Citation Nr: 22016009
Decision Date: 03/21/22	Archive Date: 03/21/22

DOCKET NO. 16-15 445A
DATE: March 21, 2022

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 June 1974 to June 1977.

The Board regrets the delay associated with this remand.  However, based on a review of the evidence of record, the Board finds that a remand is necessary to allow the Agency of Original Jurisdiction (AOJ) to conduct additional development.

1. Entitlement to a TDIU is remanded.

The Veteran's TDIU claim was most recently remanded in September 2021 for a VA opinion that addressed the combined effect of his service-connected disabilities on his employability and discussed an October 2019 VA opinion.  The Agency of Original Jurisdiction obtained a new VA examination and opinion in November 2021.  The examiner described the impact of the Veteran's bilateral lower extremity disabilities and his right upper extremity disabilities individually but did not discuss their combined effects.  She also failed to address the October 2019 opinion.  In light of these deficiencies, the claim must be remanded for an addendum opinion.  See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Stegall v. West, 11 Vet. App. 268 (1998).

The matters are REMANDED for the following actions:

1. Send the Veteran's claims file to an appropriate clinician for an opinion on his employability.  The examiner must review the entire claims file in conjunction with the opinion.  The Veteran may be recalled for examination if deemed necessary.

The examiner should state whether the Veteran is precluded from substantially gainful employment on account of his service-connected disabilities.  In making this determination, the person should consider the Veteran's education and work history BUT MAY NOT CONSIDER THE VETERAN'S AGE OR ANY IMPAIRMENT CAUSED BY NONSERVICE-CONNECTED DISABILITIES.

The examiner MUST specifically address the following:

(a.) the October 2019 VA examination, wherein the examiner noted under the functional impact that the "veteran is unable to do any significant work due to his cva residuals. NOT his ulnar neuropathy;

(b.) the combined effects of the Veteran's service-connected disabilities (e.g., the requirement that he work in a heated environment for his bilateral lower extremity disabilities and the limitations on the use of his right hand and wrist from his right upper extremity disability), and

(c.) the December 2001 Disability Determination Evaluation noting that he would be limited to part time employment due to "obvious functional disability" of the right arm, prior to his 2013 cerebrovascular accident.

The term "at least as likely as not" does not mean "within the realm of medical possibility."  Rather, it means that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of the conclusion (e.g., etiology) as it is to find against the conclusion.

2. THE AOJ MUST REVIEW THE CLAIMS FILE AND ENSURE THAT THE FOREGOING DEVELOPMENT ACTION HAS BEEN COMPLETED IN FULL.

IF ANY DEVELOPMENT IS INCOMPLETE, APPROPRIATE CORRECTIVE ACTION MUST BE IMPLEMENTED.

IF ANY REPORT DOES NOT INCLUDE ADEQUATE RESPONSES TO THE SPECIFIC OPINIONS REQUESTED, IT MUST BE RETURNED TO THE PROVIDING EXAMINER FOR CORRECTIVE ACTION.

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YVETTE R. WHITE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	M. Moore, 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.