Citation Nr: 21074085 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 17-07 198 DATE: December 14, 2021 REMANDED Entitlement to an initial compensable disability rating for service-connected right hip limitation of flexion is remanded. Entitlement to an initial compensable disability rating for service-connected right hip impairment is remanded. Entitlement to a total disability rating based on individual unemployability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1983 to May 1986, and from August 1990 to August 2014, with additional service in the reserves. These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). These matters were previously remanded by the Board in August 2020 for further development of the evidence. Under Rice v. Shinseki, the Board has jurisdiction over a total disability rating based on individual unemployability (TDIU) claim as part and parcel of the Veteran's increased rating claim if raised by the record. Rice v. Shinseki, 22 Vet. App. 447 (2009) (holding that a request for TDIU, whether expressly raised by the Veteran or reasonably raised by the record, is not a separate "claim" for benefits, but rather, is part of a claim for increased compensation). The Board notes that the Veteran's representative contends that the Veteran's right hip disabilities directly impact his work. Accordingly, the claim for entitlement to a TDIU has been separately characterized in the issues above. While the Board sincerely regrets the delay, a remand is needed for additional development. This is necessary to ensure that the Veteran is afforded every possible consideration and that there is a complete record upon which to decide his appeal. 1. Entitlement to an initial compensable disability rating for service-connected right hip limitation of flexion 2. Entitlement to an initial compensable disability rating for service-connected right hip impairment Due to the similar dispositions for the right hip increased rating claims on appeal, the Board will address them in a common discussion below. Pursuant to the August 2020 remand directives, the Veteran was afforded a new VA examination in September 2020. The examination report shows the examiner marked the Veteran's VA e-folder was reviewed. However, the examination report shows that the examiner marked that the Veteran did not report having any functional loss or functional impairment of the right hip. A review of the record shows that the Veteran reported right hip pain rising from a seated position, that sitting, sleeping, exercising, walking, standing, and driving are all negatively affected, and that running is difficult and flexibility has decreased over time. See July 2015 and May 2017 VA Hip Examination Reports, and February 2017 VA Form 9. In fact, the September 2020 examination report shows that the Veteran reported current symptoms as constant soreness with periods of sharp pain, and additionally that his right hip takes a while to warm up when standing, that he has a slight limp, and that his right hip disabilities limit his ability to run, climb or more, and cause difficulties positioning during sleep. The Board additionally notes that the September 2020 VA examiner did not attempt to differentiate the various right hip disabilities and discuss in detail the symptoms associated with each right hip disability, as directed in the August 2020 remand directives. On remand, the examiner should address the differentiation of right hip disability symptomatology to ensure that compensation is appropriately determined. Stegall v. West, 11 Vet. App. 268 (1998). The Board finds that the September 2020 VA examination did not take into account the Veteran's reported history of functional loss and/or impairment and a new VA examination is therefore warranted. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). 3. Entitlement to a TDIU The claim for entitlement to TDIU is inextricably intertwined with the remanded right hip increased ratings claims. Thus, the adjudication of the TDIU matter is deferred. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (issues are "inextricably intertwined" when they are so closely tied together that a final Board decision cannot be rendered unless both are adjudicated). Additionally, the record does not show that the Veteran has submitted VA Form 21-8940, application for TDIU. On remand, the Agency of Original Jurisdiction (AOJ) should request these forms. The Veteran is strongly encouraged to submit the requested form and any additional evidence relevant to the TDIU claim. The matters are REMANDED for the following action: 1. Schedule the Veteran for an orthopedic examination by an appropriate clinician to determine the current severity of his service-connected right hip disabilities. The examiner must review the entire claims file, to include a copy of this Remand, in conjunction with authoring the opinions. Pathology, symptoms (frequency and severity), and any associated impairment of function should be described in detail. All indicated tests or studies should be completed. The examiner is advised that the Veteran is service connected for three separate right hip disabilities: (1) right hip strain; (2) right hip impairment; and (3) right hip limitation of flexion. The examiner should differentiate the various right hip disabilities and discuss in detail the symptoms associated with each right hip disability to ensure that compensation is appropriately determined. The examiner should provide a full description of the disabilities and report all signs and symptoms necessary for evaluating the Veteran's disabilities under the rating criteria. Range of motion measurements should be included for active and passive motion in both weight-bearing and non-weight-bearing circumstances, including for the opposite undamaged joint, if applicable. If pain is noted, the point in the range of motion at which pain starts should be clearly noted. If feasible, the examiner must assess the additional functional impairment on repeated use or during flare-ups in terms of the degree of additional range of motion loss, using lay observations specifically elicited from the Veteran. If not feasible, the examiner must provide a detailed explanation and rationale for why such could not be accomplished. Specifically, if the medical professional cannot provide an opinion without resorting to mere speculation, he or she must provide a complete explanation for why an opinion cannot be rendered; a rationale based on the fact that the Veteran is not having a flare-up at the time of the examination will not be deemed adequate. To the extent possible, the examiner should identify any symptoms and functional impairments and discuss the effect on any occupational functioning and activities of daily living. The Veteran's lay statements must be addressed and a rationale for any conclusion reached should be provided. 2. Provide the Veteran with a VA Form 21-8940 with instructions that it should be completed in order to assist with the adjudication of the TDIU claim. If the Veteran provides a completed VA Form 21-8940, the AOJ should complete any additional development deemed appropriate, to include any action deemed necessary for any other downstream issue(s). C. CRAWFORD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Battaile 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.