Citation Nr: 21014032 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 15-04 472 DATE: March 11, 2021 REMANDED Entitlement to an initial rating in excess of 50 percent for an acquired psychiatric disorder is remanded. Entitlement to special monthly compensation (SMC) based on housebound status and/or aid and attendance is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1979 to October 1980. 1. Entitlement to an initial rating in excess of 50 percent for an acquired psychiatric disorder is remanded. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issues on appeal. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In a July 2019 remand, the Board instructed the Agency of Original Jurisdiction (AOJ) to obtain VA treatment records since July 2015; obtain the Veteran’s entire Vocational and Rehabilitation folder and any information regarding his performance at Bishop State Community College; and obtain a VA opinion regarding his acquired psychiatric disorders, their symptoms, and their severity. First, while the claims file now contains some VA treatment records from 2019 and 2020, it is unclear whether the AOJ associated all of the Veteran’s VA treatment records with the claims file. The Board notes that an April 2020 letter from the Veteran and his representative contained copies of some VA treatment records since 2015 that have not otherwise been associated with the claims file. A remand is needed to obtain any additional outstanding VA treatment records and associate them with the claims file. Second, while the claims file now contains Bishop State Community College records and several documents related to the Veteran’s Vocational and Rehabiliatation Employment program, the entire folder does not appear to have been associated with the claims file. A remand is needed to either verify the entire folder is associated with the claims file or obtain it and associate it with the claims file. Third, the AOJ obtained an August 2020 VA exmaiantion and September 2020 addendum opinion. The exmainer determined that the Veteran did not have major depressive disorder with psychotic features, panic disorder, or anxiety disorder, but did have unspecified depressive disorder and substance dependence disorders. The examiner also determined it is less likely than not that the Veteran’s substance abuse disorders are aggravated by his service-connected depressive disorder. However, the examiner did not offer an adequate rationale for this opinion and did not address the points the Board’s July 2019 remand required be addressed. Therefore, the examiantion and addendum opinion is inadequate for rating purposes. 2. Entitlement to SMC based on housebound status and/or aid and attendance is remanded. 3. Entitlement to a TDIU rating is remanded. Because a decision on the remanded issue of entitlement to an increased rating for an acquired psychiatric disorder could significantly impact a decision on the issues of entitlement to special monthly compensation and TDIU, the issues are inextricably intertwined. A remand of the claims for entitlement to special monthly compensation and TDIU is required. Issues are considered to be inextricably intertwined when a determination on one issue could have a significant impact on the outcome of another. Harris v. Derwinski, 1 Vet. App. 180 (1991 Text] The matters are REMANDED for the following action: 1. Obtain VA treatment records since July 2015 and associate them with the claims file. Note any attempts to obtain these records in the claims file. 2. Verify that the Veteran’s entire Vocational and Rehabilitation folder has been associated with the claims file, and if it has not been so associated, obtain it and associate it with the claims file. The Board notes that the claims folder contains several documents related to the Vocational and Rehabilitation folder, but it is unclear whether the entire folder has been associated with the claims folder. 3. Forward the Veteran’s claims file to a qualified examiner for an opinion addressing the current severity of his service-connected major depressive disorder with anxiety. The examiner must address the following: • clarify the Veteran’s current diagnosis or diagnoses; • consider August 2020 VA examination and addendum September 2020 VA opinion that the Veteran did not have major depressive disorder with psychotic features, panic disorder, or anxiety disorder; • consider the June 2018 private medical opinion diagnosing the Veteran with major depressive disorder with severe recurrent psychotic features, panic disorder, and anxiety disorder, and discuss whether those diagnoses are correct or mistaken; and • address the Veteran’s symptoms as recorded in the June 2018 private medical opinion, based on an interview with the Veteran, Rey 15-Item Memory Test, and Comprehensive Trail Making-Test, and discuss whether those symptoms are related to the service-connected major depressive disorder with anxiety or to another psychiatric disability and/or whether the reported symptoms are consistent with the Veteran’s overall functioning as demonstrated in the record, including his functioning in the VA Vocational and Rehabilitation Program; In determining the Veteran’s current psychiatric diagnoses, the examiner must explain why these diagnoses are correct and offer an opinion as to why or why not the previous diagnoses are correct or incorrect. The examiner should also provide a thorough opinion that addresses the following: • April 2011 Social Security Administration (SSA) psychiatric evaluation diagnosing the Veteran with personality disorders and substance addiction disorders, and noting symptoms that are, at worst, moderately limiting; • September 2011 VA examination diagnosing the Veteran with major depressive disorder with anxiety and alcohol dependence, and indicating that symptoms could be differentiated; • September 2015 VA examination diagnosing the Veteran with cocaine use disorder, alcohol use disorder, cannabis use disorder, and major depressive disorder, and noting that symptoms could be differentiated and noting no clinically significant symptoms due to major depressive disorder; • February 2019 disability benefits questionnaire diagnosing the Veteran with cocaine use disorder, alcohol use disorder, cannabis use disorder, and antisocial personality disorder; and • April 2019 disability benefits questionnaire diagnosing the Veteran with cocaine use disorder. If an examination is needed, one should be scheduled. A complete rationale must be provided for any opinion offered. (Continued on the next page) 4. After completing the actions detailed above, readjudicate the claim remaining on appeal, and readjudicate the claims for of special monthly compensation based on housebound status and/or aid and attendance, and TDIU, if otherwise developed. If any additional examinations are needed to adjudicate the special monthly compensation and/or TDIU claims, those examinations should be scheduled. If the benefit is not granted to Veteran’s satisfaction, a supplemental statement of the case must be provided to the Veteran and his representative. After the Veteran and his representative have had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Howell, 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.