Citation Nr: 21024235 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 14-33 399 DATE: April 22, 2021 REMANDED Entitlement to service connection for a chronic back disability, to include as secondary to right ankle and bilateral knee disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1986 to April 1987 and from October 2003 to February 2005, to include periods of unverified service in the Army National Guard. This appeal to the Board of Veterans’ Appeals (Board) is from a July 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In his August 2014 Substantive Appeal VA Form 9, the Veteran requested a hearing before the Board. But in correspondence since dated in November 2017, he withdrew his hearing request. The Board remanded this claim in April 2018 and October 2020 for further development. The Board finds there has not been substantial compliance with the October 2020 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). As such, additional development is required. Entitlement to service connection for a chronic back disability, to include as secondary to right ankle and bilateral knee disabilities, is remanded. The Veteran contends that service connection is warranted for a chronic back disability. The October 2020 Board remanded for an addendum opinion because the July 2020 VA examiner failed to address whether the service-connected right knee and right ankle disabilities aggravated the Veteran’s claimed back disability. In its remand directives, the RO was required to obtain an addendum opinion discussing whether the Veteran’s current back disability was more or less likely related to periods of service and whether his service-connected disabilities caused or aggravated his claimed disability. The RO obtained a February 2021 addendum opinion. The VA examiner stated that there is no objective evidence showing the Veteran’s back disability was caused by his service-connected knee or ankle disability. The examiner stated there was no sign of chronic disability because the Veteran’s gait, ambulation, weight bearing, and stance were normal, a rationale provided by the July 2020 examiner, verbatim. The Board finds the February 2021 VA examination report is inadequate. The VA examiner failed to address the question of aggravation when rendering the opinion. See El-Amin v. Shinseki, 26 Vet. App. 136, 141 (2013). Consequently, the Board finds that it is necessary to remand the Veteran’s claims in order to obtain these opinions. See Stegall v. West, 11 Vet. App. 268, 271 (1998); see also Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The Board notes that at the time this opinion was provided, the Veteran was only service connected for his right knee and right ankle. The RO awarded service connection for left knee strain with arthritis, effective September 2009. Therefore, the VA examiner must also discuss whether the Veteran’s left knee disability caused or aggravated his claimed back disability. The matters are REMANDED for the following action: 1. Obtain any unassociated VA treatment records. 2. Obtain an addendum opinion from an appropriate clinician: (a.) Identifying any back disability during the period on appeal. (b.) State whether any identified back disability is at least as likely as not related to active service. (c.) State whether any identified back disability is at least as likely as not proximately due to service-connected right ankle and/or bilateral knee disabilities. (d.) State whether any identified back disability is at least as likely as not aggravated by service-connected right ankle and/or bilateral knee disabilities. (Continued on the next page)   (e.) State whether any arthritis documented by x-ray evidence at least as likely as not (1) began during active service, (2) manifested within one year after discharge from active service in April 1987 or February 2005, or (3) was noted during service with continuity of the same symptomatology since discharge from active service in April 1987 or February 2005. The Board requests the examiner to provide a detailed discussion of the facts and medical principles involved for any opinion given. Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Mohammad Mahmoudi, 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.