Citation Nr: A21017443 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 190618-21385 DATE: October 27, 2021 REMANDED Service connection for a lower back disorder is remanded. REASONS FOR REMAND Veteran served on active duty in the U.S. Marine Corps from October 1985 until September 1989. A rating decision was issued under the legacy system in October 2013 by a Department of Veterans Affairs (VA) Regional Office. On January 19, 2018, the Veteran opted into the modernized review system, also known as the Appeals Modernization Act (AMA), by submitting a Rapid Appeals Modernization Program (RAMP) election form and selecting the higher-level review (HLR) lane. The agency of original jurisdiction (AOJ) notified the Veteran by letter in June 2019 that an error was found on HLR and additional development was being ordered. Additional development was completed to correct the HLR error, and in December 2018 the AOJ issued a RAMP supplemental rating decision considering all the evidence. On the June 2019 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Hearing docket. The Veteran presented testimony at a Board of Veterans' Appeals (Board) hearing before the undersigned Veterans Law Judge in January 2021. The Board may only consider the evidence of record at the time of the December 2018 decision, as well as any evidence submitted by the Veteran or his at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). Service connection for a lower back disorder is remanded. This issue is remanded to correct a duty to assist error that occurred prior to the December 2018 decision on appeal. VA's duty to assist includes providing a medical examination or opinion when is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). Where VA provides the veteran with an examination or opinion in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Generally, a medical opinion should address the appropriate theories of entitlement. Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007). Here, remand is required to obtain an addendum opinion that adequately addresses the theory of service connection raised by the Veteran. On the November 2011 claim for benefits, the Veteran wrote that lower back pain first began in 2001. He alleged his current back condition began as minor injuries from physical and operational training in service. He wrote that none of the in-service injuries were severe enough to seek treatment then but had developed into osteoarthritis over time. VA obtained a medical opinion in July 2018. That examiner opined that diagnosed degenerative arthritis of the spine was not due to the Veteran's period of service. In support of that opinion, the examiner noted the Veteran had one complaint of lower back pain in January 1985 or 1986 that appeared acute and self-limiting. The Veteran did not have a chronic back condition in service, and there was no documented continuity of care after separation from service. Rather, his current degenerative disc disease was more likely related to his civilian physical job and generalized degeneration due to age. The July 2018 medical opinion does not adequately address whether the later back symptoms and diagnoses could otherwise be etiologically related to the Veteran's period of service, to include as due to the strenuous physical activities previously described by the Veteran, despite not having onset in service or continuity of symptoms since service. Thus, remand for an addendum is required. The Veteran has also raised a theory of entitlement based on chronicity of back symptoms since an in-service onset, however the Board does not find the evidence of in-service symptoms or chronic symptoms since service to be credible or probative. At the January 2021 hearing, the Veteran testified that he injured his back in service during training exercises and that he experienced chronic pain since then. He described a back injury in service when he was kicked in the groin, and another injury at infantry training school where his back "went out" and he went to sick bay. He also reported he had regular back treatment immediately after service but that those records were no longer available. The hearing testimony of chronic symptoms since an in-service onset is inconsistent with the testimony recorded on the November 2011 claim for benefits. The objective medical evidence does not corroborate the lay testimony of in-service back symptoms and chronic symptoms since. The Veteran's entrance exam did not show any clinical findings for the spine. On the accompanying report of medical history, the Veteran reported he had been a patient in a hospital when he had a 1-day history of lower back pain in 1984, prior to service. The STRs do not show any back related complaints. Although the Veteran was treated for a groin injury in November 1985, those records do not report any back complaints. The Veteran denied recurrent back pain on May 1986 and September 1989 reports of medical history, and no back condition was noted on the report of medical history at separation. Next, private treatment records show the Veteran complained of lower back pain in January 2006, and an April 2007 private record notes the Veteran injured his lower back lifting a cement slab at his home. The available medical evidence does not show any complaints of radiculopathy until June 2017, when VA treatment records report the Veteran had a 1-month history of left leg sciatica. In light of the inconsistencies in the Veteran's testimony and the contradictory objective medical evidence, the Board does not find the Veteran's statements of chronic symptoms since an in-service onset to be credible and therefore that testimony does not need to be addressed by the VA examiner. The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding the etiology of the claimed lower back disorder from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. (a.) The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that a low back disorder is etiologically related to strenuous physical training in service, such as jumping from a height of 3 to 5 feet in full gear. LAURA E. COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Smith, 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.