Citation Nr: 22018500 Decision Date: 03/29/22 Archive Date: 03/29/22 DOCKET NO. 18-00 770 DATE: March 29, 2022 REMANDED Entitlement to service connection for disability of the cervical spine, to include as secondary to service-connected disability of the left shoulder, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Marine Corps from October 1995 to November 2003. His decorations include the National Defense Service Medal. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a July 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. In November 2021, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge, sitting in St. Louis, Missouri. A transcript of that hearing has been associated with the record. Entitlement to service connection for disability of the cervical spine is remanded. Although the Board sincerely regrets the additional delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran's claim and to afford him every possible consideration. The Veteran seeks to establish service connection for a cervical spine disability. He asserts that the disability began in service. See November 2021 Board hearing transcript. Alternatively, he contends that his cervical spine disability is secondary to his service-connected left shoulder disability. A June 2012 VA examination report notes that cervical x-rays revealed small size marginal osteophyte formation in the lower cervical spine with disc space narrowing at the level of C5-C6. It was noted that the findings were somewhat atypical for the Veteran's age. The Veteran was afforded a VA examination in connection with his claim in May 2017. The examiner found that the Veteran had a current diagnosis of degenerative arthritis of the spine. The examiner offered a negative nexus opinion with regard to secondary service connection. She reasoned that the longitudinal medical evidence provided and reviewed did not support that the Veteran's cervical spondylosis was proximately due to or the result of the Veteran's service-connected left shoulder condition. While the May 2017 VA examiner provided an opinion as to secondary causation, she did not provide an explicit opinion with respect to aggravation. She also did not provide an express opinion as to direct service connection. Because the May 2017 VA examination report is not fully adequate, an addendum opinion is warranted. See, e.g., Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA undertakes the effort to provide an examination when developing a service-connection claim, even if not statutorily obligated to do so, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided). This matter is REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed to the extent possible, arrange to provide the record on appeal to the VA examiner who evaluated the Veteran in May 2017. The examiner should review the expanded record. After reviewing the record, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran's cervical spine disability had its onset in, or is otherwise attributable to, his period of active service. If it is the examiner's conclusion that it is unlikely that the Veteran's cervical spine disability is attributable to service, the examiner should offer a further opinion as to whether it is at least as likely as not that the Veteran's disability has been (a) caused or (b) aggravated (i.e., worsened beyond natural progression) by the Veteran's service-connected left shoulder disability. If the May 2017 examiner is no longer employed by VA or is otherwise unable to provide the opinions requested, arrange to obtain the requested information from another qualified examiner. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinions. A complete medical rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue on appeal should be readjudicated based on the entirety of the evidence. If the benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Joseph T. Leonard, 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.