Citation Nr: 18159804 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 18-13 861 DATE: December 20, 2018 REMANDED Entitlement to service connection for multiple myeloma is remanded. Entitlement to a rating in excess of 10 percent for the service-connected lumbar spine, intervertebral disc syndrome, and arthritis (lumbar spine disability) is remanded. Entitlement to a rating in excess of 10 percent for the service-connected right lower extremity radiculopathy is remanded. Total disability rating based upon individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran had active duty from April 1956 to October 1976. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. In May 2018, the Board restored service connection for the Veteran’s lumbar spine disability and right lower extremity radiculopathy and remanded the issues of entitlement to increased ratings for these disabilities. In August 2018, the Veteran presented sworn testimony at a hearing before the undersigned. During the hearing, the Veteran raised the issue of whether he was unemployable due, in part, to his service-connected lumbar spine disability and radiculopathy. The Board takes jurisdiction of the issue of entitlement to a TDIU because it is part and parcel to the issues on appeal. Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009). This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c) (2017). 1. Entitlement to service connection for multiple myeloma is remanded. The Veteran relates his current multiple myeloma to in-service exposure to ionizing radiation while working on aircraft radar and along the flight line. See, e.g., Board hearing transcript (August 2018). As multiple myeloma is a radiogenic disease, remand is needed to obtain a dose estimate and perform any additionally development necessary to evaluate the Veteran’s claim in light of 38 C.F.R. § 3.311 (2017). 2. Entitlement to a rating in excess of 10 percent for the service-connected lumbar spine disability is remanded. 3. Entitlement to a rating in excess of 10 percent for the service-connected right lower extremity radiculopathy is remanded. While the record contains a contemporaneous VA examination regarding the Veteran’s lumbar spine disability and right lower extremity, such does not comply with the requirements in Sharp v. Shulkin, 29 Vet. App. 26, 34-36 (2017). The examiner did not provide sufficient information regarding the Veteran’s flare-ups and any additional functional loss suffered during flare-ups. Indeed, the Veteran reported additional functional loss due due to flare-ups during the Board hearing. 4. Total disability rating based upon individual unemployability due to service-connected disabilities (TDIU) is remanded. The Veteran’s claim for TDIU is also remanded, as it is inextricably intertwined with his claims for higher ratings. The matters are REMANDED for the following action: 1. Undertake all steps necessary for review and action pursuant to 38 C.F.R. § 3.311, to include, but not limited to, obtaining a dose estimate. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his multiple myeloma. The examiner must opine whether it is at least as likely as not that the multiple myeloma is related to an in-service injury, event, or disease, including exposure to ionizing radiation while working on aircraft radar and along the flight line. 3. Schedule the Veteran for an examination of the current severity of his lumbar spine disability and right lower extremity radiculopathy. The examiner must test the Veteran’s active motion, passive motion, and pain with weight-bearing and without weight-bearing. The examiner must also 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 each disability alone and discuss the effect of such 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). STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Joshua Castillo, Counsel