Citation Nr: 18150478 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 15-32 738 DATE: November 15, 2018 REMANDED Entitlement to an initial compensable evaluation for left hip impairment is remanded. Entitlement to an initial compensable evaluation for left hip limitation of flexion is remanded. Entitlement to a rating in excess of 10 percent for a left hip and pelvis stress reaction is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1999 to December 1999. This appeal arose to the Board of Veterans’ Appeals (Board) from an April 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. 1. Entitlement to initial compensable evaluations for left hip impairment and left hip flexion, and a rating in excess of 10 percent for left hip and pelvis stress reaction, is remanded. The Veteran contends that she is entitled to compensable evaluations for left hip impairment and flexion, as well as a rating in excess of 10 percent for left hip and pelvis stress reaction. The Veteran most recently underwent a VA examination for her left hip disability in May 2015; however, at that time, her range of motion was not tested in active motion, passive motion, weight-bearing, or nonweight-bearing activities. Without such measurements, the Board cannot adequately assess the Veteran’s hip and thigh disabilities. Correia v. McDonald, 28 Vet. App. 158 (2016) (holding that additional requirements must be met prior to finding that a VA examination is adequate). Moreover, more than three years has passed since the last examination, and the Veteran’s VA outpatient notes reflect that she has regularly had to switch medications for her left hip pain. Recently, in April 2018, she reported that her left hip pain was at a 7 out of 10 in severity. Given these indications of possibly worsening symptoms, an updated medical examination is needed. See Green v. Derwinski, 1 Vet. App. 121, 124 (1991) (VA has a duty to provide the Veteran with a thorough and contemporaneous medical examination); Caffrey v. Brown, 6 Vet. App. 377, 381(1994) (an examination too remote for rating purposes cannot be considered “contemporaneous”). 2. Entitlement to TDIU is remanded. The Board notes that in multiple statements to VA, the Veteran stated that she was unable to obtain employment due to her service-connected disabilities. Accordingly, a claim for TDIU has been raised. See Rice v. Shinseki, 22 Vet. App. 447, 454-55 (2009). Upon remand, the RO is directed to adjudicate the Veteran’s claim. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination with an appropriate VA examiner to determine the nature and severity of the Veteran’s left hip and thigh disability. The examiner is particularly asked to discuss the following: Test the Veteran’s range of motion in active motion, passive motion, weight-bearing, and non-weightbearing. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain what that is so. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups she experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment she experiences during a flare-up of her hip and thigh symptoms and/or after repeated use over time. Based on the Veteran’s lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. (Continued on the next page)   2. Send the appropriate TDIU paperwork to the Veteran and adjudicate her claim. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Ryan, Associate Counsel