Citation Nr: 1323192 Decision Date: 07/19/13 Archive Date: 07/24/13 DOCKET NO. 10-03 874 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Detroit, Michigan THE ISSUES 1. Entitlement to service connection for a low back disability. 2. Entitlement to service connection for a bilateral shoulder disability. 3. Entitlement to service connection for a bilateral knee disability. 4. Entitlement to a disability rating in excess of 20 percent for post-operative synovitis of the right hip. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Evan M. Deichert, Counsel INTRODUCTION The Veteran served on active duty from April 1961 to September 1962. This matter is before the Board of Veterans' Appeals (Board) on appeal of a rating decision of May 2009 of the Detroit, Michigan, Department of Veterans Affairs (VA) Regional Office (RO) that increased the Veteran's rating for his right hip from 10 percent to 20 percent and denied his claims for service connection. In August 2012, the Board remanded the case for further development. The appeal is, again, REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND In his April 2009 VA examination, the Veteran stated that he underwent an MRI at a VA facility 1993 that revealed he suffered from degenerative disc disease throughout the lumbar and cervical spine. In its August 2012 remand, the Board directed that these records be obtained. Though VA did attempt to obtain these records, it appears they did not inquire with the appropriate facility. The VA attempted to obtain these records from VA facilities in Michigan; in his October 2012 VA examination, however, the Veteran stated that he actually received this treatment in New Orleans, Louisiana. On remand, further attempts must be undertaken to obtain these records. Further, the Veteran contends that each of his claimed disabilities is secondary to his service-connected post-operative synovitis of the right hip. In its August 2012 remand, the Board directed the Veteran to undergo a VA examination and to have the examiner address specific questions regarding the etiology of the Veteran's claimed disabilities. The examiner's response to the Board's questions is inadequate; the Veteran must be afforded a new examination to determine the current nature and etiology of his claimed conditions. Accordingly, the case is REMANDED for the following actions: 1. Obtain the Veteran's medical records from VA facilities in New Orleans, Louisiana, including his 1993 MRI reports. 2. Schedule the Veteran for a VA examination by an appropriate medical professional (but not the examiner who performed the October 2012 examination) to determine the nature and etiology of his claimed back, shoulder, and knee disabilities. The entire claim file (i.e., the paper claim file and any medical records contained in Virtual VA, CAPRI, and AMIE) must be reviewed by the examiner. If the examiner does not have access to Virtual VA, any relevant treatment records contained in the Virtual VA file that are not available on CAPRI or AMIE must be printed and associated with the paper claim file so they can be available to the examiner for review. The examiner is to answer the following questions: a) What low back, bilateral shoulder, and bilateral knee disabilities are diagnosed? b) Is it at least as likely as not (a 50 percent or greater probability) that any identified back, shoulder, or knee disabilities are related to or had their onset in the Veteran's active service? In answering this question, the examiner must address the Veteran's August 1961 fall and his subsequent complaints of right hip and knee pain. c) Is it at least as likely as not a 50 percent or greater probability) that any identified back, shoulder, or knee disabilities are secondary to the Veteran's service-connected right hip disability? That is, is any identified back, shoulder, or knee disability proximately due to or the result of his service-connected hip disability. Or has there been any increase in the severity of any identified back, shoulder, or knee disability that is proximately due to or the result of the Veteran's right hip disability? The examination report must include a complete rationale for all opinions expressed. If the examiner feels that the requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 3. Then, readjudicate the appeal. If any of the benefits sought remain denied, issue a Supplemental Statement of the Case and return the case to the Board. The appellant has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ RONALD W. SCHOLZ Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).