Citation Nr: 22016351 Decision Date: 03/22/22 Archive Date: 03/22/22 DOCKET NO. 18-18 887 DATE: March 22, 2022 REMANDED Entitlement to service connection for a right upper extremity neurological disability, to include right upper arm radiculopathy, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1971 until his retirement in February 1992. Entitlement to service connection for a right upper extremity neurological disability, to include right upper arm radiculopathy, is remanded. In October 2021, the Board of Veterans' Appeals (Board) remanded this claim following a Joint Motion for Partial Remand granted in January 2021 by the United States Court of Appeals for Veterans Claims. The Board remand directed that the Veteran be afforded a new VA examination and that medical opinions be provided regarding both direct and secondary service connection theories. The Board specified that an opinion must be rendered regarding whether any identified right upper extremity neurological disability has been aggravated (increased in severity beyond the natural progression of the disorder) by the Veteran's right clavicular fracture residuals or other service-connected disabilities. A preliminary review of the record shows that subsequently the Veteran underwent an examination, and the VA examiner opinion provided theories regarding direct service connection and secondary service connection. However, the examiner only stated that the Veteran's condition had not been caused by his service-connected disabilities, and she did not address whether the Veteran's diagnosed condition was aggravated by his service-connected disabilities. See 38 C.F.R. §3.310(b); see also El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013) (finding that a secondary opinion which addresses a causal relationship, but which does not address the question of aggravation, is inadequate). Thus, the Board's remand instructions were not substantially complied with, and additional medical opinion is necessary before the Board may reach a decision. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: Arrange for an addendum opinion to be rendered, if possible by the same physician who conducted the Veteran's December 10, 2021 Peripheral Nerves examination, regarding the nature and etiology of the Veteran's right upper extremity neurological condition. An additional in-person examination is not necessary unless deemed so by the examiner. The examiner is asked to review the Veteran's claim file, including her previous examination reports, and to offer the following opinions: (a.) Is it at least as likely as not (approximately 50 percent or greater probability) that the Veteran's right upper extremity neurological disability has been aggravated (increased in severity beyond the natural progression of the disorder) by his right clavicular fracture residuals or other service-connected disabilities? A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are require), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Hermsdorfer, 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.