Citation Nr: 23054421 Decision Date: 09/29/23 Archive Date: 09/29/23 DOCKET NO. 20-08 011 DATE: September 29, 2023 REMANDED Entitlement to a rating in excess of 30 percent for post-traumatic stress disorder (PTSD), is remanded. Entitlement to service connection for a skin condition, claimed as seborrheic dermitis, is remanded. Entitlement to service connection for a left knee disability, to include as secondary to a right knee disability, is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU), is remanded. REASONS FOR REMAND The Veteran had active service from July 1986 to August 2002. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In November 2020, the Veteran testified in a hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that proceeding is of record. Increased Rating - PTSD The Veteran maintains that his service-connected PTSD disability warrants an initial rating in excess of the currently assigned 30 percent. See November 2020, Hearing Transcript. During the hearing before the Board, the Veteran also testified that his symptoms have worsened since the date of his last VA examination. The Board notes that the Veteran's last examination administered in relation to the instant claim was completed in January 2018, over five and half years ago. Based upon the Veteran's assertion of the severity of his disability, and considering the time that has passed since the date of the last examination, the Board finds that a new VA examination is necessary. See, e.g., Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994). Service Connection - Skin Condition The Veteran argues that he has a diagnosed skin condition of seborrheic dermatitis that began during active service and has continued ever since then. The Board finds that service treatment records (STRs) confirm that the Veteran was treated during service for a skin condition, initially diagnosed as seborrheic dermatitis. See March 1987, STRs. Given the Veteran's assertion of ongoing experience of such condition, along with the documentation in service, the Board finds that a VA examination is required. See McLendon 20 Vet. App. at 79; 38 C.F.R. § 3.159 (c)(4)(i). The Board finds that the current medical evidence of record is otherwise insufficient for evaluating the current status and existence of the disability and otherwise analyze its etiology. Accordingly, a remand is necessary to afford the Veteran a VA examination in relation to this claim. Service Connection - Left Knee Disability During his hearing before the Board, the Veteran presented an argument that his claimed left-knee disability is secondary to his service-connected right knee disability, either as proximately due to, or aggravated beyond its natural progression from the right knee condition. See November 2020, Hearing Transcript. Given the argument for secondary service connection, the documented left knee disability, and the documented bilateral knee complaints during active service, the Board finds that a VA examination is necessary to evaluate the claim. Accordingly, a remand is necessary to afford the Veteran a VA examination in relation to the instant claim. See McLendon 20 Vet. App. at 79; 38 C.F.R. § 3.159 (c)(4)(i). Entitlement to TDIU The Board finds that the issue of entitlement to a TDIU is inextricably intertwined with the claim for increase and the remanded claims for service connection. Therefore, adjudication of this issue must be remanded for further consideration following the ordered development. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). These matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Schedule the Veteran for a VA examination to evaluate the severity of his service-connected PTSD disability throughout the period on appeal. The examiner is requested to review all pertinent records associated with the electronic claims file. All appropriate, studies, tests, and evaluations deemed necessary by the examiner should be performed. After a review of the claims file, 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. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran's claimed left knee disability. The claims file must be made available to, and reviewed by the examiner All tests deemed necessary should be conducted and the results reported in detail. The examiner should provide the following opinions: Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's left knee disability is etiologically related to his active service? Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's claimed left knee disability is caused or aggravated by a service-connected disability, to include as secondary to his service-connected right knee disability and any altered gait and/or body mechanics caused by such? A complete and detailed rationale must be provided for all opinions expressed. 4. Then, forward the Veteran's claims file to an examiner with the appropriate expertise to provide an opinion regarding the nature and etiology of any diagnosed skin condition. The examiner must review the claims file and note that review in their report. Based on the review of the record, the examiner is asked to provide the following medical opinions: Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran has a skin disability that is etiologically related to his active service? The examiner is asked to specifically consider whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the skin condition treated during active service, has continued. 5. Confirm that the VA examination report and all medical opinions provided comport with this remand, and undertake any other development found to be warranted. 6. Conduct any additional development determined to be warranted to adjudicate the issue of entitlement to a TDIU. 7. Then, readjudicate the remaining claims on appeal. If any decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Sutherell, Associate 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.