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PARALYSIS OF SCIATIC NERVE OR EXTERNAL POPLITEAL NERVE

DAVID L. WIGHT · 2026 · Case ID: A26039440

MIXED

Summary

The Veteran, who served in the United States Army National Guard from May 1979 to August 1979, passed away in May 2023. His surviving spouse is the appellant in this case. The Veteran had previously been granted service connection for several conditions, including lumbar spine degeneration, cervical spine spondylosis, left shoulder residuals from rotator cuff surgery, and bilateral radiculopathy in the upper and lower extremities. The appeal concerns the denial of increased disability ratings for these conditions. Specifically, the Veteran sought ratings higher than 20 percent for bilateral lower extremity radiculopathy, higher than 30 percent for left upper extremity radiculopathy, and higher than 40 percent for right upper extremity radiculopathy. The Board reviewed the March 2021 VA examinations for the back, neck, and shoulder conditions. The examinations noted moderate incomplete paralysis in the extremities and diagnosed conditions like spondylosis and disc degeneration. However, the Board found the evidence, particularly the VA examinations, did not support ratings higher than those already assigned, concluding the paralysis was not severe enough to warrant higher evaluations. The Board denied the claims for increased ratings for the radiculopathy conditions. The case was remanded for three issues: lumbar spine degeneration, cervical spine spondylosis, and left shoulder residuals. The remand is to address a duty-to-assist error concerning the ameliorative effects of the Veteran's medications (ibuprofen, hydrocodone, ketorolac) on his lumbar spine, cervical spine, and left shoulder conditions, as per the Ingram v. Collins decision.

Rationale

Evidence did not support ratings higher than 20 percent.; Moderate incomplete paralysis found, not moderately severe or severe.; Pain and decreased sensation noted, but strength was 4/5 bilateral.

Service Branch
ARMY NATIONAL GUARD
Special Benefit
NO SPECIAL BENEFIT
Docket No.
210726-401279

Full Decision Text

Citation Nr: A26039440
Decision Date: 04/28/26	Archive Date: 04/28/26

DOCKET NO. 210726-401279
DATE: April 28, 2026

ORDER

Entitlement to an evaluation in excess of 20 percent for left lower extremity radiculopathy is denied.

Entitlement to an evaluation in excess of 20 percent for right lower extremity radiculopathy is denied.

Entitlement to an evaluation in excess of 30 percent for left upper extremity radiculopathy is denied.

Entitlement to an evaluation in excess of 40 percent for right upper extremity radiculopathy is denied.

REMANDED

Entitlement to an evaluation in excess of 10 percent for lumbar spine severe disc degeneration with collapse of disc to include spondylosis is remanded.

Entitlement to an evaluation in excess of 10 percent for cervical spine spondylosis and degenerative bulging at the C3/4 level is remanded.

Entitlement to an evaluation in excess of 20 percent for residuals of rotator cuff impingement surgery, left shoulder is remanded.

FINDINGS OF FACT

1. Throughout the period on appeal, the Veteran's left lower extremity radiculopathy manifested by no more than moderate incomplete paralysis.

2. Throughout the period on appeal, the Veteran's right lower extremity radiculopathy manifested by no more than moderate incomplete paralysis.

3. Throughout the period on appeal the Veteran's left upper extremity radiculopathy manifested by no more than moderate incomplete paralysis of the minor extremity.

4. Throughout the period on appeal the Veteran's right upper extremity radiculopathy manifested by no more than moderate incomplete paralysis of the major extremity.

CONCLUSIONS OF LAW

1. The criteria for entitlement to an evaluation in excess of 20 percent for left lower extremity radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520.

2. The criteria for entitlement to an evaluation in excess of 20 percent for right lower extremity radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8520.

3. The criteria for entitlement to an evaluation in excess of 30 percent for left upper extremity radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8510.

4. The criteria for entitlement to an evaluation in excess of 40 percent for right upper extremity radiculopathy have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.124a, Diagnostic Code 8510.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served in active service in the United States Army National Guard from May 1979 to August 1979. The Veteran died in May 2023, and the Appellant is his surviving spouse. 

In May 2021, the agency of original jurisdiction (AOJ) granted service connection for residuals of rotator cuff impingement surgery, left shoulder with an evaluation of 20 percent effective November 12, 2012. Also, the AOJ granted service connection for cervical spine spondylosis and degenerative bulging at the C3/4 level with an evaluation of 10 percent effective November 13, 2012. Moreover, the AOJ granted service connection for lumbar spine severe disc degeneration with collapse of disc to include spondylosis with an evaluation of 10 percent effective November 13, 2012. In addition, the AOJ granted service connection for radiculopathy, right upper extremity with an evaluation of 40 percent effective November 13, 2012. Furthermore, the AOJ granted service connection for radiculopathy, left upper extremity with an evaluation of 30 percent effective November 13, 2012. Equally, the AOJ granted service connection for radiculopathy, right lower extremity with an evaluation of 20 percent effective November 13, 2012. Lastly, the AOJ granted service connection for radiculopathy, left lower extremity with an evaluation of 20 percent effective November 13, 2012.

In the
 percent effective November 13, 2012. In addition, the AOJ granted service connection for radiculopathy, right upper extremity with an evaluation of 40 percent effective November 13, 2012. Furthermore, the AOJ granted service connection for radiculopathy, left upper extremity with an evaluation of 30 percent effective November 13, 2012. Equally, the AOJ granted service connection for radiculopathy, right lower extremity with an evaluation of 20 percent effective November 13, 2012. Lastly, the AOJ granted service connection for radiculopathy, left lower extremity with an evaluation of 20 percent effective November 13, 2012.

In the July 26, 2021, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A December 2024 notification advised the Appellant that a hearing was scheduled for March 27, 2025. She did not appear for the scheduled Board hearing.  Therefore, the Board may only consider the evidence of record at the time of the May 2021 AOJ decision on appeal, as well as any evidence submitted by the Appellant [or an accredited representative] within 90 days following the date of the scheduled hearing. 38?C.F.R. §?20.302(c). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date of the scheduled Board hearing, or (2) more than 90 days following the date of the scheduled hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(c), 20.801. 

If the Appellant 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 claims of increased rating related to the Veteran's left shoulder, cervical spine, and lumbar spine, 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. Entitlement to an evaluation in excess of 20 percent for left lower extremity radiculopathy is denied.

2. Entitlement to an evaluation in excess of 20 percent for right lower extremity radiculopathy is denied.

3. Entitlement to an evaluation in excess of 30 percent for left upper extremity radiculopathy is denied.

4. Entitlement to an evaluation in excess of 40 percent for right upper extremity radiculopathy is denied.

The Veteran's left and right lower extremity radiculopathy are evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8520. Under these criteria, mild incomplete paralysis is rated as 10 percent disabling. Moderate incomplete paralysis is rated as 20 percent disabling. Moderately severe incomplete paralysis is rated as 40 percent disabling. Severe incomplete paralysis, with marked muscular atrophy is rated as 60 percent disabling. Complete paralysis, with the foot dangles and drops, no active movement possible of muscles below the knee, flexion of knee weakened or (very rarely) lost is rated as 80 percent disabling. 38 C.F.R § 4.124a.  

The Veteran's left and right upper extremity is evaluated in accordance with the criteria set forth in 38 C.F.R. § 4.124a, Diagnostic Code 8510. Under these criteria, mild incomplete paralysis is rated as 20 percent for both the major and minor extremity. Moderate incomplete paralysis is rated as 40 percent for the major extremity and 30 percent for the minor extremity. Severe incomplete paralysis is rated as 50 percent for the major extremity and 40 percent for the minor extremity.  Complete paralysis in all shoulder and elbow movements lost or severely affected, hand and wrist movements not affected, is rated as 70 percent for the major extremity and 60 percent for the minor extremity. 38 C.F.R § 4.124a.  

The words "mild," "moderate," and "severe" as used in the various Diagnostic Codes are not defined in the Rating Schedule. Merriam-Webster Dictionary defines "mild
 and minor extremity. Moderate incomplete paralysis is rated as 40 percent for the major extremity and 30 percent for the minor extremity. Severe incomplete paralysis is rated as 50 percent for the major extremity and 40 percent for the minor extremity.  Complete paralysis in all shoulder and elbow movements lost or severely affected, hand and wrist movements not affected, is rated as 70 percent for the major extremity and 60 percent for the minor extremity. 38 C.F.R § 4.124a.  

The words "mild," "moderate," and "severe" as used in the various Diagnostic Codes are not defined in the Rating Schedule. Merriam-Webster Dictionary defines "mild" as gentle in nature or behavior. https://www.merriam-webster.com/dictionary/mild (last visited April 14, 2026). It defines "moderate" as limited in scope or effect. https://www.merriam-webster.com/dictionary/moderate (last visited April 14, 2026). Lastly, the term "severe" is defined as very painful or harmful. https://www.merriam-webster.com/dictionary/severe (last visited April 14, 2026).

Regulations provide that ratings for peripheral neurological disorders are to be assigned based on the relative impairment of motor function, trophic changes, or sensory disturbance. 38 C.F.R. § 4.120. Consideration is also given for loss of reflexes, pain, and muscle atrophy.  See 38 C.F.R. §§ 4.123, 4.124.

The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than the type of picture for complete paralysis given with each nerve, whether due to varied level of the nerve lesion or to partial regeneration.  When the involvement is wholly sensory, the rating is for the mild, or at most, the moderate degree. The disability ratings for the peripheral nerves are for unilateral involvement; when bilateral, the ratings combine with application of the bilateral factor.  38 C.F.R. § 4.124a, Note at "Diseases of the Peripheral Nerves." The Note to 38 C.F.R. § 4.124a establishes a maximum disability rating for conditions that are wholly sensory, as opposed to a minimum disability rating for conditions that are more than wholly sensory. See Miller v. Shulkin, 28 Vet. App. 376 (2017).

As a procedural starting point for these claims, on November 13, 2012, the Veteran submitted a fully developed claim for service connection for neck surgery, back pain, and left shoulder surgery.

After various procedural developments, in February 2020, the Board remanded the claims of service connection for a left shoulder disability, lower back disability, and neck disability.

In March 2021, the Veteran underwent a back conditions VA examination. The VA examiner noted diagnoses of lumbosacral strain, spondylosis with bilateral lower extremity radiculopathy, and severe disc degeneration with collapse of the disc. The VA examiner conducted a muscle strength testing and rated it as "active movement against some resistance" in hip flexion, knee extension, ankle plantar flexion, ankle dorsiflexion, and great toe extension. Also, the VA examiner commented that the Veteran showed decreased sensation to light touch in both lower extremities. Moreover, the VA examiner indicated that the Veteran exhibited moderate intermittent pain in both lower extremities, mild paresthesias and/or dysesthesias in both lower extremities, and mild numbness in both lower extremities.

In March 2021, the Veteran underwent a neck conditions VA examination. The VA examiner noted diagnoses of spondylosis and degenerative bulging at the C3/4 level; degenerative bulging; and bilateral upper extremity radiculopathy. In addition, the VA examiner specified that the Veteran's dominant hand was the right one. The VA examiner conducted a muscle strength testing and rated it as "active movement against some resistance" in elbow flexion, elbow extension, wrist flexion, wrist extension, finger flexion, and finger abduction. Also, the VA examiner commented that the Veteran showed decreased sensation to light touch in both upper extremities. Moreover, the VA examiner indicated that the Veteran exhibited moderate intermittent pain in both upper extremities, mild paresthesias and/or dysesthesias in both upper extremities, and mild numbness in both upper extremities.

Upon review of the evidence of record, the Board finds that an evaluation in excess of 20 percent for left and right lower extremity radiculopathy is not warranted. The medical evidence, particularly, the March 2021 VA examination, after evaluating the Veteran and considering
 against some resistance" in elbow flexion, elbow extension, wrist flexion, wrist extension, finger flexion, and finger abduction. Also, the VA examiner commented that the Veteran showed decreased sensation to light touch in both upper extremities. Moreover, the VA examiner indicated that the Veteran exhibited moderate intermittent pain in both upper extremities, mild paresthesias and/or dysesthesias in both upper extremities, and mild numbness in both upper extremities.

Upon review of the evidence of record, the Board finds that an evaluation in excess of 20 percent for left and right lower extremity radiculopathy is not warranted. The medical evidence, particularly, the March 2021 VA examination, after evaluating the Veteran and considering his lay statements determined that the Veteran had moderate incomplete paralysis in his lower extremities. The Board also finds that the most probative evidence of record is against a finding that the disability manifested by either moderately severe or severe incomplete paralysis. Therefore, an evaluation in excess of 20 percent for left and right lower extremity radiculopathy is not applicable. The Veteran's condition manifested by mild tingling sensation and numbness. Physical examination revealed decreased sensory testing for light touch in his lower extremities. Further, physical examination found that strength in his left and right lower extremity was 4/5 bilateral. Also, the VA examiner commented that the Veteran did not require the use of any assistive devices as a normal mode of locomotion.

Likewise, the Board finds that an evaluation in excess of 30 percent for left upper extremity and of 40 percent for right upper extremity is not warranted. The medical evidence, particularly, the March 2021 VA examination, after evaluating the Veteran and considering his lay statements determined that the Veteran had moderate incomplete paralysis in his upper extremities. The Board also finds that the most probative evidence of record is against a finding that the disability manifested by either moderately severe or severe incomplete paralysis. Therefore, an evaluation in excess of 30 percent for left upper extremity and 40 percent for right upper extremity (this is the Veteran's dominant hand) is not applicable. The Veteran's condition manifested by mild tingling sensation and numbness. Physical examination revealed decreased sensory testing for light touch in his upper extremities. Further, physical examination found that strength in his left and right upper extremity was 4/5 bilateral. Also, the VA examiner commented that the Veteran did not require the use of any assistive devices as a normal mode of locomotion.

The Board has considered all other potentially applicable Diagnostic Codes, but there is no evidence showing the Veteran has neurological impairment associated with any other peripheral nerves that have not already been service-connected.  Therefore, a separate or higher rating under a different Diagnostic Code is not warranted.

Given the foregoing, the Board finds that the evidence of record persuasively weighs against the Veteran's claim for a rating in excess of 20 percent for left and right lower extremity radiculopathy, in excess of 30 percent for left upper extremity radiculopathy, and in excess of 40 percent for right upper extremity radiculopathy. As the evidence of record persuasively weighs against an increased rating for any of the before-mentioned disabilities, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

REASONS FOR REMAND

1. Entitlement to an evaluation in excess of 10 percent for lumbar spine severe disc degeneration with collapse of disc to include spondylosis is remanded.

2. Entitlement to an evaluation in excess of 10 percent for cervical spine spondylosis and degenerative bulging at the C3/4 level is remanded.

3. Entitlement to an evaluation in excess of 20 percent for residuals of rotator cuff impingement surgery, left shoulder is remanded.

Under the Appeals Modernization Act (AMA), the Board has the duty to remand issues when necessary to correct a pre-decisional duty-to-assist error. Pub. L. No. 115-55 section (2)(d); 38 C.F.R. § 20.802 (a).

The Board finds remand is warranted to correct a pre-decisional duty to assist error that occurred prior to the decision on appeal. Specifically, the Board determines that the ameliorative effects of medication shall be considered when evaluating the severity of the Veteran's lumbar spine, cervical spine, and left shoulder conditions.

In March 2021, the Veteran underwent a back conditions VA examination. The VA examiner noted diagnoses of lumbosacral strain, spondylosis with bilateral
 the duty to remand issues when necessary to correct a pre-decisional duty-to-assist error. Pub. L. No. 115-55 section (2)(d); 38 C.F.R. § 20.802 (a).

The Board finds remand is warranted to correct a pre-decisional duty to assist error that occurred prior to the decision on appeal. Specifically, the Board determines that the ameliorative effects of medication shall be considered when evaluating the severity of the Veteran's lumbar spine, cervical spine, and left shoulder conditions.

In March 2021, the Veteran underwent a back conditions VA examination. The VA examiner noted diagnoses of lumbosacral strain, spondylosis with bilateral lower extremity radiculopathy, and severe disc degeneration with collapse of the disc. Also, the VA examiner highlighted that the Veteran took ibuprofen and ketorolac to treat his condition. During the examination, the Veteran reported flare up of the thoracolumbar spine with a severity categorized as severe. 

The VA examiner assessed the following active, passive, and observed repetitive use range of motion (ROM) measurements: 80 degrees for forward flexion; 25 degrees for extension; 25 degrees for right lateral flexion; 25 degrees for left lateral flexion; 25 degrees for right lateral rotation; and 25 degrees for left lateral rotation. The VA examiner noted that the Veteran exhibited pain in forward flexion, extension, right lateral flexion, and left lateral flexion. In terms of repetitive use over time, the VA examiner indicated that the ROM were: 75 degrees for forward flexion; 20 degrees for extension; 20 degrees for right lateral flexion; 20 degrees for left lateral flexion; 20 degrees for right lateral rotation; and 20 degrees for left lateral rotation. Equally, the VA examiner commented that the Veteran was not examined during a flare-up but provided the following ROM estimates: 75 degrees for forward flexion; 20 degrees for extension; 20 degrees for right lateral flexion; 20 degrees for left lateral flexion; 20 degrees for right lateral rotation; and 20 degrees for left lateral rotation. Furthermore, the VA examiner mentioned that the Veteran did not show any ankylosis of the spine. Lastly, the VA examiner determined that the Veteran's condition impacted his ability to perform any type of occupational task because the Veteran had pain in his back that radiated down to his legs with standing and walking for long periods. In addition, the VA examiner stated that lifting objects caused pain to back and legs.

In March 2021, the Veteran underwent a neck conditions VA examination. The VA examiner noted diagnoses of spondylosis and degenerative bulging at the C3/4 level; degenerative bulging; and bilateral upper extremity radiculopathy. Also, the VA examiner highlighted that the Veteran took ibuprofen, ketorolac, and hydrocodone to treat his condition. In addition, the VA examiner specified that the Veteran's dominant hand is the right one. During the examination, the Veteran reported flare up of the cervical spine with a severity categorized as severe. Moreover, the Veteran indicated that he had functional loss or impairment because he could not turn his head. 

The VA examiner assessed the following active and passive range of motion (ROM) measurements: 40 degrees for forward flexion; 40 degrees for extension; 40 degrees for right lateral flexion; 40 degrees for left lateral flexion; 75 degrees for right lateral rotation; and 75 degrees for left lateral rotation. The VA examiner noted that the Veteran exhibited pain in all ROM. In regard to observed repetitive use ROM, the VA examiner indicated that the measurements were: 35 degrees for forward flexion; 35 degrees for extension; 35 degrees for right lateral flexion; 35 degrees for left lateral flexion; 70 degrees for right lateral rotation; and 70 degrees for left lateral rotation. In terms of repetitive use over time, the VA examiner indicated that the ROM were: 35 degrees for forward flexion; 35 degrees for extension; 35 degrees for right lateral flexion; 35 degrees for left lateral flexion; 35 degrees for right lateral rotation; and 70 degrees for left lateral rotation. Equally, the VA examiner commented that the Veteran was not examined during a flare-up but provided the following ROM estimates: 35 degrees for forward flexion; 35 degrees for extension; 35 degrees for right lateral flexion; 35 degrees for left lateral flexion; 35 degrees for right lateral rotation; and 70 degrees for left lateral rotation. Furthermore, the VA examiner mentioned that the Veteran did not show any ankylosis of the spine. Lastly, the VA examiner determined that the Veteran's condition impacted on his ability to perform any type
 extension; 35 degrees for right lateral flexion; 35 degrees for left lateral flexion; 35 degrees for right lateral rotation; and 70 degrees for left lateral rotation. Equally, the VA examiner commented that the Veteran was not examined during a flare-up but provided the following ROM estimates: 35 degrees for forward flexion; 35 degrees for extension; 35 degrees for right lateral flexion; 35 degrees for left lateral flexion; 35 degrees for right lateral rotation; and 70 degrees for left lateral rotation. Furthermore, the VA examiner mentioned that the Veteran did not show any ankylosis of the spine. Lastly, the VA examiner determined that the Veteran's condition impacted on his ability to perform any type of occupational task because the Veteran had increased pain and difficulty turning his head.

In March 2021, the Veteran underwent a shoulder and arm condition VA examination. The VA examiner noted diagnoses of left shoulder strain and residuals form rotator cuff impingement surgery of the left shoulder. Also, the VA examiner highlighted that the Veteran took ibuprofen, hydrocodone, and ketorolac to treat his shoulder condition. During the examination, the Veteran reported daily flare-ups of the left shoulder with a severity categorized as moderate. Moreover, the Veteran stated that he had functional loss or impairment because of problems at times using his shoulder.

The VA examiner assessed the Veteran's active, passive, and repetitive use range of motion (ROM) and these were the measurements: 175 degrees for flexion; 175 degrees for abduction; 85 degrees for internal rotation; and 85 degrees for external rotation. Also, the VA examiner highlighted that the Veteran exhibited pain in all ROMs. In terms of repeated use over time, the VA examiner indicated that the ROM was 170 degrees for flexion; 170 degrees for abduction; 80 degrees for internal rotation; and 80 degrees for external rotation. In regard to ROM during flare-ups, the VA examiner estimated them to be 165 degrees for flexion; 165 degrees for abduction; 75 degrees for internal rotation; and 75 degrees for external rotation. Moreover, the VA examiner commented that the Veteran did not exhibit any ankylosis in his left shoulder. Lastly, the VA examiner determined that the Veteran's left shoulder condition impacted his ability to perform any type of occupational task because the Veteran had pain with lifting. In addition, the VA examiner mentioned that the Veteran had pain with increased use of shoulder and arm.

Upon review of the medical examinations, the Board finds that remand is warranted. During the examinations, the Veteran reported that he took various medications such as ibuprofen, hydrocodone, and ketorolac, for his lumbar spine, cervical spine, and left shoulder conditions. Pursuant to the recent United States Court of Appeals for Veterans Claims (CAVC) decision of Ingram v. Collins, 38 Vet. App. 130 (2025), remand is necessary to obtain a medical opinion that addresses whether the Veteran's medications are productive of ameliorative effects on his lumbar spine, cervical spine, and left shoulder conditions. Also, Ingram stated that when diagnostic codes do not explicitly contemplate medications when rating a disability, the Board must discount the beneficial effects of medication when assigning an evaluation for that disability. It is important to note that Diagnostic Code 5242 (degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome) and Diagnostic Code 5201 (limitation of motion of arm), do not explicitly contemplate medication use. Therefore, Ingram is applicable to the facts in this case, and an opinion must be rendered by a clinician that provides an estimate of additional functional loss described in degrees of additional loss of ROM without the effects of his medications for the service connected lumbar spine severe disc degeneration with collapse of disc to include spondylosis; cervical spine spondylosis and degenerative bulging at the C3/4 level; and residuals of rotator cuff impingement surgery, left shoulder. 

?

The matters are REMANDED for the following action:

Schedule an appointment with an appropriate clinician. The examiner should consider and review the claims file to include this Remand.

The VA examiner must address if any of the medications used by the Veteran including, but not limited to, ibuprofen, hydrocodone, and ketorolac produced ameliorative effects on the Veteran's service connected conditions of lumbar spine severe disc degeneration with collapse of disc to include spondylosis; cervical spine spondylosis and degenerative bulging at the C3/4 level; and residuals of rotator cuff impingement surgery, left shoulder.

If the answer is yes, the VA examiner shall list which medications produced ameliorative effects and explain the nature and extent of the Veteran's symptoms and additional limitation of motion without these
 consider and review the claims file to include this Remand.

The VA examiner must address if any of the medications used by the Veteran including, but not limited to, ibuprofen, hydrocodone, and ketorolac produced ameliorative effects on the Veteran's service connected conditions of lumbar spine severe disc degeneration with collapse of disc to include spondylosis; cervical spine spondylosis and degenerative bulging at the C3/4 level; and residuals of rotator cuff impingement surgery, left shoulder.

If the answer is yes, the VA examiner shall list which medications produced ameliorative effects and explain the nature and extent of the Veteran's symptoms and additional limitation of motion without these effects of the medications, to include during flare-ups (if applicable). Any additional functional loss with repetitive use testing or during flare-ups must be expressed in degrees of additional loss of range of motion for lumbar spine, cervical spine, and left shoulder conditions.

A complete rationale must be given for all opinions and conclusions expressed. If it is not possible to provide a specific measurement without resorting to mere speculation, the examiner must 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), a deficiency in the record 

?

(additional facts are required), or the examiner (does not have the knowledge or training). 

 

DAVID L. WIGHT

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Colon, Ivan M.

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. 

Paralysis of sciatic nerve or external popliteal nerve, Mixed, 2026: BVA Decision A26039440 | CaseScribe AI