Citation Nr: 21073067 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 13-05 099 DATE: December 7, 2021 REMANDED Entitlement to service connection for a neck disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Marine Corps from June 1987 to March 1995 including service in Southwest Asia. He was awarded the Combat Action Ribbon. This matter is before the Board of Veterans' Appeals (Board) on appeal from a June 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In February 2018, a Travel Board hearing was held before the undersigned; a transcript is in the record. In August 2018 and May 2021, this matter was remanded for additional development. Entitlement to service connection for a neck disability is remanded. In July 2021 correspondence, the RO requested that the Veteran provide authorization (VA Form 21-4142) to release private medical records to VA. Authorization was not received. It is therefore presumed that such records are from a chiropractor who reportedly treated the Veteran in 1999 and are unavailable. The Veteran was treated in October 1989 for trauma to the left thigh, in November 1992 for trauma to the right thumb and knee, both while playing football. He was hospitalized on one occasion in October 1994 for treatment for an ankle fracture while playing football, but the examiner specifically noted no other trauma. He did not report cervical spine symptoms in a December 1994 discharge examination. During the Board hearing, the Veteran testified that he first sought treatment in about 1999-2000 from a chiropractor who suggested that it might be caused by playing football. In December 2011, the Veteran reported to a VA clinician that he worked as a police officer. The Board finds that there has not been substantial compliance with previous remand directives, and that corrective action is necessary. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The May 2021 Board remand ordered a medical opinion (with rationale) addressing whether the Veteran's neck disability was related to service to include as the Veteran alleged related to injuries while playing football in service. On August 2021 medical opinion, the clinician opined noted that the service treatment records were silent for a traumatic neck injury. The clinician found that it was less likely than not that the Veteran's neck disability was related to service. The clinician was to consider the Veteran's allegation that his neck disability was related to playing football in service. The clinician acknowledges the Veteran's allegation that he injured his neck in service playing football but dismissed such allegation for lack of treatment records. The clinician notes several generally possible causes of DDD, noting that it "can be caused by injury, overuse, and age-related degeneration." While the clinician summarized general statistics of risk factors for a cervical spine disability, the clinician failed to apply such statistics to the Veteran's claim. Notably, the clinician indicated that "injury and overuse" were likely causes of DDD but failed to address how the Veteran's report of injuries while playing football over the course of eight years in service did not amount to overuse or injury. Accordingly, a new medical opinion which fully addresses the Veteran's lay statements and applies the general statistics and risk factors to the Veteran's claim is necessary. The matter is REMANDED for the following action: Arrange for the Veteran's record to be forwarded to an appropriate clinician to determine the etiology of his current neck disability. On review of the record (and acknowledgement of the Veteran's lay statements that his neck disability was related to playing football in service), the clinician should respond to the following: (a.) Is it at least as likely as not (a 50 percent probability or greater) that the Veteran's neck disability is caused by the Veteran's service to include the Veteran's allegation of injuries caused by playing football? The examiner should consider whether the repetitive contact playing football as recreation in the Marine Corps was sufficient overuse to have caused the current neck symptoms. (b.) If the Veteran's neck disability is determined to be unrelated to service, the clinician must identify the etiology that is more likely and explain why that is so. The clinician must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Staskowski, 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.