Citation Nr: 21020860 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 16-15 387A DATE: April 8, 2021 REMANDED Entitlement to a compensable rating for a right fourth finger disability is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1982 to September 1985. This matter comes before the Board of Veterans’ Appeals(Board) on appeal from a September 2014 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). In September 2018, the Board remanded the claim for additional development. The Veteran has also appealed the denial of service connection for a back disability, a right ankle disability, and a right knee disability. He requested Board hearings in these appeals. At this time, a hearing or hearings have not been provided. The issues are not considered herein. 1. Entitlement to a compensable rating for a right fourth finger disability is remanded. In September 2018, the Board remanded the Veteran’s claim for a compensable rating for a right fourth finger disability. The Board directed the RO to provide a new VA hand and finger conditions examination to determine which right upper extremity symptoms were due to his service connected finger disability. The Board also required that the RO provide a hearing before a Decision Review Officer (DRO) and refer the claim to the Director of Compensation for consideration of an extraschedular evaluation under 38 C.F.R. § 3.321(b)(1). A VA hand and finger conditions examination was provided in December 2019. The examiner noted current symptoms of right-hand pain, tingling, and numbness. The Veteran also reported stiffness in his right hand. Locking of the Veteran’s fingers, including his right fourth finger, was not noted. In March 2020, the Veteran was treated in a VA orthopedic surgery clinic. He reported that his bilateral hand symptoms were worsening. He described intermittent locking of his small and ring (fourth) fingers. Additional treatment, including corticosteroid injections, were being considered due to this locking. The Board notes August 2016 VA treatment records include the Veteran’s report of his fingers locking. However, the December 2019 examiner did not mention locking and the Veteran describes his condition as worsening in March 2020. Therefore, the Board finds the Veteran’s right fourth finger disability may have worsened since the December 2019 examination. A new VA examination must be provided. See Snuffer v. Gober, 10 Vet. App. 400 (1997). 2. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. In September 2019, the Board noted the record did not clearly indicate that the Veteran was unemployed or marginally employed over the appeal period. The Board found that, despite the Veteran’s assertions that his right fourth finger disability impacted his ability to work, entitlement to a TDIU was not raised by the record. See Rice v. Shinseki, 22 Vet. App. 447 (2009). Following the Board’s remand directives, a June 2020 DRO hearing was provided. During the hearing the Veteran stated he was no longer employed. He claimed he stopped working because of difficulties related to his hand condition and to a service-connected right Achilles tendon disability. Based on information provided at the June 2020 hearing, the issue of entitlement to a TDIU is now raised by the record. As no development on this issue has been completed, including provision of the appropriate notice, the claim must be remanded so that the RO can properly develop the TDIU claim for initial adjudication. The matters are REMANDED for the following action: 1. Provide appropriate notice and develop the issue of entitlement to a TDIU pursuant to 38 C.F.R. § 4.16. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected right fourth finger disability. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner should review the entire claims file, including past VA hand and finger examinations and VA orthopedic clinic notes. (Continued on the next page)   The examiner should identify all symptoms and functional impairments due to the Veteran’s right fourth finger condition and must differentiate any symptoms which are related to other conditions of the right hand or right upper extremity. If the examiner cannot differentiate which symptoms are solely due to the service-connected disability and which are solely due to nonservice-connected disability of the right hand or right upper extremity, this must be clearly stated. The examiner is asked to fully address the Veteran’s reports of intermittent locking in his right fourth finger. The examiner should discuss the all limitations imposed by this locking and other right fourth finger symptomatology. He or she should state whether the functional impairment of this extremity is such that the Veteran would be equally served by an amputation with prosthesis. A complete explanation must be provided. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jeanne Celtnieks 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.