Citation Nr: 18159381 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 12-24 537 DATE: December 19, 2018 REMANDED Entitlement to an extraschedular rating higher than 20 percent from May 12, 2009 and higher than 30 percent disabling from January 13, 2015 for service-connected lumbar strain is remanded. Entitlement to service connection for erectile dysfunction, claimed secondary to service-connected lumbar strain is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1962 to December 1963. He had additional service with the U.S. Army Reserves until January 1968 and with the Army National Guard of Missouri from February 1976 to September 1976. He then enlisted in the U.S. Air Force Reserve for a period of three years beginning in September 1976. These matters come before the Board of Veterans’ Appeals (Board) on appeal from June 2012 and July 2013 rating decisions of the Department of Veterans Affairs (VA) Regional Office. These matters were most recently before the Board in December 2016, when they were denied. In June 2018, the U.S. Court of Appeals for Veterans’ Claims (Court) granted a joint motion for partial remand (JMR) that vacated the part of the December 2016 decision that denied the aforementioned claims. Remanded Issues Pursuant to the June 2018 JMR, remand is necessary in order to provide a new VA opinion to determine the etiology of the Veteran’s erectile dysfunction. Although the Veteran underwent VA examinations in January 2013 and November 2013 to determine the etiology of his erectile disfunction, no examiner addressed the effects of his use of Oxycodone/Percocet used to treat service connected low back strain on the Veteran’s erectile dysfunction. Accordingly, a new VA opinion is warranted to address this issue. With regard to the Veteran’s extraschedular rating for service-connected lumbar spine strain, the JMR notes that the Veteran underwent a VA examination in June 2015, which did not comply with Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011). Therefore, a new examination is necessary to comply with Mitchell. The matters are REMANDED for the following action: 1. Arrange to provide the Veteran with an additional VA medical opinion to determine is it at least as likely as not (50 percent or more) that his erectile dysfunction is caused or aggravated by Oxycodone/Percocet used to treat his service-connected lumbar strain. 2. Schedule the Veteran for an appropriate VA examination to determine the current severity of his service-connected lumbar strain. His claims file, including a copy of this remand, must be made available to the examiner for review in connection with the examination. All pertinent symptomatology and findings must be reported in detail. Any indicated diagnostic tests that are deemed necessary for an accurate assessment must be conducted. The examiner must record all pertinent medical complaints, symptoms, and clinical findings in detail. The examiner should provide the range of motion of the Veteran's lumbar spine and comment on the degree of functional loss due to such factors as pain on motion, weakened movement, excess fatigability, diminished endurance, or incoordination. The examiner should report (in degrees) the point at which pain is objectively recorded. In doing so, the examiner should offer an opinion as to whether pain could significantly limit functional ability during flare-ups or when the left knee is used repeatedly over a period of time. Such determinations should, if feasible, be portrayed in terms of the degree of additional range of motion loss due to pain on use or during flare-ups. This information must be derived from testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. The examination report must confirm that all such testing has been made and reflect the results of the testing. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. The examiner must provide a complete rationale for any opinion given. 3. Thereafter, forward the claim for a higher rating for service-connected lumbar strain to the Director, Compensation Service, for extraschedular consideration consistent with 38 C.F.R. § 3.321(b), to determine whether a higher rating is warranted for that disability on an extraschedular basis during any part of the claim period. Thereafter, the Veteran should be notified of the decision and given the opportunity to respond M. H. HAWLEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Norwood, Associate Counsel