Citation Nr: 18142492
Decision Date: 10/17/18	Archive Date: 10/16/18

DOCKET NO. 16-30 301
DATE:	October 17, 2018
REMANDED
The issue of a rating in excess of 10 percent for post operative right hip stress fracture residuals with right femoral neck percutaneous screw fixation, femoracetabular impingement, and labral tear residuals is remanded.  
Entitlement to a total rating for compensation purposes based on individual unemployability due to service connected disabilities (TDIU) is remanded.  
REASONS FOR REMAND
The Veteran had active service from January 2005 to July 2006.  
1. The issue of a rating in excess of 10 percent for post operative right hip stress fracture residuals with right femoral neck percutaneous screw fixation, femoracetabular impingement, and labral tear residuals is remanded.  
The report of a March 2016 Department of Veterans Affairs (VA) hip examination states that the Veteran “has not been cleared to return to work” and “she is a railroad engineer and is unable to meet the job requirements of being able to sit or stand for prolonged periods of time.”  Clinical documentation of the cited occupational examination is not of record.  The Board of Veterans’ Appeals (Board) observes that it is unclear as to whether the VA examiner was stating that the Veteran was continuing to heal from her right hip surgery or rather was unable to return to work at any date.  
VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran’s claims.  Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992).  
VA’s duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive.  McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991).  When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate.  Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  The Board finds that further VA hip examination is needed to adequately address the issues raised by the instant appeal.  
2. The issue of entitlement to a TDIU is remanded.  
Entitlement to TDIU requires an accurate assessment of the impairment associated with all of the service-connected disabilities.  As the claim for TDIU is inextricably intertwined with other claims being remanded, the issue of entitlement to TDIU must also be remanded.  
The matters are REMANDED for the following actions:
1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider who has treated the service connected right hip disability.  Make two requests for any authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile.  
2. Obtain the Veteran’s VA treatment records associated with treatment after March 2016.  
3.  Schedule the Veteran for a VA hip examination to assist in determining the current severity of service connected right hip disability.  The examiner must review the record and should note that review in the report.  A rationale for all opinions should be provided. The examiner should:
(a)  Provide ranges of motion for weight-bearing and nonweight-bearing and passive and active motion of the right hip.  
(b)  State whether there is any additional loss of right hip function due to painful motion, weakened motion, excess motion, fatigability, incoordination, or on flare up. 
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(c)  Opinion as to the impact of right hip disability on the Veteran’s vocational pursuits and whether it is at least as likely as not (50 percent or greater probability) that the Veteran is unable to secure or follow a substantially gainful occupation due to the combined impact of the service-connected disabilities.  If the Veteran is felt capable of work despite the service connected disabilities, the examiner should describe what type of work and what accommodations would be necessary due to the service-connected disabilities.
 
J. T. HUTCHESON
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Saudiee Brown, Associate Counsel