Citation Nr: 21066824 Decision Date: 11/02/21 Archive Date: 11/02/21 DOCKET NO. 19-00 255 DATE: November 2, 2021 REMANDED Entitlement to service connection for a low back disability is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1978 to July 1979. He died in April 2020. The Appellant, his surviving spouse, was granted substitution and this appeal has therefore been continued. See September 2020 Correspondence. This matter comes before the Board of Veterans' Appeal (Board) on appeal from a May 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Appellant testified at a hearing conducted by the undersigned Veterans Law Judge in November 2020. Entitlement to service connection for a low back disability. The Veteran asserted that his low back disability had its onset during service. See, e.g., the December 2015 VA Form 9. The Veteran reported that he received treatment for his spine for over 30 years at the local Veterans Affairs Medical Center. See, April 2015 Notice of Disagreement. VA's duties to assist claimants in the development of claims also may include scheduling a medical examination. Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or recurrent symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence "indicates" that there "may" be a nexus between the current disability or symptoms and active service, including equivocal or non-specific medical evidence or credible lay evidence of continuity of symptomatology). The Veteran was diagnosed with spinal stenosis in July 2008 and a current disability has therefore been demonstrated. He has also described 30 years of treatment for his spine. Based on these facts, the Board finds that a medical opinion is necessary. McLendon. This matter is REMANDED for the following actions: 1. Obtain all outstanding VA treatment records specifically back treatment records that have not been associated with the claims file. The Board is particularly interested in the 30+ years of treatment records from the New Orleans VA the Veteran described in his April 2015 NOD. 2. Arrange for the Veteran's record to be forwarded to an appropriate clinician for review and an opinion regarding the likely etiology of his low back disability. On review of the record, the examiner should: (a) Identify the likely etiology of the Veteran's low back disability. Specifically, is it at least as likely as not (a 50 percent or greater probability) that the low back disability is related to his service (due to disease, injury, or event, or by onset, therein)? The examiner should review any lay statement from the Veteran, and the Appellant, regarding symptoms noted in-service as well as post-service. The examiner should include rationale with all opinions. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the examiner. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be considered in formulating the requested opinion. However, if there is a medical reason to doubt its veracity, the examiner should explain why the Veteran's statements or recollection are inconsistent with the evidence in this case, medical principles relating to the onset and progress of the disease, the specific findings in the record, and/or your professional judgment. The examiner is reminded that the absence of documented treatment in service or thereafter is not fatal to a service connection claim, and the absence of evidence in the service treatment records is an insufficient basis, by itself, for a negative opinion M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Oquendo, L., 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.