Citation Nr: 21023808 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 15-13 623 DATE: April 21, 2021 REMANDED Entitlement to service connection for a lumbosacral spine disability, including as due to a service-connected bilateral knee disability, is remanded. REASONS FOR REMAND The Veteran had active service from July 1979 to June 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a December 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claim on appeal in June 2018. In November 2019, the Board denied the claim, and the Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court). In September 2020, the Veteran, through his attorney, and the Secretary of Veterans Affairs submitted a Joint Motion for Remand. In an October 2020 Order, the Court granted the Motion and remanded the case to the Board. Remand is required because the May 2019 VA medical examination report is inadequate to determine whether service connection is warranted for a lumbosacral spine disability on both a direct and secondary basis. Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). VA obtained a medical examination regarding Veteran’s low back disability in May 2019. With respect to the issue of direct service connection, in the Board’s June 2018 remand, the Board noted that the Veteran’s “statements regarding symptoms that started in service are credible.” Following the Board’s remand, the May 2019 VA examiner evaluated the Veteran’s back disability and noted Veteran’s statements that his back pain began during service. In rendering his negative nexus opinion, the May 2019 VA examiner noted that there was a lack of pertinent records to support continuous care treatments for the lower back and several gaps in treatments. However, this rationale does not adequately consider the lay statements provided by the Veteran as to the continuity of his back-pain symptoms. See Miller v. Wilkie, 32 Vet. App. 249, 260 (2020). Moreover, in its decision, the Board acknowledged the Veteran’s statements of continuity, but never found that he lacked credibility. As such, remand is warranted for a new VA medical opinion that adequately considers the Veteran’s lay statements as to continuity of symptomatology related to his lumbosacral spine disability. See Stefl, 21 Vet. App. at 123. Regarding the theory of secondary service connection, the May 2019 VA examiner opined that there was “no sufficient objective evidence to support that the service-connected bilateral knee disability caused or aggravated (permanently worsened) the veteran’s back disability.” However, secondary service connection does not require a permanent worsening of the claimed secondary condition. Ward v. Wilkie, 31 Vet. App. 233, 240 (2019). Because the May 2019 VA examiner’s opinion appears to have applied the wrong standard when addressing secondary service connection, remand is warranted for a new VA opinion on this matter. See Stefl, 21 Vet. App. at 123. The matters are REMANDED for the following action: 1. Obtain addendum opinions regarding the Veteran’s lumbosacral spine disability to answer the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s lumbosacral spine disability had onset in or is otherwise related to service? (b.) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s lumbosacral spine disability was caused or aggravated by his service-connected bilateral knee disability? For direct service connection, the VA examiner must consider the Veteran’s lay statements regarding continuity of symptomatology related to his lumbosacral spine disability, whereas the Board’s June 2018 remand noted that the Veteran’s “statements regarding symptoms that started in service are credible.” For secondary service connection, a rationale should address both the causation and aggravation prongs, recalling that secondary service connection does not require a permanent worsening of the claimed secondary condition. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. St. Laurent, 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.