Citation Nr: 21069477 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 18-39 409 DATE: November 18, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent for service-connected chronic left wrist sprain with degenerative arthritis is remanded. Entitlement to a disability rating in excess of 20 percent for service-connected glenohumeral and acromioclavicular joint osteoarthritis of the left arm is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from April 1961 to October 1961. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts (Agency of Original Jurisdiction (AOJ)). The Veteran testified at a virtual hearing before the undersigned in September 2021. A transcript of the proceeding is of record. 1. Entitlement to a disability rating in excess of 10 percent for service-connected chronic left wrist sprain with degenerative arthritis is remanded. 2. Entitlement to a disability rating in excess of 20 percent for service-connected glenohumeral and acromioclavicular joint osteoarthritis of the left arm is remanded. During the Veteran's September 2021 virtual hearing, he testified that he feels his conditions have gotten much worse within the past year. He has difficulty getting dressed due to the pain he feels in his shoulder, which is also exacerbated by sitting in a chair or rolling over in his sleep. He is also unable to lift his shoulder over his head. The Veteran experiences constant pain and has flare ups of increased pain and numbness. He utilizes Icy Hot for his shoulder and he previously used a brace for his wrist, but it did not help alleviate his symptoms. He is currently receiving occupational therapy and physical therapy for his shoulder and feels as if it is hurting his shoulder more. CAPRI VA treatment records associated with the file after his hearing document his recent treatment for his condition and echo his sentiments from the hearing, namely that he has experienced increased pain since he was last seen for occupational therapy in January 2020. The Board notes that the Veteran last received a VA examination for his shoulder in September 2019 and his wrist in March 2018. Given the length of time that has passed since he received an examination for his wrist, as well as his complaints of increased pain after his most recent VA examination for his shoulder, the Board finds it appropriate to schedule new examinations for each condition to properly assess the nature and severity of his left shoulder and wrist conditions prior to adjudication. 3. Entitlement to TDIU is remanded. The Board took jurisdiction of the issue of entitlement to TDIU at the September 2021 virtual hearing, pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009). However, the adjudication of the issues of higher disability ratings for the Veteran's service-connected left shoulder and left wrist could significantly change the adjudication of TDIU, especially in light of the new VA examinations pending. See Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (issues are "inextricably intertwined" when a decision on one issue would have a "significant impact" on a veteran's claim for the second issue). Consideration of the issue of a TDIU, therefore, will be deferred until the intertwined issues regarding the Veterans' left shoulder and wrist conditions are resolved. See Harris, 1 Vet. App. at 183 (where a claim is inextricably intertwined with another claim, the claims must be adjudicated together). The Board will therefore revisit this issue after the disposition of the Veteran's claims noted above. The matters are REMANDED for the following action: 1. The AOJ shall associate the Veteran's most recent outstanding VA medical treatment records with his file, specifically those records from September 2021 to the present as it relates to his occupational therapy and physical therapy for his shoulder and/or wrist. 2. Ask the Veteran to complete a VA Form 21-4142 for any private treatment providers that have treated him for his left shoulder and/or left wrist conditions. Thereafter, obtain and associate with the claims folder any private treatment records identified. 3. Then, afford the Veteran orthopedic examinations to determine the current nature and severity of his left shoulder condition and left wrist condition. The claims file must be made available to and be reviewed by the examiner. The examiner should have the Veteran describe the frequency and duration of any flares of disability, and describe and/or demonstrate the extent of motion loss during flares or repetitive use and provide the extent of motion loss described in terms of degrees. The examiner should consider the Veteran's September 2021 testimony of limitations during flares. If there is no pain and/or no limitation of function, such facts must be noted in the report. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 4. Thereafter, readjudicate the claims. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case and an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Victoria A. Banis, 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.