Citation Nr: 21026962 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 12-03 291 DATE: May 4, 2021 REMANDED Entitlement to service connection for lumbar spine degenerative disc disease is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1984 to January 1997. This appeal began as an appeal of two rating decisions. The first was a September 2010 rating decision that denied a rating in excess of 10 percent for the Veteran's service-connected right knee disability. The other is a November 2015 rating decision that denied service connection for lumbar spine degenerative disc disease. A videoconference Board hearing was held in this matter in May 2017 before the undersigned Veterans Law Judge, and a transcript of the proceedings is associated with the claims file. In September 2017, the Board remanded for additional development, specifically noting that, as it relates to the lumbar spine, the September 2015 VA examiner failed to discuss the Veteran's credible contentions regarding the onset of pain in his low back immediately following the in-service fall that has continued to the present; and, failed to address the Veteran's contention that his low back disorder has been caused or worsened by his service-connected right knee disability. In January 2019, the Board denied a rating in excess of 10 percent for the Veteran's service-connected right knee disability, and remanded the issue of service connection for the lumbar spine disability, noting the Board had previously instructed that the examiner specifically address the Veteran's statements that symptomatology for his claimed disorder, including pain in his low back, had its onset in service and continued therefrom, but that the October 2017 VA examiner had not done so. On remand, again the examiner was instructed to specifically discuss the Veteran's statements that pain in his low back began in service and has continued to the present. In April 2020, the Veteran's representative and the VA General Counsel filed a joint motion for partial remand (JMPR) of only that part of the January 10, 2019 Board decision that determined a separate rating for the right knee for instability was not warranted. The Court granted the JMPR in May 2020, vacating only that part of the Board's January 2019 decision that denied a separate rating for right knee instability. After additional development, in a January 2021 rating decision, the Veteran was granted a separate rating for right knee instability. As this was a full grant of the benefit sought on appeal for this issue, a separate rating for right knee instability is no longer before the Board. What remains on appeal is the issue of service connection for lumbar spine degenerative disc disease. Entitlement to service connection for lumbar spine degenerative disc disease is remanded. The Board regrets any further delay in the matter, but finds additional development is needed before the Board can render a decision in this matter. A previous remand confers on the claimant, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). As noted above, another medical opinion was requested to address whether the Veteran's lumbar spine degenerative disc disease, was related to his service, to include whether it was caused or aggravated by his service-connected right knee disability. In providing said opinion, the Board has repeatedly instructed that the examiner specifically discuss the Veteran's credible contentions regarding the onset of pain in his low back immediately following the in-service fall, and that his pain has continued to the present. Unfortunately, while the subsequent October 2019 VA examination, and the addendum medical opinions dated in July 2020 and November 2020, address whether the claimed lumbar spine degenerative disc disease was caused or aggravated by the Veteran's service-connected right knee disability, none of these opinions addressed the Veteran's contentions as instructed by the Board in its previous remand. The Court has held that once VA undertakes the effort to provide an examination when developing a claim for service connection, even if not statutorily obligated to do so, it must provide an adequate one. See Woehlaert v. Nicholson, 21 Vet. App. 456, 464 (2007), citing Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Bowling v. Principi, 15 Vet. App. 1, 12 (2001) (emphasizing the Board's duty to return an inadequate examination report "if further evidence or clarification of the evidence... is essential for a proper appellate decision"). Based on the above, the Board finds that another remand is necessary for a new VA examination and etiological opinion supported by an adequate rationale for the Veteran's lumbar spine disorder. See Barr, 21 Vet. App at 311. The matter is REMANDED for the following action: Refer the Veteran's claims file to an appropriate clinician to determine the nature and etiology of the Veteran's claimed low back disability. The record, including a complete copy of this remand, must be made available to the examiner for review, and the examiner must indicate in the examination report that the record was reviewed. The examiner must provide an opinion as to whether it is at least as likely as not (i.e., there is at least a 50 percent probability) that the Veteran's low back disorder began in service, was caused by service, or is otherwise related to any incident, illness, or injury during service. The examiner must specifically discuss the Veteran's credible statements that pain in his low back began in service, following the in-service fall, and has continued to the present. In addition, the examiner must also provide an opinion as to: Whether it is at least as likely as not that the Veteran's low back disorder has been caused by his service connected right knee disability. Whether it is at least as likely as not that the Veteran's claimed low back disorder has been aggravated by his service connected right knee disability. The examiner must provide an adequate rationale for all opinions expressed, including for both causation and aggravation. If the examiner is unable to provide the required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Jiggetts 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.