Citation Nr: 21024683 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 11-18 739 DATE: April 23, 2021 ORDER The legacy appeal seeking entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and depression, is dismissed. Service connection for a bilateral eye disorder is denied. Service connection for hypertension is denied. Service connection for a genitourinary disorder is denied. REMANDED Entitlement to service connection for a back disorder, to include osteoarthritis and degenerative arthritis, to include as secondary to service-connected disabilities, is remanded. Entitlement to an initial rating in excess of 10 percent prior to May 23, 2016, in excess of 20 percent from May 23, 2016, to February 6, 2020, and in excess of 30 percent thereafter for degenerative arthrosis of the left foot, residual of excision of exostosis, left first metatarsal-tarsal joint (left foot disorder), exclusive of the time periods where temporary total ratings have been assigned, is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDINGS OF FACT 1. In written statements received in March 2018, April 2018, November 2019, and March 2020, prior to the promulgation of a decision in the appeal, the Board received notification from the Veteran requesting to withdraw his legacy appeal as to the issue of entitlement to service connection for an acquired psychiatric disorder, to include PTSD and depression. 2. The Veteran’s current bilateral eye disorders of right eye primary open angle glaucoma, right eye angle recession, left eye corneal scar, cataracts, and pinguecula are not shown to be causally or etiologically related to any disease, injury, or incident during service. 3. Hypertension is not shown to be causally or etiologically related to any disease, injury, or incident during service, and did not manifest to a compensable degree within one year of separation from active duty. 4. A competent and probative diagnosis of a genitourinary disorder, to include renal failure and proteinuria, is not demonstrated by the evidence of record. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the legacy appeal seeking entitlement to service connection for an acquired psychiatric disorder, to include PTSD and depression, have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205. 2. The criteria for service connection for a bilateral eye disorder have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for hypertension have not been met. 38 U.S.C. §§ 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 4. The criteria for service connection for a genitourinary disorder have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1977 to August 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from October 2007, March 2009, and January 2019 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2017, the Board remanded the instant claims, as well as the Veteran’s claim for service connection for a skin disorder, for additional development. While on remand, in a January 2020 rating decision, the Agency of Original Jurisdiction (AOJ) granted service connection for pseudofolliculitis barbae. As such is a full grant of the benefits sought on appeal with respect to this issue, this matter is no longer before the Board. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1977). The remaining issues now return for further appellate review. In this regard, in a March 2020 rating decision, the AOJ increased the rating of the Veteran’s left foot disability to 30 percent, effective February 6, 2020. As the Veteran is presumed to be seeking the maximum benefit for a disability, such claim for a higher rating remains in appellate status. A.B. v. Brown, 6 Vet. App. 35, 38 (1993). The Board notes that, in light of a February 2018 application for a TDIU in which he alleged that his left foot disorder, in part, rendered him unemployable, the Board has assumed jurisdiction over such claim pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009). Further, while the RO originally adjudicated two separate claims for service connection for a back disorder, and osteoarthritis and degenerative arthritis, given the Veteran’s descriptions of such disorders and the information submitted and developed in support of such claims, the Board has recharacterized such as a single claim for service connection for a back disorder, to include osteoarthritis and degenerative arthritis, in light of Clemons v. Shinseki, 23 Vet. App. 1 (2009) (holding that the scope of a claim is determined by the claimant’s description of the claim, the symptoms described, and the information submitted or developed in support of the claim). See November 2017 written statement, May 2019 VA examination report. Moreover, additional VA treatment records were associated with the file subsequent to the issuance of the January 2020 supplemental statement of the case and the Veteran has not waived AOJ consideration of such evidence. However, the Board finds that there is no prejudice to the Veteran in the Board proceeding with the adjudication of his service connection claims for an eye disorder, hypertension, and a genitourinary disorder herein as such evidence is either duplicative of that previously considered or irrelevant to such claims. 38 C.F.R. § 20.1304(c). Further, as the Veteran’s remaining claims are remanded herein, the AOJ will have an opportunity to review the newly received evidence such that no prejudice results to the Veteran in the Board considering it for the limited purpose of issuing a comprehensive and thorough remand. Withdrawn Claim The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the Veteran or by his or her authorized representative. 38 C.F.R. § 20.204. In the instant case, prior to the promulgation of a decision in the present appeal, the Veteran, via written statements received by the Board in March 2018, April 2018, November 2019, and March 2020 indicated that he wished to withdraw his legacy appeal as to the issue of entitlement to service connection for an acquired psychiatric disorder, to include PTSD and depression. Specifically, in his March 2018 written statement, he stated that he wanted to withdraw his service-related disabling disorder of PTSD that was currently on remand from the Board. In April 2018, the Veteran indicated that he decided to withdraw his PTSD claim. Similarly, in his November 2019 written statement, the Veteran requested to opt out of the legacy appeal program for his depression; and in his March 2020 VA Form 20-0996 Request for Higher Level Review, he stated that he withdrew his claim for depression from the legacy appeal program. Further, the Board observes that, while on remand (August 2017 Board remand), a January 2019 rating decision confirmed and continued the previous denials of service connection for PTSD and depression. In May 2019, the Veteran opted into the modernized review system of the Appeals Modernization Act (AMA) and chose the Decision Review Request: Supplemental Claim option. See 38 C.F.R. § 19.2(d). In September 2019, the AOJ issued a rating decision which similarly confirmed and continued the previous denials of service connection for PTSD and depression. By opting into the AMA, the Veteran withdrew his pending appeal under the legacy system. Hence, there remain no allegations or errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeal and it is dismissed. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996) [(table)]. Pertinent to a claim for service connection, such a determination requires a finding of a current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Under applicable regulation, the term “disability” means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; see also Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen v. Brown, 7 Vet. App. 439 (1995); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (the term “disability” as used in 38 U.S.C. § 1110 “refers to the functional impairment of earning capacity, not the underlying cause of said disability,” and held that “pain alone can serve as a functional impairment and therefore qualify as a disability”). In McClain v. Nicholson, 21 Vet. App. 319, 321 (2007), the United States Court of Appeals for Veterans Claims (Court) held that the requirement of the existence of a current disability is satisfied when a claimant has a disability at the time he files his claim for service connection or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. However, in Romanowsky v. Shinseki, 26 Vet. App. 289 (2013), the Court held that when the record contains a recent diagnosis of disability prior to a claimant filing a claim for benefits based on that disability, the report of diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency. Additionally, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, such as cardiovascular-renal disease (to include hypertension), are presumed to have been incurred in service if manifested to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. Alternatively, service connection may be established under 38 C.F.R. § 3.303(b) by (a) evidence of (i) the existence of a chronic disease in service or during an applicable presumption period under 38 C.F.R. § 3.307 and (ii) present manifestations of the same chronic disease, or (b) when a chronic disease is not present during service, evidence of continuity of symptomatology. However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.R.F. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 1. Entitlement to service connection for a bilateral eye disorder. The Veteran is seeking service connection for a bilateral eye disorder. He asserts that he developed such disorder as a result of his in-service exposure to gunpowder on the rifle range while stationed in Germany in 1978. In this regard, the Veteran’s military personnel records reflect that he served as a cannon crewman for three years and five months during active service, and he is the recipient of a Sharpshooter Badge for M-16 rifles. Such records further reflect that the Veteran served overseas in Germany in 1977 and 1978. As an initial matter, while the Veteran’s service treatment records (STRs) are negative for any complaints, treatment, or diagnoses referable to his eyes, the Board finds that the evidence of record confirms that he has current bilateral eye disorders diagnosed as right eye primary open angle glaucoma, right eye angle recession, left eye corneal scar, cataracts, and pinguecula. See May 2019 VA examination. Additionally, the first post-service documentation of eye problems is reflected in a November 2007 private treatment record, which includes an impression of vertical extraocular muscle deviation or skew deviation most likely caused by a brain stem ischemia. However, as will be discussed below, the preponderance of the evidence is against a finding that the Veteran’s bilateral eye disorders are related to his military service. Consequently, service connection for a bilateral eye disorder is not warranted. In this regard, in August 2017, the Board remanded the claim to afford the Veteran a VA examination, which was conducted in May 2019. At such time, the examiner opined that the Veteran’s angle recession glaucoma was less likely than not incurred in or caused by the claimed in-service injury, event, or illness, to include his reported exposure to gunpowder in service. As rationale for the opinion, the examiner explained that angle recession, which resulted in the subsequent development of glaucoma, was caused by some type of trauma of the eye or head; and there was no evidence that gunpowder exposure affected the angle structure of the eyes. The examiner further explained that the Veteran’s angle recession glaucoma was not diagnosed until many years after service; and while his in-service exposure was bilateral, such disorder was only present in his right eye. Furthermore, the examiner similarly determined that the Veteran’s bilateral cataracts, bilateral pinguecula, and left eye corneal scar were less likely than not incurred in or aggravated during active service, or otherwise due to an event or incident during service, to include his in-service exposure to gunpowder. As rationale for the opinion, the examiner reported that cataracts were age-related and unrelated to service or any exposure; and pinguecula was caused by chronic UV exposure or irritation and unrelated to service. The examiner further reported that the cause of the left eye corneal scar was unknown as the Veteran denied any eye injuries, and such disorder was also not documented until many decades after service. The Board finds that the May 2019 VA examiner’s opinion is entitled to great probative weight as such considered all of the pertinent evidence of record, to include the statements of the Veteran, STRs, and post-service medical history, and provided a complete rationale, relying on and citing to the records reviewed. Moreover, the examiner offered clear conclusions with supporting data as well as reasoned medical explanations connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (“[A]medical opinion… must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions”). Further, there is no medical opinion to the contrary of record. The Board has also considered the Veteran’s statements that his bilateral eye disorder is directly related to his military service; however, as a lay person, he has not shown that he has specialized training sufficient to render such an opinion. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the etiology of such disorder, described as right eye primary open angle glaucoma, right eye angle recession, left eye corneal scar, cataracts, and pinguecula, is a matter not capable of lay observation and requires medical expertise to determine. Specifically, such involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship in that it requires knowledge of the inner workings of the eye. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (explaining that while the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Moreover, whether the symptoms the Veteran reportedly experienced during or after service are in any way related to his currently diagnosed bilateral eye disorder is a matter that also requires medical expertise to determine. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) (“although the veteran is competent to testify to the pain he has experienced since his tour in the Persian Gulf, he is not competent to testify to the fact that what he experienced in service and since service is the same condition he is currently diagnosed with.”) Accordingly, the Veteran’s opinion as to the onset and etiology of such disorder is not competent evidence and, consequently, is afforded no probative weight. In sum, the most probative evidence of record fails to establish a nexus between the Veteran’s current bilateral eye disorders and service. As such, the preponderance of the evidence is against the Veteran’s claim seeking service connection for a bilateral eye disorder, and there is no reasonable doubt to resolve on his behalf. Accordingly, service connection for a bilateral eye disorder is not warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. 2. Entitlement to service connection for hypertension. The Veteran is currently diagnosed with hypertension (see May 2019 VA examination), but there is no indication that such disorder manifested during, or to a compensable degree within one year after separation, or is otherwise related to service. In this regard, in a December 2017 written statement, the Veteran indicated that his hypertension was related to stress and eating ready-to-eat meals that contained high levels of sodium when he was away in field duty for 30 days or more during active service. However, his STRs are silent for any complaints, treatment, or diagnoses referable to hypertension, to include any elevated blood pressure readings. Rather, the first reference to hypertension was recorded in April 2003, at which time a diagnosis of such was noted. Given that neither the Veteran nor his representative have reported the onset of his hypertension during or soon after service, and given that the medical evidence of record establishes that the Veteran developed hypertension many years after service, service connection for hypertension as either having manifested during service, or as a chronic disease manifesting within one year of service, is not warranted. Further, pursuant to the August 2017 Board remand, the Veteran was afforded a VA examination in May 2019 in connection with his claim. At such time, the examiner determined that the Veteran’s hypertension was less likely than not incurred in, caused by, or aggravated by active service. In support thereof, the examiner reported that the Veteran’s STRs did not indicate hypertension; and he was diagnosed with hypertension in 2006-2007. The examiner additionally noted that medical records did not indicate that the Veteran’s hypertension was aggravated by his mental health diagnosis. Here, the Board notes that, as the Veteran is not service-connected for any acquired psychiatric disorder, to include PTSD and depression, service connection for any disability as secondary to such is precluded. Additionally, while the May 2019 VA examiner did not discuss the Veteran’s earlier diagnosis of hypertension in 2003 (as described above), a VA examination report must be “read as a whole” and a medical examiner is not required to provide a detailed review of medical history or comment on every piece of favorable evidence in the record. Monzingo v. Shinseki, 26 Vet. App. 97, 105-7 (2012); Acevedo v. Shinseki, 25 Vet. App. 286, 293 (2012) (noting that VA examiners do not have a reasons or bases requirement). In the instant case, the Board finds that, when reading the May 2019 VA examination report as a whole, the examiner properly considered whether the Veteran’s hypertension is related to his military service. Here, regardless of a 2003 or 2006 hypertension diagnosis, the evidence of record demonstrates that the Veteran was first diagnosed with such disorder many years after service. Furthermore, the Board affords great probative weight to the May 2019 VA examiner’s opinion as such was predicated on an interview and examination of the Veteran, and a review of the record available at the time of such examination, to include his STRs and post-service records. Moreover, the opinion proffered considered all of the pertinent evidence of record, to include the statements of the Veteran, and provided a complete rationale, relying on and citing to the records reviewed. Further, the examiner offered clear conclusions with supporting data as well as reasoned medical explanations connecting the two. See Nieves-Rodriguez, supra; Stefl, supra. The Board has also considered the Veteran’s assertions as to the etiology of his hypertension; however, as a lay person, he does not have the requisite training and experience necessary to address such a complex medical matter. Specifically, the etiology of such disorder involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. Although lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issue in this case, the etiology of hypertension, such falls outside the realm of common knowledge of a lay person. See Jandreau, supra; see also Woehlaert, supra. Accordingly, the Veteran’s opinion as to the etiology of his hypertension is not competent evidence and, consequently, is afforded no probative weight. Based on the foregoing, the Board finds that the Veteran’s hypertension is not shown to be causally or etiologically related to any disease, injury, or incident during service, and did not manifest to a compensable degree within one year of service discharge. Consequently, service connection for such disorder is not warranted. In reaching this decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for hypertension. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. 3. Entitlement to service connection for a genitourinary disorder, to include renal failure and proteinuria. The Board finds determinative the absence of competent and probative evidence of a currently disability of a genitourinary disorder, to include renal failure and proteinuria, to include the period proximate to receipt of the Veteran’s claim. Although the Veteran underwent VA examination in May 2019, the examiner did not record a diagnosis referable to a kidney disorder, to include renal failure or proteinuria. Furthermore, the examination report does not show the Veteran reported any symptomatology related to the kidney system at that time. The Board observes that treatment records dated in August and November 2007 note renal failure among the Veteran’s medical problems; and an October 2007 treatment record indicates the Veteran had a history of renal failure. Given that the authors of the treatment records did not provide explanations for the findings or citations to evidence in support thereof, or identify the proximate date when the disability was present, the Board affords such notations no probative weight. The Board further observes that in a November 2007 treatment record, the Veteran reported sharp pain in the lower abdomen, and he noted that he had eaten foods such as prandial sausage and hot dogs. Such record further indicates that the Veteran had experienced bowel movement issues for one or two days; and that the physician found the Veteran had abdominal pain and renal failure. However, the May 2019 VA examiner specifically reconciled the previous diagnosis of record with the objective clinical findings of record in concluding that the Veteran does not have a current genitourinary disorder. Here, the examiner reported that the Veteran was diagnosed with proteinuria and renal dysfunction one time in 2007 during an evaluation for unrelated abdominal pain; however, he had no chronic proteinuria, and no chronic kidney disorder resulted from such. The examiner further reported that the Veteran’s renal function was normal and there was no proteinuria on the laboratory results. The Board affords great probative value to the May 2019 VA examination report as such was completed by a trained medical professional who reviewed the record and performed an in-person examination of the Veteran. Additionally, such report is shown to be consistent with the remaining treatment records dated during the pendency of the appeal, which similarly do not demonstrate a competent and probative diagnosis of a genitourinary disorder. In this regard, in a December 2010 treatment record, a possible history of renal failure related to diuretics was noted with a question mark. A March 2014 treatment record stated that recent labs showed normal renal function tests. A December 2014 treatment record indicated that the Veteran did not have acute renal failure. Further, treatment records dated throughout the appeal period that include urinalyses show the protein levels in the Veteran’s urine to be within normal limits. The Board has considered the Veteran’s assertions as to the diagnoses of renal failure and proteinuria; however, as a lay person, he does not have the requisite training and experience necessary to address such a complex medical matter. See Jandreau, supra. In this regard, such diagnoses involve a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. Therefore, such matters may not be competently addressed by lay statements. See Woehlaert, supra. Thus, the Board affords his statements regarding the diagnoses of renal failure and proteinuria no probative weight. Consequently, the Board finds that the evidence of record does not contain a competent and probative diagnosis of a genitourinary disorder, to include renal failure and proteinuria. Furthermore, the record does not reflect functional impairment associated with such alleged disorder. Therefore, service connection for a genitourinary disorder must be denied. Watson, supra; Brammer, supra; Rabideau, supra. In reaching such decision, the Board has considered the applicability of the benefit of the doubt doctrine. However, the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for a genitourinary disorder. As such, that doctrine is not applicable in the instant appeal, and his claim must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. REASONS FOR REMAND 4. Entitlement to service connection for a back disorder, to include osteoarthritis and degenerative arthritis, to include as secondary to service-connected disabilities. Pursuant to the August 2017 Board remand, the Veteran underwent an examination in May 2019, at such time the examiner noted a diagnosis of degenerative arthritis of the spine. However, the examiner found that such disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As rationale for the opinion, the examiner stated that the Veteran’s STRs and military medical records were silent for back problems; he was a truck driver until 2006; and he received disability benefits due to his back since September 2006. However, the non-documentation of complaints, treatment, or diagnosis referable to the Veteran’s back as described by the May 2019 VA examiner is not consistent with the record. To the contrary, an October 1977 STR (Radiographic Report) reflects that the Veteran had levoscoliosis of the mid-thoracolumbar spine. Thus, such opinion appears to be based on an incomplete factual history. See Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993) (medical opinions based on inaccurate factual premise are not probative). Further, the Veteran has argued that his back disorder is caused or aggravated by his service-connected left foot (degenerative arthritis and neuritis) and bilateral ankle disabilities (right ankle strain and left ankle degenerative joint disease). See December 2014, November and December 2017, and May 2019 written statements. Specifically, the Veteran asserts that his left foot and bilateral ankle disabilities consistently cause him to fall and injure his back. However, no examiner has provided a medical opinion as to service connection secondary to left foot and bilateral ankle disabilities. Consequently, the Board finds that a remand is necessary to obtain an addendum opinion addressing such matters. 5. Entitlement to an initial rating in excess of 10 percent prior to May 23, 2016, in excess of 20 percent from May 23, 2016, to February 6, 2020, and in excess of 30 percent thereafter for a left foot disorder, exclusive of the time periods where temporary total ratings have been assigned. In the August 2017 remand, the Board noted that, in a July 2016 written statement, the Veteran requested that VA retrieve treatment records from Maxwell Air Force Base (AFB) during the period from January 2008 to December 2016 pertaining to his left foot; however, such records had not been obtained. Thus, the AOJ was directed to obtain such outstanding treatment records. However, it does not appear the AOJ attempted to obtain such records. Thus, the Board finds that a remand is necessary to ensure compliance with the August 2017 remand orders and obtain all outstanding treatment records from Maxwell AFB from January 2007 to December 2016. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board notes that the AOJ readjudicated the Veteran’s claims for service connection for bilateral eye, back, genitourinary, and hypertension disorders in a January 2020 supplemental statement of the case, but did not readjudicate his increased rating claim for a left food disorder. As relevant, the Board observes that the evidence of record since the August 2017 remand includes June 2019 and February 2020 VA examination reports pertinent to the Veteran’s left foot disorder. Thus, the AOJ is reminded that a supplemental statement of the case must be issued if, pursuant to a remand by the Board, it develops the evidence or cures a procedural defect. 38 C.F.R. § 19.31(c). 6. Entitlement to TDIU. As previously noted, the Board has assumed jurisdiction over the Veteran’s claim for a TDIU pursuant to Rice, supra. However, as the Veteran contends that his left foot disorder, in part, rendered him unemployable, his claim for a TDIU is inextricably intertwined with the increased rating claim remanded herein. See Tyrues v. Shinseki, 23 Vet. App. 166, 177 (2009) (en banc) (explaining that claims are inextricably intertwined where the adjudication of one claim could have a significant impact on the adjudication of another claim). As such, consideration of the Veteran’s TDIU claim must be deferred pending the outcome of the increased rating claim. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (where a claim is inextricably intertwined with another claim, the claims must be adjudicated together in order to enter a final decision on the matter). Accordingly, the matters are REMANDED for the following actions: 1. Obtain treatment records referable to the Veteran’s left foot disorder from Maxwell Air Force Base dated between January 2008 and December 2016. All reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Return the record, to include a copy of this Remand, to the VA examiner who rendered the May 2019 VA medical opinion in regard to the Veteran’s back disorder for an addendum opinion. If such examiner is not available, the record should be provided to an appropriate examiner so as to render the requested opinion. Following a review of the record, the examiner should address the following inquiries: (A) Is it at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s currently diagnosed degenerative arthritis of the spine had its onset in, or is otherwise related to, his military service, to include the October 1977 STR (Radiographic Report) documenting that he had levoscoliosis of the mid-thoracolumbar spine? In offering such opinion, the examiner shoulder consider the Veteran’s statements that: (1) he hurt his back while playing sports or lifting his heavy ruck sack and missiles during active service; and (2) he was advised to have back surgery during active service. (B) Is it at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s currently diagnosed degenerative arthritis of the spine is caused OR aggravated by his service-connected left foot (degenerative arthritis and neuritis) and/or bilateral ankle disabilities (right ankle strain and left ankle degenerative joint disease)? The examiner should specifically address the Veteran’s claim that such service-connected disabilities cause him to fall and injure his back. For any aggravation found, the examiner should state, to the best of their ability, the baseline of symptomatology and the amount, quantified if possible, of aggravation beyond the baseline symptomatology. The examiner should provide a rationale for any opinion offered. K. STANTON Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dawn A. Leung, Associate 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.