Citation Nr: 21021446 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 18-48 217 DATE: April 13, 2021 REMANDED Entitlement to an initial rating higher than 10 percent for service-connected left hip disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 2003 to August 2004. This matter arises from a January 2018 rating decision issued by the Department of Veteran’s Affairs (VA) Regional Office (RO). In a July 2020 decision, the Court of Veterans Appeals (CAVC) vacated the Board of Veterans’ Appeals (Board) July 2019 decision. The Board remands this matter based on the direction in the CAVC decision. 1. Entitlement to an initial increased rating for service-connected left hip disability is remanded. The Veteran contends that her left hip disorder is very painful and her left hip flexion is limited to 25 degrees. See April 2018 Notice of Disagreement. In its July 2020 decision, CAVC found that the Board’s reliance on the Veteran’s November 2017 and July 2018 VA examinations was in error as the examination reports did not accurately describe or account for her description of her symptoms. This includes the Veteran’s claim that her hip is limited in flexion to 25 degrees. However, it is unclear how this 25-degree limitation was measured. Therefore, because there is no adequate examination of record, the Board remands this matter for a new VA examination to account for the Veteran’s physical manifestations and described symptoms. The matters are REMANDED for the following action: 1. Obtain all outstanding VA and private treatment records pertinent to the claim. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of her service-connected left hip 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. 3. The examiner is also asked to identify all applicable diagnosis to the left hip, including hip strain and/or possible bursitis identified in the November 2017 x-rays. 4. The examiner is asked to elicit from the Veteran how she measured the 25-degree limitation of flexion of her left hip. 5. The examiner is asked to reconcile the 115-degree limitation of flexion found in the November 2017 and May 2018 VA examinations with the Veteran’s reported 25-degree limitation of flexion. 6. The examiner is also asked to identify if the Veteran’s use of a walker is necessitated by her service-connected hip disability, or by a non-service-connected disability, such as her back disability, or both. In so doing, the examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran’s statements. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). Signature on the next page DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Boushehri, Darjush M. 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.