Citation Nr: 21076598 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 17-23 286 DATE: December 27, 2021 REMANDED Entitlement to service connection for a cervical spine disability, to include as secondary to service-connected lumbar spine disability, is remanded. Entitlement to service connection for left upper extremity radiculopathy, to include as secondary to service-connected lumbar spine, is remanded. Entitlement to service connection for right upper extremity radiculopathy, to include as secondary to service-connected lumbar spine, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1975 to March 1979. These matters come before the Board of Veterans' Appeals (Board) on appeal from a February 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In September 2020, the Veteran presented testimony before the undersigned Veterans Law Judge. A transcript is on record. In June 2021, the Board remanded the claims for VA opinions on whether there is a causal nexus between the Veteran's cervical spine degenerative arthritis and his service-connected lumbar spine degenerative arthritis and whether there is a causal nexus between the Veteran's left and right upper extremity radiculopathy and his service-connected lumbar spine disability or the Veteran's cervical spine disability on appeal. These opinions were attempted in August 2021. 1. Entitlement to service connection for a cervical spine disability, to include as secondary to service-connected lumbar spine disability, is remanded. 2. Entitlement to service connection for left upper extremity radiculopathy, to include as secondary to service-connected lumbar spine, is remanded. 3. Entitlement to service connection for right upper extremity radiculopathy, to include as secondary to service-connected lumbar spine is remanded. The Board regrets further delay, but finds a remand is warranted to ensure compliance with the Board's prior remand and the United States Court of Appeals for Veterans Claims' (Court) holding in Atencio v. O'Rourke, 30 Vet. App. 74 (2018). Unfortunately, an August 2021 VA examiner supplied another opinion on whether the Veteran's cervical spine disability is proximately due to or aggravated by his service-connected lumbar spine disability without separate findings and rationales for causation and aggravation. See Id. (holding causation and aggravation are independent concepts and should thus have separate findings and rationales). The Veteran must be provided another secondary service connection opinion. Barr v. Nicholson, 21 Vet. App. 303 (2007); see Stegall v. West, 11 Vet. App. 268, 271 (1998). Moreover, there appears to be a disconnect between what other opinions were requested and what was provided. The August 2021 examiner opined the Veteran did not have upper extremity neuropathy and thus it was not related to his current disabilities. However, the Board's June 2021 remand was for an opinion on the Veteran's left and right upper extremity radiculopathy. As this opinion was not accomplished, a remand is also warranted to ensure compliance with the Board's prior remand instructions. Stegall, 11 Vet. App. at 271. The matters are REMANDED for the following actions: 1. Obtain addendum opinions from an appropriately qualified clinician on whether there is a causal nexus between the Veteran's cervical spine degenerative arthritis and his service-connected lumbar spine degenerative arthritis, and whether there is a causal nexus between the Veteran's left and right upper extremity radiculopathy and his military service, to include whether they are secondary to either the Veteran's cervical spine degenerative arthritis or service-connected lumbar spine degenerative arthritis. The Veteran's claims file and a copy of this remand must be made available to the examiner for review and the examination report must reflect a review was accomplished. After a thorough review of the record, the examiner is asked to opine on: a. Whether the Veteran's cervical spine degenerative arthritis is at least as likely as not (50 percent or greater probability): (1) proximately due to; or, (2) aggravated by his service connected lumbar spine degenerative arthritis. b. Whether the Veteran's left and/or right upper extremity radiculopathy is at least as likely as not (50 percent or greater probability) (1) causally or otherwise etiologically related to service; or, (2) proximately due to; or, (3) aggravated by his cervical spine degenerative arthritis or his service-connected lumbar spine degenerative arthritis. The opinions on whether the Veteran's cervical spine degenerative arthritis is secondary to his service-connected lumbar spine degenerative arthritis must be accomplished before the opinions regarding the Veteran's upper extremity radiculopathy. The examiner is again advised that causation and aggravation are independent concepts. As such, the examiner must provide separate findings and rationales for proximate causation and aggravation. The examiner is advised that secondary service connection does not require "permanent" worsening of the condition being claimed by the service-connected disability and requires considering whether there has been any worsening, no matter how incremental, so even if not above and beyond the condition's natural progression. See Ward v. Wilkie, 31 Vet. App. 233 (2019). A complete rationale with clear conclusions, supporting data, and a reasoned medical explanation connecting the two must be provided for all expressed opinions. 2. Readjudicate the claims. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.A. Infante, 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.