Citation Nr: 22018926 Decision Date: 03/30/22 Archive Date: 03/30/22 DOCKET NO. 17-59 222 DATE: March 30, 2022 REMANDED Entitlement to service connection for a lumbar spine disability, to include degenerative disc disease and degenerative arthritis, is remanded. Entitlement to a rating in excess of 10 percent for right knee meniscotomy and arthrotomy residuals is remanded. Entitlement to an initial compensable rating for a right knee surgical scar is remanded. REASONS FOR REMAND The Veteran had active service from December 1967 to December 1971. 1. Entitlement to service connection for a lumbar spine disability, to include degenerative disc disease and degenerative arthritis, is remanded. In its July 2019 Remand instructions, the Board of Veterans' Appeals (Board) requested that the Veteran be afforded a Department of Veterans Affairs (VA) spine evaluation. The Board directed the examiner to opine "as to whether it is at least as likely as not (50 percent probability or greater probability) that any currently diagnosed lumbar spine disorder is etiologically related to the Veteran's active service;" "whether it is at least as likely as not (50 percent probability or greater probability) that any disability was caused or aggravated by his service-connected knee disability;" and "causation and aggravation are independent concepts and should have separate findings and rationales to address whether his service connected knee disability caused or aggravated his current lower back disability." The report of an October 2019 VA spine examination states that the Veteran was diagnosed with lumbar spine intervertebral disc syndrome and degenerative arthritis. The examiner concluded "the condition claimed was less likely than not incurred in or aggravated by the claimed in-service injury, event, or illness." The examiner commented that: "the Veteran states that he injured his back from jumping out of aircraft wings and wear and tear during service;" "he was not diagnosed with any bony or ligament injury;" "he is currently diagnosed with degenerative disc disease which is likely to be secondary to natural process of aging;" and "it is less likely to be sec to service without any bony or ligament injury diagnosed." The doctor did not address whether the "whether it is at least as likely as not (50 percent probability or greater probability) that any disability was caused or aggravated by his service-connected knee disability." The Agency of Original Jurisdiction's compliance with the Board's remand instructions is neither optional nor discretionary. Stegall v. West, 11 Vet. App. 268 (1998). 2. Entitlement to a rating in excess of 10 percent for right knee meniscotomy and arthrotomy residuals and an initial compensable rating for a right knee surgical scar is remanded. In its July 2019 Remand instructions, the Board directed the Agency of Original Jurisdiction to "obtain all outstanding treatment medical records and associate them with the claims file." An October 2019 Status of Information Requested Correspondence submitted by the Veteran noted that "he was waiting for the VA evidence intake center to obtain his records from the Chattanooga VA outpatient services." Further, the Veteran reported that "the Galen Medical Group were going to fax their records to VA evidence intake center on or after October 7, 2019." Clinical documentation dated after October 2019 is not of record. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran's claims. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for each private healthcare provider, including the Galen Medical Group, who treated any lumbar spine disability and the service-connected right knee disabilities. Make two requests for the authorized records from all identified healthcare providers unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran's VA treatment records not already of record, including that pertaining to treatment after October 2019. 3. Schedule the Veteran for a VA spine examination conducted by a medical doctor to assist in determining the nature and etiology of any identified recurrent lumbar spine disability and any relationship to active service and the service connected disabilities. The examiner must review the record. A rationale for all opinions should be provided. The examiner should: (a.) Identify all lumbar spine disabilities found. (b.) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified recurrent lumbar spine disability had its onset during active service or is related to any incident of service, including the documented in service lumbar spine symptoms and the Veteran's subjective history of recurrent lumbar spine complaints since active service. (c.) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified lumbar spine disability is due to or the result of his right knee disability or the other service-connected disabilities. (d.) Opine whether it is at least as likely as not (50 percent probability or greater) that any identified lumbar spine disability has been aggravated (increased in severity beyond the natural progress of the disorder) by the right knee disability and the other service-connected disabilities. J. T. HUTCHESON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Emily A. Kotroco 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.