Citation Nr: 21076364 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 17-10 453 DATE: December 23, 2021 REMANDED Service connection for chronic pain syndrome is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the United States Navy from December 1972 to November 1976 and in the Public Health Service from May 1997 to July 2013. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019 and July 2021, the Board remanded this matter for further development. Chronic Pain Syndrome Unfortunately, there has not been substantial compliance with the Board's previous remand directives regarding the issue of service connection for chronic pain syndrome. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In July 2021, the Board remanded this matter for VA to obtain an independent medical opinion pursuant to 38 C.F.R. § 3.328. In October 2021, the Veteran underwent an examination with a VA contractor. The examiner found the Veteran to not have a chronic pain syndrome separate and distince from her service-connected musculoskeletal disabilities. Their rationale was that the Veteran's pain was in the same place as her service connected conditions. This rataionle is conclusory and does not address the Veteran's contentions that the pain is not always attributable to specific musculoskeltal ailments or her reports of being told by a medical practitioner that she may have a chronic pain syndrome. The opinion provided is inadequate. The Board has previously found the issue under consideration to pose a medical problem of such complexity that an advisory opinion from an independent medical expert is required. See 38 U.S.C. § 5109; 38 C.F.R. § 3.328. Accordingly, this matter is remanded for VA to follow its established procedures for requesting an advisory opinion furnished by a medical school, university, or clinic on remand. The matter is REMANDED for the following action: Take appropriate steps to obtain an advisory opinion from an independent medical expert pursuant to 38 U.S.C. § 5109 and 38 C.F.R. § 3.328 that is responsive to the following inquiries: (a.) Does the Veteran have a chronic pain syndrome that is separate and distinct from her service-connected musculoskeletal disabilities? Any recommended testing needed to confirm the Veteran's diagnosis should be undertaken and all current symptoms, to include those reported in the Veteran's lay statements, should be noted. (b.) For any such disability identified in response to prompt (a), is it at least as likely as not that such disability was incurred in or otherwise related to active service? (c.) For any such disability identified in prompt (a), is it at least as likely as not that such disability was caused or aggravated beyond its natural progression by any service-connected disability? The examiner must specifically discuss the Veteran's lay contentions regarding her chronic pain, to include her impression that her pain is not always attributable to specific musculoskeletal ailments. The examiner must also discuss the Veteran's reports of being told by a medical practitioner that she may have a chronic pain syndrome. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael Chandeck, 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.