Citation Nr: 20006187 Decision Date: 01/24/20 Archive Date: 01/24/20 DOCKET NO. 16-25 869 DATE: January 24, 2020 REMANDED Entitlement to service connection for a low back disability, to include as secondary to a service-connected right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1985 to May 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran testified before the undersigned Veterans Law Judge in December 2019. A transcript of this hearing is of record. Entitlement to service connection for a low back disability, to include as secondary to a service-connected right knee disability is remanded. The Veteran seeks service connection for a low back disability. He asserts a current low back disability is due to or is aggravated by his service-connected right total knee replacement, and service connection is therefore warranted. Service connection may be awarded for any disability which is proximately due to or the result of, or is otherwise aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310. In adjudicating the Veteran’s claim, the Veteran was afforded a February 2016 VA examination. The examiner opined that because the knee and spine are separate joints, it was unlikely the service-connected right knee disability caused or resulted in a low back disability. The examiner did not, however, address the question of aggravation. When VA undertakes to either provide an examination or to obtain an opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Remand is therefore required in order to address this question. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA orthopedic examination to address his service connection claim for a low back disability, claimed as due to a service-connected right total knee replacement. The claims file must be reviewed by the examiner in conjunction with the examination. All necessary tests should be conducted and the results reported. Following review of the claims file and examination of the Veteran, the examiner should respond to the following: a) For any diagnosed low back disability, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any such disability was caused or aggravated (increased in severity beyond the natural progression of the disorder) by the Veteran’s right total knee replacement. Please explain why or why not. b) If the examiner finds that the Veteran’s low back disability has been permanently worsened beyond normal progression (aggravated), then the examiner should attempt to quantify the increase in severity of the low back disability (thus the degree of aggravation) beyond the baseline level of disability that would have existed but for the right total knee replacement. A rationale for all opinions expressed should be provided. 2. After undertaking any additional development deemed appropriate and giving the Veteran full opportunity to supplement the record, adjudicate the Veteran’s pending claim in light of any additional evidence added to the record. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a Supplemental Statement of the Case and be afforded the applicable opportunity to respond before the record is returned to the Board for further review. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Thomas D. Jones, 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.