Citation Nr: 21032735 Decision Date: 05/27/21 Archive Date: 05/27/21 DOCKET NO. 18-35 884 DATE: May 27, 2021 REMANDED Entitlement to an initial rating in excess of 30 percent for a posterior neck scar associated with hidradenitis suppurativa is remanded. Entitlement to an initial rating in excess of 10 percent for an unstable scar of the anterior trunk (abdominal pannus) with hidradenitis suppurativa is remanded. Entitlement to an initial rating in excess of 10 percent for non-linear scars of the anterior trunk (left axilla and left breast) associated with hidradenitis suppurativa is remanded. Entitlement to an initial compensable rating for additional scars of the anterior trunk associated with hidradenitis suppurativa is remanded. Entitlement to an initial compensable rating for a scar of the posterior trunk associated with hidradenitis suppurativa is remanded. Entitlement to a separate, compensable rating for residuals associated with removal of sweat glands in several locations of the body as due to hidradenitis suppurativa (other than scars) is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU) is remanded. Preliminary Matters The Veteran served on active duty from November 1977 to December 1981. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in a March 2021 virtual Board hearing, the transcript of which is included in the record. A claim for a TDIU due to service-connected disability is part and parcel of an increased rating claim when such claim is raised by the record. Rice v. Shinseki, 22 Vet. App. 447 (2009). During the March 2021 Board hearing, the issue of unemployability was raised (noting that the Veteran could not work due to his skin disability). See id at pgs. 3, 10, and 11. In light of the Court's holding in Rice, the Board has considered the TDIU claim as part of his pending increased rating claims and has accordingly listed the raised TDIU claim as an issue. REASONS FOR REMAND The Veteran filed a claim for service connection for hidradenitis suppurativa in November 2016. In March 2017, the RO granted service connection for hidradenitis suppurativa, but only rated the Veteran's disability as residual scars. The evidence suggests, however, that the Veteran's hidradenitis suppurativa has resulted in additional symptomology. For example, in a March 2017 VA skin examination report, the examiner noted that the Veteran's hidradenitis suppurativa and pilonidal cyst had required surgical excisions and removal of sweat glands in several locations throughout the body. The Veteran has testified that he has a difficult time staying cool in the summertime due to removal of the sweat glands. He also reported having drainage on his clothing as a result of the sores and occasionally required antibiotics and other creams to avoid infection of the open sores. During the March 2021 Board hearing, the Veteran also reported that his scars and open sores had worsened since his last VA examination conducted in 2017. On remand, the Veteran should be afforded new VA scar examination which specifically addresses the severity of his scars and open sores. Additionally, the Veteran should also be afforded a VA skin examination to properly address any other residual symptoms and functional impact associated with the removal of sweat glands in several locations of the body. TDIU As indicated above, a claim for a TDIU has been raised by the record. The Veteran has not been provided with the notice requirement for a TDIU claim. Therefore, on remand, the RO should send the Veteran proper notice, afford him the opportunity to file a formal claim for TDIU, and then adjudicate this matter in the first instance to avoid any prejudice to him. Thus, adjudication of the TDIU claim is deferred. The matters are REMANDED for the following actions: 1. Send the Veteran the proper notice that advises him about what is needed to substantiate a claim for a TDIU. In addition, ask the Veteran to complete a VA Form 21-8940, Veteran's Application for Increased Compensation Based on Unemployability. 2. Schedule the Veteran for a VA scar examination to determine the current nature and severity of his scars associated with hidradenitis suppurativa and pilonidal cyst. 3. Schedule the Veteran for a VA skin examination to determine the current nature and severity of his symptoms (other than scars) associated with hidradenitis suppurativa and pilonidal cyst. (a.) The examiner should address any physical findings, complications, or symptoms (other than scars) associated with the Veteran's hidradenitis suppurativa, to include residuals of removal of sweat glands in several locations of the body, drainage on his clothing as a result of the sores, and the use of antibiotics and other creams to avoid infection of the open sores. (b.) The examiner should also address the functional impact of the Veteran's condition on his daily functioning and on his ability to work. (c.) The examiner should provide a complete rationale for each opinion. 4. Then, readjudicate the claims on appeal. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Casadei, 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.