Citation Nr: 21022565 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 10-27 502 DATE: April 16, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for verrucous carcinoma of the right false vocal cord and residuals, excluding a period of temporary 100 percent rating, 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 1967 to February 1969. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a February 2009 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Baltimore, Maryland. In August 2016, the Veteran appeared at a hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is of record. In February 2017 and April 2020, the Board remanded these claims to the Agency of Original Jurisdiction for additional action. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c); 38 U.S.C. § 7107(a)(2). 1. Entitlement to an initial rating in excess of 10 percent for verrucous carcinoma of the right false vocal cord and residuals, excluding a period of temporary 100 percent rating, is remanded. Although the Board regrets the delay, additional development is needed prior to further disposition of the claim for entitlement to an initial rating in excess of 10 percent for verrucous carcinoma of the right false vocal cord and residuals, excluding a period of temporary 100 percent rating. VA’s duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121 (1991). When VA obtains an evaluation, the evaluation must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). In April 2020, the Board remanded this matter for a VA examination to determine any change in the severity of the service-connected residuals of verrucous carcinoma of the right false vocal cord residuals. The Board specifically asked for his examination to be performed by an oncologist. In November 2020, a surgeon performed VA esophageal condition and sinusitis/rhinitis and other conditions of the nose, throat, larynx, and pharynx examination. Later in January 2021, a physician’s assistant performed VA esophageal condition and sinusitis/rhinitis and other conditions of the nose, throat, larynx, and pharynx examination. No other medical examinations are of record since the Boards April 2020 remand. In a February 2021 correspondence, the Veteran, through the representative, argued that there is not compliance with the April 2020 Board remand as the Veteran was not subsequently examined by an oncologist. The Board finds that there has not been substantial compliance with the April 2020 remand instructions. To date, no oncologist has examined the Veteran in conjunction with the increased rating claim. That is a pre-decisional duty to assist error. Therefore, the Board finds that further examination is needed to determine the current severity of service-connected verrucous carcinoma of the right false vocal cord residuals.  After all outstanding medical records are associated with the record, more contemporaneous examination is needed to rate the claim for increased ratings for a verrucous carcinoma of the right false vocal cord residuals.  Allday v. Brown, 7 Vet. App. 517 (1995); Caffrey v. Brown, 6 Vet. App. 377 (1994); Snuffer v. Gober, 10 Vet. App. 400 (1997).  The Veteran is notified that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claim. The consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. § 3.655. 2. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. Because a decision on the remanded issue of entitlement to an initial rating in excess of 10 percent for verrucous carcinoma of the right false vocal cord and residuals, excluding a period of temporary 100 percent rating, could significantly impact a decision on the issue of entitlement TDIU, the Board finds that the issues are inextricably intertwined. Because the claims are being remanded, the Board finds that it would be potentially prejudicial to the Veteran for the Board to consider that TDIU claim prior to the determination of the other claim. Therefore, the adjudication of the TDIU claim must be deferred pending resolution of that claim. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Contact the Veteran and request that he provide information as to treatment for the claimed disability, including the names and addresses of all health care providers whose records have not already been provided to VA.  On receipt of the requested information and the appropriate releases, contact all identified health care providers and request copies of all available records pertaining to treatment of the Veteran, not already of record.  If identified records are not obtained, then notify the Veteran.  38 C.F.R. § 3.159(e). 2. Schedule the Veteran for a VA examination with an oncologist, to determine the current severity of residuals of verrucous carcinoma of the right vocal cord and the Veteran’s employability. The examiner must review the claims file, to include this remand, the April 2020 Board remand, and the Veteran’s Board hearing testimony. The examiner should note the review in the report. All necessary tests and studies should be accomplished, and all clinical findings reported in detail. The examiner should identify all symptoms and manifestations associated with service-connected verrucous carcinoma of the right vocal cord and residuals, including, but not limited to any dyspnea, bronchitis, stenosis of the larynx, hoarseness, loss of voice, vocal fatigue, loss of taste, loss of appetite, weight loss, dysphagia with liquids and solids, sleeplessness due to awakening by choking on excessive mucous in the throat. For each of those listed claimed symptoms, the examiner should specifically state whether that symptom is present or has been present during the pendency of this appeal. The examiner is also asked to comment on the impact of the service-connected disabilities on employment and activities of daily life.  The examiner should opine whether it was at least as likely as not (50 percent or greater probability) that the Veteran is unable to secure or follow a substantially gainful occupation due to the service-connected disabilities, which is consistent with education and training.  If the Veteran is found to be capable of work despite the service-connected disabilities, the examiner should state what type of work and what accommodations would have been necessary due to the service-connected disabilities. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Mondesir, Eric 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.