Citation Nr: 21077404 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 18-40 491 DATE: December 29, 2021 REMANDED Entitlement to service connection for a back condition is remanded. REASONS FOR REMAND The Veteran had active service from September 1968 to October 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claim for additional development in July 2019, January 2021, and June 2021. 1. Entitlement to service connection for a back condition is remanded. The Veteran asserts that his back condition is related to his military service. The July 2019 Board Remand noted that the Veteran was provided a VA examination in July 2013 where he reported the onset of symptoms dating back to 1969, during service. He asserts that the disorder began after a car accident and has continued to worsen since. The July 2013 examiner did not provide a medical opinion addressing the etiology of the Veteran's disorder. The January 2021 Remand noted that the Veteran was provided a VA examination in January 2020 where he reported the onset of symptoms dating back to 1970, during service. He asserts that the disorder began after a car accident and playing football. The examiner opined that the Veteran's lumbar disability was less likely than not incurred in or caused by the claimed in-service injury. The examiner reasoned that the Veteran had at least 2 motor vehicle accidents after service and these are the more likely cause of the Veteran's currently diagnosed degenerative disc disease, degenerative arthritis, and lumbar spine decompression surgery. The June 2021 Remand noted that the Veteran was provided a VA examination in March 2021 where he reported the onset of symptoms started in 1971 and has been ongoing and worsening over the years with pain now occurring daily. He asserts that the disorder began after a car accident and playing football. The examiner opined that it was less likely than not that the Veteran's lumbar condition had its onset in service or is otherwise related to service. The examiner reasoned that although the Veteran reports back pain associated with accidents that incurred while in service, there is no evidence found in the available c-file of chronic diagnosed lumbar disability during service. In a June 2021 addendum opinion, the examiner opined that the Veteran's back condition was less likely than not incurred in or caused by the claimed in-service injury. The examiner reasoned that there is no complaint, diagnosis, or treatment of low back pain noted until April 2006. However, the prior Board Remands and the record reflect a complaint of back pain in October 1998. A medical opinion based on an inaccurate factual premise has limited, if any, probative value. Reonal v. Brown, 5 Vet. App. 458, 461 (1993). Therefore, the issue is remanded to obtain another addendum opinion. Also, the examiner did not discuss the Veteran's report of injuring his back in a MVA or while playing football, during military service. Where the remand orders of the Board are not complied with, the Board errs as a matter of law when it fails to ensure compliance. Stegall v. West, 11 Vet. App. 268, 271 (1998). On remand, the examination should discuss and respond to the instructions provided in the prior Board Remands. The matter is REMANDED for the following action: 1. Obtain an addendum VA medical opinion from an appropriate clinician to determine the nature and etiology of the Veteran's back condition. The electronic claims file must be reviewed by the examiner, and a note that it was reviewed should be included in the report. Based on a full review of the record, to include the Veteran's lay statements regarding the incurrence and symptomatology of his conditions: Please opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's back disorder is causally or etiologically related to his military service, to include the Veteran's reported injuries during service. In so opining, the examiner must consider and address the following: (a) the Veteran's report of an in-service motor vehicle accident, (b) the Veteran's complaint of back pain for one year contained in a February 1970 service treatment record, (c) the Veteran's report of being kicked in the "butt on the little bone" by a drill instructor during boot camp, (d) the physical demands as a Marine reconnaissance man, and the Veteran's airborne duties. (e) the Veteran's complaint of back pain in October 1998. All opinions should be supported by a clear rationale, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Edwin B. Esmenda, 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.