Citation Nr: A25106946 Decision Date: 12/11/25 Archive Date: 12/11/25 DOCKET NO. 241120-495862 DATE: December 11, 2025 REMANDED Entitlement to a disability rating in excess of 10 percent for left lower extremity sciatic nerve radiculopathy is remanded. Entitlement to a disability rating in excess of 10 percent for right lower extremity sciatic nerve radiculopathy is remanded. Entitlement to a separate disability rating for bilateral restless leg syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 2004 to November 2012. These matters come before the Board of Veterans' Appeals (Board) from a September 2024 rating decision by the Department of Veterans Affairs (VA) Veterans Benefits Administration, which is the Agency of Original Jurisdiction (AOJ). In the November 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the September 2024 AOJ decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801. However, because the Board is remanding the left and right radiculopathy and restless leg syndrome claims, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii). 1. Evaluation of left lower extremity sciatic nerve radiculopathy. 2. Evaluation of right lower extremity sciatic nerve radiculopathy. 3. Entitlement to a separate disability rating for restless leg syndrome. The Veteran challenges the evaluation of his left and right lower extremity peripheral nerve disabilities. November 2024 Notice of Disagreement. According to the Veteran, the current disability ratings fail to recognize the severity of both his radiculopathy and restless leg symptoms in each leg. November 2024 Notice of Disagreement. As discussed below, the Veteran seeks a separate rating from lower extremity sciatic radiculopathy for his restless leg syndrome for each of left and right lower extremities. See September 2024 rating decision, September 2024 supplemental claim, July 2024 higher level review decision, April 2024 rating decision; November 2023 VA Form 21-526EZ, Fully Developed Claim. By way of background, the AOJ originally granted service connection for left lower extremity sciatic radiculopathy in a June 2013 rating decision. In a November 2015 rating decision, the AOJ additionally granted service connection for right leg sciatic radiculopathy. In April 2023, more than a year after a September 2019 rating decision addressing the evaluation of left and right leg sciatic radiculopathy, the Veteran filed a claim for an increased rating for his service-connected lumbar spine disability generally. A June 2023 rating decision increased the then noncompensable disability rating for right leg sciatic radiculopathy to 10 percent and continued a 10 percent rating for left leg sciatic radiculopathy. Within a year, in November 2023, the Veteran filed a new claim seeking a separate rating for left and right restless leg syndrome, arguing that it was a separate disability from sciatic radiculopathy. The AOJ, in an April 2024 rating decision, denied a separate rating for restless leg syndrome citing concerns regarding evaluating the same disability under multiple diagnoses, and continued each of left and right leg sciatic radiculopathy, now also with restless leg syndrome, at a 10 percent disability rating. A July 2024 higher level review decision confirmed the April 2024 rating decision. Again within a year, in September 2024, the Veteran filed a supplemental claim application challenging the left and right lower extremity ratings and the failure to rate restless leg syndrome separately in the April 2024 rating decision as confirmed by the July 2024 higher level review decision. In the September 2024 rating decision on appeal, the AOJ determined that new and relevant evidence had been received and readjudicated the ratings challenge for the left and right lower extremity disabilities but continued the single disability rating of 10 percent for each of left and right lower extremity sciatic radiculopathy with restless leg syndrome. In the September 2024 rating decision, the AOJ found that the Veteran experienced mild incomplete paralysis of the left and right legs but did not have moderate nerve damage to either leg. The AOJ did not address the Veteran's contentions that his bilateral restless leg syndrome was a separate disability. September 2024 VA Form 20-0995; November 2023 VA Form 21-526EZ. In the April 2024 rating decision first addressing the Veteran's claim for separate ratings for left and right restless leg syndrome, however, the AOJ noted that evaluation of the same disability under multiple diagnoses must be avoided and then found simply that the Veteran's left and right sciatic nerve radiculopathy each manifested in symptoms warranting a 10 percent rating. VA provided the Veteran with peripheral nerve examinations in September 2019 and March 2024. In the September 2019 VA examination, conducted prior to the filing of the Veteran's November 2023 restless leg claim, the examiner reported diagnoses of left leg radiculopathy and right leg sciatic nerve radiculopathy, which began in approximately 2007 or 2008 following a parachute rigging malfunction and a traumatic landing that resulted in a herniated L5/S1 disc and fracturing to the higher vertebrae. Although the Veteran was not reporting symptoms in the right leg at the time of the examination and the examiner determined that the right leg radiculopathy was quiescent at the time of the examination, the Veteran reported intense left posterior thigh pain darting down from the left buttock to the thigh. The Veteran reported that he had treated the unpredictable shooting pains that had begun following the parachute injury with two surgeries, narcotics, non-steroidal anti-inflammatory drugs (NSAIDs), exercise, stretching, and H-wave electrode therapy. In the March 2024 examination, following the November 2023 claim for compensation for restless leg syndrome, the VA examiner identified restless leg syndrome as the Veteran's only peripheral nerve condition. The Veteran reported to the examiner that symptoms of a constant urge to move his legs and frequent leg movement while sleeping began in approximately 2010, following a back surgery. During the March 2024 examination, the Veteran did not report pain in either leg, but only frequent leg movements and the need to move the legs. The Veteran reported that he treated his restless leg symptoms with gabapentin. VA did not, for the March 2024 VA medical opinion that accompanied the March 2024 VA examination, specifically ask the examiner to address the previously diagnosed left and right sciatic radiculopathy but only whether any currently diagnosed conditions related to restless leg syndrome were related to the Veteran's service-connected low back disability. The March 2024 VA examiner thus opined only as to the restless leg syndrome diagnosis and provided a positive nexus opinion to the Veteran's low back disability. The March 2024 VA medical examiner did not address the existing left and right sciatic radiculopathy diagnoses and so also did not address the relationship of any radiculopathy symptoms to the Veteran's restless leg syndrome diagnosis or symptoms. Because these issues were not addressed in the September 2019 and March 2024 VA examinations, the Board is unable to address whether the two disabilities manifested in distinct symptoms and so were separately ratable, or to determine the severity of the left and right lower extremity disabilities, whether rated together or separately, by applying the rating criteria to the symptoms reported in the VA examinations. VA's failure to obtain an examination adequate to permit adjudication of the Veteran's claim constituted a pre-decisional duty-to-assist error. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A remand is necessary, therefore, to provide the Veteran with a VA medical opinion to cure the defects prior to adjudicating the claim on appeal. See 38 U.S.C. § 5103A; 38 C.F.R. § 20.802(a) Additionally, neither the March 2024 nor the September 2019 evaluated the Veteran's left and right sciatic radiculopathy or restless leg syndrome discounting for the ameliorative effects of the medication and treatment described in each examination, which included narcotics and non-steroidal anti-inflammatory drugs for sciatic radiculopathy and gabapentin for the restless leg syndrome. The Veteran's left and right sciatic radiculopathy are rated under 38 C.F.R. § 4.124a, Diagnostic Code 8520, for paralysis of the sciatic nerve. 38 C.F.R. § 4.124a. Because Diagnostic Code 8520 does not mention or take into account the effects of ameliorative medication, the Board may not consider the ameliorative effects of medication in evaluating the severity of the Veteran's left and right lower extremity disabilities. See Jones v. Shinseki, 26 Vet. App. 56, 63 (2012); Ingram v. Collins, 38 Vet. App. 130, 135 (2025). For these reasons, remand is appropriate to obtain fully adequate VA medical examinations that permit the Board to adjudicate the issues of whether the Veteran's left and right restless leg syndrome is a separately ratable lower extremity disability and the severity of the left and right lower extremity disabilities, whether rated together or separately. See 38 U.S.C. § 5103A(f)(2); 38 C.F.R. § 20.802(a). The matters are REMANDED for the following action: Schedule the Veteran for an examination regarding the nature and severity of his left and right lower extremity peripheral nerve disabilities. The examiner is asked to answer the following: (a.) What is the nature and severity of each diagnosed left and right lower extremity peripheral nerve disability, to include sciatic nerve radiculopathy and restless leg syndrome, and the signs and symptoms of each disability as necessary to evaluate the disability under the rating criteria? (b.) Whether the Veteran's left and right sciatic radiculopathy and left and right restless leg syndrome are distinct disabilities that manifest in distinct, separable symptoms? The examiner's report must be based on the severity of the Veteran's disability or disabilities as if he were not taking any medication. If the clinician is unable to provide such a report without resorting to speculation, the clinician should state whether the inability is due to a deficiency in the record (additional facts are required), the clinician's lack of expertise (does not have the required training or knowledge), or a limitation of the medical community at large (no one could respond given medical science and the known facts). ERIC S. LEBOFF Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Guill, 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.