Citation Nr: 21077296 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 11-02 776A DATE: December 29, 2021 REMANDED Entitlement to a rating in excess of 10 percent for a left wrist condition, to include on an extraschedular basis, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1973 to February 1981. This matter was last before the Board in June 2020, wherein the claim seeking an increased rating for a left wrist condition was denied. Following the Veteran's appeal, the United States Court of Appeals for Veterans Claims (Court) issued a July 2021 Joint Motion for Remand (JMR) vacating the June 2020 decision as it pertained to the denial of an increased rating for the left wrist condition and remanding the claim back to the Board for readjudication in light of the deficiencies noted by the Court. The Board is now further remanding this matter for development in compliance with the directives of the JMR. The Veteran testified at an October 2017 videoconference hearing before the undersigned Veterans Law Judge. The Board incorporates by reference its prior discussion in the June 2020 decision regarding whether entitlement to TDIU has been raised by the record pursuant to Rice v. Shinseki, 22 Vet. App. 447 (2009). As the evidence concerning the impact that the Veteran's left wrist fracture residual condition has on his occupational functioning has not changed materially since the June 2020 decision, the Board confirms that TDIU is not raised by the record. As an initial matter, the Court requested that the Board reevaluate its determination in the June 2020 decision to refer an inferred claim on entitlement to service connection for left wrist neurological symptomatology to the Agency of Original Jurisdiction (AOJ). Specifically, the Court highlighted that its decision in Grimes v. McDonough, 34 Vet. App. 84 (2021), may alter the determination that AOJ referral rather than Board adjudication is warranted for the Veteran's associated left wrist neurological symptomatology. In Grimes, the Court held that a claim for service connection may encompass a related condition that is initially referenced by a claimant but not diagnosed until later in the appeal stream, regardless of whether the claim is initially granted or denied by the AOJ. The Board finds that the facts of this case are readily distinguishable from those in the Grimes case. Primarily, Grimes concerned an initial claim seeking service connection for a disability, whereas here the claim is one seeking an increased rating for a left wrist condition. Although the Veteran has competently asserted that he experiences neurological symptomatology associated with his in-service left wrist fracture, and he has a diagnosis of carpal tunnel syndrome of the left wrist, it is still not within the Board's purview to evaluate whether entitlement to service connection is warranted in the first instance for that distinct neurological symptomatology when the issue of entitlement to service connection for an associated disability (i.e., left wrist fracture residuals) has already been adjudicated in a final decision and the only issue before the Board is entitlement to an increased rating for the left wrist fracture residuals. Accordingly, the Board may not address entitlement to service connection for left wrist neurological symptomatology as jurisdiction over this issue rests with the AOJ; therefore, it is referred to the Regional Office for the issuance of an adjudicatory decision on the merits. 38 C.F.R. § 19.9(b). Entitlement to an increased rating for a left wrist condition is remanded. The Court in the July 2021 JMR found fault with the Board's reliance on an October 2018 VA wrist examination and requested that the Board either justify the propriety of that examination or remand the case to the AOJ in order to secure an addendum examination. Specifically, the Court highlighted that the Board in a prior January 2018 remand directed the AOJ to secure an examination evaluating the current severity of the left wrist fracture residual symptomatology. Those remand instructions requested that the ensuing examination must include a radiographic evaluation as well as range of motion testing with additional diagnostic measurements. In considering the October 2018 wrist examination, the Court noted that it did not indicate the specific degree of motion where pain begins throughout the range of motion, nor did it provide range of motion measurements for repetitive use, and there was no explanation for why this testing was not done or why it was not necessary. In addition, the Court found that the AOJ was required to secure an X-ray examination or other similar radiographic examination, which also was not completed by the October 2018 examiner. The Board thus finds that remand is necessary in order to schedule the Veteran for a VA examination that complies with the January 2018 remand instructions. The Veteran must be afforded an X-ray examination of the left wrist, and the examination report must include range of motion testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing, and following repetitive use. The prior January 2018 remand instructions are copied in large part below in order to ensure that they are complied with. The matters are REMANDED for the following action: Schedule the Veteran for an appropriate VA orthopedic examination to evaluate the severity of the left wrist condition. All necessary tests, including X-ray examinations, should be conducted. The entire claims file, to include a complete copy of this remand, must be made available to the examiner, and the report of the examination should note review of the file. The examiner must first record the range of motion on clinical evaluation, in terms of degrees with a goniometer. If there is clinical evidence of pain on motion, the examiner must indicate the specific degree of motion at which such pain begins. The same range of motion studies must then be repeated after at least three repetitions and after any appropriate weight-bearing exertion. This information must be derived from joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing. The examination report must confirm that all such testing has been made and reflect the results of the testing. If the examiner is unable to conduct the required testing, the examiner must clearly explain why that is so. The examiner should also specifically note whether the left wrist is ankylosed. All opinions must be supported by a rationale. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Christopher M. Collins, 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.