Citation Nr: 22013396 Decision Date: 03/09/22 Archive Date: 03/09/22 DOCKET NO. 17-04 934A DATE: March 9, 2022 REMANDED Entitlement to service connection for a lumbar spine condition, to include as secondary to service-connected left knee condition is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from July 1985 to June 1991. The Board of Veterans' Appeals (Board) remanded the issue in December 2018 and July 2021 to obtain an addendum opinion. Upon review of the record, the Board finds that further remand is necessary. Entitlement to service connection for a lumbar spine condition, to include as secondary to service-connected left knee condition is remanded. The Veteran contends that his lumbar spine condition began in service, or in the alternative, is secondary to his service-connected left knee condition. In its July 2021 remand, the Board found that the November 2019 VA medical opinion failed to meaningfully address the Veteran's lay statements regarding the onset of pain and worsening after he injured his left knee in a bicycle accident. The Board instructed the RO to obtain medical opinion to address the Veteran's lay statements. A VA medical opinion was obtained in October 2021 with an addendum opinion in December 2021. The examiner provided opinions based on direct service connection and on aggravation based on the Veteran's left and right knee conditions. However, the examiner failed to provide a medical opinion on based on secondary causation, i.e., whether the Veteran's back condition is at least as likely as not proximately due to or the result of his left knee condition, as directed by the July 2021 Board remand. Moreover, the December 2021 examiner provided a negative opinion, finding that the Veteran's lumbar spine disorder was not due to service or aggravated by his knee conditions as there was no chronicity of care, however, the December 2021 examiners did not discuss the Veteran's lay statements as set out in the Board remand. While noting the Veteran's lay statements that he was treated for a back injury and had back pain due to the bicycle accident in 1986, she did not adequately address his statements that his back pain began in service and worsened after he injured his left knee. Thus, there has not been substantial compliance with the Board's previous remand directives. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: Obtain a VA medical opinion to determine the nature and etiology of the Veteran's lumbar spine condition. If necessary, afford the Veteran a VA examination. The opinion should address each of the following questions about the Veteran's current back disability in terms of whether it is at least as likely as not: (a.) Did the current disorder have its onset during active duty? (b.) Is the current back disorder otherwise related to the Veteran's service? (c.) Is the current back disorder proximately due to his service-connected left knee condition? (d.) Is the current back disorder aggravated by his service-connected left knee condition? In addressing these questions, the examiner is advised that the Veteran is competent and credible to report back problems since service. The examiner should specifically discuss (i) the Veteran's report of increased lumbar pain after a 1987 bicycle accident and (ii) the fact that he submitted an initial claim for a back disability immediately following separation from service. Joshua Castillo Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Jaigirdar, 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.