Citation Nr: 21075655 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 15-44 646 DATE: December 21, 2021 REMANDED Entitlement to a disability rating in excess of 40 percent for service-connected right thigh muscle injury is remanded. Entitlement to an effective date prior to January 30, 2013 for the award of a 40 percent disability rating for service-connected right thigh muscle injury is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1969 to January 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from December 2013 and June 2014 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran's right thigh muscle injury (muscle injury) was granted service connection in May 1972 with a noncompensable rating. In September 2013, the Veteran filed his most recent claim for an increased rating. The RO granted a 40 percent rating for his muscle injury in the December 2013 rating decision effective January 30, 2013. The Veteran appealed the rating and the effective date of the 40 percent rating to the Board. This issue was previously before the Board in November 2018. In the November 2018 Board decision, the issues were remanded for further development. Regrettably, the Board finds a remand is warranted for further development. The Board finds the August 2019 VA examinations are inadequate. Specifically, the August 2019 examiner in the VA knee and lower leg examination noted the Veteran reported flare-ups. On examination, the examiner found the Veteran's pain resulted in functional loss, but he was unable to describe in terms of range of motion. The examiner failed to provide an explanation as to why he could not describe the functional loss in terms of range of motion. See August 2019 VA Knee and Lower Leg Conditions Disability Benefits Questionnaire (DBQ). During the August 2019 VA hip and thigh examination, the examiner failed to complete the VA examination. During the Veteran's initial range of motion (ROM) testing, the examiner failed to state whether his ROM was normal or abnormal. The evidence suggests it is abnormal, but the examiner failed to determine whether the abnormal ROM contributed to functional loss. The examiner also failed to provide any testing for his right leg on observed repetitive use, repeated use over time, and flare-ups. The Board notes that the examiner did address the left leg, but the findings are inadequate as the examiner failed to describe the Veteran's functional loss in terms of ROM during flare-ups or provide an explanation. See August 2019 VA Hip and Thigh Conditions DBQ. Furthermore, it was not clear whether either examiner first elicited relevant information as to the Veteran's flare-ups or asked him to describe any additional functional loss during a flare-up. Therefore, the matter must be remanded for a new examination. Regarding the Veteran's claim for an earlier effective date for his service-connected muscle injury rating of 40 percent, as additional development has been requested for a higher rating, the Veteran's claim for an earlier effective date must also be remanded, as the issues are inextricably intertwined. It is certainly possible that the requested examination and other development may result in findings relevant to the knee. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two or more issues are inextricably intertwined if one claim could have significant impact on the other). The matters are REMANDED for the following action: Schedule the Veteran for a VA examination to determine the current nature and severity of his right thigh muscle injury. The claims file must be made available to and reviewed by the examiner. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner should conduct range of motion studies. The joints involved should be tested for pain (1) on active motion, (2) on passive motion, (3) in weight-bearing, (4) in nonweight-bearing, and (5) with range of motion 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 also note at what degree the Veteran starts to experience pain on range of motion, if any. In assessing functional loss, please also provide an opinion describing functional impairment of the Veteran's right leg due to flare-ups, accounting for pain, incoordination, weakened movement, and excess fatigability on use, and, to the extent possible, report such impairment in terms of additional degrees of limitation of motion. If unable to provide such an opinion without resorting to speculation, please provide a rationale for this conclusion, with specific consideration of the instructions in the VA Clinician's Guide to estimate, "per [the] veteran," what extent, if any, flare-ups affect functional impairment. The examiner must include a discussion of any specific facts that cannot be determined if unable to opine without speculation. A complete rationale shall be given for all opinions and conclusions expressed. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Glaeser, Jennifer 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.