Citation Nr: 18141142 Decision Date: 10/09/18 Archive Date: 10/09/18 DOCKET NO. 16-39 718 DATE: October 9, 2018 ORDER As new and material evidence has not been received, the previously denied claim of service connection for bipolar disorder is not reopened. Entitlement to service connection for a bilateral shoulder disability is denied. Entitlement to service connection for a left elbow disability is denied. Entitlement to service connection for carpal tunnel syndrome of the left wrist is denied. Entitlement to service connection for carpal tunnel syndrome of the right wrist and hand is denied. Entitlement to an initial rating greater than 10 percent for tinnitus is denied. Entitlement to an earlier effective date than November 7, 2013, for a grant of service connection for tinnitus is denied. REMANDED Entitlement to service connection for obstructive sleep apnea is remanded. Entitlement to service connection for headaches is remanded. Entitlement to a compensable disability rating prior to November 5, 2014, and to a disability rating greater than 10 percent thereafter, for right hip limited extension is remanded. Entitlement to an initial rating greater than 10 percent for osteoarthritis of the right hip is remanded. Entitlement to a disability rating greater than 10 percent for right arm limited flexion is remanded. Entitlement to a compensable disability rating for right arm limited extension is remanded. Entitlement to an initial rating greater than 10 percent for right upper extremity ulnar neuropathy is remanded. Entitlement to an initial rating greater than 10 percent for right knee tendonitis is remanded. Entitlement to a disability rating greater than 10 percent for callosities of the right foot is remanded. FINDINGS OF FACT 1. In a rating decision dated on March 21, 2002, and issued to the Veteran and his service representative on March 26, 2002, the Agency of Original Jurisdiction (AOJ) denied, in pertinent part, a claim of service connection for bipolar disorder; this decision was not appealed and became final. 2. The evidence received since the March 2002 rating decision is either cumulative or redundant of evidence previously submitted in support of the Veteran’s claim of service connection for bipolar disorder and does not relate to an unestablished fact necessary to substantiate this claim. 3. The record evidence shows that the Veteran does not experience any current bilateral shoulder disability, left elbow disability, or carpal tunnel syndrome of the left wrist which is attributable to active service and his post-service complaints of left shoulder pain do not result in any functional impairment. 4. The record evidence shows that the Veteran’s current carpal tunnel syndrome of the right wrist and hand is not related to active service. 5. The record evidence shows that the Veteran currently is in receipt of the maximum disability rating available for tinnitus (whether unilateral or bilateral). 6. The record evidence shows that, in a letter dated on October 30, 2013, and date-stamped as received by the AOJ on November 7, 2013, the Veteran filed his original claim of service connection for tinnitus. 7. In the currently appealed rating decision dated on October 1, 2014, the AOJ granted, in pertinent part, the Veteran’s claim of service connection for tinnitus, assigning a 10 percent rating effective November 7, 2013. 8. In statements on a VA Form 21-0958, “Notice of Disagreement,” date-stamped as received electronically by VA on September 16, 2015, the Veteran disagreed with the effective date assigned for the grant of service connection for tinnitus. 9. The record evidence does not indicate that, prior to November 7, 2013, the Veteran filed a formal or informal claim of service connection for tinnitus. CONCLUSIONS OF LAW 1. The March 2002 rating decision, which denied the Veteran’s claim of service connection for bipolar disorder, is final. 38 U.S.C. § 7105 (West 2012); 38 C.F.R. § 20.302 (2017). 2. Evidence received since the March 2002 rating decision in support of the claim of service connection for bipolar disorder is not new and material; thus, this claim is not reopened. 38 U.S.C. § 5108 (West 2012); 38 C.F.R. § 3.156 (2017). 3. The criteria for entitlement to service connection for a bilateral shoulder disability have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304 (2017). 4. The criteria for entitlement to service connection for a left elbow disability have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304 (2017). 5. The criteria for entitlement to service connection for carpal tunnel syndrome of the left wrist have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304 (2017). 6. The criteria for entitlement to service connection for carpal tunnel syndrome of the right wrist and hand have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304 (2017). 7. The claim for an initial rating greater than 10 percent for tinnitus is denied as a matter of law. 38 U.S.C. §§ 1155, 5107 (West 2012); 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.87, Diagnostic Code (DC) 6260 (2017); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). 8. The criteria for entitlement to an earlier effective date than November 7, 2013, for a grant of service connection for tinnitus have not been met. 38 U.S.C. § 5110 (West 2012); 38 C.F.R. § 3.400 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from July 1980 to September 1984. The Board observes that, in a March 2002 rating decision, the AOJ denied, in pertinent part, the Veteran’s claim of service connection for bipolar disorder. The Veteran did not appeal this decision and it became final. See 38 U.S.C. § 7104 (West 2012). He also did not submit any relevant evidence or argument within 1 year of the March 2002 rating decision which would render it non-final for VA adjudication purposes. See Buie v Shinseki, 24 Vet. App. 242, 251-52 (2011) (explaining that, when statements are received within one year of a rating decision, the Board's inquiry is not limited to whether those statements constitute notices of disagreement but whether those statements include the submission of new and material evidence under 38 C.F.R. § 3.156 (b)). The Board does not have jurisdiction to consider a claim that has been adjudicated previously unless new and material evidence is presented. See Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). Therefore, the issue of whether new and material evidence has been received to reopen a claim of service connection for bipolar disorder is as stated above. Regardless of the AOJ’s actions, the Board must make its own determination as to whether new and material evidence has been received to reopen this claim. That is, the Board has a jurisdictional responsibility to consider whether a claim should be reopened. See Jackson v. Principi, 265 F.3d 1366, 1369 (Fed. Cir. 2001). Having reviewed the record evidence, the Board concludes that the remaining issues on appeal should be characterized as stated above. Service Connection The Veteran contends that new and material evidence has been received sufficient to reopen a previously denied claim of service connection for bipolar disorder. He also contends that he incurred a bilateral shoulder disability, a left elbow disability, carpal tunnel syndrome of the left wrist, and carpal tunnel syndrome of the right wrist and hand during active service. Neither the Veteran nor his representative has raised any other issues nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that Board not required to address issues unless specifically raised by claimant or reasonably raised by record evidence). 1. Whether new and material evidence has been received to reopen a claim of service connection for bipolar disorder The Board finds that the preponderance of the evidence is against granting the Veteran’s request to reopen his previously denied claim of service connection for bipolar disorder. Despite the Veteran’s assertions to the contrary, the newly received evidence does not support reopening this previously denied claim. The Board notes initially that claims of service connection may be reopened if new and material evidence is received. Manio v. Derwinski, 1 Vet. App. 140 (1991). The Veteran requested that his previously denied service connection claim be reopened when he submitted a VA Form 21-4138 which was dated on January 13, 2010, and date-stamped as received by the AOJ on January 19, 2010. New and material evidence is defined by regulation. See 38 C.F.R. § 3.156(a). In determining whether evidence is new and material, the credibility of the new evidence is to be presumed. Justus v. Principi, 3 Vet. App. 510, 513 (1992). With respect to the Veteran’s application to reopen the previously denied service connection claim for bipolar disorder, the evidence before VA at the time of the prior final AOJ decision in March 2002 consisted of his service treatment records, post-service VA treatment records, and lay statements. The AOJ essentially found that, although the Veteran had been diagnosed as having and hospitalized for treatment of bipolar disorder since his service separation, there was no medical nexus linking his current bipolar disorder to active service. Thus, the claim was denied. The newly received evidence still does not indicate that the Veteran’s current bipolar disorder is related to active service or any incident of service. The evidence received since March 2002 consists of additional post-service VA and private outpatient treatment records and the Veteran’s lay statements. Although this newly received evidence confirms ongoing complaints of and treatment for bipolar disorder, it does not this disability to active service. In other words, the Board finds that the evidence received since March 2002 is duplicative of evidence previously considered by the AOJ in adjudicating the Veteran’s claim. The Board notes that the United States Court of Appeals for Veterans Claims (Court) held in Shade v. Shinseki, 24 Vet. App 110 (2010), that the phrase “raises a reasonable possibility of substantiating the claim” found in the post-VCAA version of 38 C.F.R. § 3.156(a) must be viewed as “enabling” reopening of a previously denied claim rather than “precluding” it. All of the newly received evidence is presumed credible solely for the limited purpose of reopening the previously denied claim. See Justus, 3 Vet. App. at 513. With respect to the Veteran’s request to reopen his previously denied service connection claim for bipolar disorder, the Board finds that there is no reasonable possibility that the newly received evidence would enable rather than preclude reopening this claim. Unlike in Shade, there is no evidence in this case – either previously considered in the March 2002 AOJ decision, which denied service connection for bipolar disorder, or received since this decision became final – which demonstrates that this disability is related to active service or any incident of service. Thus, the analysis of new and material evidence claims that the Court discussed in Shade is not applicable to the Veteran’s request to reopen his previously denied service connection claim for bipolar disorder. In summary, as new and material evidence has not been received, the previously denied claim of service connection for bipolar disorder is not reopened. 2. Entitlement to service connection for a bilateral shoulder disability, a left elbow disability, and for carpal tunnel syndrome of the left wrist The Board finds that the preponderance of the evidence is against granting the Veteran’s claims of service connection for a bilateral shoulder disability, a left elbow disability, and for carpal tunnel syndrome of the left wrist. The Veteran essentially contends that he incurred each of these claimed disabilities during active service and experienced continuous disability since his service separation. The record evidence does not support his assertions regarding the existence of any current bilateral shoulder disability, left elbow disability, or carpal tunnel syndrome of the left wrist which could be attributed to active service or any incident of service. It shows instead that the Veteran does not experience any current disability due to any of these claimed disabilities and his post-service complaints of pain in the left shoulder do not result in any functional impairment which could be considered a disability. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (holding that functional impairment due to pain alone may constitute a disability for VA adjudication purposes). For example, the Veteran’s available service treatment records show no complaints of or treatment for any of these claimed disabilities at any time during active service. The Board notes that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (finding lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim); Barr v. Nicholson, 21 Vet. App. 303 (2007) ("Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms"). The post-service evidence also does not support granting the Veteran’s claims of service connection for a bilateral shoulder disability, a left elbow disability, and for carpal tunnel syndrome of the left wrist. Contrary to the Veteran’s assertions, it shows instead that he does not experience any current disability due to any of these claimed disabilities which is attributable to active service. The Board notes in this regard that, although the Veteran has complained of and sought treatment for left shoulder pain on multiple occasions since active service, his post-service VA and private outpatient treatment records do not show that he similarly complained of or sought treatment for right shoulder problems since his service separation. As noted elsewhere, the Veteran’s left shoulder pain also does not result in any functional impairment such that left shoulder pain alone may be considered a disability under Saunders. See Saunders, 886 F.3d at 1356. The Board finds it highly significant that the Veteran’s June 2014 left shoulder x rays were normal despite his ongoing complaints of left shoulder pain. The Board also finds it highly significant that the Veteran did not complain of any left elbow disability when examined for VA adjudication purposes in July 2012. The July 2012 VA elbow and forearm conditions Disability Benefits Questionnaire (DBQ) found no left elbow disability present on physical examination of the Veteran’s bilateral upper extremities. This persuasively suggests that the Veteran experienced no left elbow disability at the time of this examination. Subsequent VA outpatient treatment records documented complaints of and treatment for a right elbow disability only and not for a left elbow disability. Similarly, the Board finds it highly significant that the Veteran reported no complaints or relevant medical history of carpal tunnel syndrome of the left wrist when examined for VA adjudication purposes in December 2012. The December 2012 VA peripheral nerves conditions DBQ found no carpal tunnel syndrome of the left wrist present on physical examination of the Veteran’s wrists. This persuasively suggests that the Veteran experienced no carpal tunnel syndrome of the left wrist at the time of this examination. A service connection claim must be accompanied by evidence which establishes that the claimant currently has a disability. Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Service connection is not warranted in the absence of proof of current disability. The Board has considered whether the Veteran experienced a bilateral shoulder disability, a left elbow disability, or carpal tunnel syndrome of the left wrist at any time during the pendency of this appeal. Service connection may be granted if there is a disability at some point during the claim even if it later resolves or becomes asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007). In this case, however, despite the Veteran’s ongoing post-service complaints of left shoulder pain, the record evidence does not show that he experiences any current disability due to his claimed bilateral shoulder disability, left elbow disability, or carpal tunnel syndrome of the left wrist which is attributable to active service or any incident of service. The Veteran finally has not identified or submitted any evidence demonstrating his entitlement to service connection for any of these claimed disabilities. In summary, the Board finds that service connection for a bilateral shoulder disability, a left elbow disability, and for carpal tunnel syndrome of the left wrist is not warranted. 3. Entitlement to service connection for carpal tunnel syndrome of the right wrist and hand The Board next finds that the preponderance of the evidence is against granting the Veteran’s claim of service connection for carpal tunnel syndrome of the right wrist and hand. The Veteran contends that he incurred carpal tunnel syndrome of the right wrist and hand during active service. The record evidence does not support his assertions regarding an etiological link between his current carpal tunnel syndrome of the right wrist and hand and active service. For example, the Veteran’s available service treatment records show that he had right arm surgery for a right triceps muscle injury in August 1983. Clinical evaluation was normal at his separation physical examination in July 1984 prior to his separation from service in September 1984. The Board again notes that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan, 451 F.3d at 1337, and Barr, 21 Vet. App. at 303. The post-service evidence also does not support granting the Veteran’s claim of service connection for carpal tunnel syndrome of the right wrist and hand. Contrary to the Veteran’s assertions, the record evidence shows that his current carpal tunnel syndrome of the right wrist and hand is not related to active service. For example, on VA elbow and forearm conditions DBQ in July 2012, the Veteran’s complaints included intermittent numbness in the right fifth finger. A history of a laceration injury to the right arm with surgical tendon repair was noted. The Veteran reported being diagnosed as having carpal tunnel syndrome of the right wrist. He was right-handed. He also reported right elbow pain “at the end of the day causing difficulty lifting at the end of the day.” He was unable to play basketball. Physical examination showed pain on movement of the right upper extremity, pain on palpation of the joints/soft tissues of the right elbow or forearm, and 5/5 muscle strength. The diagnosis was right elbow pain and paresthesias status-post laceration injury. In February 2013, a VA clinician stated that she had reviewed the Veteran’s claims file and opined that it was less likely than not that the Veteran’s current carpal tunnel syndrome of the right wrist and hand was related to active service. The rationale for this opinion was based on a review of the Veteran’s claims file. The rationale also was that carpal tunnel syndrome “affects the wrist and hand and is unrelated to” the Veteran’s in-service right arm injury. The rationale further was that the Veteran injured his right posterior proximal elbow during active service “with surgical repair tendons reattached” and only experienced decreased sensation from the right posterior elbow to the fifth finger following this in-service injury and surgical repair. The Veteran contends that he incurred his current carpal tunnel syndrome of the right wrist and hand during active service. The record evidence does not support his assertions regarding an etiological link between this current disability and active service. It shows instead that, although the Veteran injured his right arm during active service and currently experiences carpal tunnel syndrome of the right wrist and hand, the latter disability is not related to the former in-service injury and surgical repair. The February 2013 VA clinician specifically opined that it was less likely than not that the Veteran’s current carpal tunnel syndrome of the right wrist and hand was related to active service. This opinion was fully supported. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (finding that a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). The Veteran finally has not identified or submitted any evidence demonstrating his entitlement to service connection for carpal tunnel syndrome of the right wrist and hand. In summary, the Board finds that service connection for carpal tunnel syndrome of the right wrist and hand is not warranted. 4. Entitlement to an initial rating greater than 10 percent for tinnitus The Board finds that the Veteran’s claim of entitlement to an initial rating greater than 10 percent for tinnitus must be denied as a matter of law. The Board notes that, in 2006, the United States Court of Appeals for the Federal Circuit (Federal Circuit) affirmed VA’s long-standing interpretation of DC 6260 as authorizing only a single 10 percent rating for tinnitus, whether perceived as unilateral or bilateral. See Smith v. Nicholson, 451 F.3d 1344 (Fed. Cir. 2006). Citing Supreme Court precedent, the Federal Circuit explained in Smith that an agency’s interpretation of its own regulations was entitled to substantial deference by the courts as long as that interpretation was not plainly erroneous or inconsistent with the regulations. Id. Finding that there was a lack of evidence in the record suggesting that VA’s interpretation of DC 6260 was plainly erroneous or inconsistent with regulations, the Federal Circuit concluded that the Court had erred in not deferring to VA’s interpretation. Id. Given the foregoing, the Board concludes that, because DC 6260 precludes assigning an initial rating greater than 10 percent for tinnitus, the Veteran’s claim for an initial rating greater than 10 percent for tinnitus is denied as a matter of law. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). 5. Entitlement to an earlier effective date than November 7, 2013, for a grant of service connection for tinnitus The Board finds that the preponderance of the evidence is against granting the Veteran’s claim of entitlement to an earlier effective date than November 7, 2013, for the grant of service connection for tinnitus. Despite the Veteran’s assertions to the contrary, the record evidence does not indicate that he filed a formal or informal service connection claim for tinnitus prior to November 7, 2013. It shows instead that his original service connection claim for tinnitus was not received by the AOJ until November 7, 2013, when he submitted a letter in which he discussed this disability. See 38 U.S.C. § 5110(a); 38 C.F.R. § 3.400. It is not clear from a review of the record evidence what earlier effective date for a grant of service connection for tinnitus the Veteran considers appropriate. Nevertheless, the record evidence does not support granting an earlier effective date than November 7, 2013, for service connection for tinnitus. It shows instead that, prior to receipt of his informal service connection claim for tinnitus on November 7, 2013, the record evidence does not show any intent to file a formal or informal claim for this disability. A review of the record evidence shows instead that, prior to this date, the Veteran sought VA disability compensation for multiple orthopedic disabilities and attempted to reopen a previously denied service connection claim for bipolar disorder (as discussed above). In the currently appealed rating decision dated on October 1, 2014, the AOJ granted, in pertinent part, the Veteran’s claim of service connection for tinnitus, assigning a 10 percent rating effective November 7, 2013. The AOJ essentially concluded that November 7, 2013, was the appropriate effective date for the grant of service connection for tinnitus because that was the day that VA received the Veteran’s claim and because an August 2014 VA examiner subsequently related this disability to active service. As noted above, in statements on a VA Form 21-0958, “Notice of Disagreement,” date-stamped as received electronically by VA on September 16, 2015, the Veteran disagreed with the effective date assigned for the grant of service connection for tinnitus. The Board observes here that the effective date for service connection claims generally will be the day following separation from active service or date entitlement arose if the claim is filed within one year of discharge from service; otherwise, the effective date is the date of receipt of claim or date entitlement arose, whichever is later. 38 C.F.R. § 3.400(b)(2)(i). Despite the Veteran’s assertions to the contrary, the record evidence does not indicate an intent to file a service connection claim for tinnitus prior to November 7, 2013, when VA received his informal claim for this disability. It is undisputed that this service connection claim was not filed within 1 year of his discharge from active service in September 1984 (or by September 1985). Instead, the November 7, 2013, letter constituted his informal service connection claim for tinnitus, filed several decades after his service separation. In other words, the date of receipt of the Veteran’s formal service connection claim for tinnitus is November 7, 2013. The evidence otherwise does not suggest an intent to file a service connection claim for tinnitus prior to this date. In summary, the Board finds that the criteria for an earlier effective date than November 7, 2013, for the grant of service connection for tinnitus have not been met. REASONS FOR REMAND 1. Entitlement to service connection for obstructive sleep apnea is remanded. The Veteran contends that he incurred obstructive sleep apnea during active service. The Board notes that, in a letter date-stamped as electronically received by the AOJ on July 23, 2018, the Veteran’s attorney presented additional evidence and argument (along with a waiver of AOJ jurisdiction) concerning this claim. Unfortunately, despite a thorough review of the Veteran’s electronic claims file, the Board is unable to locate any of the “enclosures” referred to in this July 23, 2018, submission. The Veteran’s attorney specifically noted in the July 23, 2018, submission that the attachments included a sleep study showing that the Veteran experienced moderate obstructive sleep apnea and a statement from a private physician that this disability may have been aggravated by a service-connected disability. The record evidence otherwise does not suggest that the Veteran experiences any current disability due to his claimed obstructive sleep apnea. Given the foregoing, the Board finds that, on remand, the AOJ should contact the Veteran and his attorney and advise them to resubmit the evidence previously referred to in July 23, 2018, correspondence and schedule the Veteran for appropriate examination to determine the nature and etiology of his claimed obstructive sleep apnea. 2. Entitlement to service connection for headaches is remanded. The Board acknowledges that the Veteran was examined for VA adjudication purposes in July 2014 in order to determine the nature and etiology of his claimed headaches. Unfortunately, a review of the Veteran’s July 2014 VA headaches DBQ shows that it is inadequate for VA adjudication purposes. Following this examination, the VA examiner opined that it was less likely than not that the Veteran’s currently diagnosed headaches were related to active service. The rationale for this negative nexus opinion was based, in part, on the absence of records noting complaints of and treatment for headaches. The Board again notes that that the absence of contemporaneous records is not fatal to a service connection claim. See Buchanan, 451 F.3d at 1337, and Barr, 21 Vet. App. at 303. Thus, the Board finds that the July 2014 VA headaches DBQ is inadequate for VA disability compensation purposes. See 38 C.F.R. § 4.2 (2017). The Board also finds that, on remand, the Veteran should be scheduled for another examination to determine the nature and etiology of his headaches. 3. Entitlement to a compensable disability rating prior to November 5, 2014, and to a disability rating greater than 10 percent thereafter, for right hip limited extension and to an initial rating greater than 10 percent for osteoarthritis of the right hip is remanded. The Veteran contends that his service-connected right hip limited extension and service-connected osteoarthritis of the right hip are more disabling than currently (or initially) evaluated. The Board notes that, following the Veteran’s most recent VA hip and thigh conditions DBQ in January 2015, the Court issued a decision in Correia mandating new requirements for VA examinations of musculoskeletal disabilities (including disabilities of the right hip, as in this case) in order to satisfy judicial review in increased rating claims. See Correia v. McDonald, 28 Vet. App. 158 (2016). The Court held in Correia that the final sentence of 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive motion, in weight-bearing and non weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. Id.; see also 38 C.F.R. § 4.59. A review of the record evidence shows that the Veteran’s most recent VA examination for the right hip in January 2015 did not comply with Correia. For example, there is no indication in the January 2015 VA hip and thigh conditions DBQ whether the right hip range of motion obtained at that examination is active or passive or in weight-bearing or non-weight-bearing. Accordingly, the Board finds that, on remand, the Veteran should be scheduled for updated VA examination to determine the current nature and severity of his service-connected right hip limited extension and service-connected right hip osteoarthritis. See also Southall-Norman v. McDonald, 28 Vet. App. 346 (2016) (finding 38 C.F.R. § 4.59 not limited to diagnostic codes involving range of motion and extending Correia to disabilities involving painful joint or periarticular pathology). 4. Entitlement to a disability rating greater than 10 percent for right arm limited flexion and to a compensable disability rating for right arm limited extension is remanded. The Veteran contends that his service-connected right arm limited flexion and service-connected limited extension are both more disabling than currently evaluated. As with the Veteran’s increased rating claims for a right hip disability, a review of the record evidence shows that his most recent VA elbow and forearm conditions DBQ in July 2012 does not comply with Correia. For example, there is no indication in the July 2012 VA elbow and forearm conditions DBQ whether the right arm range of motion obtained at that examination is active or passive or in weight-bearing or non-weight-bearing. Accordingly, the Board finds that, on remand, the Veteran should be scheduled for updated VA examination to determine the current nature and severity of his service-connected right arm limited flexion and service-connected right arm limited extension. See Correia, 28 Vet. App. at 158. 5. Entitlement to an initial rating greater than 10 percent for right upper extremity ulnar neuropathy is remanded. The Veteran contends that his service-connected right upper extremity ulnar neuropathy is more disabling than currently (and initially) evaluated. A review of the record evidence shows that the Veteran’s most recent VA peripheral nerves conditions DBQ occurred in December 2012. The Court has held that when a Veteran alleges that his service-connected disability has worsened since he was examined previously, a new examination may be required to evaluate the current degree of impairment. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); but see Palczewski v. Nicholson, 21 Vet. App. 174, 182 (2007) (finding "mere passage of time" does not render old examination inadequate). Given the Veteran's contentions, and given the length of time which has elapsed since his most recent VA examination in December 2012, the Board finds that, on remand, he should be scheduled for an updated VA examination to determine the current nature and severity of his service-connected right upper extremity ulnar neuropathy. 6. Entitlement to an initial rating greater than 10 percent for right knee tendonitis is remanded. The Veteran contends that his service-connected right knee tendonitis is more disabling than currently (and initially) evaluated. As with the other increased rating claims for orthopedic disabilities currently on appeal (discussed above), a review of the record evidence shows that the Veteran’s most recent VA knee and lower leg conditions DBQ in July 2012 does not comply with Correia. For example, there is no indication in the July 2012 VA knee and lower leg conditions DBQ whether the right knee range of motion obtained at that examination is active or passive or in weight-bearing or non-weight-bearing. Accordingly, the Board finds that, on remand, the Veteran should be scheduled for updated VA examination to determine the current nature and severity of his service-connected right knee tendonitis. See Correia, 28 Vet. App. at 158. 7. Entitlement to a disability rating greater than 10 percent for callosities of the right foot is remanded. The Veteran finally contends that his service-connected callosities of the right foot are more disabling than currently evaluated. A review of the record evidence shows that his most recent VA skin diseases DBQ (which evaluated his service-connected callosities of the right foot) occurred in December 2012. As noted above, the Court has held that when a Veteran alleges that his service-connected disability has worsened since he was examined previously, a new examination may be required to evaluate the current degree of impairment. See Snuffer, 10 Vet. App. at 403; but see Palczewski, 21 Vet. App. at 182. Given the Veteran's contentions, and given the length of time which has elapsed since his most recent VA examination in December 2012, the Board finds that, on remand, he should be scheduled for an updated VA examination to determine the current nature and severity of his service-connected callosities of the right foot. The matters are REMANDED for the following action: 1. Contact the Veteran and/or his attorney and advise them that none of the documents referred to in a July 23, 2018, submission as “enclosures” were received by VA. Request that they provide copies of the documents listed as “enclosures” in the July 23, 2018, submission. A copy of any response, to include all records provided, must be associated with the claims file. 2. Schedule the Veteran for an examination to determine the nature and etiology of any obstructive sleep apnea. The claims file should be provided for review. The examiner is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that obstructive sleep apnea, if diagnosed, is related to active service or any incident of service, including as due to in-service exposure to an herbicide agent. A rationale also should be provided for any opinions expressed. If any requested opinion cannot be provided without resorting to mere speculation, then the examiner should explain why. The examiner is advised that the absence of contemporaneous records showing complaints of or treatment for obstructive sleep apnea, alone, is insufficient rationale for a medical nexus opinion. 3. Schedule the Veteran for an examination to determine the nature and etiology of any headaches. The claims file should be provided for review. The examiner is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that headaches, if diagnosed, are related to active service or any incident of service. A rationale also should be provided for any opinions expressed. The examiner is advised that the absence of contemporaneous records showing complaints of or treatment for headaches, alone, is insufficient rationale for a medical nexus opinion. The examiner also is advised not to review or rely upon the July 2014 VA headaches DBQ in preparing his or her opinion. 4. Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected right hip limited extension and his service-connected right hip osteoarthritis. 5. Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected right arm limited flexion and service-connected right arm limited extension. 6. Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected right upper extremity ulnar neuropathy. 7. Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected right knee tendonitis. 8. Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected callosities of the right foot. 9. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Michael T. Osborne, Counsel