Citation Nr: 18158924 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 17-01 558 DATE: December 19, 2018 REMANDED Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for bilateral lower extremity sciatica, to include as secondary to a low back disability, is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND The Veteran had active duty service from February 1977 to February 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Decatur, Georgia. 1. Entitlement to service connection for a low back disability is remanded. 2. Entitlement to service connection for bilateral lower extremity sciatica, to include as secondary to a low back disability, is remanded. The Veteran contends that he is entitled to service connection for a low back disability, as the alleged disability is the result of multiple back strains during active service. The Veteran also alleges that the sciatica is caused by the low back disability, and as a result, should be service connected. Service medical records show in-service treatment for back strains in August 1978 and October 1978. In a March 2016 letter, the Veteran, through his representative, asserted that he also received treatment for back pain in December 1979, August 1980, and October 1980 while in service. The medical evidence of record shows that the Veteran was diagnosed with a low back disability in October 2011 and sciatica in November 2011. The Veteran has not received a VA examination for the purpose of determining if his low back disability and sciatica are related to service. VA must provide the Veteran with an examination where the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or symptoms of disability, (2) establishes an in-service event, injury or disease, or the presence of a presumptive disease during the pertinent period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. McLendon v. Nicholson, 20 Vet. App. 79 (2006). Due to the in-service documentation of low back injuries, the Board finds that a VA examination is necessary to determine if the Veteran’s current low back disability is related to in-service treatment for a low back disability. A VA examination would also be helpful in determining if the Veteran’s sciatica is caused by his low back disability. 3. Entitlement to TDIU is remanded. The TDIU claim is inextricably intertwined with the claim for service connection for a low back disability and sciatica. As a result, the claim for TDIU cannot be decided without first addressing the Veteran’s service connection claims. The matters are REMANDED for the following action: 1. Secure all outstanding VA medical records. If any records cannot be located, specifically document the attempts that were made to locate them, and explain in writing why further attempts to locate or obtain any government records would be futile. If records are not obtained (a) notify the claimant of the specific records that VA is unable to obtain; (b) explain the efforts VA has made to obtain that evidence; and (c) describe any further action it will take with respect to the claim. The claimant must then be given an opportunity to respond. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of any low back disability. The examiner must review the claims file and note that review in the report. All indicated tests and studies should be accomplished and the findings reported in detail. The examiner should discuss the Veteran’s lay statements regarding the history and continuity of symptomatology. The examiner should provide a complete rationale for any opinions offered. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any low back disability is related to active service, or complaints and treatment during service, to treatment for low back pain in August 1978 and October 1978. If the examiner determines that the low back disability is not the result of active service, and another etiology can be determined, the examiner should provide an opinion as to what more likely caused the low back disability, taking into account the Veteran’s full post-service work and medical history. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of any sciatic nerve disability. The examiner must review the claims file and note that review in the report. All indicated tests and studies should be accomplished and the findings reported in detail. The examiner should discuss the Veteran’s lay statements regarding the history and continuity of symptomatology. The examiner should provide a complete rationale for any opinions offered. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any sciatic nerve disability is related to active service, or complaints and treatment during service. The examiner should also provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any sciatic nerve disability is proximately due to, caused by, or aggravated by any diagnosed low back disability. If the examiner determines that the sciatic nerve disability is not the result of active service, or the low back disability, and another etiology can be determined, the examiner should provide an opinion as to what more likely caused the sciatic disability, taking into account the Veteran’s full post-service work and medical history. The examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran is unable to secure or follow a substantially gainful occupation due to service-connected disability. If the Veteran is felt capable of work despite the service-connected disabilities, the examiner should state what type of work and what accommodations would be necessary due to the service-connected disabilities. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. D. Cross, Associate Counsel