Citation Nr: 20052799 Decision Date: 08/10/20 Archive Date: 08/10/20 DOCKET NO. 11-18 528A DATE: August 10, 2020 REMANDED Entitlement to service connection for a disability manifested by back pain, to include as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran had active service from January 1963 to January 1966 and from November 1967 to November 1971. The Board remanded this appeal in October 2015, March 2017, and November 2017. The November 2017 remand found that a June 2017 VA opinion is inadequate for decision-making purposes because the examiner did not provide appropriate rationale to support his conclusion that the Veteran’s low back condition is less likely than not secondary to his prostate cancer. Specifically, the Board noted that the provided rationale merely summarized the evidence, mentioned the relative dates of the evidence, and stated that the Veteran’s treatment providers have not associated his low back pain with his prostate cancer. Such findings do not demonstrate any special medical knowledge or expertise. The Board therefore remanded the issue so that an addendum opinion could be obtained. On remand, the Agency of Original Jurisdiction (AOJ) obtained an addendum opinion in December 2017. A review of that opinion reveals that it is substantially the same as the June 2017 opinion and includes no additional analysis to remedy the previously noted deficiencies. As such, the November 2017 Board remand directives were not substantially completed, and the issue must again be remanded so that an addendum opinion may be obtained. See 38 U.S.C. § 5103A(b); Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s current low back disability is at least as likely as not proximately due to or aggravated beyond its natural progression by a service-connected disability, to include his prostate cancer and the radioactive seed implantation procedure he underwent to treat that condition. A complete rationale should be provided for any opinion given. An opinion is adequate when it is factually accurate, fully articulated, and soundly reasoned. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); see also Prejean v. West, 13 Vet. App. 444, 448-9 (2000). The clinician should discuss the medical significance, if any, of the Veteran’s assertions that his current low back pain began shortly after his seed implantation surgery. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. J. Anthony, 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.