Citation Nr: 21028599 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 18-07 940 DATE: May 11, 2021 REMANDED Entitlement to an initial rating higher than 20 percent for left shoulder impingement syndrome is remanded. Entitlement to an initial rating higher than 20 percent for left shoulder recurrent dislocation-scapulohumeral joint is remanded. Entitlement to an initial rating higher than 10 percent for left ulnar neuropathy prior to February 18, 2020 is remanded. Entitlement to an initial rating higher than 20 percent for left ulnar neuropathy beginning February 18, 2020 is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1979 to July 1983, and from June 2008 to June 2009. The Veteran also had service of an unverified nature in the Reserves. The case is on appeal from an August 2015 rating decision. In a January 2021 decision, the Board granted a higher 50 percent rating for service-connected posttraumatic stress disorder (PTSD). The initial higher rating claims for left shoulder impingement, left shoulder recurrent dislocation-scapulohumeral joint, and left ulnar neuropathy, were remanded for additional development. Pursuant to the Board's January 2021 remand, an addendum opinion with respect to the severity of the Veteran's left shoulder impingement syndrome and left shoulder recurrent dislocation-scapulohumeral joint was obtained in March 2021. The opinion notes that it was not possible to provide specific measurements with respect to range of motion of the left upper extremity without resorting to mere speculation, noting that medical record review was inconsistent for current clinical evidence of decreased range of motion of the left shoulder. The Board notes that in addition to the February 2020 VA examination report reflecting decreased range of motion in the left shoulder, the 20 percent rating currently assigned for impingement syndrome of the left shoulder under Diagnostic Code (DC) 5201 contemplates arm limitation of motion midway between the side and shoulder level, and the 20 percent rating assigned for recurrent dislocation-scapulohumeral joint under DC 5202 contemplates frequent episodes and guarding of all arm movements. See 38 C.F.R. § 4.71a, DCs 5201 and 5202; see also January 2018, July 2020 rating decisions. As such, the opinion is not completely adequate. Thus, remand for VA examination is warranted to assess the severity of the service-connected left shoulder impingement syndrome and left shoulder recurrent dislocation-scapulohumeral joint, to include complying with Correia v. McDonald, 28 Vet. App. 158 (2016) and Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017). Pursuant to the Board's January 2021 remand, an addendum opinion was obtained in March 2021 with respect to the severity of the Veteran's left ulnar neuropathy, including the identification and severity of all nerves involved. The opinion states that an opinion as to the severity due to ulnar and radial nerve neuropathy could not be provided without resorting to mere speculation. However, the reason why an opinion in that respect would require speculation was not provided. As such, the opinion is not completely adequate. Thus, remand for VA examination is warranted. In view of the remand, VA treatment records since the issuance of the March 2021 supplemental statement of the case should be associated with the file. The matters are REMANDED for the following actions: 1. Obtain VA treatment records since March 2021. 2. Schedule the Veteran for an examination (or telehealth interview, records request, etc. if an in-person examination is not feasible) by an appropriate clinician to assess the severity of the service-connected left shoulder impingement syndrome and recurrent dislocation-scapulohumeral joint, to include at the time of the May 2015 and March 2020 VA examinations. This should include testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. If there are flare-ups, but if the examination is not conducted during a flare-up, the functional impact of a flare-up in terms of degrees of range of motion should be estimated, to include at the time of the May 2015 and March 2020 VA examinations. Rationale for all opinions expressed should be provided. If the examiner cannot provide some or all of such opinions, the examiner must make clear that he or she has considered all relevant, procurable data, but that any member of the medical community at large could not provide such an opinion without resorting to speculation. 3. Schedule Veteran for an examination (or telehealth interview, records request, etc. if an in-person examination is not feasible) by an appropriate clinician to assess the severity of the service-connected left ulnar neuropathy, to include at the time of the May 2015 and March 2020 VA examinations. In rendering the opinion, all impaired nerves in the Veteran's left upper extremity should be identified, and the severity for each nerve identified should be described, to include any complete or incomplete paralysis or atrophy of the associated muscles, to include at the time of the May 2015 and March 2020 VA examinations. 4. Then, readjudicate the claims on appeal. Romina A. Casadei Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Taylor 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.