Citation Nr: 21013357 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 13-27 800 DATE: March 9, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for lumbar spondylosis with compression fractures at T8, T9, and S1 is remanded. REASONS FOR REMAND The Veteran served on active duty from May 2004 to July 2011. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2012 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Board remanded this matter in April 2018 and July 2020 for additional development. The matter is now returned to the Board for further appellate review. VA provided the Veteran an examination in January 2021 to determine the nature and severity of his lumbar spine disability. The examiner, however, failed to provide range of motion measurements with passive motion pursuant to Correia v. McDonald, 28 Vet. App. 158 (2016). Correia provides that the final sentence of 38 C.F.R. § 4.59 requires VA examinations to include range of motion joint testing for pain on 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. The spine has no opposite joint. The examiner did not provide range of motion measurements of the back in passive motion, indicating that passive range of motion could not be performed or was not medically appropriate. However, the examiner did not explain why the required testing could not be performed or why it would be medically inappropriate. Accordingly, the Board finds that an addendum opinion should be obtained (and examination, if found necessary) from the January 2021 examiner regarding the deficiencies noted above. The matter is REMANDED for the following action: Forward the claims file to the January 2021 VA examiner in order to obtain an addendum opinion that explains why passive range of motion testing could not be performed or was not medically appropriate for the Veteran's lumbar spine disability. If the January 2021 VA examiner is not available to provide the addendum opinion, or if it is found that a new examination is otherwise necessary, schedule the Veteran for an appropriate VA examination to determine the severity of the service-connected lumbar spine 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. The lumbar spine should be tested in both active and passive motion, and in both weightbearing and non-weightbearing. 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 must 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). M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Zachery S.C. Luce, 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.