09-18 715
09-18 715
| Board of Vet. App. | May 31, 2016Background
- Veteran served Oct 1983–Oct 2007 and appealed a RO rating of 10% for service‑connected right hip bursitis with degenerative joint disease.
- VA granted service connection for pes planus on remand (30%, effective Nov 1, 2007); that issue is not before the Board.
- Veteran reported daily right hip pain, limited motion, altered gait, difficulty with stairs/ladder, and flare‑ups; testified at a 2012 hearing.
- VA examinations: July 2009 showed flexion 90°, extension 10° with painful motion; August 2014 showed flexion 90° (pain at 60°), extension 15° (pain at 5°), abduction 20° (pain at 15°), tenderness, normal strength, and flare‑ups limiting function.
- VA assigned 10% under DC 5252/5003 for painful motion; Board found evidence of pain and functional loss but not limitation of flexion to 30° or other findings requiring a higher schedular rating.
- Board considered extraschedular and TDIU theories and declined to refer or remand: schedular criteria found adequate; Veteran was employed so TDIU remand not required.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether entitlement to >10% for right hip disability is warranted | Right hip pain, limited ROM, flare‑ups, altered gait, functional impairment justify >10% | Medical exams and records do not show ROM or other criteria meeting higher schedular ratings; 10% adequately accounts for painful motion | Denied — evidence does not approximate criteria for 20% or higher |
| Whether VA examinations were inadequate for rating during flare‑ups | August 2014 examiner could not quantify ROM loss during flare‑ups; plaintiff argues remand/clarification needed | Examiner fully reported findings and reasonably declined speculative estimates; report adequate | Denied — exam adequate under Jones; speculative estimates not required |
| Whether an extraschedular rating is warranted | Plaintiff’s symptoms and functional limits may be exceptional and justify extraschedular evaluation | Ratings schedule contemplates functional loss including pain, fatigability, and interference; no unusual or exceptional picture shown | Denied — schedular criteria adequately describe disability (Thun test failed) |
| Whether remand needed for TDIU consideration | Functional limitations from hip may support unemployability | Veteran reported current employment; no requirement to remand for TDIU opinion | No remand required for TDIU (Rice) |
Key Cases Cited
- DeLuca v. Brown, 8 Vet. App. 202 (1995) (painful use of a joint must be considered as functional loss)
- Barr v. Nicholson, 21 Vet. App. 303 (2007) (criteria for adequacy of medical examination in VA duty to assist analysis)
- Stefl v. Nicholson, 21 Vet. App. 120 (2007) (VA examination adequacy standards)
- Jones v. Shinseki, 23 Vet. App. 382 (2010) (examiner not required to speculate beyond medical basis)
- Mitchell v. Shinseki, 25 Vet. App. 32 (2011) (pain on motion is limiting only if it causes functional loss of working movement)
- Thun v. Peake, 22 Vet. App. 111 (2008) (three‑part test for extraschedular ratings)
- Bryant v. Shinseki, 23 Vet. App. 488 (2010) (duty to ensure claimant can present evidence at hearing)
- Rice v. Shinseki, 22 Vet. App. 447 (2009) (no automatic TDIU referral where veteran reports current employment)
- Bernard v. Brown, 4 Vet. App. 384 (1993) (appellate review may proceed when VCAA duties satisfied)
- Massey v. Brown, 7 Vet. App. 204 (1994) (Board generally considers only factors in rating criteria)
- Schafrath v. Derwinski, 1 Vet. App. 589 (1991) (Board may consider all relevant provisions regardless of whether raised)
