Citation Nr: 21001427 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 10-12 655 DATE: January 8, 2021 REMANDED Entitlement to service connection for lumbar spine disability on a secondary basis is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1966 to June 1989. In November 2010, the Veteran testified at a travel Board hearing before the undersigned. The Board notes that in June 2014, the Board bifurcated the issue of entitlement to service connection for a lumbar spine disability, to include on a secondary basis. Tyrues v. Shinseki, 732 F.3d 1351, 1356 (Fed. Cir. 2013) (bifurcation of a claim generally is within VA’s discretion); Locklear v. Shinseki, 24 Vet. App. 311 (2011). In an April 2016 decision, the Board denied the Veteran’s claim of entitlement to service connection for a lumbar spine disability on a secondary basis. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court). In November 2016, the Court granted a Joint Motion for Remand (JMR), remanding the matter for action consistent with terms of the JMR. Pursuant to the Board’s most recent remand directives in March 2020, a VA medical etiology opinion was obtained later in March 2020. The VA examiner concluded that the Veteran’s lumbar spine disability was less likely than not proximately related to or aggravated by his service-connected hypertension, left finger fracture, hallux valgus of the great toes, coronary artery disease, left thumb scar, or bilateral shoulder impingement disorder. As rationale, he stated that “there is no definitive medical correlation linking lumbar spine pain to [The Veteran’s service-connected disabilities]. Therefore, it is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service connected condition.” The Board finds that the March 2020 VA examination is inadequate. First, although the examiner indicated that the Veteran’s lumbar spine disability was not caused or aggravated by his service-connected disabilities, his rationale only discussed the issue of causation, but neglected to explain how the disability was not aggravated by the Veteran’s service-connected disabilities. Moreover, in stating generally that there is no definitive medical evidence between lumbar spine pain and the Veteran’s service-connected disabilities, the examiner’s rationale is conclusory and incomplete. In addition, the examiner did not consider or discuss the Veteran’s November 2010 Board hearing testimony regarding his low back pain, as directed in the Board remand. As such, the Board finds that substantial compliance with the March 2020 remand directives has not been achieved. See Stegall v. West, 11 Vet. App. 268, 271 (1998). On remand, a VA addendum opinion should be obtained with complete rationale as to whether the Veteran’s lumbar spine disability is caused or aggravated by his service-connected hypertension, left finger fracture, hallux valgus of the great toes, coronary artery disease, left thumb scar, and bilateral shoulder impingement disorder. The examiner must also consider the Veteran’s November 2010 Board hearing testimony. The matter is REMANDED for the following actions: Send the Veteran’s claims file to an appropriate medical professional to obtain an addendum opinion regarding the etiology of his lumbar spine disability. The Veteran’s entire electronic claims file must be made accessible to the designated professional for review. A detailed rationale for any opinion expressed should be provided. Following the review of the claims file, the medical opinion provider is then requested to respond to the following: (a) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s lumbar spine disability is proximately due to or caused by a service-connected disability, to specifically include hypertension, hallux valgus of the great toes, left finger fracture, coronary artery disease, left thumb scar, and bilateral shoulder impingement disorder? (b) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s lumbar spine disability has been aggravated (made worse beyond its natural progression) by a service-connected disability, to specifically include hypertension, hallux valgus of the great toes, left finger fracture, coronary artery disease, left thumb scar, and bilateral shoulder impingement disorder? If aggravation is found, the examiner should attempt to quantify the degree of additional disability resulting from the aggravation.   When rendering the requested opinions, the examiner must consider the Veteran’s November 2010 Board hearing testimony. If the requested opinions cannot be provided without a new examination, one should be scheduled. M. MAC Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Kovacs, 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.