Citation Nr: 25005751 Decision Date: 04/28/25 Archive Date: 04/28/25 DOCKET NO. 20-08 674A DATE: April 28, 2025 REMANDED Entitlement to a total disability rating for individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1969 to March 1973. This matter is before the Board of Veterans' Appeals (Board) on appeal from a June 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in June 2023. A transcript of the hearing is of record. This matter was previously before the Board in April 2024 when it was remanded for further development. Entitlement to TDIU is remanded. Although the additional delay is regrettable, the Board finds an additional remand is needed before a decision can be made on the Veteran's claim. In December 2024, the Veteran underwent a VA PTSD examination. On the report, the examiner indicated that the Veteran is retired. It was noted that the Veteran had become very forgetful recently and that he could no longer drive or use household appliances due to safety concerns related to his memory loss. It was noted that the Veteran had been prescribed medication for his memory loss/dementia. The examiner indicated that the Veteran's symptoms include distressing dreams and memories, flashbacks, avoidance of external reminders, persistent negative emotional state, markedly diminished interest or participation in significant activities, exaggerated startle response, feelings of detachment or estrangement from others, irritable behavior, hypervigilance, problems with concentration, chronic sleep impairment, anxiety, and disturbances of motivation and mood. He denied experiencing suicidal or homicidal ideation. The examiner estimated that the Veteran's condition resulted in occupational and social impairment with reduced reliability and productivity. The examiner also provided an individual unemployability statement, indicating that the Veteran has significant difficulty remembering instructions and details of work assignments, that his sleep is so disrupted that he is usually fatigued at work, making concentration and focus on work assignments difficult; and that he has other mental health symptoms that interfere significantly with his ability to work. The only rationale provided for this opinion was "retired. Symptoms of memory loss/dementia with safety concerns." After review of the examination report, the Board finds it is not entirely clear whether the Veteran's service-connected PTSD alone, and without consideration of symptoms associated with the nonservice-connected dementia, renders him unable to secure and follow substantially gainful employment. In light of this, the Board finds remand for a medical opinion necessary. The matter is REMANDED for the following action: Forward the Veteran's claims file to an appropriate clinician for a medical opinion concerning the functional effects of the Veteran's service-connected PTSD. The need for an interview of the Veteran is left to the discretion of the clinician. Following a review of the claims file, the examiner is asked to identify all limitations or functional impairment caused solely by the Veteran's PTSD. In proffering the opinion, the clinician must take into consideration the Veteran's level of education, special training, and previous work experience, but not age or any impairment caused by nonservice-connected disabilities, including dementia. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.J. 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.