Citation Nr: 18143791 Decision Date: 10/22/18 Archive Date: 10/22/18 DOCKET NO. 16-31 359 DATE: October 22, 2018 REMANDED Entitlement to service connection for a back disability, to include as secondary to service-connected disease or injury is remanded. REASONS FOR REMAND The appellant had a period of active duty for training (ACDUTRA) from January 2012 to May 2012. The appellant has been determined to qualify for status as a Veteran. Notably, he was service-connected for bilateral pes planus, trochanteric pain syndrome of the right hip, and left femoral neck stress fracture based on an in-service injury during his ACDUTRA. This case comes before the Board of Veterans’ Appeals (the Board) on appeal from a January 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).   Service connection for a back disability is remanded. The Veteran contends that he has a back disability that is related to service. The Board notes that a service treatment record dated March 2012 documents complaints of lower back pain. The Veteran alternatively contends that his back disability is secondary to his service-connected bilateral pes planus and trochanteric pain syndrome of the right hip. See the Veteran’s claim for VA benefits dated June 2012. The Veteran was provided a VA examination for his back disability in December 2015. After examination of the Veteran and consideration of his medical history, the VA examiner diagnosed the Veteran with a lumbosacral strain and concluded that it is less likely than not that the Veteran’s lumbar strain is proximately due to, the result of, or aggravated beyond natural progression by the Veteran’s “left hip condition.” As discussed above, the Veteran is service-connected for his right hip as opposed to the left hip. Moreover, although the VA examiner opined that it is more likely than not that the Veteran’s current lumbar strain is related to occupational stress, repetitive lifting, and prolonged standing at work, she did not opine as to whether it is at least as likely as not related to the in-service treatment for back pain or whether the lumbar strain is caused or aggravated by the service-connected pes planus. In light of the foregoing, the Board finds that an additional opinion should be obtained on remand which addresses the etiology of the Veteran’s back disability. The matters are REMANDED for the following action: 1. Forward the claims file to the VA examiner who provided the VA medical opinion in January 2016 concerning the etiology of the Veteran’s diagnosed lumbar strain. If that examiner is not available, then forward the claims file to another appropriate medical professional. The examiner is requested to review all pertinent records associated with the claims folder, including the Veteran’s service treatment records, post-service medical records, and lay statements. If the clinician determines that another examination is needed, the Veteran should be scheduled for a new examination. Based on the review of the Veteran’s claims file, the examiner is asked to opine as to the following: a. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran has a back disability to include diagnosed lumbar strain that is related to his period of ACDUTRA, to include treatment for back pain in March 2012. b. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s back disability is caused by service-connected bilateral pes planus. c. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s back disability is aggravated by service-connected bilateral pes planus. If aggravation is found, the examiner should also state, to the extent possible, the baseline level of disability prior to aggravation. This may be ascertained by the medical evidence of record and by the Veteran’s statements as to the nature, severity, and frequency of his observable symptoms over time. d. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s back disability is caused by service-connected trochanteric pain syndrome of the right hip. e. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s back disability is aggravated by service-connected trochanteric pain syndrome of the right hip. If aggravation is found, the examiner should also state, to the extent possible, the baseline level of disability prior to aggravation. This may be ascertained by the medical evidence of record and by the Veteran’s statements as to the nature, severity, and frequency of his observable symptoms over time. Provide a comprehensive rationale for every opinion. 2. Review the claims file to ensure that all the foregoing requested development is completed, and arrange for any additional development indicated. Then readjudicate the   claim on appeal. If the benefit sought remains denied, issue an appropriate supplemental statement of the case and provide the Veteran and his representative with the requisite period of time to respond. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Arif Syed, Counsel