Citation Nr: 21068044 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 14-24 631 DATE: November 8, 2021 REMANDED Entitlement to service connection for a lower back disorder, to include as secondary to right and left lower extremity neuropathies, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1952 to March 1956. The Veteran died in December 2016. The Appellant has been substituted onto the claim by the Agency of Original Jurisdiction. See December 18, 2018 correspondence. In November 2014, the Veteran testified before the undersigned Veterans Law Judge at a Board of Veterans' Appeals (Board) videoconference hearing in Hartford, Connecticut. A transcript of the proceeding is of record. The Board denied the claim on appeal in a January 2015 decision. This decision was appealed the United States Court of Appeals for Veterans Claims (Court). In October 2019, the Court issued an order granting an October 2019 Joint Motion for Remand (JMR), remanding this and two other issues to the Board for further action. The Board subsequently remanded the claim in July 2020, April 2021 and August 2021. The Board granted service connection for left and right lower extremity neuropathy in the April 2021 decision. 1. Entitlement to service connection for a lower back disorder, to include as secondary to right and left lower extremity neuropathies, is remanded. Upon review of the evidence of record, the Board finds remand is warranted for an additional medical opinion. The Board remanded the Appellant's claim in August 2021 in order to have medial opinions obtained on whether the Veteran had a back disability that was proximately due to or aggravated by service-connected lower extremity neuropathy. Opinions were obtained in August 2021, but the opinion and rationale with regard to aggravation is inadequate. In part, the August 2021 VA examiner wrote "The veteran's Low back condition as previously outlined in the 2012 and 2014 C&P medical opinions is less likely related to his SC BL LE neuropathies. There is no evidence of a back condition proximate to the veteran's RAD, specifically within 1 year of service. The veteran's medical record from 2002 document the ability of the veteran to participate in activities to include playing 18 holes of golf and walking the course. The veteran's claimed back condition is consistent, as previously stated in the 2012 C&P exam with spinal stenosis, a process that occurs over time due to arthritic changes. Should the SC condition have aggravated the veteran's back the veteran would not have been able to walk 18 holes of golf in 2002." See August 2021 opinion report (emphasis added). The examiner's rationale appears to focus on that the Veteran had spinal stenosis, and that it was due to post-service activities. However, with regard to aggravation, the examiner only stated, "Should the [service-connected] condition have aggravated the veteran's back the veteran would not have been able to walk 18 holes of golf in 2002". This rationale precludes the possibility that the Veteran's back disability was aggravated after 2002. Notably, subsequent treatment records indicate the use of a cart when golfing. See, e.g., VA treatment records from May 20, 2011 (cart) and May 22, 2012 (short walks while golfing); see also VA treatment records from June 10, 2013 (stopped walking golf courses in the 1980s) and June 13, 2014 (stopped walking golf courses in the 1970s). To the extent the Veteran walked the whole course in 2002, the evidence indicates he did not do so indefinitely. In light of the above, the Board finds remand is warranted for an additional opinion that addresses whether the Veteran had a back disability that was aggravated by service-connected neuropathy. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's had a back disability that was at least as likely as not aggravated, i.e. worsened beyond its natural progression, by service-connected disease or injury. If there is aggravation, the examiner must establish the baseline of the increase. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Gregory T. Shannon, 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.