Citation Nr: 18152202
Decision Date: 11/21/18	Archive Date: 11/21/18

DOCKET NO. 10-36 036
DATE:	November 21, 2018
REMANDED
Entitlement to service connection for a right hand disability, to include as secondary to herbicide exposure is remanded.
Entitlement to service connection for a right foot disability, to include as secondary to herbicide exposure is remanded.
Entitlement to service connection for a left foot disability, to include as secondary to herbicide exposure is remanded.
Entitlement to service connection for a skin disability, to include as secondary to herbicide exposure is remanded.
REASONS FOR REMAND
The Veteran served on active duty from September 1958 to September 1962 and from March 1967 to May 1972, including service in the Republic of Vietnam.
Entitlement to service connection for a right hand disability; a right foot disability; a left foot disability; and a skin disability, to include as secondary to herbicide exposure, are remanded.
Although the Board regrets further delay, remand is necessary to ensure compliance with previous remand directives and proper development. When there is not substantial compliance with Board remand requests, the Board errs as a matter of law when it does not ensure compliance. Stegall v. West, 11 Vet. App. 268 (1998).
In a September 2017 remand, the Board cited deficiencies in previous examination reports, including that the examiners did not address the Veteran’s reports of lay-observable hand, foot, and skins symptoms manifested during and after separation from service.  Further, the examiners did not discuss any skin condition that may be in remission.  A VA examination was conducted in October 2017.  However, the examiner did not discuss the lay testimony of the Veteran in the provided rationale, and instead relied on the absence of evidence of complaints, treatment, or diagnoses in service medical records and medical records following service.  The examiner also did not discuss the possibility of skin conditions of remission.  Finally, the examiner provided no explanation or rationale regarding claimed disabilities and exposure to herbicide agents.  Therefore, the Board must remand the claims to obtain opinions which address the requested evidence of record in compliance with the prior remand.
The matters are REMANDED for the following action:
1. Identify and obtain any outstanding VA and private treatment records that are not already associated with the claims file.
2. Schedule the Veteran for a VA examination with a medical doctor who has not previously examined him to determine the nature and etiology of any disability of the right hand, feet, and skin.  The examiner must record in detail the Veteran’s history of right hand, feet and skin symptoms and treatment, including when those symptoms initially manifested and whether and how frequently (whether intermittently or continuously) they continued to manifest.  The examiner should review the entire record, including post-service medical records dated since 2007, showing radiculopathy, possibly affecting both feet, and Raynaud’s disease affecting the right hand, and reports of VA examinations conducted in July 2015 and November 2016, showing multiple other hand, foot, and skin diagnoses.  Accepting as competent the Veteran’s reports of any lay-observable in-service hand, foot, and skin symptoms, the examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that any current right hand, foot, or skin disability, to include radiculopathy and Raynaud’s disease, is at least as likely as not related to the Veteran’s service, to include the reported symptoms.  The examiner should also opine as to whether it is at least as likely as not (50 percent probability or greater) any current right hand, foot or skin disability, to include radiculopathy and Raynaud’s disease, is at least as likely as not related to the presumed exposure to herbicide agents during service.  The examiner should provide a rationale with references for each opinion.  

 
LESLEY A. REIN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	H. Ahmad, Associate Counsel