Citation Nr: 22035331 Decision Date: 06/17/22 Archive Date: 06/17/22 DOCKET NO. 18-45 181 DATE: June 17, 2022 REMANDED Entitlement to an initial disability rating in excess of 10 percent for right lower extremity sciatic nerve peripheral neuropathy prior to July 13, 2015, and in excess of 20 percent thereafter, is remanded. Entitlement to an initial disability rating in excess of 10 percent for right lower extremity femoral nerve peripheral neuropathy prior to December 16, 2021, and in excess of 20 percent thereafter, is remanded. Entitlement to an initial disability rating in excess of 10 percent for left lower extremity sciatic nerve peripheral neuropathy prior to July 13, 2015, and in excess of 20 percent thereafter, is remanded. Entitlement to an initial disability rating in excess of 10 percent for left lower extremity femoral nerve peripheral neuropathy prior to December 16, 2021, and in excess of 20 percent thereafter, is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU) due to service-connected disabilities prior to July 13, 2015, to include on an extraschedular basis, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1968 to March 1972. These matters come to the Board of Veterans' Appeals (Board) on appeal from a May 2016 rating decision which, in pertinent part, continued 20 percent evaluations each for right and left lower extremity sciatic nerve peripheral neuropathy, continued 10 percent evaluations each for right and left lower extremity femoral nerve peripheral neuropathy, and denied entitlement to a TDIU. In March 2021, the Veteran testified before the undersigned Veterans Law Judge at a Board hearing. A copy of the transcript is of record. In August 2021, the Board remanded the matters for further development, to include obtaining a VA examination. In a March 2022 rating decision, VA granted increased evaluations of 20 percent each for right and left lower extremity femoral nerve peripheral neuropathy, effective December 16, 2021, and granted entitlement to a TDIU, effective July 13, 2015. As these grants do not represent a maximum grant of the benefits sought on appeal, the issues of entitlement to increased ratings for right and left sciatic and femoral nerve peripheral neuropathy and entitlement to a TDIU prior to July 13, 2015, remain pending before the Board. 1. Entitlement to an initial disability rating in excess of 10 percent for right lower extremity sciatic nerve peripheral neuropathy prior to July 13, 2015, and in excess of 20 percent thereafter. 2. Entitlement to an initial disability rating in excess of 10 percent for right lower extremity femoral nerve peripheral neuropathy prior to December 16, 2021, and in excess of 20 percent thereafter. 3. Entitlement to an initial disability rating in excess of 10 percent for left lower extremity sciatic nerve peripheral neuropathy prior to July 13, 2015, and in excess of 20 percent thereafter. 4. Entitlement to an initial disability rating in excess of 10 percent for left lower extremity femoral nerve peripheral neuropathy prior to December 16, 2021, and in excess of 20 percent thereafter. The Board cannot make a fully-informed decision on the issues of entitlement to increase ratings for bilateral lower extremity sciatic nerve and femoral nerve peripheral neuropathy at this time because it is not clear which symptoms are attributable to the Veteran's sciatic nerve peripheral neuropathy and which are attributable to his femoral nerve peripheral neuropathy. For example, a November 2015 VA peripheral nerves examination report reflects that there was severe constant pain, moderate intermittent pain, severe paresthesias and/or dysesthesias and numbness on the right, moderate paresthesias and/or dysesthesias and numbness on the left, reduced mucle strength and decreased deep tendon reflexes in the knees and ankles, decreased monofilament testing in the knee/thigh, ankle/lower leg, and foot/toes, and decreased position sense and vibration sensation. From this, the examiner diagnosed moderate, incomplete paralysis of the sciatic nerve and mild, incomplete paralysis of the femoral nerve. However, the examiner did not indicate whether each of the Veteran's symptoms were related to his sciatic nerve, his femoral nerve, or both. Because the sciatic and femoral nerves are rated separately, the Board finds that a remand is warranted for clarification whether the Veteran's symptoms are related to his sciatic nerve, his femoral nerve, or both. 5. Entitlement to a total disability rating based upon individual unemployability (TDIU) due to service-connected disabilities prior to July 13, 2015, to include on an extraschedular basis, is remanded. Because a decision on the remanded issues of entitlement to increased ratings for bilateral lower extremity sciatic and femoral nerve peripheral neuropathy could significantly impact a decision on the issue of entitlement to a TDIU prior to July 13, 2015, the issues are inextricably intertwined. A remand of the claim for a TDIU prior to July 13, 2015, is required. Finally, prior to July 13, 2015, the Veteran does not meet the schedular requirements for entitlement to a TDIU. However, the evidence of record reflects the Veteran last worked in 2012 and a December 2021 VA medical opinion reflects the Veteran is unable to perform sedentary work due to his peripheral neuropathy. Given the evidence of record which shows that the Veteran's service-connected disabilities may have impacted his ability to obtain or maintain substantially gainful employment prior to July 13, 2015, the Board finds that a remand is warranted for referral to the Director of Compensation for extraschedular consideration for entitlement to a TDIU. The Board notes that an extraschedular rating cannot be assigned in the first instance without consideration by the Director of Compensation Service. The matters are REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician as to the severity of the Veteran's bilateral lower extremity sciatic and femoral nerve peripheral neuropathy. The examiner must review the claims file. An in-person examination is not required unless deemed so by the examiner. The examiner should 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 examiner should identify the Veteran's symptoms during the September 2014, November 2015, and January 2022 VA examinations and indicate whether the symptoms were attributable to the Veteran's sciatic nerve peripheral neuropathy, femoral nerve peripheral neuropathy, or both. 2. Refer the Veteran's claim of entitlement to a TDIU prior to July 13, 2015, to the Director of Compensation Service for consideration of TDIU on an extraschedular basis. A full statement as to the Veteran's service-connected disability, employment history, educational and vocational attainment, and all other factors having a bearing on the issue should be included. 3. After completing the above, and any other development as may be indicated, the Veteran's claims should be readjudicated based on the entirety of the evidence. If the claims remain denied, the Veteran and his representative should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Owen, 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.