Citation Nr: 18140595 Decision Date: 10/03/18 Archive Date: 10/03/18 DOCKET NO. 14-31 475A DATE: October 3, 2018 REMANDED Entitlement to service connection for a left ankle disability is remanded. Entitlement to service connection for a low back disability is remanded. REASONS FOR REMAND The Veteran had active military service from February 1979 to December 1985. At the outset, the Board notes that this claim was originally denied in a May 1996 rating decision, which the Veteran did not appeal, and the decision became final. 38 C.F.R. §§ 3.104, 20.302, 20.1103 (2012). The claim was denied on the basis that the Veteran’s disability could not be related to military service due to him being assessed as normal at separation. Subsequent to that final decision, the Veteran testified at an April 2018 hearing discussing the chronicity of his disability and the symptoms he experienced since service. As this evidence is clearly new and material to the basis for the prior final denial, the claim may now be reopened on that basis and reviewed on the merits. 38 U.S.C. § 5108 (2012); 38 C.F.R. § 3.156 (2017). 1. Entitlement to service connection for a left ankle disability is remanded. 2. Entitlement to service connection for a low back disability is remanded. The claims file includes in-service complaints of left ankle and low back pain, as well as active diagnoses of left ankle and low back disabilities. However, at the Veteran’s June 2011 VA examination, the examiner acknowledged the Veteran’s repetitive injury pattern of the left ankle during active duty, but opined that the condition could not be due to service as there was no evidence the Veteran had any ongoing problems with his left ankle after service, prior to his recent fall which caused an ankle fracture. The Board finds that the Veteran reported longstanding history of reporting ankle pain and strains since service, which the examiner failed to consider the chronicity of his left ankle issues. Once VA undertakes a duty to provide a medical examination, due process requires an adequate medical opinion. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Consequently, a remand is necessary for another examination. The examiner should provide adequate rationale for any opinion rendered. Moreover, as the Veteran testified to an in-service fall where he injured his back, and the claims file includes an active diagnosis of degenerative disc disease with a history of laminectomy, the Veteran should be afforded a VA examination in connection with this claim to determine the nature and etiology. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 U.S.C. § 5103A (d)(1); 38 C.F.R. § 3.159(c)(4) (holding, in relevant part, that in order to trigger VA’s duty to provide an examination or obtain an opinion, there must be insufficient evidence to decide the case); see also 38 C.F.R. § 3.159(c)(4). The matters are REMANDED for the following action: 1. Associate with the claims file any outstanding VA and private treatment records. 2. Afford the Veteran appropriate VA examinations to determine the nature and etiology of his claimed left ankle and low back disabilities. The examiner is asked to determine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s disabilities had its onset or are etiologically related to the Veteran’s period of active service, to include his history of in-service complaints of left ankle strain and pain, and low back pain. The examiner is advised that a lack of medical evidence post-service is insufficient rationale to support a negative nexus opinion. The mere absence of evidence does not equate to unfavorable evidence. The examiner is requested to explain whether there is any medical reason to accept or reject the Veteran’s contentions that his experiencing chronic left ankle and low back pain since separation did not represent the onset of chronic orthopedic disabilities and whether there is any medical reason to accept or reject the contention that his left ankle fracture is due to the cumulative effects of multiple ankle strains during service. 3. Upon completion of the above, and any additional development deemed appropriate, the AOJ should readjudicate the remanded issue(s). If any benefit sought on appeal remains denied, the Veteran and his representative should be provided with a supplemental statement of the case. An appropriate period of time should be allowed for response, the appeal must be returned to the Board for appellate review. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.L. Reid, Associate Counsel