Citation Nr: 22016363
Decision Date: 03/22/22	Archive Date: 03/22/22

DOCKET NO. 17-21 056
DATE: March 22, 2022

REMANDED

Entitlement to an initial rating in excess of 20 percent for left shoulder acromioclavicular (AC) joint separation with degenerative changes (non-dominant) is remanded.

REASONS FOR REMAND

The Veteran served on active duty from March 1978 to March 1981.

In April 2021, the Veteran provided testimony in a Virtual Board hearing before the undersigned Veterans Law Judge (VLJ). 

In September 2021, the Board remanded the claim for further development. However, additional development is necessary to decide the claim on appeal, which is explained below.

Entitlement to an initial rating in excess of 20 percent for left shoulder AC joint separation with degenerative changes (non-dominant) is remanded.

In September 2021, the Board remanded the claim for a neurological examination to determine whether the Veteran has a neurological disorder that is caused by or aggravated by the service-connected left shoulder disability.

The Veteran was afforded a peripheral nerves condition examination (contracted Disability Benefits Questionnaire (DBQ)) in December 2021. In the DBQ report, the examiner, a family nurse practitioner, indicated that no diagnosis of a peripheral nerves condition was confirmed and explained:

"The [Veteran's] symptoms are subjective with normal neurological. The [Veteran] has type II diabetes. His tingling and numbness is in front and back of his left thigh. His symptoms are not typical of peripheral neuropathy. More testing is warrant[ed] to determine if the [Veteran] has a radicular neuropathy. Further evaluation by a trained specialist such as a neurologist to order appropriate diagnostics such as MRI to determine if there are any neurological damage."

Further, the examiner provided the opinion that the claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of Veteran's service-connected condition. She was asked if the Veteran's neurological disorder was at least as likely as not proximately due to or the result of / aggravated by, left shoulder AC joint separation with degenerative changes (non-dominant). The examiner wrote:

"The [Veteran] gives a subjective report of new onset of intermittent uncontrollable left hand shakes with moderate tingling and numbness. Neurological exam normal. There is muscle weakness and decrease in strength due to shoulder pathology. A trained specialist such as a neurologist is recommended to fully evaluate and order appropriate diagnostics to determine if there is a neurological disorder."

When VA undertakes to obtain an examination, it must ensure that the examination and opinion therein is adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Given the December 2021 examiner's recommendation for further testing by a specialist, such as a neurologist, the Board finds that an additional examination is necessary to decide the Veteran's claim on appeal.

The matter is REMANDED for the following action:

Schedule the Veteran for a VA neurological examination by an appropriate clinician (i.e. neurologist) to evaluate whether the Veteran has a neurological disorder that is caused or aggravated by the service-connected left shoulder disability. The examiner should be able to perform all appropriate testing as necessary, including as recommended by the December 2021 examiner.

 

 

A. P. SIMPSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Cheng, 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.