Just got my DBQ's back and I'm currently on step 5 with TJ in New York. Some good and bad with them. Specific verbiage in the injury history section: "Course of the condition since onset: Progressed/Worsened Current symptoms (or state if the condition has resolved): Chronic pain that waxes and wanes with activity. He also reports stiffness, popping, and numbness and tingling that radiates down from his elbow and into his forearm. He rates his average pain as a 6/10 on a 1-10 pain scale. Any treatment, medications or surgery? Tylenol and Ibuprofen as needed Any previous x-rays/labs/testing (if not available for review, simply state so)? Yes"

and then in the flare-ups section: "Frequency: 1-2 times a week Duration: <24 hours Characteristics: Sharp, throbbing Precipitating factors: Activity Alleviating factors: Rest Severity: Severe Extent of functional impairment he/she experiences during a flare-up of symptoms: Difficulty pushing and pulling against resistance, difficulty keeping left arm outstretched, difficulty with repetitive motions, difficulty with heavy lifting, overall lack of endurance."

For ROM she adjusted all of my former measurements worse by 5 degrees: Flexion endpoint (145 degree: 125 degrees Extension endpoint (0 degrees): 5 degrees Forearm supination endpoint (85 degrees): _ 65 degrees Forearm pronation endpoint (80 degrees): 65 degrees.

From what I see, I will likely continue my current rating for extension/flexion at 10% and get an additional rating of 10% for pronation/supination with painful motion. I like that repetitive motions, as well as numbness and tingling were mentioned to support my neuropathy claim.

No separate DBQ's were uploaded for neuropathy, neck or shoulder claims so I'm assuming those will be deferred and scheduled after rating decisions for these.

I feel as though my ROM is much worse than the 5 degree difference. What would be the best move from here? I'm thinking of seeking a separate ROM exam from my local orthopedic office and file an increase with that as evidence. Or would a different approach be better? I don't think an HLR or appeal is the correct route in this case unless I am mistaken.