Citation Nr: 21062111 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 19-00 148A DATE: October 6, 2021 REMANDED Entitlement to service connection for a back condition is remanded. Entitlement to service connection for left shoulder condition is remanded. REASONS FOR REMAND The Veteran served on active duty in the Marine Corps from September 1963 to August 1967, and the Army from August 1978 to October 1990. This case comes before the Board of Veterans' Appeals (Board) on an appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office. In March 2021, the Board remanded the claims for service connection for back condition, left shoulder condition, and right knee condition for additional development. While the case was in remand status, service connection was awarded for right knee condition; consequently, that issue no longer remains a claim in controversy. The Veteran testified before the undersigned at a Board videoconference hearing in January 2021, and a copy of the hearing transcript has been obtained and associated with the record. 1. Entitlement to service connection for a back condition. The Veteran appeals the denial of service connection for his back condition. The Veteran testified during his Board hearing in January 2021, that he had several back problems during service. He said he has suffered consistently from back problems that he believes originated in service. He also contended that his back condition may be related to his service-connected neck arthritis. The Veteran's service treatment records show the Veteran complained of back pain while in service. Specifically, in June 1982, while the Veteran was stationed in Italy, he was in the hospital for lower back pain; in December 1985, there is a note that the Veteran went skiing and aggravated his back injury; and in February 1986, the Veteran reported falling down a set of stairs and complained of back pain. Later, the Veteran reported occasional acute episodes of back pain in July 1986. Pursuant to the March 2021 Board remand, the Veteran underwent another VA examination for his back condition in June 2021. The examiner confirmed the Veteran's diagnosis of degenerative disc disease (DDD) other than intervertebral disc syndrome (IVDS). The examiner opined that the Veteran's DDD was less likely than not to have had its onset in or is otherwise related to the Veteran's active duty service. She referenced the Veteran's 1982 reports of back pain, and said that although he reported back pain, on his examination in January 1990, he denied suffering from recurrent back pain. She also opined that it is less likely than not proximately due to or aggravated beyond its natural progression by his service-connected neck. She concluded degeneration occurs because of age related wear and tear on a spinal disc, although this may be accelerated by injury, it rarely starts with trauma. The Board finds that there has not been substantial compliance with the March 2021 remand directives, and remand is necessary again in order to properly develop the claim. Stegall v. West, 11 Vet. App. 268 (1998). The VA examiner provided an inadequate rationale as to the nature and etiology of the Veteran's back pain. She failed to address all his in-service complaints and treatments of lower back pain, as well as his contention that his back pain has been continuous since service. Therefore, a remand is necessary to obtain an addendum opinion to address the Veteran's contentions and all his in-service complaints, as well as to provide an adequate rationale as to whether the Veteran's lower back condition was caused by service or proximately due to his service-connected neck disability. 2. Entitlement to service connection for left shoulder condition. The Veteran appeals the denial of service connection for his left shoulder condition. The Veteran testified at his January 2021 Board hearing that he was diagnosed with bursitis in both shoulders during service. He also said that while he does not recall a specific injury to his shoulder during service, due to calisthenics and other things during service he sought treatment during and after service for his left shoulder condition. His service treatment records show his right arm and left elbow were diagnosed with bursitis, and he had a complaint of left shoulder pain in October 1982. Pursuant to the March 2021 Board remand, the Veteran underwent another VA examination for his left shoulder condition. The examiner confirmed the Veteran's diagnosis of left shoulder impingement and degenerative arthritis. She stated that the Veteran's service treatment records were silent for complaints or treatment of left shoulder during service. She concluded that the Veteran's left shoulder impingement and degenerative arthritis are less likely than not incurred in or caused by the claimed in service injury, event, or illness. Unfortunately, the Board finds that there has not been substantial compliance with the March 2021 remand directives, and remand is necessary again in order to properly develop the claim. Stegall v. West, 11 Vet. App. 268 (1998). The examiner failed to address the Veteran's contentions of wear and tear during service, and his in-service complaint of left shoulder pain. Therefore, a remand is necessary to obtain an addendum opinion addressing the nature and etiology of his left shoulder condition, as well as the Veteran's contentions and his in-service complaints of left shoulder pain, to include his complaint in October 1982. The matters are remanded for the following actions: 1. Obtain an addendum opinion from the appropriate clinician to determine the nature and etiology of the Veteran's back condition. The examiner is asked to address all the Veteran's contentions and his treatments for back pain during service and after, to include his report of falling down the stairs in February 1986, and that his pain has been consistent since service. The examiner is asked to provide responses to the following: (a.) Whether it at least as likely as not (50 percent or greater probability) that such had onset in, or is otherwise related to, the Veteran's active duty service. (b.) Whether the Veteran's back condition is at least as likely as not (1) proximately due to, or (2) aggravated beyond its natural progression by his service-connected neck disability. 2. Obtain an addendum opinion from the appropriate clinician to determine the nature and etiology of the Veteran's left shoulder condition. The examiner should address the Veteran's contentions and complaints and treatments for left shoulder pain during service, to include the Veteran's complaint of left shoulder pain in October 1982. The examiner is asked to provide a response as to whether it is at least as likely as not (50 percent or greater probability) that such had onset in, or is otherwise related to, the Veteran's active duty service. 3. All examiners must review the entire claims folders, including a copy of this remand. If the examiner finds an examination is necessary, then schedule the examination. A complete rationale must be provided for all opinions expressed. If the requested opinion cannot be provided without resort to speculation, the examiner should so state and explain why an opinion would be speculative. J. B. FREEMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Doerfler, 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.