Citation Nr: 20005246
Decision Date: 01/22/20	Archive Date: 01/22/20

DOCKET NO. 16-22 035
DATE: January 22, 2020

REMANDED

Entitlement to an initial compensable rating for residuals of fractured first left metacarpal with degenerative arthritis of the left hand is remanded.

REASONS FOR REMAND

The Veteran served on active duty from June 1950 to June 1954.

This appeal arose to the Board of Veterans’ Appeals (Board) from an April 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Detroit, Michigan.

Entitlement to an initial compensable rate for residuals of fractured first left metacarpal with degenerative arthritis of the left hand is remanded.

The Veteran argues that he is entitled to an initial compensable rating for his left thumb disability. He contends that he suffers from “angulation” of the thumb, which is akin to ankylosis and causes significant limitation of motion. At his December 2009 VA Compensation and Pension (C&P) examination, it was noted that the Veteran suffered from angulation; however, the examiner did not discuss whether such was analogous to ankylosis. Additionally, more recent VA treatment records show that the Veteran’s left thumb symptoms have worsened. In January 2016, he reported progressive deformity of the thumb with decreased grip strength, including limitations with activities such as shoveling snow, moving the lawn, and opening bottles. Accordingly, an additional examination is necessary prior to adjudication. See Green v. Derwinski, 1 Vet. App. 121, 124 (1991) (VA has a duty to provide the Veteran with a thorough and contemporaneous medical examination); Caffrey v. Brown, 6 Vet. App. 377, 381(1994) (an examination too remote for rating purposes cannot be considered “contemporaneous”).

The matters are REMANDED for the following action:

Schedule the Veteran for an examination to determine the nature and severity of his left thumb disability.

(a)	Identify and describe all symptoms and manifestations attributable to the service-connected left thumb disability. All necessary diagnostic testing and evaluation should be performed, including range of motion testing for flexion and extension, in both passive and weight-bearing situations.

(b)	Determine whether the left thumb exhibits pain or painful motion, weakened movement, premature or excess fatigability, or incoordination; and, if feasible, these determinations should be expressed in terms of the degree of additional functional loss, including in terms of what effect, if any, this has on the range of motion of the left thumb, including during times when these symptoms are most problematic (“flare ups”) or during prolonged, repetitive, use of the left thumb.

(c)	Inquire whether there are periods of flare-ups and, if the answer is yes, to state their “severity, frequency, and duration; name the precipitating and alleviating factors; and estimate, ‘per [the] veteran,’ to what extent, if any, they affect functional impairment.

(d)	Specifically discuss the Veteran’s contentions that his left thumb “angulation” is analogous to ankylosis.

 

 

LESLEY A. REIN

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	C. Ryan, 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.