Citation Nr: 18140657 Decision Date: 10/04/18 Archive Date: 10/03/18 DOCKET NO. 14-13 243 DATE: October 4, 2018 ORDER 1. Service connection for right lower extremity radiculopathy is granted. 2. Service connection for left lower extremity radiculopathy is granted.   FINDINGS OF FACT 1. The Veteran’s right lower extremity radiculopathy is due to his degenerative spondylosis and discogenic disease of the lumbar spine. 2. The Veteran’s left lower extremity radiculopathy is due to his degenerative spondylosis and discogenic disease of the lumbar spine. CONCLUSIONS OF LAW 1. The criteria for right lower extremity radiculopathy, as secondary to degenerative spondylosis and discogenic disease of the lumbar spine, have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 2. The criteria for left lower extremity radiculopathy, as secondary to degenerative spondylosis and discogenic disease of the lumbar spine, have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1971 to November 1973 and from January 1991 to June 1991. The case is on appeal from a September 2011 rating decision. The Board notes this decision denied service connection for a cervical spine disorder in addition the claims addressed herein. Thereafter, in October 2015, the Board remanded such claims for additional development. Then, in February 2016, the RO granted the Veteran service connection for cervical degenerative disc disease with spondylosis. As this claim has been granted in full, it is not before the Board. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). Service Connection 1. Service connection for right lower extremity radiculopathy. 2. Service connection for left lower extremity radiculopathy. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. “To establish a right to compensation for a present disability, a veteran must show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service”—the so-called “nexus” requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. Facts and Analysis The Veteran contends he has bilateral lower extremity radiculopathy due to his service-connected low back disability or his military service. In this regard, in a June 2011 claim form, the Veteran reported experiencing radiculopathy in his bilateral lower extremities caused by a low back disorder. Thereafter, in a July 2015 correspondence, his representative reported that his bilateral lower extremity disorders were incurred during service. The Veteran’s service treatment records (STRs) do not contain any reports of, or treatment for, a lower extremity disorder. During a separation examination conducted in October 1973 for his first period of service, the Veteran’s lower extremities were found to be normal and he denied having any current medical conditions. Thereafter, in a September 2001 report of medical history for the National Guard, the Veteran denied experiencing any history of foot trouble, impaired use of the legs or feet, and numbness or tingling. In connection with the Veteran’s low back claim, his bilateral extremities were examined by VA in January 2011. During this examination, the examiner found that the Veteran’s lower extremity reflex and motor examinations were normal. In addition, he did not find the presence of lower extremity numbness, paresthesias, or weakness or that the Veteran experiences falls or unsteadiness. The examiner concluded that the Veteran’s right and left lower peripheral nerves are normal. Subsequent post-service VA treatment records contain treatment in regard to the Veteran’s lower extremities. In January 2013, an electrodiagnostic test was performed. Thereafter, in February 2013, a VA physician reviewed the electrodiagnostic test results. While she found that the study was normal and without evidence of peripheral neuropathy, she also noted benign fasciculations of the bilateral gastrocnemius muscles and that there were signs of demyelination that could indicate early changes of peripheral neuropathy. Subsequently, in April 2013, the Veteran was seen for reported numbness in his lower extremities. The treating physician did not find the presence of a gross motor or sensory deficit. Subsequently, the Veteran reported experiencing lower extremity pain and fasciculations during VA treatment in May 2014. Pursuant to the Board’s October 2015 remand, the Veteran was again examined in regard to these claims in December 2015. During the examination, the Veteran reported experiencing pain radiating from his back into his right buttock. The examiner found that the Veteran had normal strength and reflexes in his bilateral lower extremities. The examiner did not find the presence of muscle spasms, localized tenderness, guarding, or an abnormal gait. The examiner did not offer an opinion as to service connection because he did not find objective evidence of a lower extremity disorder. In February 2016, an addendum opinion was obtained also finding no current neurological disorder and therefore no basis for a nexus to service or service-connected disability. Thereafter, the Board requested an expert medical opinion from the Veterans Health Administration (VHA), which was obtained in July 2018. The opinion was obtained from the Neurology Section Chief from a VA Medical Center. Based on a review of the Veteran’s complete file, the physician found that the Veteran has bilateral lower extremity radiculopathy that is as likely as not proximately due to, or secondary to, his service connected lumbar spine disability. The physician explained that lumbar or lumbosacral radiculopathy is a common complication of degenerative spondyloarthritis and discogenic diseases of the lumbar spine due to neuroforaminal narrowing and spinal stenosis. The Board finds that the Veteran has bilateral lower extremity radiculopathy due to his service-connected degenerative spondylosis and discogenic disease of the lumbar spine. In this regard, the July 2018 VHA physician found that the Veteran has bilateral lower extremity radiculopathy due to such condition. While the other VA examiners did not find that the Veteran has lower extremity radiculopathy, the record shows that Veteran has credibly reported and sought treatment for relevant lower extremity symptoms. In addition, the VHA physician found that the Veteran experiences lower extremity radiculopathy. (Continued on the next page)   Resolving reasonable doubt in the Veteran’s favor, the Board finds that Veteran has right and left lower extremity radiculopathy that is caused by his service connected lumbar spine disability. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Accordingly, service connection is warranted for right and left lower extremity radiculopathy on a secondary basis. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Jimerfield, Associate Counsel