Citation Nr: 18159702 Decision Date: 12/19/18 Archive Date: 12/19/18 DOCKET NO. 17-05 595 DATE: December 19, 2018 REMANDED Entitlement to an initial compensable rating for a right index finger extensor tendonous rupture status-post repair; osteoarthritis is remanded. Entitlement to an initial compensable rating for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1970 to October 1990. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an June 2015 rating decision. In regard to his right index finger disability, in November 2015, the Veteran submitted private medical records (dated July 2015) which indicated that his right index finger was unable to touch his palm. In March 2017, additional private medical records indicated that the Veteran’s right index finger disability continued to cause him pain, limited flexion, and stiffness. However, the private records did not indicate the measurement of the gap between the Veteran’s fingertip and his palm. VA examinations conducted in June 2015 and November 2016 did not record this severity of symptomology or indicate that the private medical records had been reviewed. As such, the Board finds that the private medical records and the VA examinations are inadequate for adjudication purposes. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). When an examination is inadequate, the Board must remand the case for further development. Bowling v. Principi, 15 Vet.App. 1 (2001), 38 C.F.R. § 4.2. In regard to his claim for bilateral hearing loss, in March 2016, VA medical center (VAMC) records indicated that the Veteran had undergone an audiological examination which showed he had mild to moderate hearing loss. The actual audiological results of this examination, however, are not included in the Veteran’s VA medical records, however. Additionally, in the March 2016 VAMC records, the Veteran was noted to have had treatment for his hearing at Loma Linda University. These records are also not associated with the Veteran’s claims file. The Board notes that VA’s duty to assist extends to obtaining “sufficiently identified VA medical records or records of examination or treatment at non-VA facilities authorized by VA, regardless of their relevance.” Sullivan v. McDonald, 815 F.3d 786, 793 (Fed. Cir. 2016) (citing 38 C.F.R. § 3.159 (c)(3)). As such, the Board finds that remand is necessary to obtain any outstanding VA medical center records, specifically the results of the March 2016 audiology examination, pertaining to the Veteran. The matters are REMANDED for the following action: 1. Associate with the record any VA clinical documentation not already of record pertaining to treatment of the Veteran, specifically including the puretone threshold results of the March 2016 audiological examination. 2. Contact the Veteran and afford him the opportunity to identify by name, address, and dates of treatment or examination any relevant private medical treatment records for his bilateral hearing loss and right finger condition. After securing the proper authorizations where necessary, arrange to obtain all the records of treatment or examination from all the sources listed by the Veteran that are not already on file, including Loma Linda University and Orthopaedic Medical Group of Riverside, Inc., and/or Dr. J.B.G. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. Thereafter, schedule the Veteran for a VA examination to determine the nature and severity of his service-connected right finger disability. The claims file must be made available to the examiner for review in connection with the examination, and it should be confirmed that such records were available for review. All necessary tests and studies should be accomplished, and complaints and clinical manifestations should be reported in detail. The examination report must include a complete rationale for all opinions expressed. Complete range of motion testing should be accomplished and the examiner should note the point at which there is pain on motion, if any. Specifically, active and passive range of motion testing as well as weight-bearing and non-weight-bearing testing must be conducted. The examiner should also note any additional loss of function with repetition due to factors such as pain, weakness, fatigability, and pain on movement. The extent of additional limitation should be expressed in degrees. If flare-ups are reported, the examiner must express an opinion on whether the flare-ups are associated with additional functional loss; if so; the examiner should estimate the degrees of lost motion during such flare-ups. If the examination is not conducted during a flare-up, the functional impact of a flare-up should be estimated based on the Veteran’s reports. The examiner must indicate whether there is a gap between the fingertip and the proximal transverse crease of the palm, with the finger flexed to the extent possible. The examiner should also indicate whether extension of the index finger is limited by more than 30 degrees. The examiner should note whether there is favorable or unfavorable ankylosis or whether the Veteran has had any amputation or loss of use of the fingers. The examiner should indicate the nature and extent of any associated right finger(s) neurological impairment. If the examiner is unable to conduct any required testing or concludes that the required testing is not necessary in this case, the examiner should clearly explain why that is so. The Veteran’s lay statements and his private medical treatment records, specifically those from July 2015 and March 2017, should be noted and addressed. The examiner should provide a complete rationale for all opinions expressed and conclusions reached. 4. After ensuring compliance with the development requested above, readjudicate the claims. If any decision is adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Parrish, Associate Counsel