Citation Nr: 1821906 Decision Date: 04/11/18 Archive Date: 04/19/18 DOCKET NO. 12-33 115 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUE Entitlement to a disability rating in excess of 20 percent for status post left shoulder subluxation. REPRESENTATION Veteran represented by: AMVETS ATTORNEY FOR THE BOARD M. Moore, Counsel INTRODUCTION The Veteran served on active duty in the United States Army from November 1986 to July 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Seattle, Washington. The Board remanded this claim in July 2016 and April 2017. The appeal is REMANDED to the Agency of Original Jurisdiction (AOJ). VA will notify the Veteran if further action on her part is required. REMAND Although the Board regrets the delay, remand is necessary to ensure that there is a complete record on which to decide the Veteran's claim. The most recent VA examination notes that the Veteran reported flare ups of left shoulder symptoms. Although the examiner noted these complaints, he indicated that the examination was not performed during a flare up and failed to provide any estimate of the Veteran's functional loss during flare ups based on information in the medical records and elicited from the Veteran. Rather, he simply stated that he could not quantify the functional loss during a flare up because the Veteran was not experiencing a flare up during the examination. Such a statement is not sufficient. As such, the claim must be remanded for a new VA examination that adequately addresses the Veteran's reported flare ups. See Sharp v. Shulkin, 29 Vet. App. 26 (2017). As the case is being remanded, the Board will take the opportunity to obtain any outstanding VA treatment records. Accordingly, the case is REMANDED for the following actions: 1. Obtain and associate with the claims file any outstanding VA treatment records from the Sioux Falls VA Medical Center and any other VA facility identified by the Veteran. All attempts to obtain these records should be documented in the claims file. 2. Thereafter, the Veteran should be scheduled for a VA examination with an appropriate examiner to determine the current nature and severity of her service-connected left shoulder disability. The examiner must review the entire claims file and the examination report must reflect that such a review was conducted. The examiner should identify any symptoms that the Veteran currently manifests or has manifested that are attributable to her service-connected left shoulder disability. All appropriate testing, including range of motion, should be performed. The examiner should determine whether the Veteran is unable to maintain gainful employment as a result of her service-connected disabilities. The examiner is asked to describe whether pain significantly limits functional ability during flare-ups, and if so, the examiner must estimate range of motion during flares. IF THE EXAMINATION DOES NOT TAKE PLACE DURING A FLARE, THE EXAMINER MUST GLEAN INFORMATION REGARDING THE FLARES' SEVERITY, FREQUENCY, DURATION, AND FUNCTIONAL LOSS MANIFESTATIONS FROM THE VETERAN, MEDICAL RECORDS, AND OTHER AVAILABLE SOURCES. EFFORTS TO OBTAIN SUCH INFORMATION MUST BE DOCUMENTED. If there is no pain and/or no limitation of function, such facts must be noted in the report. The examination should also record the results of range of motion testing for pain on BOTH active and passive motion AND in weight-bearing and nonweight-bearing. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). 3. After completing the above actions, the Veteran's claim should be readjudicated. If the claim remains denied, a supplemental statement of the case should be provided to the Veteran and her representative. After they have had an adequate opportunity to respond, the case should be returned to the Board for further appellate review. The Veteran has the right to submit additional evidence and argument on the matter the Board has remanded. See Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by the United States Court of Appeals for Veterans Claims (Court) for additional development or other appropriate action must be handled in an expeditious manner. 38 U.S.C. §§ 5109B, 7112 (2012). _________________________________________________ A. S. CARACCIOLO Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C. § 7252 (2012), only a decision of the Board is appealable to the Court. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2017).