Citation Nr: 19133158 Decision Date: 04/29/19 Archive Date: 04/29/19 DOCKET NO. 17-53 035 DATE: April 29, 2019 REMANDED Entitlement to a disability rating higher than 20 percent for a lower back disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1965 to April 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that where the evidence indicates that a service-connected disability has worsened since the last VA examination, and that examination is too remote to constitute a contemporaneous examination, a new examination is required. See 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); see also Snuffer v. Gober, 10 Vet. App. 400 (1997); Green v. Derwinski, 1 Vet. App. 121; Caffrey v. Brown, 6 Vet. App. 377, 381 (1994). The Veteran was last afforded a VA examination to assess the severity of his service-connected lower back disability in October 2014, more than four years ago. Subsequent to the examination, evidence has been submitted, to include medical records and statements by the Veteran and his representative, indicating the Veteran’s lower back disability has worsened since the October 2014 examination. Under these circumstances, the Board finds a remand is warranted for an additional VA examination. The Board also notes the Veteran has contended he has been in receipt of medical care at the William Beaumont Army Medical Center continuously since August 2006. On review, only records between 2004 and 2006 have been associated with the record. As such, efforts to obtain any outstanding records will be undertaken on remand. The matter is REMANDED for the following actions: 1. Undertake appropriate development to obtain any outstanding records pertinent to the Veteran’s claim. If any requested records are not available, the record should be annotated to reflect such, and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 2. Obtain all treatment records from the William Beaumont Army Medical Center since August 2006. 3. Then, afford the Veteran a VA examination to determine the current severity of his service-connected lower back disability. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated tests and studies should be performed. The examiner is directed to perform range of motion testing to determine the extent of limitation of motion due to pain on active motion and passive motion, as well as with weight-bearing and without weight-bearing. If the examiner is unable to conduct the required testing or concludes the required testing is not necessary in this case, he or she should clearly explain why this is so. The examiner should further discuss additional functional limitation of the thoracolumbar spine with repeated movement over time and upon flare-ups. Any such additional limitation of motion should be expressed in additional degrees of lost motion. The examiner must attempt to provide an estimate, even in the absence of an opportunity to observe the flare-up. The estimate may be based on the Veteran’s reports of limitation during such flares. The examiner must provide a rationale for any proffered opinion. (Continued on the next page)   4. Then, readjudicate the issue on appeal, undertaking any additional development deemed necessary. If the benefit sought on appeal remains denied, issue the Veteran and his representative a Supplemental Statement of the Case and allow a reasonable period for response. Then, return the matter to the Board for its review, as appropriate. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Hampton, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.