Citation Nr: 21063221
Decision Date: 10/13/21	Archive Date: 10/13/21

DOCKET NO. 13-27 900
DATE: October 13, 2021

REMANDED

Entitlement to service connection for low back condition is remanded.

REASONS FOR REMAND

The Veteran served in the Navy from January 1982 to October 1990. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This claim was last before the Board in April 2021 where it was remanded for additional development.

1. Entitlement to service connection for low back condition is remanded.

The Veteran contends that his low back condition had its onset during service. Alternatively, he contends that his low back condition is secondary to his service-connected knee condition, to include gait accomodation and obesity from his inability to maintain a successful exercise regimen due to his service-connected knee condition. While further delay is regrettable, the Board finds that additional development is needed prior to adjudication of this claim.

In accordance with prior remand instructions, an addendum opinion was obtained in August 2021. The VA examiner was instructed to determine whether it is at least as likely as not that the service-connected knee disabilities caused the Veteran to become obese, gain weight, or aggravated his obesity and if so, state whether the obesity was a substantial factor in causing his low back condition and whether his low back condition would not have occurred or worsened but for the weight gain caused by his service-connected disabilities. See April 2021 Board Remand. The examiner was further instructed to address the September 2016 statement from private practitioner, Dr. Rodriguez, indicating that the Veteran's bilateral knees severely limited his ability to exercise and keep weight off and that his gait has "directly affected his lower back." Id. 

The August 2021 VA examiner opined "obesity does not cause degenerative    spine disease . . . [t]hough it may exacerbate symptoms, it does not aggravate the condition itself." For the rationale, the VA examiner provided general information on obesity, including its known causes. However, the VA examiner did not address the Veteran's obesity specifically, to include the statement from Dr. Rodriguez, the Veteran's service treatment records (STRs), or his post-service treatment records which together indicate that his obesity is related to his service-connected knee condition. As such, additional opinion is warranted in order to comply with the terms of the Board's prior remand instructions. See Stegall v. West, 11 Vet. App. 268 (1998) (a remand by the Board confers on the appellant, as a matter of law,    the right to compliance with the remand orders).

The matters are REMANDED for the following action:

1. Obtain an addendum opinion with respect to the Veteran's low back claim. The claims file must be reviewed by the examiner. If a new examination is deemed necessary to respond to the request, one      should be scheduled. 

Following review of the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the service-connected knee disabilities caused him to become obese, gain weight, or aggravated his obesity. The examiner should explain why or why not.

If so, state whether the obesity was a substantial factor    in causing his low back condition and whether his low back condition would not have occurred or worsened    but for the weight gain caused by his service-connected disabilities. The examiner should address the September 2016 statement from Dr. Rodriguez indicating that the Veteran's bilateral knees severely limited his ability to exercise and keep weight off and that his gait has "directly affected his lower back." The examiner     should explain why or why not.

2. If the claim remains denied, issue a supplemental statement of the case.

 

 

K. A. BANFIELD

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	G. N. Wilson, 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.