Citation Nr: 18142534 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 16-31 141 DATE: October 16, 2018 REMANDED 1. Entitlement to increases in the (10 percent prior to July 25, 2016, and 20 percent from that date) staged ratings assigned for left lower extremity sciatic nerve disability is remanded. 2. Entitlement to increases in the (10 percent prior to July 25, 2016, and 40 percent from that date) staged ratings assigned for right lower extremity sciatic nerve disability is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from November 1994 to February 1995 and from May 1997 to February 2008. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision, which granted service connection for right and left upper extremity peripheral neuropathy, granted service connection for right and left lower extremity sciatic nerve peripheral neuropathy, granted service connection for right and left lower extremity femoral nerve diabetic peripheral neuropathy, and assigned initial ratings of 10 percent for each. In June 2015 the Veteran filed a notice of disagreement as to the assignment of 10 percent ratings for right and left lower extremity sciatic nerve peripheral neuropathy. 1. 2. Entitlement to increases in the (10 percent prior to July 25, 2016, and 20 percent from that date) staged ratings assigned for left lower extremity sciatic nerve disability and the (10 percent prior to July 25, 2016, and 40 percent from that date) staged ratings assigned for right lower extremity sciatic nerve disability is remanded. There is conflicting medical evidence regarding the severity of the Veteran’s left and right lower extremity sciatic nerve disabilities prior to July 25, 2016 (without adequate explanation for the fluctuation in the findings). A November 2014 electrodiagnostic studies report notes that the findings were consistent with a moderately severe peripheral neuropathy of both lower extremities. A November 2014 VA examination report notes mild paresthesias and/or dysesthesias of both lower extremities and refers to the November 2014 EMG studies that found moderately severe peripheral neuropathy of both lower extremities (noting that that finding was not specified as caused by diabetes). A February 2015 VA examination noted mild incomplete paralysis of the sciatic nerve of both lower extremities. A July 25, 2016 VA examination found moderate incomplete paralysis of the sciatic nerve of both lower extremities. These findings reflect that the Veteran’s right and left lower extremities sciatic nerve disabilities have ranged from mild to moderately severe in severity (without explanation for the fluctuations), i.e., whether the disability is subject to frequent exacerbations and remissions and is not static or but subject to flare-ups. Furthermore, the Veteran’s last neurological examination to assess these disabilities was in July 2016; given the fluctuating findings, a contemporaneous examination to assess the disabilities and reconcile the conflicting findings is necessary. The matters are REMANDED for the following: 1. Obtain for the record all outstanding (any not already associated with the claims file) records of evaluation and treatment the Veteran has received for his right and left sciatic nerve disabilities since 2014. 2. Then arrange for the Veteran to be examined by an appropriate physician to assess the current severity of his right and left sciatic nerve disabilities. The Veteran’s entire record should be reviewed by the examiner in connection with the examination. On review of the record and examination of the Veteran, the examiner should: (a.) Describe all current symptoms of, and impairment due to sciatic peripheral neuropathies of the lower extremities in detail. (b.) Explain the fluctuating findings pertaining to the sciatic nerve disabilities cited above. Indicate whether the disabilities are one subject to frequent periods of exacerbation and remission or flare-ups (identifying any periods of flare-up shown by the record since 2014) or show actual chronic worsening or improvement (are otherwise explained). The examiner must include rationale with all opinions. GEORGE R. SENYK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Staskowski, Associate Counsel