Citation Nr: 21068402 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 12-27 642A DATE: November 10, 2021 REMANDED Entitlement to service connection for low back condition is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1992 to July 1995. This matter comes before the Board of Veterans' Appeals (Board) following January 2018, October 2019, and May 2021 Board Remands. This matter was originally on appeal from January 2010 and November 2014 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In August 2017, the Veteran testified at a hearing before the undersigned. A transcript of the hearing is of record. 1. Entitlement to service connection for low back condition is remanded. A remand by the Board confers on the Veteran, as a matter of law, the right to have compliance with the remand directives, and the Board has a duty to ensure such compliance. Stegall v. West, 11 Vet. App. 268, 271 (1998). Although the Board regrets additional delay, another remand is necessary to ensure that there is a complete record upon which to decide the claim so that the Veteran is afforded every possible consideration. For the following reasons, the Board finds the VA examiner's opinion inadequate for purposes of determining service connection. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Pursuant to the May 2021 Board remand, the Veteran was provided an addendum opinion in June 2021. In the prior remand the examiner was asked specifically to address the Veteran's statement that he fell and hit his back on a locker and that he has had pain "off and on" since that injury when discussing the issue of continuity of symptoms. Further, the examiner was asked to discuss whether the Veteran's assertions are generally inconsistent with medical knowledge or implausible, and whether the Veteran's reports about symptoms experienced over the years align with how the low back disability is known to develop. The examiner opined that the Veteran's back condition is less likely as not related to military service since chronicity of a back condition in the military could not be established as per STRs in VBMS. The examiner further stated that a single episode of back pain resolved without sequelae. In addition, the Veteran's lumbar spine arthritis is also a condition caused by the ageing process. The examiner noted his opinion was mere speculative since there is no documented continuity of these symptoms in the Veteran's available records. Furthermore, the examiner stated the Veteran's chronic low back strain is as likely as not due to obesity, current vocation, decreased physical activity, and a variety of other factors, than due to his military service. There does not appear to be any appreciable permanent impairment sustained during his military duty. The VA examiner failed to consider the Veteran's statement that he fell and hit his back on a locker and that he has had pain "off and on" since that injury. Based upon the foregoing, the Board finds the VA examiner's opinion inadequate for purposes of determining service connection and, consequently, there has not been substantial compliance with the prior remand directives. See Barr, 21 Vet. App. 303; Stegall, 11 Vet. App. 268. The matters are REMANDED for the following action: 1. Obtain and associate with the Veteran's claims file all outstanding VA treatment records. 2. Obtain an addendum opinion regarding the Veteran's low back condition. Based upon a review of all pertinent documents in the Veteran's claims file, including medical treatment and examination records, lay statements, and the examination results, the examiner must opine as to: (a.) whether it is at least as likely as not (i.e., at least a 50 percent probability or higher) the Veteran's current low back strain had its onset during service or is related to any in-service disease, event, or injury, to include the documented January 1994 back injury. Additionally, the examiner must specifically address the Veteran's statement that he fell and hit his back on a locker and that he has had pain "off and on" since that injury when discussing the issue of continuity of symptoms. Please discuss whether the Veteran's assertions are generally inconsistent with medical knowledge or implausible, and whether the Veteran's reports about symptoms experienced over the years align with how the low back disability is known to develop. A fully articulated medical rationale for each opinion expressed must be set forth in the medical report. The examiner should discuss the particulars of this Veteran's medical history and the relevant medical science as applicable to this case, which may reasonably explain the medical guidance in the study of this case. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Daley, 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.