Entitlement to an initial disability rating in excess of 10 percent for residuals of a left hand fifth digit proximal base fracture with degenerative arthritis is remanded.

Citation Nr: 26001409 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 18-47 506 DATE: January 30, 2026 REMANDED Entitlement to an initial disability rating in excess of 10 percent for residuals of a left hand fifth digit proximal base fracture with degenerative arthritis is remanded. Entitlement to an initial disability rating in excess of 10 percent for right knee strain is remanded. Entitlement to a disability rating in excess of 30 percent, effective from July 13, 2012, to February 6, 2014, for a right shoulder partial rotator cuff tear with right shoulder impingement syndrome is remanded. Entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114(s) is remanded. REASONS FOR REMAND The Veteran had active-duty service from December 1979 to December 1982, from May 1987 to August 1987, from September 1987 to January 1988, and from December 1989 to June 2001. This case comes before the Board of Veterans' Appeals (Board) from December 2015, May 2016, and April 2018 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). These matters were previously denied in a March 2024 Board decision. The Veteran filed an appeal to the United States Court of Appeals for Veterans Claims (Court). In June 2025, the Court granted a Joint Motion for Partial Remand (JMPR) vacating the March 2024 decision and among other things, the JMPR specified that the Board failed to consider the adequacy of the VA examination reports in light of Sharp v. Shulkin, 29 Vet. App. 26 (2017). 1. Entitlement to an initial disability rating in excess of 10 percent for residuals of a left hand fifth digit proximal base fracture with degenerative arthritis is remanded. The Veteran and his agent claim that he is entitled to an increased rating for his service-connected residuals of a left hand fifth digit proximal base fracture with degenerative arthritis. While the Board sincerely regrets further delay in this matter, additional development is required before the Veteran's claim may be adjudicated on the merits. Additional medical opinions are necessary if the evidence of record is not sufficient to decide the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006). This may include a retrospective medical opinion. See Chotta v. Peake, 22 Vet. App. 80 (2008). To be considered adequate for purposes of adjudication, VA examinations of the joints must particularly consider whether the disability is manifested by weakened movement, excess fatigability, incoordination, or pain, and whether such symptoms exacerbate the degree of loss of functional impairment. See DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Johnston v. Brown, 10 Vet. App. 80 (1997) (limiting highest additional rating based on DeLuca factors to schedular maximum), Mitchell v. Shinseki, 25 Vet. App. 32 (2011) (clarifying that pain may be evidence of functional loss but is not functional loss in and of itself), Correia v. McDonald, 28 Vet. App. 158 (requiring that joint pain be tested under varying conditions to better simulate functional demands), and Sharp, 29 Vet. App. at 26 (requiring evaluation of pain during periodic flare-ups). The June 2025 JMPR noted that the Board failed to consider the adequacy of the May 2017 VA examination report, as the examiner noted that after repeated use over time, while there was noted pain, weakness, and incoordination, the examiner did not observe the Veteran's range of motion, therefore the limitation was not expressed in terms of range of motion. Sharp, 29 Vet. App. at 34; DeLuca, 8 Vet. App. at 202. Therefore, the Board finds that a remand is necessary so that a VA examiner can provide a retrospective opinion for the period on appeal, including during the May 2017 VA examination. The Board adds that it cannot accept an examiner's statement that an opinion cannot be provided based on speculation if it is not clear that the basis for the refusal is a lack of knowledge among the medical community at large, as opposed to the insufficient knowledge of the specific examiner. Sharp, 29 Vet. App. at 36. 2. Entitlement to an initial disability rating in excess of 10 percent for right knee strain is remanded. The Veteran and his agent claim that he is entitled to an increased rating for his service-connected right knee strain. While the Board sincerely regrets further delay in this matter, additional development is required before the Veteran's claim may be adjudicated on the merits. Additional medical opinions are necessary if the evidence of record is not sufficient to decide the claim. McLendon, 20 Vet. App. at 79. This may include a retrospective medical opinion. See Chotta, 22 Vet. App. at 80. To be considered adequate for purposes of adjudication, VA examinations of the joints must particularly consider whether the disability is manifested by weakened movement, excess fatigability, incoordination, or pain, and whether such symptoms exacerbate the degree of loss of functional impairment. See DeLuca, 8 Vet. App. at 202; see also Johnston, 10 Vet. App. at 80 (limiting highest additional rating based on DeLuca factors to schedular maximum), Mitchell, 25 Vet. App. at 32 (clarifying that pain may be evidence of functional loss but is not functional loss in and of itself), Correia, 28 Vet. App. at 158 (requiring that joint pain be tested under varying conditions to better simulate functional demands), and Sharp, 29 Vet. App. at 26 (requiring evaluation of pain during periodic flare-ups). The June 2025 JMPR noted that the Board failed to consider the adequacy of the February 2018 VA examination report, as the examiner noted, with respect to flareups and repeated use over time, that it is not possible to determine, without resorting to mere speculation, to estimate loss of range of motion, because there is no conceptual or empirical basis for making such a determination without directly observing function under these conditions. The examiner also noted that there was evidence of pain on range of motion testing, but did not note where within the range of motion pain began. The JMPR found that the Board failed to address the examiner's reasoning for declining to provide an estimated range of motion during flare-ups and after repeated use over time and determine whether it complied with the Court's holding in Sharp. Therefore, the Board finds that a remand is necessary so that a VA examiner can provide a retrospective opinion for the period on appeal, including during the February 2018 VA examination. The Board adds that it cannot accept an examiner's statement that an opinion cannot be provided based on speculation if it is not clear that the basis for the refusal is a lack of knowledge among the medical community at large, as opposed to the insufficient knowledge of the specific examiner. Sharp, 29 Vet. App. at 36. 3. Entitlement to a disability rating in excess of 30 percent, effective from July 13, 2012, to February 6, 2014, for a right shoulder partial rotator cuff tear with right shoulder impingement syndrome is remanded. The Veteran and his agent claim that he is entitled to an increased rating for his service-connected right shoulder partial rotator cuff tear with right shoulder impingement syndrome from July 13, 2012, to February 6, 2014. While the Board sincerely regrets further delay in this matter, additional development is required before the Veteran's claim may be adjudicated on the merits. Additional medical opinions are necessary if the evidence of record is not sufficient to decide the claim. McLendon, 20 Vet. App. at 79. This may include a retrospective medical opinion. See Chotta, 22 Vet. App. at 80. To be considered adequate for purposes of adjudication, VA examinations of the joints must particularly consider whether the disability is manifested by weakened movement, excess fatigability, incoordination, or pain, and whether such symptoms exacerbate the degree of loss of functional impairment. See DeLuca, 8 Vet. App. at 202; see also Johnston, 10 Vet. App. at 80 (limiting highest additional rating based on DeLuca factors to schedular maximum), Mitchell, 25 Vet. App. at 32 (clarifying that pain may be evidence of functional loss but is not functional loss in and of itself), Correia, 28 Vet. App. at 158 (requiring that joint pain be tested under varying conditions to better simulate functional demands), and Sharp, 29 Vet. App. at 26 (requiring evaluation of pain during periodic flare-ups). The June 2025 JMPR noted that the Board failed to consider the adequacy of the July 2012 and August 2013 VA examination reports for the period on appeal from July 13, 2012, to February 6, 2014, as the examiners' noted that Veteran had flare-ups, but did not estimate the functional impact in terms of a limitation on range of motion. Sharp, 29 Vet. App. at 34; DeLuca, 8 Vet. App. at 202. The CAVC added that the Board failed to adequately discuss and discount any ameliorative or beneficial effects of medications Appellant uses to treat his right shoulder symptoms. Therefore, the Board finds that a remand is necessary so that a VA examiner can provide a retrospective opinion for the period on appeal from July 13, 2012, to February 6, 2014, including during the July 2012 and August 2013 VA examinations. The Board adds that it cannot accept an examiner's statement that an opinion cannot be provided based on speculation if it is not clear that the basis for the refusal is a lack of knowledge among the medical community at large, as opposed to the insufficient knowledge of the specific examiner. Sharp, 29 Vet. App. at 36. 4. Entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114(s) is remanded. As a decision on the remanded increased rating claims could significantly impact a decision on the issue of entitlement to SMC, the issues are intertwined. A remand of the claim for SMC is required. Accordingly, the claims are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate VA examiner with the appropriate expertise to determine the severity of the Veteran's left hand fifth finger disability. His claims file, including a copy of this remand, shall be made available to the examiner for review in conjunction with the examination. The examiner shall retrospectively evaluate the degree of additional functional loss the Veteran experienced with repetitive use and during flare-ups of his left hand fifth finger disability, and specifically estimate the impact of the disability during the May 2017 VA examination in terms of the degree of additional range of motion loss due to pain on use or during flare-ups at the time of that examination. A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. The examiner is advised that the Veteran is considered competent to be able to report his symptoms, and that his reports must be considered in formulating the requested opinion. If the Veteran's reports are discounted, the examiner should provide a reason for doing so. 2. Schedule the Veteran for an examination by an appropriate VA examiner with the appropriate expertise to determine the severity of the Veteran's right knee disability. His claims file, including a copy of this remand, shall be made available to the examiner for review in conjunction with the examination. The examiner shall retrospectively evaluate the degree of additional functional loss the Veteran experienced with repetitive use and during flare-ups of his right knee disability, and specifically estimate the impact of the disability during the February 2018 VA examination in terms of the degree of additional range of motion loss due to pain on use or during flare-ups at the time of that examination. A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. The examiner is advised that the Veteran is considered competent to be able to report his symptoms, and that his reports must be considered in formulating the requested opinion. If the Veteran's reports are discounted, the examiner should provide a reason for doing so. 3. Schedule the Veteran for an examination by an appropriate VA examiner with the appropriate expertise to determine the severity of the Veteran's right shoulder disability, from July 13, 2012, to February 6, 2014. His claims file, including a copy of this remand, shall be made available to the examiner for review in conjunction with the examination. The examiner shall retrospectively evaluate the degree of additional functional loss the Veteran experienced with repetitive use and during flare-ups of his right shoulder disability from July 13, 2012, to February 6, 2014, and specifically estimate the impact of the disability during the July 2012 and August 2013 VA examinations in terms of the degree of any additional range of motion loss due to pain on use or during flare-ups at the time of that examination. The examiner is also asked to discount the ameliorative effects of any medication the Veteran may have taken in the process of assessing the severity of the Veteran's disability. A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. The examiner is advised that the Veteran is considered competent to be able to report his symptoms, and that his reports must be considered in formulating the requested opinion. If the Veteran's reports are discounted, the examiner should also provide a reason for doing so. Michael J. Skaltsounis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A.R. Montalvo, 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.