Citation Nr: 21011236 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 14-30 423 DATE: March 1, 2021 REMANDED Entitlement to service connection for back disability is remanded. Entitlement to service connection for neck disability is remanded. Entitlement to service connection for left knee disability is remanded. Entitlement to service connection for right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1976 to June 1982 The Veteran's claim was previously before the Board in June 2018, at which time it was remanded for additional development. The claim was returned to the Board and subsequently denied in a May 2019 decision. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). The Court then issued an order approving a Joint Motion for Remand (Joint Motion) to address deficiency in the May 2019 Board decision in July 2020. The case has, thus, been returned to the Board. Entitlement to service connection for back, neck and bilateral knee disabilities are remanded. The Veteran was afforded a VA examination for his neck and bilateral knee conditions in May 2012. The examiner based his negative nexus opinions in part on a normal exit examination. The Board notes, however, the Veteran explicitly declined a separation examination. Thus, the May 2012 opinion is based upon a factually inaccurate medical history and is, therefore, a new opinion based upon an accurate review of the record is needed. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993). With regards to his back disability, the Veteran has never been afforded a VA examination for his back. Service treatment records show the Veteran had complaints of low back pain for three days in September 1980. Additionally, the Veteran had a diagnosis of lumbar spondylosis in December 2008. As such, the Veteran should be afforded a VA examination on remand, as the low threshold for obtaining an examination has been met. McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006). Lastly, the Veteran’s representative submitted a written brief presentation which referenced studies that suggested there are delayed onset of symptoms from injuries sustained in motor vehicle accidents. The Veteran contends his back, neck and knee disabilities are related to an in-service motor vehicle accident (MVA). On remand, the examiners should consider the argument of delayed onset of symptoms. The matters are REMANDED for the following action: 1. Ask the Veteran to identify any additional relevant records he wishes considered regarding this appeal, which records should be sought. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his back, neck and bilateral knee conditions. The examiner is asked to opine whether it is at least as likely as not any disability of the lumbar spine; neck and knees is due to an in-service injury or disease, to include the in-service MVA. The examiner should consider the Veteran’s lay statements, including the studies referenced by the Veteran’s representative in her April 16, 2019 written brief presentation concerning delayed onset of symptoms after an MVA. 3. After any further development as may be indicated has been accomplished, readjudicate the issues on appeal. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Jaigirdar, 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.