Citation Nr: 21070917 Decision Date: 11/26/21 Archive Date: 11/26/21 DOCKET NO. 13-10 243 DATE: November 26, 2021 REMANDED Entitlement to a compensable disability rating prior to November 29, 2012 and in excess of 20 percent thereafter for right acromioclavicular joint osteoarthritis, status post distal clavicle resection with dislocation is remanded. Entitlement to a disability rating in excess of 20 percent prior to July 15, 2019 and after November 1, 2019 for right acromioclavicular joint osteoarthritis, status post distal clavicle resection is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 1989 until November 1991. In August 2016, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. This appeal was last before the Board in September 2020 when it was remanded for further development to include providing the Veteran with another VA examination. Unfortunately, for the reasons described below, there has not been substantial compliance with the Board's prior remand directives and another remand is now required. Stegall v. West, 11 Vet. App. 268 (1998). After the prior remand, the Agency of Original Jurisdiction (AOJ) increased the rating for the right shoulder, status post clavicle resection, to 20 percent from June 1, 1994, granted a temporary total rating from July 15, 2019 to November 1, 2019 and a 20 percent from that date and grated a separated 20 percent rating for the right shoulder disability, with dislocation, from November 29, 2012. See November 2020 rating decision. 1. Entitlement to a compensable disability rating prior to November 29, 2012 and in excess of 20 percent thereafter for right acromioclavicular joint osteoarthritis, status post distal clavicle resection with dislocation is remanded. 2. Entitlement to a disability rating in excess of 20 percent prior to July 15, 2019 and after November 1, 2019 for right acromioclavicular joint osteoarthritis, status post distal clavicle resection is remanded. The claims must be remanded again because the October 2020 VA is. The examiner noted pain on passive range of motion but did not report passive range of motion findings. Additionally, the Veteran reported flares caused by certain or repetitive motions that include moderately severe pain that lasts for several hours. The examiner indicated additional loss of function due to pain with repetitive motion over time and during flares. However, the examiner also said, "no additional loss of motion is expected" and did not further describe any additional functional impact after repetitive use over time or during flares. Absent further explanation from the examiner, the Board cannot ascertain the additional functional impact of the Veteran's condition after repetitive use over time and during flares. Due to the deficiencies contained in the October 2020 VA examination, the Board finds it inadequate for adjudication and must remand the matter to provide the Veteran with another VA medical exam. Sharp v. Shulkin, 29 Vet. App. 26 (2017). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination with an appropriate clinician to determine the current nature and severity of all manifestations of the service-connected right shoulder disability. Copies of all pertinent records must be made available to the examiner for review. 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. 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. In so doing, the examiner must (i) test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing, and; (ii) attempt to elicit from the Veteran 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. 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). A complete rationale must be provided for all opinions. 2. After completion of the above development, and any additionally indicated development, confirm that the examination provided is adequate for adjudication, including both passive and active range of motion testing and sufficient detail regarding additional functional loss with repeated use over time and during flares, if appropriate. If it does not, obtain an addendum. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. Collins, Associate 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.