Citation Nr: 21013330 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 13-27 962 DATE: March 9, 2021 REMANDED Entitlement to service connection for a lumbar spine disability, to include as due to service-connected left knee disability or bilateral foot disability, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1977 to November 1991. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2015, the Veteran testified before a Veterans Law Judge (VLJ) who is no longer employed at the Board. In July 2018 correspondence, the Board notified the Veteran of the VLJ’s retirement and afforded him the opportunity to have another hearing held by a different VLJ. Although the Veteran was requested to respond within 30 days from the date of that letter, no response was submitted within the allotted time. He was again notified of the opportunity to have a hearing held by another VLJ in July 2020. In August 2020 correspondence, he responded that he did not wish to appear for another Board hearing. The record reflects that the Veteran incorrectly received a letter indicating that he could request a virtual tele-hearing instead of waiting for a travel board hearing. Based on the Veteran’s earlier statement that he did not request another hearing, there is no prejudice in the Board so proceeding. This matter was previously before the Board in June 2016 and in December 2018 when it was remanded by other VLJs for additional development. It has now been assigned to the undersigned. The December 2018 Board remand also included the issues of entitlement to service connection for a bilateral hip disability and for a right knee disability. As a June 2020 rating decision subsequently granted service connection for those issues, they are no longer before the Board. Entitlement to service connection for a lumbar spine disability is remanded. Upon review of the claims file, the Board finds that a remand is warranted before the Board can adjudicate the merits of the claim. In deciding a claim, the Board must address all potential theories of entitlement. See Robinson v. Shinseki, 557 F.3d 1355, 1361 (Fed. Cir. 2009) (“…where the claimant has raised an issue of service connection, the evidence in the record must be reviewed to determine the scope of that claim.”). In a November 2020 appellate brief, the Veteran’s representative asserted that there are medical articles that support the position that lower extremity dysfunction contribute to back pain. He included two articles in his appellate brief. The Board also notes that a number of VA examinations were conducted and a number of opinions have been provided. The most recent opinion is from a November 2019 VA examiner who noted that a knee condition “commonly affect[s] the alignment of the posture causing improper alignment” when discussing the connection between the knee and the hip. However, in a separate November 2019 VA opinion related to the back, the same examiner concluded that there is no “medical pathophysiologic relationship between the lumbar spine and the left knee” and no records showing a relationship exists between the two. To date, the Board cannot make a fully-informed decision on this issue because medical questions remain outstanding. The matter is REMANDED for the following action: 1. Obtain any outstanding VA or private treatment records related to the Veteran’s lumbar spine disability and associate them with the claims file. 2. After the above development is completed, forward the Veteran’s record to the November 2019 VA examiner for review and an addendum opinion regarding the nature and likely cause of the Veteran’s lumbar spine disability [If that provider is unavailable, the record should be forwarded to another examiner for review and the opinion sought. If another examination (including tele-health examination) is needed for the opinion sought, it should be arranged.]. The examiner should review the claims file (including this remand) and note such review was conducted. Based on review of the record, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) Is it at least as likely as not (50% or greater probability) that the Veteran’s lumbar spine disability was caused by his service-connected right and/or left knee, hip, foot and/or left ankle disabilities? Please explain why. (b.) Is it at least as likely as not (50% or greater probability) that the Veteran’s lumbar spine disability was aggravated by his service-connected right and/or left knee, hip, foot and/or left ankle disabilities? Please explain why. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. The examiner must provide a complete rationale which thoroughly explains the medical reasons for these conclusions. In doing so, the examiner should address the comment contained in a November 2019 VA opinion that a knee condition “commonly affect[s] the alignment of the posture causing improper alignment” when discussing the connection between the knee and the hip, and explain why this would not also support a pathophysiologic relationship between the knee and the back. The examiner should also address the articles contained in the November 2020 appellate brief for the position that lower extremity dysfunction contributes to back pain. 3. Thereafter, readjudicate the claim. If the benefit sought on appeal remains denied, furnish the Veteran with a supplemental statement of the case (SSOC) and provide him and his representative with an appropriate opportunity to respond. T. Matta Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Xiong, 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.