Citation Nr: 21068422
Decision Date: 11/10/21	Archive Date: 11/10/21

DOCKET NO. 17-28 380
DATE: November 10, 2021

REMANDED

Entitlement to service connection for a lumbar spine condition, to include as secondary to a service-connected right knee disability, is remanded.

REASONS FOR REMAND

The Veteran served in the Air Force, on active duty from June 1984 to March 1988. 

This claim comes before the Board of Veterans' Appeals (Board) on appeal from a January 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). 

In August 2021, the Veteran testified before the undersigned Veterans Law Judge. A transcript of that hearing is of record. 

Entitlement to service connection for a lumbar spine condition, to include as secondary to a service-connected right knee disability, is remanded.

The Veteran seeks service connection for a lumbar spine condition, which he asserts is secondary to his service-connected right knee disability. Specifically, he contends that his right knee disability has caused a limp and/or altered gait, which in turn, led to his lumbar spine condition. Inasmuch as the Board regrets any further delay in the adjudication of this appeal, a remand is necessary. 

The Veteran underwent VA examinations in July 2014 and April 2017 for his lumbar spine condition. Both examinations resulted in a negative opinion, however, the July 2014 VA examination noted that he did not walk with an altered gait due to his service-connected right knee disability. In contrast, the April 2017 VA examiner observed a limp on his right side. 

Despite the noted limp, the April 2017 VA examiner opined that his lumbar spine condition was not related to his right knee disability. The opinion concluded that the lumbar spine and right knee are "distinct" anatomical structures, and a "[p]athology in one does not result in [a] pathology in the other." The Board finds this opinion to lack clear and supporting rationale addressing whether the Veteran's service-connected right knee disability caused or aggravated his low back condition. 

Further, the Veteran submitted a September 2017 private opinion which links his lumbar spine condition to his service-connected right knee disability due to altered gait mechanics. In light of the above, the Board finds that the April 2017 opinion is inadequate, and another VA medical opinion is required. 

The matters are REMANDED for the following action:

1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's lumbar spine condition is at least as likely as not related to his service-connected right knee disability. Based upon a review of the record, including the Veteran's medical history, private opinion, and clinical findings, the VA examiner is requested to offer the following opinions:

(a)	Is it at least as likely as not that the Veteran's low back condition, diagnosed as degenerative arthritis of the spine and lumbar disc bulge, was caused by the service-connected right knee disability?

(b)	If not, is it at least as likely as not that the Veteran's low back condition is aggravated by the service-connected right knee disability? 

If aggravation is found, the examiner should identify the baseline level of severity prior to the onset of aggravation. 

 

 

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	T. McDonald