Citation Nr: 21032502 Decision Date: 05/27/21 Archive Date: 05/27/21 DOCKET NO. 15-34 832 DATE: May 27, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent for right elbow strain is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from March 1983 to March 2007. His decorations include the Southwest Asia Service Medal. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. By that decision, the RO continued a prior 0 (zero) percent (noncompensable) rating for the Veteran's service-connected right elbow strain. This case was previously before the Board in June 2019, when it was remanded to the agency of original jurisdiction (AOJ) for additional development. In September 2020, after taking further action, the AOJ increased the rating for the Veteran's right elbow strain to 10 percent, effective January 20, 2015 (the date of receipt of his claim for an increased rating), issued a supplemental statement of the case (SSOC) addressing entitlement to a rating in excess of 10 percent, and returned the case to the Board. As the Veteran has not been granted the maximum benefit available, the claim for an increased rating remains on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Although the Board sincerely regrets the additional delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran's claim and to afford him every possible consideration. Entitlement to a disability rating in excess of 10 percent for right elbow strain The Veteran's right elbow disability is rated under 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5213. The condition has been evaluated as 10 percent disabling based on painful motion of the forearm. A note following DC 5213 provides that "[i]n all the forearm and wrist injuries, codes 5205 through 5213, multiple impaired finger movements due to tendon tie-up, muscle or nerve injury, are to be separately rated and combined not to exceed rating for loss of use of hand." 38 C.F.R. § 4.71a, DCs 5205-5213, Note. Treatment records show that the Veteran has been diagnosed with a right elbow strain, and lateral epicondylitis, also known as tennis elbow. See April 2007 private treatment records. Throughout the period on appeal, he has reported pain radiating up and down his arm, and difficulty with pain in the fourth and fifth fingers. See December 2014 private medical records; see also August 2015 VA examination. He also asserted that, at times, he could not use his right hand due to pain. See April 2015 VA examination. In the June 2019 remand, the Board instructed that the Veteran be afforded a VA examination of his right elbow to ascertain the severity of the disability. While the Veteran was afforded a VA examination in January 2020, there was no assessment of his reported right hand and finger symptoms other than notations to the effect that he was "unable to grab and take lid off jar" and had an "inability to hold to the mouse and type the keyboard for [a] long period of time . . . ." Because that information is inadequate for rating purposes, additional development is required. This matter is REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed, arrange to have the Veteran scheduled for an examination of his right hand and fingers. The examiner should review the record. All indicated tests should be conducted and the results reported. After examining the Veteran and reviewing the record, together with the results of any testing deemed necessary, the examiner should identify any functional limitations of the right hand and/or fingers that have been present since January 2015 (when the underlying claim for increase was filed), to include any limitations with respect to grasping or other use of the hand. Then, with respect to each such limitation, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the functional limitation of the hand and/or fingers has been (a) caused or (b) aggravated (worsened beyond natural progression) by the Veteran's service-connected right elbow strain, to include as a result of tendon tie-up or muscle or nerve injury. If it is the examiner's opinion that the Veteran has functional limitations of the right hand and/or fingers that have at least as likely as not been caused or aggravated by the Veteran's right elbow disability, the examiner should provide a full description of the Veteran's associated functional hand and finger impairments as they relate to the relevant rating criteria. A complete medical rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a SSOC. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Joseph T. Leonard, 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.