Citation Nr: 21067907 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 16-54 065 DATE: November 8, 2021 REMANDED Service connection for a cervical spine disorder. Service connection for headaches. Service connection for a left hand disorder. Service connection for a right hand disorder. REASONS FOR REMAND In April 2019, the Board denied the claims on appeal. The Veteran appealed to the Veterans Claims Court. In April 2020, the Court Clerk granted a joint motion for remand (JMR) which vacated the Board's decision. In October 2020, the Board remanded the claims for further development in accordance with the JMR, to include obtaining new examinations to assess the nexuses between his disorders and both service and service-connected disabilities. With regard to the cervical spine disorder, a February 2021 examiner initially opined that the cervical spine disorder was at least as likely as not proximately due a service-connected lumbar spine disability. The examiner found that the cervical symptoms developed as a result of a lumbar spine disorder, but it is unclear whether the statement was objective medical evidence or a restatement of a lay assertion from the Veteran. Upon further consideration in August 2021, the February 2021 opinion was amended to find no medical evidence to support a nexus between the cervical and lumbar spine disorders; however, the amended rationale was based solely upon an absence of medical evidence in the record. Moreover, the examiner did not consider medical articles submitted by the Veteran describing lumbar and cervical spondylosis. In an additional June 2021 medical opinion, a second examiner opined that it was less likely than not that the cervical spine disorder was caused or aggravated by a lumbar spine disorder. The examiner indicated that neck pain was the product of a cervical spine disorder; however, the examiner did not offer a rationale as to why the cervical spine disorder was not proximately related to a service-connected lumbar spine disorder. Accordingly, further development is required in order to determine the nature and etiology of the Veteran's cervical spine disorder, to specifically include its relationship to a lumbar spine disorder. As to the Veteran's service connection claims for headaches and left and right hand disorders, treatment notes and June 2021 VA medical opinions suggest that the conditions may stem from a cervical spine disorder. As such, the claims are inextricably intertwined with the pending claim asserting service connection for a cervical spine disorder detailed above, and action on the claims will also be remanded. The matters are REMANDED for the following actions: 1. Identify and obtain any pertinent, outstanding VA and private medical treatment records and associate them with the claims file. 2. Direct the claims file to a clinician to determine the nature and etiology of the Veteran's cervical spine disorder. 3. Based on a review of the record, the clinician is asked to opine as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's cervical spine disorder is either etiologically related to service or proximately caused or aggravated by a service-connected disability, to specifically include a lumbar spine disorder. In forming the opinions, the clinician is asked to specifically address the findings made in the February 2021 examination and determine whether the statement that the Veteran's cervical spine disorder stemmed from his lumbar spine disability constituted lay or objective medical evidence. The examiner must also consider the medical articles submitted by the Veteran discussing lumbar and cervical spondylosis and discuss what relevance they have, if any to the Veteran's claims. The rationale for all opinions must be provided. 4. If the clinician determines that an examination is necessary in order to provide the requested opinions, then one should be scheduled. L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Spigelman, 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.