Citation Nr: 21029882 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 15-45 210 DATE: May 17, 2021 REMANDED Entitlement to service connection for a lumbar spine disorder is remanded. Entitlement to service connection for a cervical spine disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States from March 1986 to March 2006. These matters come before the Board of Veterans' Appeals (Board) on appeal from June 2014 and December 2015 rating decisions issued by a Department of Veterans Affairs Regional Office (RO). In March 2019, the instant matters were remanded for additional development, namely a VA examination to determine the nature and etiology of the claimed conditions. A March 2021 rating decision granted the Veteran's claims for service connection for bilateral temporomandibular joint disease, right ankle lateral collateral ligament strain, right knee strain, left knee and bilateral ear drums tympanic membrane rupture. An initial rating was assigned for each disability. As this decision represents a full grant of the benefits sought with respect to this claims for service connection, such issues are no longer before the Board for consideration. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1977). REASONS FOR REMAND 1. Entitlement to service connection for a lumbar spine disorder is remanded. 2. Entitlement to service connection for a cervical spine disorder is remanded. The Veteran contends that he has lumbar spine and cervical spine disorders that are the result of his service, specifically due to his duties involving flying on military planes as a crewmember. As noted in the November 2019 Board remand, the Veteran previously underwent an examination in May 2014. The examiner diagnosed cervical spine degenerative joint disease and opined that the Veteran's cervical spine disorder was less likely than not due to service. The examiner reasoned that the Veteran's cervical spine degenerative joint disease was first documented by X-ray evidence in October 2012 and that he did not seek treatment for a back condition during service. The Board determined that it could not make a fully-informed decision as no VA examiner had opined as to whether the Veteran has a current lumbar spine disorder separate from his cervical spine disorder, the etiology thereof, or addressed the Veteran's service treatment records that indicate that the Veteran had back pain during service. Therefore, the Board determined that the Veteran should be afforded a VA examination to determine the nature and etiology of his cervical spine and lumbar spine disorders. To date, such an examination has not been provided. In light of the foregoing, the Board finds that there has not been substantial compliance with its November 2019 remand. See also Stegall v. West, 11 Vet. App. 268 (1998); Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (noting that Stegall requires substantial compliance with remand orders, rather than absolute compliance). Accordingly, a remand is warranted. The matters are REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claims on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative and afford him an opportunity to submit any copies in their possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Following the receipt of outstanding records, forward the claims file to an appropriate examiner to determine the nature and etiology of the Veteran's claimed lumbar spine and cervical spine disorders. The record, to include a copy of this Remand, must be made available to and be reviewed by the examiner. Any indicated evaluations, studies and tests should be conducted. The need for further examination is left to the discretion of the examiner. Thereafter, the examiner is asked to furnish an opinion with respect to the following questions: (A) Identify all of the Veteran's lumbar spine and/or cervical spine disorders that have been present at any time since February 2012. (B) Is it at least as likely as not (50 probability or greater) that the Veteran's current lumbar spine disorder had its onset during service or is otherwise related to service? The examiner should specifically address the Veteran's reported swollen joints and recurrent back pain or back problem on his November 2005 separation examination as well as his reports of rare episodic back strain. (C) Is it at least as likely as not (50 probability or greater) that the Veteran's current cervical spine disorder had its onset during service or is otherwise related to service? The examiner should specifically address the Veteran's reported swollen joints and recurrent back pain or back problem on his November 2005 separation examination as well as his reports of rare episodic back strain. A rationale should be provided for all opinions offered. If it is not possible to provide a specific opinion regarding the above questions, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kashif I. Ali, 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.