Citation Nr: 19166367 Decision Date: 08/27/19 Archive Date: 08/27/19 DOCKET NO. 15-21 656 DATE: August 27, 2019 REMANDED Entitlement to service connection for a low back disability is remanded. REASONS FOR REMAND The Veteran had active military service from July 1962 to September 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In September 2017, the Board remanded the issue. 1. Entitlement to service connection for a low back disability is remanded. The Board’s review of the claims file reveals that further action on the claim of entitlement to service connection for a low back disability is needed. At the outset, the Board notes that the Veteran has a current diagnosis of degenerative scoliosis with associated back pain and lumbar spondylosis. See January 2013 Medical Treatment Record – Non-Government Facility. The Veteran stated that he never had a low back injury. Instead, the Veteran argued that his low back disability manifested as a result of repetitive trauma from landing helicopters and small fixed wing aircraft. See September 2017 Appellate Brief. A review of the personnel records shows that the Veteran was an airplane pilot and received a distinguished flying cross. See March 1975 Certificate of Release or Discharge from Active Duty. The records also show that the Veteran performed 10 to 20 combat strikes or flights. See October 2017 Military Personnel Record. In particular, the records note that the Veteran was a flight leader in a mission to extract an 80 men Special Forces team. In that mission, the Veteran skillfully maneuvered his aircraft and acted as a shield and fought the enemies with his gunners while another aircraft extracted the Special Forces team. Then, the Veteran, “without thought for his own safety,” went to assist another aircraft by protecting the aircraft against enemy fire. See October 2017 Military Personnel Record. The Veteran was provided a VA examination in December 2017, but the Veteran failed to appear. Based on a review of the records, the examiner diagnosed the Veteran with degenerative arthritis of the thoracolumbar spine. The examiner opined that the Veteran’s low back disability is at least as likely as not incurred in or caused by the claimed in-service injury, event or illness. The examiner explained that as there are no service treatment records and no medical documentation of any chronic or recurrent back condition over the 40 years since separation, the Veteran’s back condition is consistent with his age of 77 years old. As the examiner’s opinion and rationale was inconsistent the examiner submitted an addendum opinion in April 2019 stating that the Veteran’s low back disability is less likely than not proximately due to service. The Board finds the December 2017 VA examiner’s assessment is not based on a complete consideration of the impact of the Veteran’s in-service duties. Additionally, it appears that the examiner based his opinion on an in-service event of ‘hard helicopter landing’ but did not address the in-service events in the Veteran’s military personnel records that show multiple traumas to his body due, to include 20 combat flights. As such, the Board finds a new VA examination is necessary. The matter is REMANDED for the following action: 1. Obtain all outstanding VA and private medical records and associate them with the claims file. 2. Thereafter, arrange for a VA examination from an appropriately qualified examiner to determine the nature and etiology of any low back disability. The claims file, including a copy of this remand, must be made available to be reviewed by the examiner. (Continued on the next page)   For each diagnosed low back disability, provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that the disability had its onset in service or is otherwise etiologically related to service. The examiner is asked to review the Veteran’s military personnel file wherein the Veteran suffered trauma from being shot at during a rescue mission to extract an 80 men Special Forces team. The examiner should consider the impact of 10 to 20 combat strikes or flights on his low back. A detailed rationale for all opinions must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner 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. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. Noh, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.