Citation Nr: 25008652 Decision Date: 07/01/25 Archive Date: 07/01/25 DOCKET NO. 18-25 673 DATE: July 1, 2025 REMANDED Entitlement to an initial rating higher than 20 percent for cervical spine disability prior to September 10, 2021, is remanded. Entitlement to an initial 20 percent rating for lumbar spine disability is remanded. REASONS FOR REMAND The Veteran served on active military duty from September 1990 to September 2014. This matter is before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to an initial rating higher than 20 percent for cervical spine disability prior to September 10, 2021, is remanded. 2. Entitlement to an initial 20 percent rating for lumbar spine disability is remanded. The Board finds that remand is required for additional development. A VA examination and opinion were provided in March 2025. The examiner stated that the May 2015 VA examination indicated that the Veteran was capable of repetitive use testing without additional loss in range of motion of the cervical spine. The Veteran was noted to have pain on movement and reported flareups. The examiner stated that the Veteran's lay statements, his spouse's statements, and the May 2014 treatment records were reviewed. The examiner also noted that the February 2018 VA examination indicated that the Veteran was capable of repetitive use testing without additional loss in range of motion. The examiner then stated that she was unable to estimate additional functional impairment based on the evidence of record and the Veteran's lay descriptions of functional loss manifestations after repeated use over time and during flareups without resorting to speculation. She simply stated that she had exhausted the limits of current medical knowledge to formulate these estimations. The examiner then stated that while there would be additional limitation in range of motion on active range of motion, passive range of motion, weightbearing, and non-weightbearing testing, specific degrees in limitation of each parameter would be resorting to speculation. She again, simply stated that she had exhausted the limits of current medical knowledge to formulate these estimations. A nearly identical opinion was provided regarding the thoracolumbar spine. The Board finds that remand is warranted in order to obtain adequate VA opinions. The Board notes that in the December 2024 Board decision, the remand directives instructed the VA examiner to provide retrospective opinions for the period prior to September 2021 for the Veteran's cervical spine and lumbar spine conditions. The examiner was specifically asked to opine as to functional loss after repeated use and during flareups as well as the Veteran's range of motion during active, passive, weightbearing, and non-weightbearing motion during the May 2015 VA examination. The examiner was directed to provide a rationale if they could not provide an opinion without resorting to mere speculation. The Board notes that the above examiner failed to provide any rationale outside of stating that she had exhausted the limits of current medical knowledge. Additionally, in providing an opinion, the examiner was instructed to address the May 2014 treatment record noting neck pain, the Veteran's lay statements, to include his report that he was unable to bend over to put on his shoes and needed help getting out of bed in the morning; as well as the Veteran's wife's May 2017 statement in which she indicated that the Veteran's back often gave out and locked up. Outside of simply stating that this evidence had been reviewed, the examiner failed to address these pieces of evidence in her opinion. The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. Due to the above inadequacies the Board finds that remand is required for additional development. The matters are REMANDED for the following action: 1. Obtain an opinion(s)from an appropriate medical professional, other than the March 2025 VA examiner, regarding the Veteran's cervical spine and lumbar spine disabilities. (a) Relevant to cervical spine disability: The reviewing examiner should provide retrospective opinions on functional loss after repeated use over time and during flareups for the Veteran's cervical spine disability prior to September 10, 2021, to include at the time of the May 2015 VA cervical spine examination. The examiner should also address the May 2014 treatment record noting neck pain and the February 2018 cervical spine VA examination. The reviewing examiner is asked to provide findings in terms of degree of additional range of motion loss, if possible. (b) Relevant to lumbar spine disability: The reviewing examiner should provide retrospective opinions on functional loss after repeated use over time and during flareups for the Veteran's lumbar spine disability at the time of the May 2015 VA lumbar spine examination. The reviewing examiner is asked to provide findings in terms of degree of additional range of motion loss, if possible. The examiner should also address the Veteran's lay statements, to include his report that he was unable to bend over to put on his shoes and needed help getting out of bed in the morning; as well as the Veteran's wife's May 2017 statement in which she indicated that the Veteran's back often gave out and locked up. (c) For both disabilities, the reviewing examiner should provide retrospective opinions on the range of motion of at the time of the May 2015 VA cervical and lumbar spine examinations, in (1) active motion, (2) passive motion, (3) weight-bearing, and (4) non-weight-bearing. As the opinions the reviewing examiner must provide are retrospective, the reviewing examiner will necessarily be unable to observe the Veteran during flareups or after repeated use over time. Nonetheless, the reviewing examiner should still estimate any additional functional impairment based on the evidence of record and the Veteran's lay descriptions of functional loss manifestations after repeated use over time and during flareups. The reviewing examiner should consider the lay descriptions in formulating the opinions. All opinions are to be accompanied by a rationale consistent with the evidence of record. If the examiner cannot provide an opinion without resorting to speculation, he or she must provide complete explanations stating why this is so. In so doing, the examiner must explain whether any inability to provide a more definitive opinion(s)is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board AK 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.