Citation Nr: 21067747 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 16-11 560A DATE: November 5, 2021 REMANDED Entitlement to a rating in excess of 20 percent for a left lower extremity femoral nerve radiculopathy is remanded. Entitlement to a rating in excess of 20 percent for a right lower extremity femoral nerve radiculopathy is remanded. Entitlement to a rating in excess of 40 percent for left lower extremity sciatic nerve radiculopathy, prior to October 3, 2018, and in excess of 60 percent, thereafter, is remanded. Entitlement to a rating in excess of 40 percent for right lower extremity sciatic nerve radiculopathy, prior to October 3, 2018, and in excess of 60 percent, thereafter, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1965 through December 1968. This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from August 2017, January 2019, May 2020, September 2021 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In September 2018, the Board remanded these matters to the Agency of Original Jurisdiction (AOJ) for additional development. The appeal has since returned to the Board. 1. Entitlement to a rating in excess of 20 percent for a left lower extremity femoral nerve radiculopathy is remanded. 2. Entitlement to a rating in excess of 20 percent for a right lower extremity femoral nerve radiculopathy is remanded. 3. Entitlement to a rating in excess of 40 percent for left lower extremity sciatic nerve radiculopathy, prior to October 3, 2018, and in excess of 60 percent, thereafter, is remanded. 4. Entitlement to a rating in excess of 40 percent for right lower extremity sciatic nerve radiculopathy, prior to October 3, 2018, and in excess of 60 percent, thereafter, is remanded. The Veteran has disability ratings of 20 percent for each of his bilateral lower extremities for femoral nerve radiculopathy. He is also assigned 40 percent disability ratings for each bilateral lower extremity for sciatic nerve radiculopathy, prior to October 3, 2018, and 60 percent thereafter. He disagrees with the ratings assigned. In a May 2021 VA examination, the VA examiner opined that the Veteran had incomplete moderately severe paralysis of the sciatic nerve and moderate incomplete paralysis of the femoral nerve. The examination also documented that the Veteran had 0 of 5 muscle strength in his ankles and 1 of 5 strength in his knee extension. He had absent reflexes in his knees and ankles bilaterally. His thigh and lower leg sensation was decreased and sensation in his foot and toes were absent. The Veteran was wheelchair bound and unable to ambulate. The examiner detailed that the Veteran had multiple neuropathy and radiculopathies, to include sciatic, femoral, and obturator radiculopathies with IVDS. He had moderate loss of lower extremity functioning and significant pain while sitting in his wheelchair. In a January 2021 addendum opinion, the VA examiner detailed that the Veteran had moderate to severe loss of motor function both lower extremities. He also had minimal to no motor function in his ankles and knees. Further, the Veteran appeared to have no ankle or plantar flexion and marked diminished motor function of the knee. Based on the May 2021 and January 2019 narrative explanations, it appears that the "moderately severe" and "moderate" severity designations given for the Veteran's bilateral sciatic and femoral nerve radiculopathies are inconsistent with the objective findings and statements indicating the Veteran has absent reflexes and sensations affecting his lower extremities. Moreover, the characterization that the Veteran had no ankle dorsiflexion or plantar flexion and marked diminished motor functioning in the knees appear to indicate a greater severity rating for the Veteran's sciatic and/or femoral radiculopathies may be warranted. The Board notes, however, that the VA examiner has indicated that the Veteran has multiple neuropathy and radiculopathies, including bilateral femoral and sciatic radiculopathies. Thus, it is unclear whether the diminished objective findings should be attributed solely to the Veteran's service-connected bilateral lower extremity sciatic and femoral radiculopathies, or to which disability causes each limitation. Thus, further development is necessary. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from the appropriate clinician to consider whether the Veteran's lower extremity limitations noted in the May 2021 VA examination, to include reduced motor functioning, decreased sensory findings, foot drop, and diminished reflexes, are solely attributable to the Veteran's sciatic and femoral radiculopathy disabilities. To the extent possible, the clinician should specifically identify which symptoms are attributable to the Veteran's bilateral lower extremity sciatic nerve radiculopathy and which are attributable to his bilateral lower extremity femoral nerve radiculopathy. If it is found that the Veteran's lower extremity limitations are attributable to a non-service-connected disability, for each identified, the examiner is asked to opine whether it is at least as likely as not (i.e. probability of 50 percent or greater) related to the Veteran's service, or caused or aggravated by a service-connected disability. Lastly, the clinician is asked to reevaluate the severity of the Veteran's bilateral lower extremity sciatic and femoral nerve radiculopathies and any other disability found. Bethany L. Buck Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N.B. Mmeje, 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.