Citation Nr: 21023943 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 17-25 062 DATE: April 21, 2021 REMANDED Entitlement to a rating in excess of 10 percent for right knee patellofemoral pain syndrome is remanded. Entitlement to a compensable rating for bilateral hearing loss is remanded. Entitlement to service connection for a right shoulder disorder is remanded. Entitlement to service connection for a left shoulder disorder is remanded. Entitlement to service connection for a cervical spine disorder is remanded. Entitlement to a total disability rating for compensation purposes due to individual unemployability (TDIU) prior to March 16, 2020, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1986 to September 1989. These matters come before the Board of Veterans’ Appeals (Board) on appeal of a decision issued by the Department of Veterans Affairs (VA). The Veteran testified before the undersigned Veterans Law Judge during a hearing in July 2020. A transcript of the hearing is associated with the claims file. During the pendency of these matters, the Veteran raised a claim of entitlement to a TDIU in the context of his increased rating claims on appeal. See Rice v. Shinseki, 22 Vet. App. 447 (2009). The agency of original jurisdiction (AOJ) granted a TDIU from March 16, 2020. However, as this grant only covers a portion of the rating period, the question of a TDIU prior to that date remains within the Board’s jurisdiction. Harper v. Wilkie, 30 Vet. App. 356 (2018). The claim will be further addressed in the remand section below. 1. Entitlement to a rating in excess of 10 percent for right knee patellofemoral pain syndrome is remanded. 2. Entitlement to a compensable rating for bilateral hearing loss is remanded. The above claims must be remanded for VA examinations documenting the current severity of the disorders. The Veteran was last examined for his right knee disorder and bilateral hearing loss in 2017. He testified that the disorders have worsened since his last examination. Accordingly, the Board finds that remand is necessary to procure an updated VA examination documenting the current severity of the Veteran’s right knee and bilateral hearing loss disorders. See 38 C.F.R. § 3.327. The Board observes that the Veteran appeared for a knee examination in September 2020. However, he was unable to complete relevant knee range of motion testing due to complaints of pain. Therefore, the Board finds that another VA examination is warranted to attempt to complete relevant testing for the right knee disorder. 3. Entitlement to service connection for a right shoulder disorder is remanded. 4. Entitlement to service connection for a left shoulder disorder is remanded. 5. Entitlement to service connection for a cervical spine disorder is remanded. The Board finds that the above claims of service connection must be remanded for VA examinations and medical opinions. 38 U.S.C. § 5103A(d). The Veteran has not yet been afforded VA examinations for his claims of service connection for right and left shoulder disorders and a neck or cervical spine disorder. However, he has asserted that his current disorders are related to his occupational duties during military service, including pounding metal pickets into the ground, and also that his disorders are secondary to his service-connected right knee disorder. See 38 C.F.R. §§ 3.303, 3.310. Accordingly, the Board finds that a VA examination is necessary to consider the nature and etiology of the Veteran’s shoulder and neck disorders. McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006). 6. Entitlement to a TDIU prior to March 16, 2020, is remanded. As a grant of benefits for the above disorders may impact the Veteran’s eligibility for a TDIU prior to March 16, 2020, the claims are inextricably intertwined and must be remanded for further development. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following actions: 1. Please secure for the record copies of complete updated clinical records of all VA and non-VA treatment the Veteran has received for the disorders on appeal. 2. Schedule the Veteran for a VA audiological examination documenting the current severity of his bilateral hearing loss. The examiner is asked to describe the disorder in detail and document all symptoms necessary for rating it under relevant criteria. 3. Thereafter, schedule the Veteran for VA examinations documenting the current severity of his right knee disorder, and determining the nature and etiology of any diagnosed shoulder and neck/cervical disorders. As to the right knee disorder, the examiner is asked to describe the disorder in detail and document symptoms necessary for rating it under relevant criteria. The examiner should provide the range of motion in degrees for the Veteran’s right knee, and in doing so, should test for pain and range of motion in active motion, passive motion, weightbearing, and non-weightbearing. If the examiner is unable to conduct the required testing or concludes that such testing is not necessary in this case, he or she should clearly explain so in the report. The examiner is asked to elicit information on the characteristics, severity, frequency, and duration of the Veteran’s flare-ups, if any, and then estimate the extent of any additional functional loss during such periods. If such an estimate cannot be provided, the examiner must indicate that he or she has considered all procurable and assembled data, and that the inability to provide an estimate results from limitations in the knowledge of the medical community at large, and not limitations of his or her personal knowledge. Regarding the bilateral shoulder and neck/cervical spine disorders, the examiner is asked to review the claims file, and, thereafter, to opine on the following: (a) Is it at least as likely as not that the Veteran’s shoulder disorders, to include pain causing functional loss, had onset during or are causally related to military service, to include occupational duties hammering heavy posts into the ground? (b) Is it at least as likely as not that the Veteran’s shoulder disorders are proximately due to, a result of, or aggravated by a right knee disorder? (c) Is it at least as likely as not that the Veteran’s cervical spine disorder, to include pain causing functional loss, had onset during or is causally related to military service, to include occupational duties hammering heavy posts into the ground? (d) Is it at least as likely as not that the Veteran’s cervical spine disorder is proximately due to, a result of, or aggravated by a right knee disorder? A complete rationale should be provided for all opinions. The examiner is asked to consider and discuss relevant lay and medical evidence, to specifically include: • The Veteran’s contentions that his shoulder and neck disorders are related to using heavy pieces of metal to pound picket fence pieces into the ground during military service or are secondary to his service-connected right knee disorder • VA treatment and service medical records The examiner is reminded that the term “at least as likely as not,” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that it is as medically sound to find in favor of the proposition as it is to find against. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Reed, 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.