Citation Nr: 21022182 Decision Date: 04/15/21 Archive Date: 04/15/21 DOCKET NO. 14-28 903A DATE: April 15, 2021 REMANDED Entitlement to service connection for a back disability is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1979 to December 1981. The Veteran served in the Army National Guard of Texas from June 1982 to December 1983. The Veteran had additional service in the Army Reserve (Reserve), with periods of active duty from March 1995 to August 1995, from May 1996 to September 1996, from May 1997 to September 1997, from May 1998 to August 1998, from June 1999 to September 1999, from April 2001 to September 2001, from March 2003 to July 2003, from April 2004 to September 2004, and from January 2008 to November 2008. The Veteran had additional periods of active duty for special work (ADSW), active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) while in the Reserve. This matter comes to the Board on appeal from a January 2011 Regional Office rating decision. The Veteran testified before the undersigned at a Board hearing in July 2017; a transcript of that hearing is of record. The matter was previously remanded for additional development in April 2018. Entitlement to service connection for a back disability is remanded. At his July 2017 Board hearing, the Veteran indicated that he believed his foot disability caused shooting pain in his back, and that doctors continually said nothing was wrong with his back. At the time, the Veteran was not service connected for a foot disability. In November 2019, pursuant to the directives of the April 2018 remand, the Veteran was afforded a VA examination. There, the examiner found that the Veteran had a diagnosis of lumbar spine stenosis. The examiner elicited statements from the Veteran that his back pain began in 1995 without specific trauma or injury, and continued occasionally since with self-treatment. The examiner opined that the Veteran’s back disability was less likely than not related to service since the service treatment records are silent for complaints of back pain, and no chronicity had been established. The Board notes that the Veteran did report to the Fort Hunter Liggett Health Clinic in March 2005 with low back spasm. An addendum opinion from February 2020 further noted that stenosis is a condition due to the aging process. The Board finds the examiner’s opinions inadequate for decision-making purposes. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Veteran was granted service connection for bilateral pes planus in March 2020. Even at the time of his November 2019 VA examination, the Veteran had already suggested the theory that his back disability was secondary to a foot disability. On remand, an opinion as to whether the Veteran’s back disability is proximately due to or aggravated by his foot disability is necessary. The matters are REMANDED for the following action: 1. Forward the record and a copy of this remand to the examiner who provided the November 2019 VA examination and February 2020 addendum opinion, or if unavailable, to a suitably qualified examiner for completion of an addendum opinion. The examiner must review the electronic file and note such review in the examination report. If the VA examiner determines that an additional examination of the Veteran is necessary to provide reliable opinions as to causation, such examination should be scheduled. The examiner must address whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s back disability is proximately due to or aggravated by his service-connected foot disability. The examiner must specifically address aggravation as a separate item to proximate causation. A detailed rationale must be provided for the opinion provided, including a discussion of the evidence of record, and medical principles which led to the conclusions reached. 2. After completing the above development, readjudicate the issue on appeal. If any benefit sought remains denied, issue a supplemental statement of the case and return the case to the Board. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Baker, 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.