Citation Nr: 18159741 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 13-25 821 DATE: December 20, 2018 ORDER Entitlement to a 10 percent rating for residuals of a partial amputation of the tip of the third right finger (long finger) is granted, subject to the laws and regulations governing the award of monetary benefits. FINDING OF FACT The Veteran’s right middle finger was amputated at the distal half of the distal phalanx. The evidence shows that the Veteran’s right middle finger has manifested pain since his injury. CONCLUSION OF LAW The criteria for an initial rating of 10 percent, but no higher, for residuals of a partial amputation of the tip of the third right finger (long finger) have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.59, 4.71a, Diagnostic Code 5154. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from November 1965 to November 1967. In a September 2017 decision, the Board denied the claim. The Veteran subsequently appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In a July 2018 order, the Court granted a Joint Motion for Remand (JMR), which vacated the Board’s decision and remanded the Veteran’s appeal to the Board for action consistent with the terms of the JMR. The following decision is subsequent to that remand. Entitlement to a compensable disability rating for residuals of a partial amputation of the tip of the third right finger (long finger). The Veteran contends that he is entitled to a compensable rating for his right middle finger disability, currently evaluated as 0 percent disabling. Ratings for service-connected disabilities are determined by comparing the veteran’s symptoms with criteria listed in VA’s Schedule for Rating Disabilities, which is based, as far as practically can be determined, on average impairment in earning capacity. Separate diagnostic codes identify the various disabilities. 38 C.F.R. Part 4. When rating a service-connected disability, the entire history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). The intent of the rating schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint. 38 C.F.R. § 4.59. Service connection was initially granted in a July 1980 rating decision for residuals of an amputation of the distal half of the distal phalanx, third finger, right hand (hereinafter referred to right middle fingertip amputation). The Veteran’s right middle fingertip amputation is rated under 38 C.F.R. § 4.71a Diagnostic Code (DC) 5154, Long finger amputation of. Under DC 5154, a 20 percent rating is assigned for major or minor hand long finger amputation with metacarpal resection (more than half the bone lost). Without resection of the metacarpal, amputation of the long finger of either the major or minor hand at the proximal interphalangeal joint or proximal thereto warrants a rating of 10 percent. Id. The Veteran was given a VA examination in February 2010. The Veteran reported to the examiner that he continues to have pain to the residual amputation. The pain impacts his functionally whenever he attempts to lift something. The examiner noted that the Veteran was able to maintain his employment as a letter carrier with the post office. The Veteran further reported that he has had the pain since his injury. The examiner described the Veteran’s amputation site as: distal half of distal phalanx third finger right hand. The Veteran was given a VA examination in November 2012. The examiner noted that the Veteran’s records reflected that he has had progressive pain associated with numbness and stiffness following the amputation of the partial distal tip of his right third finger. The Veteran reported to the examiner that he has daily pain that has progressively worsened with increased sensitivity to cold, for which he takes Tylenol for relief daily. The Veteran also reported to the examiner that he retired from the postal service in 2009. He stated that his injury forced him to retire early due to it slowing him down. The examiner described the Veteran’s amputation as Status post amputation of the distal phalanx of the right third digit i.e., the middle finger. The Veteran testified at a Board hearing in December 2016. At that hearing, the Veteran testified that he experiences pain to his right middle finger. The Veteran testified that he is also right handed and the pain can affect his grip. He was also told by his providers that he should not be experiencing pain, but the Veteran reports he does have pain. Upon review of the evidence of record, he Board finds that a compensable rating is not warranted under DC 5154. The Veteran’s amputation to his right third finger is distal to the distal phalanx. The April 2010 examiner specifically noted the Veteran’s amputation was the distal half of the distal phalanx. Thus, the Veteran’s right long finger amputation does not meet the criteria for a compensable rating under DC 5154 of being at proximal interphalangeal joint or proximal thereto. The Board does find that a 10 percent rating is warranted, the minimum compensable evaluation, for painful motion per 38 C.F.R. § 4.59. The Veteran has consistently reported to the VA examiners during his April 2010 and November 2012 and during his testimony at his Board hearing in December 2016 that his right middle finger amputation causes him pain. The Veteran is competent to report these symptoms as they are readily apparent to him. Layno v. Brown, 6 Vet. App. 465 (1994). Accordingly, a 10 percent rating is granted under DC 5154. See Sowers v. McDonald, 27 Vet. App. 472 (2016); 38 C.F.R. § 4.59. (Continued on the next page)   In summary, the Board finds the preponderance of evidence shows the Veteran is entitled to a 10 percent rating, but no higher, for residuals of a partial amputation of the tip of the third right finger (long finger). M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Perkins, Michael