Citation Nr: 22015240 Decision Date: 03/16/22 Archive Date: 03/16/22 DOCKET NO. 16-32 851 DATE: March 16, 2022 REMANDED Entitlement to an initial evaluation in excess of 30 percent prior to August 7, 2021, for multiple sclerosis (MS) is remanded. Entitlement to an initial evaluation in excess of 50 percent, to include an earlier effective date for the grant of service connection, for speech and swallowing impairment as residuals of MS is remanded. Entitlement to an initial evaluation in excess of 20 percent, to include an earlier effective date for the grant of service connection, for bladder impairment as a residual of MS is remanded. Entitlement to an initial evaluation in excess of 10 percent, to include an earlier effective date for the grant of service connection, for bowel impairment as a residual of MS is remanded. Entitlement to an evaluation in excess of 30 percent for sleep impairment combined with asthma, to include an earlier effective date for the grant of service connection for sleep impairment, as residuals of MS is remanded. Entitlement to an initial evaluation in excess of 30 percent, to include an earlier effective date for the grant of service connection, for right upper extremity impairment as a residual of MS is remanded. Entitlement to an initial evaluation in excess of 20 percent, to include an earlier effective date for the grant of service connection, for left upper extremity impairment as a residual of MS is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1997 to November 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from Department of Veterans Affairs (VA) Regional Office (RO)'s rating decision issued in July 2014. The Board previously remanded the issues for further development in July 2021. The case has now been returned to the Board for appellate review. During the pendency of appeals, the Veteran was service-connected for speech and swallowing impairment, bladder impairment, bowel impairment, sleep impairment (combined with asthma for rating purpose explained below), and left upper extremity impairment, as residuals of MS. These awards of service connection arose as part of the claim of increased rating for MS. And the Veteran has not indicated satisfaction with any of the awards of increased or separate disability ratings for residuals of MS. Therefore, the issues remain on appeal and are considered as part and parcel of the claim of increased rating for MS. 38 C.F.R. § 4.124a. See also AB v. Brown, 6 Vet. App. 35 (1993). 1. Entitlement to an initial evaluation in excess of 30 percent prior to August 7, 2021, for multiple sclerosis (MS) is remanded. 2. Entitlement to an initial evaluation in excess of 50 percent, to include an earlier effective date for the grant of service connection, for speech and swallowing impairment as residuals of MS is remanded. 3. Entitlement to an initial evaluation in excess of 20 percent, to include an earlier effective date for the grant of service connection, for bladder impairment as a residual of MS is remanded. 4. Entitlement to an initial evaluation in excess of 10 percent, to include an earlier effective date for the grant of service connection, for bowel impairment as a residual of MS is remanded. 5. Entitlement to an evaluation in excess of 30 percent for sleep impairment combined with asthma, to include an earlier effective date for the grant of service connection for sleep impairment, as residuals of MS is remanded. 6. Entitlement to an initial evaluation in excess of 30 percent, to include an earlier effective date for the grant of service connection, for right upper extremity impairment as a residual of MS is remanded. 7. Entitlement to an initial evaluation in excess of 20 percent, to include an earlier effective date for the grant of service connection, for left upper extremity impairment as a residual of MS is remanded. 8. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. A review of the claims file indicates that the Veteran moved to Spain in 2017 due to her work as a government contractor and obtained community care in Rota, Spain via Department of Defense in addition to care at VA while her stay in Spain. And then, she moved back to the U.S. in 2020. She reports that she stopped working in 2020 shortly prior to leaving Spain. Moreover, the Veteran stated in January 2022 that she had not received VA Form 21-8940 and indicates that she had some of the residuals of MS earlier than the assigned effective date in August 2021 and she is entitled to TDIU because "in [her] line of work, it could be more harmful than good remaining in [her] current field of work and many other fields that [she] may be qualified for." Upon remand, the agency of original jurisdiction (AOJ) must obtain medical treatment records from 2017 to 2020 while the Veteran worked as a contractor for Department of Defense in Rota, Spain. Moreover, the AOJ must send a VA Form 21-8940 to the Veteran at her current address. The matters are REMANDED for the following action: 1. Obtain the Veteran's outstanding VA treatment records. 2. Obtain the Veteran's medical records from the Department of Defense hospital in Rota, Spain while she worked as a government contractor there from 2017 to 2020, if necessary, with release authorization (authorization is not required for federal records). Document all requests for information as well as all responses in the claims file. 3. Ask the Veteran to complete a VA Form 21-4142 for any private facilities from which she has obtained treatment for her multiple sclerosis. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. (Continued on the next page) 4. Send the Veteran a VA Form 21-8940 to complete her claim for TDIU. The Veteran is also invited to submit information from the Social Security Administration listing her employment income over the years so VA may better assess the economic component of TDIU. 5. Readjudicate the claims. Emily Tamlyn Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Y. Taylor 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.