Citation Nr: 21064651 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 17-28 708 DATE: October 21, 2021 REMANDED Entitlement to an increased rating in excess of 10 percent for a right wrist disability is remanded. Entitlement to an increased rating in excess of 10 percent for a back disability is remanded. Entitlement to an increased rating in excess of 50 percent for sleep apnea is remanded. Entitlement to an increased rating in excess of 20 percent for a right shoulder disability is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active service in the United States Navy from October 1982 to October 2002. The Veteran initially requested a Board hearing in his May 2017 Form 9, but he subsequently canceled his hearing request in August 2021. Therefore, the Board deems the hearing request withdrawn. 1. Entitlement to an increased rating in excess of 10 percent for a right wrist disability is remanded. 2. Entitlement to an increased rating in excess of 10 percent for a back disability is remanded. 3. Entitlement to an increased rating in excess of 50 percent for sleep apnea is remanded. 4. Entitlement to an increased rating in excess of 20 percent for a right shoulder disability is remanded. The Veteran last underwent VA examinations for his claimed conditions for his back, sleep apnea, and right wrist in November 2015, nearly six years ago; and with regards to the right shoulder the Veteran was last afforded a VA examination in June 2018, more than three years ago. Although VA examinations do not necessarily expire or go stale due to the mere passage of time, adequate examinations must be sufficiently detailed for the Board's evaluation of the claimed disabilities to be a fully informed decision. Barr v. Nicholson, 21 Vet. App. 303 (2007). As years have passed since the most recent VA examinations, and the last examinations have become inadequate, remand is necessary to determine the current severity level of these disabilities. With specific regards to the Veteran's claims for the back, shoulder, and wrist, the Board notes that when rating diseases of the musculoskeletal system, the final sentence of 38 C.F.R. § 4.59 requires that the examiner record the results of ROM testing for pain on both active and passive motion, weight-bearing and non-weight-bearing and, if possible, with ROM measurements of the opposite undamaged joint. Correia v. McDonald, 28 Vet. App. 158 (2016). VA examiners must obtain information about the severity, frequency, duration, precipitating and alleviating factors, and extent of functional impairment of flares from the Veterans themselves, when a flare-up is not observable at the time of examination. Sharp v. Shulkin, 29 Vet. App. 26 (2017). Here, the previous reports did not indicate the results of ROM testing in compliance with Correia and Sharp, and as such, remand is required for a more contemporaneous examination of the present nature and severity of these disabilities. 5. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. With regard to the claim for TDIU, as the claims for increased rating are being remanded for additional development, the outcome of those claims could have a direct bearing on the claim for TDIU. Therefore, the Board finds that the claims remanded are inextricably intertwined with any analysis of the claim for TDIU. Accordingly, since those claims are being remanded, the Board finds that it would be potentially prejudicial to the Veteran for the Board to consider the claim for TDIU prior to a resolution of the other claims. Bernard v. Brown, 4 Vet. App. 384 (1993); Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all outstanding VA treatment records. 2. Schedule the Veteran for a VA examination to assess the current severity level of his right wrist disability. The examiner should note review of the record. The examiner should record the results of ROM testing for pain on both active and passive motion, weight-bearing and non-weight-bearing and ROM measurements of the opposite undamaged joint. The examiner should express an opinion as to whether pain or other manifestations during flare-ups or with repeated use could significantly limit functional ability. The examiner should portray the degree of any additional ROM loss due to pain on repeated use or during flare-ups. If no estimate can be provided, the examiners should provide a sufficiently detailed explanation as to why. 3. Schedule the Veteran for a VA examination to assess the current severity level of his back disability. The examiner should note review of the record. The examiner should record the results of ROM testing for pain on both active and passive motion, weight-bearing and non-weight-bearing and ROM measurements of the opposite undamaged joint. The examiner should express an opinion as to whether pain or other manifestations during flare-ups or with repeated use could significantly limit functional ability. The examiner should portray the degree of any additional ROM loss due to pain on repeated use or during flare-ups. If no estimate can be provided, the examiners should provide a sufficiently detailed explanation as to why 4. Schedule the Veteran for a VA examination to assess the current severity level of his right shoulder disability. The examiner should note review of the record. The examiner should record the results of ROM testing for pain on both active and passive motion, weight-bearing and non-weight-bearing and ROM measurements of the opposite undamaged joint. The examiner should express an opinion as to whether pain or other manifestations during flare-ups or with repeated use could significantly limit functional ability. The examiner should portray the degree of any additional ROM loss due to pain on repeated use or during flare-ups. If no estimate can be provided, the examiners should provide a sufficiently detailed explanation as to why. 5. Schedule the Veteran for a VA examination to assess the current nature and severity level of his sleep apnea. The examiner should note review of the record and provide rationale for all findings, including explicitly consideration of any lay statements by the Veteran. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ziheng Zhu, 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.