Citation Nr: 22047263 Decision Date: 08/19/22 Archive Date: 08/19/22 DOCKET NO. 15-32 793 DATE: August 19, 2022 REMANDED Entitlement to service connection for a neck disability, to include cervical arthritis, claimed as secondary to a service-connected right shoulder disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1964 to June 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) which denied reopening the Veteran's claim. In October 2018, the Board reopened and remanded the Veteran's claim for a neck disability for further development. This matter was last before the Board in May 2022 when it was remanded for additional development. Entitlement to service connection for a neck disability, claimed as secondary to a service-connected right shoulder disability. Although the Board regrets the additional delay, remand is again necessary to ensure compliance with the Board's prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Unfortunately, the Board must again remand the claim as there has not been substantial compliance with the Board's previous remand directive. The May 2022 remand requested an addendum opinion addressing whether the Veteran's neck condition was secondary to his service-connected right shoulder disability. Specifically, the remand requested an opinion as to whether it is at least as likely as not that the Veteran's service-connected right shoulder disability worsened the neck disability beyond its normal progression (aggravated). In a June 2022 medical addendum, the examiner opined that it is less likely than not that the Veteran's pre-existing neck condition was aggravated beyond natural progression by the right shoulder disability. The examiner further noted that the symptoms the Veteran reported during his military career are inconsistent with the natural progression of his pre-existing condition. This opinion is inadequate as it is based on incorrect facts; furthermore, it does not provide the opinion requested by the Board in its May 2022 remand directives. The opinion addressed a pre-existing neck condition; however, the evidence of record does not show that the Veteran's neck condition pre-existed service or the incurrence of his right shoulder disability. Given these deficiencies in the Jun 2022 medical opinion, remand is necessary for an adequate medical opinion. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matter is REMANDED for the following action: 1. Obtain a VA addendum opinion from the examiner who provided the June 2022 addendum opinion, or another appropriate clinician to determine the etiology of the Veteran's neck disability. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a thorough review of the claims file, the examiner is asked to respond to the following: (a) Provide an opinion as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's neck disability was aggravated (worsened beyond natural progression) by the service-connected right shoulder disability. **Please note: permanent worsening is not a requirement for secondary service connection of a non-service-connected injury or disease. A detailed rationale should be provided for the opinions rendered. If the examiner cannot provide the requested information without resort to speculation, he or she must state the reasons why, and if an additional clinical evaluation is necessary to render the requested information, then that opportunity should be made available. 2. Then, readjudicate the issue on appeal. Megan R. Thomas Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Beach, Julia M. 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.