Citation Nr: 21009930 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 20-21 642 DATE: February 23, 2021 REMANDED Entitlement to an initial compensable rating for residuals of right thumb fracture is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1965 to January 1969. 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 notes that although the Veteran initiated an appeal of his claim of entitlement to service connection for hepatitis B in his November 2018 notice of disagreement (NOD), he indicated that he did not wish to appeal this claim on his May 2020 substantive appeal (VA Form 9). Accordingly, the issue is not before the Board. The Veteran testified before the undersigned during a hearing in February 2021. At the Board hearing, the Veteran testified that his right thumb disability symptoms had worsened since the most recent VA examination in August 2018, including increased aching, pain, stiffness, and functional loss. As it appears that the disability has increased in severity since the last evaluation, a new examination is necessary to determine the current severity of the Veteran's right thumb disability. The matters are REMANDED for the following action: Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of the Veteran’s service-connected right thumb disability. The claims file should be made available to and reviewed by the examiner and all necessary tests should be performed. All findings should be reported in detail, and all opinions must be supported by a rationale. The joints involved should be tested in both active and passive motion, in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to conduct the required testing, he or she should clearly explain why that is so. The examiner should describe any pain, weakened movement, excess fatigability, instability of station, and incoordination present. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups he experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he experiences during a flare-up of symptoms and/or after repeated use over time. Based on the Veteran’s lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional range of motion loss during flare-ups or after repetitive use without resorting to speculation, the examiner should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training). A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Ariasaif, Associate 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.