Citation Nr: 21032158 Decision Date: 05/26/21 Archive Date: 05/26/21 DOCKET NO. 18-04 692 DATE: May 26, 2021 REMANDED Entitlement to service connection for degenerative changes of the lumbar spine (claimed as herniated disk) is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from December 1992 to December 1996. This matter is before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In December 2018, August 2020, and January 2021, the Board remanded this for additional development. Entitlement to service connection for degenerative changes of the lumbar spine (claimed as herniated disk) This claim has been remanded three times for additional development. While the Board regrets the delay inherent with yet another remand, the Board finds that there has not been substantial compliance with the previous remand directives, and that corrective action is necessary. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The January 2021 Board remand sought a medical opinion to determine the etiology of the Veteran's low back disability. The examiner was specifically asked to consider the Veteran's contentions that he has experienced pain in the low back since service. Notably the clinical records for treatment indicate the Veteran reported pain in the low back since service many years before the Veteran filed the current claim. See April 2008 Practitioner note CAPRI receipt date April 1, 2020 pg. 85. Notably contemporaneous medical statements are considered probative evidence. See Curry v. Brown, 7 Vet. App. 59, 68 (1994). On March 2021 addendum medical opinion, the clinician opined that it was less likely than not that the Veteran's low back disability was related to service based on a lack of formal diagnosis of a chronic disability until 2008. However, this opinion fails to consider the Veteran's allegations of symptoms years prior to his formal diagnosis. In a substantive appeal, the Veteran reported that his work on the flight deck of an aircraft carrier required carrying and connecting 90 pound fueling hoses to aircraft and that he was seen for back pain on several occasions in service. Lastly, the Veteran's service treatment records (STRs) note the Veteran was involved in an in-service motor vehicle accident (MVA) in March 1995, and he was taken by ambulance to DePaul Medical Center. See March 9, 1995 STR Medical pg. 1 receipt date December 12, 1996. However, the record does not contain any indication that an effort to retrieve such hospital records has been made. Information related to an in-service MVA in which the Veteran reported low back pain afterwards is relevant information to this claim. Accordingly, such records should be sought. The matter is REMANDED for the following action: 1. Request that the Veteran to provide the necessary authorizations for VA to secure records related to his March 1995 emergency department treatment for a MVA at DePaul Medical Center. Arrange for development to secure for the record complete clinical records of such emergency department treatment. If such records are unavailable, it should be noted in the record. 2. Arrange for the Veteran's record to be forwarded to an appropriate clinician (other than the providers of the prior medical opinions) for review and a medical advisory opinion regarding the etiology of his low back disability. The consulting provider is asked to: (a.) Identify (by diagnosis) each chronic low back disability entities shown during the pendency of the claim. (b.) Identify the likely etiology for each low back disability diagnosed. Specifically, is it at least as likely as not (a 50 percent probability or greater) that it is related to the Veteran's service? The opinion and rationale must address (1) the Veteran's complaints of back pain in service from carrying and connecting heavy aircraft fueling hoses, (2) the Veteran's in service MVA, (3) the Veteran's discharge physical examination and history questionnaire, and (4) the Veteran's report in 2008 of back pain that had continued since service including whether this is medically consistent with the record and current nature and level of disability. (c.) If it is determined that the Veteran's low back disability was not caused by service, identify the etiology that is considered to be more likely, and explain why that is so. (continued next page) The clinician must provide a complete rationale for all findings and opinions, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Staskowski, 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.