Citation Nr: 21014920 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 17-12 821 DATE: March 16, 2021 REMANDED The propriety of a reduction in the rating for gastroesophageal cancer from December 1, 2016 is remanded. A total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from August 1967 to February 1970. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a September 2016 rating decision. In March 2021, a hearing was held before the undersigned. Although the transcript has not been added to the record, the Board’s disposition here renders its current absence harmless. TDIU must be considered as part and parcel of this appeal because the evidence has reasonably raised that issue during the pendency of a rating appeal. See Rice v. Shinseki, 22 Vet. App. 447, 455 (2009). At the March 2021 hearing before the undersigned, the Veteran testified that he continues to deal with diarrhea, significant weight loss, hypoglycemic reactions, anemia, reflux, incontinence (with associated embarrassment and use of absorbent materials), and five scars (at least two of which were painful to touch) associated with residuals of gastroesophageal cancer and surgery. Given this testimony clearly suggests a worsening of his condition since the most recent August 2016 VA examination, a remand is necessary to determine the current severity of the disability on appeal. See Palczewski v. Nicholson, 21 Vet. App 174, 181-82 (2007); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); see also Bolton v. Brown, 8 Vet. App. 185, 191 (1995) (VA must provide a new examination where a veteran claims the disability is worse than when originally rated and the available evidence is too old to adequately evaluate the current severity); Caffrey v. Brown, 6 Vet. App. 377, 381 (1995). This issue is remanded as inextricably intertwined with the other on appeal. See Henderson v. West, 12 Vet. App. 11, 20 (1998); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Obtain any and all VA treatment records and associate those documents with the claims file. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected gastroesophageal cancer residuals. The examiner must elicit descriptions of the types, frequency, severity, and duration of all associated symptoms. Based on an interview with the Veteran, physical examination, review of the record, and any tests or studies needed, the examiner must describe the frequency and severity of all pathology, symptoms, and functional impairment in enough detail to apply the pertinent rating criteria. The examiner MUST consider any symptoms or pathology resembling those contemplated by Diagnostic Codes 7308 (e.g., epigastric distress, circulatory symptoms, diarrhea, weight loss, hypoglycemia, malnutrition, nausea, sweating, and anemia associated with postgastrectomy syndrome), 7319 (e.g., disturbances of bowel function, abdominal distress, diarrhea, or constipation associated with irritable colon syndrome), 7328 (e.g., diarrhea, anemia, inability to gain weight, interference with absorption and nutrition, etc.), 7346 (e.g., epigastric distress, dysphagia, pyrosis, regurgitation, substernal or arm or shoulder pain, vomiting, material weight loss, hematemesis or melena with moderate anemia, etc.), and 7800 through 7805 (for any associated scar residuals). The examiner must comment on the expected impact of the Veteran’s gastroesophageal cancer residuals on his ability to function in an occupational setting, to include (but not limited to) identifying the kinds of activities or work that he would be able to engage in despite such disability and those that would be precluded by it. All opinions must include a detailed rationale. Providing an opinion without one will delay processing of the claim and may require clarification. MARTIN B. PETERS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Yuan, 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.