Citation Nr: 18152866 Decision Date: 11/27/18 Archive Date: 11/26/18 DOCKET NO. 11-18 133 DATE: November 27, 2018 REMANDED Entitlement to service connection for a spinal injury is remanded. Entitlement to service connection for a neck injury is remanded. Entitlement to service connection for a right hip disorder is remanded. Entitlement to service connection for bilateral hand numbness is remanded. Entitlement to service connection for bilateral leg numbness is remanded. REASONS FOR REMAND The Veteran service on active duty from July 1972 to February 1976. This case comes before the Board of Veterans’ Appeals (the Board) from a September 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. The Veteran appeared at a videoconference hearing at the RO in April 2016 before the undersigned Veterans’ Law Judge. A transcript of that hearing has been associated with the Veteran’s claims file. These matters were before the Board previously in August 2016 and October 2017 at which times they were remanded for additional development. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issues in this case. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Specifically, the remand instructions requested an opinion as to whether the Veteran’s current disabilities were consistent with the reported in-service injury. The examiner only provided an opinion regarding whether they were consistent with his age. Further, the examiner’s opinion exclusively relied on the absence of medical evidence in the past. Such a reliance is an inadeqate basis for an opinion, particularly when the absense of the medical evidence is predicated upon its unavailability. Therefore, a remand for a new addendum opinion is necessary. The matters are REMANDED for the following action: Forward the Veteran’s claims file to an appropriate examiner, for an addendum opinion on the nature and etiology of the Veteran’s neck injury, bilateral numbness in the upper extremities, bilateral numbness in the lower extremities, a spinal injury, and a hip disorder. Unless the examiner finds that a new examination is required, the Veteran need not be examined again. The examiner shall review the claims file, including any new development in the file. Based on the examination results and a review of the record, the examiner should provide an opinion and supportive rationale as to the following: a. For any diagnosed neck disability, opine whether it is at least as likely as not (a probability of 50 percent or greater) that it is related to an event, disease or injury during active service. b. For any diagnosed hand or leg disability, opine whether it is at least as likely as not (a probability of 50 percent or greater) that it is related to an event, disease or injury during active service. c. For any diagnosed hip disability, opine whether it is at least as likely as not (a probability of 50 percent or greater) that it is related to an event, disease or injury during active service. d. For any diagnosed spinal disability, opine whether it is at least as likely as not (a probability of 50 percent or greater) that it is related to an event, disease or injury during active service. For purposes of this examination, the examiner should accept as true the reported injuries in service. The examiner’s opinion should specifically address the Veteran’s reported injuries in service, to include a fall down a ladder while aboard a ship and reported pain in his hip and numbness in his hands while loading and unloading ammunition, to include the Veteran’s testimony at the April 2016 hearing and statements made during his November 2016 examinations. In formulating the opinions, the term “at least as likely as not” does not mean “within the realm of possibility.” Rather, it means that the weight of the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against. Any opinions offered should be accompanied by the underlying reasons for the conclusions. The examiner must provide a rationale for the opinions provided and reconcile any opinion with any contradictory evidence of record. If the examiner is unable to offer any of the requested opinions, it is essential that the he or she offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Reed, Associate Counsel