Citation Nr: 21004050 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 13-05 317 DATE: January 25, 2021 REMANDED Entitlement to service connection for a low back disability is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1992 to October 1995, with additional service in the reserves. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2010 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2016, the Veteran testified at a hearing before the undersigned. This matter was previously remanded by the Board in August 2016, July 2017, and October 2019. The case has been returned to the Board at this time for further appellate review. Entitlement to service connection for a low back disability is remanded. In October 2019, as in the prior Board remand, the Board remanded this claim for a VA examination of the Veteran’s lower back disability. The Veteran was afforded a VA examination in December 2019, which was amended in October 2020. However, as with the prior VA examinations, the December 2019 and October 2020 VA examiners did not consider the Veteran’s competent and credible statements regarding continued low back pain throughout his time in the Army Reserve, both before and after his January 2000 motor vehicle accident, as directed by the Board. Thus, the Board finds that a new VA examination is necessary to ensure compliance with its prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). This matter is REMANDED for the following action: Obtain an opinion with a qualified clinician (other than the clinician who provided the December 2019 and October 2020 medical opinions) regarding the Veteran’s claim for service connection for a low back disability. If the selected clinician determines that an examination is necessary to respond to this request, such examination should be scheduled. Following review of the claims file, and examination of the Veteran if deemed necessary, the examiner should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s lower back disability began in or is otherwise caused by the Veteran’s active service. The opinion must address the Veteran’s competent and credible statements regarding continued low back pain throughout his time in the Army Reserve, both before and after his January 2000 motor vehicle accident. The Veteran’s report of symptoms capable of lay observation may not be disregarded solely on the basis that they are not recorded in contemporaneous medical treatment records. The examiner must also address the March 1999 medical record reflecting the Veteran’s complaint of lower back pain, the April 1999 medical records reflecting the Veteran complained of lower back pain and that his lower back was x-rayed, and the April 1999 medical record diagnosing the Veteran with chronic low back pain, all of which occurred prior to the 2000 motor vehicle accident. The examiner should also opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s lower back disability is (a) caused by; or (b) aggravated (i.e., worsened beyond the normal progression of the disease) by the Veteran’s service-connected ankle disabilities, to include any altered gait due to his service-connected ankle disabilities. If aggravation is found, the examiner must attempt to establish a baseline level of severity of the lower back disability prior to aggravation by the service-connected ankle disabilities. Please note, causation and aggravation are separate concepts and must be addressed independently. (Continued on the next page)   The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports, he or she must provide a reason for doing so. All findings must be reported in detail and all opinions must be accompanied by a clear rationale. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Elias, 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.