Entitlement to service connection for lumbar spine degenerative arthritis is granted.

Citation Nr: A26069921 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 220425-239775 DATE: July 30, 2026 ORDER Entitlement to service connection for lumbar spine degenerative arthritis is granted. Entitlement to service connection for left lower extremity radiculopathy, as secondary to the now service-connected lumbar spine degenerative arthritis, on a causation basis, is granted. Entitlement to service connection for right lower extremity radiculopathy, as secondary to the now service-connected lumbar spine degenerative arthritis, on a causation basis, is granted. Entitlement to service connection for hemorrhoids is granted. REMANDED Entitlement to service connection for a right foot condition is remanded. FINDINGS OF FACT 1. The Veteran's lumbar spine degenerative arthritis is etiologically related to his active-duty service. 2. The Veteran's bilateral lower extremity radiculopathy is caused by the Veteran's now service-connected lumbar spine degenerative arthritis. 3. Resolving reasonable doubt in favor of the Veteran, his hemorrhoids are etiologically related to his active-duty service. CONCLUSIONS OF LAW 1. The criteria for service connection for lumbar spine degenerative arthritis have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for left lower extremity radiculopathy, as secondary to the now service-connected lumbar spine degenerative arthritis, on a causation basis, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 3. The criteria for service connection for right lower extremity radiculopathy, as secondary to the now service-connected lumbar spine degenerative arthritis, on a causation basis, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 4. The criteria for service connection for hemorrhoids have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Marine Corps from April 1991 to April 1995 and in the United States Army from November 2000 to July 2001 and from June 2002 to December 2016. These matters come before the Board of Veterans' Appeals (Board) on appeal from a February 2022 rating decision issued by a Department of Veterans Affairs (VA) regional office, the agency of original jurisdiction (AOJ). In the April 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. In September 2025, the Veteran testified before the undersigned Veterans Law Judge at a virtual hearing. A transcript of the hearing has been associated with the claims file. Under the Hearing docket, the Board may only consider the evidence of record at the time of the February 2022 AOJ decision on appeal, as well as any evidence submitted by the Veteran at the September 2025 hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the rating decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. However, because the Board is remanding the claim for service connection for a right foot condition, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim on remand. 38 C.F.R. § 3.103(c)(2)(ii). If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Service Connection Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires: (1) the existence of a present disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases, such as arthritis and radiculopathy (an organic disease of the nervous system), become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a). For those listed chronic disabilities, a showing of continuity of symptoms affords an alternative route to service connection when the requirements for application of the presumption are not met. 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir 2013). Establishing service connection on a secondary basis requires competent and credible evidence demonstrating (1) the existence of a current disability; (2) a service-connected disability; and (3) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. See 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). The Board must consider all the evidence of record and make appropriate determinations of competence, credibility, and weight. Wood v. Derwinski, 1 Vet. App. 190 (1991); Washington v. Nicholson, 19 Vet. App. 362 (2005). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (2021). 1. Entitlement to service connection for lumbar spine degenerative arthritis is granted. The Veteran contends that his lumbar spine degenerative arthritis is related to the performance of his various military duties over the years. See VA Form 21-526EZ, December 1, 2021; see also Hearing Transcript, pgs. 4-8, September 2025. The Board finds that service connection is warranted for the reasons set forth below. The Veteran is currently diagnosed with degenerative arthritis of the lumbar spine, as conceded by the AOJ in the February 2022 rating decision on appeal. The Board is bound by this favorable finding which is consistent with the medical evidence of record. 38 C.F.R. § 3.104(c). Thus, the first element of service connection, a current disability, has been met. An in-service treatment record dated September 16, 2013, reflects the Veteran's treatment for back spasms and a diagnosis of lumbar sprain. See STR, received February 23, 2017. This in-service incurrence of an injury satisfies the second element of service connection. The remaining determination for the Board is whether a nexus (i.e., link) exists between the Veteran's current lumbar spine degenerative arthritis and his service, including the in-service back injury. The Veteran testified to the following at his September 2025 board hearing: he served as a motor vehicle operator in the Marine Corps and constantly lifted heavy equipment on to trucks; he did a lot of road marching in the Marine Corps (from 15 to 50 miles) carrying 65-70 pound packs on his back; he served with First Surveillance Reconnaissance Intelligence Group and did a lot of road marching and reconnaissance carrying heavy equipment; his back would hurt but he wouldn't complain because he was a Marine, he took pain reliever and just "drove on"; he wore heavy gear/body armor as a military policeman in the Army; he wore heavy gear (weighing between 55 and 65 pounds) anytime he went outside the wire in Afghanistan; his back pain became worse over time because of his physical activities; he served as a recruiter during his last few years and started to notice his back was hurting really badly when sitting at his desk or just standing; after he retired in 2016 he noticed shooting pain down his extremities and he would have to lay down for 15-20 minutes; his symptoms have persisted over the years; he has taken pain medication, underwent physical therapy, and consulted with doctors; his service-connected left foot and knee cause him to limp, worsening his back pain; and he did not have back conditions prior to his military service. See Hearing Transcript, pgs. 4-8, September 2025. The Veteran reported experiencing back problems throughout his military service during a November 2021 VA back conditions examination. The Veteran also reported that his back problems had progressed/worsened over time. The examiner did not provide an opinion regarding the etiology of the Veteran's diagnosed lumbar spine degenerative arthritis. See C&P Exam, November 2021. A January 2022 VA examiner provided a negative nexus opinion, concluding that the Veteran's lumbar spine degenerative arthritis was less likely than not caused by an in-service injury, event, or illness. As rationale, the examiner provided that the Veteran's E-folder was silent for any service treatment records or other medical records regarding back pain, back injury, or back trauma during the Veteran's active military service. As such, the examiner concluded that a nexus could not be established. See C&P Exam, Medical Opinion, January 10, 2022. The Veteran provided a private nexus opinion from Dr. C.M., D.O., during the 90-day evidentiary window following the September 2025 Board hearing. Dr. C.M. noted that the Veteran had been his patient for over two years and that he had reviewed his past medical history, military history, imaging reports, and office notes. Dr. C.M. stated that based on his review of all available information and discussions with the Veteran, it was his professional opinion that the Veteran's lumbar arthritis was most likely caused by his 20 plus years of military service. See Medical Treatment Record, Non-Government Facility, received December 29, 2025. Based on the foregoing lay and medical evidence of record, the Board finds that the third and final element of service connection, a nexus, has also been satisfied. The Veteran is competent to testify to a lack of back pain prior to service and continuity of symptoms after an in-service injury, as such are capable of lay observation. Layno v. Brown, 6 Vet. App. at 465; see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (a veteran is competent to testify regarding continuous pain since service, and lay evidence, when credible, is competent to establish the presence of continuous symptoms for a claimed disability during and since separation from military service); Buchanan v. Nicholson, 451 F.3d 1331, 1337 (holding lay evidence concerning continuity of symptoms after service, if credible, is ultimately competent, regardless of the lack of contemporaneous medical evidence). The Board finds the Veteran's testimony and other lay statements to be highly credible based on the length of the Veteran's military service and the nature of his physically demanding duties. Thus, the board assigns high probative weight to the Veteran's statements. The Board also finds Dr. C.M.'s nexus opinion to have probative value. Although somewhat conclusory, Dr. C.M. provided treatment to the Veteran for more than two years and was very well acquainted with his medical history and back condition. Based on all available information, Dr. C.M. concluded that the Veteran's lumbar arthritis was medically linked to his military service. The Board acknowledges the negative nexus opinion provided by the January 2022 VA examiner, but affords it no probative weight. First, the examiner relied solely on the absence of contemporaneous treatment records and provided no other reasoning or rationale in support of the nexus opinion. Dalton v. Nicholson, 21 Vet. App. 23, 39 (2007) (noting that an examiner cannot rely on the absence of medical records corroborating an injury to conclude that there is no relationship between the veteran's current disability and his military service); Buchanan v. Nicholson, 451 F. 3d 1331, 1336-37 (2006) (holding that the lack of contemporaneous medical records does not, in and of itself, render lay evidence not credible). Next, the examiner did not address the Veteran's lay statements with regard to an in-service onset of back problems. An opinion without consideration of a claimant's competent lay statements is inadequate. See Miller v. Wilkie, 32 Vet. App. 249 (2020). Finally, the examiner failed to note the September 2013 treatment record showing that the Veteran had been treated for in-service back complaints resulting in a diagnosis of lumbar sprain. This oversight is significant as it undermines the basis of the examiner's opinion. See Reonal v. Brown, 5 Vet. App. 4458, 460-61 (1993) (A medical opinion based on an inaccurate factual premise has no probative value). Hence, the Board assigns no probative weight to the examiner's nexus opinion. A remand for a new VA medical opinion could be accomplished. However, the Board will not remand for potentially negative evidence. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003); Andrews v. McDonough, 34 Vet. App. 216, 225 (2021) ("Remand is inappropriate where the predominant purpose is not to allow the Board to make a fully informed decision unencumbered by error but to allow VA to obtain more evidence so that it can properly deny the claim"). Additionally, a remand for a VA medical opinion is not necessary because the evidence of record is sufficient to grant the Veteran's claim. In sum, all three elements of service connection have been met for the Veteran's lumbar spine degenerative arthritis. Accordingly, the claim is granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 2. Entitlement to service connection for left lower extremity radiculopathy, as secondary to the now service-connected lumbar spine degenerative arthritis, is granted. 3. Entitlement to service connection for right lower extremity radiculopathy, as secondary to the now service-connected lumbar spine degenerative arthritis, is granted. The Veteran contends that his bilateral lower extremity radiculopathy is related to his service and his lumbar spine disability. See VA Form(s) 21-526EZ, September 2021; see also Hearing Transcript, September 2025. The Board finds that service connection on a secondary causation basis is warranted for the reasons set forth below. The Veteran is currently diagnosed with bilateral lower extremity radiculopathy, as conceded by the AOJ in the February 2022 rating decision on appeal. The Board is bound by this favorable finding which is consistent with the medical evidence of record. 38 C.F.R. § 3.104(c). Thus, the first element of secondary service connection, a current bilateral disability, is met. The Board's instant decision grants service connection for lumbar spine degenerative arthritis. As such, the second element of secondary service connection, a service-connected disability, is also met. The remaining determination for the Board is whether the Veteran's bilateral lower extremity radiculopathy was either (a) caused by or (b) aggravated by the service-connected back disability. A January 2022 VA examiner examined the Veteran and diagnosed bilateral lower extremity radiculopathy. The examiner stated that the radiculopathy was "lumbar radiculopathy" secondary to the degenerative arthritis of the Veteran's lumbar spine. See C&P Exam, January 10, 2022. The Veteran's physician, Dr. C.M., determined that the Veteran's bilateral lower extremity radiculopathy was most likely secondary to and caused by his lumbar arthritis and his 20 plus years of military service. See Medical Treatment Record, Non-Government Facility, received December 29, 2025. In the February 2022 rating decision, the AOJ stated that "The radiculopathy of the bilateral lower extremities is shown to be due to your degenerative arthritis of the lower spine." Although not specifically listed as a favorable finding in the rating decision, the Board views it as such. This finding is consistent with the other medical evidence of record. In light of the foregoing, the Board finds that the third and final element of secondary service connection has also been met. Accordingly, service connection for left and right lower extremity radiculopathy, as secondary to the now service-connected lumbar spine degenerative arthritis, on a causation basis, is granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 4. Entitlement to service connection for hemorrhoids is granted. The Veteran contends that his hemorrhoids onset during his military service, worsened during his deployment, and have continued since his service. See VA Form 21-526EZ, September 2021; see also Hearing Transcript, pgs. 11-13, September 2025. The Board finds that service connection is warranted for the reasons set forth below. The Veteran is currently diagnosed with hemorrhoids, as conceded by the AOJ in the February 2022 rating decision on appeal. The Board is bound by this favorable finding which is consistent with the medical evidence of record. 38 C.F.R.3.104(c). Thus, the first element of service connection, a current disability, has been met. Turning to the remaining elements, the Veteran testified to the following at his September 2025 Board hearing: his hemorrhoids onset around the time he was leaving the Marine Corps; he was a motor vehicle operator and drove many miles in vehicles dating back to Vietnam; the vehicles were "really bad" and didn't have air seats; he didn't understand what hemorrhoids were back then; his hemorrhoids continued ever since that time; his hemorrhoids worsened after his deployment to Afghanistan because he was going to the bathroom a lot due to bowel issues; he found out what hemorrhoids were when he underwent stomach tests and a colonoscopy due to his bowel issues; his hemorrhoids still continue today; and he didn't have hemorrhoids prior to his time in service. See Hearing Transcript, pgs. 11-13, September 2025. A January 2019 private treatment record indicates that the Veteran underwent testing and a colonoscopy after the Veteran reported having stomach issues since returning from Afghanistan. The treatment record reflects a finding of mild internal hemorrhoids. See Medical Treatment Record, Non-Government Facility, January 25, 2019. The Veteran underwent a VA examination in September 2021. The Veteran reported that his condition onset during his time on active duty, but he could not recall the exact year. The examiner noted a diagnosis of internal or external hemorrhoids, the Veteran's past and current symptoms included rectal pain and bleeding, and treatment included the use of Preparation H. The examiner provided a negative nexus opinion, concluding that the Veteran's hemorrhoids were less likely than not caused by an in-service injury, event, or illness. As rationale, the examiner provided that there were no indications of hemorrhoids, rectal pain, or bleeding in the Veteran's service treatment records or health assessments. Additionally, service and post-service treatment records did not show complaints or ongoing treatment for symptoms related to hemorrhoids and there was no evidence of chronicity of care. Thus, based on the available records, a nexus could not be established. See C&P Exam, Medical Opinion, September 24, 2021. Upon review, the Board finds the examiner's nexus opinion inadequate for adjudication purposes. The examiner improperly relied solely upon an absence of documented treatment in the Veteran's service treatment records and a lack of medical records demonstrating a continuity of care. As previously discussed, relying solely on the absence of evidence in medical records without regard for lay statements is contrary to established case law. See Dalton v. Nicholson, 21 Vet. App. 23 (2007); Buchanan v. Nicholson, 451 F. 3d 1331, 1336-37 (2006); Miller v. Wilkie, 32 Vet. App. 249 (2020). Additionally, the non-documentation of chronicity of care and/or treatment is an insufficient rationale to support a negative opinion. Rather the question for consideration is whether the Veteran exhibited continuity of symptoms. See Savage v. Gober, 10 Vet. App. 488, 496 (1997) (symptoms, not treatment, are the essence of any evidence of continuity of symptomatology). Accordingly, the Board affords no probative weight to the examiner's opinion. The Veteran reported that his hemorrhoids onset during his active service, worsened after his deployment to Afghanistan, and continued thereafter. As a layperson, the Veteran is competent to report his observable symptoms, including symptoms of hemorrhoids such as rectal pain and bleeding. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Moreover, the Veteran's statements are credible and entitled to probative weight, as they are internally consistent and consistent with the overall evidence of record. See Caluza v. Brown, 7 Vet. App. at 711, aff'd, 78 F.3d 604 (Fed. Cir. 1996). The Veteran's credible reports establish a nexus by connecting his observable in-service symptoms to his post-service hemorrhoid diagnosis. Any reasonable doubt in this matter will be resolved in the Veteran's favor. Therefore, the Board finds that all elements of the Veteran's service-connection claim have been met. To the extent that this grant of service connection is based primarily on lay evidence, "nothing in the regulatory or statutory provisions [relating to evidence to be considered] require both medical and competent lay evidence; rather, they make clear that competent lay evidence can be sufficient in and of itself." Buchanan at 1335. In sum, the Board finds that all elements of service connection have been met for the Veteran's hemorrhoids. Accordingly, the claim is granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). REASONS FOR REMAND 1. Entitlement to service connection for a right foot condition is remanded. The Veteran contends that he has a right foot condition due to his military service and/or a service-connected disability. See VA Form 21-526EZ, December 1, 2021; see also Hearing Transcript, September 2025. As discussed below, the Board finds there is a pre-decisional error related to this claim as the AOJ did not provide the Veteran with an examination prior to issuing the February 2022 rating decision. Under the Appeals Modernization Act (AMA), remands are limited to correction of (1) duty to assist errors occurring prior to the date of the AOJ decision on appeal and (2) AOJ errors in satisfying a regulatory or statutory duty if correction of such error would have a reasonable possibility of aiding in substantiating the appellant's claim. 38 C.F.R. § 20.802(a). VA has a duty to assist claimants in obtaining evidence to support their claim, including providing medical examinations. 38 C.F.R. § 3.159. An examination is required when there is (1) competent evidence of a current disability or persistent or recurring symptoms of a disability; and (2) evidence establishing that an event, injury, or disease occurred in service; and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the claimant's service; but (4) there is insufficient medical evidence on file to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79, 86 (2006); 38 C.F.R. § 3.159(c)(4). As to the first McLendon prong, the AOJ determined that the evidence did not show a current diagnosed disability. See Rating Decision - Narrative, pg. 5, February 7, 2022. However, the Veteran underwent a VA foot conditions examination in January 2019 in conjunction with his claim for a left foot condition. While the examiner was focused on evaluating the Veteran's left foot condition, the examiner did note a diagnosis of bilateral hallux valgus. The examiner further noted that the Veteran had mild or moderate symptoms due to hallux valgus affecting both feet. See C&P Exam, Foot Conditions DBQ, received January 15, 2019. Therefore, the Board finds that the first McLendon prong has been met. As to the second McLendon prong of an in-service event, injury, or disease, the AOJ made a favorable finding that the evidence shows that a qualifying event, injury, or disease had its onset during the Veteran's service; specifically, service treatment records show cellulitis of the feet in May 1991. See Rating Decision - Narrative, pg. 6, February 7, 2022. Additionally, a May 2012 post-deployment health assessment reflects that the Veteran reported swollen, stiff, or painful joints. See STR, received February 23, 2017. Therefore, the Board finds that the second McLendon prong has been met. The third McLendon prong, which requires the evidence of record "indicate" the claimed disability or symptoms "may be" associated with the established event, disease, or injury, is a low threshold. McLendon, 20 Vet. App. at 83. The Board finds this low threshold is met given the evidence, the length of the Veteran's active service, and the nature of his duties. As for the fourth prong of McLendon, there is no medical evidence in the claims file which addresses the etiology of the Veteran's claimed right foot condition. It is plausible that the Veteran's right foot condition is related to his active service, but the Board cannot make this determination without the necessary medical information. Therefore, there is insufficient medical evidence of record for the Board to decide the claim. The Board finds that the McLendon prongs were met prior to the decision on appeal. Thus, remand is warranted given that the AOJ should have provided a VA examination as part of the duty to assist prior to denial of the Veteran's claim. 38 C.F.R. § 20.802(a). As a final matter, the Board notes that the Veteran's representative raised service connection on a secondary basis at the September 2025 Board hearing (i.e., that the Veteran's right foot condition is related to compensation due to his service-connected left foot condition). See Hearing Transcript, pg. 4, September 2025. The Veteran also testified that his right foot pain and tingling may be related to his back and lower extremity radicular condition. Id. at pgs. 9-11. The contention of secondary service connection was not part of the record before the AOJ at the time of the February 2022 rating decision. Thus, the AOJ did not commit a pre-decisional duty to assist error in failing to obtain a medical opinion or otherwise address whether the Veteran's right foot condition was secondary to a service-connected disability. A remand on that basis is therefore not warranted. However, as the claim is being remanded for another reason, the AOJ will have an opportunity to consider that theory when readjudicating the Veteran's claim. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination with an appropriate clinician to determine the nature and etiology his claimed right foot condition. The claims file, including a copy of this remand must be made available and reviewed by the examiner. After a review of the claims file and examination of the Veteran, the examiner is asked to address the following: (a.) Identify or diagnose any right foot condition that presently exists or that has existed during the pendency of the claim. In this regard, the examiner's attention is drawn to the January 2019 VA foot conditions examination in which the examiner noted a diagnosis of bilateral hallux valgus. If the examiner finds there to be no pathology to attribute the Veteran's symptomatology, to include pain, the examiner should address the functional effects or limitations of the Veteran's right foot condition, to include whether pain results in functional impairment of earning capacity. (b). For any diagnosed right foot condition or symptoms of a right foot condition causing functional impairment of earning capacity, is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that such had its onset in, or is otherwise related to, the Veteran's active service? The examiner may not rely on the absence of a medical record or evidence of medical treatment as the sole rationale for any negative medical nexus opinion. If the examiner finds the lack of documented treatment in service or post-service to be of medical significance given the relative severity, common symptomatology, and usual treatment of the claimed conditions, the examiner should explain such a finding in the opinion. The examiner is reminded that the Veteran is competent to offer lay statements. If any lay statements are discounted, including statements describing continuous experience of symptoms since service, the examiner must provide a rationale for doing so (e.g., whether there is any medical reason to accept or reject the Veteran's contentions). Any opinion expressed by the examiner must be accompanied by a fully articulated medical rationale. If the examiner is unable to offer an opinion without resort to speculation, a thorough explanation as to why an opinion cannot be rendered should be provided. B. D. WATSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. S. Rubin, Counsel 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.