Citation Nr: 21076686 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 19-35 673 DATE: December 27, 2021 REMANDED Eligibility for assistance in acquiring specially adapted housing is remanded. Eligibility for a special home adaptation grant is remanded. REASONS FOR REMAND The Veteran served on active duty from January to October 1987. The Veteran testified before the undersigned Veterans Law Judge in an October 2021 video conference hearing. A transcript of that hearing has been associated with the file. The Board notes that the Veteran's testimony raised the possibility of a claim under 38 U.S.C. § 1151. The Board also notes that the Veteran's VA treating physician opined that he suffers from chronic obstructive pulmonary disease (COPD), which makes ambulating any distance with the walker very difficult. See August 2015 letter. To the extent the Veteran contends that this disability is related to service or to any of his service-connected disabilities, he may file a claim. If the Veteran wishes to file a claim for COPD or a claim under § 1151, he is encouraged to do so using the prescribed forms which are available at the local Regional Office or online (https://www.ebenefits.va.gov/ebenfits/). A review of the record shows that throughout the appeal period the Veteran has ambulated using a wheelchair, brace, cane, and walker. His VA treating physician authored a letter, dated August 2015, stating that the Veteran needs certain devices to ambulate due to some of his service-connected disabilities and some non-service disabilities. The Veteran and his wife provided detailed, compelling testimony vividly describing how his service-connected disabilities of the left upper extremity, bilateral lower extremities, and hips are so severe that they cause him to fall with such frequency that the Veteran's wife testified, "I don't dare leave him alone." Judicial notice was taken that the Veteran presented to the hearing using a walker. It is clear that the Veteran uses assistive devices; however, it is not clear if this use is based solely on his service-connected disabilities and whether he would be precluded from ambulation without the use of an assistive device. As such, the Board finds that a remand is required as additional development is needed. Additionally, of note, during the pendency of the appeal, the criteria for evaluating specially adapted housing (SAH) and special home adaptation (SHA) grant claims were revised, effective November 8, 2021. See 86 Fed. Reg. 56,218 (October 8, 2021). As such, on remand the Board will request that the Veteran be provided with updated VCAA notice. The matters are REMANDED for the following action: 1. Send the Veteran proper VCAA notice which includes an explanation as to what information or evidence is needed to substantiate his SAH and SHA claims, to include clear notification of the amendments effective November 8, 2021. 2. The Agency of Original Jurisdiction (AOJ) should schedule the Veteran for a VA examination to determine the current severity of his various service-connected disabilities as they relate to his ability to use his hands, upper extremities, and lower extremities. The examiner should be provided with a list of the Veteran's service-connected disabilities. The claims file and a copy of this remand must be made available to the examiner for review. 3. The examiner should review the claims file (including this remand) and note such review was conducted. Any essential tests and studies should be accomplished. After reviewing the evidence of record, the Veteran's lay statements, and the results of any testing performed at the examination, the examiner should provide opinions as to the following: (a.) Whether the Veteran's neuropathy of the right lower extremity, degenerative arthritis of the lumbar spine with spinal stenosis and intervertebral disc syndrome, left hip degenerative changes, history of deep vein thrombosis of the left lower extremity, joint osteoarthritis of the bilateral knees, or left shoulder bursitis alone, are of such severity as to preclude the Veteran from walking without the use of an ambulatory device. 1. In responding to this question, the examiner should address whether and how frequently the Veteran must use an ambulatory device (cane, wheelchair, crutches, brace, etc.) in order to walk and get around (both within and outside her home). Answers to questions such as the following may prove helpful: What ambulatory aids does the Veteran use for locomotion, and with what frequency? How far, if at all, is the Veteran able to walk independently? Does the Veteran use ambulatory devices inside the home, and if so, what type and how frequently? 2. In responding to this question, the examiner is asked to provide a detailed description of the type and extent of functional limitations due to the Veteran's service-connected disabilities as it affects his ability to perform various activities of daily living/functions. (b.) Whether the Veteran's left shoulder bursitis alone is of such severity as to result in the loss or loss of use of both upper extremities such as to preclude use of the arms at or above the elbow? (c.) The examiner should indicate whether the Veteran's service-connected disabilities affect his functions of balance and propulsion. (d.) The examiner should indicate whether the Veteran's currently non-service-connected COPD affects his functions of balance and propulsion. The examiner should consider all medical and lay evidence of record when making his or her determinations. The examiner is advised that the Veteran asserts that he has suffered numerous falls, even when using a walker, due to his service-connected disabilities. Any opinion offered must be supported by a complete rationale. If the clinician feels that the requested opinion cannot be rendered without resorting to speculation, he or she must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given current medical science and the known facts); by a deficiency in the record (i.e., additional facts are required); or by a deficiency in the examiner (i.e., the examiner does not have the needed knowledge or training). 4. Readjudicate the SAH and SHA claims. Emily Tamlyn Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Talamantes, 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.