Citation Nr: 18140457 Decision Date: 10/03/18 Archive Date: 10/03/18 DOCKET NO. 06-24 541 DATE: October 3, 2018 REMANDED The claim of entitlement to service connection for a low back disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1964 to April 1966 and from July 19, 1975, to August 2, 1975. He served in the Republic of Vietnam (RVN) from July 1965 to April 1966. In June 2010, the Veteran and his wife testified before the undersigned at Travel Board Hearing. A transcript of hearing is of record. As the procedural history has been addressed in prior Board decisions and remands, it will not be repeated here except where appropriate for clarity. In June 2017, the Board denied the Veteran’s claim for entitlement to service connection for a low back disorder. The Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In a June Order, the Court granted the VA General Counsel’s and Appellant’s Joint Motion for Partial Remand. The Board’s decision as to the current claim was vacated and it was remanded to the Board. The Order called for the claim to be remanded because the Board decision failed to address medical findings that were supportive of the Veteran’s claim. The claim of entitlement to service connection for a low back disorder is remanded. A summarization of the pertinent medical evidence as to the claim for service connection for a low back disorder was provided in the Board’s June 2017 decision. See pgs. 6-7. That summarization is incorporated herein by reference. The Board finds that an addendum opinion is necessary. The Veteran underwent a VA examination in August 2016. The examiner diagnosed the Veteran with degenerative arthritis of the spine and intervertebral disc syndrome (IVDS). The examiner noted the Veteran’s history of pain after twisting his back while lifting ammunition in 1965 and his statement that he was examined in service for this. After examination and review of the medical records and the Veteran’s reported history, the examiner opined that it was less likely than not that the current low back disability (diagnosed as spondylosis of the lumbar spine and degenerative changes of the lower lumbar spine) was caused or aggravated by the Veteran’s period of active duty or was otherwise related to service. The rationale was that the medical records indicated no complaints of back problems prior to his exit from service and there were no supporting records of chronic back pain from 1966 to 2012 when he began having back pain again. The post-service employment, wear and tear, and deconditioning were likely contributing factors to the current back findings. The Court Order explained that the VA examiner’s opinion was inadequate in that the August 2016 VA examiner, in forming her opinions, failed to specifically discuss the previous VA examination report of February 2012 and the November 2, 2012, opinion of a VA orthopedist as specifically requested in the Board’s June 2016 remand. The examiner’s failure to reconcile her findings/opinions with the opinions of record, including the VA examination report of February 2012, and the November 2, 2012, opinion of a VA orthopedist, will be remedied pursuant to the directives in the remand below. Moreover, the Board notes that during the appeal process, (see the November 2016 rating decision), service connection was granted for degenerative joint disease of the right and left knees. Additional opinion as to whether the Veteran’s now service-connected bilateral knee disorder caused or aggravated his low back condition should be addressed. The matter is REMANDED for the following action: Obtain an addendum opinion from the August 2016 VA examiner, if possible. If the examiner is unavailable, then another appropriate examiner shall be assigned. The examiner should review pertinent documents in the Veteran’s claims file. If the examiner deems a new VA examination or any additional testing necessary, efforts to conduct such examination or testing shall be undertaken. 1. After a review of the claims file, the examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s low back disorder (diagnosed as degenerative arthritis of the spine and IVDS) was caused or aggravated (increased in severity beyond the natural course of the condition) by the Veteran’s active duty service or is otherwise related to service. 2. The examiner should also opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s low back disorder is: (1) proximately due to or the result of; or (2) aggravated by the service-connected bilateral knee degenerative joint disease. The examiner must consider the Veteran’s statements regarding the incurrence of symptoms during service. Moreover, the examiner should consider the service treatment records (STRs) noting knee complaints during service and whether the back disability was due to repeated heavy lifting in service or due to his now service-connected bilateral knee disability. The examiner must reconcile his/her findings/opinions with the opinions of record, including the August 2016 and February 2012 VA examination reports which are not favorable to the Veteran’s claim, and the VA orthopedist opinion from November 2, 2012 which supports his service connection claim. All appropriate testing should be accomplished. Rationale for the opinions rendered should be provided. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion, as well as specifically explain whether there is any potentially (CONTINUED ON NEXT PAGE) available information that, if obtained, would allow for a non-speculative opinion to be provided. BARBARA B. COPELAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Hal Smith