Citation Nr: 18140007 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 16-23 757 DATE: October 2, 2018 REMANDED The claim for an initial rating greater than 10 percent for radiculopathy of the left lower extremity (sciatic nerve) is remanded. The claim for an initial rating greater than 10 percent for radiculopathy of the right lower extremity (sciatic nerve) is remanded. REASONS FOR REMAND The Veteran served on active duty from May 2002 to February 2006. The Agency of Original Jurisdiction (AOJ) granted service connection for the Veteran’s lumbar spine disability and associated bilateral lower extremity radiculopathy in a February 2015 rating decision. The AOJ assigned a 10 percent disability rating for each lower extremity, effective January 4, 2014, citing sciatic nerve involvement. In March 2015, the Veteran filed a notice of disagreement with the amount of the initial rating assigned for lower extremity radiculopathy and limited the appeal to the rating for the sciatic nerve involvement. At the time that the Veteran filed the March 2015 notice of disagreement, the Veteran also submitted a separate claim for service connection of radiculopathy in the bilateral femoral nerves. See March 2015 claim. In a June 2015 statement, the Veteran clarified that his claim for service connection for lower extremity radiculopathy of the femoral nerves was separate from his appeal for a higher rating for radiculopathy involving the sciatic nerves and that the femoral nerves claim was not on appeal. The AOJ granted service connection for lower extremity radiculopathy of the femoral nerves (bilaterally), in addition to the sciatic nerve radiculopathy. See May 2016 rating decision. The Veteran did not express disagreement with the May 2016 rating decision. As the Veteran has clearly and consistently informed VA that he only desired to appeal the rating for lower extremity radiculopathy affecting the sciatic nerves, the only appeal present before the Board is the appeal for an initial rating for sciatic nerve radiculopathy, higher than 10 percent in each lower extremity. Entitlement a rating greater than 10 percent for radiculopathy for each lower extremity Although the Veteran only appealed the rating with respect to the sciatic nerves, the Board finds that the rating is intertwined with the rating for femoral nerve involvement. See Parker v. Brown, 7 Vet. App. 116 (1994) and Harris v. Derwinski, 1 Vet. App. 180, 183 (issues are “inextricably intertwined” when a decision on one issue would have a “significant impact” on a veteran’s claim for the second issue). Unfortunately, the evidence of record is unclear as to any distinction between symptoms or severity of radiculopathy attributed to the sciatic and femoral nerves. Thus, clarification is required. The February 2015 VA examination report noted the following observations for both lower extremities: decreased sensation to light touch, normal muscle strength, and moderate intermittent pain, paresthesias and/or dysesthesias, and numbness. The examiner opined that the overall severity of the Veteran’s radiculopathy was moderate in each lower extremity. The examiner identified the only nerve involved as the sciatic nerve. In March 2015, the Veteran’s private physician completed a DBQ noting the Veteran’s diagnosis of radiculopathy in the bilateral lower extremities affecting both the femoral and sciatic nerves. The private physician noted that the Veteran had moderate intermittent pain in both lower extremities, moderate dull pain in both lower extremities, moderate numbness in both lower extremities, but no paresthesias, dysesthesias, or constant pain in either extremity. The private physician indicated moderate radiculopathy overall and identified the femoral and sciatic nerves as being affected but did not distinguish which symptoms were due to the femoral nerve, and which were due to the sciatic nerve. As VA may not assign separate disability ratings for the same symptoms, (i.e. pyramid benefits), further clarification is required regarding the effects of the sciatic nerve and femoral nerve. Additionally, the Veteran has not been provided with a VA examination since he was found to have femoral and sciatic nerve involvement. Therefore, another VA examination is required to adequately address the claim. See 38 C.F.R. § 5103A; 38 C.F.R. § 3.159; Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). See also Green v. Derwinski, 1 Vet. App. 121, 124 (1991) (VA has a duty to provide a veteran with a thorough and contemporaneous medical examination). While on remand, any outstanding, pertinent treatment records should also be obtained. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from April 2016. 2. Offer the Veteran the opportunity to provide pertinent, outstanding private treatment records, or authorize VA to obtain the records, if any, on his behalf. 3. Afford the Veteran an examination by an appropriate clinician to determine the severity of his service-connected lower extremity radiculopathies of both the sciatic and femoral nerves. The examiner should provide a full description of the disabilities and report all signs and symptoms necessary for evaluating the Veteran’s disabilities under the rating criteria. If it is not possible to distinguish symptoms and/or severity of the sciatic nerve and femoral nerve disabilities, the examiner should so state and explain the basis for the opinion. 4. After completing the above, and any other development as may be indicated, readjudicate the Veteran’s claims based on the entirety of the evidence. If any claim remains denied, issue the Veteran a supplemental statement of the case. An appropriate period should be allowed for response. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Donna D. Ebaugh, Counsel