Citation Nr: 18108572 Decision Date: 06/05/18 Archive Date: 06/05/18 DOCKET NO. 14-37 555 DATE: June 5, 2018 REMANDED Entitlement to service connection for a right arm condition, to include as secondary to cervical spine, is remanded. Entitlement to service connection for right hand grip disability is remanded. Entitlement to service connection for left hand grip disability is remanded. Entitlement to service connection for radiculopathy of the left upper extremity is remanded. Entitlement to service connection for radiculopathy of the right upper extremity is remanded. Entitlement to an increased rating greater than 30 percent for osteoarthritis of the cervical spine with spurring, stenosis, annular tear, and decreased disc height is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1990 to May 1994. Entitlement to an increased rating greater than 30 percent for osteoarthritis of the cervical spine with spurring, stenosis, annular tear, and decreased disc height, entitlement to service connection for a right arm condition, secondary to cervical spine, left and right hand decreased hand grip, and radiculopathy of the bilateral upper extremities are all remanded. The Veteran testified at a December 2017 videoconference hearing that since her last VA examination in 2013, her cervical spine condition has worsened. She described having major pain when turning her neck too far or pushing down too hard when getting up. She said her neck locks up when turning her head while driving. She testified that she took hot showers upon waking and when returning home from work just to loosen up her neck muscles. She further complained that she was experiencing associated headaches a few times a week. The Veteran has also submitted evidence that over the last two to three years she has lost over five hundred (500) leave without pay hours due to her neck condition. She works as an account representative and is required to look up at her computer and then back down at paperwork which causes her pain. She testified to having to stand every 20 to 30 minutes while working, to give her neck some relief. The Veteran also contends that her neck condition has caused pain, tingling, and numbness in her bilateral upper extremities, to include decreased hand grip in both of her hands. At that time of the 2013 VA examination, an EMG was conducted and the VA examiner determined the Veteran did not suffer from radiculopathy of the bilateral upper extremities. However, the Veteran has continued to complain of numbness, tingling and pain in her bilateral arms and hands. The Veteran described the feeling of needle points in her arms and hands. She argues that her ability to grip with each hand has decreased. She testified during the December 2017 videoconference hearing, that she also suffers from headaches a few times a week. She testified that she is currently prescribed a muscle relaxer and a “nerve” pill. See December 2017 Hearing Transcript at page 5. The Veteran states these symptoms have all worsened since her 2013 VA examination. As noted above, evidence of a change in the condition or allegation of worsening of the condition renders an examination inadequate for rating purposes. Palczewski v. Nicholson, 21 Vet. App. 174, 182 (2007); see also Proscelle v. Derwinski, 2 Vet. App. 629 (1992). Given the Veteran’s assertion that her cervical spine disability currently includes symptoms related to bilateral upper extremity radiculopathy, to include decreased grip and pain in the bilateral hands, the Board finds that a remand is warranted for a new VA examination. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2017). As such, the Veteran is to be afforded a VA examination to determine the current nature and severity of her cervical spine disorder and the origin of her symptoms of pain, numbness, tingling and decreased grip strength in her bilateral upper extremities. The matters are REMANDED for the following action: 1. Obtain and associate all outstanding VA and private medical records relevant to the claimed conditions with the claims file. 2. Schedule the Veteran for an appropriate VA examination to fully assess the severity of her service connected cervical spine disorders. If the Veteran agrees, the examiner shall conduct an EMG to determine whether the Veteran suffers from radiculopathy of the bilateral upper extremities, to include pain and decreased grip strength in bilateral hands and numbness in right fingers. The examiner must diagnose all current cervical spine disabilities. The examiner should review pertinent documents in the Veteran’s claims file and this Remand in connection with the examination. All indicated studies should be completed, and all pertinent symptomatology and findings must be reported in detail. The examiner should conduct range of motion studies and assess any functional impairment due to such factors as pain and weakness, and express this functional impairment in terms of further loss of motion. The examiner should test the range of motion in active motion, passive motion, weight-bearing, and non-weight-bearing. 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. If it is determined the Veteran does not have radiculopathy of the bilateral upper extremities or any other nerve conditions, the examiner must address the Veteran’s complaints regarding numbness, tingling and pain in the bilateral extremities, to include pain and decreased grip strength in the bilateral hands and numbness in the right fingers. A complete rationale which includes citation to any relevant facts, evidence, or medical principles must be provided for all opinions rendered. (Continued on the next page)   3. Thereafter, readjudicate the issues on appeal. If the benefits sought are not granted, the Veteran should be furnished a supplemental statement of the case and be afforded a reasonable opportunity to respond before the record is returned to the Board for further review. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. N. Shannon, Associate Counsel