Citation Nr: 21006792 Decision Date: 02/05/21 Archive Date: 02/05/21 DOCKET NO. 17-24 967 DATE: February 5, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for the service-connected left knee strain is remanded. Entitlement to a rating in excess of 30 percent for the service-connected coronary artery disease, status post single stent placement, is remanded. Entitlement to a rating in excess of 10 percent for the service-connected lower left extremity peripheral neuropathy is remanded. Entitlement to a rating in excess of 10 percent for the service-connected lower right extremity peripheral neuropathy is remanded. Entitlement to a rating in excess of 20 percent for the service-connected diabetes mellitus with erectile dysfunction is remanded. Entitlement to a total disability rating for individual unemployability due to service-connected disability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from April 1968 to March 1970. In October 2020, the Veteran appeared and provided testimony at a hearing before the undersigned Veterans Law Judge (VLJ). Entitlement to an initial rating in excess of 10 percent for the service-connected left knee strain Entitlement to a rating in excess of 30 percent for the service-connected coronary artery disease, status post single stent placement Entitlement to a rating in excess of 10 percent for the service-connected lower left extremity peripheral neuropathy Entitlement to a rating in excess of 10 percent for the service-connected lower right extremity peripheral neuropathy Entitlement to a rating in excess of 20 percent for the service-connected diabetes mellitus with erectile dysfunction At the October 2020 Board of Veterans’ Appeals (Board) hearing, the Veteran testified that all conditions on appeal have worsened since he was last examined by VA for them over five years ago. As such, the Veteran should be provided new VA examinations to determine the current severity of the disabilities on appeal. Further, the Veteran testified that he continues to seek treatment from his private cardiologist, Dr. T.D., MD. However, the records from this provider have not been updated in the claims file since March 2019. Updated private treatment records should also be obtained on remand. Finally, VA treatment records have not been uploaded to the claims file since 2014. Updated VA treatment records should also be obtained and associated with the claims file. Entitlement to a TDIU The Veteran’s claim for a TDIU is inextricably intertwined with the other claims being remanded herein. Therefore, the Board finds that the claim for a TDIU must be remanded as well. See Harris v. Derwinski, 1 Vet. App. 180 (1991) (issues are inextricably intertwined when a decision on one issue would have a significant impact on another issue). Accordingly, these matters are REMANDED for the following actions: 1. Obtain VA treatment records from July 2014 through present. 2. Ask the Veteran to complete a VA Form 21-4142 for his private cardiologist, Dr. T.D., MD. Make two requests for all authorized records from Dr. T.D., MD, from March 2019 through the present, unless it is clear after the first request that a second request would be futile. 3. After updated medical records have been associated with the claims file, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of the service-connected left knee strain. The Veteran’s claims file should be made available to the examiner in conjunction with this examination, and the examiner’s review of the folder should be annotated in the examination report. The examiner should provide a full description of the Veteran’s service-connected left knee strain and report all signs and symptoms associated with this disorder. The ranges of motion of this joint should be provided in active and passive motion, as well as in weight-bearing and nonweight-bearing. Also, to the extent possible, the examiner should identify any symptoms and functional impairments due to his left knee disability alone and discuss the effect of the disability on any occupational functioning and activities of daily living. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. 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 that particular question. 4. Also after updated medical records have been associated with the claims file, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of the service-connected coronary artery disease, status post single stent placement. The Veteran’s claims file should be made available to the examiner in conjunction with this examination, and the examiner’s review of the folder should be annotated in the examination report. The examiner should provide a full description of the Veteran’s service-connected coronary artery disease, status post single stent placement, and report all signs and symptoms associated with this disorder. To the extent possible, the examiner should identify any symptoms and functional impairments due to this service-connected disability alone and discuss the effect of the disability on any occupational functioning and activities of daily living. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. 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 that particular question. 5. Also after updated medical records have been associated with the claims file, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of the service-connected bilateral lower extremity peripheral neuropathies. The Veteran’s claims file should be made available to the examiner in conjunction with this examination, and the examiner’s review of the folder should be annotated in the examination report. The examiner should provide a full description of the Veteran’s service-connected bilateral lower extremity peripheral neuropathies and report all signs and symptoms associated with these disorders. To the extent possible, the examiner should identify any symptoms and functional impairments due to his bilateral lower extremity peripheral neuropathies alone and discuss the effect of these disabilities on any occupational functioning and activities of daily living. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. 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 that particular question. 6. Also after updated medical records have been associated with the claims file, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of the service-connected diabetes mellitus with erectile dysfunction. The Veteran’s claims file should be made available to the examiner in conjunction with this examination, and the examiner’s review of the folder should be annotated in the examination report. The examiner should provide a full description of the Veteran’s service-connected diabetes mellitus with erectile dysfunction and report all signs and symptoms associated with this disorder. To the extent possible, the examiner should identify any symptoms and functional impairments due to his diabetes mellitus with erectile dysfunction alone and discuss the effect of the disability on any occupational functioning and activities of daily living. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. 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 that particular question. No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). His failure to report for a VA medical examination may impact the determination made. 38 C.F.R. § 3.655. The (CONTINUED ON NEXT PAGE) Veteran also is advised that he has the right to submit additional evidence and argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Davidoski, 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.