Citation Nr: 21026495 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 15-23 004 DATE: May 3, 2021 REMANDED Entitlement to service connection for a cervical spine condition is remanded. Entitlement to service connection for a right shoulder condition is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1974 to May 1977 and from June 1977 to May 1995. This matter is before the Board of Veterans' Appeals (Board) on appeal from a June 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Board denied, in pertinent part, service connection for a right shoulder condition and service connection for a cervical spine condition. The Veteran appealed the August 2019 Board decision to the United States Court of Appeals (Court). In November 2020 the Court granted a Joint Motion for Partial Remand (JMPR), vacating the denial. The parties agreed that the December 2014 VA examiner's opinion was inadequate because the examiner did not adequately address whether the claimed conditions were aggravated by the Appellant's service connected back disability. The Board also has concerns that the December 2014 medical opinion did not adequately address the causation aspect of secondary service connection. Regarding, the cervical spine condition only conclusionary statements were provided as supporting rationale, which is inadequate. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) (examiner must provide "not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two"). Regarding, the right shoulder condition no opinion was provided as to whether the condition was caused by his service connected back disability. Additionally, a July 2013 letter from Dr. L. R, indicates that the Veteran was seen at RiverWay Clinic over the past 8 years for his cervical spine condition. However, these treatment records are not of record. Thus, a remand is necessary to obtain a medical opinion that adequately addresses secondary service connection and treatment records from RiverWay Clinic. The matters are REMANDED for the following action: 1. Request authorizations to obtain private treatment records from RiverWay Clinic. If the Veteran responds, all reasonable attempts should be made to obtain such records. If any such records are unavailable, inform the Veteran and afford him the opportunity to submit any copies in his possession. 2. After completion of the above development, obtain a medical opinion regarding the nature and etiology of the Veteran's right shoulder condition and cervical spine condition. A copy of this remand must be provided to and reviewed by the examiner. The entire claims file must also be made available to and be reviewed by the examiner. If the examiner finds that a physical examination is needed, such should be scheduled. 3. The examiner must address whether it is at least as likely as not (50 percent or greater probability) that the Veteran's right shoulder condition: a. was caused by his service-connected back condition. b. underwent any incremental increase in disability, regardless of its permanence, due to a service-connected back disability. The term "incremental increase in disability" means additional impairment of earning capacity. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. Moreover, any "incremental increase in disability" need not be permanent. 4. The examiner must address whether it is at least as likely as not (50 percent or greater probability) that the Veteran's cervical spine condition: a. was caused by his service-connected back condition. b. underwent any incremental increase in disability, regardless of its permanence, due to a service-connected back disability. The term "incremental increase in disability" means additional impairment of earning capacity. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. Moreover, any "incremental increase in disability" need not be permanent. Rationale must be provided for the requested opinion. Discussion and citation of supporting medical treatise/research would be very helpful. If the examiner concludes that an opinion cannot be offered without resort to mere speculation, the examiner must address whether research in the medical literature might assist him/her in providing the medical opinion requested in this matter, and if so, such research in the medical literature must be conducted. DUSTIN L. WARE Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Smith, Associate 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.