Citation Nr: 18155339
Decision Date: 12/04/18	Archive Date: 12/04/18

DOCKET NO. 16-55 667
DATE:	December 4, 2018
REMANDED
Entitlement to an initial rating higher than 10 percent for right wrist contusion and scaphoid fracture (claimed as right wrist disability) is remanded.
REASONS FOR REMAND
The Veteran had active military service from July 1999 to October 2012.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA).  The Veteran perfected an appeal only as to the matter of entitlement to an initial rating higher than 10 percent for right disability.  
In his November 2016 Substantive Appeal (VA Form 9) the Veteran noted disagreement with the report from the September 2016 VA wrist conditions examination.  He indicated discrepancies in range of motion measurements of his right wrist.  He stated he has severe lack of motion of the right wrist.  Additionally, he stated that he experiences occasional pain during flare-ups even though he was not experiencing any at the time of the examination.  He could not recall whether the examiner asked if he had flare-ups.  On September 2016 VA wrist conditions examination, the examiner was unable to say without mere speculation whether pain, weakness, fatigability or incoordination significantly limited functional ability with repeated use over a period of time or with flare-ups.  On remand, the examiner must provide explanations for why this is so.
The matter is REMANDED for the following action:
1. Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected right wrist disability.  The claims file and a copy of this remand must be made available to and reviewed by the examiner.  The examination must include all physical and diagnostic testing deemed necessary by the examiner in conjunction with this request, utilizing the most up-to-date Disability Benefits Questionnaire.  The examiner should report all manifestations related to the Veteran’s service-connected right wrist disability.  
(a) The examiner should record the results of range-of-motion testing for pain on both active and passive motion and in weight-bearing and nonweight-bearing for the right wrist.  If the examiner is unable to conduct any required testing, the examiner should clearly explain why that is so.  In recording the ranges of motion for the Veteran’s right wrist, the examiner should note whether, upon repetitive motion, there is any pain, weakened movement, excess fatigability, or incoordination of movement, and whether there is likely to be additional functional loss due to pain on use, weakened movement, excess fatigability, or incoordination over time.  If there is no pain, no limitation of motion, and/or no limitation of function, such facts must be noted in the report.
(b) The examiner should also express an opinion concerning whether there would be additional functional impairment on repeated use over time or during flare-ups.  The examiner should assess the additional functional impairment on repeated use or during flare-ups in terms of the degree of additional range-of-motion loss, if possible.  If the Veteran indicates that he is not currently experiencing a flare-up at the time of the examination, the examiner should estimate any additional functional loss during flare-ups or on repeated use, if feasible.  If it is not feasible to determine, even by estimation, the extent to which the Veteran experiences additional functional loss on repeated use over time or during flare-ups without resorting to speculation, the examiner must provide an explanation for why this is so.
A detailed rationale is requested for any opinion provided.

 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Young, Counsel