Citation Nr: 21030054 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 13-10 628 DATE: May 17, 2021 REMANDED Entitlement to a disability rating in excess of 50 percent for service-connected posttraumatic stress disorder (PTSD) is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active duty service from June 1966 to December 1969. This matter comes before the Board of Veterans' Appeals (Board) from a March 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In September 2018, the Board denied the Veteran's claim for a disability rating in excess of 50 percent for his service-connected PTSD disability. Subsequently, the Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (CAVC). In a December 2019 CAVC Memorandum Decision, the Court remanded the claim on appeal in opining that the Board erred by not properly discussing the Veteran's relevant symptoms and their severity. While the December 2019 CAVC Memorandum Decision did not address the issue of TDIU in remanding the Veteran's increased rating claim, pursuant to Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009), the Board finds that TDIU is reasonably raised by the record and part and parcel to the increased rating claim for the Veteran's service-connected PTSD and will therefore be addressed herein. See also September 2018 Board decision (remanding the issue of TDIU as being inextricably intertwined with the Veteran's service-connected diabetes mellitus, Type II disability). 1. Entitlement to a disability rating in excess of 50 percent for service-connected posttraumatic stress disorder is remanded. 2. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. The duty to conduct a contemporaneous examination is triggered when the evidence indicates there has been a material change in disability or that the current rating may be incorrect. Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). Upon review of the record, the Board finds that the Veteran's service-connected disability has undergone material changes since last being examined by the VA in October 2017. To point, a June 2018 VA treatment indicates increased symptomatology of irritability. See also July 2019 VA treatment record ("Having more issues with PTSD"). As such, an updated VA examination should be obtained to assess the current severity level of the Veteran's service-connected PTSD disability; the Board will defer deciding the issue of TDIU pending the aforesaid additional development on the increased rating claim. Harris v. Derwinski, 1 Vet. App. 180 (1991). The record also reveals that the Veteran sought treatment from a private psychologist for his service-connected PTSD disability; however, it does not appear as though said records have been associated with his claims file. See July 15, 2019 VA treatment record. Accordingly, upon remand, the AOJ should request the Veteran's authority to obtain any outstanding private treatment records. The matters are REMANDED for the following action: 1. Associate with the Veteran's claims file any outstanding VA treatment records since March 2021. 2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination of any relevant medical records relating to his service-connected PSTD disability. 3. After any additional records are associated with the claims file, to the extent possible, afford the Veteran a new VA examination with an appropriate medical examiner to determine the current severity level of his service-connected PTSD disability, to include the level of functional impairment it causes him as it relates to his ability to secure and maintain substantially gainful employment (TDIU). The claims folder, including a copy of this remand, must be made available to, and reviewed by, the VA examiner. The VA examiner is requested to specifically review the psychiatric evaluation report of record by Dr. M.L.C. See VBMS, document labeled "Medical Treatment Record - Non-Government Facility," receipt date March 17, 2021; see also VBMS, document labeled "C&P Exam," receipt date October 11, 2017; VBMS, document labeled "C&P Exam," receipt date March 3, 2015. Bethany L. Buck Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.R. Fey, 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.