Citation Nr: 21021485 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 16-62 752 DATE: April 13, 2021 REMANDED Entitlement to an initial evaluation in excess of 20 percent prior to October 19, 2016, and in excess of 40 percent thereafter, for a lumbar spine disability is remanded. Entitlement to an initial evaluation in excess of 10 percent prior to October 19, 2016, and in excess of 20 percent thereafter for radiculopathy of the right lower extremity is remanded. Entitlement to an initial evaluation in excess of 20 percent for radiculopathy of the left lower extremity is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) prior to May 26, 2015, is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Army from May 1968 to May 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from August 2015 and March 2017 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in October 2019. This case was previously before the Board in September 2020, when it was remanded for development. The case has been returned to the Board for further appellate review. A January 2021 rating decision granted service connection for radiculopathy of the right and left lower extremities associated with the lumbar spine disability. While this rating decision was not appealed, the Board finds that the ratings for service-connected radiculopathy of the right and left lower extremities are part and parcel of the claim for a higher disability rating for the service-connected lumbar spine disability. See 38 C.F.R. § 4.71a, General Rating for Diseases and Injuries of the Spine, Note 1. Therefore, the Board will consider the evaluations of the radiculopathy of the right and left lower extremities in conjunction with the evaluation of the lumbar spine disability that was appealed from the March 2013 rating decision noted above. 1. Entitlement to an initial evaluation in excess of 20 percent prior to October 19, 2016, and in excess of 40 percent thereafter, for a lumbar spine disability is remanded. The Board previously remanded this case for an opinion regarding whether there was osteoarthritis of the lumbar spine that developed due to the service-connected lumbar strain. This was necessary, in part, because the Veteran also has a diagnosis of psoriatic arthritis of the entire spine. The RO obtained a VA opinion in November 2020 that determined the osteoarthritis was indeed as likely as not proximately due to the lumbar strain. This opinion also noted that the Veteran’s back problems are likely due to a combination of the effects of the osteoarthritis and the psoriatic arthritis. In order to determine the proper evaluation for the Veteran’s service-connected lumbar spine disability, which includes lumbar strain and osteoarthritis, but not psoriatic arthritis, the Board finds it necessary to obtain an opinion regarding whether it is possible to distinguish the symptoms of both types of arthritis. See Mittleider v. West, 11 Vet. App. 181, 182 (1998) (where it is not possible to separate the effects of a service-connected disability from a non-service-connected disability, the signs and symptoms must be attributed to the service-connected disability). Entitlement to an initial evaluation in excess of 10 percent prior to October 19, 2016, and in excess of 20 percent thereafter for radiculopathy of the right lower extremity is remanded. 2. Entitlement to an initial evaluation in excess of 20 percent for radiculopathy of the left lower extremity is remanded. 3. Entitlement to a TDIU prior to May 26, 2015, is remanded. The radiculopathy ratings and TDIU issue are intertwined with the lumbar spine issue remanded above and are also remanded at this time. See Henderson v. West, 12 Vet. App. 11, 20 (1998); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: Forward the claims file to an appropriate clinician to determine whether the symptoms of the Veteran’s service-connected lumbar disability (which includes lumbosacral strain with degenerative arthritis, degenerative disc disease, degenerative scoliosis, foraminal/lateral recess/central stenosis, and intervertebral disc syndrome) can be distinguished from the symptoms of his non-service-connected psoriatic arthritis of the spine. Following detailed review of the claims file, the examiner should opine whether the symptoms associated with the Veteran’s service-connected lumbar spine disability can be clearly delineated from the symptoms of the non-service-connected psoriatic arthritis of the spine. If so, the examiner should specifically list which symptoms are clearly attributable to the service-connected lumbar disability and which are clearly attributable to the non-service-connected psoriatic arthritis. If the symptoms from each disability cannot be clearly delineated, this must be expressly noted. In providing the requested opinion, the examiner should consider lay evidence of functional loss associated with flare-ups and repeated use over time as well as clinical evidence, such as initial range of motion measurements. All findings must be reported in detail and all opinions must be accompanied by a clear rationale. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Josey, 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.