Citation Nr: 18156358 Decision Date: 12/07/18 Archive Date: 12/07/18 DOCKET NO. 16-58 364 DATE: December 7, 2018 REMANDED Entitlement to service connection for a back condition is remanded. REASONS FOR REMAND The Veteran had active duty for training (ADT) from March 1975 to August 1975. He served honorably in the United States Army Reserve. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that the Veteran is already service-connected for other disabilities based on the above ADT service. Entitlement to service connection for a back condition is remanded. Here, pursuant to a June 2016 VA examination, the Veteran has current diagnoses of degenerative arthritis of the spine, intervertebral disc syndrome, and lumbosacral strain. He has contended that he injured his back in-service while playing basketball or performing calisthenics, or else that his service-connected bilateral knee disabilities have aggravated his back condition. Service treatment records (STRs) show a normal enlistment examination as to the back but numerous complaints and treatment for back pain during ADT in 1975, including physical therapy. Although nexus opinions regarding direct service connection were added to the claims file in June and October 2016, the Board finds that they are inadequate, to include because they demonstrate conclusions inconsistent with cited rationale and language that does not conform to the standard required for service connection. Accordingly, a remand is needed to obtain a legally sufficient direct service connection nexus opinion. Further, pursuant to contentions made in the Veteran’s November 2016 substantive appeal, a nexus opinion regarding secondary service connection is warranted so that VA can render a decision on that aspect of the Veteran’s claim. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). At the same time, the Board finds that the Veteran’s statements regarding the circumstances of his service and his back condition are competent, but the statements are not credible. This is because the claims file shows significant misrepresentations in the Veteran’s statements concerning the nature and length of his service as well as his back symptoms. For example, the evidence shows the Veteran was discharged from the Army Reserve in 1975 after five months of ADT in connection with disciplinary issues (e.g. shoplifting) and failure to complete required training. However, he has communicated to at least two VA examiners that he served beyond that time, including until 1979 and even in combat. In December 2016, he wrote that he “vividly remember[s]” that the injury to his back occurred while dunking a basketball; however, earlier in January 2016 a VA physician stated that the Veteran said it happened “specifically” during calisthenics. The June 2016 VA examiner referenced “exaggerated pain” in his report during the examination with the Veteran that was inconsistent with pain levels observed before and after the examination. In sum, the Board finds that the Veteran’s statements are competent, but the statements with respect to the origin, development, and severity of his back disorder are not credible, and thus they will be afforded no probative weight. The matter is REMANDED for the following action: 1. Please associate with the claims file all outstanding VA and non-VA medical records for the Veteran’s nonservice-connected back condition. 2. After the record is determined to be complete, please obtain an addendum medical opinion with respect to the Veteran’s back condition. A new examination should only be performed if the opinion provider finds a new examination is necessary. The opinion provider must review the Veteran’s claims file, and based on such review (and, if necessary, examination of the Veteran), provide an opinion responding to the following: (a.) Is the Veteran’s current back disorder at least as likely as not (50 percent or higher probability) related to an in-service injury, event, or disease, including complaints of back pain/treatment noted in STRs from 1975? The opinion provider is advised that the Veteran’s lay statements as to incurrence and symptomatology are not credible and therefore should not be considered. In particular, the opinion provider is advised that the Veteran served in the Army Reserve on ADT from March 1975 to August 1975 and he did not serve in combat. Further, the examiner should consider and discuss as necessary the Veteran’s post-service civilian work experience as an athletic director. (b.) If the answer to the previous question is no, then please obtain an addendum medical opinion as to secondary service connection. A new examination should only be performed if the opinion provider finds a new examination is necessary. The opinion provider must review the Veteran’s claims file, and based on such review (and, if necessary, examination of the Veteran), provide an opinion responding to the following: (i.) Is it at least as likely as not (50 percent or higher probability) that the Veteran’s diagnosed back condition is caused by his service-connected bilateral knee disabilities? The opinion provider is advised that the Board finds the Veteran’s lay statements as to incurrence and symptomatology to be non-credible and therefore should not be considered. (ii.) Is it at least as likely as not (50 percent or higher probability) that the Veteran’s diagnosed back condition is aggravated by his service-connected bilateral knee disabilities? The opinion provider should note that the term “aggravated by” refers to “any increase in severity” of a nonservice-connected disability that is proximately due to or the result of a service-connected disability. If the opinion is to the effect that the service-connected bilateral knee disabilities aggravated (but did not cause) the Veteran’s back condition, please identify, to the extent possible, the degree of additional disability (pathology/impairment) resulting from such aggravation, indicating the “baseline” severity of such disability prior to any aggravation by a service-connected disability and the level of severity existing after the aggravation occurred. A complete rationale for all opinions rendered must be provided. If an opinion cannot be provided without resorting to speculation, the opinion provider must   explain why this is so and must identify what additional information, if any, would be required to provide an opinion. M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Fales, Associate Counsel