Citation Nr: 22013372 Decision Date: 03/09/22 Archive Date: 03/09/22 DOCKET NO. 11-06 070 DATE: March 9, 2022 REMANDED Entitlement to an evaluation in excess of 50 percent for an adjustment disorder with mixed emotional features is remanded. Entitlement to a total disability evaluation based upon individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1987 to August 2007. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2008 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), which is the Agency of Original Jurisdiction (AOJ). In that rating decision, the RO granted service connection for an adjustment disorder and assigned a 10 percent evaluation, effective from September 1, 2007. The Veteran appealed the initial evaluation. In January 2016, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. In an April 2016 rating decision, the RO increased the evaluation for an adjustment disorder to 50 percent, effective from November 18, 2015. Because that evaluation is less than the maximum award allowed under VA law and regulations, the claim for an increased evaluation remained on appeal. AB v. Brown, 6 Vet. App. 35, 38 (1993). In June 2016, the Board remanded the case to the AOJ for further development. That development was completed, and the case has since been returned to the Board for appellate review. The Board notes that the appeal also originally included the issues of entitlement to service connection for carpal tunnel syndrome of the left wrist; a left wrist disorder other than carpal tunnel syndrome, to include tendonitis; and hyperhidrosis. However, following the remand, the AOJ granted those claims. Specifically, the AOJ granted service connection for left wrist carpal tunnel syndrome in a July 2016 rating decision, hyperhidrosis in a January 2017 rating decision, and deQuervain's syndrome of the left wrist in a July 2017 rating decision. The grant of service connection constitutes a full award of the benefits sought on appeal. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). Thus, those matters are no longer in appellate status. See Grantham, 114 F.3d at 1158 (holding that a separate notice of disagreement must be filed to initiate appellate review of "downstream" elements such as the disability rating or effective date assigned). In July 2017 and August 2017 rating decisions, the AOJ increased the evaluation for an adjustment disorder to 50 percent, effective from September 1, 2007. Nevertheless, the issue remains in appellate status, as the maximum schedular rating has not been assigned. AB v. Brown, 6 Vet. App. 35, 38 (1993). In addition, in a July 2017 letter, the Veteran asserted that she was unable to work due to her service-connected adjustment disorder. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the United States Court of Appeals for Veterans Claims (Court) held that a claim for TDIU is part and parcel of an increased rating claim when such a claim is raised by the record. Therefore, the issue of entitlement to TDIU is also on appeal. Upon review, the Board finds that further development is needed prior to adjudication of the issue remaining on appeal. The Veteran was most recently afforded a VA examination in February 2016 in connection with her claim; however, in a July 2017 statement, she reported that her adjustment disorder had steadily worsened since that examination. VA's General Counsel has indicated that, when a claimant asserts that the severity of a disability has increased since the most recent rating examination, an additional examination is appropriate. VAOPGCPREC 11-95 (April 7, 1995); see also Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994). In addition, the Veteran has submitted evidence suggesting that her symptoms have increased in severity. See, e.g., April 2021 VA Disability Benefits Questionnaire. Therefore, the Board finds that an additional VA examination is needed to ascertain the current severity and manifestations of the Veteran's service-connected adjustment disorder. In addition, in the April 2021 VA Disability Benefits Questionnaire, the physician noted that the Veteran was currently receiving state disability benefits for a mental disorder and that she had been deemed permanently disabled by her state. However, the claims file does not include state disability records or Social Security Administration (SSA) records, and it does not appear any attempt to obtain those records has been made. Thus, on remand, AOJ should attempt to secure the Veteran's state disability records and any SSA records. Murincsak v. Derwinski, 2 Vet. App. 363, 370 (1992); Golz v. Shinseki, 590 F.3d 1317, 1323 (Fed. Cir. 2010). The matters are REMANDED for the following action: 1. The AOJ should obtain a copy of any decision to grant or deny state disability benefits and SSA disability benefits to the Veteran and the records upon which those decisions were based and associate them with the claims file. If the search for such records has negative results, the claims file should be properly documented as to the unavailability of those records 2. The AOJ should request the Veteran provide the names and addresses of any and all healthcare providers who have provided psychiatric treatment that are not already of record. After acquiring this information and obtaining any necessary authorization, the AOJ should obtain and associate the records with the claims file. The AOJ should also secure any outstanding VA medical records, as well as any outstanding treatment records from a Vet Center. 3. After completing the foregoing development, the Veteran should be afforded a VA examination to ascertain the current severity and manifestations of her service-connected adjustment disorder. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. It should be noted that the Veteran is competent to attest to matters of which she has first-hand knowledge, including observable symptomatology. If there is a clinical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner should report all signs and symptoms necessary for rating the disability under the General Rating Formula for Mental Disorders. The findings of the examiner should address the level of social and occupational impairment attributable to the Veteran's adjustment disorder. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 4. The AOJ should consider whether the Veteran is entitled to TDIU under the provisions of 38 C.F.R. § 4.16, based on impairment attributable to her service-connected disabilities, in accordance with Rice v. Shinseki, 22 Vet. App. 447 (2009). See also See Bradley v. Peake, 22 Vet. App. 280, 293-94 (2008). In so doing, the AOJ may decide to pursue further development of the Veteran's employment history or to obtain additional medical evidence or medical opinion, as is deemed necessary. 5. After completing the above actions, the AOJ should conduct any other development as may be indicated. J.W. ZISSIMOS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Osegueda, 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.