Citation Nr: 21073126 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 16-39 128 DATE: December 7, 2021 ORDER Entitlement to a disability rating in excess of 40 percent for a lumbar strain is denied. Entitlement to an initial 20 percent disability rating for left ulnar neuropathy is granted. Entitlement to a disability rating in excess of 20 percent for the period following November 24, 2020, for left ulnar neuropathy is denied. REMANDED Entitlement to a disability rating in excess of 10 percent prior to December 28, 2010, and in excess of 20 percent for the period following, for left lower extremity radiculopathy is remanded. FINDINGS OF FACT 1. The Veteran's lumbar strain was not manifested by unfavorable ankylosis of the entire thoracolumbar spine. 2. For the period prior to November 24, 2020, the Veteran's left ulnar neuropathy was manifested by moderate incomplete paralysis. 3. For the period following November 24, 2020, the Veteran's left ulnar neuropathy was manifested by no more than moderate incomplete paralysis. CONCLUSIONS OF LAW 1. The criteria for a disability rating in excess of 40 percent for lumbar strain have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.14, 4.40, 4.45, 4.59, 4.71, 4.71a, Diagnostic Code (DC) 5237. 2. The criteria for an initial 20 percent rating for left ulnar neuropathy have been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, 4.40, Diagnostic Code 8516. 3. The criteria for a rating in excess of 20 percent for the period following November 24, 2020, for left ulnar neuropathy have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.124a, 4.40, Diagnostic Code 8516. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from May 1969 to July 1970. These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). Prior to the Veteran's hearing being scheduled, he submitted a statement indicating that he wished to withdraw his request for a Board hearing elected in the February 2018 VA Form 9. See January 2020 Correspondence. This matter was last before the Board in June 2021, at which time it was remanded for further development. It is now returned to the Board for further appellate consideration. Increased Rating Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (rating schedule), found in 38 C.F.R. Part 4. Disability ratings are intended to compensate impairment in earning capacity due to a service-connected disability. 38 U.S.C. § 1155. Evaluation of a service-connected disability requires a review of the Veteran's entire medical history regarding that disability. 38 C.F.R. § 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589 (1991). After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. See 38 C.F.R. § 4.3. The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as "staged ratings," whether it is an initial rating case or not. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran. 38 C.F.R. § 4.3. For disabilities evaluated on the basis of limitation of motion, VA is required to apply the provisions of 38 C.F.R. §§ 4.40, 4.45, pertaining to functional impairment. The Court has instructed that in applying these regulations VA should obtain examinations in which the examiner determined whether the disability was manifested by weakened movement, excess fatigability, incoordination, or pain. Such inquiry is not to be limited to muscles or nerves. These determinations are, if feasible, to be expressed in terms of the degree of additional range-of-motion loss due to any weakened movement, excess fatigability, incoordination, flare-ups, or pain. DeLuca v. Brown, 8 Vet. App. 202 (1995); see also Johnston v. Brown, 10 Vet. App. 80, 84-85 (1997); 38 C.F.R. § 4.59. 1. Entitlement to a disability rating in excess of 40 percent for lumbar strain The Veteran contends that his service-connected lumbar spine is more severe than the currently assigned 40 percent rating. The Veteran's lumbar spine disability is currently evaluated under Diagnostic Code 5237, pertaining to the General Rating Formula for Diseases and Injuries to the Spine. 38 C.F.R. § 4.71a, Diagnostic Codes 5237. Recently, VA amended the criteria for rating the musculoskeletal system and muscle injures, effective from February 7, 2021. However, the criteria were not changed in a manner that affects the analysis in this case. See Schedule for Rating Disabilities: Musculoskeletal System and Muscle Injuries, 85 Fed. Reg. 76453, 76463 (Nov. 30, 2020) (to be codified at 38 C.F.R. § 4.71a, Diagnostic Code 5237). That formula provides that with or without symptoms such as pain (whether or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease, the following ratings are assigned: A 20 percent rating is assigned for forward flexion of the thoracolumbar spine greater than 30 degrees but not greater than 60 degrees; or, forward flexion of the thoracolumbar spine greater than 15 degrees but not greater than 30 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 120 degrees; or, the combined range of motion of the thoracolumbar spine not greater than 170 degrees; or, muscle spasm or guarding severe enough to result in an abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. A 40 percent rating is assigned for forward flexion of the thoracolumbar spine 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine. A 50 percent rating is assigned for unfavorable ankylosis of the entire thoracolumbar spine. A 100 percent rating is assigned for unfavorable ankylosis of the entire spine. Several notes to the General Rating Formula for Diseases and Injuries of the Spine provide additional guidance. Note 1 provides that any associated objective neurologic abnormalities, including, but not limited to, bowel or bladder impairment, are to be rated separately, under an appropriate diagnostic code. In that regard, the Board notes that the Veteran has been rated separately for sciatic and femoral radiculopathy of the right and left lower extremities. The Veteran has not appealed the ratings assigned for those disabilities. Under Note 5, unfavorable ankylosis is defined as a condition in which the entire cervical spine, the entire thoracolumbar spine, or the entire spine is fixed in flexion or extension, and the ankylosis results in one or more of the following: difficulty walking because of a limited line of vision; restricted opening of the mouth and chewing; breathing limited to diaphragmatic respiration; gastrointestinal symptoms due to pressure of the costal margin on the abdomen; dyspnea or dysphagia; atlantoaxial or cervical subluxation or dislocation; or neurologic symptoms due to nerve root stretching. Fixation of a spinal segment in neutral position (zero degrees) always represents favorable ankylosis. In addition to the General Rating Formula for Diseases and Injuries of the Spine, intervertebral disc syndrome may be evaluated under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation. See 38 C.F.R. § 4.71a, Diagnostic Code 5243. The Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes provides that when intervertebral disc syndrome is productive of incapacitating episodes have a total duration of at least two weeks but less than four weeks during the past 12 months; a 20 percent rating is assigned. When intervertebral disc syndrome is productive of incapacitating episodes having a total duration of at least four weeks but less than six weeks during the past twelve months, a 40 percent rating is assigned. When incapacitating episodes have a total duration of at least six weeks during the past 12 months, a maximum 60 percent rating is assigned. Note (1) following 38 C.F.R. § 4.71a, Diagnostic Code 5243 provides that an incapacitating episode is a period of acute signs and symptoms due to intervertebral disc syndrome that requires bed rest prescribed by a physician and treatment by a physician. In December 2010, the Veteran submitted a correspondence that was construed as a claim for an increased rating for his service-connected lumbar strain. While the Board recognizes that the Veteran was granted a separate compensable rating for radiculopathy of the left lower extremity in a February 2018 rating decision, the symptoms will not be discussed in great detail herein, as they will be addressed in the remand section below. Turning to the medical evidence, the Veteran was afforded a VA examination in May 2010. The Veteran reported mild constant daily low back pain. His symptoms were reported as fatigue, decreased motion, stiffness, weakness, spasms, and pain. The Veteran reported severe flare-ups every 3-4 months, that lasted 1-2 days, and were alleviated with rest, medication, and therapy. The functional limitations of the flare-ups were noted as leg weakness with back pain, and occasionally his knee gives away. The Veteran was noted to have IVDS with one incapacitating episode in the prior 12 months. On range of motion (ROM) testing, the Veteran had flexion of 80 degrees, extension of 10 degrees; left lateral flexion of 25 degrees; left lateral rotation to 40 degrees; right lateral flexion of 30 degrees; and right lateral rotation of 45 degrees. There was evidence of pain on motion. On repetitive motion, all measurements remained the same with the exception of left lateral flexion of 30 degrees and left lateral rotation to 35 degrees. Lack of endurance was noted to cause additional limitation. As to functional limitations, the Veteran's lumbar strain was noted to cause problems with lifting and carrying, decreased strength, and lower extremity pain. The Veteran was afforded a VA examination in February 2011. His symptoms were reported as fatigue, decreased motion, stiffness, weakness, spasms, and pain. His pain was described as constant, shooting, moderate to severe, and occurring daily. The Veteran reported incapacitating episodes every 3-4 months that required him to stay in bed for a few days. The examiner indicated that the Veteran's incapacitating episodes were due to IVDS; however, there was no evidence that the described bedrest was prescribed by a physician. On ROM testing, the Veteran had flexion of 25 degrees, extension of 10 degrees; left lateral flexion of 10 degrees; left lateral rotation to 10 degrees; right lateral flexion of 5 degrees; and right lateral rotation of 10 degrees. There was no evidence of scoliosis, reversed lordosis, abnormal kyphosis, or ankylosis. The Veteran was again afforded a VA examination in July 2013. The Veteran reported increasing lower back pain which travelled from his lower back into the large toe on the left foot. He reported stumbles and falls due to sudden buckling of the left leg. On ROM testing, the Veteran had flexion of 35 degrees, extension of 20 degrees; left lateral flexion of 20 degrees; left lateral rotation to 20 degrees; right lateral flexion of 20 degrees; and right lateral rotation of 20 degrees. The Veteran was unable to perform repetitive-use testing due to pain. The functional impairment of the spine was noted as less movement than normal, weakened movement, pain on movement, instability of station, and disturbance of locomotion. There was evidence of central spinal tenderness, with no guarding or muscle spasm. All strength and reflex testing were normal. There was decreased sensation of the left foot. The Veteran was noted to have IVDS with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks over the past 12 months. It was further noted that the Veteran had retired in 2004 due to back trouble. The Veteran denied any flare-ups. A March 2016 private treatment record indicates that the Veteran had spasms of the lumbar spine, limiting flexion to 70 degrees. This matter was before the Board in July 2020, at which time it was remanded based on the possibility that the Veteran's low back disability had increased in severity since he was last examined by VA, which was over seven years prior. The Veteran was afforded a VA examination in November 2020. The Veteran reported back pain with stiffness and a limited ROM. He reported that the condition limited his ability to perform daily activities. He reported daily severe flare-ups of the back that lasted for multiple days and were not precipitated by any specific activity. He reported that the flare-ups were alleviated by laying still/non-usage. On ROM testing, the Veteran had flexion of 60 degrees, extension of 20 degrees; left lateral flexion of 20 degrees; left lateral rotation to 20 degrees; right lateral flexion of 20 degrees; and right lateral rotation of 20 degrees. Pain was noted on examination that caused functional loss. There was evidence of pain with weightbearing. There was no additional loss of function or ROM after three repetitions. Pain and weakness were noted to significantly limit functional ability with repeated use over a period of time. On repeated use testing, the Veteran had flexion of 55 degrees, extension of 15 degrees; left lateral flexion of 15 degrees; left lateral rotation to 15 degrees; right lateral flexion of 15 degrees; and right lateral rotation of 15 degrees. Pain and weakness were noted to significantly limit functional ability with flare ups. The examiner estimated that on flare-up, the Veteran would be limited to flexion of 50 degrees, extension of 10 degrees; left lateral flexion of 10 degrees; left lateral rotation to 10 degrees; right lateral flexion of 10 degrees; and right lateral rotation of 10 degrees. There was no evidence of guarding or muscle spasm. All muscle strength and reflex testing were normal. There was no evidence of ankylosis or IVDS. The Veteran's ROM was to 60 degrees with active weightbearing, passive weightbearing, and non-passive weightbearing. As to functional limitation, the Veteran reported that he could not walk for more than 100 yards without feeling back pain. This matter was returned to the Board in June 2021. It was again remanded based on a finding that the November 2020 examination did not comply with the requirements in Sharp v. Shulkin, 29 Vet. App. 26 (2017), in terms of any additional functional loss suffered during flare-ups of the Veteran's disability. Additionally, despite the Veteran's reports stating he experienced severe flare-ups that last for days and are alleviated by laying still or "non usage", the examiner failed to address whether the severity of these symptoms and the Veteran's reports of functional immobility amounted to ankylosis. The Veteran was then afforded a VA examination in July 2021. He reported chronic pain with subjective symptoms to his lower extremities, including radicular pain to the lower extremities. He also reported moderate flare-ups 2 to 3 times a month, lasting 3-4 days, that were precipitated by increased physical activity, and alleviated by rest and analgesic medication. As to functional impairment during flare-ups, the back condition was noted to cause difficulty with walking. On ROM testing, the Veteran had flexion of 90 degrees, extension of 20 degrees; left lateral flexion of 15 degrees; left lateral rotation to 30 degrees; right lateral flexion of 15 degrees; and right lateral rotation of 30 degrees. Pain was noted on all motion. Passive ROM testing was not performed as it would cause additional discomfort for the Veteran. There was evidence of pain with weight-bearing. The examiner also noted mild tenderness or pain on palpation of the spine. With repetitive use, there was no additional loss of function or range of motion. Pain and lack of endurance were noted to cause functional loss with repeated use over time. With repeated use, the Veteran's estimated ROM was flexion of 70 degrees, extension of 15 degrees; left lateral flexion of 10 degrees; left lateral rotation to 25 degrees; right lateral flexion of 10 degrees; and right lateral rotation of 25 degrees. During flare-ups, pain, fatigability, and lack of endurance were noted to significantly limit functional ability. The Veteran's estimated ROM during flare-ups was flexion of 60 degrees, extension of 10 degrees; left lateral flexion of 10 degrees; left lateral rotation to 20 degrees; right lateral flexion of 10 degrees; and right lateral rotation of 20 degrees. There was evidence of localized tenderness, not resulting in abnormal gait or abnormal spinal contour. All muscle strength testing and reflex examinations were normal. All sensory examination was normal, with the exception of decreased sensation to light touch on the toes of the left foot. The Veteran was unable to perform straight leg raising testing as it would cause additional discomfort. There was no evidence of ankylosis of the spine or IVDS. The Veteran reported using a brace and cane on a regular basis. As to functional impact, the Veteran was noted to have difficulty with heavy lifting, prolonged standing, walking, and an inability to run. Notably, the examiner reported that there was evidence of symptom magnification from the Veteran; indicating that flexion to 90 degrees was observed when the Veteran was on the examination table, but that he artificially limited flexion to 70 degrees on active ROM testing. As noted above, an opinion was also requested that addresses whether the Veteran's reports of functional impairments during flare-ups amount to ankylosis. The examiner indicated that when a flare-up occurs, the Veteran walks over to the bed and lays down and then gets up after a few hours. The examiner concluded that the motions of walking and laying down involve active movement of the back, and thus, no ankylosis. Based on the evidence of record, the Board finds that an evaluation in excess of 40 percent for the Veteran's lumbar spine disability is not warranted. Findings from the Veteran's VA examinations are consistent with a 40 percent evaluation, but no greater. Even with pain, after repetitive testing, and with flare-up, there is no evidence of ankylosis of the lumbar spine. Deluca, 8 Vet. App. 202 (1995); 38 C.F.R. § 4.59. While the Board has considered the Veteran's lay testimony that his lumbar strain condition is manifested by ankylosis during flare-ups, the Board affords higher probative value to the July 2021 examiner's opinion that the limitation of ROM and reported immobility experienced by the Veteran does not amount to ankylosis. The Board has also considered whether an increased rating is warranted under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, and likewise finds that it is not. At worst, at the time of the July 2013 examination the Veteran was noted to have IVDS with incapacitating episodes having a total duration of at least 2 weeks but less than 4 weeks; meeting the criteria for a 20 percent rating but no higher. For the reasons stated above, a rating in excess of 40 percent for the Veteran's service-connected lumbar strain must be denied. 2. Entitlement to a disability rating in excess of 10 percent prior to November 24, 2020, for left ulnar neuropathy The Veteran was assigned a 10 percent rating for left ulnar neuropathy in a June 2010 rating decision, effective January 11. 2010. He was then awarded an increased 20 percent rating in a December 2020 rating decision, effective November 24, 2020. He contends that increased ratings are warranted throughout the period on appeal. The Veteran's left ulnar neuropathy is rated under diagnostic code 8516. That code distinguishes between the minor and dominant arm. As the record indicates that the Veteran is right-handed, his service-connected left ulnar neuropathy is rated under the criteria for the minor arm. Under 38 C.F.R. § 4.124a, Diagnostic Code 8516, for the minor ulnar nerve, a 10 percent rating requires mild incomplete paralysis. A 20 percent rating requires moderate incomplete paralysis. A 30 percent rating requires severe incomplete paralysis. A 50 percent disability rating requires complete paralysis requires complete paralysis with the "griffin claim" deformity due to flexor contraction of ring and little fingers, atrophy very marked in dorsal interspace and thenar and hypothenar eminences; loss of extension of ring and little fingers cannot spread the fingers (or reverse); flexion of wrist weakened. See 38 C.F.R. § 4.124a, Diagnostic Code 8516. The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type pictured for complete paralysis, whether due to a varied level of the nerve lesion or to partial regeneration. When sciatic nerve involvement is wholly sensory, the rating should be for, at most, moderately severe incomplete paralysis. See 38 C.F.R. §§ 4.123, 4.124a. Disability of the musculoskeletal system is primarily the inability, due to damage or inflammation in parts of the system, to perform normal working movements of the body with normal exertion, strength, speed, coordination, and endurance. The functional loss may be due to absence of part or all of the necessary bones, joints and muscles, or associated structures, or to deformity, adhesions, defective innervation, or other pathology, or may be due to pain, supported by adequate pathology and evidenced by visible behavior of the claimant undertaking the motion. Weakness is as important as limitation of motion, and a part which becomes painful on use must be regarded as disabled. See DeLuca v. Brown, 8 Vet. App. 202, 205 (1995); 38 C.F.R. § 4.40; see also 38 C.F.R. §§ 4.45, 4.59. Turning to the medical evidence of record, a January 2010 VA treatment record indicates that the Veteran had left ulnar neuropathy across the elbow. Examination of the left arm showed decreased sensation to soft touch; 2/5 strength at the left deltoid, left triceps, and left biceps; intrinsic muscles of the hand with 3/5 strength; reflexes of the left bicep at 3/4; and his triceps elicited too much pain for reflex assessment. The Veteran was afforded a VA examination in February 2011. He was noted to have progressively worsening chronic left ulnar neuropathy. The Veteran was noted to have locking of the left thumb, tingling in digits 1-3, and described the feeling of pins and needles. All reflexes of the left upper extremity were normal. There was no evidence of paralysis, neuritis, or neuralgia. Pain was noted to have an effect on the Veteran's occupational activities, and he was limited in his ability to do chores. A February 2013 private treatment record indicated that the Veteran had weakness of grip strength on his left hand, with pain, numbness, and weakness along the left elbow. The Veteran was noted to have abnormal EMG findings with evidence of chronic denervation in selected muscles of the upper arm, including the hand. At the time of a May 2013 VA examination of the peripheral nerves, the examiner diagnosed left ulnar neuropathy. The Veteran reported increased tingling in his arm, loss of grip strength, and increased locking up of the elbow. The examiner noted severe intermittent pain, severe paresthesias or dysesthesias, and moderate numbness of the left upper extremity. Muscle strength testing was normal. Reflex examination showed hypoactive deep tendon reflexes. The examiner noted a decreased sensory examination. Phalen's sign and Tinel's sign were negative. The examiner noted a normal ulnar nerve with no incomplete or complete paralysis. The Veteran was noted to regularly use a hand brace. At the time of the Veteran's August 2013 Notice of Disagreement (NOD), he reported decreased grip strength, numbness, cramping, causing the need for assistance with activities of daily living. A September 2013 VA treatment record showed subtle weakness in left arm strength distally and proximally. At the time of a November 2017 Examination for Housebound Status, the Veteran was noted to have a weak grip of the hand, with issues holding items such as a spoon or fork. In this case, the Board acknowledges that no VA examination of record for the period prior to November 24, 2020, has determined the Veteran's left ulnar neuropathy was manifested by mild or moderate incomplete paralysis. However, in consideration of the medical evidence showing pain, decreased sensation and muscle strength, locking of the left thumb and elbow, and chronic denervation, the Board finds that the Veteran's disability picture more nearly approximates moderate incomplete paralysis to warrant a 20 percent rating. This is considered in conjunction with the functional impact of the Veteran's nerve impairment, causing a weak grip of the hand, with issues holding items such as a spoon or fork, and the limitation of the Veteran's ability to do household chores. See 38 C.F.R. § 4.40. The medical evidence of record does not reflect that he experiences muscle atrophy or other neurological impairments, or other indicia of more than moderate paralysis in the left upper extremity for this period. Accordingly, an increased 30 percent rating is not warranted for severe incomplete paralysis. For the reasons stated above, an initial 20 percent rating for the Veteran's service-connected left ulnar neuropathy is granted. 3. Entitlement to a disability rating in excess of 20 percent for the period following November 24, 2020, for left ulnar neuropathy As noted above, the Veteran was granted an increased 20 percent rating for his service-connected left ulnar neuropathy in a December 2020 rating decision, effective November 24, 2020. He contends that a rating in excess of 20 percent is warranted. A VA examination conducted in November 2020 serves as the basis for the assignment of a 20 percent evaluation. At the time, the Veteran reported radiating pain, numbness, and tingling. The Veteran was noted to have moderate constant pain, intermittent pain, paresthesias and/or dysesthesias, and numbness of the left upper extremity. Muscle strength, reflex, and sensory testing were normal. The Veteran had moderate incomplete paralysis of the left upper ulnar nerve. As to functional impact, the Veteran was unable to grasp, grip or pick up objects without feeling pain in the left fingers. The remainder of the medical evidence of record for this period, to include VA treatment records, are silent as to the severity of the Veteran's left ulnar neuropathy. Based on the foregoing, the Board finds that the currently assigned 20 percent rating most nearly approximates the severity of the Veteran's left ulnar neuropathy for the period following November 24, 2020. As noted above, the November 2020 examiner concluded that the Veteran's condition was manifested by moderate incomplete paralysis of the left upper ulnar nerve. Additionally, as with the period prior, the Veteran continued to have issues with a decreased grip of the left hand. The medical evidence of record does not reflect that he experiences muscle atrophy or other neurological impairments, or other indicia of more than moderate paralysis in the left upper extremity for this period. Additionally, all muscle strength, reflex, and sensory testing were normal at the time of the November 2020 examination. For the reasons stated above, a rating in excess of 20 percent is not warranted for the Veteran's service-connected left upper ulnar nerve. REASONS FOR REMAND Entitlement to a disability rating in excess of 10 percent prior to December 28, 2010, and in excess of 20 percent for the period following, for left lower extremity radiculopathy is remanded. In a February 2018 rating decision, the Veteran was awarded a 10 percent disability rating for radiculopathy of the left lower extremity effective September 1, 2009, and an increased 20 percent disability evaluation, effective December 28, 2010. The Veteran contends that increased ratings are warranted for his radiculopathy of the left lower extremity throughout the period on appeal. While the Veteran has been afforded several examinations to assess the severity of his service-connected lumbar strain and neuropathy of his left upper extremity, he has not been afforded an examination that specifically assesses the severity of his radiculopathy of the left lower extremity. On remand, the Veteran should be afforded a VA examination in accordance with the applicable Disability Benefits Questionnaire (DBQ) for peripheral nerve conditions to assess the current severity of his left lower extremity radiculopathy. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination with the applicable Disability Benefits Questionnaire (DBQ) for peripheral nerve conditions, to assess the current severity of his left lower extremity radiculopathy. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Marsh II, 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.