Citation Nr: 21010813 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 18-22 849A DATE: February 25, 2021 REMANDED Entitlement to a total disability rating for compensation based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1967 to August 1969. This case was initially before the Board of Veterans’ Appeals (Board) in June 2019, when a service connection claim for bilateral hearing loss was denied. Additionally, increased ratings for erectile dysfunction and posttraumatic stress disorder (PTSD) were denied, as was a reduction claim pertaining to the Veteran’s service-connected residuals of prostate cancer. Claims for entitlement to service connection for papillary urothelial carcinoma and entitlement to a TDIU were remanded for additional development. The Veteran appealed to the Court of Appeals for Veterans Claims (Court). In August 2020, the Court issued an order that partially vacated the June 2019 Board decision, and remanded the claims for compliance with a Joint Motion for Partial Remand (JMR). The Court did not disturb the portions of the June 2019 Board decision addressing the propriety of the reduction for his service-connected residuals of prostate cancer or the rating assigned for the Veteran’s PTSD. Additionally, the Court noted that the remanded claims for service connection of papillary urothelial carcinoma and for TDIU were not before the Court as they were in Remand status. The case was once again before the Board in December 2020. The Board granted the Veteran’s service connection claim for bilateral hearing loss and denied entitlement to an increased rating for erectile dysfunction. His claim for entitlement to a TDIU was again remanded for additional development. A January 2021 supplemental statement of the case was most recently issued, and the claim is once again before the Board. The Board notes that the Veteran’s remanded claim for papillary urothelial carcinoma, right kidney status post nephrectomy was recently granted in a June 2020 rating decision. This claim is no longer before the Board at this time. 1. Entitlement to TDIU The Veteran contends his service-connected disabilities prevent him from obtaining and maintaining substantially gainful employment. The Board finds that additional development is necessary prior to adjudication of this claim. Under the applicable criteria, total disability ratings for compensation may be assigned, where the schedular rating is less than total, when a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that if there is only one such disability, such disability shall be ratable as 60 percent or more, and if there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. § 4.16(a). Here, the Veteran is service connected for voiding and renal dysfunction, residuals of adenocarcinoma, prostate and papillary urothelial carcinoma, right kidney status post nephrectomy, evaluated as 100 percent disabling, effective October 6, 2006 through March 31, 2015 and 60 percent thereafter; PTSD with other specified depressive disorder, evaluated as 50 percent disabling, effective May 29, 2014; tinnitus, evaluated as 10 percent disabling, effective May 29, 2014; erectile dysfunction, evaluated as noncompensable, effective December 6, 2006; bilateral hearing loss, evaluated as noncompensable, effective May 29, 2014; and scars, residuals of nephrectomy, evaluated as noncompensable, effective October 7, 2019. His service-connected disabilities are currently assigned a combined rating of 80 percent. In May 2014, the RO received the Veteran’s VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability. In the application, the Veteran indicated that he last worked fulltime, in April 2013, as a maintenance worker for a school system. The Veteran indicated that he graduated from high school and had not received any other training or education since that time. The Veteran reported that his service-connected disabilities prevented him from securing or following any substantially gainful employment. The evidence of record includes a May 2014 prostate cancer VA examination which notes that the Veteran’s prostate cancer does not impact his ability to work. No rationale was provided. A May 2014 private evaluation notes that because of the Veteran’s military related urgency, incontinence, history of prostate cancer, unpredictable manifestations of PTSD, chronic fatigue, and hearing impairment the Veteran is medically deemed unemployable. The examiner noted that all of his conditions are permanent and progressive without reasonable expectation of clinical and/or symptomatic improvement. He concluded stating that it is clinically evident that these disabilities do not allow him to follow any form of gainful occupation. Further explanation was not provided. In a May 2014 private psychological evaluation, the Veteran reported that he was most recently employed in March 2013, at which time he “just got disinterested” in working and, as such, retired. He reported that he had helped his neighbors with various projects since that time. It was noted that the Veteran’s symptoms were commensurate with serious impairment in social, occupational, or school functioning. In a January 2015 VA PTSD examination, the examiner noted that the Veteran’s current emotional difficulties are not so significant that they limit his employability. A December 2014 VA audio examination noted some functional impact of the Veteran’s hearing loss and tinnitus. December 2014 VA examinations for prostate cancer and erectile dysfunction both noted no impact on the Veteran’s ability to work. No rationale was provided. An April 2018 VA examiner noted that because of the Veteran’s voiding dysfunction he would need to change his absorbent materials during the day, but that would be addressed with frequent restroom breaks as needed. Other than that, he noted that there was no other interference with the Veteran’s ability to do the sedentary and physical aspects of employment. It appears that the VA examiner only considered the Veteran’s erectile dysfunction and voiding dysfunction when completing this opinion. An October 2019 VA urinary tract examiner opined that the Veteran’s bladder or urethra did not impact his ability to work. No rationale was provided. The Veteran was recently granted service connection for bilateral hearing loss in a December 2020 Board decision; this was effectuated in a December 2020 rating decision. The Board finds that there is insufficient competent evidence to decide the claim. A VA examination is required. The matters are REMANDED for the following action: Schedule the Veteran for the appropriate VA examination(s) to determine the level of functional impairment his service-connected disabilities have on his ability to obtain and retain substantially gainful employment. After reviewing the file, the Veteran’s educational and occupational history and examination findings, the examiner should provide an opinion addressing what functional impairment the Veteran’s service-connected disabilities have on his ability to perform occupational tasks. (Continued on the next page)   A rationale for any opinion offered should be provided. C. CRAWFORD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. M. Clark, 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.