Citation Nr: 18146909
Decision Date: 11/02/18	Archive Date: 11/01/18

DOCKET NO. 18-03 350
DATE:	November 2, 2018
REMANDED
Entitlement to service connection for lumbar strain, to include as secondary to service-connected right knee post-traumatic arthritis (claimed as bilateral knee condition), is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Army from June 1975 to December 1977.
A VA examination was conducted in May 2016.  The examiner diagnosed lumbosacral strain with bilateral sciatica.  He determined that the Veteran’s back condition was less likely than not proximately due to or the result of his service-connected knee condition.  However, no opinion was provided regarding aggravation.  There are no other medical opinions in the claim file concerning the etiology of the Veteran’s back disorder.
Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability.  Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc).  
The medical opinion did not address whether the Veteran’s right knee disability has aggravated his back condition.  The Court of Appeals for Veterans Claims holding in El-Amin v. Shinseki, 26 Vet. App. 136 (2013), indicates that in circumstances such as this case, a medical opinion addressing that question should be sought.  In addition, new VA treatment records were added to the claims file after issuance of the November 2017 Statement of the Case indicating a progression of the Veteran’s condition.   Accordingly, the issue of entitlement to service connection for lumbar strain must be remanded for an addendum opinion before it can be adjudicated.  38 C.F.R. §§ 3.159, 3.310 (2017).
The matter is REMANDED for the following action:
1. Attempt to obtain relevant outstanding VA treatment records, to include records from January 2018 to the present.
2. After the above development is completed, obtain an addendum opinion from an appropriate VA clinician.  Make the claim file available to this person for review of the case.  The clinician is asked to review the case.  The need for an examination is left to the discretion of the clinician selected to write the addendum opinion. 
The clinician is asked to address the following:  
(a.) Whether it is at least as likely as not (probability of 50 percent or better) that the Veteran’s back disorder is etiologically related to an in-service disease or injury; and 
(b.) Whether it is at least as likely as not (probability of 50 percent or better) that his back disorder was caused by his service-connected knee disability; and
(c.) Whether it is at least as likely as not (probability of 50 percent or better) that his back disorder was aggravated (i.e., permanently worsened beyond the natural progression) by his service-connected knee disability. 
(d.) In determining whether his back disorder is aggravated by the service-connected disability, the clinician should identify a baseline level of severity of his back disorder established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of a back disorder.  38 C.F.R. § 3.310(b).
(e.) The clinician is asked to provide a rationale and explain the reasons behind any opinions expressed and conclusions reached.







3. After completing the requested actions, and any additional development deemed warranted, readjudicate the claim in light of all pertinent evidence and legal authority.  
 
M. E. KILCOYNE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Rachel E. Jensen, Associate Counsel