09-50 948, 09-50 948

Background

Veteran served active duty Oct 1987–Jul 1990; filed claims for residuals of left wrist fracture and bronchial asthma (claimed Nov 14, 2005). VA granted service connection and assigned initial ratings (10% wrist; 30% asthma) in Oct 2006 and confirmed in Jun 2008.
Veteran sought higher ratings; multiple remands and hearings were conducted or scheduled between 2010–2016; veteran ultimately failed to appear for a 2014 hearing and request considered withdrawn. Case returned to Board after remands for further development and examinations (most recent VA exam May 2016).
Medical evidence: serial VA exam reports (2006, 2008, 2011, 2016) and treatment records showing active left wrist range of motion (no ankylosis) and asthma with PFTs showing FEV-1 ~63–66% pre-bronchodilator and post-bronchodilator improvement to ~67–72%, daily inhaled bronchodilator/inhaled steroid therapy, and up to two systemic corticosteroid courses in one year (2010).
Legal framework: ratings governed by VA Schedule for Rating Disabilities (Diagnostic Codes 5214/5215 for wrist; 6602 for asthma); higher schedular or extraschedular ratings considered only if criteria met or schedular criteria inadequate; staged ratings and TDIU considered and rejected on record.
Board’s factual findings: wrist never manifested ankylosis during the appeal period; asthma manifestations approximated FEV-1 ~63% pre/67% post, FEV-1/FVC ~57–59%, daily inhaled therapy, and at most two systemic corticosteroid courses in a year — not meeting criteria for >30%.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether entitlement to an initial rating >10% for residuals of left wrist fracture is warranted	Veteran: increased pain, stiffness, decreased ROM, flare-ups, functional loss justify higher rating	VA/Board: medical record shows preserved active ROM, no ankylosis; 10% is schedular maximum for limitation of motion	Denied — no evidence of ankylosis; 10% remains appropriate
Whether entitlement to an initial rating >30% for bronchial asthma is warranted	Veteran: more frequent/severe attacks, increased medication, monthly doctor visits, systemic steroid treatments justify >30%	VA/Board: PFTs show FEV-1 and FEV-1/FVC consistent with 30% criteria; inhaled meds documented; systemic steroids occurred at most twice in one year; no monthly exacerbation visits or respiratory failure episodes	Denied — objective tests and treatment record do not meet criteria for >30%
Whether additional VA development or a new exam is required (Correia compliance / further testing)	Veteran/Representative: request for independent medical opinion and further development due to evidentiary conflict	VA/Board: exams adequate for decision; Correia-compliant testing not necessary because ankylosis (required for higher wrist rating) is absent; veteran missed scheduled PFTs without showing good cause	No remand required; decision based on existing competent medical evidence
Whether extraschedular evaluation, staged ratings, or TDIU are warranted	Veteran: asserted increased severity and functional impact (work limitations)	VA/Board: no exceptional/collective impact beyond schedular criteria; disability picture stable for appeal period; veteran employed	Denied — no extraschedular referral, no staged ratings, no TDIU awarded

Key Cases Cited

Golz v. Shinseki, 590 F.3d 1317 (Fed. Cir.) (records relevancy requirement for VA requests)
Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir.) (clarifying VA record-request standards)
Stegall v. West, 11 Vet. App. 268 (Vet. App.) (remand compliance requirement)
Correia v. McDonald, 25 Vet. App. 158 (Vet. App.) (requirements for testing passive and weight-bearing motion in musculoskeletal exams)
DeLuca v. Brown, 8 Vet. App. 202 (Vet. App.) (consideration of functional loss due to pain)
Thun v. Peake, 22 Vet. App. 111 (Vet. App.) (framework for extraschedular referral)
Johnson v. McDonald, 762 F.3d 1362 (Fed. Cir.) (extraschedular referral for combined effects)
Lewis v. Derwinski, 3 Vet. App. 259 (Vet. App.) (definition of ankylosis)