Citation Nr: 21009064 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 20-08 041 DATE: February 18, 2021 REMANDED The appeal for an increased initial disability rating in excess of 10 percent for residual burn scars to the face and cheeks is remanded. The appeal for an increased initial disability rating in excess of 10 percent for residual burn scars to both forearms is remanded. The appeal for a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1965 to September 1967. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a September 2018 rating decision by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). The Board notes that in March 2019, the Veteran filed a RAMP Opt-in Election form, which was rejected in a March 2019 notification letter. The Veteran was given the opportunity to send in the correct form, but he did not respond. Therefore, the Veteran’s claims will continue to be processed in the Legacy system. 1. The appeal for an increased initial disability rating in excess of 10 percent for residual burn scars to the face and cheeks is remanded. 2. The appeal for an increased initial rating in excess of 10 percent for residual burn scars to both forearms is remanded. The Veteran attended an August 2018 VA examination for his residual burn scar conditions. The examiner diagnosed the Veteran with residual burn scars to the face and bilateral forearms. The examiner estimated that the scars cover 5 to 20 percent of the Veteran’s face and bilateral forearms. The examination revealed scars on the forearms were 5 centimeters (cm) by .1 cm (right) and 6 cm by 3 cm (left) or 5 square cm and 6 square cm respectively. Examination of the head, face, and neck revealed two scars on the Veteran’s right cheek, with one being 2 cm by 1 cm and another 1 cm by .5 cm. The VA examiner noted the Veteran's right forearm scar was 5 by .1 cm, but then indicated that the total area was 5 cm squared. There is an inconsistency on the examination regarding the total coverage area of the scars present on the Veteran’s body, which is important because it directly affects the outcome of the issue on appeal. Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (a medical opinion based on an inaccurate factual premise has no probative value). Additionally, there is evidence in the claims file that the Veteran may also have a scar on his chest which was not evaluated on the August 2018 VA examination. (See November 2017 private treatment record, received January 2018.) Therefore, a remand is required to obtain a new VA examination. 3. The appeal for a total disability rating based on individual unemployability (TDIU) is remanded. The matter of entitlement to TDIU is inextricably intertwined with the other remanded issues; accordingly, it must be remanded as well. The matters are REMANDED for the following action: 1. Please note that this Veteran’s case has been advanced on the docket and, by law, ALL remanded claims must be processed expeditiously. 2. The AOJ should arrange for an examination of the Veteran to assess the current severity of his service-connected residual burn scars of the face and bilateral forearms. The examiner must review the entire record (including this remand) in conjunction with the examination and note that this review was conducted. The examiner should provide a full description of the disability and report all signs and symptoms associated with the Veteran’s disability. (a.) The examiner must also evaluate whether separate ratings should be assigned for any residual burn scars to the Veteran’s chest. (b.) The examiner and the AOJ should assess whether the Veteran’s bilateral burn scars to the forearms should receive separate ratings under Diagnostic Code 7802. A detailed explanation (rationale) is required for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested.) 3. The AOJ should readjudicate the issue of TDIU once all remanded issues within both appeal streams have been readjudicated. **The Veteran is also welcome to obtain an updated version of the private medical opinion that meets the criteria for the Board to use as evidence; for the above issues any medical opinion is adequate if it is “thorough and contemporaneous,” considers the veteran’s prior medical examinations and treatment, and “describes the disability... in sufficient detail so that the Board’s ‘evaluation of the claimed disability will be a fully informed one.’”** VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Williams, 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.