Citation Nr: 21009019 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 00-19 956 DATE: February 18, 2021 REMANDED Entitlement to service connection for cervical spine disability, secondary to service-connected left knee and to service-connected ulcer disorder is remanded. Entitlement to service connection for lumbar spine disability, secondary to service-connected left knee and to service-connected ulcer disorder is remanded. REASONS AND BASES FOR REMAND The Veteran served on active duty from June 1957 to June 1960. The Veteran appealed the issue of service connection for cervical and lumbar spine disabilities to the Court of Appeals for Veterans Claims (Court) and returned these issues to the Board three times for readjudication. Notably the Veteran has appeared before this Veterans law Judge (VLJ) in a February 2018 hearing, but the Veteran and his representative indicated that although these issues were perfected, they did not require a hearing. A copy of the hearing transcript has been associated with the electronic claims file. This matter is now back before the Board for further appellate review. Service Connection Service connection for cervical spine and lumbar spine disabilities, secondary to service-connected left knee and to service-connected ulcer disorder is remanded The Veteran contends that his cervical and lumbar spine disabilities should be service connected directly because he was hit by the rotating turret of his tank while in service or as secondary to his service-connected left knee disability which alters his gait and negatively impacts his back and his service-connected ulcer disease, which makes the prescription of nonsteroidal anti-inflammatories unsafe. As an initial matter, to address the contentions stated in the July 2020 Court decision, the Board states that the pre-2006 version of 38 C.F.R. § 3.310 apply in deciding the Veteran’s claim. The Veteran has had several spine examinations and several medical opinions on the etiology of his neck and back disability over the years. His latest VA examination in January 2017 diagnosed him with degenerative arthritis of the lumbar spine and a herniated lumbar disc (removed) for his back and cervical spondylosis of the neck. The examinations of record agree that the Veteran has arthritis. The Veteran has a current diagnosis of osteoarthritis of both his back and neck. However, there is disagreement as to the cause of the Veteran’s back and neck disabilities. The Veteran has undergone numerous VA examinations to determine the etiology of his current lumbar spine and cervical spine disorders. Unfortunately, none of these examinations have adequately and thoroughly addressed this question. As such, it is the Board’s opinion that an additional VA examination is necessary to address etiology. Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). Expedited handling is requested.) 1. The Veteran should be requested to indicate if he has received any VA or non-VA medical treatment for his cervical spine or lumbar spine that is not evidenced by the current record. If so, the Veteran should be provided with the necessary authorizations for the release of any treatment records not currently on file. These records should then be obtained and associated with the claims folder. The Veteran should be advised that he may also submit any evidence or further argument relative to the claim at issue. 2. The Veteran should be scheduled for a VA examination by an appropriate examiner to address the nature and etiology of the back and neck disabilities. The examiner is to be provided access to the Virtual VA and VBMS. The examiner must specify in the report that Virtual VA and VBMS records have been reviewed. All pertinent symptomatology and findings should be reported in detail. Any indicated diagnostic tests and studies should be accomplished. The examiner is asked to address: (a.) The examiner is asked to identify all current chronic cervical spine and lumbar spine disorders and for each such disorder provide an opinion as to whether it is at least as likely as not that any such disorder is related in any way to the Veteran’s active duty service. (b.) The examiner is asked to identify all current chronic cervical spine and lumbar spine disorders and for each such disorder provide an opinion as to whether it is at least as likely as not that any such disorder is related in any way to or aggravated by a service-connected disability. The examiner is directed to address Dr. Power’s April 1994 letter. Specifically, the examiner should address the following: (i) Whether the Veteran’s service-connected knee disability (left knee arthritis with limitation of flexion and extension, status post cartilage. surgery, and postoperative scar) in any way altered the Veteran’s gait; and if so, whether such an alteration of gait either caused or aggravated such spine disorder. (ii) Whether the record demonstrates an inability to take nonsteroidal anti-inflammatories (NSAIDs); and if so, whether increased pain due to an inability to take NSAIDs is the proximate cause of the neck and back disability. A complete rationale for all opinions is required. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Black, Jeffrey W. 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.