Citation Nr: 18158947 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 15-46 408 DATE: December 19, 2018 ORDER The appeal pertaining to the issue of entitlement to service connection for left elbow disorder is dismissed. The appeal pertaining to the issue of entitlement to service connection for right elbow disorder is dismissed. The appeal pertaining to the issue of entitlement to an initial compensable rating for left foot residual surgical scar is dismissed. An initial rating of 30 percent, but no higher, for status-post internal fixation with residual hardware and pain of the left fifth metatarsal is granted, subject to the laws and regulations governing the payment of monetary benefits. REMANDED Entitlement to an initial rating in excess of 10 percent for lumbar strain is remanded. Entitlement to a compensable initial rating for left knee femoropatellar syndrome is remanded. Entitlement to a compensable initial rating for right knee femoropatellar syndrome is remanded. Entitlement to service connection for right hand disorder is remanded. Entitlement to service connection for left ankle disorder is remanded. Entitlement to service connection for right ankle disorder is remanded. Entitlement to an initial rating in excess of 20 percent for left shoulder impingement syndrome prior to June 7, 2016, and in excess of 10 percent thereafter for left shoulder degenerative joint disease is remanded. Entitlement to an initial rating in excess 10 percent for cervical strain with supraspinatus spasm prior to June 7, 2016, and for cervical spine degenerative joint disease thereafter is remanded. FINDINGS OF FACT 1. At the August 2016 Board hearing, prior to the promulgation of a decision, the Veteran withdrew his appeal as the issues of entitlement to service connection for a left elbow disorder and a right elbow disorder, and entitlement to an initial compensable rating for left foot residual surgical scar. 2. For the entire appeal period, the Veteran’s status-post internal fixation with residual hardware and pain of the left fifth metatarsal resulted in a severe foot injury as demonstrated by constant pain that worsened with cold weather, stiffness, swelling, and an altered gait. CONCLUSIONS OF LAW 1. The criteria for the withdrawal of the issue of entitlement to service connection for left elbow disorder have been met. 38 U.S.C. § 7105(b)(2), (d)(5); 38 C.F.R. §§ 20.202, 20.204. 2. The criteria for the withdrawal of the issue of entitlement to service connection for right elbow disorder have been met. 38 U.S.C. § 7105(b)(2), (d)(5); 38 C.F.R. §§ 20.202, 20.204. 3. The criteria for the withdrawal of the issue of entitlement to an initial compensable rating for left foot residual surgical scar have been met. 38 U.S.C. § 7105(b)(2), (d)(5); 38 C.F.R. §§ 20.202, 20.204. 4. The criteria for an initial rating of 30 percent, but no higher, for status-post internal fixation with residual hardware and pain of the left fifth metatarsal have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 5284. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 2006 to January 2013.This matter comes to the Board of Veterans’ Appeals (Board) on appeal from rating decisions issued in April 2013 and June 2016 by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2016, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Withdrawn Claims 1. Entitlement to service connection for left elbow disorder. 2. Entitlement to service connection for right elbow disorder. 3. Entitlement to an initial compensable rating for left foot residual surgical scar. The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 20.204. Except for appeals withdrawn on the record at a hearing, appeal withdrawals must be in writing. 38 C.F.R. § 20.204(b)(1). At the August 2016 Board hearing, prior to the promulgation of a Board decision, the Veteran withdrew his appeal as the issues of entitlement to service connection for a left elbow disorder and a right elbow disorder, and entitlement to an initial compensable rating for left foot residual surgical scar. In Acree v. O’Rourke, 891 F.3d 1009 (Fed. Cir. 2018), the United States Court of Appeals for the Federal Circuit (Federal Circuit) affirmed the United States Court of Appeals for Veterans Claims’ (Court) holding in that an effective claim withdrawal must be (1) explicit, (2) unambiguous, and (3) done with a full understanding of the consequences of such action on the part of the veteran. DeLisio v. Shinseki, 25 Vet. App. 45, 57 (2011). The Federal Circuit stressed the importance of ensuring veterans understand the consequences of withdrawing a claim at a hearing. In the instant case, the hearing transcript reflects that the withdrawal of such claims was explicit and unambiguous. Further, such reflects a reference to an off the record discussion in which the undersigned, the Veteran, and the Veteran’s representative, an attorney, discussed the withdrawal of such claims. Consequently, the Board finds that the Veteran understands the consequences of the withdrawal. Hence, the Board finds that such claims were withdrawn. Therefore, there remain no allegations of errors of fact or law for appellate consideration regarding them. Accordingly, the Board does not have jurisdiction to review the appeal of such claims and they are dismissed. Increased Rating Claim Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Each disability must be viewed in relation to its history, and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. Examination reports are to be interpreted in light of the whole recorded history, and each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2. All reasonable doubt will be resolved in the claimant’s favor. 38 C.F.R. § 4.3. Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation is to be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating is to be assigned. 38 C.F.R. § 4.7. Separate ratings can be assigned for separate periods based on the facts found - a practice known as “staged” ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life, including employment. 38 C.F.R. § 4.10. Disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. Functional loss may be due to the absence or deformity of structures or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior in undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. § 4.40. In Mitchell v. Shinseki, 25 Vet. App. 32, 44 (2011), the Court held that, although pain may cause a functional loss, “pain itself does not rise to the level of functional loss as contemplated by VA regulations applicable to the musculoskeletal system.” Rather, pain may result in functional loss, but only if it limits the ability “to perform the normal working movements of the body with normal excursion, strength, speed, coordination, or endurance.” Id., quoting 38 C.F.R. § 4.40. With respect to joints, in particular, the factors of disability reside in reductions of normal excursion of movements in different planes. Inquiry will be directed to more or less than normal movement, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity or atrophy of disuse. 38 C.F.R. § 4.45; DeLuca v. Brown, 8 Vet. App. 202 (1995). The intent of the Rating Schedule is to recognize actually painful, unstable or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint, even in the absence of arthritis. 38 C.F.R. § 4.59; Burton v. Shinseki, 25 Vet. App. 1, 5 (2011). In this regard, 38 C.F.R. § 4.59 requires that “[t]he joints involved should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint.” Correia v. McDonald, 28 Vet. App. 158 (2016). Further, 38 C.F.R. § 4.59 is applicable to the evaluation of musculoskeletal disabilities involving actually painful, unstable or malaligned joints or periarticular regions, regardless of whether the Diagnostic Code under which the disability is evaluated is predicated on range of motion measurements. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). 4. Entitlement to an initial rating in excess of 10 percent for status-post internal fixation with residual hardware and pain of the left fifth metatarsal. The Veteran’s service-connected status-post internal fixation with residual hardware and pain of the left fifth metatarsal has been assigned an initial rating of 10 percent under 38 C.F.R. 4.71a, Diagnostic Code 5284. Under Diagnostic Code 5284, a 10 percent rating is provided for a “moderate” foot injury. A 20 percent rating is provided for a “moderately severe” foot injury, and a 30 percent evaluation is provided for a “severe” foot injury. The Note to Diagnostic Code 5284 indicates that a maximum 40 percent rating will be assigned for actual loss of use of the foot. 38 C.F.R. § 4.71a. The words “slight,” “moderate,” and “severe” as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all of the evidence, to the end that its decisions are “equitable and just.” 38 C.F.R. § 4.6. Here, the Board finds the medical evidence and the Veteran’s lay statements show his service-connected left foot disability resulted in severe disability throughout the pendency of the appeal. On VA examination in March 2013, the Veteran reported constant pain, which was worsened by cold weather, and the examiner assessed a severe foot injury. At the June 2016 VA examination, the Veteran reported that his left foot disability remained stable, and hurts with cold weather or walking. He denied flare-ups, but there was pain upon examination. At the August 2016 hearing, the Veteran testified that his foot was stiff and swollen in the mornings and that he tended to lean more towards the inside of his foot. The Veteran reported that he experienced pain with every motion and had to replace his shoes approximately every three months. Based on this evidence, the Board finds that an initial rating of 30 percent for the Veteran’s status-post internal fixation with residual hardware and pain of the left fifth metatarsal is warranted. 38 C.F.R. § 4.71a, Diagnostic Code 5284. However, as the medical evidence does not show, and the Veteran does not assert, actual loss of use of the foot, a 40 percent rating is not warranted under Diagnostic Code 5284. The Board has considered whether a higher and/or separate rating is warranted under other relevant Diagnostic Codes. However, as the medical evidence does not reflect flat foot, weak foot, claw foot, anterior metatarsalgia, hallux valgus, hammer toe, or malunion of tarsal or metatarsal bones associated with his service-connected left foot disability, such are not applicable in this case. 38 C.F.R. § 4.71a, Diagnostic Codes 5276-5283. Further, while the Veteran reported a burning sensation on the top of his left foot at the August 2016 Board hearing, VA examinations conducted in June 2016 reflect normal sensation to the left foot. Consequently, a separate rating based on such symptomatology is likewise not warranted. Further, neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record, in regard to the instant claim. Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). The Board has also considered whether staged ratings under Fenderson, supra, are appropriate for the Veteran’s service-connected left foot disability; however, the Board finds that his symptomatology has been stable throughout the appeal period. Therefore, assigning staged ratings for such disability is not warranted. Therefore, the Board finds that an initial rating of 30 percent, but no higher, is warranted for the Veteran’s left foot disability. In reaching such determination, the Board has resolved all doubt in favor of the Veteran. However, as the preponderance of the evidence is against higher or separate ratings, such doctrine is not applicable and his initial rating claim must otherwise be denied. See 38 U.S.C. § 5107; 38 C.F.R. §§ 4.3, 4.7. REASONS FOR REMAND 5. Entitlement to an initial rating in excess of 10 percent for lumbar strain. 6. Entitlement to an initial compensable rating for left knee femoropatellar syndrome. 7. Entitlement to an initial compensable rating for right knee femoropatellar syndrome. As noted above, the Court has held that service-connected joints should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with the range of the opposite undamaged joint. Correia, supra. Here, the March 2013 VA examinations for the Veteran’s back and knee disabilities do not indicate that such testing was performed. In addition, although the June 2016 VA back examination report indicates the Veteran did not have pain on weight-bearing, range of motion testing on weight-bearing and nonweight-bearing were not tested. The examination report also does not reflect the requisite testing for pain on both active and passive motion. Likewise, the June 2016 VA knee examination report does not reflect range of motion testing on weight-bearing, nonweight-bearing, or on active and passive motion. Therefore, a remand is necessary in order to afford the Veteran VA examinations so as to address the nature and severity of the Veteran’s back and bilateral knee disabilities. 8. Entitlement to service connection for right hand disorder. The Veteran asserts he has a current right hand disorder related to an in-service training accident and in-service parachute jumps. A March 2013 VA examination report reflects a diagnosis of status-post right hand metacarpal fracture with residual reduced movement of the right fifth digit, and the examiner noted the Veteran’s report of a fracture during a training event in 2009. However, he did not offer an opinion as to whether the Veteran’s current right hand disorder was related to such reported injury. At a June 2016 VA examination, a diagnosis of right hand strain was rendered, and the examiner noted that the Veteran fractured his right hand in 2008 and reinjured the hand in 2010 when it was pinched between boxes and containers. The examiner opined the right hand strain was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In this regard, he found there were no service treatment records (STRs) concerning any right hand pain or fracture. In addition, the examiner stated parachute jumping did not lead to a permanent hand strain unless it was actually injured at landing. Here, he found there was no evidence of that in the STRs and, therefore, the right hand strain was less likely than not from service. Upon review, the Board finds the June 2016 examiner’s opinion inadequate for determining service connection for a right hand disorder. Here, his conclusion is based on the absence of documentation of an in-service injury in the STRs; however, the Veteran has reported injuries to his hand in 2008, 2009, and 2010. Consequently, the Board finds remand is warranted for an addendum opinion that addresses whether the Veteran’s hand disorders are related to his reported injuries. 9. Entitlement to service connection for left ankle disorder. 10. Entitlement to service connection for right ankle disorder. The Veteran asserts he has disorders of the left and right ankles related to in-service parachute jumps. On VA examination in March 2013, the examiner determined the Veteran did not have a bilateral ankle disorder. In this regard, he noted that the Veteran did not have pain associated with movement, flare-ups, and/or repetitive use over time, or functional impairment related to any ankle symptoms. However, the Board finds the examiner’s opinion is not supported by the examination finding of bilateral shin splints and an X-ray impression of slight medial tilt to the talus in both ankles. As a result, remand is warranted to clarify whether the Veteran has a current left and/or right ankle disorder related to service, to include as due to the reported parachute jumps. 11. Entitlement to an initial rating in excess of 20 percent for left shoulder impingement syndrome prior to June 7, 2016, and in excess of 10 percent thereafter for left shoulder degenerative joint disease is remanded. 12. Entitlement to an initial rating in excess 10 percent for cervical strain with supraspinatus spasm prior to June 7, 2016, and for cervical spine degenerative joint disease thereafter. In a June 2016 rating decision, the Agency of Original Jurisdiction (AOJ) granted service connection for left shoulder impingement syndrome with a 20 percent rating as of January 18, 2013, which was noted to have progressed to degenerative joint disease with a 10 percent rating as of June 7, 2016; and cervical strain with supraspinatus spasm with a 10 percent rating as of January 18, 2013, which was noted to have progressed to cervical spine degenerative joint disease with a 10 percent rating as of June 7, 2016. In August 2016, the Veteran entered a notice of disagreement as to the propriety of the initially assigned ratings for such disabilities. When there has been an initial AOJ adjudication of a claim and a notice of disagreement as to its denial, the claimant is entitled to a statement of the case. 38 C.F.R. § 19.26. Thus, remand for issuance of a statement of the case as to such issues is necessary. Manlincon v. West, 12 Vet. App. 238 (1999). However, they will be returned to the Board after issuance of the statement of the case only if perfected by the filing of a timely substantive appeal. See Smallwood v. Brown, 10 Vet. App. 93, 97 (1997). The matters are REMANDED for the following actions: 1. Afford the Veteran appropriate VA examinations to determine the current nature and severity of his service-connected lumbar strain. The record, to include a complete copy of this Remand, must be made available to the examiner, and all indicated tests should be accomplished. If possible, the examination should be conducted during a flare-up. The examiner should identify the current nature and severity of all manifestations of the Veteran’s lumbar strain. The examiner should record the range of motion of the lumbar spine observed on clinical evaluation in terms of degrees for all planes. If there is evidence of pain on motion, the examiner should indicate the degree of range of motion at which such pain begins, and whether such pain on movement, as well as weakness, excess fatigability, or incoordination, results in any loss of range of motion. The examiner should record the results of range of motion testing for pain on both active and passive motion, on weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case he or she should clearly explain why that is so. The examiner is also requested to review the VA examinations containing range of motion findings pertinent to the Veteran’s lumbar strain conducted in March 2013 and June 2016. In this regard, the examiner is requested to offer an opinion as to the range of motion findings for pain on both active and passive motion, on weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to do so, he or she should explain why. It is also imperative that the examiner comment on the functional limitations caused by flare-ups and repetitive use. In this regard, the examiner should indicate whether, and to what extent, the Veteran’s range of motion is additionally limited during flare-ups or on repetitive use, expressed, if possible, in terms of degrees, or explain why such details cannot be feasibly provided. If the Veteran endorses experiencing flare-ups of his back, the examiner must obtain information regarding the frequency, duration, characteristics, severity, and/or functional loss related to such flare-ups. Then, if the examination is not being conducted during a flare-up, the examiner should provide an opinion based on estimates derived from the information above as to the additional loss of range of motion that may be present during a flare-up. If the examiner cannot provide an opinion as to additional loss of motion during a flare-up without resorting to mere speculation, the examiner must make clear that s/he has considered all procurable data (i.e., the information regarding frequency, duration, characteristics, severity, and/or functional loss related to such flare-ups elicited from the Veteran), but any member of the medical community at large could not provide such an opinion without resorting to speculation. The examiner is requested to indicate whether intervertebral disc syndrome related to the Veteran’s service-connected lumbar strain is present. If so, the examiner should the total duration of any incapacitating episodes over the past 12 months. The examiner is advised that an ‘incapacitating episode’ is defined as a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. The examiner is also requested to indicate whether the Veteran’s lumbar strain results in any objective neurologic impairment, to include radiculopathy of the right and/or left lower extremity, and, if so, the nature and severity of such neurologic impairment. The examiner should also comment upon the functional impairment resulting from the Veteran’s lumbar strain. A rationale for all opinions offered should be provided. 2. The Veteran should be afforded an appropriate VA examination to determine the current nature and severity of his service-connected left and right knee femoropatellar syndrome. All indicated tests and studies should be undertaken. The record, including a complete copy of this Remand, must be made available for review with the examination. If possible, such examination should be conducted during a flare-up. The examiner should identify the current nature and severity of all manifestations of the Veteran’s bilateral knee disabilities. The examiner should record the range of motion of the bilateral knees observed on clinical evaluation in terms of degrees for flexion and extension. If there is evidence of pain on motion, the examiner should indicate the degree of range of motion at which such pain begins, and whether such pain on movement, as well as weakness, excess fatigability, or incoordination, results in any loss of range of motion. The examiner should record the results of range of motion testing for pain on both active and passive motion, on weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case he or she should clearly explain why that is so. The examiner is also requested to review the VA examinations containing range of motion findings pertinent to the Veteran’s left and right knee disabilities conducted in March 2013 and June 2016. In this regard, the examiner is requested to offer an opinion as to the range of motion findings for pain on both active and passive motion, on weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. If the examiner is unable to do so, he or she should explain why. It is also imperative that the examiner comment on the functional limitations caused by flare-ups and repetitive use. In this regard, the examiner should indicate whether, and to what extent, the Veteran’s range of motion is additionally limited during flare-ups or on repetitive use, expressed, if possible, in terms of degrees, or explain why such details cannot be feasibly provided. If the Veteran endorses experiencing flare-ups of his right and/or left knee, the examiner must obtain information regarding the frequency, duration, characteristics, severity, and/or functional loss related to such flare-ups. Then, if the examination is not being conducted during a flare-up, the examiner should provide an opinion based on estimates derived from the information above as to the additional loss of range of motion that may be present during a flare-up. If the examiner cannot provide an opinion as to additional loss of motion during a flare-up without resorting to mere speculation, the examiner must make clear that s/he has considered all procurable data (i.e., the information regarding frequency, duration, characteristics, severity, and/or functional loss related to such flare-ups elicited from the Veteran), but any member of the medical community at large could not provide such an opinion without resorting to speculation. The examiner should also comment as to whether (and if so, to what extent, (i.e., slight, moderate, or severe)) the Veteran’s right and/or left knee disabilities result in recurrent subluxation or lateral instability. The examiner should also indicate whether there is dislocated or removed semilunar cartilage and, if so, the nature of the symptoms associated with such meniscus impairment. The examiner should also comment upon the functional impairment resulting from the Veteran’s bilateral knee disabilities. A rationale for any opinion offered should be provided. 3. Forward the claims file to the clinician who performed the June 2016 examination or, if unavailable, an appropriate clinician for an opinion as to the current nature and etiology of any right hand disorder. The record, to include a complete copy of this Remand, must be made available. The need for additional examination is left to the discretion of the clinician. Thereafter, the clinician should address the following inquiries: (A) Identify all current right hand disorders. In this respect, the examiner must address the March 2013 diagnosis of status-post right hand metacarpal fracture with residual reduced movement of the right fifth digit, and the June 2016 diagnosis of right hand strain. (B) For each currently diagnosed right hand disorder, offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that such is related to the Veteran’s military service, to include the reported in-service fracture and injuries due to parachute jumps. In offering any opinion, the clinician should consider the Veteran’s statements regarding the onset and continuity of his right hand symptomatology. A rationale should be offered for any opinion provided. 4. Forward the claims file to the clinician who performed the March 2013 examination or, if unavailable, an appropriate clinician for an opinion as to the current nature and etiology of any right or left ankle disorder. The record, to include a complete copy of this Remand, must be made available to the clinician. The need for additional examination is left to the discretion of the clinician. Thereafter, the clinician should address the following inquiries: (A) Identify all current right and/or left ankle disorders. In this regard, the examiner should address the March 2013 finding of bilateral shin splints and X-ray impression of slight medial tilt to the talus in both ankles. If a diagnosis referable to the left and/or right ankle is not found, the examiner should indicate whether the Veteran’s reported subjective complaints result in functional impairment of his earning capacity. If so, the examiner is advised that he or she should assume that the Veteran’s has a right and/or left ankle disability for VA purposes for addressing the below opinion. (B) For each current right and/or left ankle disability, offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that such is related to the Veteran’s military service, to include the in-service parachute jumps. In offering any opinion, the examiner should consider the Veteran’s statements regarding the onset and continuity of his ankle symptomatology. A rationale should be offered for any opinion provided. 5. Provide the Veteran and his representative with a statement of the case regarding the issues of entitlement to an initial rating in excess of 20 percent for left shoulder impingement syndrome prior to June 7, 2016, and in excess of 10 percent thereafter for left shoulder degenerative joint disease and entitlement to an initial rating in excess 10 percent for cervical strain with supraspinatus spasm prior to June 7, 2016, and for cervical spine degenerative joint disease thereafter. Advise them of the time period in which to perfect an appeal. If the Veteran perfects his appeal of such issue in a timely fashion, then return the case to the Board for its review, as appropriate. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. M. Celli, Counsel