Citation Nr: 21068020 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 10-26 440 DATE: November 8, 2021 ORDER Entitlement to a 10 percent disability rating for right hip arthritis is granted. REMAND Entitlement to a compensable disability rating for residuals of laceration to the middle finger of the left hand is remanded. Entitlement to a compensable disability rating for residuals of laceration of right hand is remanded. FINDING OF FACT The Veteran's right hip arthritis is manifested by restriction of motion with pain. CONCLUSION OF LAW The criteria for entitlement to a 10 percent disability rating for right hip arthritis have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Codes 5003 and 5251. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty military service from February 1991 to December 1996 and from November 2000 to March 2006. This matter was previously before the Board in August 2019 when it was remanded for additional development, including obtaining outstanding medical records and providing the Veteran with updated VA examinations. The Board finds that the remand directives were complied with and outstanding medical records were duly sought. The Veteran was provided with additional VA examinations which provided the information necessary to adjudicate the claims. INCREASED RATING Entitlement to a compensable disability rating for right hip arthritis The Veteran was involved in a motor vehicle accident in service which resulted in a broken jaw and a bone graft taken from the right hip. He now has arthritis in the right hip. It is currently rated as noncompensably (0 percent) disabling because there was no evidence of limitation of motion at the initial examination. Under Diagnostic Code 5010, arthritis due to trauma substantiated by X-ray findings is rated under Diagnostic Code 5003 as degenerative arthritis. Under Diagnostic Code 5003, degenerative arthritis established by X-ray findings is rated on the basis of limitation of motion under the appropriate Diagnostic Codes for the specific joint or joints involved. When there is some limitation of motion of the specific joint that is noncompensable under the appropriate diagnostic codes, a rating of 10 percent for each such major joint affected by limitation of motion is assigned. Limitation of motion must be objectively confirmed by findings such as swelling, muscle spasm, or satisfactory evidence of painful motion. Under 38 C.F.R. § 4.59, painful motion is a factor to be considered with any form of arthritis; however, 38 C.F.R. § 4.59 is not limited to disabilities involving arthritis. See Burton v. Shinseki, 25 Vet. App. 1 (2011). Diagnostic Code 5250 provides for rating the hip on the basis of ankylosis. Favorable ankylosis of the hip in flexion at an angle between 20 degrees and 40 degrees and slight adduction or abduction is to be rated 60 percent disabling; intermediate ankylosis of the hip is to be rated 70 percent disabling; and extremely unfavorable ankylosis, with the foot not reaching ground, crutches necessitated, is to be rated 90 percent disabling, and is entitled to special monthly compensation. 38 C.F.R. § 4.71a. Diagnostic Code 5251 provides a 10 percent disability rating for limitation of extension of the thigh that is limited to 5 degrees. 38 C.F.R. § 4.71a. Diagnostic Code 5252 provides ratings based on limitation of flexion of the thigh. A 10 percent disability rating is for flexion of the thigh that is limited to 45 degrees; a 20 percent rating is for flexion of the thigh that is limited to 30 degrees; a 30 percent rating is for flexion of the thigh that is limited to 20 degrees; and a 40 percent rating is for flexion of the thigh that is limited to 10 degrees. 38 C.F.R. § 4.71a. The Board further notes that the above code sections were unaffected by revisions to the schedule effective February 7, 2021. The Board notes that the Veteran has consistently reported having pain in his right hip where the bone graft was taken. X-rays have confirmed evidence of arthritis in the right hip. At the VA examination in August 2009, the Veteran reported experiencing numbness in his right hip following the bone graft. He denied having any pain or loss of function. (See VA Examination, 08/14/2009.) In September 2009, he reported having paraesthesia and pins and needles sensations in his right hip and groin on a daily basis. (See VA Examination, 09/17/2009.) He reported difficulty standing for more than 30 minutes and difficulty walking more than a few yards. A VA examination in December 2016 noted that the Veteran's right hip arthritis did not have any functional impact on his ability to work or on his usual daily activities. (See Medical Opinion, 12/06/2016.) At the VA examination in September 2020, the Veteran had limitation of motion including flexion to 95 degrees out of 125, abduction to 20 degrees out of 25, external rotation to 40 degrees out of 60, and internal rotation to 35 degrees out of 40. (See C&P Exam, 09/01/2020.) In light of the evidence of arthritis in the Veteran's right hip as shown on X-ray and his consistent reports of pain in the right hip which impacts his motion throughout the appeals period, the Board finds that entitlement to a 10 percent disability rating is warranted under Diagnostic Codes 5003 and 5010. A higher disability rating is not warranted as the Veteran's range of motion in his right hip has not been shown to result in limitation of flexion to less than 45 degrees or any ankylosis. 38 C.F.R. § 4.71a. In making this determination, the Board REASONS FOR REMAND Entitlement to a compensable disability rating for residuals of laceration to the middle finger of the left hand Entitlement to a compensable disability rating for residuals of laceration of right hand The Veteran is service connected for residuals of injuries to his left and right hands, both of which are currently rated as noncompensably (0 percent) disabling. He seeks a compensable disability rating. The Board notes that a 10 percent disability rating is in effect for a painful scar on each hand, which are separate conditions despite being based on the same injuries. The Veteran's Notice of Disagreement in October 2009 stated that he had been scheduled for an examination of his right hand similar to a carpal tunnel examination, but that was not performed. Given that his claim involves loss of grip strength, which is one of the symptoms of incomplete paralysis of the median nerve under 38 C.F.R. § 4.121A, this aspect of the claim should also be evaluated on remand. Accordingly, the case is REMANDED for the following action: Afford the Veteran an appropriate VA examination to determine the nature and severity of his left- and right-hand disabilities. Specifically, the examiner should evaluate range of motion of the affected digits, including any gap between fingertip and transverse crease of the palm in accordance with the rating criteria of Diagnostic Code 5229. The examiner should also provide an assessment of any muscle damage to either of the Veteran's hands resulting in limitation of functioning, including reduced grip strength. Finally, the examiner should provide an assessment of any nerve damage of either in accordance with the rating criteria under 38 C.F.R. § 4.121A. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Cheryl E. Handy 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.