Citation Nr: 18154559 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 12-34 961 DATE: December 4, 2018 REMANDED An increased rating for residuals of an anterior wedge fracture at T-12 (spine disability). Entitlement to a total disability rating based on individual unemployability (TDIU) due to service connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1991 to July 1995 and from October 2007 to October 2009. This case comes before the Board of Veteran’s Appeals (the Board) on appeal from an August 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. In March 2015 and March 2016, the Board remanded the current claims for further development. 1. An increased rating for a residuals of an anterior wedge fracture at T-12 is remanded. 2. Entitlement to a total disability rating based on TDIU due to service connected disabilities is remanded. The Board is well aware these matters were remanded before and sincerely regrets the delay in final adjudication that is inherent with a remand. The Veteran’s service connected residuals of an anterior wedge fracture at T-12 is currently rated as 10 percent disabling. The Veteran was most recently provided with a VA spine examination in November 2016; an addendum opinion concerning functional ability was obtained in May 2018. In October 2018 correspondence, the Veteran's representative argued that the 2018 addendum relied on evidence that was over two years old, and was therefore not probative. They also suggested that the Veteran's condition had worsened. Accordingly, the Veteran should be afforded a VA examination. See Proscelle v. Derwinski, 2 Vet. App. 629, 632 (1992). Additionally, two seminal Court of Appeals for Veterans Claims (CAVC) holdings since the November 2016 VA examination have affected the way VA evaluates orthopedic disabilities. Therefore, another examination must be provided to comply with these decisions. See Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017); Correia v. McDonald, 28 Vet. App. 158 (2016). Finally, as TDIU is inextricably intertwined with the remanded increased rating claim, an adjudication of that matter must be deferred at this time. See Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Obtain all updated records (i.e., those not already of record) of VA and adequately identified private treatment the Veteran has received for the disabilities remaining on appeal. 2. Then, arrange for the Veteran to be examined by an orthopedist to determine the current severity of his service connected spine disability. The entire claims file should be made available to, and be reviewed by, the examiner in conjunction with this request. Based on an examination, review of the record, and any tests or studies deemed necessary, the examiner should describe all pathology, symptoms (frequency and severity), and functional impairment associated with such disabilities in sufficient detail to allow for application of the pertinent rating criteria. Range of motion studies must be completed, and must include active and passive motion, evaluation with and without weight-bearing. The examiner should also note any further functional limitations due to pain, weakness, fatigue, incoordination, or any other such factors. The examiner MUST ALSO comment on or describe, to the extent possible and attempt to elicit information from the Veteran about the impact the Veteran’s service connected spine disability has on his functioning during flare-ups or with repeated use over a period of time. In doing so, the examiner MUST elicit from the Veteran subjective reports of his functioning under such conditions and consider such reports along with all other pertinent evidence. If the examiner is still unable to provide such an opinion, he or she MUST explain why that is so in specificity. The examiner should note that the inability to directly observe functioning under such conditions IS NOT a valid reason to avoid providing an opinion in this matter per se. 3. Thereafter, schedule the Veteran for an examination(s) with respect to his remaining service connected disabilities. The entire claims file should be made available to, and be reviewed by, the examiner(s) in conjunction with this request. A complete employment history of the Veteran should be obtained, including the last date of full-time and/or part-time employment. An assessment of the Veteran’s day-to-day functioning should also be made. The examiner(s) is requested to opine on the types of limitations the Veteran’s service-connected disabilities ALONE (without consideration of his age or nonservice-connected disabilities) have on his ability to obtain or maintain a substantially gainful occupation. The examiner(s) is requested to discuss the types of employment in which the Veteran would be capable of engaging, given his skill set and educational background. A detailed explanation (rationale) is requested for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). L. BARSTOW Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. McKone, Law Clerk