and major depressive disorder The Veteran was most recently afforded a VA examination in connection with his increased rating claim for PTSD in 2014. Since that time, the Veteran has submitted evidence, to include a May 2019 private evaluation (although not an in-person evaluation) and a "residual functional capacity evaluation," of worsening symptoms associated with his PTSD. Additionally, although the record indicates that the Veteran has sought consistent psychiatric care for his PTSD through VA, the most recent VA treatment records associated with the claims file date to 2019, nearly three years ago. As such, on appeal the RO should make efforts to update the claims file with the Veteran's complete VA treatment records, if available, and afford the Veteran a new examination to assess the present severity of his PTSD and major depressive disorder. 2. Entitlement to service connection for stroke residuals, to include as secondary to service-connected diabetes mellitus, type II, and/or an acquired psychiatric disorder, is remanded. The Veteran is seeking service connection for residuals of an August 2015 stroke. In statements submitted by the Veteran and his attorney, it has been suggested that the Veteran's stroke may be secondarily caused or aggravated by his service-connected diabetes mellitus, type II and/or his acquired psychiatric disorder. It has also been put forward that his stroke may be related to his non-service-connected hypertension. Finally, it is noted that it is conceded that the Veteran was exposed to herbicides while stationed in the Republic of Vietnam. The Veteran has not been afforded a VA examination in conjunction with this service connection claim. VA's duty to assist includes providing a medical examination and obtaining an opinion when it is necessary to make a decision on a claim. 38 U.S.C. § 5103A (d), 38 C.F.R. § 3.159. Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of a diagnosed disability or symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006). The threshold for finding a link between a current disability and service so as to require medical examination is low. Locklear v. Nicholson, 20 Vet. App. 410 (2006); McLendon, 20 Vet. App. at 83. Thus, the Veteran's claim for service-connection for residuals of a stroke is remanded so that a medical examination can be obtained. 3. Entitlement to a total disability rating based on individual unemployment (TDIU) is remanded. As noted above, the Veteran has not explicitly raised the issue of entitlement to a TDIU, however, the May 2019 VA examiner opined that due to the Veteran's acquired psychiatric disorder, he may likely be unable to sustain gainful employment. Thus, the Board finds that a claim for TDIU has been raised by the record. Rice v. Shinseki, 22 Vet. App. 447 (2009). Entitlement to a TDIU is inextricably intertwined with the claims remanded herein, thus the Board will defer consideration of the appeal with regard to entitlement to a TDIU. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are "inextricably intertwined" when they are so closely tied together that a final Board decision on one issue cannot be rendered until the other issue has been considered). The matters are REMANDED for the following action: 1. Invite the Veteran to submit any additional evidence in support of his claim. The RO should make all necessary and appropriate efforts to associate any outstanding VA treatment records with the claims file prior to scheduling any of the below ordered examinations. The RO should also make all necessary and appropriate efforts to obtain any outstanding private treatment records adequately identified by the Veteran. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected PTSD and major depressive disorder. 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 must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to his service-connected psychiatric disorder alone. 3. Schedule the Veteran for a VA examination with an appropriate clinician to evaluate the etiology of his claimed stroke residuals. The claims folder must be made available to and be reviewed by any examiner(s). All tests deemed necessary should be conducted and the results reported in detail. The examiner is to address the following questions: (1) whether it is at least as likely as not that the Veteran's stroke and its resulting residuals are related to his active-duty service, to specifically include exposure to herbicides; (2) whether it is at least as likely as not that his stroke and its residuals were (a) caused or (b) aggravated by another-service connected disability, including his diabetes mellitus, type II, and/or his acquired psychiatric disorder (the examiner should be careful to discuss both causation and aggravation when discussing secondary service connection). All opinions should be accompanied by adequate reasons and bases. M. Pryce Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Q. Hernan, Attorney Advisor