Citation Nr: 22018667 Decision Date: 03/30/22 Archive Date: 03/30/22 DOCKET NO. 17-56 304 DATE: March 30, 2022 REMANDED Entitlement to service connection for sciatic nerve damage associated with lumbar spine disability is remanded. Entitlement to service connection for lumbar spine degenerative disc disease (DDD) with radiculopathy is remanded. Entitlement to service connection for bilateral lower extremity (BLE) neuropathy is remanded. Entitlement to service connection for bilateral knee degenerative arthritis (DA) is remanded. REASONS FOR REMAND The Veteran served active duty in the U.S. Army from October 1972 to July 1974, and from July 1974 to January 1996. This case comes before the Board on appeal of a March 2015 rating decision. This case was previously before the Board in April 2019, where the issues on appeal were remanded for further evidentiary development. Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. 1. Entitlement to service connection for sciatic nerve damage associated with lumbar spine disability is remanded. 2. Entitlement to service connection for lumbar spine degenerative disc disease (DDD) with radiculopathy is remanded. 3. Entitlement to service connection for bilateral lower extremity (BLE) neuropathy is remanded. Here, remand is necessary for an addendum opinion regarding the etiology of the Veteran's lumbar spine condition. In the December 2019 medical opinion, Dr. S.C. opined that the Veteran's lumbar spine DDD with bilateral leg sciatic radiculopathy was less likely than not caused by or related to active duty service. She reasoned that although the Veteran was seen for low back strain and sciatic complaints, separation examination was normal and no complaint of recurrent back pain. Thus, current back symptoms more likely due to age related changes. The Board notes that the opinion is inadequate and thus of little probative value. The examiner reasoned that the Veteran complained of sciatic complaints; however, the record indicates that the Veteran was diagnosed with sciatica and pyriformis syndrome. See June 1988 STR. The explanation from Dr. S.C. that the Veteran complained of sciatica does not address that he was diagnosed with sciatica and pyriformis syndrome. In fact, Dr. S.C. did not explain the diagnosis of pyriformis syndrome and how that diagnosis relates to the Veteran's current lumbar condition. Thus, the examination is inadequate as the examiner did not appear to consider all the relevant evidence or, considering such, provide sufficient rationale for the opinion. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008). Moreover, the Veteran reported that he suffered a lumbar spine injury during his time in Germany. Specifically, between October 1972 and July 1974, the Veteran explained that he got pinched between a 2.5-ton truck and trailer trying to connect the trailer. He stated that he went a dispensary in Germany, but his records do not reflect this period. See December 2019 correspondence. The Board notes that a military personnel record shows that the Veteran served active duty in the U.S. Army from October 1972 to July 1974, which is not reflected on his DD-214. See Military personnel record. 4. Entitlement to service connection for bilateral knee degenerative arthritis (DA) is remanded. Similarly, remand is necessary to obtain an addendum opinion regarding the Veteran's bilateral knee DA. In the December 2019 medical opinion, Dr. S.C. opined that the Veteran's bilateral knee condition was less likely than caused by or related to service. She reasoned that the Veteran's right knee IT band syndrome was a soft tissue condition, and the Veteran did not report any trick or locked knee condition at separation. Therefore, his current symptoms are more likely due to age related changes. Again, Dr. S.C.'s opinion is inadequate and thus of little probative value. The Veteran's lack of indication regarding a trick or locked knee at the time of separation does not invalidate his complaints of both left and right knee issues during service. The Veteran was diagnosed with a right knee syndrome as well as complaints of left knee pain that was positive for bony protrusions of the left knee. Furthermore, there are other complaints of the Veteran's left and right knee during service including records from March 1981, April 1981, October 1981, and October 1987. Dr. S.C.'s opinion fails to account for all the relevant evidence regarding the Veteran's knees. Thus, the examination is inadequate as the examiner did not appear to consider all the relevant evidence or, considering such, provide sufficient rationale for the opinion. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008). The matters are REMANDED for the following action: 1. Obtain all treatment records from the Veteran's service from October 1972 to July 1974. Additionally, obtain all relevant outstanding VA treatment records, and any private treatment records identified by the Veteran. All records and/or responses received should be associated with the claims file. 2. After all outstanding treatment records have been associated with the claims file, obtain VA addendum opinions to determine the nature and etiology of the Veteran's lumbar spine disability and bilateral knee disability. If an opinion cannot be obtained without an examination, then a VA examination should be afforded to the Veteran. The record, including a copy of this remand, must be made available to and reviewed by the examiner. The VA examiner should address the following: (a.) Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's lumbar spine disability had its onset during service or is otherwise causally related to any event or circumstance of the Veteran's service. (b.) Whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's bilateral knee disability had its onset during service or is otherwise causally related to any event or circumstance of the Veteran's service. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as against it. 3. The examiner should cite to the pertinent medical and competent lay evidence of record and explain the rationale for all opinions given. If after consideration of all pertinent factors it remains that the opinion sought cannot be given without resort to speculation, it should be so stated, and the provider must (to comply with governing legal guidelines) explain why the opinion sought cannot be offered without resort to speculation. 4. Thereafter, readjudicate the claims on appeal. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Umo, 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.