Citation Nr: 18145363 Decision Date: 10/26/18 Archive Date: 10/26/18 DOCKET NO. 15-24 631 DATE: October 26, 2018 REMANDED Entitlement to service connection for neuropathy is remanded. Entitlement to an increased rating for lumbosacral strain with degenerative joint disease (arthritis) currently rated at 20 percent is remanded. REASONS FOR REMAND The Veteran served in the Army from March 1971 to March 1985. This matter comes to the Board on appeal from a March 2013 rating decision. The Veteran filed a notice of disagreement in September 2013. A statement of the case was issued in June 2015. The Veteran filed an appeal to the Board in July 2015. A supplemental statement of the case was issued in January 2017. The Veteran requested a hearing, which was held in September 2018 before the undersigned Veterans Law Judge. 1. Entitlement to service connection for neuropathy is remanded. The Veteran is seeking service connection on a secondary basis for neuropathy that he believes is caused by his service connected lumbosacral strain with degenerative joint disease. The competent evidence reflects that the Veteran has two possible neuropathic conditions: peripheral neuropathy and sciatica. The Veteran is currently diagnosed with peripheral neuropathy, which is also referred to in the medical records as diabetic neuropathy. There is no evidence in the record that indicates that this condition is related to the Veteran’s service. On the contrary, a diagnosis of diabetic neuropathy indicates that the neuropathy is caused by diabetes mellitus. The Veteran has been diagnosed with diabetes mellitus, but his diabetes mellitus is not service connected. The Veteran also asserts that the pain and symptoms he experiences could be sciatica. During his hearing, the Veteran described feeling sciatic nerve pain on a frequent basis. The Veteran stated that he experiences nerve pain that is distinguishable from the symptomology caused by his diabetic neuropathy. However, the Veteran’s medical records do not reflect a diagnosis of sciatica. In September 2016 the Veteran saw S.R., who conducted an examination and filled out a back conditions disability benefits questionnaire. S.R. stated that the Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy (which would include involvement of the sciatic nerve). S.R. also stated that the Veteran did not have any signs or symptoms of nerve root irritation (including sciatic pain). These findings are consistent with the findings of a VA examination in February 2013 wherein the examiner found no radiculopathy and no signs or symptoms of nerve root irritation. The Veteran is competent to testify as to the pain and limitations that he experiences in his daily life, and the Veteran’s contentions on appeal are sufficient to raise a question as to the adequacy of the record. As such a new examination would be appropriate along with a medical opinion regarding the origins of the Veteran’s lower extremity symptoms. 2. Entitlement to an increased rating for lumbosacral strain with degenerative joint disease (arthritis) currently rated at 20 percent is remanded. The Veteran was seen for his lumbosacral strain with degenerative joint disease in February 2016 by S.R., who completed a back conditions disability benefits questionnaire which documented the Veteran’s range of motion and functional limitations. However, the veteran testified at the 2018 Board hearing that this examination was very short and was only based upon an oral interview (the Board notes that the DBQ indicates that Dr. S.R. did not review the Veteran’s VA claims file or e-folder). The Veteran contends that this visit was not sufficient to accurately assess his back condition(s). Furthermore, the Veteran has testified that his back condition has gotten worse since that visit. The Veteran is competent to testify as to the pain and limitations that he experiences in his daily life, and the Veteran’s contentions on appeal are sufficient to raise a question as to the adequacy of the record. As such, the Board finds a remand for a new examination is necessary. The matters are REMANDED for the following actions: 1. Obtain and associate with the claims file any outstanding, pertinent VA treatment records. As many attempts should be made as necessary to obtain the VA records, to include requesting a specific negative response if no records are located. The appellant is to be notified of any unsuccessful effort to obtain outstanding VA and private treatment records to allow the opportunity to obtain and submit those records for VA review. Moreover, notify the appellant that he may submit VA Forms 21-4142 and 21-4142a to authorize any private medical provider to disclose and release to VA information on the Veteran’s treatment, and then request those medical records from the private medical provider(s). Additionally, notify the appellant that he may submit any relevant VA and private treatment records in his possession to VA 2. After associating any records with the claims file, schedule the Veteran for a VA examination, where the VA examiner should assess the current state of the Veteran’s lumbosacral strain with degenerative joint disease. The examiner should comment on the effect that the Veteran’s service-connected back has on his ability to function in an occupational environment and describe any functional impairment/limitations caused by this service-connected disability; and 3. After associating any records with the claims file, schedule the Veteran for a VA examination, where the VA examiner should determine the nature and etiology of the Veteran’s claimed neuropathy, and it to answer the following with a supporting rationale: a. Whether the Veteran currently suffers from a neurological disorder of the lower extremities; if yes, please identify the diagnosis or diagnoses. b. For each diagnosis, state whether it is at least as likely as not that it is due to, or has been aggravated by, his military service. (Continued on the next page)   c. For each diagnosis, state whether is it at least as likely as not (50 percent or greater) that the Veteran’s neurological disorder of the lower extremities was either 1) proximately due to OR 2) aggravated by any service-connected disability, to include the Veteran’s lumbosacral strain with degenerative joint disease. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Macchiaroli, Law Clerk