Citation Nr: 18148789 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 16-45 148 DATE: November 8, 2018 REMANDED Entitlement to service connection for a lumbar spine disability is remanded. Entitlement to service connection for a cervical spine disability is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for a sleeping disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1989 to April 1990. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 rating decision by the Department of Veterans Affairs (VA). Entitlement to service connection for a lumbar spine disability, a cervical spine disability, a left knee disability, and tinnitus is remanded. No VA examinations have been conducted. The Veteran stated that his physical disabilities began during service; he did not report any symptoms because he was young and believed he would heal on his own. See, e.g., January 2015 correspondence. His entrance examination notes that he had slight scoliosis, see January 1989 enlistment medical examination, although his separation examination did not note a spine disability. See February 1990 separation medical examination. Service treatment records (STRs) reflect he had a prior history of osteochondritis of his left knee, but that an x-ray was normal. See June 1989 STRs. His military occupational specialty (MOS) was a patriot missile crewmember, see DD 214, and thus noise exposure is conceded. Because there are medical questions remaining, remand is necessary for VA examinations for the Veteran’s cervical spine, lumbar spine, left knee, and tinnitus. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The Veteran is currently incarcerated. VA has special procedures for handling the scheduling of VA examinations for incarcerated Veterans, as those individuals are entitled to the same care and consideration given to non-incarcerated Veterans. The Agency of Original Jurisdiction (AOJ) attempted to send a VA psychological examiner to the Veteran’s prison, but was not able to find one, see June 2015 email correspondence, and was otherwise unable to obtain clearance from the Veteran’s prison to send an examiner into the prison. See October 2015 VA memorandum. It does not appear that the AOJ attempted to schedule non-psychological VA examinations, nor did the AOJ attempt to have a prison medical provider conduct an examination at VA’s expense. Thus, remand is necessary to ensure that the AOJ has exhausted all possible avenues for obtaining access to the incarcerated Veteran. Entitlement to service connection for a sleep disorder is remanded. The Veteran stated that his trouble sleeping was due to his physical disabilities. See January 2015 correspondence. As such, this issue is inextricably intertwined with the remanded issues and must be remanded as well. The matters are REMANDED for the following action: 1. The AOJ should arrange for VA examinations of the Veteran in adherence with VA’s guidelines for examinations of incarcerated Veterans to determine the nature and likely cause of any lumbar spine disability, cervical spine disability, left knee disability, and tinnitus. The AOJ should exhaust all efforts, to include arranging for the Veteran to be escorted to a VA medical facility for examination or being examined at the prison by contract examiners, VHA personnel, prison medical providers at VA expense, or fee-basis providers contracted by VHA. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record and examination of the Veteran, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Please identify, by diagnosis and as applicable, any lumbar spine, cervical spine, and left knee disabilities present during the appeal period (from January 2015), as well as whether the Veteran has tinnitus. (b.) For each disability diagnosed, is it at least as likely as not (50% or greater probability) that such disorder was either incurred in or otherwise related to the Veteran’s military service? Please explain why. The examiner should discuss the Veteran’s statements that his symptoms began in service. (c.) If a lumbar spine disability is diagnosed, is there clear and unmistakable (undebatable) evidence that it pre-existed service? Please explain why. If the answer is yes, is it clear and unmistakable (undebatable) that such disability did not become aggravated during service? Please explain why. As appropriate, the enlistment medical examination finding of slight scoliosis should be discussed. 2. If upon completion of the above action the issues remain denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Sandler, Associate Counsel