Citation Nr: 21016059 Decision Date: 03/19/21 Archive Date: 03/19/21 DOCKET NO. 19-04 076 DATE: March 19, 2021 ORDER Service connection for radiculopathy of the fingers and thumb of the left hand (hereinafter left hand radiculopathy) is granted. FINDING OF FACT The Veteran’s left hand radiculopathy is proximately due to his service-connected cervical spine stenosis. CONCLUSION OF LAW The criteria for service connection for left hand radiculopathy as secondary to service-connected cervical spine stenosis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1989 to September 2014. In a decision issued in February 2020, the Board, in pertinent part, denied entitlement to service connection for radiculopathy of the left hand. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In October 2020, the Court issued an order that vacated the Board’s February 2020 decision with respect to the issue of entitlement to service connection for radiculopathy of the left hand and remanded the matter for adjudication consistent with the instructions outlined in an October 2020 Joint Motion for Partial Remand (JMPR) by the parties. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). With any claim for service connection, it is necessary for a current disability to be present. See Brammer v. Derwinski, 3 Vet. App. 223 (1992); McClain v. Nicholson, 21 Vet. App. 319 (2007) (recognizing the disability could arise at any time during the claim); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013) (recognizing disabilities that occur immediately prior to filing of a claim). The requirement that a current disability exists is satisfied if the claimant had a disability at the time her claim for VA disability compensation was filed or during the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Secondary service connection is warranted where a disability is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Briefly, the threshold legal requirements for a successful secondary service connection claim are: (1) evidence of a current disability for which secondary service connection is sought; (2) a disability for which service connection has been established; and (3) competent evidence of a nexus between the two. With an approximate balance of positive and negative evidence on a relevant issue, VA resolves reasonable doubt in the claimant's favor. 38 U.S.C. § 5107; 38 C.F.R. § 3.102 (2017); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). 1. Entitlement to service connection for left hand radiculopathy as secondary to service-connected cervical spine stenosis. The Veteran seeks service connection for left hand radiculopathy. After a thorough review of the record, the Board finds that the preponderance of the evidence weighs in favor of an award of service connection for left hand radiculopathy as secondary to the Veteran’s service-connected cervical spine stenosis. A threshold question that must be addressed, is whether the Veteran has a current disability for which service connection is sought. In the February 2020 decision, the Board, relying on the reports from VA examinations conducted in July 2014 and March 2018, denied the Veteran’s claim on the basis that he did not have a current disability and thus failed to satisfy the first element of service connection. See February 2020 Board Decision. Specifically, it was stated that during the July 2014 VA examination, mild to moderate numbness in the tip of the left index finger was noted. However, the sensory examination was normal with no signs or symptoms of radiculopathy. It was also noted that during March 2018 VA examinations, it was concluded that the Veteran did not have a current left-hand condition or signs of radiculopathy in the left upper extremity. Therefore, it appeared the issue had resolved itself, as had been initially projected when the Veteran sought treatment for tingling in his left hand following a surgical procedure that took place in service. Upon further review of the record, however, it shows that during the July 2014 VA examination, the Veteran was given a diagnosis of chronic radiculopathy of the fingers and thumb of the left hand. Moreover, this examination was provided as a result of the Veteran having initiated a claim for service connection, in June 2014, while he was still in service. See Fully Developed Claim. Thus, while the evidence shows the Veteran’s symptoms may have abated over time, because the Veteran was given a diagnosis of radiculopathy of the fingers and thumb of the left hand during the pendency of the claim, the current disability element is satisfied. See McClain, 21 Vet. App. 319; see also Romanowsky 26 Vet. App. 289. An April 2015 rating decision granted service connection for cervical spine stenosis. See April 2015 Rating Decision. Thus, the second element of secondary service connection is met. Finally, the Board finds that the preponderance of the evidence demonstrates that a nexus exists between the Veteran’s left hand radiculopathy and his service-connected cervical spine stenosis. Service treatment records (STRs) reveal that in November 2013, the Veteran presented to physicians with complaints of left shoulder pain and numbness in his left thumb and index finger. A neck X-ray revealed mild arthritic changes at the joint space C5-6. The treating physician indicated that this could cause pain and tingling to the digits. In an appointment later in November 2013, after conducting a physical examination, the treating physician opined that the Veteran demonstrated signs and symptoms consistent with a possible left C6 radiculitis. More specifically, the doctor noted that the Veteran had “symptomatic functional limitations of pain, numbness/ tingling/ shooting” into the left upper extremity secondary to functional and/or “structural foraminal encroachment.” See STR received February 2015. As noted above, in July 2014, the Veteran underwent a VA examination prior to his separation from the military. The examiner noted that the Veteran reported sustaining an injury to his neck in August or September of 1991, and at the time was told that he pinched a nerve in his neck. The Veteran reported that the symptoms resolved until September 2013 when he began experiencing left upper extremity pain and left index finger numbness. The Veteran was diagnosed with cervical spine degeneration C5-C6 and cervical nerve root compression, and underwent a total cervical discectomy and replacement in February 2014 to treat the condition. The examiner noted that the Veteran did not suffer an injury to the left index finger and that his left index finger numbness was improving since the February 2014 cervical surgery. Ultimately, the examiner diagnosed the Veteran with radiculopathy of the fingers and thumb of the left hand and opined that the numbness associated with the condition was related to his cervicalgia. See July 2014 VA Examination. Based on the foregoing, the Board finds that the evidence is at least in equipoise as to whether a nexus is established between the Veteran’s service-connected cervical spine stenosis and left hand radiculopathy. Accordingly, the criteria for left hand radiculopathy as secondary to service-connected cervical spine stenosis are met. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Talton, John H. 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.