Citation Nr: 21074714 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 17-19 280 DATE: December 16, 2021 REMANDED Entitlement to an initial disability rating in excess of 10 percent for cervical strain, prior to March 5, 2018, and in excess of 20 percent thereafter is remanded. Entitlement to a higher initial rating for right upper extremity radiculopathy rated as 40 percent disabling effective March 5, 2018 is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1998 to July 2007. These matters are before the Board of Veterans' Appeals (Board) on appeal from an April 2018 rating decision issued by a regional office (hereinafter agency of original jurisdiction or AOJ) of the Department of Veterans Affairs (VA). In August 2021, the Veteran appeared for a hearing before the undersigned Veterans Law Judge (VLJ). The transcript has been associated with the claims file. Notably, the appeal before the Board stems from a September 2016 AOJ rating decision which granted service connection for cervical strain, and assigned an initial 10 percent rating effective January 13, 2014. An April 2018 AOJ rating decision awarded a 20 percent rating for cervical strain with intervertebral disc syndrome effective March 8, 2018, and granted "service connection" for right upper extremity radiculopathy and assigned a 40 percent rating effective March 5, 2018. An appeal seeking an increased rating for a spine disability may include the issue of compensation for objective neurologic abnormalities related to the spine disability even if a veteran does not file a separate claim or notice of disagreement as to the neurologic abnormalities. Chavis v. McDonough, 34 Vet. App. 1 (2021). 1. Entitlement to a disability rating in excess of 10 percent for cervical strain, prior to March 5, 2018, and in excess of 20 percent thereafter is remanded. 2. Entitlement to a higher initial rating for right upper extremity radiculopathy rated as 40 percent disabling effective March 5, 2018 is remanded. The Veteran was last afforded a VA examination in March 2018. The VA examiner noted the Veteran's report of continued pain with worsening spasms of the right neck muscles and occasional intermittent numbness radiating from the neck into the upper right arm with some loss of strength of the right upper arm. And the Veteran's reports of less motion of the neck, difficulties when seated for prolonged periods, and when he has to drive and move his head repeatedly. Further, the Veteran reported flair-ups, which impacted his ability to sleep and sit for long periods of time. However, the examiner did not provide an estimated degree of additional loss of range of motion due to flare ups, repeated use over time. As such, the Board finds the March 2018 VA examination is inadequate for decision making purposes as it does not comply with the requirements set forth in Sharp v. Shulkin, 29 Vet. App. 26, 35 (2017). Further, there is evidence of record that indicates that the Veteran's right upper extremity radiculopathy may have occurred prior to the March 2018 VA examination, which has not discussed by the VA examiner. Additionally, during the August 2021 Board hearing, the Veteran described worsening, as well as possibly experiencing similar neurological symptoms in his left upper extremity. Therefore, remand is necessary in order to obtain a medical examination in compliance with Sharp , to determine the current severity of the Veteran's cervical strain, and if it is medically possible to determine whether the Veteran's upper extremity radiculopathy manifested prior to the March 2018 VA examination. The matters are REMANDED for the following action: 1. Associate with the claims folder updated VA treatment records. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected cervical strain. 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 rating criteria. In so doing, the examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran's statements. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). Also, the examiner must assess any neurological impairment associated with the Veteran's service-connected cervical spine disability. Lastly, the examiner is asked to opine whether it is medically possible to determine whether the Veteran's right upper extremity radiculopathy manifested prior to the March 2018 VA examination. The examination report must include a complete rationale for the opinion provided. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Patrick C. Brady, 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.