Citation Nr: 22016324 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 17-34 955 DATE: March 21, 2022 REMANDED Entitlement to service connection for a back disorder, to include as secondary to service-connected left knee disability, is remanded. Entitlement to service connection for a neck disorder, to include as due to back disorder and/or secondary to service-connected left knee disability, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from November 1984 to November 1990, May 2004 to September 2004, October 2004 to August 2005, and September 2007 to September 2009. In July 2021, the Board determined that new and material evidence was received to reopen the previously denied issues of service connection for degenerative disc disease (DDD) of the cervical spine and DDD of the thoracic and lumbar spine, and remanded the issues of service connection for back and neck disorders for additional evidentiary development. The case has been returned to the Board for appellate review. 1. Entitlement to service connection for a back disorder, to include as secondary to service-connected left knee disability 2. Entitlement to service connection for a neck disorder, to include as secondary to back disorder and/or service-connected left knee disability In June 2015, the Veteran's request to reopen her claims for back and neck disorders was obtained and associated with the record. As noted in the July 2021 Board decision, treatment records, lay statements, and testimony at the February 2021 Board hearing shows the Veteran's assertion that her service-connected left knee disability altered her gait, causing her back disability, which then caused her neck disability. Pursuant to the July 2021 Board remand directives, the Agency of Original Jurisdiction (AOJ) was instructed to obtain VA medical opinions regarding the Veteran's current back and neck disorders on direct and secondary bases to the service-connected left knee disability. The Veteran was provided VA examinations for back (thoracolumbar spine) and neck (cervical spine) conditions in September 2021 by Dr. N. W. The Veteran was also provided a VA medical opinion in November 2021 by Dr. T. D., which explained in detail the direct cause of the Veteran's current back and neck disorders. Nevertheless, the November 2021 VA medical opinion is incomplete because secondary service connection due to aggravation was not addressed. 38 C.F.R. § 3.310(b). As a result, the Board finds that additional development is needed to properly adjudicate the appeal, specifically to include an addendum VA medical opinion. See 38 U.S.C. § 5103A(a); 38 C.F.R. §§ 3.159, 3.310; Barr v. Nicholson, 21 Vet. App. at 312. The matters are REMANDED for the following actions: 1. Return the Veteran's claims file to the examiner (Dr. T. D.) who provided the November 2021 VA medical opinion so a supplemental opinion may be provided. If that examiner is no longer available, provide the Veteran's claims file to a similarly qualified clinician. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination is only required if deemed necessary by the examiner. Although an independent review of the claims file is required, the Board calls the examiner's attention to the following: February 2021 Board hearing transcript shows the Veteran stated that her "knee lock[s] up constantly "[a]nd from there [her] back problems exasperated dramatically," which then caused her neck disability. The examiner must opine as to the following: (a.) Whether the Veteran's back disorder (diagnosed as DDD in 2011 and intervertebral disc syndrome (IVDS) and arthritis in 2021, even if resolved since) was aggravated beyond its natural progression by her service-connected left knee disability. (b.) Whether the Veteran's neck disorder (diagnosed as DDD in 2011 and IVDS and arthritis in 2021, even if resolved since) was aggravated beyond its natural progression by her service-connected left knee disability. (c.) Whether the Veteran's neck disorder was aggravated beyond its natural progression by her back disorder. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 2. Then, review all examination reports and medical opinions provided to ensure that the requested information was provided. If any report or opinion is deficient in any manner, the AOJ must implement corrective procedures. 3. Then, readjudicate the claims. If any decision is adverse to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Carter, 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.