Citation Nr: 21073371 Decision Date: 12/08/21 Archive Date: 12/08/21 DOCKET NO. 14-37 907 DATE: December 8, 2021 REMANDED Entitlement to a rating in excess of 10 percent for a cervical spine disability prior to March 21, 2019, and in excess of 30 percent thereafter, is remanded. Entitlement to a rating in excess of 20 percent for a lumbar spine disability prior to March 21, 2019, and in excess of 40 percent thereafter, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1994 to April 1997. These matters are before the Board of Veterans' Appeals (Board) on appeal from a March 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In May 2018, the Veteran testified before the undersigned Veterans Law Judge at a video conference hearing. A transcript of the hearing is of record. The Board remanded these matters in July 2018, August 2020, and March 2021 for additional development. Unfortunately, as explained below, the Board is not satisfied that there was substantial compliance with its most recent remand; therefore, the Veteran's appeal must be remanded once again. See D'Aries v. Peake, 22 Vet. App. 97, 105 (2008); Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to a rating in excess of 10 percent for a cervical spine disability prior to March 21, 2019, and in excess of 30 percent thereafter, is remanded. 2. Entitlement to a rating in excess of 20 percent for a lumbar spine disability prior to March 21, 2019, and in excess of 40 percent thereafter, is remanded. The March 2021 Board remand instructed the RO to procure an addendum opinion that thoroughly addressed all neurological abnormalities reported by the Veteran at the May 2018 Board hearing or found on examination, including but not limited to urinary or bowel complaints, headaches, and vision problems. On remand, the April 2021 VA examiner failed to address the Veteran's headache and vision complaints. She additionally checked a box indicating that the Veteran did not have bowel or urinary problems and did not provide any further details, which contradicts the Veteran's May 2018 testimony and the September 2020 VA examiner's report indicating that the Veteran complained of bowel and bladder problems. The RO attempted to contact the April 2021 VA examiner to seek an addendum opinion addressing deficiencies in her April 2021 opinion, including addressing all neurological abnormalities reported by the Veteran at the May 2018 Board hearing or found on examination, including but not limited to urinary or bowel complaints, headaches, and vision problems, however the RO contacted a different VA clinician who provided an August 2021 addendum opinion. The August 2021 addendum opinion by the VA clinician stated that on the day of the Veteran's April 2021 VA examination the Veteran failed to mention any issues regarding headaches and vision problems related to her cervical spine. Unfortunately, the Board finds the Veteran's claims must be remanded once again because there is not substantial compliance with the Board's prior remand directive, as a VA examiner did not fully address all of the neurological abnormalities that the Veteran testified to experiencing in the May 2018 Board hearing. See Stegall, 11 Vet. App. at 268 (a remand by the Board confers upon a veteran, as a matter of law, the right to compliance with the remand instructions). The matters are REMANDED for the following actions: 1. Obtain the Veteran's outstanding VA medical records. 2. Obtain an addendum medical opinion from the April 2021 VA examiner (or a physician of the appropriate specialty, i.e., a neurologist) regarding the Veteran's neurological abnormalities. An in-person examination need not be scheduled unless deemed necessary by the examiner or otherwise required by the evidence. The examiner must review the claims file in its entirety, to include a copy of this REMAND, and the review should be noted in the examination report. Thereafter, the examiner is asked to provide an addendum opinion with respect to the following: Thoroughly address all neurological abnormalities reported by the Veteran at the May 2018 Board hearing, including urinary/bowel complaints, headaches, and vision problems. If an EMG study is required to objectively confirm the Veteran's reported neurological manifestations, then such testing should be performed. If any neurological abnormality is confirmed, the examiner should opine whether any such abnormality is at least as likely as not related to the Veteran's cervical and/or lumbar spine disabilities. A full and complete explanatory rationale must be provided for any opinions offered. If the examiner feels that any of the requested opinions cannot be rendered without resorting to speculation, the examiner must indicate whether this inability is due to a lack of knowledge among the medical community or based on a lack of procurable information. The Board reminds the examiner that failure to comply with the directives outlined herein renders an examination report inadequate and will result in further remand of the Veteran's claims. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ahuva D. Sunshine 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.