Citation Nr: 18144188
Decision Date: 10/24/18	Archive Date: 10/23/18

DOCKET NO. 18-17 464
DATE:	
REMANDED
An initial rating in excess of 10 percent for posttraumatic arthritis of the left wrist, radiocarpal and radioulnar joints, open comminuted fracture left distal radius, status post surgery with skin graft proximal volar left forearm, is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the U.S. Army from October 1972 to October 1974, and from November 1974 to July 1981.
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an August 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, the Commonwealth of Puerto Rico.  
An initial rating in excess of 10 percent for posttraumatic arthritis of the left wrist, radiocarpal and radioulnar joints, open comminuted fracture left distal radius, status post surgery with skin graft proximal volar left forearm, is remanded.
The Veteran’s service treatment records reflect that he injured his left wrist and forearm in a motorcycle accident in November 1980.  The diagnoses included severe post-traumatic arthritis and severe fibrous ankylosis of the left radiocarpal and radioulnar joints; and open comminuted fracture of the left distal radius (Smith’s fracture) with marked intra-articular comminution into the radiocarpal and radioulnar joints.  He underwent exploration and debridement of the Smith’s fracture with reduction and split thickness skin graft of the left forearm.  It was noted that he was intact from a neurovascular standpoint.  He was discharged from service due to this disability—described as being causative of loss of use of the left hand—together with additional disability of his right hand.
On appeal, the Veteran seeks a rating in excess of 10 percent for the disability here at issue.  He maintains that the VA examination he was afforded was inadequate because the examiner did not note or evaluate the lack of left wrist rotational/radial movement (pronation and supination of the forearm) and associated atrophy.
The Board agrees that another examination is warranted.  As the Veteran correctly points out, the examination conducted in July 2015 does not contain any explicit findings relative to the left forearm, to include with respect to pronation and supination.  Significantly, during service, the Veteran’s left forearm was noted to be ankylosed in a position of 20 degrees of supination with no active or passive pronation or supination.  This needs to be explored further.
This matter is REMANDED for the following action:
1.  Arrange to have the Veteran scheduled for an examination of his left forearm.  The examiner should review the record.  All indicated tests should be conducted and the results reported.
After examining the Veteran and reviewing the record, together with the results of any testing deemed necessary, the examiner should provide a full description of any and all functional limitations associated with the left forearm so as to permit a proper evaluation under the relevant diagnostic criteria (38 C.F.R. § 4.71a, Diagnostic Codes 5206 through 5213).
A complete medical rationale for all opinions expressed must be provided.
2.  After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraph, the Veteran’s claim should be readjudicated based on the entirety of the evidence.  If any benefit sought remains denied, the Veteran should be issued a supplemental statement of the case.  An appropriate period of time should be allowed for response.
 
DAVID A. BRENNINGMEYER
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Boyea, Law Clerk