Citation Nr: 21032667 Decision Date: 05/27/21 Archive Date: 05/27/21 DOCKET NO. 13-02 000 DATE: May 27, 2021 ORDER From February 24, 2015, entitlement to special monthly compensation (SMC) pursuant to 38 U.S.C. § 1114(s) is granted. REMANDED For the period prior to February 24, 2015, entitlement to SMC pursuant to 38 U.S.C. § 1114(s) is remanded. Service connection for a digestive system disability manifested by constipation and diarrhea, due to service-connected multiple myeloma with bilateral lower extremity chemotherapy-induced polyneuropathy, is remanded. FINDING OF FACT From February 24, 2015, the Veteran has a single service-connected disability rated as 100 percent and has additional service-connected disabilities independently ratable at 60 percent or higher, which are separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems. CONCLUSION OF LAW From February 24, 2015, the criteria for entitlement to a SMC under 38 U.S.C. § 1114(s) have been met. 38 U.S.C. § 1114(s), 5103, 5103A, 5107(b), 5110. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from November 1967 to April 1968; January 2001 to October 2001; from February 2003 to October 2003; and, from March 2004 to January 2010. He also had service in the U.S. Naval reserves. In a March 2020 Board of Veterans' Appeals (Board) decision, service connection was denied for a chronic disability to account for pain/numbness of the right flank or hip; a chronic disability to account for pain/numbness of the left flank or hip; and, deep vein thrombosis (DVT), right lower extremity; for the period on appeal up to October 28, 2009 a 20 percent rating was awarded for DVT of the left lower extremity, but from October 29, 2009 a compensable rating was denied; a compensable rating for multiple myeloma prior to July 11, 2011 was denied; and, a compensable rating for hemorrhoids was denied. To date, the Agency of Original Jurisdiction (AOJ) has not implemented the Board's grant of a 20 percent rating for DVT of the left lower extremity for the period on appeal up to October 28, 2009. The Veteran filed a timely appeal to the United States Court of Appeals for Veterans Claims (Court). Pursuant to a Joint Motion for Partial Remand (JMPR), an appeal of the issues addressed in the March 2020 Board decision was dismissed, but the Board was instructed to consider entitlement to SMC per § 1114(s) and consider a digestive system issue raised by the record. Entitlement to SMC If the Veteran has a service-connected disability rated as total, and (1) has additional service-connected disability or disabilities independently ratable at 60 percent or more, or, (2) by reason of such veteran's service-connected disability or disabilities, is permanently housebound, then the monthly compensation shall be $2,993. 38 U.S.C. § 1114(s). The total plus 60 percent requirements for SMC is payable where the veteran has a single service-connected disability rated as 100 percent and has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability and involving different anatomical segments or bodily systems. Id. Service connection is in effect for multiple myeloma with bilateral lower extremity chemotherapy-induced polyneuropathy (100% 07/11/2011); anxiety disorder and adjustment disorder with depression (30% 02/24/2015; 50% 07/02/2015); right foot plantar fasciitis (20% 02/01/2010); degenerative arthritis, thoracolumbar spine (10% 02/01/2010); chronic allergic conjunctivitis (10% 02/01/2010); tinnitus (10% 02/01/2010); right lower extremity post-herpetic neuralgia with neuropathy, residual of shingles and chemotherapy-induced polyneuropathy (10% 02/01/2010-07/10/2011); right lower extremity post-herpetic neuralgia with neuropathy, residual of shingles (10% 07/11/2011); degenerative arthritis, 1st CMC joint, right hand (0% 02/01/2010); degenerative arthritis, 1st CMC joint, left hand with residual scarring (0% 02/01/2010); bilateral sensorineural hearing loss (0% 02/01/2010); deep vein thrombosis, left lower extremity (0% 02/01/2010); hemorrhoids (0% 02/01/2010); multiple myeloma with left lower extremity chemotherapy-induced polyneuropathy (0% 02/01/2010-07/10/2011); right upper extremity chemotherapy-induced polyneuropathy associated with multiple myeloma with left lower extremity chemotherapy-induced polyneuropathy (10% 02/01/2010; 0% 07/11/2011); and, left upper extremity chemotherapy-induced polyneuropathy associated with multiple myeloma with left lower extremity chemotherapy-induced polyneuropathy (10% 02/01/2010; 0% 07/11/2011). From July 11, 2011, the Veteran has a single service-connected disability rated 100 percent disabling, but from July 11, 2011 to February 23, 2015 his additional service-connected disabilities are ratable at a 48 percent combined rating, converted to a 50 percent combined rating. From February 24, 2015, he has a single service-connected disability rated 100 percent disabling, and his additional service-connected disabilities are ratable at a 64 percent combined rating, converted to a 60 percent combined rating. From July 2, 2015, he has a single service-connected disability rated 100 percent disabling, and his additional service-connected disabilities are ratable at a 74 percent combined rating, converted to a 70 percent combined rating. Thus, the criteria for SMC pursuant to § 1114(s) are met from February 24, 2015. REASONS FOR REMAND Entitlement to SMC prior to February 24, 2015 In March 2020, the Board remanded the issues of degenerative arthritis, 1st CMC joint, right hand (0% 02/01/2010); degenerative arthritis, 1st CMC joint, left hand with residual scarring (0% 02/01/2010). As higher ratings could be awarded, such issues are inextricably intertwined with whether the Veteran would meet the schedular criteria for SMC per § 1114(s) for the period prior to February 24, 2015. See Harris v. Derwinski, 1 Vet. App. 180 (1991). Service connection for a digestive system disability manifested by constipation and diarrhea, due to service-connected multiple myeloma with bilateral lower extremity chemotherapy-induced polyneuropathy The Veteran has complained of discomfort, drainage of blood and pus, and constipation that began during his chemotherapy for multiple myeloma. At a June 2015 Board hearing, the Veteran described how the chemotherapy drugs affected his digestive system causing him to alternate between multi-day constipation and diarrhea. 06/18/2015 Hearing Testimony at 5-6. A May 2016 C&P examination pertaining to his service-connected hemorrhoids reflects that the Veteran complained of issues with constipation at times which he attributed to the side effects of medications that he takes for his multiple myeloma. 05/04/2016 VA Examination. A claim of service connection for a digestive system disability manifested by constipation and diarrhea has been raised by the record and must be adjudicated by the AOJ. See Clemons v. Shinseki, 23 Vet. App. 1, 6 (2009); see also Ingram v. Nicholson, 21 Vet. App. 232, 240 (2007). The matters are REMANDED for the following actions: 1. Adjudicate a claim of service connection for a digestive system disability manifested by constipation and diarrhea claimed as due to multiple myeloma with bilateral lower extremity chemotherapy-induced polyneuropathy. 2. Following the March 2020 development regarding the issues of compensable ratings for degenerative arthritis, 1st CMC joint, right hand, and degenerative arthritis, 1st CMC joint, left hand, make a determination as to whether SMC per § 1114(s) is warranted for any period prior to February 24, 2015. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.W. Kreindler, 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.