Citation Nr: 21062943 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 15-27 637A DATE: October 12, 2021 REMANDED Entitlement to service connection for a lumbar spine condition is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1964 to July 1968 and from January 1991 to May 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board issued a decision on this matter in March 2020, denying service connection for the Veteran's lumbar spine condition. The Veteran appealed the decision to the U.S. Court of Appeals for Veterans Claims (Court). Pursuant to a joint motion for remand (JMR) granted by the Court in January 20201, the March 2020 decision was vacated, and the matter remanded in order for the Board to provide additional reasons and bases addressing the competency of the Veteran's lay statements as to the etiology of his lumbar spine condition. Following the Court's remand, the Board remanded the matter in June 2021 to obtain updated VA treatment records and to reconcile conflicting findings between VA and private medical opinions. While the RO obtained updated VA treatment records and an addendum medical opinion, the Board finds that the addendum medical opinion did not substantially comply with the remand directives; regrettably, further remand is necessary. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The June 2021 remand directives requested that a VA examiner "specifically discuss and reconcile the conflicting medical findings included in Dr. G.F.'s May 2021 medical nexus statement versus the prior March 2019 VA opinion," with specific reference to multiple assertions made in Dr. G.F.'s statement. The July 2021 VA examiner did not comply with this directive; rather, he merely copied a portion of the remand directives and stated that "[t]here is no evidence to support the Veteran's disc degeneration is far greater than the ordinary degenerative changes without merely speculating" and "[t]here is no evidence to support the Veteran's trauma or injury caused or aggravated claimant's degenerative disc disease without merely speculating." Not only did the examiner improperly conclude that there is "no evidence" to support the private medical opinions, he also failed to provide rationale as to why consideration of such evidence would be mere speculation. As discussed in Stegall, a remand by the Board "confers on the veteran or other claimant, as a matter of law, the right to compliance with the remand orders" and "imposes upon the Secretary of Veterans Affairs a concomitant duty to ensure compliance with the terms of the remand." Accordingly, although the Board sincerely regrets the additional delay, further remand is necessary to afford the Veteran due process of law and ensure substantial compliance with the prior remand directives. Id. The matters are REMANDED for the following action: Return the claims file to the July 2021 VA examiner, or another VA examiner if he is not available, to obtain an addendum medical opinion that complies with the Board's current and prior remand directives. The examiner should review the claims file, specifically including the private medical opinions provided by Dr. G.F. and Dr. H., and respond to the following: (a.) Is it as likely as not the Veteran's lumbar spine condition is at least as likely as not related to his active duty, to include his MVA in service? (b.) If the answer to (a) is negative, is it as likely as not the Veteran's lumbar spine condition was caused or aggravated by his service-connected cervical spine degenerative disc disease? In doing so, the examiner must specifically discuss and reconcile the conflicting medical findings included in Dr. G.F.'s May 2021 medical nexus statement verus the prior March 2019 VA opinion, to include the following: that the extent of the Veteran's disc degeneration is far greater than the ordinary degenerative changes; that medical literature, to include a portion of Dr. G.F.'s own research and academic publication, positively indicates an interrelationship between arthritis in different areas of the spine; and that trauma or injury can cause or aggravate degenerative disc disease All opinions must be accompanied by a rationale reflecting full consideration of the evidence of record. A discussion of the pertinent evidence, relevant medical treatises, and generally accepted medical principles is required. It is not sufficient for the examiner to merely conclude, without rationale as to why, that there is no evidence to support Dr. G.F.'s opinion. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Tierno 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.