Citation Nr: 19129686 Decision Date: 04/16/19 Archive Date: 04/16/19 DOCKET NO. 17 61-528 DATE: April 16, 2019 ORDER Entitlement to a compensable evaluation for residuals of fracture of left 4th metacarpal is denied. REMANDED Entitlement to service connection for a thoracolumbar spine disability is remanded. Entitlement to service connection for a cervical spine disability is remanded. FINDINGS OF FACT Residuals of fracture of the left 4th metacarpal is productive of painful motion. CONCLUSIONS OF LAW The criteria for a compensable evaluation of residuals of fracture of the left 4th metacarpal have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.7, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5230. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is a Veteran who served on active duty from May 1976 to May 1979. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a December 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to a compensable evaluation for residuals of fracture of the left 4th metacarpal The Veteran contends that his residuals of fracture of the left 4th metacarpal warrant a higher evaluation. The Veteran is evaluated under Diagnostic Code (DC) 5230. Under DC 5230 any limitation of motion is noncompensable. A maximum 0 percent rating is assigned under DC 5230 for any limitation of motion of the ring or little finger, whether on the major or minor hand. There is no indication of involvement of another finger. The Veteran underwent an examination in December 2016. He was diagnosed with status-post fracture of the 4th metacarpal. He reported pain at a level 10 out of 10. The location of pain was below the 4th finger, that is throbbing, sharp, and intermittent. There were reported unknown aggravating and alleviating factors. He reported flare ups on a daily basis. He is left hand dominant. He reported flare ups of pain that result in him being unable to use his hand. He reported limitations with writing. On examination he had extension of the MCP, PIP, and DIP joints to 0 degrees, and flexion of the MCP to 90 degrees, PIP to 100 degrees, and DIP to 70 degrees. There was no gap between the thumb and fingers, or between the finger and proximal transverse crease of the hand on maximal finger flexion. There was pain noted on finger flexion and evidence of pain with use of the hand. There was localized tenderness or pain on palpation of the joint and associated soft tissue. Following 3 repetitions, there was no additional function loss of range of motion. The examiner was unable to say without mere speculation whether pain, weakness, fatigability or incoordination limit functional ability with repeated use over a period of time. The reason was the examiner did not witness active flare ups during the exam and did not witness the joint being used repeated over a period of time. The examination was deemed neither medically consistent or inconsistent with the Veteran’s statements describing functional loss with repetitive use over time. X-rays were taken of the left hand that were unremarkable. VA treatment records are consistent with the findings of the examination. The Veteran is already receiving the maximum evaluation for the 4th metacarpal. As there is no minimum compensable evaluation available in this case, 38 C.F.R. § 4.59 and DeLuca are inapplicable. Based on the evidence of record, a higher rating for limited motion associated with left ring finger is not warranted. The Veteran has limited ring finger motion, without other symptomatology. Though the Veteran has noted pain associated with his left ring finger, because the diagnostic code under which the disability is rated does not provide for a compensable rating, a minimum compensable rating is not available for pain. Sowers v. McDonald, 27 Vet. App. 472 (2011). A higher rating for limited motion itself is denied. REASONS FOR REMAND 1. Entitlement to service connection for a thoracolumbar spine disability is remanded. 2. Entitlement to service connection for a cervical spine disability is remanded. Records from Healthcare Associates reveal the Veteran suffers from chronic cervical pain associated with radiculopathy symptoms into bilateral upper extremities with intermittent paresthesias, as well as radiculopathy at the lumbosacral region, intervertebral disc displacement of the lumbar region, cervical disc degeneration, and myalgia. The Veteran contends that these disabilities are related to his time in service. The only available service treatment records is a report of examination completed during the entrance examination. The Veteran has reported that his discharge examination notes his neck and back pain. There is a request on file from the NPRC for STRs, with a note all records were submitted. It is in the Veteran’s interest that the VA make another attempt to obtain a complete set of his STRs. The Veteran’s DD-214 noted he received a Parachute Badge. The Veteran has attributed his neck and back pain to his parachute jumps. He has not been afforded a VA examination. Accordingly, the Veteran’s STRs should be sought, and any further development as may then be required should occur. The matters are REMANDED for the following action: 1. Obtain any outstanding private and VA medical records and associate these records with the claims folder. 2. Contact the appropriate records repository to obtain the Veteran’s service treatment records for his period of active service. 3. Arrange for the Veteran to undergo a VA examination to determine the nature and etiology of the claimed cervical and thoracolumbar back disabilities. Following a review of the claims file, the examiner should provide an opinion for the following: Is it at least as likely as not (50 percent probability or greater) that the Veteran’s cervical spine disability, and thoracolumbar back disability are related to his service? The examiner is asked to consider the Veteran’s contentions, personnel records, and STRs. The examiner is also asked to provide a rationale for all opinions reached. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Skiouris, Associate Counsel