Citation Nr: 18156790 Decision Date: 12/11/18 Archive Date: 12/10/18 DOCKET NO. 12-03 148 DATE: December 11, 2018 REMANDED Service connection for left lower extremity neurological impairment, to include peripheral neuropathy, sciatica, and radiculopathy, and to include as secondary to a service-connected disability and as secondary to the service-connected lumbar spine degenerative disc disease (left lower extremity neuropathy), is remanded. Entitlement to an initial disability rating greater than 10 percent for left femur osteochondroma with excision of the lesion with scar residual (left femur disability) is remanded. Entitlement to a total disability rating based on individual employability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from October 1966 to October 1970. The issue is appealed from a July 2009 rating decision. 1. Service connection for left lower extremity radiculopathy is remanded Per July 2016 remand instructions by the Board of Veterans’ Appeals (Board), the Veteran was afforded a VA examination in September 2016 for peripheral polyneuropathy. Included in the remand directives were instructions for the VA examiner to provide etiological opinions on direct service connection and secondary service connection. Although the September 2016 VA examiner provided an etiological opinion on secondary service connection, he did not provide an etiological opinion on direct service connection. See Stegall v. West, 11 Vet. App. 268 (1998). On remand, an addendum opinion from the September 2016 VA examiner is required addressing an etiological opinion for the direct service connection claim. Additionally, in the July 2016 Board remand, the regional office (RO) was instructed to obtain medical records from Dr. L. Richard and Greater Ann Arbor Neurology Associates dating from December 2008 to present. There is no indication in the Veteran’s claims file that RO attempted to obtain these records. Stegall, 11 Vet. App. at 268. On remand, these medical records should be obtained. 2. Entitlement to an initial disability rating greater than 10 percent for left femur disability is remanded As the Veteran’s last VA examination for his left femur disability was in September 2016, a new VA examination should be scheduled to assess the current status of his disability. 3. Entitlement to TDIU due to service-connected disabilities is remanded As the TDIU claim is inextricably intertwined with the remanded service connection and increased rating claims, it will also be remanded pending adjudication of those claims. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two or more issues are inextricably intertwined if one claim could have significant impact on the other). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for Dr. L. Richard and his practicing facility, Greater Ann Arbor Neurology Associates from December 2008 to present. Make two requests for the authorized records from Dr. L. Richard and Greater Ann Arbor Neurology Associates unless it is clear after the first request that a second request would be futile. 2. Obtain an addendum opinion from the September 2016 VA examiner on the Veteran’s left lower extremity neuropathy. If the September 2016 VA examiner is not available, obtain an addendum opinion from another appropriate physician. The VA examiner is asked to opine on whether it is at least as likely as not (probability of 50 percent) that any such lower extremity neurological disability is etiologically related to service. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected left femur disability. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to left femur disability alone and discuss the effect of the Veteran’s left femur disability on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 4. Readjudicate the appeals. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Lee, Associate Counsel