Citation Nr: 21006990 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 14-42 458 DATE: February 8, 2021 REMANDED Entitlement to a total disability rating based on individual unemployability (TDIU) prior to December 4, 2019 is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1964 to January 1969. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) in April 2018. A transcript of the hearing is associated with the electronic claims file. The Board previously issued a decision denying this claim in June 2018. Following an appeal to the United States Court of Appeals for Veteran’s Claims (Court) a Joint Motion for Remand was issued in December 2018. In accordance with the Court’s Joint Motion, the Board issued a remand on the claim in September 2019. The Board issued another remand on the claim in October 2020. 1. Entitlement to a TDIU prior to December 4, 2019 is remanded. Following the Board’s September 2019 remand, the RO granted a TDIU effective December 4, 2019. Thus, the issue now before the Board is whether the Veteran was entitled to a TDIU prior to that date. In the Board’s September 2019 remand, the RO was instructed to obtain an addendum opinion regarding the functional impact of the Veteran’s service-connected PTSD with the examiner addressing the December 2014 letter provided by the Veteran’s nurse practitioner. While the RO provided the Veteran with another VA examination for his PTSD in December 2019, the examiner did not provide a discussion regarding the nurse practitioner’s letter. Thus, the claim was remanded for another opinion in October 2020. Again, while an addendum opinion was provided in October 2020, the examiner failed to specifically consider and address (1) the Veteran’s April 2014 VA examination for PTSD; (2) the December 2014 letter provided by the Veteran’s nurse practitioner; and (3) the Veteran’s December 2019 VA examination for PTSD, as instructed in the remand directive. Accordingly, another remand is warranted. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding remand by the Board confers on the claimant the right to compliance with the remand requests). Moreover, in the October 2020 remand, the Board noted that the December 2019 VA examiner did not provide an opinion as to the functional impact of the Veteran’s peripheral neuropathy prior to December 4, 2019. Thus, the claim was remanded for an addendum opinion on this issue as well. Again, while an addendum opinion was provided in October 2020, the examiner failed to specifically address and consider as instructed in the remand directives, the Veteran’s December 2019 VA examination wherein the examiner noted “has used walker for past one year for neuropathy and poor balance” and “He has trouble sitting more than 20 minutes or standing more than 20 minutes; has poor sensation in arms and legs frequently.” Accordingly, another remand is warranted for this issue as well. Id. The matters are REMANDED for the following action: 1. Obtain an addendum opinion with regard to the functional impairment imposed by the Veteran’s PTSD. Based on a review of the record, the examiner should answer the following questions: (a.) Prior to December 4, 2019, did the Veteran’s PTSD, alone, cause an inability to perform the mental acts of work? (b.) If so, at what date was the Veteran unable to work due to his PTSD symptoms? In formulating an opinion, the examiner must specifically consider and address: (1) the Veteran’s April 2014 VA examination for PTSD; (2) the December 2014 letter provided by the Veteran’s nurse practitioner; and (3) the Veteran’s December 2019 VA examination for PTSD. A detailed rationale for the opinion must be provided and the examiner should include a note that the entire claims file was reviewed in formulating an opinion. If the examiner is unable to offer the requested opinion, it is essential that he or she offer a rationale for the conclusion that an opinion could not be provided without resort to mere speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge.   2. Obtain an addendum opinion with regard to the functional impairment imposed by the Veteran’s peripheral neuropathy. Based on a review of the record, the examiner should answer the following question: (a.) Prior to December 4, 2019, does the record support a finding that the Veteran’s peripheral neuropathy, alone, caused an inability to perform the physical acts of work? (b.) If so, at what date was the Veteran unable to work due to his peripheral neuropathy? In formulating an opinion, the examiner must specifically consider and address the Veteran’s December 2019 VA examination wherein the examiner noted “has used walker for past one year for neuropathy and poor balance” and “He has trouble sitting more than 20 minutes or standing more than 20 minutes; has poor sensation in arms and legs frequently.” A detailed rationale for the opinion must be provided and the examiner should include a note that the entire claims file was reviewed in formulating an opinion. If the examiner is unable to offer the requested opinion, it is essential that he or she offer a rationale for the conclusion that an opinion could not be provided without resort to mere speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge.   (continued on next page) TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Ruiz, Associate Attorney 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.