Citation Nr: 23055293 Decision Date: 10/10/23 Archive Date: 10/10/23 DOCKET NO. 20-14 001 DATE: October 10, 2023 REMANDED The claim of entitlement to a disability rating higher than 10 percent for fracture proximal end first metacarpal, right thumb is remanded. The claim of entitlement to a disability rating higher than 20 percent for lower spine disability is remanded. The claim of entitlement to a disability rating higher than 10 percent for sciatic radiculopathy in the left lower extremity is remanded. The claim of entitlement to an effective date earlier than October 12, 2018 for the assignment of a 10 percent rating for right thumb disability is remanded. The claim of entitlement to an effective date earlier than October 12, 2018 for the assigment of a 20 percent rating for lower spine disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1984 to May 1987. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a rating decision by a U.S. Department of Veterans Affairs (VA) Regional Office (RO). In November 2022, the Veteran testified in a hearing before the Board. A transcript of the hearing is included in the electronic claims file and has been reviewed. During the Board hearing, the Veteran testified that the service-connected disabilities at issue before the Board had worsened since the most recent VA medical examinations in 2018, nearly five years ago. New VA compensation examinations should be provided. See Green v. Derwinski, 1 Vet. App. 121 (1991). The matters are REMANDED for the following action: 1. Include in the electronic claims file any outstanding treatment records, to include any VA treatment records, the most recent of which are dated in February 2020. 2. Schedule an examination of the thumb and lower spine disability (to include radiculopathy). After reviewing the claims file, interviewing the Veteran, and examining her, the examiner should address the following: (a). Right thumb: (i). Since October 2017, has right thumb impairment involved unfavorable ankylosis? (ii). Since October 2017, has right thumb impairment caused limited motion of a gap of more than two inches (5.1 cm.) between the thumb pad and the fingers, with the thumb attempting to oppose the fingers? See 38 C.F.R. § 4.71a, Diagnostic Codes 5224, 5228. (b). Lower Spine (i). Between October 2017 and October 2018, did lower spine disability cause: -forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees? -combined range of motion of the thoracolumbar spine not greater than 120 degrees? -muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis? (ii). Since October 2018, has lower spine impairment involved limitation of flexion of 30 degrees or less? (iii). Since October 2017, has lower spine impairment involved intervertebral disc syndrome and incapacitating episodes? (iv). Since October 2017, has sciatica caused incomplete paralysis in the left lower extremity that has been moderate, moderately severe, or severe? See 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine and General Rating Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes; see also 38 C.F.R. § 4.124a, Diagnostic Code 8520. When estimating range of motion, provide, if possible, active and passive range of motion, weightbearing and non-weightbearing range of motion, range of motion after repetitive use testing, range of motion during flare ups, and range of motion after repetitive use over time. In assessing evidence of range of motion, comment on whether any limitation you find is tantamount to, or the functional equivalent of, limitation typically associated with ankylosis, even in the absence of evidence of ankylosis. See Chavis v. McDonough, 34 Vet. App. 1 (2021). In rendering the requested report, the examiner should note that the Veteran is competent to attest to matters of which she has first-hand knowledge, including observable matters. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. Please explain in detail any opinion provided and the supporting rationale. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Christopher McEntee 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.