Citation Nr: 21007849 Decision Date: 02/10/21 Archive Date: 02/10/21 DOCKET NO. 17-26 665 DATE: February 10, 2021 REMANDED The claim for a rating higher than 20 percent for diabetes mellitus is remanded. The claim for a total disability rating due to individual unemployability resulting from service-connected disability (TDIU) prior to October 30, 2018 is remanded. Entitlement to special monthly compensation (SMC) based on the need for regular aid and attendance or on account of housebound status is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1969 to March 1971. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) which, inter alia, denied a rating in excess of 20 percent for diabetes mellitus. The Veteran, his wife, and his son testified before the undersigned Veterans Law Judge at a Board videoconference hearing in January 2020. A transcript of the hearing is associated with the claims file. The Board finds that a claim for TDIU prior to October 30, 2018 is part of the increased rating claim currently on appeal. The Veteran filed a claim for TDIU in April 2018 contending that he was unemployable due to several disabilities, including diabetes mellitus. The claim was denied in a November 2018 rating decision. Although the claim for TDIU was denied, as it was raised during the course of an increased rating claim it is considered part and parcel of the current claim for an increased rating for diabetes mellitus and applies throughout the entire claims period encompassed by the increased rating claim. It is therefore still before the Board. Additionally, the Veteran is in receipt of a schedular 100 percent evaluation effective October 30, 2018. Typically, the award of a total schedular rating renders the need for TDIU moot, as a TDIU is meant to provide a total rating for unemployability when the Veteran’s schedular rating is less than total. While the Court of Appeals for Veterans Claims (Court) has carved out an exception to the above rule, in this case, the Veteran’s schedular 100 percent rating was assigned based on the combined total of all his service-connected disabilities. As such, the Veteran cannot be awarded TDIU based on any disabilities other than the conditions for which a 100 percent evaluation was in effect. See Bradley v. Peake, 22 Vet. App. 280 (2008). The claim for a TDIU is therefore moot during the period beginning October 30, 2018, but is still before the Board prior to that date. The Board also finds that an inferred claim for entitlement to SMC has been reasonably raised by the record. The Veteran submitted additional medical evidence in support of his increased rating claim at the January 2020 hearing. This evidence includes a statement from his private physician noting that the Veteran requires the assistance of another person for all his activities of daily living and he is essentially housebound. This evidence is sufficient to raise an inferred claim for SMC. See Akles v. Derwinski, 1 Vet. App. 118, 121 (1991) (entitlement to SMC is part of an increased rating claim, and VA should consider the issue when it is reasonably raised by the record, regardless of whether a veteran has specifically pled it). The Board finds that a remand is necessary in this case to further develop the record. First, updated records of VA treatment from the Saginaw and Ann Arbor VA facilities must be obtained and added to the claims file. Second, in January 2020, the Veteran submitted a statement from his private primary care physician and the most recent record of treatment from this doctor dated in July 2019; however, other records from this provider are not of record. And third, the Board finds that a medical opinion is required to resolve a conflict in the evidence regarding whether the Veteran requires the aid and assistance of another person and is housebound due to service-connected disabilities or instead due to residuals of a nonservice-connected cerebrovascular accident (CVA). Finally, the Board notes that the Veteran’s case has not been adjudicated by the agency of original jurisdiction (AOJ) since the May 2017 statement of the case. Since that time, numerous pieces of medical and lay evidence have been added to the record, including multiple VA examinations and records of VA and private treatment. The Board is precluded from issuing a decision in this case until the new evidence is considered by the AOJ. See 38 C.F.R. §§ 19.37, 19.38. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records from the Saginaw VA Medical Center (VAMC) dating from September 2019 to the present and from the Ann Arbor VA Health Care System (HCS) dating from April 2019 to the present. 2. Ask the Veteran to complete a VA Form 21-4142 for his private primary care physician, identified as Dr. Lioudmila Kinachtchouk. If the requested medical release form is received, make two requests for the authorized records from the private doctor unless it is clear after the first request that a second request would be futile. 3. Obtain a medical opinion from an appropriate clinician addressing whether the Veteran requires the aid and attendance of another person to perform his activities of daily living and/or is housebound due to his service-connected disabilities. If the clinician determines that an examination is necessary, one should be scheduled. The clinician’s opinion must be accompanied by a full rationale and explanation for all conclusions and reflect review of the relevant medical and lay evidence of record, including the evidence submitted by the Veteran at the January 2020 hearing. The Veteran is service connected for diabetes mellitus with associated polyneuropathy of the bilateral upper and lower extremities, posttraumatic stress disorder (PTSD), coronary artery disease (CAD), and hearing loss and tinnitus. He is not service connected for residuals of a CVA in 1999 (left-sided weakness, vascular dementia, seizure disorder), peripheral vascular disease, and hypertension. K. Conner Veterans Law Judge Board of Veterans’ Appeals M. Riley, Attorney for the Board Department of Veterans Affairs 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.