Citation Nr: 20021247 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 16-32 565 DATE: March 25, 2020 REMANDED Entitlement to an initial compensable rating for left lower extremity shin splints is remanded. Entitlement to an initial compensable rating for right lower extremity shin splints is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corp from July 1978 to June 1983. These matters come before the Board of Veterans’ Appeals (Board) from an April 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2019, the Veteran provided testimony before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the claims file. In December 2019, the Board remanded the claims for further development and the appeal has been returned to the Board. Entitlement to an initial compensable rating for bilateral lower extremity shin splints is remanded. As stated above, the Board previously remanded the issue of entitlement to an initial compensable rating for bilateral lower extremity shin splints in December 2019. That remand instructed the RO to afford the Veteran a medical examination to address the functional impairment and limitations due to the bilateral lower extremity condition and to indicate whether the shin splints cause any knee or ankle impairments. The examination was also to address the functional impairment and limitations, if any, during flare-ups, and to address whether the flare-ups cause any knee or ankle impairments, and if so, to indicate whether the impairments are slight, moderate, or marked. Pursuant to that remand, the Veteran attended a December 2019 VA knee and lower leg conditions examination. The examiner confirmed a diagnosis of bilateral shin splints and right knee meniscal tear. The examination report included range of motion measurements. In a section entitled “additional comments” with a question inquiring whether the Veteran has or ever had recurrent patellar dislocation, “shin splints,” stress fractures, chronic exertional compartment syndrome, or any other tibial or fibular impairment; the examiner indicated “no.” This is in direct contradiction with the Veteran’s history of bilateral shin splints, as noted in the April 2016 and April 2019 VA knee and lower leg examinations. Furthermore, subsequent portions of the examination report addressing the impact of the ankle and knee impairments were left blank. The Board also notes that the examination reflected pain, weakness, or fatigability, limiting functional ability with flare-ups. However, the examiner did not indicate whether the flare ups cause any knee or ankle impairments, and if so, whether the impairments are slight, moderate, or marked pursuant to the December 2019 Board remand. Stegall v. West, 11 Vet. App. 268 (1998) (holding that a remand by the Board confers the right to compliance with remand orders). The omission in discussing the impact of functional impairments during flare-ups on the knee or ankle, as well as, the degree of severity for those impairments, renders the December 2019 examination inadequate. On remand, an addendum opinion is needed to address the Veteran’s history of shin splints and whether it causes any knee or ankle impairments, as well as, the functional impairment during flare-ups, to include any knee or ankle impairments and whether those impairments are slight, moderate, or marked. These matters are REMANDED for the following actions: 1. Obtain and associate with the claims file updated VA and/or private treatment records, if any. All efforts to obtain additional evidence must be documented in the claims folder. 2. Obtain an addendum opinion from the examiner who conducted the December 2019 VA examination for knee and lower leg conditions, or another appropriate clinician. The examiner providing the opinions must be provided access to the electronic claims file and indicate review of the file in the examination report. The claims folder and a copy of this remand in its entirety must be provided to the examiner in conjunction with the addendum opinion. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, and lay statements; the examiner must indicate on the examination report that such review was undertaken. If examination of the Veteran is necessary, such should be arranged. The examiner must conduct all necessary testing to determine the severity of the Veteran’s bilateral lower extremity shin splints and document all symptoms in detail. The examiner should address the functional impairment and limitations due to the disabilities and indicate whether the shin splints cause any knee or ankle impairments. The examiner should also address the functional impairment and limitations, if any, during flare-ups, and indicate whether the flare-ups cause any knee or ankle impairments. If the shin splints result in impairments of the knee or ankle, the examiner should discuss the severity of the impairments, to include whether the impairments are slight, moderate, or marked. The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to the bilateral shin splints and discuss the effect of the Veteran’s lower extremity on his knee and ankle. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran’s statements. 3. Readjudicate the Veteran’s claims on appeal. If the benefits sought on appeal remains denied, provide the Veteran and his representative a supplemental statement of the case and allow an appropriate period for response. L. CHU Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Y. Asfaw, 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.