Citation Nr: 21027355 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 15-25 980 DATE: May 5, 2021 REMANDED Entitlement to a rating in excess of 10 percent for tendonitis, right wrist is remanded. Entitlement to a total disability rating due to unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1970 to May 1971, with additional periods of National Guard service. This matter came before the Board of Veterans Appeals (Board) on appeal from an August 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran's Law Judge during a July 2017 hearing. The transcript of the hearing is of record. A July 2018 Board decision remanded the issues on appeal for further development. A July 2020 rating decision granted service connection for post-traumatic stress disorder, major depressive disorder and alcohol abuse disorder and assigned a 100 percent rating effective November 9, 2011. As this constituted a complete grant of the benefit sought on appeal for the issues of service connection for an acquired psychiatric disability and PTSD, they are not before the Board. The July 2020 rating decision also found that the issue of entitlement to TDIU was moot as a 100 percent schedular rating had been granted for the entire period on appeal. However, it is not categorically true that assignment of a total schedular rating always renders a TDIU request moot, particularly as it relates to possible entitlement to special monthly compensation. See Bradley v. Peake, 22 Vet. App. 280 (2008). In Bradley, the Court held that a TDIU rating could be warranted in addition to a schedular 100 percent evaluation, where the TDIU could be granted for a disability other than a disability for which a 100 percent rating was in effect, explaining that under such circumstances, there was no "duplicate counting of disabilities." Bradley, 22 Vet. App. at 293. Here, while the Veteran has a 100 percent schedular rating for his service-connected psychiatric disability, he is also service connected for the right wrist and at the July 2017 Board hearing indicated that his right wrist disability and chronic pain had affected his ability to work. The Board therefore finds that the issue of entitlement to TDIU is not moot and will proceed to adjudicate the issue based on the evidence of record. 1. Entitlement to a rating in excess of 10 percent for tendonitis, right wrist The July 2018 Board decision requested a new VA wrist examination, specifically asking that if pain was noted on range of motion testing, the examiner should indicate the point during range of motion that pain began. A VA wrist examination was provided in June 2019. However, while the examiner found pain on dorsiflexion and ulnar deviation and stated that the pain caused functional loss, the examiner did not note the point in range of motion that pain began. This does not allow the Board to properly assess the functional impairment caused by the disability. Examinations for joint disabilities generally must include range of motion measurements. See Correia v. McDonald, 28 Vet. App. 158, 169 (2016). In conducting these measurements, the examiner should note when any incoordination, weakened movement, or excess fatigability sets in. Id. The examiner should also note whether pain on motion is present, and, if so, where in the range of motion the pain sets in and whether that pain causes functional loss. Id. Remand is therefore required to obtain the requested information regarding functional loss. 2. Entitlement to a total disability rating due to unemployability (TDIU) The issue of entitlement to TDIU must also be remanded as it is inextricably intertwined with the issue of increased ratings for the right wrist disability. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are "inextricably intertwined" when the adjudication of one issue could have "significant impact" on the other issue). The matters are REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination to determine the current nature and severity of his right wrist disability. The claim file should be made available to and reviewed by the examiner and the examination report should state a review of the file was completed. All findings should be reported in detail. The examiner should identify all right wrist pathology found to be present. The examiner should conduct range of motion studies. The joints involved should be tested in both active and passive motion, in weight-bearing and non-weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. 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 state whether the range of motion is so limited as to functionally constitute ankylosis. The examiner should describe any pain, weakened movement, excess fatigability, instability of station and incoordination present. If pain is noted, the point during range of motion at which pain starts must be clearly indicated. The examiner should also state whether the examination is taking place during a period of flare-up. If not, the examiner should ask the Veteran to describe the flare-ups he experiences, including: frequency, duration, characteristics, precipitating and alleviating factors, severity and/or extent of functional impairment he experiences during a flare-up of symptoms and/or after repeated use over time. Based on the Veteran's lay statements and the other evidence of record, the examiner should provide an opinion estimating any additional degrees of limited motion caused by functional loss during a flare-up or after repeated use over time. If the examiner cannot estimate the degrees of additional range of motion loss during flare-ups or after repetitive use without resorting to speculation, the examiner should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). (Continued on next page) 2. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Arnold 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.