Citation Nr: 21032128 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 16-46 448 DATE: May 25, 2021 REMANDED Entitlement to service connection for degenerative disc disease of the lumbar spine is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1958 to December 1960. This appeal comes before the Board of Veterans' Appeals (Board) from a September 2013 rating decision of a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). In May 2019, the Veteran testified before a Veterans Law Judge (VLJ). A transcript of the hearing is available in the record. The Board remanded the appeal to the AOJ for additional development in August 2020 and January 2021. In March 2021, the Board informed the Veteran that the VLJ who conducted the May 2019 hearing was no longer employed by the Board and informed the Veteran that he had a right to request another optional Board hearing. The Veteran did not respond to the March 2021 letter within 30 days of that letter, as instructed. Therefore, the Board will proceed with review of the Veteran's appeal. 1. Entitlement to service connection for degenerative disc disease of the lumbar spine is remanded. The Veteran contends that his back disability is the result of an in-service parachute jump. As noted, the Board previously remanded this matter in August 2020 and January 2021 in order for a VA examiner to provide an opinion which addresses the history provided by the Veteran regarding a parachute accident in service with the instruction that for examination purposes, the examiner was to accept as true that the parachute incident did occur as reported by the Veteran. In February 2021, VA obtained an addendum medical opinion. The examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned that there was no chronic diagnosis for a lumbar spine condition while on active duty. The Veteran's symptoms were subjective only and a nexus had not been established. The examiner stated that she considered the Veteran's lay statements and other buddy statements regarding the Veteran's symptoms and the undocumented parachute accident during military service. The examiner explained that the available medical records do not note medical evaluations, treatment, or diagnosis for a lumbar spine condition while on active duty. The examiner stated the symptoms were self-reported only and were confirmed in the claims file. The examiner noted that the separation examination in November 1960 did not note a lumbar condition and per the Veteran's statements he did not receive any treatment after his first parachute jump. The examiner concluded that there is no objective medical evidence noted in the available medical records showing a link between the Veteran's current lumbar spine condition the Veteran's time in the military. The Board finds that the February 2021 VA medical opinion is not adequate for adjudication. First, although the February 2021 examiner stated the lay statements regarding the Veteran's back pain and parachute injury were considered, the examiner failed to explain why that the injury did not cause the Veteran's current disability if the incident is accepted as having occurred. Relatedly, the examiner's reasoning appeared to solely relied on the fact that there are no service treatment records regarding the Veteran's back. A medical opinion is not adequate if the only rationale negating service connection is an absence of service treatment records. The Board notes that the January 2021 Board remand specifically instructed the examiner that such opinion would not be adequate. As such the Board finds a remand is required in order to obtain an adequate examination. The matters are REMANDED for the following action: 1. Obtain an addendum medical opinion from an appropriate clinician to determine whether the Veteran's degenerative disc disease of the lumbar spine is related to the Veteran's service. The examiner must provide the following opinion: (a.) Whether it at least as likely as not (50 percent probability or greater) that the Veteran's current lumbar condition was incurred in or aggravated by his military service, specifically from a parachuting accident during his first parachute jump. i. The examiner is instructed to accept for purposes of the examination that the described parachute incident did occur. ii. The examiner must address the Veteran's brother's lay statement in 1991 that when the Veteran left the Army in 1960, he experienced back pain (see March 1991 Buddy/Lay Statement). iii. The examiner must address the Veteran's January 2021 statement that his back pain is due to his parachute accident while in service. iv. The examiner's rationale MUST directly address the contention that he had an undocumented lower back injury during his first parachute jump in July 1958. Simply stating that the contention was considered is not adequate. (b.) The examiner must provide a complete medical rationale for any opinion. The absence of service treatment records cannot be the sole basis upon which a negative nexus opinion is based. S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Robert Batten 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.