Citation Nr: 21074867 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 15-21 344 DATE: December 16, 2021 REMANDED Entitlement to an initial evaluation in excess of 40 percent for service-connected low back disability is remanded. Entitlement to a separate evaluation for mild fecal incontinence associated with a service-connected low back disability is remanded. Entitlement to an initial evaluation in excess of 20 percent for service-connected radiculopathy of the right leg is remanded. Entitlement to an initial evaluation in excess of 20 percent for service-connected radiculopathy of the left leg is remanded. Entitlement to an initial evaluation in excess of 10 percent for service-connected hypertension is remanded. Entitlement to an increased initial evaluation for service-connected ischemic heart disease (hereinafter, heart disability), evaluated 60 percent disabling from August 24, 2011, to July 8, 2012, and 30 percent disabling from November 1, 2012, to the present, is remanded. Entitlement to a separate evaluation for scarring of the chest and legs associated with surgery fora service-connected heart disability is remanded. Entitlement to service connection for residuals of plantar warts of the left foot is remanded. Entitlement to service connection for a respiratory disability is remanded. Entitlement to service connection for erectile dysfunction, to include as secondary to a service-connected disability is remanded. Entitlement to service connection for an eye disability is remanded. Entitlement to service connection for peripheral neuropathy of the left arm, to include as secondary to a service-connected disability, is remanded. Entitlement to service connection for peripheral neuropathy of the right arm, to include as secondary to a service-connected disability, is remanded. Entitlement to service connection for gastroesophageal reflux disease (GERD), to include as secondary to a service-connected disability, is remanded. Entitlement to service connection for obstructive sleep apnea, to include as secondary to a service-connected disability, is remanded. Entitlement to a total evaluation based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2014 rating decision from a Department of Veterans Affairs (VA) Regional Offices (RO) of the Veterans Benefits Administrations (VBA), which is the Agency of Original Jurisdiction (AOJ). In March 2019, the Board remanded the above issues for further development, to include scheduling of VA examinations. A record of a March 22, 2021 phone call indicates that the disability examination contractor informed the VA that the Veteran stated that he did not wish to continue with the examinations but that contact would be make with the Veteran to confirm. A March 23, 2021 record indicates the cancelation of all examinations based on the Veteran refusal. In a letter dated March 24, 2021 but listed as being received by the VA on May 24, 2021, the Veteran's attorney stated that the Veteran intended to attend scheduled VA examinations but to ensure that they are handicap accessible and as close to the Veteran's home as possible. A June VA examination scheduling request indicates that the location is not conducting in-person examinations at the time due to COVID-19. August and October 2021 records indicate that examinations were canceled at the Veteran's request. There is no correspondence of record either with respect to the scheduling of the examinations or contact with the Veteran with respect to canceling the examinations. Given the lack of documentation in the file with respect to the VA examination scheduling, the Board finds that the Veteran should be given another opportunity to attend VA examinations or clarify whether he no longer wishes to attend examinations or pursue his appeal. Finally, the Board notes that the copy of the October 2021 supplemental statement of the case (SSOC) sent to the Veteran's representative was returned as undeliverable. It appears the address used to mail the SSOC did not include the P.O. Box listed by the attorney representative. The address has been updated. The matters are REMANDED for the following action: 1. Schedule VA examinations to determine the nature and etiology of his claimed respiratory disability, eye disability, neurologic disability of the upper extremities, residuals of plantar warts of the left foot, GERD, obstructive sleep apnea, and erectile dysfunction, and to evaluate his service-connected hypertension, spine disability, heart disability, scarring of the chest and legs, fecal incontinence, radiculopathy of the lower extremities. The complete electronic record must be made available to, and reviewed by, the VA examiner(s) prior to conducting the examination(s). All necessary tests and studies should be conducted. The examiner(s) must describe the frequency and severity of all of the manifestations of the Veteran's service-connected hypertension, spine disability, heart disability, scarring of the chest and legs associated with his heart surgery, fecal incontinence, and radiculopathy of the lower extremities. In addressing the above, the examiner is specifically requested to address the following: (a.) Fully describe the frequency and severity of the symptoms associated with the Veteran's fecal incontinence associated with his service-connected low back disability and fully describe the frequency and severity of the symptoms associated with this disability. In addressing the above, please comment on whether the fecal incontinence identified at the March 2014 VA examination resolved prior to the February 2016 VA examination noting that the Veteran experienced constipation without periods of diarrhea. (b.) Fully describe the frequency and severity of the symptoms associated with the Veteran's radiculopathy of the lower extremities associated with his service-connected low back disability and fully describe the frequency and severity of the symptoms associated with this disability. (c.) Fully describe the frequency and severity of the symptoms associated with the Veteran's scarring of the chest and legs associated with the surgery for treatment of his service-connected heart disability. The examiner(s) is/are also requested to address the following: (d.) Confirm or rule out diagnoses related to the following: a. Erectile dysfunction; b. Plantar warts of the left foot, including residuals thereof; c. COPD or any other respiratory disability; d. Any disability of either eye; e. Any neurologic disability affecting either upper extremity (resulting in twitching and/or tremors of the hands); f. GERD; g. Obstructive sleep apnea. (e.) For all disabilities identified in any subpart of part (d), provide an opinion considering whether each is at least as likely as not proximately due to or the result of any incident of the Veteran's service, to include his presumed in-service exposure to an herbicide agent. (f.) For all disabilities identified in any subpart of part (d), provide an opinion considering whether each is at least as likely as not caused or aggravated by a service-connected disability. (g.) Provide an opinion considering whether it is at least as likely as not that the Veteran's obesity is caused by or related to any of the Veteran's service-connected disabilities and/or medications prescribed for such. If so, further state whether the obesity that was the result of service-connected disability was a substantial factor in causing or aggravating any disability/disabilities identified in any subpart of part (d). (Continued on the next page) If the examiner cannot provide an opinion without resorting to mere speculation, this should be so stated along with supporting rationale. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to the particular question H. SEESEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Christensen 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.