Citation Nr: 18154199
Decision Date: 11/30/18	Archive Date: 11/29/18

DOCKET NO. 16-51 682
DATE:	November 30, 2018
REMANDED
Entitlement to service connection for a low back disability is remanded.
REASONS FOR REMAND
The Veteran served on active duty from October 1983 to October 1987. 
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Newman, Georgia.  Jurisdiction is now with the RO in Detroit, Michigan.
1. Entitlement to service connection for a low back disability is remanded.
The Veteran was afforded a June 2015 VA examination and opinion.  Subsequently, the Veteran submitted a September 2016 private opinion from D. Mika, D.O..  In that opinion letter, it was noted that the Veteran sustained a traumatic back injury in the military in 1984 and in August 2014 the Veteran was involved in a motor vehicle accident (MVA) resulting in neck and back pain.  The Veteran was noted to have been seen multiple times for back pain prior to the accident.  Following the MVA, the back issues were heightened.  In his opinion, not all diagnoses pertaining to his back pain could have been caused by the MVA. In light of this opinion, and the indication that there are outstanding private medical records, the Board finds that a remand is warranted to obtain all outstanding private medical records and a supplemental VA opinion. 
The matter is REMANDED for the following action:
1. Obtain all outstanding VA and/or private treatment records for the Veteran’s low back disability.  Specifically request the Veteran to provide authorization to obtain private treatment records from Dr. David Mika, D.O., Mika and Mika Family Medicine, Brighton, Michigan.
2. After the above is completed, obtain a supplemental VA opinion.  Provide the claims file, including a copy of this REMAND, to the June 2015 VA examiner, if available for review.  If the June 2015 VA examiner is unavailable, or is unable to render the requested supplemental opinion without examining the Veteran, schedule the Veteran for a VA examination, by an examiner with the appropriate expertise to obtain the answers to the questions posed below.
After reviewing the claims file, the examiner should address whether it is at least as likely as not (50 percent probability or greater) that any diagnosed low back disability had its onset during active duty service, or was otherwise etiologically related to service.  The examiner should address the September 2016 opinion by Dr. David Mika. 
The examiner must consider the Veteran's statements regarding onset/in-service injury and statements regarding the continuity of symptomatology. Dalton v. Nicholson, 21 Vet. App. 23 (2007).  If the examiner chooses to reject the lay statements, a reason must be provided.
If it is determined that there is another likely etiology for any diagnosed low back disability, that should be stated
All opinions expressed must be accompanied by a complete rationale. 
 
LESLEY A. REIN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	E. Ko, Associate Counsel

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

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