Citation Nr: 20048091 Decision Date: 07/17/20 Archive Date: 07/17/20 DOCKET NO. 15-12 922 DATE: July 17, 2020 REMANDED Entitlement to service connection for a back disorder, to include herniated disc at T11-T12, status post-surgery, is remanded. Entitlement to service connection for a right foot disorder is remanded. Entitlement to service connection for a stomach disorder, to include as an undiagnosed illness under the provisions of 38C.F.R. §3.317, is remanded. Entitlement to service connection for a bilateral leg disorder is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from April 1989 to April 1995. 1. Entitlement to service connection for a back disorder, to include herniated disc at T11-T12, status post-surgery, is remanded. In November 2019 the Board remanded the Veteran claim for service connection for a back disorder for further development including obtaining an addendum medical opinion. Once VA has provided an examination, it is required to provide an adequate one, regardless of whether it was legally obligated to provide an examination in the first place. Barr v. Nicholson, 21 Vet. App. 303 (2007). An opinion that relies on an inaccurate factual premise can be of little probative weight. See Reonal v. Brown, 5 Vet. App. 458 (1993). In the present case, the Board notes that the record contains a February 2020 addendum VA opinion indicating that it is unlikely that the Veteran’s back disorder is related to service. The Board finds, however, that the February 2020 opinion is inadequate because the examiner repeatedly attributed the Veteran’s post-service onset of symptoms to a traumatic fall in February 2019 despite a lack of evidence that the Veteran suffered a traumatic fall in February 1999 or any time close to that. The examiner appears to be relying on an October 2014 record which states “[the Veteran] informs that after putting a back pack on his back he fell tingling, weakness and loss of sensation in few minutes in the R lower extremity.” Both in the context of the quoted sentence and read in conjunction with all other records related to the Veteran’s February 1999 onset of symptoms, the word “fell” appears to be a typo and was most likely intended to say “felt.” Because the February 2020 examination is based at least in part on an inaccurate factual premise, it is of little probative value and is not in substantial compliance with the Board’s previous remand directives regarding the issue of service connection for a back disorder. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). 2. Entitlement to service connection for a stomach disorder, a right foot disorder, and a bilateral leg disorder are remanded. Because a decision on the remanded issue of entitlement to service connection for a back disorder could significantly impact a decision on the issues of entitlement to service connection for a stomach disorder, service connection for a right foot disorder, and service connection for a bilateral leg disorder, each of which has been claimed as secondary to the back disorder on remand, the issues are inextricably intertwined. A remand of the claims for entitlement to service connection for a stomach disorder, service connection for a right foot disorder, and service connection for a bilateral leg disorder is required. The matters are REMANDED for the following action: 1. Forward the claims file to an appropriate medical professional to obtain an addendum opinion. The claims file must be reviewed, and such should be noted in the opinion. An additional VA examination may be provided if deemed appropriate. The examiner must opine whether it at least as likely as not that any back disorder(1) began during active service, (2) manifested within one year after discharge from service, (3) was noted during service with continuity of the same symptomatology since service; or (4) related to an in-service injury, event, or disease, including his duties as a helicopter mechanic. In rendering an opinion, the examiner is asked to comment on the August 2019 opinion from Dr. T.H. The examiner is also asked to clarify whether the Veteran has a current right foot disorder and should reconcile any finding with VA treatment records showing a diagnosis of foot drop, and that the Veteran requires a foot brace. If the examiner determined that the Veteran’s back disorder is related to service, the examiner must opine whether it is at least as likely as not that any bilateral leg disorder or right foot disorder is an (1) associated objective abnormality, (2) proximately due to the back disability, or (3) aggravated beyond its natural progression by the back disability. The absence of clinical evidence of treatment for the claimed disorder in the Veteran’s post-service medical records cannot, standing alone, serve as the basis for a negative opinion. If the examiner opines that the Veteran’s back condition is the result of a traumatic fall in February 1999 the examiner must include a rationale citing evidence other than the October 2014 record stating that the Veteran “fell tingling, weakness and loss of sensation” which the Board has determined is a typo. Any opinion expressed should be accompanied by a complete rationale. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined issues of entitlement to service connection for a stomach disorder, service connection for a right foot disorder, and service connection for a bilateral leg disorder. If any benefit sought is not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Zimmerman 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.