Citation Nr: 19130488 Decision Date: 04/18/19 Archive Date: 04/18/19 DOCKET NO. 17-24 945 DATE: April 18, 2019 REMANDED The claim of entitlement to an initial rating higher than 10 percent for thoracolumbar scoliosis with degenerative arthritis is remanded. The claim of entitlement to an initial rating higher than 20 percent for left lower extremity radiculopathy associated with thoracolumbar scoliosis is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1969 to April 1973, September 1979 to November 1979, and December 1979 to November 1995. 1. The claim of entitlement to an initial rating higher than 10 percent for thoracolumbar scoliosis with degenerative arthritis is remanded. Unfortunately, this claim requires additional development. The Veteran’s thoracolumbar scoliosis has not been subject to a VA examination since 2014. The record suggests that it has increased in severity. The Veteran reports that she is unable to stand up straight, which she argues is tantamount to ankylosis. The record shows she had a surgical fusion of the T1/C3 vertebrae in March 2015, which further suggests the presence of ankylosis. Ankylosis is the “[s]tiffening or fixation of a joint as the result of a disease process, with fibrous or bony union across the joint.” Dinsay v. Brown, 9 Vet. App. 79, 81 (1996). It also has been described as complete immobility and consolidation of a joint due to disease, injury or surgical procedure. See Lewis v. Derwinski, 3 Vet. App. 259 (1992). She has also asserted, and the record supports, that her scoliosis affects her lung function. An updated VA examination report that details her symptoms must be obtained. 2. The claim of entitlement to an initial rating higher than 20 percent for left lower extremity radiculopathy associated with thoracolumbar scoliosis is remanded. This claim is inextricably intertwined with the above claim, and must also be remanded. An updated VA examination shall also be conducted. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records since September 2018. 2. After completion of directive 1, schedule the Veteran for an appropriate examination of the spine for a report on the current severity of her thoracolumbar scoliosis. The examiner is asked to review the claims file and medical records prior to the examination. Given the level of discomfort caused by her disability, the examiner is asked to limit physical testing to only what is necessary to answer the questions posed by the Board. To that end, the examiner is asked to take a detailed history from the Veteran regarding her symptoms. The Veteran has reported that she is unable to stand up straight. She reported it causes her to lose her balance and fall forward. The record also shows that she has had surgical fusion of the T1/C3 vertebrae. The examiner is asked whether this evidence demonstrates that the Veteran has ankylosis. If so, the examiner is asked what part of the spine, and if it is favorable or unfavorable ankylosis. The examiner is asked whether the ankylosis causes difficulty walking because of limited line of vision, restricted opening of the mouth and chewing, breathing limited to diaphragmatic respiration, gastrointestinal symptoms due to pressure on the abdomen, dyspnea or dysphagia, atlantoaxial or cervical subluxation or dislocation, or neurologic symptoms due to nerve root stretching. The examiner is asked to provide a report on the effect scoliosis has on lung function and breathing. If unable to opine on this aspect of her claim, the examiner is asked to notify the scheduling authority to schedule a separate pulmonary examination. All opinions must be accompanied by explanation. 3.   4. After completion of directive 1, schedule an appropriate examination for a report on the current severity of left lower extremity radiculopathy. The examiner is asked to review the record prior to the examination. The examiner is asked whether the Veteran has moderately severe incomplete paralysis of the sciatic nerve, or severe incomplete paralysis with marked muscular atrophy. All opinions must be accompanied by explanation. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Gibson