Citation Nr: 18159445 Decision Date: 12/19/18 Archive Date: 12/19/18 DOCKET NO. 16-15 195A DATE: December 19, 2018 ORDER Entitlement to service connection for a bilateral hip disability, including as due to a service-connected lumbosacral spine disability, is denied. Entitlement to service connection for a bilateral shoulder disability, including as due to a service-connected lumbosacral spine disability, is denied. Entitlement to service connection for bilateral knee osteoarthritis, including as due to a service-connected lumbosacral spine disability, is denied. Entitlement to service connection for a bilateral ankle disability, including as due to a service-connected lumbosacral spine disability, is denied. Entitlement to service connection for bilateral lower extremity radiculopathy, including as due to a service-connected lumbosacral spine disability, is denied. Entitlement to service connection for bilateral upper extremity radiculopathy, including as due to a service-connected lumbosacral spine disability, is denied. Entitlement to an acquired psychiatric disability other than posttraumatic stress disorder (PTSD), to include major neurocognitive disorder and Alzheimer's Disease, is denied. REMANDED Entitlement to a cervical spine disability, including as due to a service-connected lumbosacral spine disability, is remanded. Entitlement to service connection for cardiovascular disease is remanded. Entitlement to service connection for a gastrointestinal disability, to include gastroesophageal reflux disease (GERD), is remanded. Entitlement to service connection for a prostate disability is remanded. Entitlement to a disability rating greater than 40 percent for a lumbosacral spine disability is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. FINDINGS OF FACT 1. The record evidence shows that the Veteran’s current bilateral hip disability, bilateral shoulder disability, bilateral knee osteoarthritis, bilateral ankle disability, and bilateral lower extremity radiculopathy are not related to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. 2. The record evidence shows that the Veteran does not experience any current disability due to his claimed bilateral upper extremity radiculopathy which is related to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. 3. The record evidence shows that the Veteran’s current acquired psychiatric disability other than PTSD, to include major neurocognitive disorder and Alzheimer’s Disease, is not related to active service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a bilateral hip disability, including as due to a service-connected lumbosacral spine disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304, 3.310 (2017). 2. The criteria for entitlement to service connection for a bilateral shoulder disability, including as due to a service-connected lumbosacral spine disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304, 3.310 (2017). 3. The criteria for entitlement to service connection for bilateral knee osteoarthritis, including as due to a service-connected lumbosacral spine disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304, 3.310 (2017). 4. The criteria for entitlement to service connection for a bilateral ankle disability, including as due to a service-connected lumbosacral spine disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304, 3.310 (2017). 5. The criteria for entitlement to service connection for bilateral lower extremity radiculopathy, including as due to a service-connected lumbosacral spine disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304, 3.310 (2017). 6. The criteria for entitlement to service connection for bilateral upper extremity radiculopathy, including as due to a service-connected lumbosacral spine disability, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304, 3.310 (2017). 7. The criteria for entitlement to an acquired psychiatric disability other than PTSD, to include major neurocognitive disorder and Alzheimer’s Disease, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2012); 38 C.F.R. §§ 3.303, 3.304 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from September 1953 to August 1955 in the U.S. Army. He also had additional unverified U.S. Army Reserve service. The Appellant, his wife, was appointed his fiduciary for VA adjudication purposes in September 2016. Service Connection The Veteran contends that he incurred a bilateral hip disability, a bilateral shoulder disability, bilateral knee osteoarthritis, a bilateral ankle disability, bilateral lower extremity radiculopathy, bilateral upper extremity radiculopathy, and an acquired psychiatric disability during active service and experienced continuous disability due to each of these claimed disabilities since his service separation. He alternatively contends that his service-connected lumbosacral spine disability caused or aggravated (permanently worsened) his claimed bilateral hip disability, bilateral shoulder disability, bilateral knee osteoarthritis, bilateral ankle disability, bilateral lower extremity radiculopathy, and bilateral upper extremity radiculopathy. Neither the Veteran nor his representative has raised any other issues nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that Board not required to address issues unless specifically raised by claimant or reasonably raised by record evidence). Having reviewed the record evidence, the Board finds that these issues should be characterized as stated above. 1. Entitlement to service connection for a bilateral hip disability, a bilateral shoulder disability, bilateral knee osteoarthritis, a bilateral ankle disability, and for bilateral lower extremity radiculopathy, each including as due to a service-connected lumbosacral spine disability The Board finds that the preponderance of the evidence is against granting the Veteran’s claims of service connection for a bilateral hip disability, a bilateral shoulder disability, bilateral knee osteoarthritis, a bilateral ankle disability, and for bilateral lower extremity radiculopathy, each including as due to a service-connected lumbosacral spine disability. Contrary to the Veteran’s lay assertions, the record evidence shows that each of these disabilities is related to the natural aging process and is not related to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. For example, the Veteran’s available service treatment records show no complaints of or treatment for any of these claimed disabilities during active service. The Board notes that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (finding lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim); Barr v. Nicholson, 21 Vet. App. 303 (2007) ("Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms"). The post-service evidence also does not support granting the Veteran’s claims of service connection for a bilateral hip disability, a bilateral shoulder disability, bilateral knee osteoarthritis, a bilateral ankle disability, and for bilateral lower extremity radiculopathy, each including as due to a service-connected lumbosacral spine disability. It shows instead that, although the Veteran has complained of and been treated for each of these claimed disabilities since his service separation, none of them are related to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. For example, on VA back (thoracolumbar spine) conditions Disability Benefits Questionnaire (DBQ) in January 2014, the Veteran’s complaints included worsening low back pain with limited ambulation and back bending and bilateral leg numbness. The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. The Veteran denied experiencing any flare-ups of low back pain. He was unable to perform repetitive range of motion testing because his back cracked during the initial range of motion evaluation “and he developed severe pain.” Physical examination in January 2014 showed tenderness to palpation in the bilateral lumbosacral muscles, muscle spasm of the thoracolumbar spine severe enough to result in abnormal gait or abnormal spinal contour, guarding of the thoracolumbar spine resulting in abnormal gait or abnormal spinal contour, 5/5 muscle strength in the hips and knees, 4/5 muscle strength in the ankles and great toes, no muscle atrophy, normal deep tendon reflexes, normal sensation in the thighs and knees, decreased sensation in the lower legs/ankles and foot/toes, positive straight leg raising bilaterally, moderate intermittent pain of the bilateral lower extremities, severe paresthesias and/or dysesthesias of the bilateral lower extremities, moderate numbness of the bilateral lower extremities, moderate bilateral radiculopathy of the sciatic nerves, and no ankylosis or intervertebral disc syndrome. The Veteran constantly used a cane for ambulation due to his back and bilateral knees. X-rays showed traumatic arthritis. The VA examiner opined that it was less likely than not that the Veteran’s current lumbosacral spine disability is related to active service. The rationale for this opinion was that this disability instead was at least as likely as not related to “the natural aging process. There is no evidence that a muscle strain can cause degenerative changes or intervertebral disc syndrome.” This examiner also opined that it was less likely than not that the Veteran’s bilateral lower extremity radiculopathy is related to active service. The rationale for this opinion was that the Veteran’s bilateral lower extremity radiculopathy was related to intervertebral disc syndrome because “it can cause nerve impingement.” The diagnoses included bilateral radiculopathy. On VA knee and lower leg conditions DBQ in November 2014, the Veteran’s complaints included bilateral knee pain since active service. The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. The Veteran reported experiencing flare-ups of knee pain when kneeling and on prolonged ambulation and standing. He also reported experiencing loss of ambulation tolerance. Physical examination of the knees showed 5/5 muscle strength, and no muscle atrophy, ankylosis, or joint instability. X-rays of the knees showed left knee traumatic arthritis. The diagnosis was bilateral knee osteoarthritis. On VA hip and thigh conditions DBQ in March 2015, the Veteran’s complaints included “occasional hip pain associated with repetitive rotation of the waist.” The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. He denied experiencing flare-ups of hip pain. Physical examination of the hips showed less movement than normal, 5/5 muscle strength, and no muscle atrophy, ankylosis, malunion or nonunion of the femur, flail hip joint, or leg length discrepancy. X-rays showed traumatic arthritis in both hips. The diagnoses were bilateral hip calcific tendinosis and degenerative changes of the hips by x-ray. On VA shoulder and arm conditions DBQ in March 2015, the Veteran’s complaints included bilateral hip “pain associated with overhead movements.” The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. He was right-hand dominant. Physical examination of the shoulders showed less movement than normal, 5/5 muscle strength, and no muscle atrophy, ankylosis, rotator cuff condition, shoulder instability, dislocation, or labral pathology, loss of head, nonunion, or fibrous union of the humerus, malunion of the humerus. X-rays showed traumatic arthritis of both shoulders. The diagnoses were bilateral calcific tendinosis and degenerative changes by x-ray. On VA back (thoracolumbar spine) conditions DBQ in March 2015, the Veteran’s complaints included episodes of bilateral leg numbness. The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. Physical examination showed muscle spasm and localized tenderness not resulting in abnormal gait or abnormal spinal contour, no guarding, 5/5 muscle strength in the hips and knees, 4/5 muscle strength in the ankles and great toes, normal deep tendon reflexes, decreased sensation in the lower legs/ankles and feet/toes, positive straight leg raising bilaterally, mild constant pain of the bilateral lower extremities, moderate intermittent pain of the bilateral lower extremities, severe paresthesias and/or dysesthesias of the bilateral lower extremities, moderate numbness of the bilateral lower extremities, moderate bilateral radiculopathy, and no intervertebral disc syndrome. X-rays showed arthritis. The diagnoses included bilateral radiculopathy. On VA ankle conditions DBQ in March 2015, the Veteran’s complaints included constant bilateral ankle pain which worsened “with prolonged ambulation.” The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. Physical examination of the ankles showed less movement than normal, 5/5 muscle strength, and no muscle atrophy, ankylosis, or instability or dislocation. X-rays showed bilateral ankle arthritis. There was objective evidence of bilateral ankle crepitus. The diagnosis was degenerative arthritis of the bilateral ankles. In a lengthy series of opinions dated in March 2015, the VA examiner who conducted the Veteran’s VA examinations completed that same month opined that it was less likely than not that his current bilateral hip disability, bilateral shoulder disability, bilateral knee osteoarthritis, bilateral ankle disability, or bilateral lower extremity radiculopathy was related to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. The rationale for each of the opinions provided by this VA examiner was that the Veteran’s multiple orthopedic disabilities examined in March 2015 were normal expected changes as a result of the aging process. This examiner also found that each of the Veteran’s multiple orthopedic disabilities examined in March 2015 was a different disease entity than his service-connected lumbosacral spine disability “with different pathophysiological processes unrelated to each other.” On VA back (thoracolumbar spine) conditions DBQ in October 2015, the Veteran’s complaints included “bilateral distal lower extremities muscle cramps and numbness sensation which gets worse when walking.” The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. Physical examination showed guarding and localized tenderness in the lumbar paravertebral muscles not resulting in abnormal gait or abnormal spinal contour, 5/5 muscle strength in the hips and knees, 4/5 muscle strength in the ankles and great toes, no muscle atrophy, normal reflexes in the knees, absent reflexes in the ankles, decreased sensation in the lower legs/ankles and feet/toes, negative straight leg raising bilaterally, mild constant pain of the bilateral lower extremities, moderate intermittent pain of the bilateral lower extremities, moderate paresthesias and/or dysesthesias of the bilateral lower extremities, moderate numbness of the bilateral lower extremities, moderate bilateral radiculopathy, no ankylosis, and intervertebral disc syndrome with episodes of bed rest of between 2-4 weeks in the previous 12 months. The Veteran wore a lumbar brace. The VA examiner opined that it was less likely than not that the Veteran’s bilateral lower extremity radiculopathy was related to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. The rationale for this opinion was a review of medical literature which showed that lumbar radiculopathy is due to degenerative arthritis of the spine and intervertebral disc syndrome, both of which were considered part of the normal aging process in patients more than 40 years old. The diagnoses included bilateral radiculopathy. The Veteran contends that he incurred a bilateral hip disability, a bilateral shoulder disability, bilateral knee osteoarthritis, a bilateral ankle disability, and bilateral lower extremity radiculopathy during active service. He alternatively contends that his service-connected lumbosacral spine disability caused or aggravated (permanently worsened) each of his current orthopedic disabilities. Contrary to these lay assertions, the record evidence shows instead that the Veteran’s current bilateral hip disability, bilateral shoulder disability, bilateral knee osteoarthritis, bilateral ankle disability, and bilateral lower extremity radiculopathy are not related to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. Multiple VA examiners opined in November 2014, March 2015, and in October 2015 that the Veteran’s current bilateral hip disability, bilateral shoulder disability, bilateral knee osteoarthritis, bilateral ankle disability, and bilateral lower extremity radiculopathy were part of the normal aging process and were not related to active service, including as due to a service-connected lumbosacral spine disability. All of these opinions were fully supported. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (finding that a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). The Veteran finally has not identified or submitted any evidence demonstrating that a bilateral hip disability, a bilateral shoulder disability, bilateral knee osteoarthritis, a bilateral ankle disability, or bilateral lower extremity radiculopathy is related to active service, including as due to a service-connected lumbosacral spine disability. In summary, the Board finds that service connection for a bilateral hip disability, a bilateral shoulder disability, bilateral knee osteoarthritis, a bilateral ankle disability, and for bilateral lower extremity radiculopathy, each including as due to a service-connected lumbosacral spine disability, is not warranted. 2. Entitlement to service connection for bilateral upper extremity radiculopathy, including as due to a service-connected lumbosacral spine disability The Board next finds that the preponderance of the evidence is against granting the Veteran’s claim of service connection for bilateral upper extremity radiculopathy, including as due to a service-connected lumbosacral spine disability. The Veteran essentially contends that he incurred bilateral upper extremity radiculopathy during active service and experienced continuous disability due to this claimed disability since his service separation. He alternatively contends that his service-connected lumbosacral spine disability caused or aggravated his claimed bilateral upper extremity radiculopathy. The record evidence does not support his assertions regarding the existence of any current disability due to his claimed bilateral upper extremity radiculopathy which could be attributed to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. It shows instead that the Veteran does not experience any current disability due to his claimed bilateral upper extremity radiculopathy which could be attributed to service. For example, the Veteran’s available service treatment records show no complaints of or treatment for bilateral upper extremity radiculopathy during active service although this is not necessarily fatal to his claim. See Buchanan, 451 F.3d at 1337, and Barr, 21 Vet. App. at 303. The post-service evidence also does not support granting the Veteran’s service connection claim for bilateral upper extremity radiculopathy, including as due to a service-connected lumbosacral spine disability. Contrary to the Veteran’s lay assertions, it shows that he does not experience any current disability due to his claimed bilateral upper extremity radiculopathy which could be attributed to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. A review of the Veteran’s voluminous post-service VA outpatient treatment records shows no complaints of or treatment for his claimed bilateral upper extremity radiculopathy since his service separation several decades ago. The Board finds it highly persuasive that, on VA neck (cervical spine) conditions DBQ in March 2015, the VA examiner specifically found that there was no evidence of bilateral cervical radiculopathy on physical examination of the Veteran. This persuasively suggests that the Veteran does not experience any current disability due to his claimed bilateral upper extremity radiculopathy which could be attributed to active service. A service connection claim must be accompanied by evidence which establishes that the claimant currently has a disability. Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Service connection is not warranted in the absence of proof of current disability. The Board has considered whether the Veteran experienced bilateral upper extremity radiculopathy at any time during the pendency of this appeal. Service connection may be granted if there is a disability at some point during the claim even if it later resolves or becomes asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007). In this case, however, there is no evidence – other than the Veteran’s lay assertions – that he experienced any bilateral upper extremity radiculopathy which could be attributed to active service or any incident of service, including as due to a service-connected lumbosacral spine disability. The Veteran finally has not identified or submitted any evidence demonstrating his entitlement to service connection for a cervical spine disability, including as due to his service-connected lumbosacral spine disability. In summary, the Board finds that service connection for a cervical spine disability, including as due to a service-connected lumbosacral spine disability, is not warranted. 3. Entitlement to an acquired psychiatric disability other than PTSD, to include major neurocognitive disorder and Alzheimer’s Disease The Board finally finds that the preponderance of the evidence is against granting the Veteran’s claim of service connection for an acquired psychiatric disability other than PTSD, to include major neurocognitive disorder and Alzheimer’s Disease. The Veteran essentially contends that his current acquired psychiatric disability is related to active service. The record evidence does not support the Veteran’s lay assertions of an etiological link between any current acquired psychiatric disability and active service. It shows instead that, although the Veteran has been diagnosed as having and treated for a variety of acquired psychiatric disabilities since his service separation, to include major neurocognitive disorder and probable Alzheimer’s Disease, no current acquired psychiatric disability is related to his active service. For example, the Veteran’s available service treatment records show no complaints of or treatment for any acquired psychiatric disability during active service although this is not necessarily fatal to his claim. See Buchanan, 451 F.3d at 1337, and Barr, 21 Vet. App. at 303. The post-service evidence also does not support granting the Veteran’s service connection claim for an acquired psychiatric disability other than PTSD, to include major neurocognitive disorder and Alzheimer’s Disease. Contrary to his lay assertions, it shows instead that, although he has been diagnosed as having and treated for a variety of acquired psychiatric disabilities since his service separation, to include major neurocognitive disorder and probable Alzheimer’s Disease, no current acquired psychiatric disability is related to his active service. For example, on VA PTSD DBQ in January 2016, no relevant complaints were noted. The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. The Veteran had been married twice and lived with his second wife in his own home. His reported symptoms included impairment of short-term and long-term memory, memory loss for names of close relatives, own occupation, or own name, difficulty in adapting to stressful circumstances, spatial disorientation, and disorientation to time and place. The Veteran appeared mildly confused. His wife reported that the Veteran had memory difficulties, disorientation in familiar surroundings, easy irritability, “repeats questions over and over,” and “word finding difficulties.” A family history of Alzheimer’s Disease was noted. The VA examiner concluded that the Veteran’s symptoms did not meet the diagnostic criteria for a diagnosis of PTSD. The VA examiner opined that it was less likely than not that the Veteran’s current acquired psychiatric disability is related to active service. The rationale for this opinion was that there was “no temporal or circumstantial relationship between” this disability and active service. The diagnoses included major neurocognitive disorder and probable Alzheimer’s Disease. The Veteran contends that his current acquired psychiatric disability is related to active service. The record evidence does not support his assertions concerning an etiological link between any current acquired psychiatric disability (diagnosed as major neurocognitive disorder and probable Alzheimer’s Disease) and active service. The January 2016 VA PTSD DBQ examiner specifically found that this disability is not related to active service. This opinion was fully supported. See Stefl, 21 Vet. App. at 124. The Veteran also has not identified or submitted any evidence demonstrating his entitlement to service connection for an acquired psychiatric disability. In summary, the Board finds that service connection for an acquired psychiatric disability other than PTSD, to include major neurocognitive disorder and Alzheimer’s Disease, is not warranted. REASONS FOR REMAND 1. Entitlement to a cervical spine disability, including as due to a service-connected lumbosacral spine disability, is remanded. The Veteran also contends that he incurred a cervical spine disability during active service or, alternatively, his service-connected lumbosacral spine disability caused or aggravated (permanently worsened) his current cervical spine disability. The Board acknowledges that the Veteran’s cervical spine was examined for VA adjudication purposes in a March 2015 VA neck conditions DBQ. Unfortunately, the March 2015 VA neck conditions DBQ examiner did not provide an opinion concerning the contended etiological relationship between the Veteran’s current cervical spine disability and active service on a direct service connection basis. See also 38 C.F.R. §§ 3.303, 3.304 (2017). Thus, the Board finds that, on remand, the March 2015 VA neck conditions DBQ should be returned to the examiner who completed it or another appropriate clinician for an addendum opinion concerning whether the Veteran’s current cervical spine disability is related directly to active service. 2. Entitlement to service connection for cardiovascular disease, a gastrointestinal disability, to include GERD, and for a prostate disability, is remanded. The Veteran asserts that he incurred cardiovascular disease, a gastrointestinal disability, to include GERD, and a prostate disability during active service and experienced continuous disability due to each of these claimed disabilities since his service separation. The medical evidence shows that the Veteran experiences current disability due to each of these claimed disabilities. To date, however, the AOJ has not scheduled the Veteran for appropriate examination to determine the nature and etiology of each of these claimed disabilities. Because VA’s duty to assist includes providing an examination where necessary, the Board finds that it was error for the AOJ to deny these claims on the merits without first attempting to schedule the Veteran for appropriate examinations. The Board also finds that, on remand, the AOJ should schedule the Veteran for appropriate examination to determine the nature and etiology of his cardiovascular disease, gastrointestinal disability, to include GERD, and prostate disability. 3. Entitlement to a disability rating greater than 40 percent for a lumbosacral spine disability is remanded. The Board acknowledges that the Veteran’s service-connected lumbosacral spine disability was examined most recently for VA adjudication purposes in October 2015. Following this examination, the Court issued a decision in Correia mandating new requirements for VA examinations of musculoskeletal disabilities (including disabilities of lumbosacral spine, as in this case) in order to satisfy judicial review in increased rating claims. See Correia v. McDonald, 28 Vet. App. 158 (2016). The Court held in Correia that the final sentence of 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive motion, in weight-bearing and non weight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. Id.; see also 38 C.F.R. § 4.59. A review of the record evidence shows that the Veteran’s most recent VA examination for the lumbosacral spine in October 2015 did not comply with Correia. For example, there is no indication in the October 2015 VA back (thoracolumbar spine) conditions DBQ whether the range of motion obtained at that examination is active or passive or in weight-bearing or non-weight-bearing. Accordingly, the Board finds that, on remand, the Veteran should be scheduled for updated VA examination to determine the current nature and severity of his service-connected lumbosacral spine disability. See also Southall-Norman v. McDonald, 28 Vet. App. 346 (2016) (finding 38 C.F.R. § 4.59 not limited to diagnostic codes involving range of motion and extending Correia to disabilities involving painful joint or periarticular pathology). 4. Entitlement to a TDIU is remanded. The Veteran finally contends that his service-connected disabilities, alone or in combination, preclude his employability. The Board notes that adjudication of the other claims being remanded in this appeal likely will impact adjudication of the Veteran’s TDIU claim. Thus, the Board finds that the TDIU claim is inextricably intertwined with the other claims being remanded in this appeal and adjudication of the TDIU claim must be deferred. See Henderson v. West, 12 Vet. App. 11, 20 (1998), citing 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 on one issue cannot be rendered until the other issue has been considered). The matters are REMANDED for the following action: 1. Obtain the Veteran’s updated treatment records and associate them with the claims file. If any records obtained are not in English, please have them translated and associate the translations with the claims file. 2. Return the March 2015 VA neck (cervical spine) conditions DBQ to the examiner who completed it or another appropriate clinician for an addendum opinion. In the addendum opinion, the March 2015 VA neck (cervical spine) conditions DBQ examiner or another appropriate clinician is asked to opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s current cervical spine disability is related to active service. A rationale must be provided for any opinion expressed. The March 2015 VA neck (cervical spine) conditions DBQ examiner or another appropriate clinician is advised that the lack of contemporaneous records showing complaints of or treatment for a cervical spine disability, alone, is insufficient rationale for a medical nexus opinion. 3. Schedule the Veteran for an examination to determine the nature and etiology of any cardiovascular disease. The claims file should be provided for review. The examiner is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that cardiovascular disease, if diagnosed, is related to active service or any incident of service. A rationale also should be provided for any opinions expressed. A separate opinion and rationale should be provided for each cardiovascular disease currently experienced by the Veteran, if possible. The examiner is advised that the Veteran suffers from a cognitive disorder. The examiner also is advised that the absence of contemporaneous records showing complaints of or treatment for cardiovascular disease, alone, is insufficient rationale for a medical nexus opinion. 4. Schedule the Veteran for an examination to determine the nature and etiology of any gastrointestinal disability, to include GERD. The claims file should be provided for review. The examiner is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that a gastrointestinal disability, to include GERD, if diagnosed, is related to active service or any incident of service. A rationale also should be provided for any opinions expressed. A separate opinion and rationale should be provided for each gastrointestinal disability currently experienced by the Veteran, if possible. The examiner is advised that the Veteran suffers from a cognitive disorder. The examiner also is advised that the absence of contemporaneous records showing complaints of or treatment for a gastrointestinal disability, alone, is insufficient rationale for a medical nexus opinion. 5. Schedule the Veteran for an examination to determine the nature and etiology of any prostate disability. The claims file should be provided for review. The examiner is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that a prostate disability, if diagnosed, is related to active service or any incident of service. A rationale also should be provided for any opinions expressed. A separate opinion and rationale should be provided for each prostate disability currently experienced by the Veteran, if possible. The examiner is advised that the Veteran suffers from a cognitive disorder. The examiner also is advised that the absence of contemporaneous records showing complaints of or treatment for a prostate disability, alone, is insufficient rationale for a medical nexus opinion. 6. Schedule the Veteran for an examination to determine the current nature and severity of his service-connected lumbosacral spine disability. The examiner is advised that the Veteran suffers from a cognitive disorder. (Continued on the next page)   7. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Michael T. Osborne, Counsel