Citation Nr: 21011753 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 14-11 333 DATE: March 2, 2021 REMANDED Entitlement to service connection for right lower extremity neuropathy and/or radiculopathy is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1996 to January 1997, October 2003 to July 2004, and April 2005 to June 2006, including service in Southwest Asia. He also had additional service in the Army National Guard of Puerto Rico. The Veteran appealed a January 2018 decision of the Board of Veterans’ Appeals (Board) to the United States Court of Appeals for Veterans Claims (Court) to the extent that the Board denied service connection for a lumbar disability and related radiculopathy/neuropathy of the right lower extremity. Pursuant to a Joint Motion for Partial Remand (JMPR), the Court, in a November 2018 Order, vacated the Board’s January 2018 decision and remanded the matter to the Board to ensure that adequate reasons or bases are provided to the Veteran. The Board then remanded the issues on appeal to the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) in June 2019. 1. Entitlement to service connection for right lower extremity neuropathy and/or radiculopathy is remanded. The Board notes that, the September 2010 VA examiner diagnosed right L5-S1 radiculopathy and concluded that it is less likely as not caused by or the result of or related to complaints and treatment received while in active military service. The rationale was that although he complained of right leg pain after the June 2003 in- service fall, he did not complain of numbness, cramps, paresthesias, or weakness as will occur with radiculopathy. Neither were there any complaints of such in the remainder of the Veteran’s service treatment records. Rather, the examiner indicated that the Veteran’s radiculopathy is more likely than not related to his lumbar bulging disc and degenerative changes of the lumbar spine. The October 2012 examiner indicated that the peripheral nerve examination revealed neuralgia based on sensory dysfunction demonstrated by cramp-like pain. The November 2017 VA examiner stated that the Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy. The December 2019 examiner noted that there was no clinical evidence of peripheral nerve pathology (neuropathy or radiculopathy) that could explain the Veteran’s subjective complaint of lower extremity numbness. Therefore, an opinion could not be rendered. In a September 2020 VA addendum opinion, a VA examiner found that the Veteran had a lumbar strain and not multilevel spondylosis and degenerative disc disease of the lumbar spine. He had paravertebral tenderness, spasms, and limitation of motion due to a muscular strain (inflammatory condition). However, the symptoms related to spondylosis, which were not present in the Veteran’s 2019 VA back examination are 1) paresthesias in lowers, 2) radicular signs, and 3) intervertebral disc disease and morning stiffness (since they are osteoarthritic in nature and not muscular). Patients with spondylosis very often develop radiculopathies if nerve roots are impinged which is very common. In a September 2020 rating decision, the AOJ granted service connection for lumbar strain. The Board finds that based on the above, the etiology of the Veteran’s claimed disability is still unclear. As such a remand is necessary to obtain a new VA examination. The matters are REMANDED for the following action: 1. Afford the Veteran a medical examination with corresponding report from an appropriate examiner to determine the nature and etiology of the Veteran’s claimed right lower extremity disability. The examiner should provide opinions on the questions below. In so opining, the Board calls the examiner’s attention to the September 2010 VA examiner’s diagnoses of right L5-S1 radiculopathy and the October 2012 VA examiner’s diagnoses of right sciatic neuralgia October 2012. Is it as least as likely as not (50 percent or greater probability) that the Veteran’s right lower extremity disability is due to the Veteran’s active military service, to include the documented fall? Is it as least as likely as not (50 percent or greater probability) that the Veteran’s right lower extremity disability was caused by the Veteran’s service-connected lumbar strain? Is it as least as likely as not (50 percent or greater probability) that the Veteran’s right lower extremity disability was aggravated by the Veteran’s service-connected lumbar strain? (Continued on the next page)   The examiner must provide a complete rationale for all opinions rendered. D. SMART Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Costello, 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.