Citation Nr: 18139886 Decision Date: 10/01/18 Archive Date: 10/01/18 DOCKET NO. 13-18 495A DATE: October 1, 2018 REMANDED Service connection for heloma molle, fifth digit, right foot, to include as secondary to service-connected disease or injury is remanded. Service connection for hypertension, to include as secondary to service-connected disease or injury is remanded. Entitlement to a temporary total rating for convalescence due surgery for a service-connected condition requiring convalescence (Paragraph 30) is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1968 to May 1970, to include in Vietnam from April 1969 to May 1970, where he served as a field wireman. His appeal of these three issues was denied in a June 2017 Board decision, which he in turn appealed to the United States Court of Appeals for Veterans Claims (Court). In a March 2018 Order, the Court granted a Joint Motion for Remand (JMR), which served to both vacate the Board's June 2017 decision and remand the case back to the Board for action in compliance with the Joint Motion for Remand This case must be remanded to the Agency of Original Jurisdiction (AOJ) to comply with the Court's Order and the directives of the underlying JMR. 1. Heloma molle, fifth digit, right foot is remanded. The Veteran should be provided a new examination that addresses the Veteran’s assertion that heloma molle fifth digit, right foot is related to an abnormal gait that developed as a result of service-connected peripheral neuropathy. While the Veteran’s peripheral neuropathy was noted to interfere with walking during his September 2009 VA examination, no medical opinion as to this theory has been obtained. Examination is required to determine whether his heloma molle was caused or aggravated by his service-connected peripheral neuropathy. 2. Hypertension is remanded. The Veteran should be provided a new examination that addresses whether the Veteran’s hypertension is aggravated by his service-connected diabetes or could be directly caused by his exposure to Agent Orange in Vietnam. In this regard, a National Academy of Science report finds limited or suggestive evidence of a relationship between hypertension and herbicide exposure. See 75 Fed. Reg. 32540, 32549 (June 8, 2010); see also 38 C.F.R. §§ 3.307, 3.309. 3. Paragraph 30 is remanded. Resolution of this claim for a temporary rating for convalescence due to surgery for heloma molle is directly dependent on whether the VA grants his claim for service connection for heloma molle. Harris v. Derwinski, 1 Vet. App. 180,183 (1991). Therefore, the claims are inextricably intertwined and must be remanded together. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any heloma molle fifth digit, right foot. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease. The examiner must also opine whether any heloma molle fifth digit, right foot is at least as likely as not (1) proximately due to service-connected disability, specifically to include peripheral neuropathy, or (2) aggravated beyond its natural progression by service-connected disability, specifically to include peripheral neuropathy. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran’s hypertension. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including. The examiner should also opine whether it at least as likely as not (1) began during active service, (2) manifested within the initial year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. The examiner should also opine whether the Veteran’s hypertension is at least as likely as not related to in-service herbicide agent exposure. In so opining, the examiner should consider the aforementioned National Academy of Science report noting limited or suggestive evidence of a relationship between hypertension and herbicide exposure. The examiner should also opine whether it is at least as likely as not (1) proximately due to service-connected disability, specifically to include service-connected diabetes, or (2) aggravated beyond its natural progression by service-connected disability specifically to include service-connected diabetes. 3. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined issue of a temporary rating for convalescence due to surgery for heloma molle. If the benefits sought are not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Rippel, Counsel