Citation Nr: 21015827 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 15-42 103 DATE: March 18, 2021 REMANDED Entitlement to an evaluation in excess of 10 percent for (service-connected under 38 U.S.C. § 1151) muscle and nerve damage from rib harvest for rhinoplasty is remanded. Entitlement to service connection for stiff person syndrome (claimed also as progressive weakness of arms) is remanded. The claim to reopen the previously denied claim of entitlement to service connection for a back condition to include the right hip and lower leg condition (not claimed as nerve damage right side of legs; hip muscle spasms) as secondary to service-connected muscle and nerve damage is remanded. Entitlement to automobile and adaptive equipment or for adaptive equipment only is remanded. REASONS FOR REMAND The Veteran had active duty service in the United States Air Force from June 1964 through July 1966; his character of discharge was subsequently deemed to have been under honorable conditions. The matters come to the Board of Veterans’ Appeals (Board) from an August 2013 Rating Decision. 1. Entitlement to an evaluation in excess of 10 percent for (service-connected under 38 U.S.C. § 1151) muscle and nerve damage from rib harvest for rhinoplasty is remanded; and 2. Entitlement to service connection for stiff person syndrome (claimed also as progressive weakness of arms) is remanded; and 3. The claim to reopen the previously denied claim of entitlement to service connection for a back condition to include the right hip and lower leg condition (not claimed as nerve damage right side of legs; hip muscle spasms) as secondary to service-connected muscle and nerve damage is remanded; and 4. Entitlement to automobile and adaptive equipment or for adaptive equipment only is remanded. The Veteran currently has a compensable rating under 38 U.S.C. § 1151 for a muscle and nerve damage condition, for which he seeks an increase. The Veteran also seeks service connection for a back condition and lower leg nerve condition, which he contends are related to his compensable disorder. He seeks service connection for “stiff person syndrome;” the precise theory underlying this claim is unclear. He also seeks financial assistance for the purchase of an automobile and adaptive equipment or for adaptive equipment only. Remand of all claims is warranted as it does not appear all necessary development has yet been performed. Specifically, documents associated with the record indicate the Veteran is receiving Social Security disability benefits; therefore, on remand, medical records pertaining to the Veteran’s disabilities should be obtained from the Social Security Administration (SSA). Additionally, it is noted that on review of the VA examinations of record, the extent of the compensable condition may not lend itself well to the format of the DBQs and appears a matter of significant medical complexity. Under the circumstances of this particular claim, an independent medical opinion by a nerve specialist, as provided for by 38 U.S.C. § 5109, detailing the extent of all symptoms and functional impacts of the disability at hand is warranted. The examiner should identify if there is any causation or aggravation of any condition for which service connection is sought on appeal (nerve condition affecting the bilateral upper extremities, nerve condition affecting the bilateral lower extremities, back condition) by the Veteran’s compensable muscle/nerve condition. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate such with the file. 2. Obtain relevant medical records from SSA relating to the Veteran’s disability claims. 3. After the above development has been performed, obtain an advisory medical opinion from a nerve specialist pursuant to 38 U.S.C. § 5109. The entire claims file, to include a copy of this remand, must be available to and reviewed by the expert. If the specialist determines that an in-person examination is warranted, such shall be scheduled. After reviewing the Veteran’s claims file, the expert is asked to answer the following questions: (a) Please detail all symptoms related to the Veteran’s § 1151 compensable muscle/nerve condition, and the functional limitations that are at least as likely as not attributable to this condition. (b) Is it at least as likely as not that any current identified back disorder was caused or aggravated by the § 1151 compensable muscle/nerve condition? (c) Is it at least as likely as not that any current identified nerve condition affecting the bilateral lower extremities or bilateral upper extremities was caused or aggravated by the § 1151 compensable muscle/nerve condition? A complete rationale for all requested opinions must be provided by the reviewing medical expert. 4. Following the receipt of the opinion requested, provide a copy of the opinion to the Veteran and representative, and allow an adequate time to submit any response. J. NICHOLS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. C. KING 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.