Citation Nr: 21013138 Decision Date: 03/08/21 Archive Date: 03/08/21 DOCKET NO. 15-28 905 DATE: March 8, 2021 REMANDED Entitlement to a total disability rating for individual unemployability (TDIU) prior to September 6, 2017, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1969 to September 1970. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to a total disability rating for individual unemployability (TDIU) prior to September 6, 2017, is remanded. The Board previously remanded the claim in May 2020 for further development in compliance with a January 2020 order issued by the United States Court of Appeals for Veterans Claims granting a Joint Motion for Remand. The Board instructed the RO to obtain a VA medical opinion to determine the functional and occupational impact of the Veteran’s service-connected disabilities prior to September 6, 2017. Additionally, the Board requested that the VA examiner providing the opinion also discuss a March 2015 opinion from Dr. K.C., the Veteran’s private physician, which the Board previously determined was inadequate due to a lack of supporting rationale. New VA medical opinions were obtained. However, the Board finds they are inadequate to determine whether the Veteran’s service-connected disabilities precluding him from securing and maintaining substantially gainful employment prior to September 6, 2017. An October 2020 opinion essentially recites Dr. K.C.’s March 2015 opinion, and provides no additional rationale or conclusion regarding the combined impact of the Veteran’s service-connected disabilities prior to September 6, 2017. An additional October 2020 opinion states the Veteran’s tinnitus may impact his employment activities. Therefore, remand is required to obtain a new VA medical opinion that appropriately addresses the combined impact of the Veteran’s service-connected disabilities on his ability to function in an occupational environment prior to September 6, 2017. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning); Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993) (medical opinions based on an incomplete or inaccurate factual premise are not probative). The matter is REMANDED for the following action: 1. Obtain a VA medical opinion to determine the functional and occupational impact of the Veteran’s service-connected disabilities prior to September 6, 2017. An in-person examination is not required unless deemed necessary by the clinician. The examiner should review the virtual file. (a.) Note: Prior to September 6, 2017, the Veteran’s service-connected disabilities included the following: coronary artery disease (CAD), anxiety, residuals of prostatectomy, tinnitus, hypertension, and erectile dysfunction. 2. A comprehensive rationale for all opinions must be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be provided without resorting to speculation, the examiner must explain why this is so and 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), the record (additional facts are required), or the examiner (does not have the knowledge or training). Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Miller, 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.