Citation Nr: 21006571 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 19-34 155 DATE: February 4, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for lumbosacral strain is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from November 1997 to November 2001. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claim for further development in April 2020. Notably, during the pendency of this appeal, the Veteran was awarded service connection for a right knee disability. See December 2020 and January 2021 rating decisions. This issue is accordingly not in appellate status. If the Veteran disagrees with her initially-assigned disability ratings, she is advised to file a Notice of Disagreement (NOD) on the appropriate VA-promulgated form. 1. Entitlement to an initial rating in excess of 10 percent for lumbosacral strain is remanded. The Veteran was last afforded a VA examination for her service-connected back disability in December 2020. The examiner did not provide an opinion on additional functional loss during a flare-up, indicating that the Veteran did not report any flare-ups. However, the Board notes that the Veteran reported back flare-ups during the appeal period, as documented in the October 2018 VA examination report and the December 2018 Disability Benefits Questionnaire (DBQ). Therefore, an addendum opinion adequately addressing functional impact during flare-ups is necessary on remand. See Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017). Any outstanding treatment records should also be secured. The matter is REMANDED for the following action: 1. Obtain all outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records. 3. Then obtain an addendum opinion from an examiner other than the October 2018, September 2019, and December 2020 VA examiners, preferably an orthopedic physician, to determine the nature of the Veteran’s lumbar spine disability during a flare-up. The claims file should be made available to the examiner. No additional examination of the Veteran is necessary, unless the examiner indicates otherwise. Following a review of the claims file, to include the October 2018 VA examination report and the December 2018 DBQ, and the Veteran’s description of flare-ups therein, the examiner should provide an opinion describing functional impairments of the Veteran’s lumbar spine 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 (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). Noting that the Veteran was not examined during a flare-up will not suffice. A complete rationale shall be given for all opinions and conclusions expressed. S. BUSH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S.S. Mahoney 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.