Citation Nr: 21015685 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 18-40 609 DATE: March 18, 2021 REMANDED Entitlement to a compensable rating for bilateral inguinal hernia, status post repair, is remanded. Entitlement to a rating in excess of 20 percent for painful residual inguinal hernia scars (combined with painful pelvic scars) is remanded. Entitlement to a rating in excess of 70 percent for posttraumatic stress disorder (PTSD) prior to November 1, 2019, is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) prior to June 5, 2018, is remanded. Entitlement to a TDIU from November 1, 2019, is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1979 to October 1988. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The issue of entitlement to an increased rating for bilateral inguinal hernia was denied by the Board in a July 2019 Board decision. The Veteran appealed that decision to the Court of Appeals for Veterans Claims (Court), which vacated the decision pursuant to a May 2020 Joint Motion for Remand. The Board remanded that issue in October 2020. Following that remand, the RO granted separate ratings for right lower extremity peripheral neuropathy of the femoral nerve (20 percent) and for right lower extremity peripheral neuropathy of the ilio-inguinal nerve (0 percent), finding both related to the Veteran’s service-connected bilateral inguinal hernia. Those separate ratings are not currently before the Board. The July 2019 Board decision also remanded the issues of entitlement to a compensable rating for residual scars secondary to bilateral inguinal hernia and entitlement to TDIU due to such scars. An October 2020 rating decision assigned a 10 percent evaluation for painful residual inguinal hernia scars and combined that rating with the one assigned for painful pelvic scars, increasing the rating to 20 percent. With respect to TDIU, a November 2019 rating decision granted TDIU based on service-connected PTSD from June 5, 2018, to November 1, 2019. An October 2020 supplemental statement of the case (SSOC) continued the denial for TDIU due to service-connected residual scars. Because the grant did not encompass the entire appeal period, the issue remains before the Board. See Harper v. Wilkie, 30 Vet. App. 356 (2018). The Board acknowledges that the issue of entitlement to a rating in excess of 70 percent for PTSD prior to November 1, 2019, has been perfected since January 2020, but not been certified to the Board. As the Board’s review of the claim file does not show that the AOJ is taking action on this issue, the Board will accept jurisdiction of it. 1. Entitlement to a compensable rating for bilateral inguinal hernia, status post repair, is remanded. 2. Entitlement to a rating in excess of 20 percent for painful residual inguinal hernia scars (combined with painful pelvic scars) is remanded. 3. Entitlement to a rating in excess of 70 percent for PTSD prior to November 1, 2019, is remanded. 4. Entitlement to a TDIU prior to June 5, 2018, is remanded. 5. Entitlement to a TDIU from November 1, 2019, is remanded. As an initial matter, the Board notes that the RO is developing a TDIU claim in the modernized review system, also known as the Appeals Modernization Act, and that such development includes obtaining records from the Social Security Administration (SSA). As those records may contain information that is relevant to the issues currently on appeal, the Board will defer a decision on these issues until that development is completed. With respect to the Veteran’s request for increased ratings on her service-connected disabilities (excluding service-connected PTSD), the Board notes that she has received a noncompensable rating for her bilateral hernia, a 20 percent rating based on painful scars (combined to include hernia and hysterectomy scars), and separate 20 percent and noncompensable ratings for right lower extremity femoral and ilio-inguinal peripheral neuropathy, respectively, associated with her service-connected bilateral hernia. Despite these separate grants of service connection, the Board finds that additional development is required. Specifically, the question has been raised as to whether the Veteran’s reported pain is due to internal scar tissue. See March 2014 statement in support of claim (Veteran reporting she experiences high levels of pain due to hernia repairs and scar tissue); June 2015 VA hernia examination (Veteran’s pain may be coming from something else, including scar tissue unrelated to the hernia surgery or from a completely difference source); April 2018 VA muscle injuries examination (noting injury to Muscle Group XIX, bilateral, in remission); April 2018 VA gynecological examination (hysterectomy scar tissue is tangled up with hernia scars); January 2021 VA medical opinion (the pain the Veteran reports experiencing, and the area of pain located on exam, is the underlying tissue located just proximal to incision scar site on both the right and left sides). Accordingly, an additional examination is needed to determine whether a separate rating is warranted based on separate and distinct symptomatology. The matters are REMANDED for the following action: 1. Obtain copies of VA treatment records from October 2020 to the present. 2. Obtain, if possible, records of relevant private evaluations and treatment the Veteran has received. The Veteran must assist in the matter by identifying her private healthcare providers and by submitting releases for VA to obtain any private records identified. 3. After the development above is completed, then schedule the Veteran for an appropriate VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the current nature and severity of her hernia residuals and scars. The claim file should be made available to and reviewed by the examiner and the examination report should state a review of the file was completed. All findings should be reported in detail. Based on interview and examination of the Veteran, and review of the record, the examiner should address the following: (a) Provide a full description of the disability and report all signs and symptoms associated with such disability. The examiner should specifically note whether the Veteran’s reported pain is due to a separate muscle injury and/or underlying internal scar tissue, and, if so, the severity of such disability. (b) The examiner should also provide a description of the hernia scars, including the size and location, and discuss whether the scars are associated with underlying soft tissue damage or cause any limitation of the affected part. 4. Once the above action has been completed, and any other development as may be indicated by any response received as a consequence of the actions taken above, readjudicate the issues on appeal. If they remain denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Matta, 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.