Citation Nr: 21070412 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 12-21 172A DATE: November 23, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent for service-connected left achilles tendonitis is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) from February 4, 2009 to December 22, 2010 due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1989 to May 1993. Unfortunately, there has not been substantial compliance with the Board's April 2021 remand directives regarding the issue of entitlement to an increased rating for service-connected left achilles tendonitis. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to a disability rating in excess of 10 percent for service-connected left achilles tendonitis is remanded. The Board's previous remand requested an addendum opinion that addressed, in part, the Veteran's left achillies flare-ups. The Board also instructed the AOJ to schedule the Veteran for a VA examination if necessary to provide the requested opinion. A VA addendum medical opinion was provided in June 2021 and a clarification was issued in July 2021, however, no examination was ever conducted. The examiner said that an opinion distinguishing tendonitis flare-up range of motion from baseline degenerative joint disease range of motion could not be provided without resort to speculation. The opinion is inadequate because the examiner did not indicate whether it is based on a lack of knowledge within the medical community at large and not the insufficient knowledge of this specific examiner. Although the examiner stated that "it is reasonable to opine that the flare-ups of left achilles tendonitis is as likely as not attributing to reduced ROM during the flare-ups." As noted above, there was no attempt to schedule the Veteran for an actual examination. Therefore, the Board finds that the Veteran should be provided the opportunity to attend a VA examination for his service-connected left achilles tendonitis to determine the severity of flare-ups and any additional loss in range of motion. 2. Entitlement to a TDIU from February 4, 2009 to December 22, 2010 is remanded. The TDIU claim must be deferred as inextricably intertwined with the remanded issue. A remand of the claim for TDIU is required. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected left achilles tendonitis. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. In so doing, the examiner must 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 at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran's statements. The examiner must complete the corresponding VA disability benefits questionnaire (DBQ), provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. 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). 2. After the above development, and any additionally indicated development, has been completed, readjudicate the claims, including the inextricably intertwined issue of entitlement to a TDIU. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.S. McLeod 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.