Citation Nr: 20007685 Decision Date: 01/29/20 Archive Date: 01/29/20 DOCKET NO. 18-02 392 DATE: January 29, 2020 REMANDED Entitlement to a rating in excess of 20 percent for residuals of left radial and median nerve disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1975 to July 1978. In December 2019, the Veteran presented testimony before the undersigned Veterans Law Judge of the Board. The content of that testimony has been considered and is reflected in the remand discussion below. By way of background, the Board notes that the Veteran was awarded a 20 percent rating effective from October 26, 1981, in an April 2014 rating decision. In so finding, the RO determined there was clear and unmistakable error (CUE) in an October 1982 rating decision that awarded only 10 percent for residuals of left wrist laceration with injury of radial nerve and painful subcutaneous nodule. Further, a July 2008 rating decision granted service connection for traumatic injury to the left median nerve with a 10 percent rating, effective February 5, 2008. A November 2009 rating decision assigned an effective date of January 31, 2000 for the 10 percent rating of the left median nerve. The Veteran now seeks a rating in excess of 20 percent for his service-connected nerve disabilities. He also argues that he is entitled to separate ratings for the radial and median nerve disabilities. The evidence of record shows the last examination of the Veteran’s nerves was in September 2011. In his December 2019 Board hearing, the Veteran indicated that it is his belief that his service-connected radial and ulnar nerves are more severe than indicated by the prior examination on record. Therefore, for the reasons noted above, the Board finds that a new VA examination is needed to ascertain the current severity and manifestations of this service-connected disability. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994). The matters are REMANDED for the following action: 1. Associate with the file all VA and private treatment for the Veteran dated from December 2017 to the present that have not previously been obtained. 2. After completing the foregoing development, the Veteran should be afforded a VA examination to ascertain the severity and manifestation of his service-connected left hand radial and ulnar nerve disabilities. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is instructed to review all pertinent records associated with the claims file. It should be noted that the Veteran is competent to attest to factual matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. THE EXAMINER IS ASKED TO PROVIDE COMMENT ON WHETHER THE MANIFESTATIONS OF THE RADIAL AND ULNAR NERVE DISABILITIES ARE SEPARATE AND DISTINCT, OR DO THEY OVERLAP TO THE EXTENT THE DIFFERENTIATION IS NOT POSSIBLE. 3. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Because it is important “that each disability be viewed in relation to its history [,]” (38 C.F.R. § 4.1), copies of all pertinent records in the Veteran’s claims file, or in the alternative, the claims file, must be made available to the examiner for review. 4. THE AOJ MUST REVIEW THE CLAIMS FILE AND ENSURE THAT THE FOREGOING DEVELOPMENT ACTION HAS BEEN COMPLETED IN FULL. IF ANY DEVELOPMENT IS INCOMPLETE, APPROPRIATE CORRECTIVE ACTION MUST BE IMPLEMENTED. IF ANY REPORT DOES NOT INCLUDE ADEQUATE RESPONSES TO THE SPECIFIC OPINIONS REQUESTED, IT MUST BE RETURNED TO THE PROVIDING EXAMINER FOR CORRECTIVE ACTION. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Berry, 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.