Citation Nr: 22051172 Decision Date: 09/08/22 Archive Date: 09/08/22 DOCKET NO. 15-32 372 DATE: September 8, 2022 REMANDED Entitlement to service connection for a back condition is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1974 to August 1977. This matter is before the Board of Veterans' Appeals (Board) on appeal from an August 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in November 2018. A transcript of the hearing is of record. This matter was previously before the Board in April 2019 and November 2021 when it was remanded for further development. Entitlement to service connection for a back condition is remanded. The Board finds an additional remand is required before a decision can be made on the Veteran's claim. In the November 2021 remand order, the Board requested a medical opinion addressing the etiology of the Veteran's back condition. Specifically, the examiner was asked to provide an opinion as to whether the Veteran's condition was incurred in or otherwise related to his service, including his in-service treatment for back pain. In providing the opinion, the examiner was asked to consider (i) the Veteran's August 1977 statement noted in his military personnel records that his medical condition changed after his separation examination as he was experiencing back pain; (ii) private medical records documenting ongoing complaints of back pain beginning in 1992; and (iii) a statement on the Veteran's VA Form 9 that he did not have insurance when he first separated from service so he self-treated his back condition. In May 2022, a VA examiner opined that the Veteran's condition was not related to his active service. The examiner noted that, although the Veteran reported "a little back pain" in August 1977, there was no medical disability at the time. The examiner also noted that medical records after separation are silent for a chronic back condition; that records do not note any complaints of back pain until 1992, which is over 14 years after discharge, and was noted to be an episode of acute low back pain; and that medical records are silent for any medical history of a chronic back disability in 2006 when, at age 51 and at a weight of 280 pounds, he was diagnosed with a mild disc bulge. Thus, the examiner concluded that the Veteran's back condition was the result of a combination of aging, obesity, and occupational exposure in deliveries with bending and lifting. However, the examiner failed to address the Veteran's in-service treatment for back pain, as requested. Additionally, it does not appear the examiner considered the Veteran's statement on his VA Form 9 that he did not have insurance when he first separated from service, so he self-treated his back condition. In light of this, remand is required to ensure substantial compliance with the Board's prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that where the remand orders of the Board are not substantially complied with, the Board errs as a matter of law when it fails to ensure substantial compliance). The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records for the period from May 2022 to the present. 2. After obtaining any additional records, obtain an addendum opinion from a VA examiner other than the December 2019 and May 2022 examiners addressing the etiology of the Veteran's back condition. The electronic claims file, including this remand, should be made available to the examiner for review in connection with this request. An examination should only be scheduled if the examiner deems one is necessary for providing the requested opinion. Following a review of the Veteran's claims file, the examiner is asked to 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) the Veteran's back condition was incurred in or is otherwise related to the Veteran's active service, to include his in-service treatment for back pain. In providing the requested opinion, the examiner is asked to consider the following: (i) the Veteran's August 1977 statement noted in his military personnel records that his medical condition changed after his separation examination as he was experiencing back pain; (ii) private medical records documenting ongoing complaints of back pain beginning in 1992; and (iii) a statement on the Veteran's VA Form 9 that he did not have insurance when he first separated from service so he self-treated his back condition. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the examiner must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Jiggetts 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.