Citation Nr: 21010703 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 09-36 067 DATE: February 25, 2021 REMANDED Entitlement to service connection for neuropathy and numbness of the left lower extremity, to include as secondary to a low back disability, is remanded. Entitlement to service connection for a neck disorder, to include as secondary to a low back disability, is remanded. Entitlement to service connection for a right hip disorder, to include as secondary to a low back disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1972 to July 1973, and he had additional active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) service in the Army National Guard. The claims were most recently before the Board in January 2018 when they were remanded for additional development. 1. Entitlement to service connection for neuropathy and numbness of the left lower extremity, to include as secondary to a low back disability, is remanded. 2. Entitlement to service connection for a neck disorder, to include as secondary to a low back disability, is remanded. 3. Entitlement to service connection for a right hip disorder, to include as secondary to a low back disability, is remanded. In January 2018 the Board remanded the issues finding that prior VA examination opinions were inadequate. Additional VA medical examinations and opinions were obtained in July 2018. However, the medical opinions obtained are not adequate. The VA examiner concluded the neck neuropathy and neck disorders were not directly related to service, but the rationale provided was solely that the service treatment records were silent for a cervical spine condition and lower extremity neuropathy during service or one year after separation. The examiner also opined that the disabilities were not due to or aggravated by the Veteran’s low back disability. The rationale for the opinions was inadequate because it was conclusory. In addition, although the examiner identified a peripheral nerve diagnosis of axonal neuropathy bilateral tibial nerve and the opinion referenced related neuropathy, there is no explanation of any distinction between the Veteran’s neuropathy and any neurologic disorder (i.e., radiculopathy) that may be associated with the Veteran’s service-connected back disability and thus, separately compensable. The VA examination said the right hip trochanteric bursitis was less likely as not related to military service, but relied solely on a lack of documented hip injury in service or documented complaint or condition within several years after separation from service. The examiner also provided a negative secondary opinion, noting that trochanteric bursitis was frequently caused by direct trauma to the trochanter, leg length discrepancies, or bad posture. Despite the Veteran’s report that he had many traumas to his body as an infantryman jumping off of trucks, the examiner did not comment on the significance of the reported injuries in rendering the opinion. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file complete VA treatment records regarding the Veteran dated since August 2020. Any additional pertinent records identified by the Veteran during the course of the remand should also be obtained, following the receipt of any necessary authorizations from the Veteran, and associated with the claims file. 2. Thereafter, forward the claims file to an appropriate VA medical examiner to obtain medical opinions regarding the etiology of the Veteran's neck disorder and neuropathy and numbness of the left lower extremity. Copies of all pertinent records should be made available to the examiner(s)for review. If the examiner determines that an opinion cannot be provided without an examination, one should be scheduled (or telehealth interview, review of the record, etc., if an in-person examination is not feasible). Based on a review of the record, the examiner should address the following: (i) Is it at least as likely as not that the Veteran's neck disorder and/or neuropathy and numbness of the left lower extremity was incurred in or related to service? (ii) Is it at least as likely as not that the Veteran's neck disorder and/or neuropathy and numbness of the left lower extremity is due to or aggravated by his service-connected degenerative disc disease of L5-S1? The examiner is informed that aggravation here is defined as any increase in disability. If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. In answering the questions, the examiner must consider, and discuss as necessary, the prior examinations. The examiner must comment on the Veteran’s report of many traumas to his body as an infantryman jumping off of trucks. With regard to the claim for neuropathy and numbness of the left lower extremity, the examiner must discuss any distinction between the Veteran’s neuropathy and a neuropathy that may be associated with degenerative disc disease. A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. 3. Thereafter, obtain an opinion from an appropriate examiner regarding the etiology of the Veteran’s right hip disorder. Copies of all pertinent records should be made available to the examiner for review. If the examiner determines that an opinion cannot be provided without an examination, one should be scheduled (or telehealth interview, review of the record, etc., if an in-person examination is not feasible). Based on examination and review of the record, the examiner should address the following: Is it at least as likely as not (50 percent or higher degree of probability) that the Veteran's right hip disorder was incurred in or aggravated by service? In answering the questions, the examiner must consider, and discuss as necessary, the prior examinations. The examiner must comment on the Veteran’s report of many traumas to his body as an infantryman jumping off of trucks. A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. M.E. LARKIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Robert J. Burriesci, 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.