Citation Nr: 21010002 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-40 935 DATE: February 23, 2021 REMANDED The issue of entitlement to an increased (compensable) disability rating for status post right lower lobe resection (lung cancer) residuals, including the question of whether reduction of the 100 percent disability rating to 0 percent lung cancer residuals effective from June 1, 2014 was proper, is remanded. The issue of entitlement to special monthly compensation (SMC) at the housebound rate from June 1, 2014, is remanded. The issue of entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active service from July 1968 to April 1971, July 1973 to June 1980, and September 1980 to October 1990. These matters are on appeal from a March 2014 rating decision. In June 2018, the Veteran and his spouse testified at a Travel Board hearing before the undersigned. A transcript of that proceeding is of record. In October 2018, the Board remanded this appeal for additional development. Unfortunately, the Board finds that further remand is necessary for an addendum opinion, as the July 2019 opinion obtained pursuant to the prior remand is insufficient. In this regard, the examiner did not identify symptoms and functional impairment due solely to the Veteran’s service-connected lung cancer residuals, without consideration of his nonservice-connected COPD, or otherwise indicate that such a distinction was not possible. As such, remand is necessary to obtain an opinion that complies with the prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (Board remand confers a right on a claimant to compliance with the remand order). Additionally, as it relates to the TDIU claim, the Board previously requested that all the Veteran’s vocational rehabilitation records be obtained and associated with the claims file. The record currently contains historical vocational rehabilitation records, and it is unclear whether they represent the Veteran’s complete vocational rehabilitation file. Correspondence shows that, pursuant to the prior remand, records were requested and “shipped to be scanned into VBMS on 7/24/19.” However, it does not appear that any additional records were scanned into the Veteran’s file, and there is nothing to indicate that the historical records in the file are the complete vocational rehabilitation file. As such, further remand is necessary in order to obtain and associate all vocational rehabilitation records, or for a determination that additional vocational rehabilitation records do not exist. The Board further notes that a request for private records from Viera Hospital was rejected because the authorization was not completed properly. The Veteran should be asked to resubmit an authorization for the release of those records, as well as any additional evidence he wishes to submit in support of his appeal, as he has indicated in various statements that he wishes to submit additional evidence. Finally, because a decision on the remanded issues of whether the rating reduction for the lung cancer residuals was proper and a TDIU could significantly impact a decision on the issue of SMC at the housebound rate effective from June 1, 2014, the issues are inextricably intertwined; therefore, a remand of the SMC appeal is required. The matters are REMANDED for the following action: 1. Ask the Veteran to submit or resubmit authorizations for the release of any relevant outstanding private treatment records in support of his appeal. 2. Obtain the Veteran’s complete vocational rehabilitation records. If no additional records exist, the claims file should be annotated to reflect as such, and the Veteran notified as such. 3. After the foregoing development is completed to the extent possible, obtain an opinion from a pulmonologist regarding the current severity of the Veteran’s service-connected lung cancer residuals to the extent possible, without consideration of COPD. If a new examination is deemed necessary, one should be scheduled. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. (a) To the extent possible, the examiner should identify all signs, symptoms and functional impairment due to the service-connected lung cancer residuals alone, without consideration of COPD, and discuss the effect of the Veteran’s lung cancer residuals on any occupational functioning and activities of daily living. The examiner should discuss whether and to what extent the right lobe resection causes any current difficulty in breathing. The examiner should also discuss whether any current respiratory symptoms and functional impairment attributable to the nonservice-connected COPD are distinguishable from respiratory symptoms and functional impairment attributable to lung cancer residuals and, if so, explain why/how such a distinction can be made. (b) Based on his/her expertise, the examiner should offer an estimation of what would be the Veteran’s pulmonary function, status post lobe resection, if the Veteran did NOT have COPD. (c) If it is not possible to provide a specific measurement, or an opinion regarding pulmonary function, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). S. C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Fagan 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.