Citation Nr: 21023799 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 11-33 679 DATE: April 21, 2021 REMANDED The issue of a rating of more than 20 percent since October 8, 2009, for residuals of hepatitis manifested by an abnormal hepatic profile is remanded. The issue of entitlement to a total rating for compensation purposes based on individual unemployability due to service-connected disabilities (TDIU) since October 8, 2009, is remanded. REASONS FOR REMAND The Veteran had active service in the United States Marine Corps from June 1969 to June 1975. In July 2011, the Veteran was afforded a hearing before a Decision Review Officer (DRO) and in May 2014, the Veteran was afforded a hearing at the VA Central Office before the undersigned Veterans Law Judge. In July 2018, the Board denied an increased rating for residuals of hepatitis manifested by an abnormal hepatic profile and denied TDIU. The Veteran appealed to the United States Court of Appeals for Veterans’ Claims (Court). In a February 2020 Memorandum Decision, the Court vacated the July 2018 Board decision and remanded the appeal to the Board. 1. The issue of a rating of more than 20 percent since October 8, 2009, for residuals of hepatitis manifested by an abnormal hepatic profile is remanded. 2. The issue of entitlement to TDIU since October 8, 2009, is remanded. The matters are REMANDED for the following action: 1. BACKGROUND FOR THE RO ADJUDICATOR: Remand is necessary to attempt to resolve several issues that the Veteran has raised before the Court and the Board. The Veteran indicated that the Board failed to obtain private treatment records from Dr. Klein and, therefore, remand is necessary to attempt to associate the records with the file. Another attempt should also be made to obtain any treatment records from the Veteran’s brother who has indicated that he has treated the Veteran for hepatitis residuals. In June 2020, the Veteran also raised the issue of the competency of VA examiners. The RO should obtain and associate with the file curriculum vitae (CVs) for each of the examiners who conducted VA examinations or provided medical opinions during the period on appeal. In a July 2018 statement, the Veteran reported that he was returning to work and was withdrawing the issue of entitlement to TDIU. He has subsequently continued to argue, however, that he is entitled to TDIU. It is unclear whether the Veteran is working. Remand is necessary to obtain information about the Veteran’s employment history and current work situation. Lastly, in the February 2020 Memorandum Decision, the Court indicated that the Board may have severed service connection in its July 2018 decision because it determined that his current symptoms were not associated with his service-connected disorder. The Veteran has reported various symptoms which he asserts are part of his service-connected disorder, even if he does not have active hepatitis. Service connection was granted in October 1975 and the Veteran was afforded a VA examination in August 1975. Remand is necessary to have the August 1975 examination report reviewed by a hepatologist to determine exactly what hepatitis residuals the Veteran had at the time service connection was granted. This will explain the extent of the Veteran’s “current disability” at the time of service connection and, therefore, what symptoms the service-connected disability encompasses. At the Court, the Veteran indicated that he had symptoms of anorexia and hepatomegaly and had incapacitating episodes which were not detected by his VA examinations. He was last afforded a VA examination in May 2018, but it seems his symptoms may have worsened. Therefore, remand is necessary to afford him a new examination, which expressly addresses whether he has anorexia, hepatomegaly, and incapacitating episodes, and which addresses the current state of all symptoms which are determined to be part of the service-connected disorder. The remand directives follow. 2. Request authorization from the Veteran to obtain: (a.) Private treatment records from Dr. Klein. (b.) Treatment records from the Veteran’s brother. If authorization is provided, take all appropriate steps to associate the records with the file. 3. Obtain and associate with the file CVs for all VA clinicians who have conducted VA examinations or provided medical opinions regarding the Veteran’s hepatitis residuals since October 2009. 4. Conduct all appropriate development to determine whether the Veteran is currently working or has worked since October 2009, and the nature of any employment since that time. 5. Schedule the Veteran for a VA examination with a hepatologist who has not provided an opinion in this case. All indicated tests and studies should be accomplished and the findings reported in detail. All relevant medical records must be made available to the examiner for review of pertinent documents. The examination report should specifically state that such a review was conducted. The examiner must provide a comprehensive explanation for all opinions provided. The examiner should address the following: (a.) Review the August 1975 VA examination report and state all residuals of hepatitis that the Veteran had at the time service connection was granted. (b.) Determine the current severity of all these hepatitis residuals. (c.) Determine the current severity of any other hepatitis residuals. (d.) State whether the Veteran has each of the following: i. Anorexia. ii. Hepatomegaly. iii. Incapacitating episodes—including the frequency and duration thereof. 6. Readjudicate the hepatitis and TDIU claims and follow all other appropriate appellate procedures. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. E. Miller, 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.