Citation Nr: 21075831 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 13-28 332 DATE: December 21, 2021 REMANDED Service connection for a back disability. REASONS FOR REMAND The Veteran served on active duty from June 1977 to May 1979. The case is on appeal from a June 2012 rating decision. In August 2017, the Veteran testified at a Board hearing. Most recently, in June 2021, the Board remanded the appeal for additional development. Service connection for a back disability. Pursuant to the Board's June 2021 remand, a VA back opinion was obtained in June 2021. The examiner opined that that Veteran's spondylolisthesis with spina bifida occulta was a congenital disease, noting that it preexisted service and was not aggravated during service. However, an opinion was not provided in terms of whether preexisting spondylolisthesis clearly and unmistakably pre-existed service and clearly and unmistakably was not aggravated in service. As such, the opinion is not completely adequate, particularly in view of the normal service entrance examination. In addition, and although the opinion states that spondylosis, noted on imaging in 2001, was a congenital defect, an opinion with respect to spondylolysis was not provided. As such, remand is warranted for an addendum opinion. In view of the remand, VA treatment records since the issuance of the August 2021 supplemental statement of the case (SSOC) should be associated with the claims file. The matter is REMANDED for the following action: 1. Obtain VA treatment records since August 2021. 2. Obtain an etiology opinion from an appropriate clinician to determine the nature and etiology of the Veteran's back disability. The need for a physical examination is left to the discretion of the clinician offering the medical opinion. The record must be made available to the clinician for review, and the clinician should indicate that the record was reviewed in connection with opinion. The clinician should respond to the following: (A) Identify the Veteran's current back disabilities. (B) Whether it is at least as likely as not (50 percent or greater probability) that any back condition found not to be congenital, had its onset during service or within the initial year after separation, or is otherwise related to service, to include the muscle strain/marked lumbar paravertebral spasm in 1978. (C) Whether it is at least as likely as not (50 percent or greater probability) that there was a superimposed disease or injury with respect to any diagnosis considered to be a congenital "defect," to include spondylolysis and spondylolisthesis, and if so, identify the resultant disability due to such superimposed disease or injury. (D) Whether any diagnosed back condition determined to be a congenital "disease," to include spondylolysis and spondylolisthesis, clearly and unmistakably pre-existed service and clearly and unmistakably was not aggravated (increased in severity beyond the normal progress of the disease) in service. In rendering the opinion, the specific evidence should be considered, including the service entrance examination, the June 1986 imaging report noting spondylolysis and no spondylolisthesis, and the Veteran's lay statements. Rationale for all opinions expressed should be provided. If the clinician is unable to provide the requested opinions without resort to speculation, it must be so stated, and he or she must provide the reasons why an opinion would require speculation. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Taylor 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.