Citation Nr: 25004158 Decision Date: 03/26/25 Archive Date: 03/26/25 DOCKET NO. 19-02 236 DATE: March 26, 2025 REMANDED Entitlement to service connection for a cervical spine disability is remanded. Entitlement to service connection for right upper extremity radiculopathy, to include as secondary to a cervical spine disability, is remanded. Entitlement to service connection for left upper extremity radiculopathy, to include as secondary to a cervical spine disability, is remanded. REASONS FOR REMAND The Veteran served honorably on active duty with the United States Coast Guard from July 1980 to May 2004. These matters come before the Board of Veterans' Appeals (Board) on appeal from July 2015 and August 2018 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO), which is the agency of original jurisdiction (AOJ) in this matter. The matters were previously remanded by the Board in August 2020. In an April 2022 decision, the Board denied the claims. In March 2023, the United States Court of Appeals for Veterans' Claims (Court) granted a Joint Motion for Remand vacating the Board's decision and remanding the claims on appeal for further development. In May 2023, the Board remanded the matters for further development. After the RO completed the requested development, the Board issued a decision in March 2024 in which it denied the claims on appeal. In November 2024, the Court granted a Joint Motion for Partial Remand (Joint Motion) vacating that part of the Board's decision that denied claims of entitlement to service connection for a cervical spine disability and right and left upper extremity radiculopathy and remanding the matters for additional development. 1. Entitlement to service connection for a cervical spine disability is remanded. The parties to the November 2024 Joint Motion agreed that remand was necessary for the Board to obtain a new VA medical opinion that adequately addresses whether the Veteran's cervical spine disability was caused by an event in service, specifically to include his reported heavy lifting, regardless of whether there was continuity of symptomatology. The parties also agreed that the Board must address whether service connection is warranted pursuant to 38 C.F.R. §3.303(b), as a chronic disease rather than simply based on continuity of symptomatology, and whether a VA medical opinion is needed to determine whether there was (a) a combination of manifestations sufficient to identify a relevant disease entity and (b) sufficient observation to establish chronicity in service. Accordingly, the Board finds that remand is warranted to obtain an addendum opinion on these matters. 2. Entitlement to service connection for right upper extremity radiculopathy, to include as secondary to a cervical spine disability, is remanded. 3. Entitlement to service connection for left upper extremity radiculopathy, to include as secondary to a cervical spine disability, is remanded. As noted by the parties to the Joint Motion, a decision on the remanded issue of service connection for a cervical spine disability could significantly impact a decision on the issues of entitlement to service connection for right and left upper extremity radiculopathy; therefore, the issues are inextricably intertwined. The claims for service connection for right and left upper extremity radiculopathy must be remanded pending adjudication of the claim of entitlement to service connection for a cervical spine disability. Harris v. Derwinski, 1 Vet.App. 180, 183 (1991). The matters are REMANDED for the following actions: 1. Return the claims file to the October 2023 VA examiner or another qualified clinician for an addendum opinion concerning the etiology of the Veteran's cervical spine disability. The examiner must review the claims file and note such review in providing an opinion. The need for another examination is left to the discretion of the examiner. The examiner must provide a response to the following: (a) Is the Veteran's cervical spine disability, diagnosed as degenerative arthritis, IVDS, and DISH, at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to service, including heavy lifting performed therein? In providing the requested opinion, the examiner must consider the Veteran's description of the onset of his cervical spine disability and in-service symptoms as well as post-service symptoms. The examiner must specifically address the Veteran's reports that he performed heavy lifting during active service and opine as to whether his current cervical spine disability was caused by heavy lifting during service. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of the current disability, this should be noted. Stated another way, do the Veteran's reports about the symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? The examiner must also provide a response to the following: (b) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's cervical spine disability, diagnosed as degenerative arthritis, IVDS, and DISH, (1) began during active service, (2) manifested to a compensable level within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service? In determining whether the disability began during service, the examiner should address whether there was a combination of manifestations sufficient to identify a relevant disease entity and sufficient observation to establish chronicity in service. A complete supporting rationale must be provided for all opinions expressed. 2. Then, readjudicate the claims. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. T. Raftery, 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.