Citation Nr: 20006665 Decision Date: 01/28/20 Archive Date: 02/18/20 DOCKET NO. 17-14 991 DATE: January 28, 2020 REMANDED Entitlement to an increased rating greater than 10 percent for left navicular joint fracture with arthritis is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1966 to November 1968. He appeals an October 2014 rating decision by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) denying entitlement to an increased rating greater than 10 percent for his service-connected left navicular joint fracture with arthritis. A Board of Veterans’ Appeals (Board) hearing was held in November 2019. A transcript is of record. The Veteran was afforded a VA examination in October 2014 to assess the current severity of his residual fracture of the left navicular joint with arthritis. The Board finds the VA examiner’s opinion inadequate for adjudication purposes and remands for a new VA examination. At the October 2014 VA examination, the Veteran’s left wrist was not observed during a flare-up and the VA examiner entered “no” to the question, “does the Veteran report that flare-ups impact the function of the wrist?” See October 2014 VA examination report. While the above response implies the Veteran does suffer from flare-ups, the VA examiner stated he could not quantify “any additional range of motion loss due to pain on use or during flare-ups is impossible to measure or quantify without speculating.” Id. He also stated he could not assess whether the Veteran’s “pain, weakness, fatigability, lack of endurance or incoordination limits the functional ability during flare ups or when the joint or spine is used repeatedly over a period of time” without resorting to speculation. Id. At the November 2019 Board hearing, the Veteran reported a history of left wrist flare-ups “a few years back.” See November 2019 Board hearing transcript at 3. A VA examination is inadequate when the examiner does not elicit relevant information as to the Veteran’s flare-ups or ask him to describe additional functional loss, if any, he suffered during flares and then does not “estimate the [Veteran’s] functional loss due to flares based on all the evidence of record (including the [Veteran’s] lay information) or explain why [he] could not do so.” Sharp v. Shulkin, 29 Vet. App. 26, 35 (2017). As the October 2014 VA examiner limited his inquiry to observed flare-ups at the examination and did not elicit information from the Veteran to estimate the Veteran’s functional loss and range of motion during a flare-up, the VA examination is inadequate for rating purposes. Furthermore, the VA examination did not conduct any passive range of motion testing and is therefore not compliant with Correia v. McDonald, 28 Vet. App. 158, 169-170 (2016). See October 2014 VA examination report. On remand, attempts must be made to comply with the directives of both Correia and Sharp to properly determine the severity of the Veteran’s left wrist condition. The matters are REMANDED for the following action: 1. Obtain any outstanding and updated relevant VA and/or private treatment records and associate the same with the claims file. 2. Thereafter, schedule the Veteran for a VA examination to determine the nature and severity of his residual fracture of left navicular with arthritis. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examiner must also test the Veteran’s left wrist active motion, passive motion, and pain with weight-bearing and without weight-bearing. If possible, this should include the range of motion for the right wrist as well. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. The examiner must specifically indicate whether the Veteran’s flare-ups of left wrist pain are productive of ankylosis and, if so, whether such is favorable or unfavorable. To the extent possible, the examiner should identify any symptoms and functional impairments due to his residual fracture of left navicular alone and discuss the effect of the fracture residuals on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner 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). (Continued on the next page)   3. After the above development has been completed to the extent possible, readjudicate the claims. If any benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Bona, 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.