Citation Nr: 18123946
Decision Date: 08/06/18	Archive Date: 08/03/18

DOCKET NO. 15-20 719
DATE:	August 6, 2018
REMANDED
1. Entitlement to service connection for a lower back disorder.
2. Entitlement to service connection for a right knee condition disorder, as secondary to a lower back disorder.
3. Entitlement to service connection for a right hip condition, as secondary to a lower back disorder.
4. Entitlement to service connection for radiculopathy of the right lower extremity as secondary to a lower back disorder.
5. Entitlement to service connection for radiculopathy of the left lower extremity as secondary to a lower back disorder.
REASONS FOR REMAND
These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions dated in May 2013 and January 2014 by the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts.  
The Veteran contends that his current back disability began during service as a result of carrying heavy packs and training.
Included in the evidence of record are opinions for and against the Veteran’s claim.  However, upon review, the Board finds that none of the opinions of record are adequate, as they do not address a full account of the Veteran’s medical records, history, and lay evidence.  
The Veteran was provided with a VA examination in January 2013.  This examiner related the Veteran’s back disability to service, based on service treatment records reflecting treatment for back pain, and the Veteran’s statements that his back pain began during service; however, he did not address the Veteran’s exit examination or post-service work-related back injury in 2008.  This VA examiner issued an addendum to the opinion in May 2013, rescinding the opinion based on the Veteran’s negative exit examination and his intercurrent back injury.  Unfortunately, this examiner did not fully address the Veteran’s statements that he had suffered back pain since service, and that it was present prior to the work-related 2008 back injury.  The Veteran had provided statements of his own at the examination and has also submitted additional statements from friends and family reflecting their observations that the Veteran complained of back pain when he returned from service—prior to the work-related injury.
The Veteran submitted a positive opinion dated in June 2016.  This examiner did not address the Veteran’s post-service work-related injury.
As such, these examinations are not adequate.  On remand, the Veteran should be provided with another VA examination to determine whether his current back disorder is related to service.  The examiner must address the Veteran’s complete history, including lay statements showing that he had back pain since service.  
The remaining issues are all secondary to the Veteran’s claim for entitlement to service connection for a back disorder.  Consequently, these issues are inextricably intertwined with his claim for service connection for a lumbar spine condition. Therefore, consideration of these issues must be deferred pending resolution of the claim for service connection for a low back disorder.  Harris v. Derwinski, 1 Vet. App. 180 (1991).
The matters are REMANDED for the following action:
Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any low back disability.  The examiner must opine (1) whether it is at least as likely as not related to an in-service injury, event, or disease, including carrying heavy packs and training in service, (2) in the case of arthritis, whether it manifested within one year after discharge from service, or (3) whether it was noted during service with continuity of the same symptomatology since service.
The examiner must address the statements made by the Veteran, his friends, and his family that he had back pain since service, prior to his work-related injury in 2008. 
(Continued on the next page)
 
The examiner must provide a rationale for each opinion given.  If the examiner is unable to provide an opinion without resort to speculation, he or she should explain why this is so and what if any additional evidence would be necessary before an opinion could be rendered.
 
M. HYLAND
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Harrigan Smith

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