Citation Nr: 21075729 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 17-46 574A DATE: December 21, 2021 REMANDED Entitlement to service connection for a back disability, to include degenerative joint disease of the lumbar and thoracic spine, to include as secondary to service-connected headaches, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from September 1989 to September 1993. The claim arises before the Board of Veterans' Appeals (Board) from a January 2016 rating decision. The Veteran testified before the undersigned Veterans Law Judge at a July 2021 Board Hearing. At the Board Hearing, the claim to add a disabled parent as a dependent was also heard, and will be addressed in a separate Board decision. 1. Entitlement to service connection for a back disability, to include degenerative joint disease of the lumbar and thoracic spine, to include as secondary to service-connected headaches, is remanded. A negative VA direct service connection etiology opinion was obtained in November 2015 for the Veteran's back disability. However, the Board finds this opinion inadequate because it did not consider the Veteran's lay statements that she sustained an injury in service and that she has had back pain since service to which she is competent to attest, as back pain, and its duration and onset, are things that come through her senses. See July 2021 private medical treatment record; see also July 2021 Buddy Statement from M.F.F. (recalling that Veteran has been experiencing migraine headaches and back pain in 1991 when she was on active duty in the United States Air Force). The Board acknowledges a private July 2021 private medical treatment record, which states: "[Veteran] reports having a previous history of lifting and twisting injury when she was in the Air Force. Her previous work history could be the cause of her symptoms." However, it is unclear from this record whether the previous work history refers to work history during active service or after service. Additionally, the Veteran has alternatively asserted that her service-connected migraines impact her back disability and has submitted medical literature to support her assertion. See September 2019 Form 9; Medical Literature submitted on December 2015. However, a secondary etiology opinion that comports with the holding in Ward v. Wilkie has not yet been obtained. Therefore, upon remand, new etiology opinions that address the foregoing concerns must be obtained. The matters are REMANDED for the following action: 1. Obtain new etiology opinions from a new examiner to assess the nature and etiology of the Veteran's back disability. Regardless of who offers the opinion, if the examiner determines that an opinion may not be offered without first examining the Veteran, then schedule the Veteran for an appropriate examination. After reviewing the claims folder and examining the Veteran, for the Veteran's back disability, the examiner is specifically instructed to provide the following information, for each back disability during the appeal period: (a) Is it "at least as likely as not (50 percent probability or greater)" that the Veteran's back disability began in or is related to her time in the service, yes or no? (b) Is it "at least as likely as not (50 percent probability or greater)" that the Veteran's back disability was: (i) caused by her service-connected migraines, or (ii) any other service-connected disability, yes or no? (c) Is it "at least as likely as not (50 percent probability or greater)" that the Veteran's back disability underwent any incremental increase in disability, regardless of its permanence, due to: (i) the service-connected migraines, or (ii) any other service-connected disability, yes or no? The examiner is specifically instructed to address and consider: The Veteran's lay statements that she sustained an injury in service and that she has had back pain since service which she is competent to attest to as back pain, and its duration, is something that comes through her senses. See July 2021 private medical treatment record; see also July 2021 Buddy Statement from M.F.F. (recalling that Veteran has been experiencing migraine headaches and back pain in 1991 when she was on active duty in the United States Air Force). A private July 2021 private medical treatment record, which states: "[Veteran] reports having a previous history of lifting and twisting injury when she was in the Air Force. Her previous work history could be the cause of her symptoms." The Veteran's alternative theory that her service-connected migraines worsens her back disability and the medical literature she submitted in support of this theory. See September 2019 Form 9; Medical Literature submitted on December 2015. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. J. Cho, 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.