ULNAR NERVE PARALYSIS

M. DONOHUE · 2026 · Case ID: A26032197

MIXED

Summary

The veteran, who served in the United States Army from September 2014 to February 2015 and again from February 2019 to June 2019, appeals the denial of service connection for bilateral upper extremity radiculopathy, claimed as secondary to cervical strain. The Board found that the evidence persuasively weighed against a current diagnosis of bilateral upper extremity radiculopathy. A VA examination in August 2020 noted no radicular pain or symptoms, and the examiner did not diagnose radiculopathy. While the veteran reported upper extremity symptoms in service treatment records, these were not diagnosed as radiculopathy, and the Board found the veteran's lay statements regarding a current diagnosis to be unsubstantiated and not probative. The Board noted the veteran is competent to report symptoms but not to diagnose medical conditions. As no current disability was established, the claim for radiculopathy was denied. However, the issue of service connection for cervical strain was remanded. The Board found the VA examiner's opinion regarding cervical strain incomplete, as it impermissibly relied solely on the absence of in-service complaints. Remand is necessary for an addendum opinion to determine the nature and etiology of the cervical strain and whether it had its onset during service or is due to a service event.

Rationale

No current diagnosis of radiculopathy; VA examination showed no radicular pain or symptoms; Veteran's lay statements not probative for diagnosis

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210609-164944

Full Decision Text

Citation Nr: A26032197
Decision Date: 04/08/26 Archive Date: 04/08/26

DOCKET NO. 210609-164944
DATE: April 8, 2026

ORDER

Service connection for right upper extremity radiculopathy, to include as secondary to cervical strain, is denied.

Service connection for left upper extremity radiculopathy, to include as secondary to cervical strain, is denied.

REMANDED

The issue of entitlement to service connection for cervical strain is remanded.

FINDINGS OF FACT

1. The evidence of record persuasively weights against a finding that the Veteran had a current diagnosis of right upper extremity radiculopathy at any time during, or approximate to, the pendency of the claim.

2. The evidence of record persuasively weights against a finding that the Veteran has a current diagnosis of left upper extremity radiculopathy at any time during, or approximate to, the pendency of the claim.

CONCLUSIONS OF LAW

1. The criteria for service connection for right upper extremity radiculopathy, to include as secondary to cervical strain, have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

2. The criteria for service connection for left upper extremity radiculopathy, to include as secondary to cervical strain, have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from September 2014 to February 2015, and from February 2019 to June 2019.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2020 rating decision issued by an agency of original jurisdiction (AOJ).

In the June 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the hearing docket. On November 14, 2024, the Veteran testified at a hearing before the undersigned Veterans Law Judge.

Therefore, the Board may only consider the evidence of record at the time of the September 2020 AOJ decision on appeal, as well as any evidence submitted by the Veteran, or his representative, at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision.

However, because the Board is remanding the claim of entitlement to service connection for cervical strain, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii).

Service Connection

Service connection will be granted for a disability resulting from disease or injury incurred in, or aggravated by, active military service. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.303, 3.304. The three-element test for service connection requires evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. See 38 C.F.R. § 3.310. Secondary causation exists when, but for the service connected disability, the nonservice connected disability was caused by a service connected disability either in a direct, etiological way or via multiple steps in a causal chain. Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023). Secondary aggravation exists when the nonservice connected disability not caused by a service connected disability would be less severe were it not for a service connected disability. Secondary service connection isn't limited to "a single cause and effect" but also applies to conditions "that...would have been less severe were it not for the service connected disability." Id. at 1364.

Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(d).

Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical and lay evidence, with due consideration to VA's policy to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a).

The Board is responsible for determining whether the evidence persuasively supports the claim or is in approximate balance, with the Veteran prevailing in either event, or whether the evidence is persuasively against the claim, in which case the claim is denied. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. 38?U.S.C. §?5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

1. Service connection for right upper extremity radiculopathy, to include as secondary to cervical strain

2. Service connection for left upper extremity radiculopathy, to include as secondary to cervical strain

The Veteran contends that his bilateral upper extremity radiculopathy was incurred during active military service. Alternatively, the Veteran contends that his bilateral upper extremity radiculopathy is secondary to his cervical strain.

For the reasons that follow, the Board finds the evidence persuasively weighs against finding that the Veteran has a current diagnosis of bilateral upper extremity radiculopathy.

The Veteran was afforded a VA neck examination in August 2020. The Veteran reported the onset of neck pain in 2019. Complaints or a history of upper extremity radiculopathy were not noted or reported. On examination, no radicular pain or other signs and symptoms due to radiculopathy were noted or reported. The VA examiner did not diagnose the Veteran with any upper extremity radiculopathy.

Review of the Veteran's medical treatment records show that twice the Veteran reported upper extremity symptoms down to his hand. See December 2020 VA Treatment Record; August 2020 Service Treatment Record (STR). The Board notes that the August 2020 report of upper extremity radicular symptoms did not occur during a period of active duty service despite being included in the Veteran's STRs. Further, in the December 2020 record, the Veteran complained of pain going down his arm into his forearm and then his palm and that stretching and shaking his arm helped reduce the pain. He was diagnosed with cervicalgia, and no diagnoses of upper extremity radiculopathy was rendered.

The Board has considered the Veteran's statements that he has bilateral upper extremity radiculopathy. The Veteran is competent to report on that of which he has personal knowledge, including experienced symptomatology. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, the Veteran is not competent to diagnose radiculopathy as doing so requires complex medical knowledge and training
STRs. Further, in the December 2020 record, the Veteran complained of pain going down his arm into his forearm and then his palm and that stretching and shaking his arm helped reduce the pain. He was diagnosed with cervicalgia, and no diagnoses of upper extremity radiculopathy was rendered.

The Board has considered the Veteran's statements that he has bilateral upper extremity radiculopathy. The Veteran is competent to report on that of which he has personal knowledge, including experienced symptomatology. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, the Veteran is not competent to diagnose radiculopathy as doing so requires complex medical knowledge and training of which the Veteran does not have. Id. (noting general competence to testify as to symptoms but not to provide medical diagnosis). Thus, the Veteran's generalized, unsubstantiated, lay statements that he has a current diagnosis of bilateral upper extremity radiculopathy are not probative. Further, given the absence of any radiculopathy findings in the August 2020 VA examination report, the Board finds that functional impairment of the Veteran's earning capacity has not been demonstrated by his reported symptoms.

Pivotal to any service connection claim is the presence of a current disability. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). In the absence of proof of a current disability, there can be no valid claim. Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998). As such, an assessment of the remaining elements of service connection is not warranted.

In conclusion, the Board finds that the competent evidence of record persuasively weighs against the Veteran's claim for service connection for bilateral upper extremity radiculopathy. As the competent evidence of record persuasively weighs against service connection, the benefit-of-the-doubt rule does not apply, and service connection for bilateral upper extremity radiculopathy is not warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021). Accordingly, the claim is denied.

REASONS FOR REMAND

The issue of entitlement to service connection for cervical strain

The Veteran contends that his cervical strain was incurred during active military service. Alternatively, the Veteran contends that his cervical strain is secondary to his service-connected left shoulder disability. The Board notes that this alternative theory of entitlement was not raised prior to the AOJ issuing the rating decision on appeal. Thus, the AOJ's failure to address this theory of entitlement is not a pre-decisional duty to assist error. 38 C.F.R. § 20.802(a).

The AOJ made favorable findings that the Veteran has a current diagnosis of cervical strain and that a qualifying event, injury, or disease had its onset during service. These are favorable findings by the AOJ, and the Board is bound by them absent clear and unmistakable error. 38 C.F.R. § 3.104(c).

After careful review of the evidence of record, and as set forth more fully below, the Board finds remand is required to correct pre-decisional duty to assist errors.

The Veteran was afforded a VA examination in August 2020. In rendering a negative etiological opinion, the examiner explained that she was unable to locate any STRs related to neck pain until April 2020 which is after active military service and he was seen for shoulder pain. The examiner further explained that although she was able to locate in-service records for shoulder complaints, the medical notes appear specific to shoulder activity and dysfunction only, and not neck dysfunction.

The Board finds the August 2020 VA etiological opinion incomplete for adjudicative purposes. Upon review, the examiner impermissibly relied solely on the absence of in-service complaints, treatment, or diagnoses of a neck condition to support her conclusions. The absence of contemporary medical records documenting an in-service diagnosis of a claimed condition is not, standing alone, sufficient to support an unfavorable opinion. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).

The AOJ's failure to obtain complete medical opinions upon which to adjudicate the Veteran's bilateral hand and feet disabilities constitutes pre-decisional duty to assist errors, and the Board is not competent to substitute its own medical rationale for that of the opinions. Accordingly, remand is necessary to obtain addendum opinions to determine the nature and etiology of the Veteran's claimed bilateral hand and feet disabilities.

The Board does not, at this time, make any determinations regarding the
of contemporary medical records documenting an in-service diagnosis of a claimed condition is not, standing alone, sufficient to support an unfavorable opinion. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).

The Board does not, at this time, make any determinations regarding the competency or credibility of any evidence currently of record, to include those described in this remand.

The matters are REMANDED for the following action:

Obtain an addendum opinion to determine the nature and etiology of the Veteran's diagnosed cervical strain. The need for an additional examination is left to the discretion of the clinician selected to write the addendum opinion.

Upon review of the claims file, the examiner must address and provide an opinion, with supporting rationale, as whether the Veteran's claimed cervical strain had its clinical onset during service or is due to an event or incident of the Veteran's period of active service.

M. Donohue

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board D. Bellack, 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.

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