Citation Nr: 21026277 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 16-24 018 DATE: April 30, 2021 REMANDED Entitlement to service connection for a back disability is remanded. REASONS FOR REMAND The Veteran served on active duty in May 1974 and from July 1976 to January 1982. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). This matter was remanded by the Board for additional development in November 2018 and September 2020; the Board finds that there was substantial compliance with the directives of those remands. See Stegall v. West, 11 Vet. App. 268 (1998). The Board finds that this appeal must be remanded so another VA medical opinion can be obtained. Several attempts were made following the Board’s 2018 remand to schedule the Veteran for a VA examination but he did not attend them nor was good cause shown for his absence. The only medical opinion concerning the nature and etiology of the Veteran’s back disability was obtained in March 2016 based on a review of the claims file. The examiner opined that it is less likely as not that the Veteran’s current back condition is due solely to his military service duties. The examiner stated that although the Veteran was seen on several occasions for lower back complaints during his active service, a prior strain or muscle spasm does not necessarily lead to a chronic condition such as arthritis. The examiner then stated it appears that the Veteran’s in-service back problems did not lead to a chronic back condition because the Veteran’s separation examination report and subsequent medical records were silent for lower back complaints; in addition, the Veteran’s post-service trauma and stroke while in jail and aging could have also caused his current back condition. The Board notes that it cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence, and that pain that constitutes a “functional impairment of earning capacity” can be service connected. See Buchanan v. Nicholson, 451 F.3d 1331, 1331 (Fed. Cir. 2006); Saunders v. Wilkie, 886 F.3d 1356 (2018). The March 2016 examiner based his opinion largely on an absence of contemporaneous medical records (e.g., a lack of any report of back pain in the separation examination report and an absence of medical records documenting back pain for some time after service), and it is not clear whether the examiner considered pain causing functional loss a disability. Thus, the Board finds that remand to obtain another VA medical opinion is required. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records from the Gainesville and Lake City VA medical centers. 2. Obtain an addendum opinion to determine the nature and etiology of the Veteran’s back disability. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a.) Is the Veteran’s back disability at least as likely as not related to service, including his in-service complaints of back pain and related symptoms? (b.) Is it at least as likely as not that the Veteran’s back disability (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service? Provide a complete rationale to support the opinions. In providing the requested opinion, consider the Veteran’s description of his in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran’s reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran’s reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran’s reports generally inconsistent with medical knowledge or implausible? Tiffany Dawson Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Banks, 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.