Citation Nr: 21006266 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 15-12 109 DATE: February 3, 2021 REMANDED Service connection for a left upper extremity disorder is remanded. REASONS FOR REMAND The Veteran served on active duty for training in the U.S. Army from June 2001 to December 2001 and on active duty from December 2003 to March 2004. This matter is on appeal to the Board of Veterans’ Appeals (Board) from a July 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office. The July 2010 rating decision also denied service connection for a left knee disorder. The Veteran filed a notice of disagreement (NOD) in August 2010 with regard to both claims. Thereafter, in February 2015, the RO granted service connection for left knee traumatic arthritis. As the left knee claim has been granted in full, it is not before the Board. In October 2018, the Veteran testified at a Board hearing. However, the recording of this hearing was lost prior to the creation of a transcript. The Board remanded the claim for additional development in October 2018. Thereafter, in November 2020, the Veteran testified at another Board hearing before the undersigned Veterans Law Judge (VLJ). During the hearing, the VLJ explained that the recording of the October 2018 hearing is unavailable. Service connection for a left upper extremity disorder. The Veteran contends that she has a left upper extremity condition that had its onset during service. In this regard, in an April 2015 correspondence, she reported experiencing the onset of left arm symptoms during service in 2004 that continued to worsen until she began receiving treatment at VA facilities in 2007. Subsequently, during the November 2020 Board hearing, the Veteran reported lifting heavy equipment and injuring her left shoulder while firing a rifle during service in 2004. She also reported experiencing the onset of intermittent pain after the injury that has progressively worsened over the years. She further reported experiencing the onset of left arm tingling and numbness in 2007. The Veteran’s service treatment records (STRs) do not include reports of or treatment for a left arm condition. She did not report relevant symptoms during February 2004 and March 2004 in-service health assessments. The Veteran was afforded a VA examination in regard to this claim in July 2012. The examiner found that the Veteran had been diagnosed with left brachial plexopathy in February 2008 and left ulnar neuropathy in April 2012. The Veteran reported mild constant pain and moderate intermittent pain and paresthesias in her left upper extremity. The examiner found that the diagnosed conditions were not related to service because the symptoms did not have onset until 2007. Thereafter, in December 2014, a private physician examined the Veteran in regard to her neurologic symptoms. This physician found that the Veteran’s condition is multifactorial and complex. He noted several diagnostic impressions including cervical nonallopathic lesions, myalgia and myositis, brachial neuritis or radiculitis, left upper extremity nonallopathic lesions, and unspecified and idiopathic peripheral neuropathy. Pursuant to the October 2018 Board remand, the Veteran was afforded another examination in September 2019. The examiner diagnosed the Veteran with idiopathic brachial plexus disorder. The examiner explained that a February 2008 nerve study showed subtle multifocal sensorimotor neuropathy of an unclear origin. The examiner found the condition is less likely than not related to an in-service injury, event, or illness, but did not explain how this conclusion was reached. In December 2018, the Veteran underwent additional electrodiagnostic nerve studies. In January 2021, a VA contract examiner noted these studies, found that there was cervical stenosis at C7-8 with cervical radiculopathies and provided an opinion that the cervical disorder was caused by neck strain in service. The examiner did not address radiculopathy as it was relevant to the left arm. The Board finds that another opinion is required to determine the nature and etiology of the Veteran’s left upper extremity disorder. The claim is REMANDED for the following action: Forward the claims file to an appropriate VA examiner to assess the nature and etiology of the Veteran’s diagnosed left upper extremity disorder. The examiner should opine whether it at least as likely as not (a 50 percent probability or greater) that the Veteran’s current left upper extremity disorder was caused by an in-service injury or disease, including lifting heavy equipment and injuring her shoulder while firing a rifle or that it is a manifestation of cervical spine radiculopathy. Review of the entire claims file is required. The examiner must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. (continued next page) Attention is invited to the Veteran’s reports of experiencing in-service onset of intermittent left shoulder pain during service followed by the onset of left arm tingling and numbness in 2007. Attention is also invited to the examinations cited above in 2012, 2014, 2019, and 2021. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Jimerfield, 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.