Citation Nr: 18147495 Decision Date: 11/06/18 Archive Date: 11/05/18 DOCKET NO. 14-35 836 DATE: November 6, 2018 REMANDED Entitlement to an initial rating in excess of 20 percent for degenerative disc disease, low back is remanded. Entitlement to a compensable rating prior to April 26, 2017 for left lower extremity radiculopathy and in excess of 10 percent from that date is remanded. REASONS FOR REMAND Entitlement to an initial rating in excess of 20 percent for degenerative disc disease, low back is remanded. Entitlement to a compensable rating prior to April 26, 2017 for left lower extremity radiculopathy and in excess of 10 percent from that date is remanded. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a January 2012 rating decision by Department of Veterans Affairs (VA) Regional Offices (RO) that granted service connection and assigned a 10 percent rating for the low back disability, effective January 11, 2005. An August 2014 rating decision increased the rating to 20 percent, effective date of January 22, 2005, noting that January 22, 2005. The change in dates had no effect as to the payment of benefits to the Veteran as VA regulations provide that payment begins the first day of the calendar month following the month in which the award became effective. See 38 C.F.R. § 3.31 (2018). An interim April 2017 rating decision granted service connection and assigned a separate 10 percent rating for left lower extremity radiculopathy, effective January 10, 2017, the date of a VA examination. As the left lower extremity radiculopathy is a manifestation of the Veteran’s service-connected back disability, his appeal of that claim encompassed ratings for all manifestations of the condition. Thus, the Board will consider whether a compensable rating is warranted for the left lower extremity prior to January 2017. See AB v Brown, 6 Vet. App. 35 (1993); 38 C.F.R. § 4.71a, Note (1). In a February 2018 statement, the Veteran asserted that his low back disability has increased in severity since the Veteran was last examined by VA in January 2017. The Veteran reported that he now uses a cane to walk nearly every day. The Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations (including neurological) of his low back disability. The examination conducted on remand should also attempt to provide range of limitation of motion evaluation based on pain due to flare ups, with consideration of the frequency and duration of flare-ups. Sharp v. Shulkin, 29 Vet. App. 26 (2017). The January 2017 examiner noted that the Veteran had flare-ups which resulted in increased pain and on April 2014 VA examination the Veteran reported having flare-ups of his lower back disability that resulted in occasional pain. In a February 2018 statement, the Veteran identified relevant outstanding private treatment records from Rush University Hospital in Chicago, Illinois. Additionally, the record reflects the Veteran has received treatment from private provider Dr. H.M.K. A remand is required to allow VA to obtain authorization and request these records.   The matters are REMANDED for the following action: 1. Obtain the names and addresses of all medical care providers who treated the Veteran for any lower back or neurological complaints since March 2018. After securing the necessary release, take all appropriate action to obtain these records, private treatment records from Rush University Hospital and Dr. H.M.K. in Chicago Illinois, including any updated VA treatment records since January 2017. 2. After the completion of the above, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected lower back disability, both orthopedic and neurological manifestations. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to his lower back disability alone and discuss the effect of the Veteran’s lower back disability on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). The examiner must provide a complete rationale for any opinion expressed. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Eric Struening, Associate Counsel