Citation Nr: 21007951 Decision Date: 02/11/21 Archive Date: 02/11/21 DOCKET NO. 15-00 301A DATE: February 11, 2021 REMANDED Entitlement to a rating in excess of 20 percent for chronic lumbar strain is remanded. REASONS FOR REMAND The Veteran served on active duty from September 2003 to April 2005. This case comes before the Board of Veterans’ Appeals (Board) on appeal of a May 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This case was previously remanded in December 2018 for a VA examination for the Veteran’s service-connected chronic lumbar strain. One of the remand directives from the December 2018 remand stated that the examiner’s “. . . inability to provide an opinion without resorting to speculation must be based the limitation of knowledge in the medical community at large and not a limitation -whether based on lack of expertise, insufficient information, or unprocured testing -of the individual examiner.” The Veteran was afforded the VA examination in October 2019. However, the examiner opined that there was insufficient information in the history and the Disability Benefits Questionnaire to estimate range of motion loss during flare-ups or after repetitive use, back in 2014. Additionally, the examiner was requested to clearly explain why, if not necessary or is not medically appropriate, she did not test the lumbar spine on both active and passive motion, in weight-bearing, and non-weight bearing. The examiner found that the passive range of motion could not be performed or was not medically appropriate. No explanation or rationale was given. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issue of the Veteran’s chronic lumbar strain. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following action: After completing any needed preliminary development, forward the Veteran’s claims file to a qualified medical professional for a new VA examination to determine the symptoms and severity of the Veteran’s service-connected chronic lumbar strain. The Veteran’s entire record, including this remand, must be reviewed by the examiner. The examiner must provide opinions, with a full rationale. a.) The lumbar spine should be tested for pain on both active and passive motion, in weight-bearing and non weight-bearing. If for any reason the examiner is unable to conduct the required, he or she should clearly explain why that is so. The examiner is asked to express an opinion regarding whether pain, weakness, fatigability, or incoordination cause additional functional impairment of the lumbar spine on repeated use overtime OR during flare-ups. The examiner should assess additional functional impairment in terms of the degree of additional range-of-motion loss, if possible. If the Veteran is not being observed during a flare-up or after repeated use over time during the examination, the examiner should still estimate any additional functional loss during such events based on the Veteran’s description of their severity, frequency, duration, and/or functional loss manifestations. b.) The examiner must also include a retrospective medical opinion regarding the functional limitations during flare-ups or after repeated use over time, expressed in terms of reduced range of motion, at the time of the April 2014 VA examination. The examiner is advised that the inability to provide an opinion without resorting to speculation must be based the limitation of knowledge in the medical community at large and not a limitation - whether based on lack of expertise, insufficient information, or unprocured testing - of the individual examiner. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Hetman 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.