Citation Nr: 22040486 Decision Date: 07/14/22 Archive Date: 07/14/22 DOCKET NO. 15-35 713 DATE: July 14, 2022 REMANDED Entitlement to service connection for a cervical spine disability is remanded. Entitlement to service connection for a left upper extremity neurological disability is remanded. Entitlement to service connection for a right upper extremity neurological disability is remanded. INTRODUCTION The Veteran had active service from May 1965 to July 1965. In September 2017 the Veteran attended a videoconference hearing before the undersigned Veterans Law Judge. When this case was previously before the Board in March 2018, April 2021, and October 2021, the above-noted issues were remanded for further development. The case has since been returned for additional appellate review. REASONS FOR REMAND Unfortunately, this case must again be remanded in order to ensure compliance with the prior Board remand instructions. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In the October 2021 remand, the Board instructed the RO to obtain VA examinations and medical opinions from an Orthopedic Specialist to address the Veteran's above-claimed disabilities. Following that remand, the RO requested these examinations; however, by way of a May 2022 correspondence, the outsourced examination provider Logistics Health Incorporated (LHI) notified the RO that the Veteran had cancelled his examinations. LHI provided no explanation for why the Veteran requested to cancel his examinations, and the RO appears to have made no further inquiries. Further, it does not appear the RO initiated even basic telephone contact to determine whether the Veteran wished to reschedule his examination, or whether he wished to withdraw his claims. Based on the above-noted deficiencies, the Board finds substantial compliance with the prior remand instructions has not been achieved. Accordingly, this case is REMANDED for the following actions: 1. Initiate both written and telephone contact with the Veteran to determine whether he is ready, willing, and able to attend his missed VA examinations. 2. If so, afford the Veteran a VA examination by an Orthopedic Specialist Physician with sufficient expertise, who has not previously examined this Veteran, to address the etiology of the Veteran's claimed cervical spine and bilateral upper extremity neurological disabilities. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether any diagnosed cervical spine or bilateral upper extremity neurological disability at least as likely as not: a) originated during his period of active service or is otherwise etiologically related to his active service; b) was caused by his service-connected lumbar spine disability; or c) was worsened to any degree by his service-connected lumbar spine disability. The examiner must specifically address the Veteran's reports relative to the etiology of the claimed disabilities, and should also consider and expressly discuss the March 2015 note from the Veteran's treating clinician at the Houston VAMC, wherein the clinician found the Veteran's "back and neck issues are most likely related." If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. 3. If the Veteran indicates he no longer wishes to pursue his appeal he should be provided with an Appeals Satisfaction Notice for his completion. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Fraser, 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.