Citation Nr: 21042446 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 08-06 579A DATE: July 13, 2021 REMANDED Entitlement to separate rating for boils of the buttocks is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1986 to February 1989. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2008 rating decision of a Department of Veteran's Affairs (VA) Regional Office (RO). The Board remanded the claims for further development in July 20012 and March 2017. The claims were denied in a March 2018 Board decision, which the Veteran appealed to the Court of Appeals for Veterans Claims (Court). In December 2018, the Court granted a Joint Motion for Partial Remand as to the claims on appeal. The Board again denied the claims in a June 2019 decision, which the Veteran also appealed. The Court granted a Joint Motion for Remand in March 2020. The Board remanded the appeal for further development in June 2020 and March 2021. 1. Entitlement to separate rating for boils of the buttocks is remanded. The Board sincerely regrets the additional delay; however, another remand is necessary. In this regard, while April 2021 VA examiner opined that the Veteran's recurrent boils of the buttocks were manifestations of his steatocystoma multiplex, his rationale was primarily based on speculation and he did not sufficiently address the conflicting opinions of record, as specifically requested in the prior remand. Accordingly, the Board finds that the opinion is inadequate, and an addendum opinion is needed on remand. Stegall v. West, 11 Vet. App. 268, 271 (1998). Moreover, this opinion should be obtained from a Veterans Health Administration (VHA) expert pursuant to 38 C.F.R. § 20.906(a), as the issue under consideration requires medical expertise for equitable disposition of the appeal. 2. Entitlement to a TDIU is remanded. The Board finds that the Veteran's claim for TDIU is inextricably intertwined with the claim above and must be remanded as well. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that where a claim is inextricably intertwined with another claim, the claims must be adjudicated together in order to enter a final decision on the matter). Furthermore, the Board notes that the Veteran reported that he would be retiring on April 31, 2021. See April 2021 VA Form 21-4138. Therefore, the Veteran should be asked to submit an updated VA Form 21-8940 in support of his claim. The matters are REMANDED for the following action: 1. Request that the Veteran complete and return VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability. 2. Then obtain a medical opinion from a VHA dermatologist pursuant to 38 C.F.R. § 20.906(a) addressing the etiology of the Veteran's recurrent boils of the buttocks. The entire claims file should be made available to the examiner. Following a review of the claims file, the examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's recurrent boils of the buttocks are: (a) symptoms or manifestations of steatocystoma multiplex and/or perianal cyst; or (b) are a separate and distinct condition apart from steatocystoma multiplex and/or perianal cyst. In addressing these questions, the examiner should discuss the following: The Veteran's report during a December 2011 VA examination that his recurrent boils are due to a past perianal cyst removal procedure. The September 2016 VA opinion indicating that the Veteran's recurrent boils are related to his perianal abscess. The September 2020 VA treatment record in which the Veteran denied prior treatment for buttock boils and the dermatologist stated they were "likely separate entity compared to steatocystoma multiplex." The October 2020 VA opinion indicating that the boils of the buttocks are related to his perianal cyst and are manifestations of steatocystoma multiplex. The April 2021 VA opinion indicating that the boils of the buttocks are manifestations of steatocystoma multiplex. Please address parts (a) and (b) separately. A complete rationale should be given for all opinions and conclusions expressed. If the examiner is unable to render an opinion without resorting to speculation, supporting rationale for that conclusion should be furnished. S. S. MAHONEY Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lee Feldman, 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.