Citation Nr: 18143451 Decision Date: 10/23/18 Archive Date: 10/19/18 DOCKET NO. 14-42 559 DATE: October 23, 2018 REMANDED Entitlement to an initial evaluation in excess of 30 percent for residuals of muscle injury of the left arm involving Muscle Groups III, V, and VI, and impairment of the musculocutaneous nerve, status post left brachial neuritis is remanded. Entitlement to an initial rating in excess of 30 percent for residuals of muscle injury of the left forearm and hand involving Muscle Groups VII and VIII is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1984 to August 2004. The Board notes that the Veteran has an appeal for entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) that is being processed under the Rapid Appeals Modernization Program (RAMP). While the Board acknowledges that the Veteran submitted a RAMP opt-in election form, the present appeal had already been activated at the Board and is therefore no longer eligible for the RAMP program. Entitlement to an initial evaluation in excess of 30 percent for residuals of muscle injury of the left arm involving Muscle Groups V, VI, and III, and impairment of the musculocutaneous nerve, status post left brachial neuritis; and entitlement to an initial rating in excess of 30 percent for residuals of muscle injury of the left forearm and hand involving Muscle Groups VII and VIII are remanded. In its May 2018 remand, the Board requested that the Veteran undergo new VA nerve and muscle examination to assess the severity of his service-connected muscle injury disabilities and to determine whether he is entitled to a separate rating for the impairment caused to his musculocutaneous nerve. The rating for the Veteran’s musculocutaneous nerve disability is currently included with the 30 percent rating for his residuals of a muscle injury to the left arm involving Muscle Groups III, V, and VI. The Veteran alleges that he should be awarded a separate 30 percent disability rating for the musculocutaneous nerve injury associated with his service-connected left arm disability. Pursuant to 38 C.F.R. § 4.55(a), a muscle injury rating will not be combined with a peripheral nerve paralysis rating of the same body part unless the injuries affect entirely different functions. In its May 2018 remand, the Board specifically requested the examiner to indicate “whether the Veteran’s left arm muscle injury affects entirely different functions from his left arm nerve injury.” While the Veteran was provided with the requested VA examinations in June 2018, the examination reports list the identical left arm symptomatology in both the muscle examination and the nerve examination. The VA examiner did not identify which specific symptoms were associated with the muscle injuries and which symptoms were attributable to the nerve injuries (if the symptoms are, indeed, different), as was requested by the Board. Additionally, the examiner did not provide an opinion as to whether the Veteran’s left arm muscle injury affected entirely different functions from his left arm nerve injury. Such a finding is critical to determining whether the Veteran is entitled to a separate rating for the nerve injuries associated with his left arm disability, as he contends. Accordingly, the RO should obtain a supplemental opinion from the June 2018 VA examiner to state whether the Veteran’s nerve injury symptoms affect entirely different functions from his muscle injury symptoms, and if so, what functions each affect. The matters are REMANDED for the following action: 1. Obtain a supplemental opinion from the VA examiner who conducted the June 2018 VA muscle and nerve examinations, if available, to address whether the Veteran’s left arm muscle injuries affect entirely different functions from his left arm nerve injuries. If the examiner finds that different functions are affected, the examiner is requested to state the specific functions affected which are attributable to the muscle injuries and which functions are affected by the nerve injuries. If the examiner who conducted the June 2018 VA examinations is not available, the RO should obtain a new opinion. The examiner’s opinion must be based upon a complete review of the evidence contained in the claims file. The rationale for any opinion expressed must be set forth. If deemed necessary by the examiner in order to provide the requested opinion, schedule a VA examination of the Veteran. 2. Thereafter, the RO must readjudicate the issues on appeal. If any benefit sought on appeal remains denied, the RO must issue the Veteran a supplemental statement of the case and provide an opportunity to respond. The case must then be returned to the Board for appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Katz, Counsel