Citation Nr: 21028537 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 12-10 798 DATE: May 11, 2021 REMANDED Entitlement to service connection for neck disability, to include as secondary to service-connected degenerative joint disease of the right hand and residuals of right ring finger amputation, is remanded. REASONS FOR REMAND The Veteran served with the Army National Guard, to include periods of active duty for training (ACDUTRA) from August 1966 to December 1966 and in June 1969. This matter initially came before the Board of Veterans' Appeals (Board) from a May 2010 rating decision. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at an April 2015 hearing and a transcript of the hearing is associated with his claims file. In June 2015 and August 2020, the Board remanded this matter for further development. Entitlement to service connection for neck disability, to include as secondary to service-connected degenerative joint disease of the right hand and residuals of right ring finger amputation, is remanded. The Board finds that it is necessary to obtain an adequate medical opinion as to whether the Veteran's claimed neck disability is aggravated by his service-connected degenerative joint disease of the right hand and residuals of right ring finger amputation. Consequently, the Board wishes to assure the Veteran that it would not be remanding this matter again unless it was essential for a full and fair adjudication of his claim. The Veteran contends, among other things, that he has current cervical spine disability that is associated with his service-connected degenerative joint disease of the right hand and residuals of right ring finger amputation. In the August 2020 remand, the Board instructed the agency of original jurisdiction (AOJ) to obtain a medical opinion that addressed, in pertinent part, whether the Veteran's current cervical spine disability was aggravated by his service-connected right hand disabilities. Pursuant to the Board's remand, a VA cervical spine examination was conducted in November 2020 and the Veteran was diagnosed as having degenerative arthritis of the cervical spine, intervertebral disc syndrome, spinal stenosis, and degenerative disc disease. The nurse practitioner who conducted the examination provided opinions in November 2020 and January 2021 that the Veteran's cervical spine disability was not aggravated by his service-connected right hand disabilities. However, the rationales that accompany these opinions essentially only address whether the cervical spine disability was aggravated by service itself and the Veteran's hand injury that occurred during service (as opposed to whether the disability was aggravated by the currently service-connected right hand disabilities which the Veteran has experienced in the years following service). Specifically, the examiner reasoned in November 2020 that the Veteran's cervical spine disability was not aggravated by his ring finger injury and that there was no evidence of any neck condition "occurring in service, to be aggravated beyond its natural progression." In January 2021, the examiner reasoned that since there was no evidence that the Veteran had any cervical spine complaints during service, there was no cervical spine disability "to have been aggravated by his service, or his right ring finger amputation." In light of the inadequacy of the November 2020 and January 2021 opinions, as noted above, the Board finds that a remand is necessary to obtain a new medical opinion as to whether the Veteran's current cervical spine disability is aggravated by his service-connected right hand disabilities. Also, the evidence indicates that there may be outstanding relevant VA treatment records. The most recent VA treatment records in the claims file are from the New Mexico VA Health Care System and are dated to May 2020. Any VA treatment records are within VA's constructive possession, and must be obtained regardless of their relevance as long as they are sufficiently identified. Sullivan v. McDonald, 815 F.3d 786, 793 (Fed. Cir. 2016) (VA has a duty to assist in obtaining sufficiently identified VA medical records regardless of their relevance). See also Jones v. Wilkie, 918 F.3d 922 (Fed. Cir. 2019) (confirming the holding in Sullivan). A remand is required to allow VA to obtain them. The matter is REMANDED for the following action: 1. Obtain all of the Veteran's VA treatment records dated from May 2020 to the present. 2. After all efforts have been exhausted to obtain and associate with the claims file any additional treatment records, obtain an addendum opinion from an appropriate clinician regarding whether any cervical spine disability experienced by the Veteran since approximately November 2008 is at least as likely as not (50 percent probability or more) aggravated by his service-connected degenerative joint disease of the right hand and/or residuals of right ring finger amputation. Aggravation is defined as a worsening beyond the natural progression of the disability. The clinician must provide reasons for each opinion given. In this regard, the clinician must address whether any current cervical spine disability is aggravated by the Veteran's currently service-connected right hand disabilities that he has experienced in the years since service, and not whether any cervical spine disability was aggravated by the Veteran's active service itself and any injury that occurred during service. ROBERT C. SCHARNBERGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Elwood, 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.