Citation Nr: 18155978
Decision Date: 12/06/18	Archive Date: 12/06/18

DOCKET NO. 09-43 502
DATE:	December 6, 2018
REMANDED
Entitlement to service connection for degenerative joint disease (DJD) of the lumbosacral spine is remanded.
REASONS FOR REMAND
The Veteran served on active duty from January 1981 to December 1983 in the United States Army.
1.  Entitlement to service connection for degenerative joint disease (DJD) of the lumbosacral spine is remanded.
The Board cannot make a fully-informed decision on the issue of entitlement to service connection for lumbosacral spine DJD because previous VA medical opinons do not adequately address whether the Veteran’s back disability is aggravated by her service-connected posttraumatic stress disorder (PTSD).
It appears that the question posed in the previous remand of this issue did not include the correct standard as the examiner was asked to address the likelihood the Veteran’s lumbosacral spine DJD was aggravated “(i.e., permanently worsened) beyond the natural progression” by her service-connected PTSD. 
Under 38 C.F.R. § 3.310(a), aggravation means “any increase in disability.”
Given the consideration of the incorrect standard of determining whether there was any increase in disability a new opinion is required.
The matter is REMANDED for the following action:
Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s lumbosacral spine DJD is at least as likely as not aggravated by service-connected disability, specifically service-connected PTSD.
The examiner is informed that aggravation here is defined as any increase in disability.  If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. 
 
M.E. Larkin
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	P.S. McLeod