Citation Nr: 18148130 Decision Date: 11/06/18 Archive Date: 11/06/18 DOCKET NO. 16-40 984 DATE: November 6, 2018 REMANDED Entitlement to rating in excess of 30 percent for right ulnar neuropathy (claimed as right elbow with nerve damage to fingers/hands) is remanded. REASONS FOR REMAND The Veteran served on active duty with the Army from May 12 to July 14, 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to rating in excess of 30 percent for right ulnar neuropathy (claimed as right elbow with nerve damage to fingers/hands) The Veteran contends that his dominant right ulnar neuropathy is more disabling than currently evaluated warranting an increase in rating. Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. VA’s duty to assist includes a duty to provide a medical examination or obtain a medical opinion where it is deemed necessary to decide on the claim. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c) (4); Duenas v. Principi, 18 Vet. App. 512 (2004); Robinette v. Brown, 8 Vet. App. 69 (1995); McLendon v. Nicholson, 20 Vet. App. 79 (2006). In addition, once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). For the below noted reasons, the Board finds that, while the Veteran underwent a VA examination in April 2015 regarding his claim for an increased rating for his service-connected right ulnar neuropathy disability, a contemporaneous VA examination is necessary. The Veteran asserts that his right hand and arm are getting worse and he experiences daily pain. In the May 2015 Notice of Disagreement, the Veteran asserts that his condition is worse, he cannot hold things in his hand, his hand locks up all the time, and he drops things all the time. In the VA Form 9 dated August 2016, the Veteran further contends that he is the only person who knows how much his arm hurts and how much usage he has in both his right hand and arm. A review of the record evidence shows that the Veteran’s most recent VA peripheral nerves conditions disability and benefits questionnaire occurred in April 2015, as noted by the Veteran’s representative in the appellant brief dated August 2018. Additionally, VA treatment records show that the Veteran attended a June 2016 neurology appointment where his physician noted that the Veteran experienced decreased sensation to light touch over his right arm. Further, the physician noted that the Veteran has tried all available medical therapies and has had intolerance to the treatments. The United States Court of Veterans Appeals has held that when a Veteran alleges that his service-connected disability has worsened since he was examined previously, a new examination may be required to evaluate the current degree of impairment. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); but see Palczewski v. Nicholson, 21 Vet. App. 174, 182 (2007) (finding “mere passage of time” does not render old examinations inadequate). Given the Veteran’s contentions, and given the length of time which has elapsed since his most recent VA examination in April 2015, the Board finds that, on remand, he should be scheduled for an updated VA examination to determine the current nature and severity of his service-connected right ulnar neuropathy disability. The matter is REMANDED for the following actions: 1. Obtain updated relevant VA treatment records. 2. After the foregoing development has been completed, schedule the Veteran for a VA examination to assess the severity of right ulnar neuropathy. The claims file must be made available to, and reviewed by, the examiner. The examination report should indicate that the claims file was reviewed. All pertinent symptomatology and findings must be reported in detail. Any diagnostic tests deemed necessary for an accurate assessment must be conducted. The examiner must record all pertinent medical complaints, symptoms, and clinical findings, in detail. The examiner should indicate whether right ulnar neuropathy more nearly approximates mild, moderate, or severe incomplete paralysis or complete paralysis of the ulnar nerve. 3. Readjudicate the appeal. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Hartford, Associate Counsel