Citation Nr: 21061355 Decision Date: 10/01/21 Archive Date: 10/01/21 DOCKET NO. 16-23 998 DATE: October 1, 2021 REMANDED Entitlement to service connection for a cervical spine disorder, to include as secondary to a service-connected disability is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the U.S. Army from June 1962 to August 1965 and from August 1966 to August 1969. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2012 rating decision of a Department of Veterans Affairs (VA) Agency of Original Jurisdiction. In a March 2019 decision, the Board denied entitlement to service connection for a cervical spine disability. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court). In an October 2019 Order, the Court granted the parties' Joint Motion, partially vacated the Board's March 2019 decision, and remanded the matters to the Board for readjudication. The matter was remanded by the Board in March 2020 and April 2021 for action consistent with the Joint Motion, and the matter has been returned for further appellate review. Unfortunately, remand is again required. 1. Entitlement to service connection for a cervical spine disorder, to include as secondary to a service-connected disability is remanded. This issue is remanded for compliance with the October 2019 Joint Motion and the Board's March 2020 remand directives. The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. In the October 2019 Joint Motion, the parties agreed that a September 2018 VA examiner's opinion was inadequate because of an incomplete rationale. The examiner indicated that the neck condition was not aggravated beyond its natural progression by any service-connected condition, to include the low back condition. No further explanation was provided, and the examiner did not specifically mention the service-connected bilateral lower extremity radiculopathy or right inguinal hernia. A March 2020 Board decision remanded the matter for action consistent with the October 2019 Joint Motion, to include obtaining addendum opinions on whether a cervical spine disorder was caused or aggravated by any service-connected disability, to include a postoperative right inguinal hernia. VA obtained the requested addendum opinions in February 2021. In an April 2021 decision, the Board remanded the matter again after finding that the February 2021 opinions were inadequate, although that remand did not specifically request an addendum regarding the etiological relationship, if any, to the postoperative right inguinal hernia. Following the most recent remand, VA obtained addendum opinions that adequately addressed whether the cervical spine disorder was caused or aggravated by the service-connected bilateral lower extremity radiculopathy and low back disorder, but there has been no new addendum opinion regarding whether the cervical spine disorder could have been caused or aggravated by the service-connected postoperative right inguinal hernia. In sum, the March 2020 Board remand directed the AOJ to obtain an adequate addendum on whether the claimed cervical spine disorder was caused or aggravated by the postoperative right inguinal hernia, the April 2021 Board decision and remand found that all the addendum opinions obtained in February 2021 were inadequate, and VA has not obtained a new addendum opinion addressing the causal relationship, if any, to the postoperative right inguinal hernia. Thus, remand for compliance with the prior remand directives is required. The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding the etiology of the cervical spine disorder from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. The examiner must provide an opinion regarding whether the diagnosed cervical spine disability was at least as likely as not (50 percent or greater probability): (a.) proximately due to a postoperative right inguinal hernia, or (b.) aggravated beyond natural progression by a postoperative right inguinal hernia. (Continued on the next page) The reviewer must include in the medical report the rationale for any conclusions expressed, to include descriptions of the medical processes involved and citation to relevant medical literature/treatise as necessary. A report containing unsupported, unexplained, or speculative conclusions will be returned as inadequate. LAURA E. COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Smith, 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.