Citation Nr: 20041275 Decision Date: 06/17/20 Archive Date: 06/17/20 DOCKET NO. 13-08 949 DATE: June 17, 2020 REMANDED Entitlement to an increased disability rating greater than 10 percent for left wrist sprain, to include on an extraschedular basis, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1982 to November 1985. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a July 2010 rating decision by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). The Board first denied the Veteran’s claim in April 2015. She appealed the Board denial to the Court of Appeals for Veterans Claims (Court) and, in a June 2016 Memorandum Decision, the Court vacated the decision and remanded the case for readjudication as the Board decision did not include adequate reasons and bases and did not address why a referral of the matter to the Director of Compensation Service for extraschedular consideration was not warranted. In May 2017, the Veteran submitted additional evidence in support of the claim and requested AOJ review of the evidence in addition to a request for a functional capacity evaluation (FCE) if the claim could not be granted in full. The matter was returned to the Board in July 2017 where it was, again, denied. Again, the Veteran appealed to the Court. In April 2018, pursuant to a Joint Motion for Remand (JMR), the Court vacated and remanded the matter to the Board so the additional evidence provided by the Veteran in May 2017 could be considered by the AOJ, as requested by the Veteran. In August 2018, pursuant to the April 2018 JMR, the Board remanded the Veteran’s claim back to the AOJ for further development consistent with the Court’s JMR findings. This included a request to refer the claim to the Director of Compensation Service for extraschedular consideration. After this development, an April 2019 Board decision denied the Veteran’s increased ratings claim, to include on an extraschedular basis. The Veteran, for a third time, appealed this decision to the Court. In December 2019, pursuant to a JMR, the Court vacated the April 2019 Board decision and remanded for further development. The claim is now returned to the Board for further consideration consistent with the Court’s order. The December 2019 JMR noted the Veteran requested Functional Capacity Evaluation (FCE) testing to fully assess the full effect of her left wrist sprain on her ability to work; the Court determined the Board had not adequately explained why such an evaluation was not necessary. In May 2017, the Veteran also submitted a private medical examination report by Dr. DS who opined FCE testing would assist in assessing the effect of the Veteran’s left wrist sprain on her ability to work as she is left hand dominant. The Board determines that FCE testing is unnecessary, as the normal process of a compensation and pension examination contemplates and addresses all of the reported problems and limitations raised by the Veteran. The VA examinations are designed, and periodically revised, to best capture the “the average impairment in earning capacity” from functional limitations imposed by service-connected disabilities. 38 C.F.R. § 4.1. Such examinations are intended to describe the actual degree of functional impairment imposed by pain, incoordination, weakness, fatigue, and lack of endurance with repetitive motion. 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202 (1995). A proper examination considers ability and function with flare-ups to best reflect the true extent of disability. Sharp v. Shulkin, 29 Vet. App. 26 (2017). Moreover, the limitations described by the Veteran in manipulations fall squarely within the factors addressed as loss of use, also included in the VA examinations. 38 C.F.R. § 4.63. That said, however, the Board does find that a new VA examination is necessary. The most recent March 2015 examination is dated, and is inconsistent with the findings on VA and private examinations before and after. Further, as is discussed above, an adequate VA examination will fully address the concerns and allegations of the Veteran in requesting an FCE. The matters are REMANDED for the following action: 1. Obtain any outstanding and updated relevant VA and/or private treatment records and associate them with the claims file. 2. Schedule the Veteran for a VA joints (wrist) examination. The examiner must describe in detail the current status of the Veteran’s left wrist disability, to include with repeated movement and on flare-ups. The examiner must address the impact of the condition on the Veteran’s ability to use the left (dominant) hand in functions such as grasping and manipulation. The examiner must comment on the impact of the service connected disability on the Veteran’s ability to function in work-related tasks (e.g., typing, carrying and manipulating objects, using keys, sitting, standing, walking, bending, stooping, lifting, cognitive functioning, attendance, etc.). A full and complete rationale for any opinion expressed is required. If the examiner feels that the 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). Jones v. Shinseki, 23 Vet. App. 382 (2010). 3. Then, readjudicate the claim. If any benefit sought remains denied, provide the Claimant with a supplemental statement of the case (SSOC), and return the case to the Board. WILLIAM H. DONNELLY 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.