Citation Nr: 21013698 Decision Date: 03/10/21 Archive Date: 03/10/21 DOCKET NO. 10-47 052A DATE: March 10, 2021 REMANDED Entitlement to service connection for a neurological disability manifested by sexual dysfunction, as associated with a service-connected thoracolumbar strain, is remanded. Entitlement to service connection for a neurological disability of the right upper extremity, as associated with a service-connected thoracolumbar strain, is remanded. Entitlement to service connection for a neurological disability of the left upper extremity, as associated with a service-connected thoracolumbar strain, is remanded. Entitlement to a total disability rating based upon individual unemployability due to service connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1966 to February 1967. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2008 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) that assigned an initial noncompensable disability rating for a service-connected thoracolumbar strain. In a June 2012 rating decision, the RO increased the Veteran’s initial disability rating for his thoracolumbar strain to 10 percent. In a December 2017 rating decision, the RO increased the thoracolumbar strain disability rating to 20 percent, effective from May 10, 2017. Thereafter, in a May 2018 decision, the Board denied the Veteran’s claim for an increased disability rating. In August 2018, the Veteran’s attorney requested reconsideration of the May 2018 Board decision, indicating that the issues of entitlement to service connection for neuropathy in the upper extremities and erectile dysfunction as secondary to the service-connected back disability and entitlement to a TDIU based on the Veteran’s service-connected back disability were raised by the record. These issues are under the Board’s jurisdiction as part and parcel of the appeal of that underlying rating. See 38 C.F.R. § 4.71a; Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009); Harper v. Wilkie, 30 Vet. App. 356 (2018). 1. Entitlement to service connection for a neurological disability manifested by sexual dysfunction, as associated with a service-connected thoracolumbar strain, is remanded. 2. Entitlement to service connection for a neurological disability of the right upper extremity, as associated with a service-connected thoracolumbar strain, is remanded. 3. Entitlement to service connection for a neurological disability of the left upper extremity, as associated with a service-connected thoracolumbar strain, is remanded. The Veteran’s attorney asserts that he has sexual dysfunction and bilateral upper extremity peripheral neuropathy or radiculopathy related to his service-connected thoracolumbar strain. Specifically, the Veteran’s attorney pointed to private treatment records dated in January 2017 reflecting that the Veteran sought treatment for back pain with associated arm numbness and weakness. At that time, the Veteran also reported that the back pain causes sexual dysfunction. The Board notes that objective neurologic abnormalities associated with a spinal disability are evaluated as separate disabilities. 38 C.F.R. § 4.71a, General Rating Formula for Diseases and Injuries of the Spine, Note (1). However, during a May 2017 VA examination, the examiner noted that the Veteran did not have any radicular signs or symptoms and while the Veteran noted that his back pain interferes with his sex life, there is no objective evidence of sexual dysfunction. A VA opinion should be obtained to address the nature and etiology of the Veteran’s claimed neurological disabilities. 4. Entitlement to a total disability rating based upon individual unemployability due to service connected disabilities (TDIU) The Veteran’s attorney, as well as the record as a whole, has raised the issue of whether the Veteran qualifies for a TDIU. While not specifically raised by the Veteran, it has been indicated that his back disability may have resulted in retiring early and possibly in stopping work altogether. During a June 2017 VA examination, the Veteran reported that he last worked in 2010 as a terminal operator but was no longer able to work in that field due to physical ailments. Initial consideration of this matter needs development and initial review by the Agency of Original Jurisdiction in order to protect the Veteran’s due process rights. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician or telehealth interview, as appropriate, to address his claimed sexual dysfunction and upper extremity symptomatology. All indicated tests and studies should be completed. The examiner should also review the claims folder, to include this remand, and respond to the following: Sexual Dysfunction (a.) Whether it is at least as likely as not (a probability of 50 percent or greater) that the Veteran has a neurological disability manifested as sexual dysfunction that was caused by his service-connected thoracolumbar strain. (b.) Whether it is at least as likely as not (a probability of 50 percent or greater) that the Veteran has a neurological disability manifested as sexual dysfunction that was aggravated by his service-connected thoracolumbar strain. Neurological Disability Right Upper Extremity (c.) Whether it is at least as likely as not (a probability of 50 percent or greater) that the Veteran has a neurological disability of the right upper extremity, claimed as peripheral neuropathy or radiculopathy, that was caused by his service-connected thoracolumbar strain. (d.) Whether it is at least as likely as not (a probability of 50 percent or greater) that the Veteran has a neurological disability of the right upper extremity, claimed as peripheral neuropathy or radiculopathy, that was aggravated by his service-connected thoracolumbar strain. Neurological Disability Left Upper Extremity (e.) Whether it is at least as likely as not (a probability of 50 percent or greater) that the Veteran has a neurological disability of the left upper extremity, claimed as peripheral neuropathy or radiculopathy, that was caused by his service-connected thoracolumbar strain. (f.) Whether it is at least as likely as not (a probability of 50 percent or greater) that the Veteran has a neurological disability of the left upper extremity, claimed as peripheral neuropathy or radiculopathy, that was aggravated by his service-connected thoracolumbar strain. A rationale should be provided for all opinions offered. 2. Develop and adjudicate the TDIU claim. This should include soliciting work history, educational background, and any other pertinent information prior to adjudication. Adjudication should then be undertaken in accordance with applicable procedures. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Connor, 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.