Citation Nr: 18159380 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 15-22 984A DATE: December 19, 2018 REMANDED Entitlement to an initial compensable disability rating for service-connected scapulocostal syndrome is remanded. REASONS FOR REMAND Although further delay is regrettable, the Board finds that additional development is required prior to adjudication of the remaining issue on appeal. The Veteran had active duty service from January 1973 to December 1974. This case is on appeal before the Board of Veterans’ Appeals (Board) from an October 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in New Orleans, Louisiana. In May 2018, the Board remanded this case to solicit a retrospective VA examiner opinion concerning the nature and severity of the Veteran’s scapulocostal syndrome between December 21, 1974 and February 23, 2001. The examiner was to review the claims file, and specifically comment upon whether he or she could distinguish between the symptoms attributable to the Veteran’s scapulocostal syndrome and those related to his service-connected cervical spondylosis and impingement tendonitis of the right shoulder. A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand. Stegall v. West, 11 Vet. App. 268, 271 (1998). The requested opinion was issued in June 2018. The examiner described how the three joints comprising the shoulder work together, and how scapulocostal syndrome affects the movement of the acromioclavicular and scapulothoracic joints. He went on to say that scapulocostal syndrome is often inconstantly painful, and presents as a deep aching beneath the shoulder blade where it comes against the rib cage. In particular, it is often associated with pain such as when one leans back on a hard chair or takes a long ride in an uncomfortable metal seat – such as those found in military vehicles and aircraft used in the era during which the Veteran served. The examiner also stated that scapulocostal syndrome would make it uncomfortable to carry a weapon with a strap across the affected area. Lastly, the examiner opined that the Veteran’s scapulocostal syndrome did not have any relationship to his cervical spine disorder or impingement tendonitis. Here, the Board finds that VA only partially complied with the directives of the May 2018 remand order. Although the examiner described some of the symptoms attributable to scapulocostal syndrome and discussed its relationship to other disorders of the spine and shoulder, he never actually addressed the severity of the Veteran’s condition between December 21, 1974 and February 23, 2001. Indeed, the examiner simply stated that the Veteran’s condition would cause pain if he took a long ride in a metal seat or carried a weapon with a strap across his back. However, given that the Veteran separated from active service on December 20, 1974, these assessments are not particularly useful for rating the severity of impairment during the relevant period at issue. The Veteran’s scapulocostal syndrome is currently rated under 38 C.F.R. § 4.73, Diagnostic Code 5399-5231. In this case, the rating schedule does not provide a specific diagnostic code for scapulocostal syndrome, so the Veteran’s impairment has been rated analogously under Diagnostic Code 5321 for an injury to Muscle Group XXI, the muscles of respiration of the thoracic muscle group. Id. Under Diagnostic Code 5321, a slight injury warrants a noncompensable evaluation. For a moderate injury, a 10 percent disability rating is assigned. Lastly, a moderately severe or severe injury warrants a 20 percent evaluation. The June 2018 VA examiner never opined as to whether the Veteran’s scapulocostal syndrome resulted in slight, moderate, moderately severe, or severe injury symptomatology between December 21, 1974 and February 23, 2001. Therefore, under these circumstances, the matter must be remanded to ensure compliance with the Board’s prior remand order. Stegall, 11 Vet. App. at 271. The matter is REMANDED for the following action: 1. Return the June 2018 opinion report to the VA examiner who rendered the original opinion to obtain a retrospective opinion concerning the nature and severity of the Veteran’s service-connected scapulocostal syndrome between December 21, 1974 and February 23, 2001. If the original VA examiner is unavailable, a new examiner may be assigned to address the requested opinion. The claims file should be made available to and reviewed by the examiner. An examination of the Veteran should be performed if deemed necessary by the examiner. In issuing the retrospective opinion, the examiner should specifically comment on whether he or she can distinguish the symptoms attributable to the Veteran’s service-connected scapulocostal syndrome and those related to his service-connected cervical spondylosis and impingement tendonitis of the right shoulder. The examiner should also opine, to the extent that he or she is able, whether the Veteran’s scapulocostal syndrome resulted in a slight, moderate, moderately severe, or severe level of disability with reference to the ratings criteria found in Diagnostic Code 5321 for the period from December 21, 1974 to February 23, 2001. 2. Then, readjudicate the issue of an initial compensable disability rating for service-connected scapulocostal syndrome. If any benefit sought on appeal remains denied, the Veteran and representative should be provided a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response before the case is returned to the Board. E. BLOWERS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD MJS, Associate Counsel