Citation Nr: 18147268
Decision Date: 11/02/18	Archive Date: 11/02/18

DOCKET NO. 12-32 960
DATE:	November 2, 2018
REMANDED
Entitlement to service connection for Lyme disease is remanded.
REASONS FOR REMAND
The claim was remanded by the Board in April 2018 for additional development to include a VA examination. The Veteran underwent an additional VA examination in August 2018. The examiner noted a history of treatment for Lyme disease by a homeopathic doctor. However, in the August 2018 opinion, the examiner stated the Veteran does not have a diagnosis of Lyme disease as there is no evidence in the claims file or history from the Veteran that he had Lyme disease or symptoms of Lyme disease. As the opinion and VA examination are clearly contradictory, the Board finds an additional VA opinion is necessary. 
The matter is REMANDED for the following action:
Return the claims file to the August 2018 VA examiner, or, if necessary, an appropriate examiner, for an addendum opinion which addresses the following:
(a.) Since the initiation of the Veteran’s claim in February 2013 to present, does the Veteran have Lyme disease?  Why do you say so?  What is the diagnostic criteria for a diagnosis?  The examiner must consider records from December 2012 suggest that the Veteran may have received homeopathic treatment for Lyme disease, though he denied taking any medications to treat his condition during an October 2017 VA examination.
(b.) If Lyme disease is present, is it at least as likely as not (50 percent or greater probability) that the condition is etiologically related to service? The examiner should note that the Veteran’s complete service treatment records are not available, but he has provided testimony that he was bitten by a tick sometime between October 1979 and December 1980. A June 1982 separation examination was normal. During that separation examination, the Veteran reported a history of headaches, but denied history of any fever, joint pain, cramps, or skin diseases. 
(Continued on the next page)
 
The examiner must provide a complete explanation for any opinions rendered.  If an opinion cannot be provided without resorting to speculation, he/she must state whether there is inadequate factual information, whether the question falls beyond the examiner’s knowledge, whether the question falls beyond the scope of the medical community, or another reason.
 
Matthew Tenner
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Diane M. Donahue Boushehri, Counsel