Citation Nr: 21064267 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 16-11 198A DATE: October 19, 2021 REMANDED Entitlement to service connection for residuals of a tailbone injury, to include degenerative disc and joint disease of the lumbar spine and sacroiliitis, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Air Force from July 1964 to May 1967. He later served in the Mississippi Army National Guard from August 1976 to June 1983 and from February 1984 to November 1997. This matter is before the Board of Veterans' Appeals (Board) on remand from the United States Court of Appeals for Veterans Claims (Court). This case was previously before the Board on appeal from a November 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Veteran testified before the undersigned Veterans Law Judge at a video conference hearing. The Board remanded the case for further development in March 2019. In a June 2020 decision, the Board denied the Veteran's claim for entitlement to service connection for the above disability. The Veteran appealed the Board's decision to the Court. In March 2021 the Court issued an Order that vacated the Board's June 2020 decision and remanded the matter for readjudication consistent with instructions outlined by the parties in a Joint Motion for Remand (JMR). The Board remanded the claim in compliance with the June 2020 JMR in July 2021. As discussed below, there has not been substantial compliance with the July 2021 remand instructions, so the matter must be remanded. See Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). Entitlement to service connection for residuals of a tailbone injury, to include degenerative disc and joint disease of the lumbar spine and sacroiliitis, is remanded. The Veteran testified in his January 2019 hearing that he broke his tailbone in 1984 at Camp Shelby when he was a passenger in an M60 tank that went off the road and hit two terraces. He asserted that records of his injury were thrown away and replaced with records indicating a bruised hip in retaliation for getting injured. The Veteran stated that his lumbar pain continued from then on into the present. This incident occurred during a period of active duty for training. In the March 2021 JMR, the parties agreed that the Board erred in its June 2020 decision by failing to provide an adequate statement of reasons or bases addressing the Veteran's lay statements regarding continuity of symptomatology of lumbar pain. The Board's July 2021 remand instructed for a new VA opinion to specifically discuss the Veteran's January 2019 testimony that he continued to experience lumbar pain ever since his 1984 in-service injury. However, the August 2021 VA physician stated that the Veteran's lower back pain started in 2016. Additionally, he did not review the Veteran's October 2019 x-ray displaying degenerative disc disease. Because the examiner formulated an opinion without properly considering the Veteran's lay statements, the Board finds the August 2021 medical opinion to be inadequate. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). The Board also finds that therefore the RO did not substantially comply with the Board's prior remand directive to consider the Veteran's reports of his history of symptomatology. See Stegall, 11 Vet. App. at 268. Accordingly, another remand is required to complete the requested development. The matter is REMANDED for the following actions: 1. Obtain an addendum VA medical opinion from a VA physician (M.D.) of appropriate expertise who has not previously provided an opinion in this case to assess the nature and etiology of the Veteran's claimed disability. A full VA examination need not be scheduled unless it is deemed necessary by the examiner or otherwise required by the evidence. The examiner must review the Veteran's claims file in its entirety, to include a copy of this REMAND. The completion of this review must be noted in the report. Thereafter, the examiner is asked to provide a complete and thorough medical opinion addressing the following: (a) Is it at least as likely as not (50 percent or greater probability) that the Veteran has a residual disability involving the low back, tailbone, and/or right hip that was incurred in or caused by an in-service injury, event, or illness, to include the injury documented on July 12, 1984? In providing the above opinion, the examiner must specifically discuss the etiology of the Veteran's currently-diagnosed degenerative joint and disc disease of the lumbar spine and sacroiliitis AND his January 2019 Board testimony that he has continued to experience lumbar pain ever since the injury to his tailbone during service. The examiner must also address the Veteran's contention that he fractured his tailbone in the in-service accident. The examiner is reminded that the term "as likely as not" does not mean within the realm of possibility. Rather, it means that the weight of the medical evidence, both for and against a conclusion, is so evenly divided that it is as medically sound to find in favor of causation as it is to find against it. It is imperative that the requested medical opinion reconcile all available evidence of record, to include the Veteran's lay statements and hearing testimony, buddy statements, service treatment records, post-service medical records, including prior VA examinations and opinions, and any other pertinent evidence of record. (Continued on the next page) The Veteran is considered competent to report when his symptoms began, and such reports must be acknowledged. The Veteran's lay contentions must be considered and weighed in making the determination as to whether a nexus exists between the claimed disability and military service. The examiner must provide a complete rationale for any opinion offered, citing to the examiner's own expertise, medical principals, and/or evidence in the Veteran's record, when necessary, to support the conclusion reached. If the requested opinion cannot be rendered without resorting to speculation, the examiner must fully explain why that is so. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ahuva D. Sunshine 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.