Citation Nr: 21071643 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 17-57 715 DATE: December 1, 2021 REMANDED Entitlement to an increased rating in excess of 10 percent for residuals of a right wrist fracture, also claimed as limitation of right wrist motion, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from August 1969 to June 1970. This matter was initially before the Board in February 2020, where it was remanded for additional development. Specifically, the Board determined that the Veteran should be afforded a VA examination to assess the current severity of his service-connected right wrist disability. Entitlement to an increased rating in excess of 10 percent for residuals of a right wrist fracture, also claimed as limitation of right wrist motion, is remanded. While the Board regrets further delay, the matter is remanded for clarification of the medical evidence. According to the examiner's October 2020 opinion, it was opined that the Veteran's wrist drop, tingling and numbness, contracture and tremors in his right hand are less likely than not due to his service-connected residuals of a right wrist fracture. The examiner reasoned that "these are neurological symptoms and no neurological condition has been diagnosed to date. 2019 [electromyogram] EMG is [normal]." However, in the Veteran's July 2020 VA examination, the examiner stated that there was "no evidence of right upper extremity entrapment neuropathy," based on a January 2020 EMG. The July 2020 VA examiner also stated the following: "decreased range of motion in long, ring and little fingers of right hand. Exam also noted trigger finger on right ring finger." However, no further testing was provided for his fingers. Lastly, a July 2020 MRI revealed carpel tunnel syndrome. The impression was "moderate to severe degenerative changes at the articulation of the distal scaphoid with the trapezoid and the articulation of the base of the second metacarpal with the distal capitate" and "mild osteoarthritis of the first carpometacarpal join, third carpometacarpal joint, radiocarpal joint and distal radial ulnar joint." Based on the medical findings, the Board cannot make a fully informed decision on the matter as further clarification is needed to determine whether the Veteran's conditions and symptoms listed above are contemplated by the rating criteria. The matters are REMANDED for the following action: 1. Afford the Veteran an appropriate VA examination to determine the severity and nature of his service-connected right wrist disability. The examiner should identify whether the Veteran's symptoms and diagnoses in the right hand and fingers are due to his service-connected right wrist disability. The examiner should also determine whether further testing is warranted for his hand and/or fingers. In doing so, the examiner should consider the July 2020 VA examination, noting "decreased range of motion in long, ring and little fingers of right hand. Exam also noted trigger finger on right ring finger," as well as the July 2020 MRI. If further testing of the right wrist, hand, or finger is performed, pursuant to Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017), the examiner is asked to describe whether pain, weakness, fatigue and/or incoordination significantly limits functional ability during flare-ups or repetitive use, and if so, the examiner must estimate range of motion during flare-ups or repetitive use. The examiner should have the Veteran describe and/or demonstrate the extent of motion loss during flare-ups or repetitive use and provide the extent of motion loss described in terms of degrees. If there is no pain and/or no limitation of function, such facts must be noted in the report. The examiner should comment as to whether there is any medical reason to accept or reject the Veteran's description of reduced range of motion during flare-ups or repetitive use. A complete explanation must be provided for all opinions given. If the examiner cannot provide an opinion without resorting to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. (continued on the next page) 2. Upon completion of the above, and any additional development deemed appropriate, the AOJ should readjudicate the remanded issue(s). The AOJ should specifically consider whether separate ratings are warranted for his fingers and/or hand. If any benefit sought on appeal remains denied, the Veteran and his representative should be provided with a supplemental statement of the case. An appropriate period of time should be allowed for response, and the appeal must be returned to the Board for appellate review. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Adeleke, T. 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.