Citation Nr: 21029607 Decision Date: 05/14/21 Archive Date: 05/14/21 DOCKET NO. 18-46 252A DATE: May 14, 2021 REMANDED Eligibility for financial assistance in the purchase of one automobile or other conveyance and automobile adaptive equipment is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from October 2007 to July 2008. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Eligibility for financial assistance in the purchase of one automobile or other conveyance and automobile adaptive equipment is remanded. The Veteran has not yet been provided with VA examination or medical opinion with respect to this claim. On his notice of disagreement, the Veteran asserted that his in-service surgery and radiation treatment for his malignant cancer on the chest resulted in permanent burn and scar formation that causes severe uncontrollable muscle spasms/contractures, and limits motion of his core/midsection including his left underarm and back areas. In relevant part, the Veteran was previously granted service connection for thymoma, status post resection and residual scar, left upper extremity complex regional pain syndrome, complex regional pain syndrome affecting muscle group XX, and complex regional pain syndrome of the thoracolumbar spine. On remand, an examination should be provided to assess the current severity of these service-connected disabilities and their affect on the Veteran's functioning as it relates to the criteria of 38 C.F.R. § 3.808. While the case is in remand status, the RO should take all necessary action to associate all outstanding VA treatment records for this Veteran with the claims file and contact the Veteran to request that he identify and authorize the release of any relevant private treatment records. The matter is REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from August 2018 to the Present. 2. Ask the Veteran to clarify whether he is presently under the care of a private medical professional, and to complete a VA Form 21-4142 for any relevant private treatment records he wishes for VA to obtain on his behalf. Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. 3. After associating all records responsive to Remand directives #1 and #2 with the claims file, schedule the Veteran for an examination with an appropriate medical professional ("examiner") to determine the functional impairment attributable to the Veteran's service-connected disabilities. The examiner should be provided with a list of the Veteran's service connected disabilities, and be given access to the claims file. Considering the evidence of record, including but not limited to any findings and observations made at the time of the examination and the Veteran's lay statements, the examiner must address the following: A. whether it is at least as likely as not (50 percent or greater probability) that the Veteran's service-connected disabilities, alone, limit his ability to use his left hand to such an extent that he would be equally well-served by amputation with use of an appropriate prosthetic. If answered in the negative, the examiner should state in what way(s) the Veteran's remaining functional capacity to use his left hand (e.g. for grasping and manipulation) is superior to the functional capacity that would remain were he to be using a prosthetic, post-amputation. The examiner is advised that the above question is asking for a comparison between the Veteran's actual functional ability to use his left hand and his level of functioning if the left hand was amputated and he was making use of a prosthetic. The question is not asking whether the Veteran's current service-connected disabilities warrant amputation of the left upper extremity. B. whether it is at least as likely as not that the Veteran has deep partial thickness or full thickness burns that have resulted in scar formation that causes contractures and limits motions of his left upper extremity or his trunk. If so, please describe how that affects the Veteran's ability to operate an automobile. The Veteran asserts that surgical and radiation treatment of his cancer resulted in permanent burn to chest area and scar formation that causes muscle spasms and contractures. If the Veteran has any such "burn," please explain whether these could be considered to be deep partial thickness or full thickness burns. A clear rationale must be provided for any opinion or conclusion stated. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Solomon, 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.