Citation Nr: 18154496
Decision Date: 11/30/18	Archive Date: 11/29/18

DOCKET NO. 14-32 621
DATE:	November 30, 2018
REMANDED
Entitlement to an evaluation in excess of 10 percent for lumbosacral strain is remanded for additional development.
REASONS FOR REMAND
The Veteran served on active duty from December 1968 to December 1972.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).  
The Board notes that the Veteran requested a hearing before a Veterans Law Judge in his August 2014 substantive appeal.  The Veteran was scheduled to testify at a Board hearing in October 2017, but failed to report for his scheduled hearing.  To date, the Veteran has not requested a new Board hearing.  Accordingly, the Board considers his hearing request to be withdrawn.  38 C.F.R. § 20.704(d).
The issue of entitlement to an evaluation in excess of 10 percent for lumbosacral strain is remanded.
The Veteran was afforded VA examinations for his service-connected lumbosacral strain in February 2014 and July 2014.  The results in the second examination are suggestive of worsening but there is a large discrepancy in the findings between examinations and the July 2014 examiner called into doubt of the validity of the July 2014 results.  Given the discrepancy in the findings, and the length of time since the last examination, the Board finds that an additional examination would be helpful in clarifying the severity of the disability.  Accordingly, the Veteran should be afforded a new VA examination to assess the current nature, extent, and severity of his service-connected lumbosacral strain.  See Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997).
The matter is REMANDED for the following action:
1. Schedule the Veteran for a VA examination to assess the current nature and severity of his service-connected lumbosacral strain.  
(a.) Range of motion should be reported, including whether and the extent to which such motion is affected by pain, weakness, fatigue, lack of endurance, incoordination or other symptoms resulting in functional loss.  
(b.) Based upon a review of the medical records, lay statements submitted in support of the claim, and/or statements elicited from the Veteran during the examination, state whether the Veteran experiences flare ups of his service-connected lumbosacral strain, and how he or she characterizes the additional functional loss during a flare.
(c.) If the Veteran describes experiencing flare ups, identify the:
frequency;
duration; 
precipitating factors; and
alleviating factors.
(d.) Based upon the information elicited as a result of the foregoing, state whether it is at least as likely as not (50 percent probability or greater) that during a flare up range of motion is additionally limited from 30 to 60 degrees (the measurement required for the next higher rating).  Please explain why or why not.
(e.) Based upon the information elicited as a result of the foregoing, state whether it is at least as likely as not (50 percent probability or greater) that repetitive use over time additionally limits motion to 60 degrees or less (for flexion) or 120 degrees or less (for combined range of motion).  Please explain why or why not.
(f.) If the examiner cannot provide the requested opinions without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence in this case, or a lack of knowledge among the medical community at large, and not the insufficient knowledge of the individual examiner).
(g.) If the inability to provide an opinion without resorting to speculation is due to a deficiency in the record (additional facts are required), the AOJ should develop the claim to the extent it is necessary to cure any such deficiency.  If the inability to provide an opinion is due to the examiner’s lack of requisite knowledge or training, then the AOJ should obtain an opinion from a medical professional who has the knowledge and training needed to render such an opinion.  


 
S. C. KREMBS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Bilstein, Associate Counsel