Citation Nr: 20002940 Decision Date: 01/14/20 Archive Date: 01/13/20 DOCKET NO. 17-08 185 DATE: January 14, 2020 ORDER Service connection for bilateral lower extremity radiculopathy is denied. REMANDED A rating in excess of 30 percent for status/post total left knee replacement. Service connection for hypertension. FINDINGS OF FACT 1. The Veteran had active service from May 1968 to September 1969. 2. Lower extremity radiculopathy was not shown in service, is not causally or etiologically related to service, and was not caused by or permanently worsened in severity by a service-connected disability. CONCLUSION OF LAW Bilateral lower extremity radiculopathy was not incurred in service and is not proximately due to, aggravated by, or the result of a service-connected disability. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.310 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSION Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). The Veteran contends that bilateral lower extremity radiculopathy is related to service. Turning to the medical evidence, VA examinations in August 2014 and December 2018 weigh against the Veteran’s claim as the examiners found no signs or symptoms of radiculopathy. Further, a VA treatment note from September 2013 indicated no signs of radiculopathy. In support of the claim, an August 2015 VA treatment record noted lumbar radiculopathy of the extremities. Further, a private physician diagnosed the Veteran with lumbar radiculopathy with numbness, tingling, and weakness radiating to both legs in January 2014. As such, the evidence is in relative equipoise as to the presence of a current disability. For purposes of this decision, a current diagnosis of radiculopathy is shown and the first element of service connection is met. As to in-service incurrence, the service treatment records (STRs) do not show complaints of, treatment for, or diagnoses of radiculopathy during service or any symptoms reasonably associated with nerve pain or a back injury or disorder. Further, clinical assessment of the lower extremities in the July 1979 separation examination related only to a knee injury but did not report any symptoms associated with radiculopathy. As such, the medical evidence does not support the second element of service connection as an in-service incurrence was not shown. Next, the Veteran contends that his service-connected left knee affects his entire body, including his back and lower extremities. As he has a current diagnosis of radiculopathy of the BLE and is already service-connected for a left knee disability, the first two elements of secondary service connection are met. Turning to nexus, an August 2014 VA examiner opined that the Veteran’s bilateral leg numbness was less likely as not related to a service-connected left knee disability. He reasoned that medical literature did not support a connection between left knee degenerative joint disease, status/post replacement, and neurogenic claudication. Rather, the examiner attributed lower extremity numbness to the nonservice-connected lumbar stenosis. There is no contradictory medical evidence. As such, the medical evidence does not support a nexus between radiculopathy and a service-connected disability. The Board has considered the Veteran’s lay statements that his disorder was caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (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). REASONS FOR REMAND The Board denied an increased rating for a left knee disability and service connection for hypertension in an August 2018 decision. The Veteran appealed and in July 2019, the Court Clerk granted a Joint Motion for Remand (JMR), vacating the Board’s decision and remanding the matters for action consistent with the JMR. Pursuant to the JMR, a remand is required to schedule a new examination to address the left knee disability and hypertension. The matters are REMANDED for the following actions: 1. Obtain any outstanding private and VA treatment records and associate them with the claims file. 2. Schedule the Veteran for an examination to assess the severity of his left knee disability. The examiner is asked to offer an opinion as to the following: • whether pain associated with the left knee disability could limit functional ability during flare-ups or during periods of repeated use, noting the degree of additional range of motion loss due to pain on use or during flare-ups. 3. Schedule the Veteran for an examination to determine the etiology of hypertension. The examiner is asked to address the following: • Is it at least as likely as not (50 percent or greater probability) that hypertension is due to or aggravated by service-connected diabetes mellitus? • Is it at least as likely as not (50 percent or greater probability) that hypertension is directly due to herbicide exposure, to include Agent Orange? A full rationale must be included for all opinions provided. L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Kokolas, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.