Citation Nr: 21006238 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 20-00 722 DATE: February 3, 2021 ORDER Entitlement to an increased disability evaluation for patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia, currently evaluated as 10 percent disabling, is denied. New and relevant evidence has been received to reopen the previously denied claim of entitlement to service connection for a psychiatric disorder, and the claim is reopened. Entitlement to service connection for depressive disorder is granted. REMANDED Entitlement to service connection for PTSD is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDINGS OF FACT 1. Patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia is manifested by painful limitation of flexion; but not flexion at 45 degrees or less, not extension of 15 degrees or greater; no indication of instability, no meniscal condition, no locking, and no ankylosis. 2. In an unappealed September 2010 rating decision, the RO denied service connection for a psychiatric disorder. 3. The evidence associated with the claims file subsequent to the September 2010 rating decision is relevant to and probative of the issue of entitlement to service connection for the claim for service connection for an acquired psychiatric disorder. 4. Depressive disorder is attributable to service. CONCLUSIONS OF LAW 1. The criteria for a disability evaluation in excess of 10 percent for patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia have not been met. 38 U.S.C. §§ 1155, 5103A, 5107(b); 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.2, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Codes 5010 – 5260 (2019). 2. The September 2010 rating decision denying the application to reopen the previously denied claim of entitlement to service connection for an acquired psychiatric disorder, other than PTSD, is final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103 (2019). 3. New and material evidence has been received to reopen the claim for service connection for an acquired psychiatric disorder. 38 U.S.C. § 5108; 38 C.F.R. § 3.156 (2019). 4. The criteria for service connection for depressive disorder have been met. 38 U.S.C. §§ 1101, 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Navy from March 2005 to April 2010. These matters come before the Board of Veterans’ Appeals (Board or BVA) on appeal from a November 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Duties to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA) imposes obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107, 5126; Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, Pub. L. No. 112-154, §§ 504, 505, 126 Stat. 1165, 1191-93; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2017). The VCAA requires VA to assist a claimant at the time that he or she files a claim for benefits. As part of this assistance, VA is required to notify claimants of the evidence that is necessary in substantiating their claims, and provide notice that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded. 38 U.S.C. § 5103(a); 38 C.F.R. § 3.159(b)(1); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002); Dingess v. Nicholson, 19 Vet. App. 473, 486 (2006). Neither the Veteran nor his representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Increased Rating Disability evaluations are determined by application of the criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. An evaluation of the level of disability present must also include consideration of the functional impairment of the Veteran's ability to engage in ordinary activities, including employment. 38 C.F.R. § 4.10. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. Separate evaluations may be assigned for separate periods of time based on the facts found. In other words, the evaluations may be staged. Staged ratings are appropriate for any rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). In addition, when assessing the severity of a musculoskeletal disability that is rated on the basis of limitation of motion, VA must also consider the extent that the veteran may have additional functional impairment above and beyond the limitation of motion objectively demonstrated, such as during times when his symptoms are most prevalent (“flare-ups”) due to the extent of his pain (and painful motion), weakness, premature or excess fatigability, and incoordination. See DeLuca v. Brown, 8 Vet. App. 202, 204-7 (1995); see also 38 C.F.R. §§ 4.40, 4.45, 4.59. When evaluating musculoskeletal disabilities, VA must consider whether a higher evaluation is warranted, where the claimant experiences additional functional loss due to pain, weakness, excess fatigability, or incoordination, to include with repeated use or during flare-ups. See 38 C.F.R. § § 4.40, 4.45; DeLuca v. Brown, 8 Vet. App. 202, 204-7 (1995). The provisions of 38 C.F.R. § 4.40 and 38 C.F.R. § 4.45 are to be considered in conjunction with the diagnostic codes predicated on limitation of motion. See Johnson v. Brown, 9 Vet. App. 7 (1996). Nevertheless, pain itself does not rise to the level of functional loss as contemplated by the VA regulations applicable to the musculoskeletal system. Mitchell v. Shinseki, 25 Vet. App. 32 (2011). Moreover, functional impairment must be supported by adequate pathology. Id.; Johnson v. Brown, 9 Vet. App. 7, 10 (1996) (both citing to 38 C.F.R. § 4.40). 1. Entitlement to an increased disability evaluation for patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia, currently evaluated as 10 percent disabling. The Veteran is currently assigned a 10 percent rating for his patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia, pursuant to the provisions of 38 C.F.R. § 4.71a, Diagnostic Code 5260. See 38 C.F.R. § 4.20. Under Diagnostic Code 5260, limitation of flexion of a leg warrants a noncompensable rating when flexion is limited to 60 degrees. A 10 percent rating is warranted if flexion is limited to 45 degrees, and a 20 percent rating is warranted if flexion is limited to 30 degrees. Flexion that is limited to 15 degrees warrants a 30 percent rating. 38 C.F.R. § 4.71. Under Diagnostic Code 5261, limitation of extension to 10 degrees warrants a 10 percent rating, to at degrees warrants a 20 percent rating, to 20 degrees warrants a 30 percent rating, to 30 degrees warrants a 40 percent rating, and to 45 degrees warrants a 50 percent rating. 38 C.F.R. § 4.71 Normal range of motion of the knee is to 0 degrees extension and to 140 degrees flexion. 38 C.F.R. § 4.71, Plate II. VA’s General Counsel has held that separate ratings may be warranted for limitation of flexion and extension when the criteria for compensable ratings are met for such limitation under Diagnostic Codes 5260 and 5261. VAOPGCPREC 9-2004 (2004). The Veteran was awarded a separate, 10 percent disability evaluation for limitation of extension of the right knee, effective March 26, 2017. Under Diagnostic Code 5258, a 20 percent rating can be assigned for dislocated semilunar (meniscal) cartilage with frequent episodes of locking, pain and effusion into the joint; and under Diagnostic Code 5259 a 10 percent rating is assignable for symptomatic removal of the semilunar (meniscal) cartilage. 38 C.F.R. § 4.71. Diagnostic Code 5257 governs instability of the knee, and provides a 10 percent rating for mild instability, a 20 percent rating for moderate instability, and a 30 percent rating for severe instability. 38 C.F.R. § 4.71. In VAOGCPREC 23-97 (July 1, 1997; revised July 24, 1997), VA’s General Counsel held that a claimant who has arthritis and instability of the knee may be rated separately under Diagnostic Codes 5003 and 5257, respectively. The Board finds that the weight of the evidence demonstrates that the symptoms of the Veteran’s service-connected patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia most closely approximate the diagnostic criteria for the currently assigned 10 percent rating. Initially, the Board notes that the evidence of record does not demonstrate that the Veteran has ankylosis of the knee, impairment of the tibia and fibula, or genu recurvatum. Accordingly, Diagnostic Codes 5256, 5262, and 5263 governing the evaluations for these conditions are not applicable and will not be addressed further. With regard to limitation of motion, the Veteran has not demonstrated that his right knee has compensable limitation of flexion. The Board observes that the evidence of record shows that he had flexion to no worse than 130 degrees and extension no worse than 5 degrees. A higher, 20 percent rating would require flexion limited to 30 degrees and extension to 15 degrees. In the absence of these levels of limited motion, a higher rating based on limitation of motion is not warranted. 38 C.F.R. § 4.71a, Diagnostic Codes 5260, 5261. Further, there is no evidence of a meniscal condition or locking of the right knee at any time during the rating period on appeal. Thus, a higher rating for the right knee based on Diagnostic Codes 5258 or 5259 is not warranted. With regard to instability, the record contains no reports by the Veteran of his knee giving way and both VA examination reports fail to show any objective manifestations of instability on testing or observation. Nor are there any such report in the VA treatment records. As such, a separate evaluation for instability pursuant to Diagnostic Code 5257 is not warranted for the right knee. Finally, with regard to functional loss, the Veteran reported that he experienced pain and weakness based on repeated use over time. Likewise, he had pain on weight-bearing and flexion of the right knee, with tenderness to palpation of the patella of the right knee. The Veteran also stated at his October 2018 examination that he had flare-ups after use that varied depending on how much he used from difficulty bending the knee at all to minimal loss of motion. Since the flare-ups were based on use, they were not predictable. The Board finds that the Veteran’s current evaluation contemplates pathology productive of painful motion, including that occurring during flare-ups. Initially, the Board notes that neither examination found any functional loss other than painful motion, and this is essentially the Veteran’s complaint as well. The current evaluation is consistent with the functional equivalent of limitation of flexion to 45 degrees. In order to warrant a higher evaluation, there must be the functional equivalent of limitation of flexion to 30 degrees (Diagnostic Code 5260). The Board accepts the lay evidence that the Veteran experiences pain. Similarly, the Board accepts the evidence that he has limitation of flexion and pain upon flexion and extensive use. However, such evidence does not establish that flexion is functionally limited to less than 45 degrees or less such that additional compensation is warranted. Rather, the Veteran primarily retains functional flexion to better than 45 degree, and the limitation due to pain is contemplated in the current evaluation that recognizes his painful motion. There is no indication that he has sufficient additional functional impairment, above and beyond the 10 percent level for his service-connected patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia which would support a higher rating. See DeLuca, citing 38 C.F.R. §§ 4.40, 4.45, and 4.59. Here, neither the medical nor lay evidence suggests that his limitation of motion approximated 30 degrees of flexion for the right knee outside of inconsistent episodes of over use. Moreover, the available medical findings do not show that painful motion, limitation of motion on repetitive use testing, or pain or limitation of motion on active motion/passive motion/in weight-bearing/nonweight-bearing resulted in functional loss warranting the assignment of any higher evaluation for the right knee during the entire appeal period. See Correia v. McDonald, 28 Vet. App. 158 (2016). Therefore, the Board finds that the evidence does not support a disability evaluation in excess of 10 percent for service-connected patellar tendonitis of the right knee with limited flexion, knee strain, and low-grade femorotibial chondromalacia for the entire rating period on appeal. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990). New and Material Evidence to Reopen Service Connection In general, rating decisions and Board decisions that are not timely appealed are final. See 38 U.S.C. §§ 7104, 7105; 38 C.F.R. § § 20.1103. If new and material evidence is presented or secured with respect to a claim that has been finally disallowed, the claim shall be reopened and reviewed. See 38 U.S.C. § 5108; 38 C.F.R. § § 3.156. Under 38 C.F.R. § § 3.156, a claimant may reopen a finally adjudicated claim by submitting new and material evidence. “New” evidence is defined as evidence not previously submitted to agency decision makers. “Material” evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § § 3.156(a). The United States Court of Appeals for Veterans Claims (Court) has interpreted the language of 38 C.F.R. § § 3.156(a) as creating a low threshold. Shade v. Shinseki, 24 Vet. App. 110 (2010). New and material evidence received prior to the expiration of the appeal period, or prior to the appellate decision if a timely appeal has been filed (including evidence received prior to an appellate decision and referred to the AOJ by the Board without consideration in that decision in accordance with the provisions of 38 C.F.R. § § 20.1304(b)(1)), will be considered as having been filed in connection with the claim which was pending at the beginning of the appeal period. 38 C.F.R. § § 3.156(b). If VA receives or associates with the claims file relevant official service department records that existed and had not been associated with the claims file when VA first decided the claim, VA will reconsider the claim as an original claim for benefits. 38 C.F.R. § § 3.156(c). If it is determined that new and material evidence has been submitted, the claim must be reopened. The evidence is presumed credible for the purposes of reopening a claim, unless it is inherently false or untrue or, if it is in the nature of a statement or other assertion, it is beyond the competence of the person making the assertion. Justus v. Principi, 3 Vet. App. 510 (1992). 2. Whether new and material evidence has been received to reopen the previously denied claim of entitlement to service connection for an acquired psychiatric disorder. The RO initially denied service connection for an acquired psychiatric disorder in September 2010. The Veteran did not file a substantive appeal and the decision became final. 38 U.S.C. § 7105(c). The September 2010 rating decision denied the Veteran’s claim for service connection of an acquired psychiatric disorder on the basis that there was no evidence that the Veteran had a current psychiatric disorder which was etiologically related to his active duty. The rating decision noted that the Veteran’s service treatment records showed complaints and treatment for insomnia, anxiety, and binge drinking; the rating decision also noted that the Veteran was diagnosed with an adjustment disorder in July 2008. The rating decision also found that there is no evidence of a current diagnosis of an acquired psychiatric disorder, despite the Veteran’s continued complaints of impaired sleep, anxiety, and depressed mood. Evidence received since the September 2010 rating decision includes VA treatment records, an October 2017 VA examination report, a January 2019 VA examination report, private treatment records and statements from the Veteran’s treating psychologist (R.C.M., PhD) at Psychological Services, as well as the Veteran’s lay statements. The additional evidence speaks directly to an element which was not of record. In this regard, the Board notes that the private medical opinion from Dr. M, dated July 2019 reflect that the Veteran has been diagnosed with a depressive disorder, not otherwise specified, which may be related to his service. This evidence cures evidentiary defects; namely, that the Veteran has an acquired psychiatric disorder which may be etiologically related to events and/or injuries during his service. See Kent v. Nicholson, 20 Vet. App. 1, 10 (2006) (finding that “the question of what constitutes material evidence to reopen a claim for service connection depends on the basis on which the prior claim was denied”). Accordingly, the Board finds that the claim for service connection of an acquired psychiatric disorder is reopened. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § §§ 1110, 1131; 38 C.F.R. § 3.303(a) (2019). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service—the so-called “nexus” requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. For chronic diseases, if chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. § § 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). 3. Entitlement to service connection for a psychiatric disorder other than PTSD. At the outset, the Board notes that the Veteran does not claim, and the evidence does not reflect, that his disability is the result of combat with the enemy. Therefore, the combat provisions of 38 U.S.C. § § 1154 are not applicable. Service treatment records indicate that the Veteran was treated for complaints of nervousness, difficulty sleeping, and alcohol abuse; diagnoses included adjustment disorder and binge drinking. The Veteran was afforded a VA examination in September 2010. According to the VA examiner, the Veteran complained of loss of appetite, anxiety, sleep impairment, decreased motivation, depression, irritability, suspiciousness, and memory loss; he reported a history of alcohol abuse. The VA examiner stated that the Veteran did not have a psychological diagnosis. However, the VA examiner found that the Veteran’s psychiatric symptom presentation, including suspiciousness, anxiety, and insomnia were productive of occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. VA treatment records indicate that the Veteran first sought psychotherapy in April 2012 for symptoms of anxiety, depression, and decreased concentration, which the Veteran attributed to his experiences during service. Following an evaluation, the diagnosis was recurrent moderate major depressive disorder with anxious distress and panic attacks, and unspecified trauma-related disorder. Treatment records from Dr. M, dated in March 2017, indicate that the Veteran reported experiencing anxiety, irritability, difficulty adapting to stressful circumstances, disturbances of motivation and mood, depression, decreased interest, feelings of hopelessness, episodes of isolation, nightmares, and flashbacks. Dr. M noted that the Veteran had poor frustration tolerance and suspiciousness, and met the diagnostic criteria for PTSD. An October 2017 VA examination, the VA examiner found that the Veteran did not meet the DSM-V diagnostic criteria for a diagnosis of a psychiatric disorder. The VA examiner indicated that the Veteran did not meet the diagnostic criteria for a diagnosis of PTSD, but noted that the Veteran reported a history of irritability, nightmares, depression, and anxiety. The Veteran was most recently afforded a VA examination in January 2019. According to the examination report, the Veteran was diagnosed with unspecified depressive disorder. The VA examiner opined that the Veteran’s unspecified depressive disorder was not incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner indicated that this opinion was based on an absence of mental health complaints during service and the absence of mental health complaints and treatment prior to 2018. The VA examiner found that the Veteran’s depressive disorder was related to a post-service family and work-related stressors. The VA examiner also found that the Veteran’s unspecified depressive disorder is not related to, aggravated by, or secondary to any service-connected disabilities because “no nexus was found.” A July 2019 report from Dr. M indicates that the Veteran had unspecified depressive disorder. Dr. M indicated that the Veteran experienced nervousness, anxiety, irritability, disturbance of motivation, depressed mood, decreased interest, feelings of hopelessness, insomnia, nightmares, intrusive memories, and episodic isolation related to his experiences during his active duty period in Guantanamo Bay. In this case, the Board finds that the most probative evidence of record shows that the Veteran has a current diagnosis of depressive disorder related to service. The Board finds the January 2019 VA examination report to be of low probative value because the VA examiner’s rationale is based on an incorrect factual background. To the extent that the VA examiner found that the Veteran’s depressive disorder was unrelated to his service on the basis of a lack of service treatment records reflecting treatment for psychiatric symptomatology and an absence of a post-service diagnosis or treatment for depressive disorder until 2018, the Board finds this opinion is inadequate, as service treatment records and post-service treatment records clearly reflect a history of depression, anxiety, and insomnia; the Veteran sought post-service treatment in 2012. See Black v. Brown, 5 Vet. App. 177 (1993); Reonal v. Brown, 5 Vet. App. 458, 461 (1993). Moreover, the Board points out that the May 2010 and October 2017 VA examiners’ findings that the Veteran did not have a psychiatric disorder were inconsistent with the findings in the record. To this point, the Board observes that the October 2017 VA examiner failed to explain how the Veteran did not meet the criteria for a diagnosis of a psychiatric disorder other than PTSD and the May 2010 VA examiner found that the Veteran did not have a psychiatric disorder, but also opined that the Veteran’s psychiatric symptomatology caused occupational and social impairment. Thus, the most probative evidence of record supports that service connection for unspecified depressive disorder is granted. The Veteran’s has been diagnosed with depressive disorder in accordance with DSM-V, as confirmed by the Veteran’s treating providers at VA. Additionally, a nexus has been established between his service and his diagnosis of depressive disorder by Dr. M in his March 2017 and July 2019 reports. Therefore, service connection for unspecified depressive disorder is warranted. REASONS FOR REMAND 4. Entitlement to service connection for PTSD is remanded. There are particular requirements for establishing PTSD in 38 C.F.R. § 3.304(f) that are separate from those for establishing service connection generally. Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f) and 38 C.F.R. § 4.125 (2019) (requiring PTSD diagnoses to conform to the DSM-IV/V). Effective July 13, 2010, 38 C.F.R. § 3.304(f) was amended to reduce the evidentiary burden of establishing a stressor when it is related to a fear of hostile military or terrorist activity. See 75 Fed. Reg. 39843-01 (July 13, 2010), codified at 38 C.F.R. § 3.304(f)(3). The amendment provides that, if a stressor claimed by a veteran is related to the veteran's fear of hostile military activity, and a VA psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD, a veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor, as long as the claimed stressor is consistent with the places, types, and circumstances of the veteran's service and there is no clear and convincing evidence to the contrary. Id. “Fear of hostile military activity” is defined to mean that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. Id. The list of examples of such an event or circumstance specifically includes attack upon friendly military aircraft, vehicle-imbedded explosive devices, and incoming artillery, rocket, or mortar fire. In this regard, the Board points out that efforts to confirm the Veteran’s alleged stressor events are incomplete. The Board observes that the Veteran, in a July 2017 statement, alleged that his experiences as a military corrections officer while stationed at Guantanamo Bay, Cuba, were traumatic; the Veteran asserted that he was subject to harassment and violence by detainees in his care, and that he encountered a group of detainees that committed suicide by hanging. Despite a deferred rating that reflects that a request for the Veteran’s service personnel records was deemed necessary, there is no indication that the RO made the request for his military personnel records or notified the Veteran of any unavailable records. As such, the Board finds that remand is required to obtain any official records which may assist in corroborating the Veteran's assertions. 5. Entitlement to TDIU. In a statement submitted with his August 2019 Notice of Disagreement, the Veteran appears to raise a claim of to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU). The Veteran has repeatedly asserted that he is unable to obtain and maintain employment due to his service-connected disabilities. However, the Veteran has not yet submitted VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability. Moreover, it does not appear that the RO forwarded a VA Form 21-8940 to the Veteran or VA Form 21-4192, Request for Employment Information in Connection with Claim for Benefits, to the Veteran’s last employer; on remand, the RO should do so. Given that service connection for depressive disorder has been granted, but has not yet been rated by the RO, and that final adjudication of the service connection issue on remand could result in eligibility for a TDIU, or result in additional evidence speaking to the Veteran’s employability, the claim of entitlement to a TDIU is inextricably intertwined with the claim being remanded herein, and the claims should be considered together. See Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 2 Vet. App. 180, 183 (1991) (issues are “inextricably intertwined” when a decision on one issue would have a “significant impact” on a Veteran’s claim for the second issue). Furthermore, VA must make all necessary efforts to obtain relevant records in the possession of a Federal agency. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. See also Bell v. Derwinski, 2 Vet. App. 611 (1992). All available VA treatment records relevant to the claims remaining on appeal should be associated with the Veteran’s claims file. The matters are REMANDED for the following action: 1. Send a summary of the Veteran's alleged stressor events, to include dates, and a copy of his DD Form 214 to the JSRRC. The JSRRC should be requested to provide any additional information that might corroborate his alleged stressors. 2. Request any additional available service personnel or other official records from NARA, the NPRC, and the Defense Personnel Records Imaging System. If no additional service records or unit histories can be found, or if they have been destroyed, ask for specific written confirmation of that fact. 3. Send the Veteran a VA Form 21-8940 and request that he fill it out and return it to enable adjudication of his claim for TDIU. 4. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. If the records are unavailable, notify the Veteran in accordance with 38 C.F.R. § 3.159. 5. If the Veteran’s stressors are corroborated, the RO should schedule a VA examination to determine the presence and etiology of PTSD. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. The examiner should indicate whether it is as least as likely as not (50 percent probability or more) that the Veteran has PTSD which is caused or aggravated by his service. The examiner is requested to identify the stressor that serves as the basis for any PTSD diagnosis and note the diagnostic criteria utilized to support the diagnosis under DSM-IV/V. If the VA examiner finds the diagnostic criteria is not met, the VA examiner is to provide an explanation for such a finding. The requested determination should also consider the Veteran's medical history prior to, during, and since his military service. The VA examiner is advised that the Veteran is competent to report symptoms, treatment, events, and injuries in service, and that his reports must be taken into account, along with the other evidence of record, in formulating the requested opinion. A complete rationale should accompany each opinion provided. 6. After completing all indicated development, the RO should readjudicate the Veteran’s claim of entitlement to service connection for PTSD; the RO should also adjudicate the claim of entitlement to TDIU. If the claims remain denied, the Veteran should be furnished with a supplemental statement of the case and afforded a reasonable opportunity for response. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Hallie E. Brokowsky, 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.