Citation Nr: 18152009
Decision Date: 11/21/18	Archive Date: 11/20/18

DOCKET NO. 09-37 028A
DATE:	November 21, 2018
REMANDED
Entitlement to an initial disability rating higher than 10 percent for left wrist disability including lunate and navicular chondromalacia, synovitis, and scars, status post arthroscopy is remanded.
REASONS FOR REMAND
The Veteran served on active duty from March 1968 to November 1972, from December 1990 to June 1991, from October 1991 to July 1992, and from August 1992 to September 1992.
Entitlement to an initial disability rating higher than 10 percent for left wrist disability including lunate and navicular chondromalacia, synovitis, and scars, status post arthroscopy is remanded.
Pursuant to the Board’s 2017 remand, the Veteran was provided a VA examination to evaluate the current severity of his left wrist disability; however, the examiner failed to adequately provide an opinion on the extent of the Veteran’s functional impairment due to this condition, including during flare-ups.  The November 2017 examiner stated that the Veteran did not report flare-ups related to his left wrist condition and stated that the Veteran’s most recent wrist examination was in 2009.  The evidence in the claims file indicates that the Veteran’s left wrist was examined in May 2015 and that he complained of flare-ups during his November 2009 examination and the May 2015 examination. See Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007).  As none of these examinations has provided an opinion regarding the extent of additional limitation of range of motion that would be caused by the Veteran’s symptoms during flare-ups, the Board finds that a new VA examination should be provided that discusses any additional functional limitations during periods of flare-ups of the Veteran’s conditions, if possible.
The matter is REMANDED for the following action:
1. Undertake appropriate efforts to schedule the Veteran for a current VA examination to determine the severity, manifestations, and effects of his service-connected left wrist disability. 
The examiner must review the claims file in conjunction with the examination.  All pertinent symptomatology and findings should be reported in detail.  The examiner must specifically provide an opinion regarding whether the Veteran’s condition would result in additional functional limitations during periods of flare-ups. 
If the examination is not conducted during a period of a flare-up, the examiner must provide an estimated opinion of additional functional limitations based upon the evidence of record, including the Veteran’s lay statements and medical evidence of record, including his reports in the November 2009 and May 2015 VA examinations.  If the examiner is unable to provide such an opinion, the inability to furnish such an estimate must be predicated on a lack of medical knowledge among the medical community at large, rather than insufficient knowledge by the individual examiner.
2. After the above-development has been completed, readjudicate the Veteran’s claim on appeal.  If the claim remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC) and an adequate opportunity to respond, after which the matter should be returned to the Board for further adjudication, if otherwise in order.

 
K. Parakkal
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	P.M. Johnson, Counsel