Citation Nr: 18143067 Decision Date: 10/17/18 Archive Date: 10/17/18 DOCKET NO. 15-16 606 DATE: October 17, 2018 REMANDED Entitlement to a rating in excess of 10 percent for chronic cervical strain is remanded. Entitlement to a rating in excess of 10 percent for chronic lumbosacral strain is remanded. Entitlement to a rating in excess of 10 percent for chronic left shoulder strain is remanded. Entitlement to a rating in excess of 10 percent for chronic right shoulder strain is remanded. Entitlement to a compensable rating for dermatitis of the face and chest is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1999 to September 2004. This matter came before the Board of Veterans Appeals (Board) on appeal from an October 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran’s Law Judge during an October 2018 Video Conference hearing. 1. Entitlement to a rating in excess of 10 percent for chronic cervical strain is remanded. 2. Entitlement to a rating in excess of 10 percent for chronic lumbosacral strain is remanded. 3. Entitlement to a rating in excess of 10 percent for chronic left shoulder strain is remanded. 4. Entitlement to a rating in excess of 10 percent for chronic right shoulder strain is remanded. 5. Entitlement to a compensable rating for dermatitis of the face and chest is remanded. At the October 2018 Video hearing, the Veteran testified that her cervical spine, lumbosacral spine, bilateral shoulder and dermatitis disabilities had worsened since her last VA examinations in February 2012. The Board also notes that the record contains an August 2013 statement that the disabilities had worsened, in which the Veteran specifically stated that since the February 2012 examination, her pain had increased and she was started on medication for her musculoskeletal disabilities and begun physical therapy at the VA. She also stated that her dermatitis had worsened and she had begun treatment. As the evidence of record suggests that the Veteran’s service-connected disabilities have increased in severity since the most recent VA examination in 2012, the Board finds that the Veteran should be afforded a new examination. See Snuffer v. Gober, 10 Vet. App. 400 (1997). 6. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. The issue of entitlement to TDIU must also be remanded as it is inextricably intertwined with the issue of increased ratings for cervical strain, lumbosacral strain, bilateral shoulder strain and dermatitis. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are “inextricably intertwined” when the adjudication of one issue could have “significant impact” on the other issue). The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from June 2012 to the Present. 2. Schedule the Veteran for an appropriate VA examination to determine the current level of severity of her cervical spine, lumbosacral spine and left and right shoulder disabilities. The claim file should be made available to and reviewed by the examiner and the examination report should state a review of the file was completed. All necessary tests should be performed and all findings should be reported in detail. The examiner should identify all cervical spine, lumbosacral spine and left and right shoulder pathology found to be present. The examiner should conduct all indicated tests and studies, to include range of motion studies. The joints involved should be tested in 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. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. The examiner should describe any pain, weakened movement, excess fatigability, instability of station and incoordination present. If pain is noted, the point during range of motion at which pain starts must be clearly indicated. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups she experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment she experiences during a flare-up of symptoms and/or after repeated use over time. Based on the Veteran’s lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional range of motion loss during flare-ups or after repetitive use without resorting to speculation, the examiner should 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). The examiner should also provide an opinion regarding the functional impact of the Veteran’s cervical spine, lumbosacral spine and left and right shoulder disabilities disability upon her ability to work. 3. Schedule the Veteran for an appropriate VA examination to determine the current level of severity of her dermatitis. The examiner should review the file and provide a complete rationale for all opinions expressed. The examiner should also provide an opinion regarding the functional impact of the Veteran’s dermatitis disability upon her ability to work. 4. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Arnold, Associate Counsel