Citation Nr: 22005397 Decision Date: 02/01/22 Archive Date: 02/01/22 DOCKET NO. 16-25 875 DATE: February 1, 2022 REMANDED Entitlement to service connection for a lower back condition is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1974 to December 1975. This matter comes before the Board of Veterans' Appeals (Board) from an August 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), which denied entitlement to service connection for a lower back condition and an acquired psychiatric disorder. The issues were remanded by the Board in April 2021 for further development. In an August 2021 rating decision, the RO granted service connection for unspecified anxiety disorder. Therefore, the claim is considered granted in full and the issue is no longer before the Board. However, the issue of entitlement to service connection for a lower back condition remains in appellate status, as reflected on the title page. Service connection for a lower back condition. The Veteran seeks service connection for a lower back condition. He has stated that he was treated for back issues during active duty. The Board notes that on his June 1971 entrance Report of Medical History, the Veteran confirmed a history of back issues, which caused an inability to perform certain motions. He explained that his back would sometimes "get in a catch." In August 2021, the Veteran was afforded a VA examination. The examiner provided a negative etiology opinion for direct service connection, finding that the Veteran's diagnosed lumbar spine condition was a result of wear and tear with normal activity, a physiological effect of the aging process; and because there was no evidence in the Veteran's service treatment records to support a lumbar spine diagnosis since March 2015. Additionally, she opined that the Veteran's claimed back condition, which clearly and unmistakably existed prior to service, had less likely than not been aggravated beyond its natural progression by service. The Board finds the August 2021 opinions and rationale are insufficient for adjudication purposes. First, regarding the August 2021 examiner's statement that there was no evidence to support a lumbar spine disorder since March 2015, which touches upon continuity of symptomatology, the examiner, herself, noted that the Veteran has a diagnosis of degenerative arthritis of the lumbar spine based on a May 2019 MRI. Second, regarding the theory of entitlement to service connection based on a pre-existing disability, the examiner provided a negative nexus opinion, stating that the Veteran's active duty did not aggravate his pre-existing back condition beyond natural progression. The examiner did not provide a rationale for this opinion. Remand is necessary to obtain addendum opinions regarding direct service connection and aggravation of a pre-existing disability, each with correct and sufficient rationale. Additionally, the Veteran submitted additional service treatment records documenting his back pain and treatment for back issues in service, and the new evidence should be considered. The matters are REMANDED for the following action: 1. Obtain an addendum VA medical opinion as to whether it is at least as likely as not (i.e. 50 percent or greater) that the current lumbar disability was not aggravated by service, had its onset during service, or is otherwise related to an in-service injury, event, or disease. Regarding whether the current lumbar disability was not aggravated by service in other words, is it clear and unmistakable that any worsening was acute and transitory or was due to the natural progression of the disease? In this context, aggravation is defined as a permanent worsening beyond the natural progression of the disability. The need for an examination is left to the discretion of the examiner. Sufficient rationale for all opinions offered is requested as the Board is precluded from making any medical findings. 2. Readjudicate the appeal. J. LEE Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Hofmeister 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.