Citation Nr: 21030378 Decision Date: 05/18/21 Archive Date: 05/18/21 DOCKET NO. 17-51 944 DATE: May 18, 2021 REMANDED Entitlement to service connection for a neck disability, to include as secondary to service-connected bilateral knee disabilities, is remanded. REASONS FOR REMAND The Veteran honorably served on active duty with the United States Army from January 2002 to May 2006. This matter is before the Board of Veterans' Appeals (Board) on appeal from a March 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded in February 2020. The issue of entitlement to service connection for a back disability to include as secondary to service-connected bilateral knee disabilities was granted in an August 2020 rating decision issued by the RO and therefore is no longer under the jurisdiction of the Board. The issue of entitlement to service connection for a neck disability is now properly before the Board. Although the further delay is regrettable, the Board finds remand is necessary to ensure compliance with the Board's previous remand instructions. The Board provided specific remand instructions in which the June 2020 VA examiner did not comply. The examiner failed to address the nature and etiology of the Veteran's neck disability. The examiner failed to take into consideration that "pain is an impairment because it diminishes the body's ability to function, and that pain need not be diagnosed as connected to a current underlying condition to function as an impairment." See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). The examiner did not address the whether the Veteran's neck pain manifested during active military service and whether that could have been caused by or aggravated by the Veteran's bilateral knee disabilities. The examiner did not take the Veteran's statements and reports and all pertinent medical records into consideration. Compliance with remand directives is not optional or discretionary, and the Board errs as a matter of law when it fails to ensure compliance. Stegall v. West, 11 Vet. App. 268 (1998). Therefore, remand is necessary to consider the Veteran's statements and reports and all pertinent medical records into consideration. The matters are REMANDED for the following action: 1. Obtain any outstanding VA and private treatment records that are not already associated with the claims file. If any record identified cannot be obtained, the Veteran and his representative should be notified of this in writing to include all efforts taken by the VA to attempt to obtain such a record. 2. Schedule the Veteran for a new examination by an appropriate clinician to determine the nature and etiology of any neck disability. The Veteran's claim file and a copy of this remand should be provided to the examiner and the examination report should reflect that these items were reviewed. The examiner must offer the following opinions: 3. Whether it is at least as likely as not that the Veteran's neck disability / pain manifested during or as a result of active military service. b.) Whether it is at least as likely as not that the Veteran's neck disability / pain was caused by the Veteran's service-connected bilateral knee disabilities, or any other service-connected disability. c.) Whether it is at least as likely as not that the Veteran's neck disability / pain was aggravated by, the Veteran's service-connected bilateral knee disabilities, or any other service-connected disability. 4. In consideration of all of the Veteran's statements and reports and all pertinent medical records, the examiner is also asked to offer an opinion as to whether it is at least as likely as not that his neck disability was either caused or aggravated beyond the natural progression by the Veteran's service-connected bilateral knee disabilities or any other service-connected disability. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what additional evidence, if any would allow for a more definitive opinion. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. Hailu, 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.