Citation Nr: 21004640 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 14-02 706 DATE: January 27, 2021 REMANDED Entitlement to service connection for a low back disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from October 1968 to July 1970, including service in Vietnam from July 1969 to July 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at an April 2014 videoconference hearing. A transcript of the hearing is of record. The Board remanded this matter for further development in June 2015, August 2018, and most recently in November 2019. As discussed below, there has not been substantial compliance with the November 2019 remand, and unfortunately the matter must once again be remanded. See Stegall v. West, 11Vet. App.268 (1998); D’Aries v. Peake, 22Vet. App.97, 105 (2008). 1. Entitlement to service connection for a low back disability is remanded. In its November 2019 decision, the Board remanded the case due to the examiner’s non-compliance with its August 2018 remand instructions. The examiner’s July 2019 opinion relied solely on the lack of documented treatment for back problems until 2010, did not assume that the Veteran’s reported in-service back injury, where a tree fell on him, occurred, as previously instructed, and did not address the Veteran’s lay assertions regarding the onset and history of his back problems during and following service. Thereafter, the Board remanded the case for the examiner to provide an addendum opinion addressing these issues. The examiner provided an addendum opinion in January 2020. However, once again the examiner did not address the deficiencies outlined by the Board in its November 2019 remand. In light of the above deficiencies, the Board finds the January 2020 addendum opinion to be inadequate. Because the examiner did not comply with the Board’s November 2019 remand directives, this matter must once again be remanded for compliance. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following actions: 1. Obtain any outstanding treatment records for the Veteran’s low back disability that are not currently of record. 2. Then, forward the Veteran’s claims file to a VA examiner of appropriate expertise who has not previously provided an opinion in this case, to provide an addendum medical opinion regarding whether the Veteran’s low back disability is at least as likely as not related to his active duty service, to include his reported in-service back injury, where a tree fell on him. The examiner must review the entire claims file, to include a copy of this (and the prior) REMAND, and that review must be noted in the report. If a new examination is required to answer the questions posed below, such should be scheduled. In providing the above opinion, the VA examiner must assume that the Veteran’s reported in-service back injury, where a tree fell on him, occurred. The VA examiner must also address the Veteran’s lay assertions regarding the onset and continuity of his back problems during and following service, to specifically include: the Veteran’s April 2014 testimony and complaints throughout VA treatment records since 2010, and his July 2010 statement, that his back problems were caused by the tree falling on his back in service and have persisted ever since. A complete rationale with discussion of medical literature for any opinion expressed must be provided. If an opinion cannot be expressed without resort to mere speculation, the examiner must fully explain why that is so. The Board reminds the examiner that failure to comply with the directives outlined herein will render the opinion inadequate and will result in further remand of the Veteran's claims. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Gates 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.