Citation Nr: 21015960 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 15-37 103 DATE: March 18, 2021 REMANDED Entitlement to an initial evaluation in excess of 10 percent for right wrist sprain (claimed as arthritis) is remanded. Entitlement an initial evaluation in excess of 10 percent for left wrist sprain (claimed as arthritis) is remanded. Entitlement to an initial evaluation in excess of 10 percent for long finger strain (claimed as arthritis), right hand, is remanded. Entitlement to an initial evaluation in excess of 10 percent for long finger strain (claimed as arthritis), left hand, is remanded. Entitlement to an initial evaluation in excess of 10 percent for index finger strain (claimed as arthritis), right hand, is remanded. Entitlement to an initial evaluation in excess of 10 percent for index finger strain (claimed as arthritis), left hand, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 15, 2003, to June 30, 2003, February 2004 to May 2005, May 2008 to January 2009, and January 2009 to March 2010, with additional periods in the Army National Guard. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision from by the Department of Veterans Affairs (VA) Regional Office (RO). In his October 2015 VA Form 9, the Veteran requested a hearing at his local VA office. Subsequently, in May 2016, the Veteran withdrew his hearing request. As such, the Board finds that the hearing request has been withdrawn. 38 C.F.R. § 20.704. The matters were previously remanded by the Board for further development in March 2019. These matters return to the Board for appellate consideration. In a September 2020 rating decision, the RO assigned a separate compensable evaluation for long finger strain, bilaterally. As such, the issues have been recharacterized above to better reflect the issues on appeal. 1. Entitlement to an initial evaluation in excess of 10 percent for right wrist sprain (claimed as arthritis) is remanded. 2. Entitlement an initial evaluation in excess of 10 percent for left wrist sprain (claimed as arthritis) is remanded. 3. Entitlement to an initial evaluation in excess of 10 percent for long finger strain (claimed as arthritis), right hand, is remanded. 4. Entitlement to an initial evaluation in excess of 10 percent for long finger strain (claimed as arthritis), left hand, is remanded. 5. Entitlement to an initial evaluation in excess of 10 percent for index finger strain (claimed as arthritis), right hand, is remanded. 6. Entitlement to an initial evaluation in excess of 10 percent for index finger strain (claimed as arthritis), left hand, is remanded. The Veteran contends that his bilateral wrist and finger disabilities are more disabling than contemplated in the assigned evaluations. Although the Board regrets the delay, further development is required before the Board can render an appellate decision. In the March 2019 remand, the Board instructed the Agency of Original Jurisdiction (AOJ) to schedule the Veteran for a VA examination to determine the current severity of his bilateral wrist and hand conditions. The examiner was asked to test the Veteran’s active motion, passive motion, and pain with weight bearing and non-weight bearing testing for both joints. The examiner was also asked to describe any functional limitation due to pain, weakened movement, excess fatigability, pain with use, incoordination, or on flare up, and that if the Veteran described flare-ups of pain, the examiner was asked to offer an opinion as to whether there would be additional limits on functional ability during flare-ups. Pursuant to the March 2019 Board remand, the Veteran underwent an August 2020 wrist examination. The examination reflected abnormal ranges of motion on active range testing, pain on weight-bearing testing, and pain that caused functional loss. The examiner indicated that pain, fatigue, and weakness limited functional ability with flare ups, demonstrated by palmar flexion to 10 degrees, dorsiflexion to 5 degrees, and ulnar and radial deviation to 5 degrees, in the bilateral wrist. The Veteran reported constant flare-ups in the bilateral wrist, alleviated by either non-use or upon medication. He also reported reduced movement. The examiner noted objective evidence of pain in both passive range of motion and non-weight bearing testing, in the bilateral wrist. However, the examination findings did not include passive range of motion measurements. Furthermore, the examiner did not provide an opinion as to whether there would be additional limits on functional ability based on the Veteran’s reported flare-ups. Stegall v. West, 11 Vet. App. 268 (1998) (holding that a remand by the Board confers the right to compliance with remand orders). An August 2020 hand/finger examination was also administered. The examination reflected abnormal ranges of motion on active range testing and right-hand pain that caused functional loss. The examiner indicated that pain and fatigue limited functional ability with flare-ups, demonstrated by max extension to 0 degrees and max flexion to 60 degrees in the index and long fingers, max extension to 0 degrees and max flexion to 90 degrees in the ring and little fingers; and max extension to 0 degrees and max flexion to 50 degrees in the thumb. The Veteran reported severe, constant flare-ups in the bilateral hand, alleviated by either non-use or medication. He also reported reduced movement. The examiner noted objective evidence of pain on passive range of motion and non-weight bearing testing, in the bilateral hand. Again, the examination findings did not include passive range of motion measurements or an opinion regarding additional limits on functional ability based on the Veteran’s description of flare-ups. Id. As such, an addendum opinion is needed to address the Veteran’s passive range of motion measurements in both the wrist and hand/fingers, particularly since the examiner has also indicated objective evidence of pain on passive range of motion testing. The matters are REMANDED for the following action: Obtain an addendum opinion from the examiner who conducted the August 2020 VA examination or another appropriate clinician. The examiner providing the opinions must be provided access to the electronic claims file and indicate review of the file in the examination report. The claims folder and a copy of this remand in its entirety must be provided to the examiner in conjunction with the addendum opinion. The examiner is requested to review all pertinent records associated with the claims file, and the examiner must indicate on the examination report that such review was undertaken. If examination of the Veteran is necessary, such should be arranged. To comply with the Correia v. McDonald, the examiner must test and record the range of motion in active motion, passive motion, weight-bearing, and non-weight-bearing of both wrists and hands/fingers. 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 should clearly explain why that is so. The examiner should also provide an opinion on as to whether there would be additional limitations on functional ability based on the Veteran’s reports of flare-ups, which include severe pain and reduced movement in the bilateral wrist and hand/fingers. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Y. Asfaw, 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.