Citation Nr: 21039704 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 14-31 192A DATE: July 1, 2021 REMANDED Entitlement to an increased rating in excess of 20 percent prior to July 9, 2019, and an evaluation in excess of 60 percent, effective July 9, 2019, for service-connected narcolepsy is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to a service-connected disability, to include on an extraschedular basis, prior to July 9, 2019, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1994 to May 1997. As an initial matter, the Board acknowledges that, in September 2020, the Veteran submitted a Decision Review Request: Supplemental Claim, VA Form 20-0995, pertaining to, in pertinent part, an increased rating for his service-connected narcolepsy and entitlement to TDIU prior to July 9, 2019, in an attempt to opt into the Appeals Modernization Act (AMA). However, the 'OPT-IN from SOC/SSOC' box was not checked, which would have withdrawn the issues from the Legacy appeals process. Per September 2020 correspondence, the Agency of Original Jurisdiction (AOJ) determined that his appeal would remain in the Legacy appeal system. When the attorney's office questioned this determination, the RO sent a detailed email in October 2020, explaining that since the opt-in from SSOC box was not checked, the appeal would remain in Legacy. As such, the Board will proceed to adjudicate the issues on appeal in accordance with the Legacy appeals system. In May 2018, the Veteran testified in a Travel Board hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is of record. In August 2018, the Board remanded these issues for further development. In June 2021, the Veteran submitted a General Release for Medical Provider Information to the Department of Veterans Affairs (VA) form identifying 2 medical providers by whom he is being treated. In an attached statement, the representative specifically requested that these records be obtained. As no attempts have been made to obtain these records, these issues must be remanded. Moreover, with regard to the Veteran's claim for entitlement to TDIU prior to July 9, 2019, the Board notes that the Veteran does not currently meet the schedular criteria for entitlement to TDIU prior to July 9, 2019. If he still does not meet the schedular criteria after the AOJ reconsiders the rating for his narcolepsy, there is sufficient evidence of record to warrant referral for extraschedular TDIU consideration prior to July 9, 2019. The Social Security Administration (SSA) grant of benefits was based, in part, on narcolepsy, and the Veteran submitted a January 2018 letter from a medical professional opining he could not work due to his narcolepsy. This was ordered in the last remand, yet not done. The matters are REMANDED for the following action: 1. Associate the following with the claims file: (a.) All treatment records from the Bay Pines VA Healthcare System (and associated outpatient clinics) from September 2020 to the present; and (b.) All treatment records from the Miami VA Healthcare System (and associated outpatient clinics) from April 2019 to the present. 2. Request all private medical records identified in the June 2021 release form. Associate any records received, including negative responses, with the claims file. 3. Then, adjudicate the Veteran's claim for an increase for narcolepsy. If he does not meet the schedular criteria for a TDIU prior to July 9, 2019, refer his TDIU claim to the Director of Compensation Service or designee for consideration of whether an extraschedular rating is warranted. See SSA grant based, in part, on narcolepsy, and 2018 letter from a medical professional opining he could not work due to his narcolepsy. 4. Then, readjudicate the claims on appeal. If the benefits on appeal remain denied, furnish the Veteran and his representative with a copy of a supplemental statement of the case and allow an appropriate time for response. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Durham, 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.