Citation Nr: 21075667 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 14-42 074 DATE: December 21, 2021 REMANDED The issue of entitlement to service connection for a cervical spine disability is remanded. REASONS FOR REMAND The Veteran had active service from May 1990 to October 1991. The procedural history of this claim is outlined in the May 2018 and December 2020 Board of Veterans' Appeals (Board) remands and decisions. In a July 2021 rating decision, the Agency of Original Jurisdiction (AOJ) granted the Veteran's claims of service connection for lumbar spine and bilateral shoulder disabilities. The issue of service connection for these three conditions are no longer in appeal status. Entitlement to service connection for a cervical spine disability. The matters are REMANDED for the following action: 1. The Board has determined that additional development is necessary, and the matter is remanded for the following: 2. Return the claims folder to the March 2021 VA examiner and request she re-review the claims file and respond to the inquiries below. IF THE EXAMINER FINDS IT NECESSARY, ANOTHER EXAMINATION SHOULD BE CONDUCTED. IF THE MARCH 2021 EXAMINER IS NO AVAILABLE, arrange for another appropriate VA examiner to provide an addendum medical opinion to assist in determining IF THE VETERAN'S CURRENT CERVICAL SPINE DISABILITY WAS CAUSED OR WORSENED BY HIS SERVICE-CONNECTED DISORDERS. The VA examiner must provide the following opinions. a) Are any of the Veteran's current cervical spine diagnoses proximately due to any of the Veteran's service-connected musculoskeletal disabilities? [i.e. bilateral shoulder strain; thoracolumbar strain; right hip strain; bilateral knee instability; bilateral knee strain] b) Are any of the Veteran's current cervical spine diagnoses WORSENED, AND IF SO, TO WHAT DEGREE by any of the Veteran's service-connected musculoskeletal disabilities? [i.e. bilateral shoulder strain; thoracolumbar strain; right hip strain; bilateral knee instability; bilateral knee strain] c) If aggravation is found, the examiner should also state, to the extent possible, the baseline level of disability prior to aggravation. This may be ascertained by the medical evidence of record and by the Veteran's statements as to the nature, severity, and frequency of his observable symptoms over time. d) Given the medical evidence in this case, your experience and knowledge, and the state of medical science, is the Veteran's account of the development of his cervical spine disability as secondary to his service-connected musculoskeletal disabilities consistent with the clinical findings? Please fully explain your opinion. The examiner must review the entire record in conjunction with rendering the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: * VA treatment records indicate the Veteran has reported chronic cervicalgia (neck pain). * December 2014 imaging indicated cervical degenerative disc disease (DDD). See "Medical Treatment Record Government Facility," received December 29, 2014, page 3 of 21. * April 2015 EMG indicated cervical radiculopathy. See "Medical Treatment Record Non-Government Facility," received May 4, 2015, page 3 of 6. * April 2019 VA medical examination and opinion. See "C&P Exam," received April 19, 2019. The examiner opined the Veteran's cervical DDD and radiculopathy were not incurred in service, nor due to his bilateral knee or right shoulder conditions. * March 2021 VA medical examination and April 2021 opinion. The examiner diagnosed the Veteran with a cervical strain, noted that imaging did not indicate degenerative changes, and did not diagnose the Veteran with cervical radiculopathy. The examiner opined the Veteran's cervical diagnosis was not proximately due to or aggravated by his right shoulder disability. See "C&P Exam," received July 14, 2021. A thorough explanation must be provided for the opinions rendered. If the examiner cannot provide the requested opinion without resorting to speculation, s/he must expressly indicate this and provide supporting rationale as to why the opinion cannot be made without resorting to speculation. The examiner must schedule a new examination only if necessary to provide an adequate opinion. THE EXAMINER IS ADVISED THAT BY LAW, THE MERE STATEMENT THAT THE CLAIMS FOLDER WAS REVIEWED, AND/OR THE EXAMINER HAS EXPERTISE IS NOT SUFFICIENT TO FIND THE EXAMINATION/OPINION SUFFICIENT. 3. Following the review and any additional development deemed necessary, readjudicate the claim. If the regional office (RO) does not grant the claim, issue a supplemental statement of the case (SSOC) and return the claim to the Board. The Veteran may submit additional evidence and argument. Kutscherousky v. West, 12 Vet. App. 369 (1999). (continued on next page) This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by the United States Court of Appeals for Veterans Claims (Court) for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112 (West 2014). Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Anwar, Attorney-Advisor The Board's action is binding only in this case. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.