Citation Nr: 21014411 Decision Date: 03/12/21 Archive Date: 03/12/21 DOCKET NO. 13-00 055 DATE: March 12, 2021 REMANDED Entitlement to a separate rating for RLE radiculopathy (other than impairment of the sciatic nerve) is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1985 to January 1990, from March 2003 to September 2003, and from May 2004 to March 2005. In June 2020, the Board denied a rating in excess of 20 percent for degenerative disc disease of the lumbar spine and granted a 40 percent rating for RLE radiculopathy involving the sciatic nerve. The Board also remanded the issue of entitlement to “a separate rating for RLE radiculopathy involving the femoral nerve.” In this regard, the Board indicated that a February 2018 VA spine examination report noted that the Veteran had moderate radiculopathy involving both the right femoral and sciatic nerves. However, a few months later, the June 2018 VA examiner found that the anterior crural (femoral) nerve was normal. Therefore, a remand was requested in order to clarify whether the Veteran had RLE radiculopathy involving the femoral nerve, for which a separate rating may be warranted. Subsequently, the Veteran underwent a January 2021 VA peripheral nerves examination report. In addition to finding moderate incomplete paralysis of the sciatic nerve, the examiner indicated that the Veteran had “mild” incomplete paralysis of ALL other lower extremity nerves. The Board emphasizes that evaluation of the same disability under several diagnostic codes, known as pyramiding, must be avoided. Separate ratings may be assigned for distinct disabilities resulting from the same injury so long as the symptomatology for one condition is not duplicative of, or overlapping with, the symptomatology of the other condition. 38 C.F.R. § 4.14; Esteban v. Brown, 6 Vet. App. 259, 262 (1994). The January 2021 VA examiner did not provide any clarification as to which symptoms were attributable to each nerve (e. g., decreased sensation of the toes is related to the sciatic nerve versus sensational changes in the thigh or knee related to the femoral nerve). On remand, a clarifying medical opinion should be obtained in order to properly evaluate the Veteran’s RLE radiculopathy disability. The matters are REMANDED for the following actions: 1. Obtain a clarifying medical opinion from the January 2021 VA examiner who conducted the peripheral nerves examination. If that examiner is not available, obtain an opinion from another appropriate VA examiner. The need for the Veteran to be re-examined is left to the designee’s discretion. The examiner must review the entire claims file and a copy of this Remand. The examiner is asked to address the following: (a.) Opine whether it is possible to differentiate which symptoms are attributable to each of the Veteran’s RLE nerve impairments. (b.) If it is possible to differentiate what symptoms are attributable to each nerve in the right leg, specify what symptoms are related to the sciatic nerve and what symptoms are related to his other nerve impairments (e. g., decreased sensation of the toes is related to the sciatic nerve versus sensational changes in the thigh or knee is related to the femoral nerve). (c.) If the examiner determines that it is not possible to differentiate the symptoms attributable to the Veteran’s RLE nerve impairment(s), explain why. (d.) A complete rationale must be provided for all opinions expressed. 2. Then, readjudicate the issue on appeal. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Casadei, 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.