Citation Nr: 21063251 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 15-32 716 DATE: October 13, 2021 REMANDED Entitlement to an initial disability rating in excess of 20 percent for cervical spine disability is remanded. REASONS FOR REMAND The Veteran served in the United States Army on active duty from December 1981 to January 2002. The issue comes before the Board of Veterans' Appeals (Board) on appeal from a June 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in January 2019. A transcript of the hearing has been included with the record. The issue was previously before the Board in February 2019 and September 2020. The Board remanded to provide for further development. In an August 2021 rating decision, the RO granted an increased initial rating of 20 percent for the Veteran's cervical spine disability, effective August 31, 2010. As the full benefit was not granted, the Veteran's claim remains on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Although the Board regrets further delay, another remand is necessary to provide the Veteran with every possible consideration. Further development is necessary prior to appellate review to provide the Veteran with an adequate VA medical opinion addressing radicular symptoms and neurological abnormalities associated with the Veteran's cervical spine disability, to include cervical strain and degenerative disc disease. Entitlement to an initial disability rating in excess of 20 percent for cervical spine disability is remanded. The Veteran contends that his cervical spine disability manifested as symptoms so severe warranting an increased initial disability rating. The Board must consider all theories of entitlement either expressly raised by the claimant or which are reasonably raised by the record. See Robinson v. Shinseki, 557 F.3d 1355, 1362 (Fed. Cir. 2009). Further, Note (1) of the General Rating Formula for Diseases and Injuries of the Spine states that VA shall evaluate any associated objective neurologic abnormalities separately, under an appropriate diagnostic code. 38 C.F.R. § 4.71a. A review of the evidence of record reveals the Veteran experienced neurological abnormalities related to his cervical spine disability through the period on appeal. The Veteran's November 2010 VA cervical spine evaluation reported the Veteran experienced numbness and paresthesias in all five fingers of each hand. The VA examiner noted the Veteran had radiating pain, described as dull and sharp, down the entirety of both arms. The examination noted the etiology of the neurological symptoms were related to the Veteran's claimed cervical disability. Further, the Veteran's reflex examination reported hypoactive findings for the Veteran's bilateral biceps, triceps, and brachioradialis. The Veteran's reflex examination noted the Veteran's finger jerk reflex was absent in both hands. Additionally, the Veteran's December 2011 VA primary care physician noted that the Veteran complained of pulsating tingling and numbness in the left hand. The medical treatment record noted the Veteran experienced neck pain and pressure with radiating pain down his arms. Further, the Veteran's November 2019 VA examination noted spasm on the right side of the neck, and the Veteran reported pressure inside his neck. Without a medical opinion that clearly addresses the relevant facts and medical science, the Board is left to rely on its own lay opinion, which it is forbidden from doing. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Here, the Board finds remand is needed to provide the Veteran an adequate examination and medical opinion addressing the Veteran's radicular symptoms, throughout the period on appeal. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination with an appropriate examiner to address the Veteran's service-connected cervical spine disability. The record and a copy of this Remand must be made available to the examiner. The examination may be conducted via telehealth or similar service during the social distancing restrictions of the COVID-19 pandemic. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail. Notably, the VA examiner must address the Veteran's associated objective neurologic abnormalities, including, but not limited to, radiating pain, pressure, numbness, and paresthesias, affecting the Veteran's upper extremities. For the purposes of this examination, the examiner must provide a medical opinion as to the Veteran's radicular symptoms found in the November 2010 VA examination and December 2011 VA medical treatment record. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the appropriate rating criteria. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A.V. Bona, 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.