Citation Nr: 21012279 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 10-47 229A DATE: March 4, 2021 REMANDED Entitlement to service connection for a low back condition with leg condition is remanded. REFERRED As noted in the Board’s July 2018 remand, the issue of entitlement to service connection for a cervical spine condition was raised in a June 2011 statement. That issue is referred to the Agency of Original Jurisdiction (AOJ) for adjudication. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from February 1972 to June 1972. He also served in the New Jersey National Guard with periods of active duty for training (“ACDUTRA”) from June 2, 1973 to June 17, 1973; from May 25, 1974 to June 8, 1974; from May 31, 1975 to June 14, 1975; and from May 15, 1976 to May 29, 1976. This matter comes before the Board of Veterans’ Appeals (“Board”) on appeal from a December 2009 rating decision of the Department of Veterans Affairs Regional Office. Entitlement to service connection for a low back condition with leg condition is remanded. Pursuant to the Board’s July 2018 remand, the Veteran was afforded a VA examination and opinion in November 2020. The examiner diagnosed the Veteran with a thoracolumbar spine (back) condition and noted mild chronic anterior wedging L1, partial sacralization of L5, degenerative arthritis and degenerative disc disease of the lumbar spine. The examiner noted the onset of a back condition in the late 1970s to early 1980s. However, the examiner opined that the Veteran’s low back condition was not related to his military service because the examiner could not find the record of a May 1976 motor vehicle accident during the Veteran’s service. The Board finds the November 2020 medical opinion inadequate for deciding the issue on appeal. In that regard, in its July 2018 remand, the Board specifically asked the examiner to discuss the Veteran’s contentions and the May 1976 in-service motor vehicle accident, which is documented in the claims file. Once VA undertakes to provide an examination or medical opinion, it must provide an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Here, the Veteran’s contentions and the documented May 1976 in-service accident are integral parts of the medical opinion required to decide the matter on appeal. Accordingly, on remand, the AOJ must try to obtain an addendum medical opinion with adequate rationale that addresses that evidence. The Veteran has contended that his leg condition is secondary to his low back condition. Thus, this issue is inextricably intertwined with the question of whether he has a current low back disability related to his military service. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that issues are “inextricably intertwined” when they are so closely tied together that a final Board decision on issue cannot be rendered until the other issue has been considered). The matter is REMANDED for the following action: Forward the claims file and a copy of this remand to the examiner who rendered the November 2020 opinion, or to an appropriate clinician if the November 2020 examiner is unavailable, to obtain an addendum opinion on the nature and etiology of the Veteran’s low back condition with leg condition. After reviewing the claims file, the examiner is asked to address the following: 1. Whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s low back condition is related to service. Please explain why or why not. In responding to this question, please specifically consider and discuss (1) the Veteran’s report that he injured his lower back in a documented in-service motor vehicle accident in May 1976 (see document labeled Medical Treatment Record – Government Facility, dated 5/4/2009, and describing impact with a tree and “severe pain in my neck, back, and left shoulder”) and (2) a 2001 incident where he walked off a 15-foot ladder, landing on his feet on a grass surface, and experienced knife-like pain in his low back area (see document labeled Medical Treatment Record – Non-Government Facility, dated 5/4/2009). 2. If, and only, if, you find that the Veteran has a low back disability that is related to service, please provide an opinion on whether he has a leg condition that is at least as likely as not (1) proximately due to or (2) aggravated by that low back disability. Please explain why or why not. (Continued on the next page)   A complete rationale for the opinions rendered must be provided. If you cannot provide the requested opinions without resorting to speculation, please expressly indicate this and state why it is so. L. STEPANICK Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Tariq, Nadeem, Associate Attorney 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.