Citation Nr: 22012251
Decision Date: 03/03/22	Archive Date: 03/03/22

DOCKET NO. 16-30 316
DATE: March 3, 2022

REMANDED

The claim of entitlement to a rating in excess of 10 percent for residuals of a fracture to the left ring finger with intrinsic muscle injury of the left hand (muscle group IX) is remanded.  

REASONS FOR REMAND

The Veteran served on active duty from March 1991 to November 1993.  This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

This matter was previously before the Board in July 2019 and August 2021         and was remanded for further development. The requested development was completed, and the case has been returned to the Board for further appellate action.

1. Entitlement to a rating in excess of 10 percent for residuals of a fracture to the left ring finger with intrinsic muscle injury of the left hand (muscle group IX) is remanded. 

For VA rating purposes, the cardinal signs and symptoms of muscle disability are loss of power, weakness, a lowered threshold of fatigue, fatigue-pain, impairment of coordination and uncertainty of movement. 38 C.F.R. § 4.56(c).  Under Diagnostic Code 5309 (muscle group IX), injuries to the forearm muscles and intrinsic muscles of the hand, are to be rated based on limitation of motion, with a minimum 10 percent rating. 38 C.F.R. § 4.73, Note to Diagnostic Code 5309. 

In this case, the Veteran's service-connected left hand/finger disability has been assigned a 10 percent rating for favorable ankylosis of the ring and little fingers under Diagnostic Code 5223. See 38 C.F.R. § 4.71a, Diagnostic Code 5223. 

The Veteran has undergone VA hand/finger and muscle injuries examinations in October 2021, November 2019, and November 2021, with an addendum provided in December 2021.  During those examinations, the Veteran reported symptoms of pain, decreased range of motion, numbness, and tingling in the left fourth (ring) and fifth (little) fingers, which affected his ability to type quickly and securely hold objects.  

In a January 2022 brief, the Veteran's representative asserted that the Veteran has not received a VA examination that adequately addresses the Veteran's complaints of numbness and tingling in the fingers and has requested a VA peripheral nerve examination.  Although a muscle injury rating may not be combined with a peripheral nerve paralysis rating of the same body part unless the injuries affect entirely different functions, a higher rating could potentially be assigned under a different diagnostic code relating to diseases of the peripheral nerves if the Veteran has such a disability related to his service-connected left hand/finger disability. See 38 C.F.R. § 4.55(a), see also 38 C.F.R. § 4.124a (providing for ratings for diseases of the peripheral nerves).  Accordingly, the Board finds that a remand is necessary in order to provider the Veteran with a VA peripheral nerve examination.  

The matters are REMANDED for the following action:

Schedule the Veteran for a VA peripheral nerve examination pursuant to his claim for a higher rating for residuals of a fracture to the left ring finger with intrinsic muscle injury of the left hand (muscle group IX).  The claims file must be reviewed by the examiner.  All indicated testing must be conducted, and all pertinent symptomatology must be reported.  

The examiner should indicate whether the Veteran has a disease of the peripheral nerves related to his service-connected residuals of a fracture to the left ring finger with intrinsic muscle injury of the left hand (muscle group IX).  

 

 

K. A. BANFIELD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	C. Banister, 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.