Citation Nr: 22014206 Decision Date: 03/11/22 Archive Date: 03/11/22 DOCKET NO. 14-04 718 DATE: March 11, 2022 REMANDED Entitlement to an initial rating in excess of 30 percent for the service-connected anxiety disorder not otherwise specified, also claimed as posttraumatic stress disorder (PTSD) and manic depression (hereinafter, "anxiety disorder") is remanded. Entitlement to service connection for a nerve disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1966 to April 1968. The claims were most recently before the Board in January 2019 when they were remanded for additional development. There has not been substantial compliance with the Board's remand directives and the claims must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to an initial rating in excess of 30 percent for the service-connected anxiety disorder is remanded. 2. Entitlement to service connection for a nerve disorder is remanded. The claim must be remanded again because it is unclear whether the Veteran was properly notified of prior VA examinations. Pursuant to the prior remand, the Veteran was scheduled for examinations in January 2019 and there is notation in the record that he failed to appear for the examinations. In March 2022 the Veteran's representative indicated that there was no objective evidence of record that the Veteran was timely notified of the date, time, and location of the examinations. Review of the claims file does not show a letter notifying the Veteran of the date, time, and location of any scheduled examinations. Moreover, there is no correspondence from the Veteran indicating that he cancelled or refused to report for any scheduled examinations. The Board is mindful of the provisions of 38 C.F.R. § 3.655 regarding action to be taken when a Veteran fails to report for a scheduled VA examination. In this case, however, it is unclear whether the Veteran was properly notified of the examination. Therefore, the Veteran must be afforded another opportunity to appear for VA examinations. The Board reminds the Veteran that the "duty to assist is not always a one-way street." A Veteran is expected to cooperate in the efforts to adjudicate the claim, and his failure to do so would subject him to the risk of an adverse adjudication based on an incomplete and underdeveloped record. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). Evidence indicates that there may be outstanding relevant VA treatment records. VA treatment records indicate that the Veteran receives medical treatment from VA. However, the last VA treatment record associated with the file are from November 2015. Any outstanding records must be obtained on remand. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from November 2015 to the present. 2. Scheduled the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the current severity of his service-connected anxiety disorder. The examiner should identify all current manifestations of this service-connected disorder. The examiner should also opine on the current degree of occupational and social functioning associated with this disorder. The examiner must complete the corresponding VA disability benefits questionnaire (DBQ), provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The Veteran should be notified that it is his responsibility to report for a scheduled examination. In the event that the Veteran does not report for any scheduled examination, documentation which shows that notice scheduling the examination was sent to the last known address should be associated with the claims file. It should also be noted whether any notice that was sent was returned as undeliverable. 3. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the nature and etiology of his nerve condition. The claims file must be made available to the examiner for review of the case. Electromyography (EMG) studies should be conducted as well as any other tests and studies deemed necessary. All examination findings, along with the complete rationale for all opinions expressed, should be set forth in the examination report. After reviewing the claims folder and examining the Veteran the examiner must: a.) Identify/diagnose all current nerve disorders. In doing so, the examiner must reconcile the inconsistencies between the July 2007 VA EMG which showed a mild left median sensory neuropathy with the clinical findings on the January 2016 VA examination that showed that the Veteran did not have symptoms attributable to a peripheral nerve condition. The examiner also must address whether the Veteran has a nerve condition that was manifested by the bilateral nerve root lesion at the mid and low neck level shown on the July 2007 EMG. b.) For each identified neurological disorder the examiner should provide an opinion as to whether itis at least as likely as not (50 percent probability or more) that it was incurred during service, to include the Veteran's in-service exposure to Agent Orange as well as other chemicals that the Veteran claims he was exposed to in Vietnam. See Veteran's November 2011 statement asserting that his nerves were "shot" due to his exposure to Agent Orange and other chemicals to include nerve gas in Vietnam. The examiner also is asked to address the Veteran's contentions of having nerve damage in service. See, e.g., February 2013 notice of disagreement whereby the Veteran stated that during service in Vietnam he incurred nerve damage when he was thrown off a truck that hit a mine. The examiner is advised that the Veteran is competent to report his symptoms and history and that such reports must be acknowledged and considered in formulating any opinion. A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge; the examiner's own expertise, or; whether additional facts are required and note what, if any, additional evidence would permit such an opinion to be made. The Veteran should be notified that it is his responsibility to report for a scheduled examination. In the event that the Veteran does not report for any scheduled examination, documentation which shows that notice scheduling the examination was sent to the last known address should be associated with the claims file. It should also be noted whether any notice that was sent was returned as undeliverable. M.E. LARKIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Robert J. Burriesci, 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.