Citation Nr: 21070096 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 15-44 506 DATE: November 23, 2021 REMANDED Service connection for a back or neck disability, to include nerve impingement, is remanded. Service connection for a bilateral shoulder disability, to include nerve impingement, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1977 to January 1997. In June 2021, the Board of Veterans' Appeals (Board) remanded the issues above to the agency of original jurisdiction (AOJ) for a third time. The Board explained in the most recent remand that the February 2021 VA examiner failed to consider the Veteran's lay statements concerning the onset of his claimed disabilities, as well as a November 2018 private treatment record noting a long history of neck pain, as previously instructed. The Board instructed the examiner on remand to consider and discuss this evidence in addendum opinions. The Veteran received a new examination in September 2021. During this examination, he reported an in-service onset of his back, neck and shoulder symptoms, which he self-medicated with Tylenol, heat and/or rest. The Board notes that he has made similar statements throughout this appeal, including at his 2018 Board hearing and at prior examinations. The Board also notes that he has been diagnosed with degenerative arthritis (of the spine and the acromioclavicular joints), which is one of the chronic diseases subject to presumptive service connection under 38 C.F.R. § 3.309(a). The September 2021 examiner determined that the claimed disabilities were all less likely than not incurred in or caused by service because the Veteran's service treatment records were "silent" for any such conditions. In a parenthetical comment, the examiner also noted that they had reviewed the claims file, including the 2018 private treatment record. However, the examiner did not actually discuss the significance of this treatment record, or discuss any of the Veteran's lay statements about the onset of his disabilities. Thus, like the previous examiner's opinions, the September 2021 opinions are inadequate. Miller v. Wilkie, 32 Vet. App. 249, 25960 (2020) (holding that a VA examiner "must address the veteran's lay statements to provide the Board with an adequate medical opinion"). Another remand is necessary to ensure compliance with the Board's previous instructions. Stegall v. West, 11 Vet. App. 268, 271 (1998); see also Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (when VA undertakes the effort to provide a VA examination or obtain an opinion, it must ensure that the examination or opinion is adequate). On remand, the AOJ must obtain adequate addendum opinions for each claimed disability. The examiner must clearly consider and discuss the Veteran's lay statements about his subjective symptoms and treatment, during and after service, in the opinions. These include his 2018 testimony before the Board and statements made to the previous examiners. The examiner must also clearly consider and discuss pertinent post-service medical records, including the November 2018 private treatment record noting a long history of neck pain. The Board by this remand makes no determination, expressed or implied, concerning the credibility of any statements on file. The matters are REMANDED for the following action: 1. Obtain addendum medical opinions on the nature and etiology of the Veteran's claimed back/neck and bilateral shoulder disabilities. After reviewing the claims file, the examiner must address the following: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's neck/back disability was incurred in or caused by service? (b.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's neck/back disability became manifest within one year of separation from service? If so, what were the manifestations? (c.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's bilateral shoulder disability was incurred in or caused by service? (d.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's bilateral shoulder disability became manifest within one year of separation from service? If so, what were the manifestations? In particular, the examiner must clearly consider and discuss the Veteran's lay statements about his subjective symptoms and treatment, during and after service, in the opinions. These include his 2018 testimony before the Board and statements made to the previous examiners. The examiner must also clearly consider and discuss pertinent post-service medical records, including the November 2018 private treatment record noting a long history of neck pain. 2. Review the medical opinions above to ensure substantial compliance with the Board's directives. Take any necessary corrective action. 3. Readjudicate the Veteran's claims. If any claim remains denied, issue a supplemental statement of the case and allow the Veteran and his representative the opportunity to respond. Then return to the Board for further appellate review. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D.Z. Wall, 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.