Citation Nr: 18144240
Decision Date: 10/24/18	Archive Date: 10/24/18

DOCKET NO. 12-16 472
DATE:	October 24, 2018
REMANDED
Entitlement to service connection for myotonic myopathy is remanded.
REASONS FOR REMAND
The Veteran served on active duty from July 1973 to September 1993.  
Entitlement to service connection for myotonic myopathy is remanded.
The Board is required to enforce compliance with its prior remand orders.  See Stegall v. West, 11 Vet. App. 268 (1998).  In August 2018, the Board remanded this case with instructions to the Agency of Original Jurisdiction (AOJ) to make further efforts to obtain copies of potentially relevant medical records and to obtain a new medical opinion on the probability of a relationship between the claimed disability and the Veteran’s active duty service.  
In September 2018, slightly more than one month after the remand, the AOJ returned the case to the Board.  Yet the electronic claims file does not include any notes or records or other information suggesting that the AOJ made any efforts to comply with the Board’s remand orders.  It is unclear whether anyone attempted to obtain the missing records and the requested medical opinion has not been associated with the claims file.  Pursuant to Stegall, the Board must remand the case again.  
The matter is REMANDED for the following action:
1. The AOJ should make further efforts to obtain copies of records from the Veteran’s deceased primary care physician, records which are the subject of the report of contact form, dated April 2018, which apparently describes telephone conversations about these missing records.  Efforts to obtain the missing records should continue until copies of the records are obtained or until it is clear that further efforts to locate them would be futile.  Copies of all requests for records and copies of all responses to those requests should be associated with the electronic claims file.  
2. Arrange for the examiner who prepared the December 2016 medical opinion and May 2018 addendum opinion to review the claims file, including a copy of this REMAND, and prepare another addendum opinion concerning the probability that a relationship exists between the Veteran’s current myotonic myopathy and any separate service-connected disability.  If the examiner who prepared the December 2016 and May 2018 reports is unavailable for any reason, the AOJ should obtain the requested opinion from another qualified person.  If the examiner decides that he or she cannot provide the requested opinion without a new in-person examination, then a new in-person examination should be arranged.
3. After the completion of the records review and, if necessary, the examination, the examiner should indicate whether it is at least as likely as not (i.e., a probability of 50 percent or greater) that the Veteran’s myotonic myopathy was caused by, or has been permanently aggravated by, the Veteran’s service-connected disabilities, to include his degenerative disc and joint disease and left Bell’s Palsy.
4. The examiner should fully explain the medical reasons supporting his or her conclusion.  If it is the examiner’s opinion that it is unlikely that a separate service-connected disability aggravated the Veteran’s myotonic myopathy, THE EXAMINER SHOULD SPECIFICALLY ADDRESS THE JUNE 2011 LETTER FROM A VA PHYSICIAN WHICH INDICATES THAT, IN HIS OPINION, MUSCULAR DYSTROPHIC DISEASE WAS AGGRAVATED BY DEGENERATIVE DISC AND JOINT DISEASE.  If the examiner disagrees with this opinion, he or she should clearly explain why.  
A copy of the requested opinion must be associated with the Veteran’s electronic claims file.  
 
DAVID L. WIGHT
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Nye, Associate Counsel