Citation Nr: 19106979 Decision Date: 02/01/19 Archive Date: 01/29/19 DOCKET NO. 12-25 011 DATE: February 1, 2019 REMANDED Entitlement to an increased initial rating for a left hip disability prior to December 13, 2016, rated as noncompensable is remanded. Entitlement to an increased initial rating for a left hip disability from December 13, 2016, rated at 10 percent thereafter for arthritis with limitation of motion is remanded. Entitlement to an increased initial rating for a right hip disability prior to June 18, 2014, rated at 10 percent for arthritis with limitation of motion is remanded. Entitlement to an increased initial rating for a right hip disability from June 18, 2014, to July 7, 2017, rated at 10 percent for arthritis with limitation of flexion and 10 percent for limitation of extension is remanded. Entitlement to an increased initial rating for a right hip disability, status-post total hip arthroplasty, from July 7, 2017, rated at 100 percent until September 1, 2018, and 30 percent thereafter is remanded. Entitlement to an increased initial rating for a left shoulder disability, rated at 20 percent except for a temporary total rating from March 20, 2013, to June 1, 2013, is remanded. REASONS FOR REMAND The Veteran had active service from July 1957 to July 1961. In August 2016, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. The claims for entitlement to increased initial ratings for the left hip, right hip, and left shoulder disabilities are remanded. The Board finds the record would benefit if additional evidence were obtained about any functional impairment associated with flares or repetitive use over time. Additionally, the Board finds the record warrants an updated VA examination to determine the status of the right hip disability after the June 2017 hip replacement. The matters are REMANDED for the following action: 1. Undertake appropriate development to obtain any outstanding, pertinent evidence, notably VA treatment records not currently associated with the electronic record. 2. Afford the Veteran a VA examination by an examiner with sufficient expertise to fully assess the Veteran’s service-connected left shoulder disability. All pertinent evidence of record should be made available to and reviewed by the examiner. Any indicated studies should be performed. If the examiner is unable to conduct the required testing or concludes any required testing is not necessary, he or she must explain why that is so. The examiner must provide all information required for rating purposes, to specifically include both active and passive range of motion testing, as well as weight-bearing and nonweight-bearing range of motion assessments for each shoulder. Further, the examiner must indicate if movement is limited by pain, and if so, at what point. The examiner must provide an assessment of the Veteran’s functional loss during flares, if possible in degrees of motion lost. In doing so, the examiner must consider and discuss all procurable and assembled data such as the frequency, duration, characteristics, precipitating and alleviating factors, and the severity of flare-ups. The examiner must provide a complete rationale for all proffered opinions. If the examiner cannot provide the required opinions without resorting to speculation, he or she must state whether this is based on a personal limitation or on a lack of knowledge among the medical community at large. 3. Afford the Veteran a VA examination by an examiner with sufficient expertise to fully assess the Veteran’s service-connected right and left hip disabilities. All pertinent evidence of record should be made available to and reviewed by the examiner. Any indicated studies should be performed. If the examiner is unable to conduct the required testing or concludes any required testing is not necessary, he or she must explain why that is so. The examiner must provide all information required for rating purposes, to specifically include both active and passive range of motion testing, as well as weight-bearing and nonweight-bearing range of motion assessments for each shoulder. Further, the examiner must indicate if movement is limited by pain, and if so, at what point. The examiner must provide an assessment of the Veteran’s functional loss during flares, if possible in degrees of motion lost. In doing so, the examiner must consider and discuss all procurable and assembled data such as the frequency, duration, characteristics, precipitating and alleviating factors, and the severity of flare-ups. The examiner must provide a complete rationale for all proffered opinions. If the examiner cannot provide the required opinions without resorting to speculation, he or she must state whether this is based on a personal limitation or on a lack of knowledge among the medical community at large. (Continued on the next page)   4. Thereafter, readjudicate the Veteran’s claims. If a benefit sought on appeal remains denied, the Veteran should be provided a supplemental statement of the case (SSOC). The SSOC must contain notice of all relevant actions taken on the claim for benefits, to include a summary of the evidence and applicable law and regulations considered pertinent to the issue currently on appeal. An appropriate period of time should be allowed for response. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Snyder, counsel