Citation Nr: 22014128 Decision Date: 03/11/22 Archive Date: 03/11/22 DOCKET NO. 09-22 939 DATE: March 11, 2022 REMANDED Entitlement to a rating in excess of 40 percent for generalized arthralgias in the shoulders, elbows, knees, hands, thumbs, and lumbar spine, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1972 to September 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2007 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2017, the Board denied the claim, and the Veteran appealed the Board decision to the United States Court of Appeals for Veterans Claims. In a March 2019 Memorandum Decision, the Court vacated and remanded the June 2017 Board decision for action consistent with the Memorandum Decision. In December 2020, the Board again denied the claim, and the Veteran appealed that decision to the Court. In August 2021, the Court granted a Joint Motion for Remand, and vacated and remanded the Board's December 2020. Entitlement to a rating in excess of 40 percent for generalized arthralgias in the shoulders, elbows, knees, hands, thumbs, and lumbar spine. Although the Board regrets the additional delay and appreciates the Veteran's desire for a decision, remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the claim. The Board finds that remand is necessary in order to provide the Veteran a contemporaneous VA examination to determine the current nature and severity of generalized arthralgias. The Veteran was most recently examined by VA in March 2020. However, subsequent to the March 2020 examination, the Veteran reported a worsening of multi-joint arthralgia. Specifically, the Veteran contacted a VA medical provider in September 2020, requesting to be evaluated for worsening joint pain. The Veteran stated that the pain had worsened to the point where he could not move. The Veteran's provider ordered imaging of the knees, left wrist, and left ankle in response to what was described as worsening joint pain. Therefore, as the evidence suggests the Veteran's generalized arthralgias may have increased in severity since the March 2020 VA examination, remand is necessary in order to schedule a VA examination to assess the current nature and severity of the service-connected disability. Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and severity of arthritis as it affects his lumbar spine, and shoulders, elbows, knees, hands, and thumbs. The examiner must review the record, to include a copy of this Remand, and should note that review in the report. All indicated tests and studies should be accomplished. The examiner should review the record and describe, to the extent possible, the nature and severity of the symptoms specifically attributable to rheumatoid arthritis affecting the lumbar spine, bilateral shoulders, elbows, knees, hands, and thumbs, particularly since the March 2020 examination. In so doing, the examiner must provide range of motion findings for each joint affected for active motion, passive motion, with weight-bearing and without weight-bearing. The examiner should attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss following repeated use over time and during flare-ups for every involved joint. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate of the additional impairment following repeated use over time or due to flare-ups based on the other evidence of record and the Veteran's statements. The examiner should state whether or not the condition has resulted in constitutional manifestations associated with active joint involvement which are totally incapacitating, weight loss and anemia productive of severe impairment of health, or severely incapacitating exacerbations occurring four or more times a year or a lesser number over prolonged periods. A rationale for any opinion offered should be provided. 2. Then, readjudicate the claim. Specifically consider whether the multiple joint arthritis warrants separate ratings for each involved joint, to include whether there is any arthritis of the joints with compensable or noncompensable limitation of motion, and to include the application of 38 C.F.R. § 4.59. If any decision is adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Breckenridge 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.