Citation Nr: 21062070 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 17-46 258 DATE: October 6, 2021 REMANDED Entitlement to service connection for a back condition is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marines from August 2003 to August 2007. This September 2017 appeal comes before the Board of Veterans' Appeals (Board) from a November 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO), in Phoenix, Arizona. In the Veteran's September 2017 appeal, he requested a Board hearing by videoconference. The Veteran was afforded a Board hearing in June 2020 on the remaining issue on appeal. In a May 2021 decision, the Board remanded the case for a VA examination and the RO then issued an August 2021 supplemental statement of case (SSOC). 1. Entitlement to service connection for a back condition is remanded. Although the Board is aware this case has been on appeal since September 2017 and further delay is regrettable, the Board finds a remand is necessary in order to make a fully informed decision on the Veteran's claim. During a June 2017 VA examination for his back condition, the Veteran was diagnosed with a lumbar strain. The examiner noted that the Veteran's January 2006 x-rays indicated minimal upper dorsal scoliosis. In a May 2021 decision, the Board remanded the case in accordance with Quirin v. Shinseki, 22 Vet. App. 390 (2009) because the June 2017 VA examination did not include an opinion regarding whether the Veteran's congenital scoliosis was a congenital disease or defect. In a June 2021 VA examination, the examiner opined the Veteran's spinal condition was a congenital disease and not a defect. However, during a subsequent August 2021 VA examination, the examiner opined the Veteran's spinal condition was a developmental condition, not congenital, and that people are not born with the condition. In order to properly apply the presumption of soundness and determine whether the condition pre-existed service, the Board needs clarification regarding whether the condition is congenital or developmental. The matter is REMANDED for the following action: 1. Obtain an addendum medical opinion from an appropriate medical professional that specializes in spinal conditions regarding the Veteran's scoliosis. The claims file should be made available for review, and the examination report should reflect that such review occurred. Following the review of the record, the examiner should respond to the following: a. Is the Veteran's scoliosis considered to be a congenital condition (a condition present from birth) or a developmental condition (a condition not present at birth but occurs later during development)? b. If his scoliosis is a developmental condition, is there clear and unmistakable evidence that 1) the condition preexisted the Veteran's active service, 2) that his back condition was not aggravated during service, and 3) that any increase in the condition was due to the natural progression of the pre-existing condition. It should be noted that the Veteran is competent to attest to observable symptomatology. The examiner's opinion must include a discussion regarding the Veteran's statements concerning the in-service onset of the claimed condition and the continuity of symptomatology he has experienced since service. The examiner is reminded that a medical opinion based solely on the absence of documentation in the record or that does not address the Veteran's reports of symptoms and history is inadequate. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed should be provided as the Board is precluded from making medical findings. A discussion of the facts and the medical principles involved will be of considerable assistance to the Board, including citation to any supporting medical treatises. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Aubee, 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.