Citation Nr: 21027207 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 20-08 915 DATE: May 5, 2021 REMANDED Entitlement to a compensable rating for lung cancer, status post right lobectomy is remanded. Entitlement to a compensable rating for right lobectomy scar is remanded. Entitlement to special monthly compensation based on a need for aid and attendance or housebound status is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1955 to January 1959. These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to a compensable rating for lung cancer, status post right lobectomy is remanded. The Veteran is service connected for lung cancer and has also been diagnosed with chronic obstructive pulmonary disease (COPD) as due to smoking tobacco, which is not service connected. Initially, the Board notes VA treatment records from August 2014 are outstanding. Those VA treatment records are constructively of record, and must be secured to allow for a fully informed appellate review. Bell v. Derwinski, 2 Vet. App. 611 (1992). Next, the Veteran was examined for his lung cancer disability in February 2016 and January 2020. See February 2016 Examination; see also January 2020 Examination. The VA examiners did not indicate which respiratory disability caused the use each of his inhaled medications, and most recently, outpatient oxygen therapy. As noted above, his COPD was found more likely than not due to his lengthy tobacco smoking history, for which compensation is prohibited. See 38 U.S.C. § 1103; 38 C.F.R. § 3.300. The Veteran has testified before the undersigned that his disability has worsened since he was last examined. See February 2021 Hearing Transcript. The Board finds that additional examination is necessary to determine the current severity of his service-connected lung cancer and the medical treatment required for this disability. Consequently, an updated examination is warranted. See Snuffer v. Gober, 10 Vet. App. 400 (1997) (holding that a claimant is entitled to a new VA examination where there is evidence that the condition has worsened since the last examination). 2. Entitlement to a compensable rating for right lobectomy scar is remanded. The Veteran contends that his service-connected right lobectomy scar warrants a compensable rating. The Board notes the Veteran's daughter testified at the February 2021 hearing that the Veteran's scar itched and had shooting pains and neuropathy pain. In contrast, February 2016 and January 2020 VA examinations show the Veteran reported the scar was stable and not painful. See February 2016 Examination; see also January 2020 Examination. Given the contentions at the hearing, the issue is remanded for a current examination. Snuffer, 10 Vet. App. at 400. 3. Entitlement to special monthly compensation based on a need for aid and attendance or housebound status is remanded. The Veteran and his daughter testified at the hearing before the undersigned that the Veteran requires the aid and attendance of another to tend to activities of daily living. Because a decision on the remanded issues could significantly impact a decision on the issues of SMC for housebound or based on the need for regular aid and attendance based on all of the Veteran's service-connected disabilities, the issues are inextricably intertwined. A remand of the claims for SMC for housebound and aid and attendance is required. The matters are REMANDED for the following action: 1. Obtain all outstanding VA medical records. 2. Schedule the Veteran for an examination with an appropriate examiner for his service-connected lung cancer. a. The reviewer should attempt to distinguish symptomatology which is attributable to the Veteran's service-connected lung cancer and that which is attributable to non-service-connected COPD, including the use of inhaled medications and outpatient oxygen therapy and when oxygen therapy was prescribed. b. The examiner should elicit a medical history from the Veteran regarding the right lobectomy scar, whether it is unstable or painful, and when these symptoms became manifest. 3. Schedule the Veteran for an appropriate examination and/or medical opinion to determine whether the Veteran is housebound or in need of the regular aid and attendance of another person as a result of his service-connected disabilities. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Trickey 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.