Citation Nr: 18140690 Decision Date: 10/05/18 Archive Date: 10/05/18 DOCKET NO. 14-31 357A DATE: REMANDED Entitlement to service connection for a lumbar spine disability is remanded. Entitlement to service connection for a hernia disability is remanded. Entitlement to an initial compensable rating for left wrist carpal tunnel syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from August 1983 to August 1987 and from April 1990 to October 2005. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from March 2012 and November 2013 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in June 2018. 1. Entitlement to service connection for a lumbar spine disability is remanded. The Veteran relates his lumbar spine disability to an incident in service, in which a 650-pound door fell on him. See Board Hearing Transcript (Tr.) at 3. The December 2011 VA examination report is inadequate for lack of discussion of the Veteran’s in-service reports of a back injury, and the examiner solely based his negative opinion on the lack of documentation in the service treatment records (STRs) pertaining to degenerative disease or radicular symptoms. The June 2018 favorable private opinion is also not adequate, because it is not supported by any rationale. Accordingly, an addendum opinion is necessary on remand. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). 2. Entitlement to service connection for a hernia disability is remanded. The Veteran also relates his hernia disability to the door incident in service. See Board Hearing Tr. at 10. Alternatively, he attributes his hernia disability to the cumulative impact of performing his occupational specialty duties as a maintenance technician repairing aircrafts. Specifically, he testified that his maintenance duties required him to lean over the cockpit and reach down to work on different components, which constantly put pressure on his stomach because it was always pressed against the still. Id at 11. The June 2018 private opinion is inadequate, as it employs speculative language in its rationale and does not consider relevant STRs. The Veteran has not yet been afforded a VA examination for this disability, and the duty to obtain one is triggered. McLendon v. Nicholson, 20 Vet. App. 79 (2006). 3. Entitlement to an initial compensable rating for left wrist carpal tunnel syndrome is remanded. The Veteran testified that his left wrist carpal tunnel syndrome has worsened since his last VA examination, which was in February 2012. Specifically, he reported that his symptoms of pain, numbness and tingling have gotten worse, and that he drops things more frequently. See Board Hearing Tr. at 15-16. As such, a remand is required to afford the Veteran a contemporaneous VA examination to assess the current nature, extent, and severity of his disability. See Caffrey v. Brown, 6 Vet. App. 377 (1994); Snuffer v. Gober, 10 Vet. App. 400 (1997). Any outstanding VA and private treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records. 3. Obtain any separately stored records from Malcolm Grow Medical Clinic on Andrews Air Force Base, to include any magnetic resonance imaging and upper gastrointestinal tract radiography of the Veteran’s lower back or stomach. See Board Hearing Tr. 3, 9. 4. Then obtain an addendum opinion addressing the etiology of the Veteran’s lumbar spine disability. The entire claims file should be made available to the examiner. No additional examination is necessary, unless the examiner determines otherwise. Following a review of the claims file, the examiner is asked to address the following: For all lumbar spine disabilities diagnosed since December 2012, to include degenerative disc disease, status post laminectomy and fusion, please opine as to whether it is at least as likely as not (50 percent or greater probability) that such disability had its onset in service or is otherwise related to service, to include as a result of: (1) the documented October 2000 and November 2000 complaints of back pain therein; and (2) the Veteran’s report of a door falling on his back in service, coupled with his assertions of continuous back symptomatology since that time. See Board Hearing Transcript. A complete rationale should be given for all opinions and conclusions expressed. 5. Then schedule the Veteran for a VA examination to determine the nature and etiology of his hernia disability. The entire claims file should be made available to the examiner. All indicated studies should be performed, and all findings should be reported in detail. Following a review of the claims file, the examiner is asked to address the following: (a) Indicate whether the Veteran has been diagnosed with right and left inguinal hernias since December 2012. Please consider the diagnosis of a right inguinal hernia in the February 2018 private treatment record, and the June 2018 private opinion showing a diagnosis of a left inguinal hernia. (b) For each hernia so diagnosed, please opine as to whether it is at least as likely as not (50 percent or greater probability) that such disability had its onset in service or is otherwise related to service, to include as a result of: (1) the documented October 1985 complaint of constant epigastric discomfort and February 2001 report of abdominal pain and swelling, (2) a 650-pound door falling on him in service, and (3) the cumulative impact of his in-service duties repairing aircrafts, which required continuous pressure on his abdominal area for extended periods of time. See Board Hearing Transcript; June 2018 private medical opinion. A complete rationale should be given for all opinions and conclusions expressed. 6. Then schedule the Veteran for a VA examination to assess the current nature and severity of his left wrist carpal tunnel syndrome. The claims file should be made available to and be reviewed by the examiner, all necessary tests should be conducted, and all findings reported in detail. S. BUSH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S.S. Mahoney, Associate Counsel