Citation Nr: 21028490 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 14-28 109A DATE: May 11, 2021 REMANDED Entitlement to a rating in excess of 10 percent prior to July 17, 2018, for the low back disability is remanded. Entitlement to a rating in excess of 20 percent from July 17, 2018, to October 16, 2020, for the low back disability is remanded. Entitlement to a rating in excess of 40 percent from October 15, 2020, for a low back disability is remanded. Entitlement to a rating in excess of 10 percent for chronic sinusitis is remanded. REASONS FOR REMAND The Veteran had active service from June to August 1984, November 1984 to August 1985, February 1987 to July 1989, and September 1989 to June 1998. A videoconference hearing before the undersigned Veterans Law Judge was held at the RO in October 2018. 1. The claim for increased ratings for a lumbar spine disability is remanded. The Board finds the record would benefit if the Veteran were afforded another examination to determine any impact of medication on functional impairment. Additionally, the Board finds the record would benefit if a VA medical professional quantified the degree of flexion represented by "fingertips to knee" as reported in the January 2019 private treatment record. 2. The claim for increased rating for sinusitis is remanded. The record indicates that some treatment records were scanned to VistA imaging. These records are not associated with the file; this must be done. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records and the VistA Imaging records. If any requested records are unavailable, the Veteran should be notified of such. In addition, ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed disabilities. After securing any necessary releases, request any relevant records identified. 2. Afford the Veteran VA examination by an examiner with sufficient expertise to fully assess the Veteran's service-connected low back disability. The examiner must provide all information required for rating purposes, including pursuant to the "new" rating criteria (effective February 7, 2021). The examiner must discuss functional limitation with repeated movement over time and during flare-ups. Any such additional limitation of motion should be expressed in additional degrees of lost motion. The examiner must attempt to provide an estimate, even in the absence of an opportunity to observe the flare-up. The estimate may be based on the Veteran's reports of limitation during such flares. The Veteran should be requested to visually estimate the functional impairment during the most common flares and most severe flares. The examiner must attempt to describe the severity of the back disability without consideration of the ameliorative effects of steroid medication. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment 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). T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Snyder, 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.