Citation Nr: 21072932 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 14-02 504 DATE: December 6, 2021 REMANDED Entitlement to service connection for low back pain is remanded. REASONS FOR REMAND The Veteran served with the Army National Guard, including a confirmed period where she was ordered to active duty in support of Operation Enduring Freedom from November 2009 to June 2010. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2011 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In August 2021, the Board remanded the claim for additional development. Unfortunately, a remand is necessary for an addendum VA opinion that adequately addresses the Veteran's lay statements of record. 1. Entitlement to service connection for low back pain is remanded. The Veteran contends that her low back pain is related to service. In the November 2020 remand, the examiner was instructed to address the significance, if any, of the Veteran's lay statements regarding continuity of low back pain in service and afterwards. In this regard, the Board also noted that treatment records show the Veteran sought treatment for back pain in 2009 and 2010 for back pain during active service. The Veteran was afforded a VA examination in May 2021. In the August 2021 remand, the Board determined that the VA examination relied on an inaccurate factual premise, specifically that underlying service and medical records did not indicate complaints, diagnosis, or treatment for low back pain since 2010. The examiner was instructed to consider all pertinent evidence, to include lay statements of post-service symptomatology and medical records. The Veteran was afforded a VA examination in September 2021. The examiner indicated that there was insufficient evidence to establish continuity, as evidence by a physical dated August 2012 which was silent for any diagnosis of a low back condition. The examiner also noted that the Veteran is medically classified as morbidly obese, and that there is a strong association of obesity and chronic back pain. However, the examiner did not discuss the significance, if any, of the Veteran's lay statements regarding recurrent back pain symptoms in service and afterward as per the Board's November 2020 and September 2021 remand directives. Given this deficiency, there has not been substantial compliance with the Board's remand directives and an addendum opinion is required. Stegall v. West, 11 Vet. App. 268 (1998). The matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's low back disability is at least as likely as not related service. Provide a rationale to support the opinion. In providing the requested opinion, consider the Veteran's description of her in-service symptoms as well as her post-service symptoms. If there is any medical reason to accept or reject the proposition that the recurrent back pain, which the Veteran reportedly noticed in service, represented the onset of her current disability, this should be noted. Stated another way, does the Veteran's reported history of recurrent back pain in service and afterwards align with how lumbosacral strain is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? B. G. LeMoine Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Lauritzen, 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.