Citation Nr: 18148218
Decision Date: 11/08/18	Archive Date: 11/07/18

DOCKET NO. 16-34 739
DATE:	November 8, 2018
REMANDED
Entitlement to service connection for a lumbar strain, to include as secondary to the service-connected disability of left pelvic stress fracture with left hip pain, is remanded.
REASONS FOR REMAND
The Veteran served in the United States Air Force from December 2006 through November 2007.  She was honorably discharged.
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from the July 2013 rating decision denying secondary service connection to the service-connected disability of left pelvic stress fracture with hip strain issued by a Department of Veterans Affairs (VA) Regional Office (RO) located in Winston-Salem, North Carolina.
Entitlement to service connection for a lumbar strain, to include as secondary to the service-connected disability of left pelvic stress fracture with left hip pain is remanded.
The Veteran contends her current low back disorder was caused or aggravated by her service-connected pelvic fracture.  
On VA examination in April 2013, the examiner opined that the Veteran’s condition is “less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service connected condition.”  The examiner’s basis for his finding was that the Veteran’s thoracolumbar pain was distinct and separate from the service-connected left pelvic stress fracture.  An opinion that a disability is not related to or associated with another disability is not adequate to address the aggravation factor.  Allen at 449; see also El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013).  The examiner did not discuss whether the Veteran’s current disability was aggravated by her service connected disability.  For these reasons the April 2013 VA examination is inadequate.
The matter is REMANDED for the following action:
1. Obtain a VA opinion from an appropriate examiner regarding whether the Veteran’s lumbar sprain is secondary to the service-connected left pelvic hip stress fracture with left hip pain.  After reviewing the claims folder, including a copy of this remand, the examiner must provide an opinion on the following: 
a.	Identify/diagnose any disability of the low back or lumbar spine that presently exists of that has existed during the appeal period.
b.	For each diagnosed disability, state whether it is at least as likely as not (50 percent probability or more) that:
i.	the disorder had its onset inservice or was otherwise etiologically related to the Veteran’s active service, to include her in service hip injury.
ii.	the disorder was caused by the service-connected left pelvic hip stress fracture with left hip pain. 
iii.	the disorder was aggravated (worsened) by the service-connected by the service-connected left pelvic hip stress fracture with left hip pain.
b.	The examiner is advised that the Veteran is competent to report her symptoms and history, and such reports must be acknowledged and considered in formulating any opinion.
c.	A clear explanation for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board.  If the examiner is unable to provide an opinion he or she should explain why. 
 
MICHAEL A. HERMAN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Mahmoudi, Associate Counsel