Citation Nr: 21040608 Decision Date: 07/06/21 Archive Date: 07/06/21 DOCKET NO. 16-27 954 DATE: July 6, 2021 ISSUES 1. Entitlement to a compensable disability rating for right ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs, for the period prior to March 29, 2016, and in excess of 10 percent thereafter. 2. Entitlement to an increased compensable disability rating for left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs, currently rated as zero percent disabling. REMANDED Entitlement to a compensable disability rating for right ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs, for the period prior to March 29, 2016 and in excess of 10 percent thereafter, is remanded. Entitlement to an increased disability rating for left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs, currently rated as zero percent disabling, is remanded. REASONS FOR REMAND The Veteran served from May 2002 to April 2013. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision of a Department of Veterans Affairs (VA), Regional Office (RO) in Decatur, GA. This October 2014 rating decision continued a noncompensable rating for the Veteran's right and left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs. In January 2021, the Veteran testified at a virtual tele-hearing before the undersigned Veteran's Law Judge. A transcript of that Board Hearing has been associated with the claims file. At the Board hearing, the record was held open for 60 days to allow the Veteran to submit additional evidence. The Board notes that additional evidence was submitted by the Veteran, including private treatment records and a Disability Benefits Questionnaire completed by one of the Veteran's physicians. The Board has accepted this additional evidence for inclusion into the record on appeal. See 38 C.F.R. § 20.800. In a May 2016 rating decision, the Veteran's disability rating for his right ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs was increased to 10 percent, effective March 29, 2016. As this increase does not represent a full grant of benefits sought on appeal, the claim for an increased disability rating for the service-connected right ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs remains pending before the Board, as reflected on the title page. See A.B. v. Brown, 6 Vet. App., 35, 39 (1993) (the claimant is presumed to be seeking the highest possible rating for a disability unless he or she expressly indicates otherwise). At the outset, the Board notes that there is considerable overlap in the applicable evidence for the Veteran's claims for entitlement to increased ratings for his right and left ilio-inguinal neuritis, with radiation of pain to the groin, pelvis, hips, thighs, neck shoulder, chest and ribs; hence, these two claims will be discussed together. For reasons that will be discussed below, this appeal is remanded to the AOJ for further development and adjudication. 1. Entitlement to a compensable disability rating for the period prior to March 29, 2016 and in excess of 10 percent thereafter, for right ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs, is remanded. 2. Entitlement to increased rating for left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs, currently rated at zero percent disabling, is remanded. The Veteran contends that a higher rating for his right and left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs is warranted. See October 20, 2014, Notice of Disagreement (NOD). The Veteran was last afforded a VA Peripheral Nerve Conditions examination to evaluate the severity of his disability in March 2016. See March 29, 2016 VA Peripheral Nerve Conditions examination. At his January 2021 Board hearing, the Veteran testified that that his right and left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs had worsened since his last March 2016 VA examination. See Board Hearing transcript, pgs. 4-6. The Veteran testified that he is treated by a pain specialist (Dr. Sheehan) for his right and left inguinal neuritis disability. The Veteran testified that a private practice physician (Dr. Master) also works with him. The Veteran testified that as a result of his disability, he has numbness through arms, sharp pain going up to his chest area and more sharp pain going down to his legs and knees. The Veteran testified that his hips are always in excruciating pain. The Veteran testified that because of his disability, it hurts to sit and to use the bathroom. The Veteran testified that he takes oral morphine 4 times a day for his condition and that he cannot participate in any physical therapy. At this Board hearing, the Veteran described his right and left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs as severe. Id. at pgs. 3-5. The Veteran has also submitted a February 2021 Peripheral Nerve Conditions Disability Benefits Questionnaire (DBQ) completed by the Veteran's pain medicine specialist (Dr. Sheahan) who diagnosed the Veteran with chronic pain syndrome, neurologic neuritis and complex regional pain syndrome. This pain specialist reported that the Veteran is in constant, severe pain despite numerous interventional procedures, a spinal cord stimulator, etc. See February 18, 2021 Peripheral Nerve Conditions DBQ; See also, April 1, 2016 Peripheral Nerve Conditions DBQ (Dr. Sheahan). Here, the Board is reminded that 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. See Caffrey v. Brown, 6 Vet. App. 377 (1994); Snuffer v. Gober, 10 Vet. App. 400 (1997). Thus, as the record indicates a potential worsening of the Veteran's condition since the last examination, based on the Veteran's January 2021 Board Hearing testimony and the February 2021 Peripheral Nerve Conditions Disability Benefits Questionnaire (DBQ), and that his last VA Peripheral Nerve Conditions examination was five years ago (March 2016), a new VA examination should be obtained on remand. Accordingly, these matters are REMANDED for the following action: 1. Provide the Veteran with an opportunity to identify any outstanding relevant private or VA treatment records, including private treatment records from Dr. Sheahan and Dr. Master. After obtaining any necessary authorizations from the Veteran, attempt to obtain the outstanding records in accordance with 38 C.F.R. § 3.159. 2. Next, the AOJ shall arrange an examination by an appropriate examiner to determine the current extent and severity of the Veteran's right and left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs. The examination shall include examining for any neurological manifestations, and all indicated diagnostic tests should be conducted. The examiner should state whether there is "mild," "moderate," or "severe" incomplete paralysis associated with any peripheral nerve associated with the Veteran's service connected right and left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs. All functional limitations resulting from the service-connected right and left ilio-inguinal neuritis, with radiation of pain to groin, pelvis, hips, thighs, neck, shoulder, chest and ribs, at issue in this appeal, should be described by the examiner. The Veteran's lay reported symptomatology must be considered. The examiner is invited to review the February 18, 2021 Peripheral Nerve Conditions DBQ completed by the Veteran's pain medicine specialist (Dr. Sheahan). (Continued on next page.) 3. After completing any other development that may be warranted, readjudicate the claims on appeal. If the benefits sought are not granted, the Veteran and his representative must be furnished a SSOC and afforded a reasonable opportunity to respond before the record is returned to the Board for further review. Michael A. Pappas Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Little, 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.