Citation Nr: 22019970 Decision Date: 04/03/22 Archive Date: 04/03/22 DOCKET NO. 17-39 928A DATE: April 3, 2022 REMANDED Entitlement to service connection for a lumbar spine disability, to include L-5 spondylolysis is remanded. Entitlement to service connection for sciatic radicular pain, right lower extremity (RLE) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from August 2007 to June 2011. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in August 2016 by a Department of Veterans Affairs (VA) Regional Office. This appeal was previously before the Board in January 2020 and October 2021, at which times it was remanded for further development. Unfortunately, as discussed below, a VA opinion obtained in January 2022 in response to the most recent Board remand did not substantially comply with the Board's remand directives. A remand by the Board "confers on the claimant, as a matter of law, the right to compliance with the remand orders." See Stegall v. West, 11 Vet. App. 268 (1998). The October 2021 Board decision directed the examiner to consider whether or not the Veteran's lumbar spine disability clearly and unmistakably pre-existed service, and if so, then to consider additional questions regarding the disability. Although the January 2022 examiner concluded that the Veteran's lumbar spine disability clearly and unmistakably pre-existed service, and was clearly and unmistakably not aggravated beyond its natural progression by service, his conclusions lack any sort of explanation, detail, or rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Once VA undertakes the effort to provide an examination for 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. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Here, because the Board's remand directives were not followed, and the January 2022 opinion is inadequate, the Board finds that a remand is once again required. The matters are REMANDED for the following action: 1. Obtain an opinion from an appropriate clinician to determine the nature and etiology of lumbar spine disability, to include L-5 spondylolysis. The clinician is asked to opine as whether the Veteran's lumbar spine disability clearly and unmistakably existed prior to his entry into active service. If the answer is yes, then is the Veteran's lumbar spine disability a static developmental condition, or is it one that can increase in severity? If the clinician opines that the Veteran's lumbar spine disability is a condition that can increase in severity, then has the Veteran's lumbar spine disability increased in severity and, if so, is any increase in severity clearly and unmistakably due to the natural progression of the lumbar spine disability? If the clinician opines that there is not clear and unmistakable evidence that the lumbar spine disability existed prior to Veteran's entry into active service, then discuss whether it is at least as likely as not (that is, a 50 percent probability or greater) that the lumbar spine disability is causally connected to active service. The clinician is instructed that the Veteran's spine is deemed to have been in sound condition at the time he entered active service unless clear and unmistakable evidence (evidence that it is undebatable) shows that the lumbar spine disability preexisted his active service. The examiner must provide a detailed rationale for all conclusions reached, with reference to relevant evidence of record and/or medical principles, as appropriate. 2. Obtain an opinion from an appropriate clinician to determine the nature and etiology of sciatic radicular pain, right lower extremity. Please schedule an examination if deemed necessary. The clinician is asked to opine as to whether the Veteran's sciatic radicular pain of the right lower extremity is at least as likely as not (a 50 percent probability or greater) due to his lumbar spine disability? If the answer is no, the examiner is asked to determine whether the Veteran's sciatic radicular pain of the right lower extremity was aggravated beyond its natural progression by the lumbar spine disability. If the examiner finds that the lumbar spine disability aggravates/aggravated the Veteran's sciatic radicular pain of the right lower extremity, he or she should state whether there is medical evidence created prior to the aggravation or at any time between the time of aggravation and the current level of disability that shows a baseline for the sciatic radicular pain of the right lower extremity prior to aggravation. If the examiner is unable to establish a baseline for the sciatic radicular pain of the right lower extremity prior to the aggravation, he or she should state such and explain why a baseline cannot be determined. The examiner must provide a detailed rationale for all conclusions reached, with reference to relevant evidence of record and/or medical principles, as appropriate. JEREMY J. OLSEN Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Husain, 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.