Citation Nr: 18154368 Decision Date: 11/29/18 Archive Date: 11/29/18 DOCKET NO. 17-10 560 DATE: November 29, 2018 REMANDED Entitlement to service connection for headaches, to include as secondary to a service-connected neck disability. Entitlement to a rating higher than 20 percent for a neck disability. Entitlement to a rating higher than 20 percent for a low back disability. Entitlement to a compensable rating for radiculopathy of the left arm. Entitlement to a compensable rating for radiculopathy of the right arm. Entitlement to a compensable rating for radiculopathy of the left leg. Entitlement to a compensable rating for radiculopathy of the right leg. Entitlement to an effective date earlier than November 29, 2012 for the grant of a separate rating for radiculopathy of the left leg. Entitlement to an effective date earlier than November 29, 2012 for the grant of a separate rating for radiculopathy of the right leg. Entitlement to an effective date earlier than November 29, 2012 for the grant of a separate rating for radiculopathy of the left arm. Entitlement to an effective date earlier than November 29, 2012 for the grant of a separate rating for radiculopathy of the right arm. REASONS FOR REMAND The Veteran served on active duty from July 1995 to July 1999. These matters are on appeal from a December 2013 rating decision. 1. Service connection claim The Veteran contends that he has a headache disability that is related to his service. However, the evidence of record has raised a theory of secondary service connection. On October 2013 VA peripheral nerve conditions Disability Benefits Questionnaire (DBQ) examination, the Veteran complained of increased neck pain with headaches and stiffness. The Veteran has not yet been afforded a VA examination regarding his claim for service connection for a headache disability. On remand, a VA examination and medical opinion regarding the etiology of his claimed disability should be obtained. 2. Increased rating claims The Veteran contends that his service connected neck, low back, and radicular symptoms have worsened since the last VA examination. See, September 2016 substantive appeal and March 2018 statement. Therefore, the Veteran’s rating claims should be remanded for new VA examinations. See Weggenmann v. Brown, 5 Vet. App. 281, 284 (1993). VAOPGCPREC 11-95 (1995). 3. Earlier effective date claims The Veteran contends that he is entitled to an effective date earlier than November 29, 2012, for the grant of separate ratings for radiculopathy of the arms and legs. He contends that his bilateral lower and upper radicular symptoms are related to his service-connected low back and neck disabilities and should have an effective date at least one year prior to the November 29, 2012 claim for an increased rating for low back and neck disabilities. See, March 2018 90-day response. In this regard, the Board agrees that the earlier effective date claims are considered part and parcel of the Veteran’s low back and neck increased rating claims, as the rating criteria for the spine require consideration of neurologic disability associated with the lumbar and cervical spine disabilities throughout the period on appeal. See 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine. Accordingly, the Board finds that the Veteran’s earlier effective date claims for radiculopathy of the upper and lower extremities are inextricably intertwined with his claims of entitlement to increased ratings for his service-connected low back and neck disabilities. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that two issues are “inextricably intertwined” when they are so closely tied together that a final Board decision cannot be rendered unless both issues have been considered). As such, the Board will defer further consideration of these matters until the other increased rating claims are adjudicated. While on Remand any additional VA and private treatment records should be associated with the claims file. The matters are REMANDED for the following actions: 1. Contact the Veteran and request that he either submit, or provide VA sufficient information and authorization to obtain any private treatment records related to the Veteran’s headaches and bilateral arm, low back, and neck disabilities, including any additional record from Dr. L.J.V. and The Back Center. 2. Obtain all outstanding VA medical records related to the Veteran’s headaches, low back, neck, and bilateral arm and leg disabilities, including those from the Tampa VAMC, dated from January 2016 to the present. All records and/or responses received should be associated with the claims file (the Veteran himself can also submit all record he believes to be pertinent). 3. After the foregoing has been completed, schedule the Veteran for a VA examination which addresses the nature and etiology of any headache disability. The claims file must be provided to the examiner for review. All indicated tests and studies should be performed. The claims folder should be provided to the examiner for review of pertinent documents. The examination report should reflect that such a review was conducted. The examiner should provide the following opinions: a) Is it at least as likely as not (50 percent or more probability) that any headache disability, had its onset in or is etiologically-related to the Veteran's active duty service? b) If the answer to part (a) above is “no,” is it at least as likely as not (50 percent probability or more) that headaches, are (a) proximately due to or the result of the Veteran’s service-connected neck and bilateral arm disabilities, or (b) aggravated or permanently worsened by his service-connected neck and bilateral arm disabilities? If it is determined that the headaches are related to any service-connected disability, to the extent possible, the examiner should indicate the approximate degree of disability or baseline before the onset of aggravation. 4. Schedule the Veteran for a VA examination, to ascertain and evaluate the current level of severity of his neck, low back, and bilateral arm and leg disabilities. All indicated studies and tests should be performed. The claims folder should be made available to the examiner for review of pertinent documents. The examination report should reflect that such a review was conducted. If possible, but not required, an assessment of the Veteran’s capability at employment would be greatly appreciated by the Board. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Adams, Counsel