Citation Nr: 21021059 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 16-46 470 DATE: April 9, 2021 REMANDED Entitlement to service connection for respiratory disorder, to include sarcoidosis, is remanded. Entitlement to service connection for esophageal cancer is remanded. Entitlement to service connection for residuals of a gallbladder removal is remanded. Entitlement to an initial rating higher than 10 percent for cellulitis of the right ankle and foot is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from June 1967 to March 1971. This matter is before the Board of Veterans’ Appeals (Board) on appeal of a June 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Los Angeles, California, that granted service connection and a noncompensable rating for cellulitis of the right ankle and foot, effective July 21, 2011. By this decision, the RO also denied service connection for a respiratory disorder, to include sarcoidosis (listed as sarcoidosis, also claimed as lung disease); esophageal cancer; and for residuals of a gallbladder removal (listed as a gallbladder removal). A July 2016 RO decision increased the rating for the Veteran’s service-connected cellulitis of the right ankle and foot to 10 percent, effective July 21, 2011. In December 2019, the Veteran appeared at a hearing before the undersigned Veterans Law Judge. The Board notes that a claim for a total disability rating based on individual unemployability (TDIU) is part of an increased rating claim when such claim is raised by the record. Rice v. Shinseki, 22 Vet. App. 447 (2009). An October 2019 RO decision granted a TDIU, effective June 21, 2008. The Board observes that at the December 2019 Board hearing, the Veteran testified that his service-connected cellulitis of the right ankle and foot was not the reason he stopped working, and that he was not pursuing a TDIU issue. Therefore, the issue of entitlement to a TDIU is not before the Board. In April 2020, the Board remanded this appeal, partly to schedule the Veteran for VA examination(s) to determine the onset and/or etiology of his claimed respiratory disorder, to include sarcoidosis; esophageal cancer; and residuals of a gallbladder removal. The examiner(s) was/were to diagnose all current respiratory disorders, to include sarcoidosis, and residuals of a gallbladder removal, and to specifically indicate if the Veteran had currently diagnosed esophageal cancer. The examiner(s) was/were to provide medical opinion(s), as to whether it was at least as likely as not that any currently diagnosed respiratory disorders, to include sarcoidosis; esophageal cancer; and residuals of a gallbladder removal, were related to and/or had their onset during the Veteran’s period of service, to specifically include his presumed in-service Agent Orange exposure and asbestos exposure, as well as his exposure to oil fumes. The April 2020 Board remand also directed that the examiner(s) was/were to specifically acknowledge and discuss any reports by the Veteran of respiratory problems, as well as symptoms he believed were due to his esophageal cancer and gallbladder problems, during service and since service. The examiner(s) was/were to also state whether it was at least as likely as not that any diagnosed respiratory disorders, to include sarcoidosis; esophageal cancer; and residuals of a gallbladder removal, were caused or aggravated by Veteran’s service-connected disabilities. The Board observes that following the April 2020 Board remand, there are notations in the record that indicate that the appointments for the Veteran’s examinations had yet to be scheduled. Additionally, a July 2020 report of general information indicates that the RO was inquiring about the status of examinations requested in May 2020. It was noted that QTC was called, and that the response was that the examinations were in active scheduling, but that the scheduling had been postponed due to COVID-19. A September 2020 report of general information indicates that the Veteran responded to the April 2020 Board remand regarding examination(s). It was noted that the Veteran stated that he was not willing to attend an examination in the midst of COVID-19, and to please make decisions without an examination. The Board notes that the entire examination scheduling request was subsequently canceled in October 2020. The Board finds that there are no responsive medical opinions of record, following a review of the claims file, as to the claims for entitlement to service connection for respiratory disorder, to include sarcoidosis; esophageal cancer; and residuals of a gallbladder removal, and that medical opinions must be obtained on remand to decide those claims. See also Stegall v. West, 11 Vet. App. 268, 271 (1998). As to the Veteran’s claim for a higher rating for cellulitis of the right ankle and foot, the Board notes that the Veteran indicated in September 2020, as noted above, that he was not willing to attend an examination due to COVID-19. The Board emphasizes that it is important that the Veteran report for his scheduled VA examinations. His failure to attend any scheduled VA examinations without showing good cause may adversely affect his claim. 38 C.F.R. § 3.655. Examples of good cause include, but are not limited to, the illness or hospitalization of a claimant and death of an immediate family member. 38 C.F.R. § 3.655(a). The Board observes that the Veteran was last afforded a VA skin diseases examination report in January 2015. The Board notes that, at a December 2019 Board hearing, the Veteran testified that during flare-ups of his service-connected cellulitis of the right ankle and foot, his right leg, as well as his right foot and ankle, would be covered. He also reported that he was using systemic corticosteroids and that physicians would change his antibiotics. As the record raises a question as to the current severity of his service-connected disability, the Board finds that another attempt should be made to afford the Veteran an opportunity to undergo a contemporaneous VA examination. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); VAOPGCPREC 11-95 (1995), 60 Fed. Reg. 43186 (1995). In doing so, the Veteran is advised that failure to report for a VA examination, without good cause, may result in the denial of his appeal. The matters are REMANDED for the following action: 1. Obtain any outstanding medical records. 2. Make arrangements for the claims file to be forwarded to a VA examiner to determine the onset and/or etiology of the Veteran’s respiratory disorder, to include sarcoidosis; esophageal cancer; and residuals of a gallbladder removal. The examiner must diagnose all respiratory disorders, to include sarcoidosis and residuals of a gallbladder removal, and specifically indicate if the Veteran has currently diagnosed esophageal cancer. The examiner must provide a medical opinion, as to whether it is at least as likely as not that any currently diagnosed respiratory disorders, to include sarcoidosis; esophageal cancer; and residuals of a gallbladder removal, are related to and/or had their onset during the Veteran’s period of service, to specifically include his presumed in-service Agent Orange exposure and asbestos exposure, as well as his exposure to oil fumes. The examiner must specifically acknowledge and discuss any reports by the Veteran of respiratory problems, as well as symptoms he believes were due to his esophageal cancer and gallbladder problems, during service and since service. The examiner must state whether it is at least as likely as not that any diagnosed respiratory disorders, to include sarcoidosis; esophageal cancer; and residuals of a gallbladder removal, are caused or aggravated by Veteran’s service-connected disabilities. 3. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the extent and severity of his service-connected cellulitis of the right ankle and foot. All indicated tests should be conducted and all symptoms associated with the Veteran’s cellulitis of the right ankle and foot must be described in detail. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. D. Regan, 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.