Citation Nr: 1328478 Decision Date: 09/06/13 Archive Date: 09/16/13 DOCKET NO. 11-21 998 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to a compensable evaluation for a laceration of the right index finger. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD K. L. Wallin, Counsel INTRODUCTION The Veteran served on active duty from October 1971 to January 1992. This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from a July 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The RO, in pertinent part, denied claims for increased evaluations for the service-connected laceration of the right index finger and left varicocelectomy. The Veteran appealed the denials and a statement of the case was issued in June 2011, which addressed both claims. In his August 2011 VA Form 9, Appeal to the Board, the Veteran indicated that he was no longer appealing the claim for increase for a left varicocelectomy. As such, the matter is no longer in appellate status. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the Veteran if further action is required. REMAND A preliminary review of the record discloses the matter is not ready for appellate disposition. The Board has determined that additional evidentiary development is necessary. The record compiled for appellate review of this matter appears incomplete. The Veteran has indicated that he takes daily medication for his right index finger and receives physical therapy once to twice a week to keep functioning in his hand. Physical therapy notes and prescription records have not been associated with the claims folder. An attempt must be made to obtain medical records identified by the Veteran to fully assist him with his claim. 38 C.F.R. § 3.159(c)(1). The Veteran contends that his laceration of the right index finger has worsened in severity. See VA Form 9 received in August 2011. Specifically, he asserts that the disability is productive of visible scarring of the index finger, permanent flexion of the tip of his finger, loss of range of motion, and pain. He further contends that he has decrease in dexterity and limited fine motor skills that affects his job performance. See Notice of Disagreement received in September 2009. The last VA examination was in June 2009, over four years ago. The Board cannot ascertain to what extent the right index finger has increased in severity, if at all, without a new VA examination. The Board is not free to substitute its own judgment for that of such an expert. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Further, where there is evidence of a material change in the Veteran's condition or as in the instant case, when the Veteran asserts that the service-connected disability in question has undergone an increase in severity since the time of his last VA examination, the prior VA examination report may be inadequate for rating purposes and a new VA examination is required. 38 C.F.R. § 3.327(a); See Snuffer v. Gober, 10 Vet. App. 400, 402-03 (1997). Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested.) 1. Ask the Veteran to provide releases for VA to obtain records of any prescription medication taken and any physical therapy treatment for the right index finger and then request the identified private records directly from the provider. All requests for records and their responses must be associated with the claims folder. 2. After completion of the foregoing, schedule the Veteran for a VA examination to ascertain the severity of his laceration of the right index finger. The Veteran's entire claims file (i.e. the paper claims file and any medical records contained in Virtual VA, VBMS, CAPRI, and AMIE) must be available for review by the examiner. If the examiner does not have access to Virtual VA or VBMS, any relevant treatment records in Virtual VA or VBMS that are not available on CAPRI or AMIE must be printed and associated with the paper claims file so they can be available to the examiner for review. All indicated tests or studies must be completed. a) Examination findings pertinent to the right index finger should be reported to allow for application of VA rating criteria for musculoskeletal disabilities of individual and multiple digits of the hand. Range of motion should be reported along with the point (in degrees) that motion is limited by additional function loss due to pain, weakness, fatigue or incoordination. The examiner should perform repetitive range of motion testing and also comment on the degree of limitation of function, if any, due to pain, weakness, lack of endurance, fatigue, or incoordination. b) The examiner should describe the scar of the index finger in detail, to include whether the scar is deep (one associated with underlying soft tissue damage), superficial (one not associated with underlying soft tissue damage), unstable (frequent loss of covering of the skin over the scar), painful on examination, causes limited motion (describe the area affected), and/or limits the function of the right index finger. c) The examiner should also ascertain whether or not the Veteran has any neurological manifestations of his laceration of the right index finger (if a neurological consultation is deemed necessary, such should be arranged) and, if so, describe their nature, severity and comment on any associated impairment of function. The examiner should identify any neurological impairment found by indicating the nerve affected and indicating the degree of any such involvement and describing any related impairment of function. d) Please discuss the functional limitations, if any, associated with, and expected effect on employment resulting from the Veteran's service connected laceration of the right index finger alone (not including the effects of any non-service connected disabilities). 3. In the interest of avoiding further remand, ensure that the requested actions have been accomplished (to the extent possible) in compliance with this REMAND. 4. After completing the requested actions, and any additional notification and/or development deemed warranted, the RO should readjudicate the issue in light of all evidence of record and should consider whether a total rating for compensation based on individual unemployability (TDIU) is warranted. Rice v. Shinseki, 22 Vet. App. 447 (2009). If any benefit sought on appeal remains denied, the RO must furnish to the Veteran and his representative with an appropriate supplemental statement of the case and afford a reasonable opportunity for response. The Veteran has the right to submit additional evidence and argument on the matter or 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). _________________________________________________ MILO H. HAWLEY 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).