Citation Nr: 21012412 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 15-15 811 DATE: March 4, 2021 REMANDED Entitlement to service connection for a left shoulder condition, to include as secondary to epilepsy, is remanded. Entitlement to service connection for a right shoulder condition, to include as secondary to epilepsy, is remanded. Entitlement to service connection for a back condition, to include as secondary to epilepsy, is remanded. Entitlement to service connection for a neck condition, to include as secondary to epilepsy, is remanded. Entitlement to a rating in excess of 10 percent for left foot hallux valgus with arthritis in the MTP joint, beginning January 9, 2013, to include on an extraschedular basis is remanded. Entitlement to a rating in excess of 10 percent for right foot hallux valgus with arthritis in the MTP joint, beginning January 9, 2013, to include on an extraschedular basis is remanded. Entitlement to a total disability rating due to individual unemployability (TDIU) prior to January 7, 2016 is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1984 to August 1986. In October 2017, the Veteran testified before the Board of Veterans’ Appeals (Board) and the undersigned Veterans Law Judge. The Board remanded the matters for further development in April 2019. In January 2020, the regional office (RO) increased both the Veteran’s left and right foot hallux valgus ratings to 10 percent, effective January 9, 2013. This decision constitutes a partial grant of the benefits sought on appeal; therefore, the rating claim remains on appeal and is for consideration by the Board. See AB v. Brown, 6 Vet. App. 35 (1993). In January 2020, the RO also granted entitlement to TDIU with an effective date of January 7, 2016. However, pursuant to Harper, the issue of TDIU prior to January 7, 2016 is still pending in conjunction with the claims for increased ratings. See Harper v. Wilkie, 30 Vet. App. 356 (2018). 1. Entitlement to service connection for bilateral shoulder conditions, to include as secondary to epilepsy are remanded. 2. Entitlement to service connection for a back condition, to include as secondary to epilepsy is remanded. 3. Entitlement to service connection for a neck condition, to include as secondary to epilepsy is remanded. In accordance with the April 2019 remand, the Veteran was provided with VA examinations and nexus opinions in August 2019 for his shoulders, back, and neck. The Veteran was diagnosed with shoulder impingement syndrome, rotator cuff tendonitis, and osteoarthritis of both shoulders; degenerative arthritis of the lumbar spine; and degenerative arthritis and intervertebral disc syndrome of the cervical spine. The examiner provided negative nexus opinions, finding the Veteran’s shoulder, back, and neck conditions were not related to active service or the service-connected epilepsy condition. Although the examiner based their opinions on a review of the claims file, the examiner failed to explain why the Veteran’s epilepsy and related falls did not cause or aggravate the Veteran’s diagnosed disabilities in adequate detail. The Board notes the examiner provided explanation for the negative nexus on direct bases; however, the examiner appears to have copy and pasted the rationale for finding the Veteran’s claims were not secondary to epilepsy between the three distinct service connection claims. Each diagnosed condition (shoulder impingement syndrome, rotator cuff tendonitis, and osteoarthritis of both shoulders; degenerative arthritis of the lumbar spine; and degenerative arthritis and intervertebral disc syndrome of the cervical spine) and claim have individual and distinct medical histories within the Veteran’s claim file, and the examiner failed to adequately address such in the rationale. Therefore, addendum opinions are necessary to determine the nature and etiology of the service connection claims on appeal. 4. Entitlement to a rating in excess of 10 percent for left foot hallux valgus with arthritis in the MTP joint, beginning January 9, 2013, to include on an extraschedular basis is remanded. 5. Entitlement to a rating in excess of 10 percent for right foot hallux valgus with arthritis in the MTP joint, beginning January 9, 2013, to include on an extraschedular basis is remanded. 6. Entitlement to a TDIU prior to January 7, 2016 is remanded. In April 2019, the Board remanded the Veteran’s bilateral hallux valgus and TDIU claims in order to obtain the Veteran’s complete VA Vocational Rehabilitation file. A review of the Veteran’s claims file since April 2019 is negative for evidence of such evidence, or documentation of attempts to obtain such evidence. Accordingly, the claims are remanded to ensure compliance with the previous remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. The RO should attempt to obtain the Veteran's vocational rehabilitation file, if possible. All actions taken to obtain the file should be documented. 2. After all outstanding records have been associated with the claims file, forward the Veteran’s claims file to a qualified medical professional for an addendum opinion to determine the nature and etiology of the Veteran’s neck, back, and shoulder disabilities. Based on a review of the entire record, the examiner must respond to the following: (a.) Provide current diagnoses for any left or right shoulder conditions which manifested at any time during the period on appeal; (b.) Provide an opinion as to whether any diagnosed left or right shoulder condition at least as likely as not is etiologically related to service; (c.) Provide an opinion as to whether any diagnosed left or right shoulder condition at least as likely as not was caused or aggravated (increased in severity beyond the natural progression of the disorder) by the Veteran’s epilepsy, to include related falls from epilepsy; (d.) Provide current diagnoses for any back conditions which manifested at any time during the period on appeal; (e.) Provide an opinion as to whether any diagnosed back condition at least as likely as not is etiologically related to service; (f.) Provide an opinion as to whether any diagnosed back condition at least as likely as not was caused or aggravated by the Veteran’s epilepsy, to include related falls from epilepsy; (g.) Provide current diagnoses for any neck conditions which manifested at any time during the period on appeal; (h.) Provide an opinion as to whether any diagnosed neck condition at least as likely as not is etiologically related to service; and (i.) Provide an opinion as to whether any diagnosed neck condition at least as likely as not was caused or aggravated by the Veteran’s epilepsy, to include related falls from epilepsy. In answering all questions, please articulate the reasoning underpinning the conclusions. That is, (1) identify what facts and information--whether found in the record or outside the record--support the opinion, and (2) explain how that evidence justifies the opinion. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. N. Quarles, 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.