Citation Nr: 21013672 Decision Date: 03/10/21 Archive Date: 03/10/21 DOCKET NO. 16-38 554 DATE: March 10, 2021 REMANDED Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to February 1971. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA). This case was previously before the Board in June 2019, at which point the Veteran’s claim for entitlement to a TDIU was denied. The Veteran appealed the Board’s June 2019 denial to the United States Court of Appeals for Veterans Claims (Court). In August 2020 the Court issued a joint motion for remand (JMR) setting aside the Board’s June 2019 decision and remanding the issue for further proceedings. The issue was returned to the Board in January 2021, at which point the claim was remanded for the issuance of a supplemental statement of the case (SSOC). A SSOC was sent to the Veteran on January 2021. The issue has again returned to the Board for adjudication. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. Upon review of the claims file, the Board has determined that further development is necessary before the claim can be adjudicated.  38 U.S.C. § 5103A; 38 C.F.R. § 3.159. In this regard, there is insufficient medical evidence of record to determine the severity and frequency of the Veteran’s episodes of diarrhea. In the August 2020 JMR, the Court found that the Board failed to consider lay evidence that the Veteran’s service-connected diabetes medication causes “constant diarrhea.” The Board notes that the Veteran provided a lay statement in March 2014 in which he indicated that he experiences “constant diarrhea” as a side-effect of medication prescribed to treat his service-connected diabetes. (3/13/2014, VA 21-4138, p. 1). The Board additionally notes that the Veteran’s VA medical records indicate that he experiences diarrhea with Metformin. (1/21/2021, CAPRI, p. 26, 268). While the record supports the Veteran’s assertion that he experiences diarrhea as a side-effect of medication prescribed to treat his service-connected diabetes, the record does not contain evidence regarding the current severity or functional impact of his gastrointestinal issues. As such, the Board finds that the Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations of his gastrointestinal issues. Additionally, the Veteran was last afforded VA examinations for his service-connected diabetes, diabetic nephropathy, diabetic peripheral neuropathy, and hypertension in June 2016. In light of how much time has elapsed since his last examinations, reexamination is needed to fully and fairly evaluate his claim and determine the effects of these disorders on his employability. See Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007), citing Caluza v. Brown, 7 Vet. App. 498, 505-06 (1998) ("Where the record does not adequately reveal the current state of the claimant's disability . . . the fulfillment of the statutory duty to assist requires a thorough and contemporaneous medical examination."). The matters are REMANDED for the following action: 1. The AOJ should obtain copies of VA treatment records for the Veteran’s disabilities from January 2021 to the present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of diarrhea. 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. 3. Schedule the Veteran for examinations by appropriate clinicians regarding the current severity of his diabetes, diabetic nephropathy, diabetic peripheral neuropathy, and hypertension. The examiner should identify all limitations or functional impairment caused solely by his service-connected disabilities. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Glenn, 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.