Citation Nr: 18149340
Decision Date: 11/09/18	Archive Date: 11/09/18

DOCKET NO. 13-11 252
DATE:	November 9, 2018
REMANDED
Entitlement to service connection for a back disability is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Air Force from March 1985 to July 1991 and from January 1997 to July 1997, with additional periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) in the Air National Guard of Texas from September 1997 to September 2002.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).  
The Veteran testified at a hearing before the undersigned Veterans Law Judge in May 2017.  
In August 2017, the Board remanded the claim for further development.
1. Entitlement to service connection for a back disability is remanded.
Pursuant to the Board’s August 2017 remand directives, an addendum opinion was obtained in November 2016.  The VA examiner opined that the Veteran’s sacralization and scoliosis were congenital defects, but did not comment on whether the Veteran incurred any superimposed disease or injury in relation to said congenital defects during his service, as was specifically requested by the Board.  Additionally, the examiner did not review the Veteran’s relevant National Guard records or opine as to whether his back disability was related to such service, as also requested by the Board.  Thus, based on the lack of compliance with the prior remand directives, an addendum opinion with a different examiner is needed on remand.  Stegall v. West, 11 Vet. App. 268 (1998).  Any outstanding VA treatment records should also be secured.
The matter is REMANDED for the following action:
1. Obtain any outstanding VA treatment records.
2. Then refer the claims file to an examiner other than the July 2015/November 2017 VA examiner for preparation of an addendum opinion.  The entire claims file should be made available to, and reviewed by 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:
(a)	Regarding the diagnosed lumbar scoliosis and sacralization, which have been determined to be congenital and developmental defects, please opine as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran incurred any:
(1)	superimposed disease or injury on such congenital defects during his military service or a period of ACDUTRA that resulted in additional back disability; or 
(2)	superimposed injury on such defects during a period of INACDUTRA that resulted in additional back disability.  If so, please describe the resultant disability.
(b)	For diagnosed degenerative disc disease, degenerative changes, and facet degeneration, please opine as to whether it is as least as likely as not (50 percent or greater probability) that such disability:
(1)	had its onset during service or a verified period of ACDUTRA; 
(2)	is otherwise the result of a disease or injury incurred during active duty or a verified period of ACDUTRA; or
(3)	is otherwise the result of an injury incurred during a verified period of INACDUTRA.
In addressing these questions, the examiner is asked to review and consider all STRs, including the December 1988 STR from active duty and the November 1999, January 2001, May 2001, October 2001, November 2001, January 2002, February 2002, and March 2002 STRs from his National Guard service, as well as the Board Hearing testimony.  
A complete rationale should be given for all opinions and conclusions expressed.  If the examiner is unable to render an opinion without resorting to speculation, he or she must provide a complete explanation for the reasoning underlying that conclusion.
 
S. BUSH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	S.S. Mahoney, Associate Counsel