Citation Nr: 21064636 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 16-17 519 DATE: October 21, 2021 REMANDED Entitlement to an initial rating greater than 10 percent for 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. In January 2021, the Board remanded this matter for additional development, which has not been substantially completed. See Stegall v. West, 11 Vet. App. 268 (1998). In July 2021, the RO granted a 10 percent rating for the left elbow disability for the entire pendency of the claim. 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 an initial rating greater than 10 percent for service-connected left elbow disability is remanded. The Veteran seeks an initial rating greater than 10 percent for his service-connected left elbow disability. In January 2021, the Board remanded this matter for an examination. The examination was completed in March 2021 and an addendum opinion was provided in May 2021. The March 2021 examination report shows conflicting findings regarding the Veteran's left elbow mobility. In May 2021, the RO asked the examiner to clarify how the Veteran could have mobility and immobility (ankylosis) of the elbow. In the addendum opinion, the examiner stated that the Veteran did not have ankylosis and that he could not fully extend his elbow. However, she did not address the notation of the left elbow being fixed at 15 degrees of supination, unfavorable ankylosis at an angle of 50 degrees, and limitation of supination to 30 degrees or less. The findings are unclear and as such, the examination report is inadequate for rating purposes. 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). (Continued on the next page) 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). 3. Then, readjudicate the Veteran's claim on appeal. If the benefit 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 A. G. Alderman, 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.