Citation Nr: 20032983 Decision Date: 05/12/20 Archive Date: 05/12/20 DOCKET NO. 16-19 043 DATE: May 12, 2020 REMANDED Entitlement to increased rating in excess of 20 percent for degenerative disc disease of the thoracolumbar spine is remanded. Entitlement to increased rating in excess of 10 percent for essential tremors effective October 25, 2012 is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1, 2009 to February 22, 2010. This matter come to the Board of Veterans’ Appeals (Board) on appeal from a June 2014 and March 2016 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In May 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that proceeding is of record. 1. Entitlement to increased rating in excess of 20 percent for degenerative disc disease of the thoracolumbar spine is remanded. 2. Entitlement to increased rating in excess of 10 percent for essential tremors effective October 25, 2012 The Veteran contends that he is entitled to a higher rating currently for his degenerative disc disease of the thoracolumbar spine and essential tremors. The Veteran last underwent a VA examination for compensation and pension purposes in February 2016. At the May 2019 hearing, the Veteran testified that he believes his symptoms have increased since his last VA examination. Based on the contention that his symptoms may have worsened, a new VA examination is warranted to determine the current severity of the Veteran’s degenerative disc disease of the thoracolumbar spine. The matters are REMANDED for the following action: 1. Obtain updated VA and/or identified pertinent private treatment records. If such records are unavailable, the Veteran’s claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159 (e). 2. Schedule the Veteran for a VA medical examination to determine the current severity of his service-connected degenerative disc disease of the thoracolumbar spine. The electronic claims file, to include a copy of this remand must be reviewed in conjunction with the examination. All necessary testing should be conducted. In particular, the examination must include tests of all applicable ranges of motion in active motion, passive motion, weight-bearing, and non-weight-bearing. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. In addition, if the examination is not conducted during a flare-up, the examiner must attempt to ascertain information, such as frequency, duration, characteristics, severity, and functional loss, regarding any flare-ups by alternative means. The examiner must provide an estimate of additional functional loss in terms of range of motion based on the Veteran’s statements, available medical records, and other relevant sources. The examiner must assess whether the Veteran had any episodes of acute signs and symptoms due to IDVS that required bed rest prescribed by a physician and treatment by a physician in the past 12 months. A complete rationale for all medical opinions is required. The examiner should identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge or literature, etc., relied upon in reaching the conclusion(s). If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 3. Arrange to provide the Veteran with a VA examination in order to determine the current severity of the essential tremors. (a.) 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. (b.) To the extent possible, the examiner should identify any symptoms and functional impairments due to the Veteran's essential tremors alone and discuss the effect of the essential tremors on any occupational functioning and activities of daily living. (c.) 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)   All examination findings, along with the complete rationale for all opinions expressed, must be set forth in the examination report. G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Hughes 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.