Citation Nr: 21070400 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 15-25 980 DATE: November 23, 2021 REMANDED Entitlement to a rating in excess of 10 percent for right wrist tendonitis is remanded. Entitlement to a total disability rating due to unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1970 to May 1971, with additional periods of National Guard service. This matter came before the Board of Veterans Appeals (Board) on appeal from an August 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran's Law Judge during a July 2017 hearing. The transcript of the hearing is of record. A July 2018 Board decision remanded the issues on appeal for further development. A May 2021 Board decision remanded the issues on appeal, finding that the issue of entitlement to TDIU was still pending despite the award of a 100 percent rating for PTSD as the Veteran reported that his right wrist caused interference with employment. A TDIU rating may be warranted in addition to a schedular 100 percent evaluation when TDIU could be granted for a disability other than the disability for which the 100 percent rating is in effect. See Bradley v. Peake, 22 Vet. App. 280 (2008). 1. Entitlement to a rating in excess of 10 percent for right wrist tendonitis is remanded. The May 2021 Board remand found that the June 2019 VA examination had not provided the requested information regarding where pain began on range of motion testing and requested a new examination, again specifically stating that if pain was noted on range of motion testing, the examiner should note the point pain began. A VA wrist examination was provided in June 2021. However, while the examiner found pain on active range of motion testing and also found that the pain caused functional loss, she did not note the point in range of motion that pain began as requested in the remand directives. As noted in the May 2021 Board remand, this does not allow the Board to properly assess the functional impairment caused by the disability. Examinations for joint disabilities generally must include range of motion measurements. See Correia v. McDonald, 28 Vet. App. 158, 169 (2016). In conducting these measurements, the examiner should note when any incoordination, weakened movement, or excess fatigability sets in. Id. The examiner should also note whether pain on motion is present, and, if so, where in the range of motion the pain sets in and whether that pain causes functional loss. Id. Remand is therefore required to provide an accurate picture of functional loss associated with the Veteran's cervical spine disability. 2. Entitlement to a total disability rating due to unemployability (TDIU) is remanded. The issue of entitlement to TDIU must also be remanded as it is inextricably intertwined with the issue of an increased rating for the right wrist disability. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are "inextricably intertwined" when the adjudication of one issue could have "significant impact" on the other issue). The Board notes that a July 2021 letter asked the Veteran to complete VA form 8940, Application for Increased Compensation Based on Unemployability. However, the record is silent for any response from the Veteran. As the issue is already being remanded, and the form contains information required to properly adjudicate the TDIU claim, upon remand the Veteran should be contacted and given an additional opportunity to complete the form. The matters are REMANDED for the following action: 1. Contact the Veteran to provide him with VA Form 21-8940 and ask that it be completed. 2. Schedule the Veteran for an appropriate VA examination to determine the current nature and severity of his right wrist disability. The claim file should be made available to and reviewed by the examiner and the examination report should state a review of the file was completed. All findings should be reported in detail. The examiner should identify all right wrist pathology found to be present. The examiner should conduct range of motion studies. The joints involved should be tested in both active and passive motion, in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. The examiner should describe any pain, weakened movement, excess fatigability, instability of station and incoordination present. If pain is noted, the point during range of motion at which pain starts must be clearly indicated. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups he experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he experiences during a flare-up of symptoms and/or after repeated use over time. Based on the Veteran's lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional range of motion loss during flare-ups or after repetitive use without resorting to speculation, the examiner should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 3. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Arnold 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.