Citation Nr: 1318709 Decision Date: 06/07/13 Archive Date: 06/11/13 DOCKET NO. 12-17 052 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUE Entitlement to service connection for a low back disability. ATTORNEY FOR THE BOARD M. Hudson, Associate Counsel INTRODUCTION The Veteran served on active duty from October 1999 to October 2001. This case comes before the Board of Veterans' Appeals (Board) on appeal from an October 2011 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. In March 2013, the Board reopened and remanded the case to the RO for additional evidentiary development. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012); 38 U.S.C.A. § 7107(a)(2) (West 2002). REMAND The Veteran contends that his back condition is related to his military service, specifically, heavy lifting and road marches while in-service. See, e.g., Veteran's Application for Compensation and/or Pension, May 2011. Pursuant to the Board's March 2013 remand, the Veteran was afforded a VA back examination in April 2013. See 38 C.F.R. § 3.159(c)(4). In response to the question of whether the Veteran has now or has had a back condition, the examiner noted lumbar strain, diagnosed in 2000. The examiner opined that the Veteran's lumbar strain was less likely than not incurred in or caused by the claimed in-service injury. The examiner opined that while it is "certainly true" that the Veteran's 2000 lumbar strain was likely due to lifting heavy objects and road marches, lumbar strain usually resolves in 8 to 12 weeks following its onset. As the in-service injury occurred many years ago, it is highly unlikely that the Veteran's current back condition was due to anything sustained while in service. Based upon recent imaging studies, the Veteran has mild degenerative disk disease, which may explain his low back symptoms. Degenerative disk disease is a multi-factorial etiology process and may be caused by aging, genetics, sports or activities of daily living. It is necessary to obtain clarification from the April 2013 examiner. Specifically, the examiner should explain whether the Veteran is currently diagnosed with lumbar strain, what evidence supports a finding that this particular Veteran's in-service lumbar strain resolved within 8 to 12 weeks and whether it at least as likely as not that the Veteran's current degenerative disk disease had its onset in service or is otherwise related to service. Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested.) 1. Return the claims folder to the physician who examined the Veteran in April 2013, if available, for an addendum medical opinion (if that examiner is unavailable, a medical professional with appropriate expertise). The examiner should address the following: (a) Indicate whether a current diagnosis of lumbar strain is appropriate. If so, is at least as likely as not (i.e., probability of approximately 50 percent), that any currently diagnosed lumbar strain is the same as that diagnosed in 2000. If lumbar strain is not diagnosed, the examiner should identify what evidence supports a finding that the in-service lumbar strain resolved within 8 to 12 weeks. Further, the examiner's rationale must address the Veteran's reports of chronic intermittent back pain since his 2000 in-service injury. (b) Is it at least as likely as not (i.e., probability of approximately 50 percent), that the currently diagnosed degenerative disc disease had its clinical onset in service or is otherwise related to active duty, specifically the Veteran's claims that his back pain began as a result of lifting heavy objects, road marches, and general training activities and his reports of chronic intermittent back pain since his 2000 in-service injury. A complete and detailed rationale should be given for all opinions and conclusions expressed. 2. Then, readjudicate the issue of entitlement to service connection for a low back disability. If the benefit remains denied, the Veteran should be provided a supplemental statement of the case and given an appropriate opportunity to respond. The case should then be returned to the Board for further consideration, if otherwise in order. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ M. E. LARKIN Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).