Citation Nr: 21015005 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 16-22 597 DATE: March 16, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent for status-post stress fracture of the right femoral neck is remanded. INTRODUCTION The Veteran had active service from September 1966 to August 1968. In May 2019, the appellant testified at a hearing before the undersigned Veterans Law Judge via videoconference. A transcript of the proceeding is of record. When this case was previously before the Board in October 2019 and October 2020, the above-noted issue was remanded for further development. The case has since been returned for additional appellate review. REASONS FOR REMAND While further delay of this appeal is untenable, the Board finds additional development is yet again required before the Veteran’s claim is decided. As previously noted, when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). In the course of both the October 2019 and October 2020 remands, the Board fully explained that an assessment of the Veteran’s range of motion measurements in weight bearing, non-weight bearing, and in passive motion were necessary to properly evaluate the Veteran’s right hip disability. See Correia v. McDonald, 28 Vet. App. 158 (2016). The Veteran recently underwent another VA examination; however, like the prior examiners, the January 2021 VA examiner failed to provide all of these critical evaluative criteria. As such, a remand is again required. A remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Additionally, in the October 2020 remand the Board observed the Veteran’s reports of ongoing leg numbness and tingling, which travels to his right foot. The Veteran has indicated he experiences sitting/walking limitations, and has also suffered a number of falls as a result of his pain, numbness, and tingling in his leg. The Veteran also underwent a VA peripheral nerves examination in January 2021, at which time he was diagnosed with neuropathy of the right leg sciatic and ilioinguinal nerves. The examiner then concluded the Veteran’s lower extremity nerve disabilities were less likely than not caused or aggravated by his service-connected right hip disability. In support of this conclusion the examiner provided a medical description of the Veteran’s right hip disability, and then indicated his right hip disability is more localized than radiating. The examiner in no way explained how or why the Veteran’s lower extremity neuropathy could not have been caused or aggravated by his right hip disability. Further, it appears the examiner ignored the Veteran’s reports of numbness and tingling of the leg since his initial hip injury in service. A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008). Further, examiners simply are not free to ignore a veteran’s statements related to lay observable symptoms. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). Based on the above-noted deficiencies, the Board finds substantial compliance with the October 2020 remand instructions has not been achieved. Therefore, a remand is again required. Accordingly, these matters are REMANDED for the following actions: Afford the Veteran a VA examination by an examiner with sufficient expertise, who has not previously examined the Veteran, to fully assess the severity of the Veteran’s service-connected right hip status-post stress fracture of the right femoral neck. All pertinent evidence of record should be made available to and reviewed by the examiner. Any indicated studies should be performed. Ensure the examiner provides all information required for rating purposes, to specifically include both active and passive range of motion testing, as well as weight-bearing and nonweight-bearing range of motion assessments. In addition, the examiner must consider and discuss all procurable and assembled data such as the frequency, duration, characteristics, precipitating and alleviating factors, and the severity of the flare-ups, and then provide an assessment of the functional loss during flares, if possible in degrees of motion lost. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary, he or she should be directed to clearly explain why that is so. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether the Veteran’s right sciatic or ilioinguinal neuropathy at least as likely as not (a 50 percent probability or greater): a) was caused by his service-connected status-post stress fracture of the right femoral neck; or b) was worsened to any degree by his service-connected status-post stress fracture of the right femoral neck. The examiner must discuss and consider the Veteran’s competent lay statements. Additionally, the examiner must provide a complete rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Fraser, 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.