Citation Nr: 22017350 Decision Date: 03/24/22 Archive Date: 03/24/22 DOCKET NO. 16-32 857 DATE: March 24, 2022 REMANDED Entitlement to a disability rating in excess of 20 percent for service-connected degenerative joint disease with recurrent subluxation, right shoulder, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from January 2001 to August 2007. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas (Agency of Original Jurisdiction (AOJ)). The Veteran testified at a video conference hearing before the undersigned in March 2019. However, an audible transcript from this hearing is unavailable. A subsequent hearing before a second Veterans' Law Judge (VLJ) took place in February 2021. A transcript of this proceeding is of record. The latter VLJ has since retired. The Veteran was offered an additional hearing, which he subsequently declined and requested that his claim be considered based on the evidence of record. This matter is now before the Board for adjudication. The Veteran's most recent VA examination for his right shoulder took place in September 2017, nearly five years ago. At that time, the examiner documented that the Veteran did not experience flare ups and thus did not perform any range of motion testing as it related to his experience during flare ups. However, since that time, the Veteran has reported having flare ups. At his February 2021 hearing, he testified that he has had several flare ups where his shoulder "feels like it is on fire, [and he has had] loss of feeling in...two fingers." The Board will therefore remand for a more up-to-date examination that properly assesses the Veteran's right shoulder degenerative joint disease with recurrent subluxation, to include any paresthesias. The Board also observes that the Veteran mentioned receiving an MRI and seeing his primary care physician for his right shoulder following his February 2021 hearing. On remand, the AOJ should seek these treatment records. The matters are REMANDED for the following action: 1. The AOJ shall associate the Veteran's most recent outstanding VA medical treatment records with his file, specifically those records from September 2019 to the present. 2. Ask the Veteran to complete a VA Form 21-4142 for any private treatment providers that have treated him for his right shoulder and/or performed evaluations including MRI as reported by the Veteran. Thereafter, obtain and associate with the claims folder any private treatment records identified. 3. Then, afford the Veteran an orthopedic examination to determine the current severity of his right shoulder. In order to comply with Sharp v. Shulkin, 29 Vet. App. 26 (2017), the examiner is asked to describe whether pain, weakness, or incoordination significantly limits functional ability during flares or repetitive use, and if so, the examiner must estimate range of motion during flares. The examiner should have the Veteran describe and/or demonstrate the extent of motion loss during flares or repetitive use and provide the extent of motion loss described in terms of degrees. If there is no pain and/or no limitation of function, such facts must be noted in the report. The examiner should specifically review the history of rotator cuff repair and MRI findings, including electromyography studies in February 2016 and August 2017 (in addition to any subsequent EMGs) and clarify whether there is any nerve impairment of the right shoulder causally related to the prior history of surgery and/or scar tissue formation as reported by the Veteran. 4. Thereafter, readjudicate the claim. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case and an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Victoria A. Banis, 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.