Citation Nr: 21076037 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 15-10 570 DATE: December 22, 2021 REMANDED A total disability rating based on individual unemployability (TDIU) due to service-connected disabilities. An initial evaluation in excess of 50 percent for PTSD prior to December 19, 2019. REASONS FOR REMAND The Veteran served on active duty from February 1969 to December 1972. The case is on appeal from a March 2013 rating decision. In September 2018, the Veteran testified at a Board videoconference hearing. Most recently, in January 2021, the Board granted an increased initial rating of 50 percent from January 26, 2010 to December 19, 2019 for PTSD, denied a rating in excess of 70 percent for PTSD from December 19, 2019, and denied entitlement to a TDIU. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In a September 2021 Joint Motion for Remand (JMR), the parties moved to vacate and remand the Board's decision denying entitlement to a higher initial rating than 30 percent for PTSD prior to December 2019, and for a TDIU. In the JMR, the Veteran also abandoned his appeal before the Court of the Board's denial of his claim for a rating in excess of 70 percent for PTSD from December 19, 2019. In a September 2021 Order, the Court granted the JMR and remanded the matter to the Board for further appellate review consistent with the Order. 1. A TDIU. The Veteran contends he is entitled to TDIU as a result of the aggregate effect of his service-connected disabilities, including PTSD and coronary artery disease, stable angina, supraventricular arrhythmia, with implanted cardiac pacemaker. The record provides that as of March 12, 2020, the Veteran had a combined disability rating evaluation of 100 percent, to include coronary artery disease, stable angina, supraventricular arrhythmia, implanted cardiac pacemaker (100 percent) and PTSD from January 26, 2010 (50 percent) and from December 19, 2019 (70 percent). The Veteran's most recent VA medical opinion in connection with his PTSD claim was in December 2019. The VA examiner opined that the Veteran's current degree of disability could be described as occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood. However, it seems to appear that the VA examiner limited his opinion to address the effect of the Veteran's service-connected PTSD on his functional capacity without considering the remaining service-connected disabilities and their aggregate effect on the Veteran's functionality. Additionally, the evidence of record includes a March 2020 VA medical opinion noting the Veteran's heart condition has a functional impact on his ability to work, as he had decreased activity tolerance and became easily fatigued/short of breath/fatigued with activity within the 12 months prior to the examination. Given the evidence of record, especially the fact that neither the December 2019 nor March 2020 VA examiner seems to have considered the aggregate effect of all his service-connected disabilities, the Board finds that a remand is warranted for a new VA examination and retrospective medical opinion that takes into consideration the aggregate effect of all the Veteran's service-connected disabilities on his functional capacity from December 19, 2019 and thereafter. 2. An initial evaluation in excess of 30 percent for PTSD prior to December 19, 2019. The intertwined issue of an initial evaluation in excess of 30 percent for PTSD prior to December 19, 2019, is also remanded. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). In light of the remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain outstanding VA treatment records dated from August 2021. 2. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) by an appropriate medical professional to comment on the aggregate effect of the Veteran's service-connected disabilities on his employability. The Veteran is presently service connected for PTSD and coronary artery disease, stable angina, supraventricular arrhythmia, with implanted cardiac pacemaker. The examiner is asked to provide a full description of the combined effects the service-connected disabilities had on the Veteran's ability to secure and follow a substantially gainful occupation December 19, 2019 and thereafter, when considering his educational background and vocational experience, but not his age or non-service-connected disabilities. The examiner should discuss the Veteran's statements regarding his inability to maintain substantially gainful employment. A complete rationale or explanation should be provided for any opinion reached. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Becton, 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.