Citation Nr: 21072826 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 19-28 734 DATE: December 6, 2021 REMANDED Entitlement to service connection for left upper extremity carpal tunnel syndrome is remanded. Entitlement to service connection for right upper extremity carpal tunnel syndrome is remanded. Entitlement to service connection for a low back condition is remanded. Entitlement to service connection for left lower extremity radiculopathy, as secondary to claimed low back condition, is remanded. Entitlement to service connection for right lower extremity radiculopathy, as secondary to claimed low back condition, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1966 to September 1968. He testified at a videoconference hearing before the undersigned in October 2021. A transcript is of record. The Veteran has not been afforded VA examinations to assess the nature and etiology of his bilateral carpal tunnel, low back, and bilateral lower extremity radiculopathy conditions. Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in disability compensation (service connection) claims, VA must provide a VA medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for VA to make a decision on the claim. The threshold for finding a link between current disability and service, for the purpose of determining whether an examination is warranted, is low. McLendon, 20 Vet. App. at 83. In this case, the Board finds that the evidence surpasses the low threshold established by McLendon. A remand is warranted to afford the Veteran VA examinations and to obtain medical opinions addressing the etiology of his bilateral carpal tunnel, low back and bilateral lower extremity radiculopathy conditions. Additionally, during the Veteran's October 2021 hearing, he indicated that he saw physicians at OrthoCarolina as part of the VA Choice program. After a review of the claims file, it is unclear if all OrthoCarolina records have been associated with his VA treatment records and/or his claim file. The Veteran's VA treatment records contain numerous referrals to OrthoCarolina but do not contain complete consultation reports. One treatment record specifically notes that VA Choice consultation reports have been scanned into the Veteran's treatment records but these consultation reports are contained in a portion of the Veteran's health records that is not available to the Board. See December 2017 NonVA Consult. On remand, the AOJ should attempt to associate with the claims file all VA and private treatment records that have not already been done so. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for OrthoCarolina and any other pertinent private treatment providers that he has seen for his bilateral carpal tunnel, low back, and bilateral lower extremity radiculopathy conditions. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran's VA treatment records that have not already been associated with the claims file, including any records located in the VistA Imaging portion of the Veteran's VA treatment records. 3. Schedule the Veteran for an examination to assess the nature and etiology of his bilateral carpal tunnel conditions. The claims file should be sent to and reviewed by the examiner. The examiner should take a history from the Veteran as to the progression of his symptoms. Upon review of the record, and examination of the Veteran, the examiner should respond to the following: (a.) Is it at least as likely as not (approximately 50 percent or greater probability) that the Veteran has a left upper extremity carpal tunnel disability that had onset in, or is otherwise related to his active-duty service? (b.) Is it at least as likely as not (approximately 50 percent or greater probability) that the Veteran has a right upper extremity carpal tunnel disability that had onset in, or is otherwise related to his active-duty service? The examiner should consider the Veteran's report of in-service onset of numbness and pain in his upper extremities due to lifting heavy tools and truck parts as part of the regular course of his work. All opinions should be supported by a medical explanation or rationale. 4. Schedule the Veteran for an examination to assess the nature and etiology of his low back and bilateral lower extremity radiculopathy conditions. The claims file should be sent to and reviewed by the examiner. The examiner should take a history from the Veteran as to the progression of his symptoms. Upon review of the record, and examination of the Veteran, the examiner should respond to the following: (a.) Is it at least as likely as not (approximately 50 percent or greater probability) that the Veteran has a low back disability that had onset in, or is otherwise related to his active-duty service? (b.) Is it at least as likely as not (approximately 50 percent or greater probability) that the Veteran has a left or right lower extremity radiculopathy condition that had onset in, or is otherwise related to his active-duty service? (c.) Is it at least as likely as not (approximately 50 percent or greater probability) that the Veteran has a left or right lower radiculopathy condition that is proximately due to and/or aggravated by its natural progression by his low back disability? The examiner should consider the Veteran's report of in-service onset of back pain that required nightly rest due to lifting heavy tools and truck parts, as well as due to jumping on and off large work trucks as part of the regular course of his work. All opinions should be supported by a medical explanation or rationale. 5. Then, readjudicate the issue on appeal. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Bristow Williams, 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.