Citation Nr: 21021864 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 14-40 411 DATE: April 14, 2021 REMANDED Entitlement to an initial disability rating in excess of 10 percent for chronic fatigue associated with multiple sclerosis with right lower extremity weakness (chronic fatigue) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 2000 to January 2007, to include service in Southwest Asia. She served a period of active duty for training from September 1998 to January 1999. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2018, the Board remanded the matter to the Agency of Original Jurisdiction (AOJ) for development, and it has since returned for further appellate review. The Board notes that the claim of entitlement to a total disability rating based on individual unemployability (TDIU) was also remanded for development. In a February 2021 rating decision, the RO granted entitlement to a TDIU effective January 28, 2013, the entire period on appeal. As the grant of a TDIU constitutes a full grant of benefits sought for the issue during the appeal period and the Veteran was provided notice, the appeal is satisfied in full and thus not before the Board. Neither the Veteran nor her representative has raised any other issues, nor have any other issues been reasonably raised by the record with regards to the issue of entitlement to a TDIU. See Yancy v. McDonald, 27 Vet. App. 484, 495 (2016); Doucette v. Shulkin, 38 Vet. App. 366, 369-70 (2017). Pursuant to the April 2018 Board remand, the issue of increased rating for service-connected chronic fatigue was remanded to allow the AOJ to conduct a VA examination. This action was completed as the Veteran was provided an examination for her chronic fatigue on October 2020. Subsequently, the record suggests the Veteran’s chronic fatigue may have worsened since her last VA examination in October 2020. Notably, at that examination the examiner reported that the Veteran was not forgetful, but in a January 2021 statement, the Veteran reported having a bad memory and often is unable to remember tasks or appointments. The Board notes there are no updated VA treatment records, subsequent to September 2020, in which to evaluate the current severity of the Veteran’s disability. As the disability may have worsened, a new VA examination is necessary. See Allday v. Brown, 7 Vet. App. 517, 526 (1995) (indicating that where the record does not adequately reveal the current state of the claimant’s disability, fulfillment of the statutory duty to assist requires a contemporaneous medical examination, particularly if there is no additional medical evidence that adequately addresses the level of impairment of the disability since the previous examination). Additionally, the Board notes that during the October 2020 VA examination, the examiner indicated that the Veteran does not have a diagnosis of chronic fatigue syndrome, but instead has chronic fatigue due to multiple sclerosis. It was noted that her fatigue has gotten worse, making daily activities difficult to complete, and that she can only one activity in a day; however, the examiner failed to indicate the percentage of restriction in daily activities caused by her fatigue, other than it had not reduced it to less than 50 percent. The Board finds this information is necessary to appropriately rate the Veteran’s chronic fatigue due to multiple sclerosis. On remand, this information should be provided in the VA examination report. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all updated treatment records. 2. After records development is completed, schedule the Veteran for a VA examination to determine the current symptoms, level of severity, and functional impairment associated with her chronic fatigue. The claims file should be reviewed by the examiner. The examiner should provide a detailed review of the Veteran’s current complaints, as well as findings as to the nature, extent, and severity of symptoms caused by the Veteran’s disability. In particular, the examiner should address the Veteran’s contentions that she experiences cognitive impairments, such as forgetfulness. The examiner should also indicate the percentage of restriction in daily activities caused by her fatigue. L. ANDERSEN Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Mathew 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.