Citation Nr: 21042598 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 16-15 275 DATE: July 13, 2021 REMANDED Entitlement to an initial compensable rating for right (major) hand volar plate avulsion residuals is remanded. REASONS FOR REMAND The Veteran had active service from February 1974 to February 1977. The Veteran appeared at a June 2019 hearing before the undersigned Veterans Law Judge at the Montgomery, Alabama, Regional Office. A hearing transcript is of record. The issue of entitlement to an initial compensable rating for right (major) hand volar plate avulsion residuals is remanded. The accredited representative contends that the report of a December 2019 Department of Veterans Affairs (VA) examination and the January 2020 addendum are inadequate for rating purposes as the examiner did not properly evaluate the Veteran's right hand pain. The report of the December 2019 VA examination states that the Veteran complained of "aching pain in the right hand which is worse with cold weather or repetitive use." The Veteran was diagnosed with right hand volar plate injury and degenerative arthritis. On examination of the right hand, the Veteran exhibited a "normal" range of motion of the hand with pain on finger flexion and opposition with the thumb; "no evidence of pain with use of the hand;" and "tenderness or pain in palpation" of the proximal long finger. The examiner commented that "pain noted on exam, but does not result in/cause functional loss" and "there is no right hand/finger pain at rest, but there is with palpation and range of motion." In the January 2020 addendum to the December 2019 VA examination report, the examiner clarified "affected finger is right long finger which has aching pain related to service connected right volar plate avulsion." The examiner did not identify the degree at which the identified right long finger pain was exhibited. Because of that deficiency, the Board of Veterans' Appeals (Board) finds that the December 2019 examination report and the addendum thereto are of limited probative value. The Board observes that the Secretary of VA has recently amended that portion of 38 C.F.R. Part 4 which pertains to musculoskeletal disabilities. On February 7, 2021, the provisions of 38 C.F.R. § 4.71a, Diagnostic Codes 5003 and 5010 addressing degenerative arthritis and post traumatic arthritis were amended. Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020) (to be codified at 38 C.F.R. § 4.71a, Diagnostic Codes 5003, 5010). VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121 (1991). When VA obtains an evaluation, the evaluation must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, the Board finds that further VA right hand evaluation is needed. At the June 2019 Board hearing, the Veteran denied receiving any private treatment for the hand. VA clinical documentation dated after July 2020 is not of record. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran's claims. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records dated after July 2020, including those associated with treatment at the Birmingham, Alabama, VA Medical Center. 2. Schedule the Veteran for a VA examination conducted by a medical doctor to assist in determining the current nature and severity of service-connected right (major) hand volar plate avulsion residuals. The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. The examiner should: (a) Describe all functional impairment of the right hand and fingers and specifically identify which joints and fingers are involved with the volar plate avulsion residuals. The examiner should provide ranges of motion for the right fingers and hand and should state whether there is any additional limitation of function due to weakened motion, painful motion, excess motion, incoordination, fatigability, or on flare up. The degree at which any pain is exhibited should be specifically reported. (b) State whether or not any arthritis shown is due to the service-connected disability. (c) State whether there is ankylosis of any of the fingers or any part of the hand. (d) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran has no effective function remaining of the hand or any fingers other than that which would be equally well served by amputation with use of a suitable prosthetic appliance. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. T. Hutcheson, 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.