Citation Nr: 21001394 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 16-17 519 DATE: January 7, 2021 REMANDED Entitlement to an initial compensable rating prior to January 24, 2020, and to a rating greater than 10 percent thereafter for the service-connected left elbow disability is remanded. REASONS FOR REMAND The Veteran had active service from July 1970 to January 1971. This matter comes before the Board of Veterans’ Appeals (Board) from a June 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In December 2019, the Veteran provided testimony via videoconference before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. In December 2019, the Board remanded the issue of entitlement to an initial compensable rating for the left elbow disability for additional development. In September 2020, the RO granted a 10 percent rating for the left elbow disability, effective January 24, 2020. As discussed below, additional development is necessary before the Board can adjudicate this matter. Also on appeal are claims for service connection for left hand, left shoulder, left wrist, and neck disabilities, each claimed as secondary to the service-connected left elbow disability. These issues are before the Board; however, since the Veteran appealed these issues under the Appeals Modernization Act (AMA), these issues must be addressed in a separate Board decision. Entitlement to increased ratings for service-connected left elbow disability is remanded. In December 2019, the Board remanded this matter to schedule the Veteran for a VA examination to determine the severity of his service-connected left elbow disability. An examination was conducted in January 2020, but the examination report is not adequate for rating purposes because the examiner provided inconsistent or incomplete responses. For example, the examiner stated that he did not observe pain on range of motion testing but then noted in a separate paragraph that the Veteran had pain with extension and forearm supination. The examiner also stated that the Veteran had “[l]ess movement than normal due to ankylosis, adhesions, etc.” but did not address ankylosis under the appropriate section. Thus, it is unclear whether the Veteran had ankylosis of the left elbow joint. Finally, the examiner stated that the Veteran had weakened movement due to muscle or peripheral nerve injury, but the examiner did not specify whether the Veteran has peripheral nerve injury related to the left elbow disability. Given the Veteran’s testimony before the Board indicating that he had tingling and numbness of the joint, clarification of the examiner’s finding is necessary. On remand, the Veteran should be scheduled for a VA examination to determine the current severity of his left elbow disability. The matter is REMANDED for the following actions: 1. Associate with the claims file updated VA treatment records, if any. 2. Then, schedule the Veteran for an examination to determine the severity of his service-connected left elbow disability. The examiner must be provided access to the electronic claims file and he or she must indicate review of the file in the examination report. All necessary testing must be completed, and all symptoms described in detail. In so doing, the examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing of both elbows. If it is not possible to provide a specific measurement 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). 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. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran’s statements. If it is not possible to provide a specific measurement 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. Provide the Veteran a copy of the examination report. 4. Then, readjudicate the Veteran’s claim on appeal. If the benefits sought on appeal remain 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 Amanda G. Alderman 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.