Citation Nr: 18148881 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 16-44 307 DATE: November 8, 2018 REMANDED Entitlement to an initial compensable rating for left hip strain is remanded. REASONS FOR REMAND The Veteran served on active duty from January 2002 to August 2014. This matter is on appeal from a September 2014 rating decision. On his September 2016 VA Form 9, Appeal to Board of Veterans’ Appeals, the Veteran specifically limited his appeal to the issue of entitlement to an initial compensable rating for left his strain, and that is the only issue before the Board. Entitlement to an initial compensable rating for left hip strain is remanded. Regarding the claim for a higher rating for the Veteran’s left hip disability, a new VA examination must be provided that complies with Correia v. McDonald, 28 Vet. App. 158 (2016) and Sharp v. Shulkin, 29 Vet. App. 26 (2017). Correia mandates that orthopedic examinations include the testing described in 38 C.F.R. § 4.59 (2017), or an explanation as to why such testing is not warranted or not possible. The September 2014 VA examination does not specify that such testing was performed, including passive range of motion, or whether such testing was considered not warranted or not possible. Sharp requires VA examiner to obtain information from the Veteran as to the severity, frequency, and duration of flare-ups, as well as precipitating and alleviating factors, and the extent of functional impairment. It also requires that VA examiners estimate the additional loss of range of motion during a flare-up based on all procurable information from the record, as well as the Veteran’s own statements. If an estimate cannot be provided without resort to speculation, it must be clear whether this is due to a lack of knowledge among the medical community at large, or insufficient knowledge of the specific examiner. In this case, the September 2014 VA examination report does not provide the necessary information regarding flare-ups, as specified above. Moreover, the examiner’s reason for not providing an estimate of additional functional loss during flare-ups is too general in nature to comply with Sharp. In this regard, although the examination was not performed during a flare-up, it is not apparent why the examiner could not estimate additional functional loss based on the Veteran’s statements describing the flare-ups, or why the available information in the file was not sufficient to permit such an estimate. During his examination, the Veteran reported that he had flare-ups of his hip, in which pain limited his activity; however, the examiner failed to ascertain adequate information—i.e. frequency, duration, characteristics, severity, or functional loss-regarding his flares by alternative means. Since the examination, on his August 2016 VA Form 9, the Veteran specified that he has re-occurring pain in his left hip that flares up about every six months from 2011 to today, and that the pain is so severe that he cannot walk, sit or stand. Additionally, while on remand, the Veteran should be given an opportunity to identify any records relevant to treatment for his left hip disability, including VA treatment records dated since September 2014. The matter is REMANDED for the following action: 1. After obtaining any necessary releases, obtain any outstanding VA (since September 2014) and private treatment records pertaining to the Veteran’s service-connected left hip disability. 2. Schedule the Veteran for a VA examination with an appropriate professional to determine the extent and severity of his service-connected left hip disability. (A) All indicated tests should be performed, including range of motion findings expressed in degrees and in relation to normal range of motion; (B) The examination must include testing results of joint pain on both active and passive motion, and in weight-bearing and non-weight bearing in both hips. If such testing cannot be completed, an explanation should be provided as to why this is so. See Correia v. McDonald, 28 Vet. App. 158 (2016). (C) The examiner must also estimate any functional loss in terms of additional degrees of limited motion the left hip experienced during flare-ups and repetitive use over time. If the examiner cannot provide this estimate without resorting to speculation, he or she should state whether all procurable medical evidence had been considered, to specifically include the Veteran’s description as to the severity, frequency, duration of the flare-ups and his description as to the extent of functional loss during a flare-up and after repetitive use over time; whether the inability is due to the limits of medical community or the limits of the examiner’s medical knowledge; and whether there is additional evidence, which if obtained, would permit the opinion to be provided. See Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017). (D) The examiner should set forth all examination findings, along with complete rationale for the conclusions reached, in a printed report. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Crohe, Counsel