Citation Nr: 21029955 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 14-30 657 DATE: May 17, 2021 REMANDED Entitlement to service connection for irregular curvature of the spine is remanded. REASONS FOR REMAND The Veteran served on active duty in the from August 1979 to August 1999. In July 2020, the Board remanded this case for additional development. The Board finds that there has been substantial compliance with the Board's previous remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for an irregular curvature of the spine is remanded. The Veteran asserts that an irregular curvature of the spine is the result of service. In a February 2021 addendum opinion, a VA examiner stated that there was no identifiable "irregular curvature of the spine that was manifested in service." The examiner noted an MRI finding of "straightening of the cervical spine lordosis" and explained that according to medical literature, loss of the healthy curve in the neck could "be due to a combination of factors." The examiner opined that "because of the multiple risk factors for developing cervical lordosis, such as poor posture, injuries, accidents, or repetitive prolonged actions, the irregular curvature of the spine [could] not solely be related to military service," to include as a result of numerous road marches while carrying 20 to 25 pound sacks. The Board finds the examiner's opinion incomplete. The examiner did not discuss evidence which showed that any of the noted risk factors were specific to the Veteran. The examiner did explain why the stated risk factors were a more or less likely etiology. The risk factors listed by the examiner included repetitive prolonged actions, which is the claimed cause of the disability. When VA provides an examination or obtains an opinion, the examination or opinion must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, remand is necessary to obtain a medical opinion that more thoroughly address the contentions and the available medical evidence of record. The Board finds that it is not clear from the medical evidence available whether irregular curvature of the spine relates to irregular curvature of the cervical, thoracic, or lumbar spine. No medical professional has opined whether straightening of the cervical spine represents an irregular curvature of the spine and whether straightening of the cervical spine is a symptom of a service-connected cervical spine disability. The Veteran has already established service-connection for "cervical strain DDD with IVDS (claimed as neck condition)." The matter is REMANDED for the following action: Schedule the Veteran for a VA examination to determine the etiology of any irregular curvature of the spine. The examiner must review the claims file, to include a copy of this Remand, and consider the Veteran's lay statements. The examiner should: (a.) Diagnose any irregular curvature of the cervical, thoracic, and lumbar spines. (b.) Opine whether it is at least as likely as not (50 percent probability or greater) that any irregular curvature of the spine was incurred in or is otherwise related to service, to include as a result of in-service road marches while carrying 20 to 25 pounds on the back. If there is a more likely etiology than service, the examiner must explain why that etiology is more likely. (c.) Opine whether it is at least as likely as not (50 percent probability or greater) that any irregular curvature of the spine is the result of or caused by service-connected cervical spine strain, degenerative disc disease of the cervical spine, and intervertebral disc syndrome of the cervical spine. (d.) Opine whether it is at least as likely as not (50 percent probability or greater) that any irregular curvature of the spine has been aggravated (increased in severity beyond the natural progress of the disorder) by service-connected cervical spine strain, degenerative disc disease of the cervical spine, and intervertebral disc syndrome of the cervical spine. (e.) Opine whether irregular curvature of the spine results in additional symptoms or symptoms which are separate and distinct from the symptoms of a service-connected cervical spine disability. If so, can any such additional functional loss be expressed in terms of additional degrees of limited motion. The examiner is advised that service connection has been established for cervical spine strain, degenerative disc disease of the cervical spine, and intervertebral disc syndrome of the cervical spine. (f.) Opine whether any irregular curvature of the spine is indicative of muscle spasm or guarding severe enough to result in abnormal gait or abnormal spinal contour such as scoliosis, reversed lordosis, or abnormal kyphosis. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Department of Veterans Affairs 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.