Citation Nr: 18152712 Decision Date: 11/27/18 Archive Date: 11/23/18 DOCKET NO. 17-27 538 DATE: November 27, 2018 REMANDED Entitlement to a rating in excess of 30 percent for neuropathy of the upper left extremity is remanded. Entitlement to service connection for a right hip disability, to include as secondary to service-connected back disability is remanded. Entitlement to service connection for a right knee disability, to include as secondary to service-connected back disability is remanded. Entitlement to service connection for a left knee disability, to include as secondary to service-connected back disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1975 to August 1998. This matter comes before the Board of Veterans’ Appeals (Board) from an October 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas.   1. Entitlement to a rating in excess of 30 percent for neuropathy of the upper left extremity is remanded. The Veteran last underwent an examination for his left arm disability in October 2014. The record shows ongoing treatment and the Veteran stated his arm is numb all the time. In addition, private treatment records show the Veteran’s disability may have worsened, as his left hand has diminished light touch sensation. As a result, the October 2014 VA examination is insufficient for adjudication and a new VA examination is necessary. 2. – 4. Entitlement to service connection for a right hip disability, right knee disability, and left knee disability, to include as secondary to service-connected back disability is remanded. The Veteran underwent VA examinations in October 2014 and February 2017 for the right hip, right knee, and left knee disability claims. However, the Board finds the October 2014 and February 2017 etiological opinions are inadequate because neither opinion fully addresses whether the claimed disabilities are directly related to the Veteran’s military service or are caused or aggravated by his service-connected back disability. As a result, new VA examinations are necessary. The matters are REMANDED for the following action: 1. Identify any VA or private medical records of treatment that are not already of record and associate them with the claims file, to specifically include Carolina Coastal Health Care Neurology, Carolina Internal Medicine, and Crystal Coastal Pain Management. 2. After all outstanding treatment records have been obtained, schedule the Veteran for a VA examination to determine the current level of severity of his service-connected neuropathy in the left upper extremity. The VA examiner must review the claims file, to include a copy of this remand. All necessary tests and studies should be accomplished and all clinical findings reported in detail. If the VA examiner is unable to conduct the required testing or finds that it is unnecessary, the VA examiner must provide a clear explanation. The RO should ensure that the examination report(s) include all necessary information for rating purposes. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of his right hip and bilateral knee disability. The examiner must review the claims file. All tests and studies deemed necessary by the examiner must be performed. Based on a review of the claims file and the clinical findings of the examination, the examiner is requested to address the following: (a.) Whether it at least as likely as not (50 percent or greater probability) that the Veteran has a right hip disability that was caused by or is related to service. (b.) Whether it at least as likely as not (50 percent or greater probability) that the Veteran has a right knee disability that was caused by or is related to service. (c.) Whether it at least as likely as not (50 percent or greater probability) that the Veteran has a left knee disability that was caused by or is related to service. (d.) Whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s right hip disability is proximately due to or aggravated by a service-connected, to specifically include his back disability. (e.) Whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s right knee disability is proximately due to or aggravated by a service-connected disability, to specifically include his back disability. (f.) Whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s left knee disability is proximately due to or aggravated by a service-connected disability, to specifically include his back disability. In providing the requested opinion, the examiner should specifically address the Veteran’s lay statements regarding his injuries during service and the 1995 boat accident. (Continued on the next page)   A complete rationale must be given for all opinions and conclusions. DELYVONNE M. WHITEHEAD Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Kass, Associate Counsel