Citation Nr: 20003885 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 14-21 379 DATE: January 16, 2020 ISSUES 1. Entitlement to service connection for arthritis of the bilateral hips, to include as secondary to the service-connected osteoporosis with residuals, fracture of the bilateral pubic bones. 2. Entitlement to an initial disability evaluation in excess of 10 percent for service-connected limited flexion with osteoporosis, residuals, fracture right pubic bone. 3. Entitlement to an initial disability evaluation in excess of 10 percent for service-connected limited flexion with osteoporosis, residuals, fracture left pubic bone. 4. Entitlement to an initial compensable disability evaluation for service-connected limited extension with osteoporosis, residuals, fracture right pubic bone. 5. Entitlement to an initial compensable disability evaluation for service-connected limited extension with osteoporosis, residuals, fracture left pubic bone. 6. Entitlement to a total disability rating based on individual unemployability (TDIU). REMANDED Entitlement to service connection for arthritis of the bilateral hips, to include as secondary to the service-connected osteoporosis with residuals, fracture of the bilateral pubic bones is remanded. Entitlement to an initial disability evaluation in excess of 10 percent for service-connected limited flexion with osteoporosis, residuals, fracture right pubic bone is remanded. Entitlement to an initial disability evaluation in excess of 10 percent for service-connected limited flexion with osteoporosis, residuals, fracture left pubic bone is remanded. Entitlement to an initial compensable disability evaluation for service-connected limited extension with osteoporosis, residuals, fracture right pubic bone is remanded. Entitlement to an initial compensable disability evaluation for service-connected limited extension with osteoporosis, residuals, fracture left pubic bone is remanded. Entitlement to a TDIU is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1951 to June 1954, from June 1956 to June 1960, and from September 1960 to August 1964. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Decatur, Georgia. Jurisdiction was transferred to the RO in Roanoke, Virginia. In October 2017 the Veteran and D. W. presented testimony in a travel Board hearing before the undersigned. A copy of the transcript has been associated with the record. When this case was previously before the Board in December 2017, it was remanded for additional evidentiary development. It has since been returned to the Board for further appellate action. The Board notes that the Veteran changed representation during the pendency of this appeal, and Robert Holub is recognized as his attorney. In response to the Board’s remand, the Veteran was afforded VA-contracted examination in April 2018. Moreover, an opinion regarding bilateral hip osteoarthritis was provided in August 2018; however, no opinion was provided regarding bilateral pelvic bone osteoarthritis. Subsequent to the April 2018 examination, the Veteran submitted lay statements in December 2019 attesting to the severity of his symptoms to include an inability to cross his legs without falling due to his legs giving out and needing help getting up and down from a walker. The Board notes that these symptoms were not noted on the April 2018 examination. To this point, the Veteran requested a new VA examination in December 2019 correspondence, noting that the August 2018 opinion did not address any bilateral pelvic bone osteoarthritis. Moreover, the Veteran stated that the examination did not adequately address his testimony as to having pain at all times; the Board notes that the August 2018 examination noted no pain on examination. As such, the Board finds that the Veteran should be afforded a VA examination on remand to address the severity of his service-connected disabilities on appeal and to address the etiology of the bilateral pelvic bone osteoarthritis. Finally, the Board notes that in the December 2019 correspondence, the Veteran’s attorney asked that the RO try again to contact his former employer MSC to obtain his records. As such, the Board finds that the RO should request records from MSC on remand. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA treatment records; and, with appropriate authorization from the Veteran, any additional outstanding private treatment records identified by him as pertinent to his claims. If any of these records are found to be unavailable, this should be specifically noted in the claims file, and the Veteran should be notified as to the unavailability of such records pursuant to 38 C.F.R. § 3.159 (e). 2. Request employment records from MSC. If any of these records are found to be unavailable, this should be specifically noted in the claims file, and the Veteran should be notified as to the unavailability of such records pursuant to 38 C.F.R. § 3.159 (e). 3. Then, the Veteran should be afforded a VA examination by an examiner with appropriate expertise to determine the etiology of any bilateral pelvic bone osteoarthritis diagnosed during the pendency of this appeal and the current degree of severity of the service-connected bilateral pubic bones and hips disabilities. The electronic claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed. All testing deemed necessary must be conducted and results reported in detail. The examiner should: a) Opine whether is it at least as likely as not (a 50 percent probability or greater) that any bilateral pelvic bone osteoarthritis diagnosed during the pendency of this appeal had onset in service or is otherwise etiologically related to service. b) Opine whether is it at least as likely as not (a 50 percent probability or greater) that any bilateral pelvic bone osteoarthritis diagnosed during the pendency of this appeal was caused by the Veteran’s service-connected osteoporosis with residuals, fracture of the bilateral pubic bones. c) Opine whether is it at least as likely as not (a 50 percent probability or greater) that any bilateral pelvic bone osteoarthritis diagnosed during the pendency of this appeal was aggravated (permanently worsened beyond its natural progression) by the Veteran’s service-connected osteoporosis with residuals, fracture of the bilateral pubic bones. Conduct all indicated tests and studies, to include range of motion studies expressed in degrees and in relation to normal range of motion, and should describe any pain, weakened movement, excess fatigability, and incoordination present. To the extent possible, express any functional loss in terms of additional degrees of limited motion of the Veteran’s bilateral pubic bones and hips, i.e., the extent of the Veteran’s pain-free motion. Pursuant to Correia v. McDonald, 28 Vet. App. 158 (2016), please record the results of range of motion testing for pain on both active and passive motion and in weight-bearing and non-weight-bearing. If a joint cannot be tested on “weight-bearing,” please specifically indicate why that testing cannot be done. If no pain is found on examination, the examiner must address the Veteran’s testimony as to having pain at all times. Pursuant to Sharp v. Shulkin, 29 Vet. App. 26 (2017), 29 Vet. App. 26, the examiner is instructed to inquire whether there are periods of flare-ups. If the answer is “yes,” the examiner should state their severity, frequency, and duration explaining if there are any additional or increased symptoms and limitations experienced during flares. Additionally, the examiner must provide an assessment of the Veteran’s functional loss during flares and with repeated use over a period of time, 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 ALSO name the precipitating and alleviating factors. The examiner must ALSO estimate, “per [the] Veteran,” to what extent, if any, they affect functional impairment. If the examiner cannot provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, he or she must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). A full and complete rationale for any opinions expressed is required. 4. Ensure that the examination report is adequate. If it is deficient in any manner, return the report to the examiner as inadequate. 5. After conducting any other development deemed necessary, readjudicate the Veteran’s claim. If any benefit sought on appeal remains denied, provide the Veteran and his attorney with a supplemental statement of the case and allow an appropriate period of time for response. Thereafter, the claims folder should be returned to the Board. MICHAEL A. PAPPAS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R.M.K., 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.