Citation Nr: 18153389 Decision Date: 11/27/18 Archive Date: 11/27/18 DOCKET NO. 08-02 297 DATE: November 27, 2018 REMANDED Entitlement to service connection for inguinal, umbilical, and ventral hernias (hernia condition), to include as secondary to service-connected intervertebral disc syndrome (IVDS), is remanded. Entitlement to an initial rating in excess of 10 percent for left knee osteoarthritis is remanded. Entitlement to an initial rating in excess of 10 percent for IVDS associated with pes planus is remanded. Entitlement to an initial rating in excess of 10 percent for right knee patellofemoral syndrome is remanded. Entitlement to a rating in excess of 30 percent for bilateral pes planus is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from February 1969 to September 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). A June 2006 rating decision denied a rating in excess of 30 percent for the Veteran’s bilateral pes planus, granted service connection for IVDS and assigned an initial 10 percent rating therefor, and granted service connection for bilateral knee disabilities, assigning initial noncompensable evaluations for each knee. A February 2009 rating decision denied service connection for a hernia condition. The appeal previously was remanded by the Board in December 2013. The appeal previously included claims of service connection for an acquired psychiatric disability and a gastrointestinal disorder. The RO granted such claims in a September 2018 rating decision. As this award represented a full grant of the benefits sought on appeal, the claims are no longer before the Board. In the September 2018 rating decision, the RO also awarded an increased 10 percent evaluation for each of the Veteran’s knee disabilities, effective September 21, 2005, the date of his claim for service connection. As this evaluation was less than the maximum benefit allowed under VA law and regulations, the claims for increased ratings for the Veteran’s knee disabilities remain on appeal. AB v. Brown, 6 Vet. App. 35 (1993). 1. Entitlement to service connection for a hernia condition, to include as secondary to service-connected IVDS, is remanded. While the Board regrets further delay, a remand is necessary to obtain a new VA medical opinion. The Veteran seeks service connection for a hernia condition secondary to his service-connected IVDS. The Board previously remanded this claim in December 2013 for additional development, to include obtaining a VA medical opinion addressing whether the Veteran’s hernias were secondary to his IVDS. Upon review, the Board finds the July 2018 VA medical opinion obtained is inadequate. The examiner opined the Veteran’s ventral hernia was less likely than not proximately due to or a result of the service-connected IVDS. The examiner noted the Veteran’s history of ventral hernia but found it was not supported with the etiology of IVDS. The examiner also opined a ventral hernia “would not be worsened by IVDS”. The examiner rationale for both opinions was that a ventral hernia is a bulge of tissue through an opening of weakness within the abdominal wall muscles. First, the Board notes the VA examiner did not address the Veteran’s history of an umbilical hernia repair but focused solely on the ventral hernia. Second, the Board finds the July 2018 VA examiner’s rationales amount to conclusory statements that do not allow for a fully informed decision. Stefl v. Nicholson, 21, Vet. App. 120, 124 (2007). Although the VA examiner provided a definition for a ventral hernia, the VA examiner did not explain how such definition provided an explanation for the negative opinions. As such, remand is required for an additional addendum opinion. 2. Entitlement to an initial rating in excess of 10 percent for left knee osteoarthritis is remanded. 3. Entitlement to an initial rating in excess of 10 percent for IVDS associated with pes planus is remanded. 4. Entitlement to an initial rating in excess of 10 percent for right knee patellofemoral syndrome is remanded. 5. Entitlement to a rating in excess of 30 percent for bilateral pes planus is remanded. The December 2013 Remand instructed the RO to obtain the Veteran’s medical records and disability determinations from the U.S. Postal Service and the U.S. Office of Personnel Management (OPM). Upon review, the Board finds the RO did not complete the development. After requesting records from OPM in June and September 2016, the RO sent a letter to the Veteran in December 2016 stating the records could not be located and, therefore, were unavailable for review. In February 2017, OPM responded and confirmed the Veteran was in receipt of retirement benefits. However, the response simply indicated the agency was not a treatment facility; the letter did not state whether any pertinent records relating to the Veteran’s retirement benefits were available. In this respect, the record does not show the RO contacted OPM thereafter to determine the existence of any such records or further notified the Veteran of the response. Given the foregoing, remand is required to attempt to obtain any medical records and/or disability determinations in possession of OPM. Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following actions: 1. Obtain all outstanding VA treatment records dated from July 2018 to the present. 2. Obtain from OPM all pertinent records relating to the Veteran’s claim for disability/retirement benefits, clearly instructing OPM that the request is for records intertwined with the claim and not records documenting treatment through OPM. All reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the file. The Veteran must be notified of the attempts made and why further attempts would be futile and allowed the opportunity to submit such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 3. Obtain an addendum medical opinion concerning the nature and etiology of any current hernia condition. If possible, the opinion should be authored by the same examiner who conducted the July 2018 VA examination. The examiner must review the entire claims file, to include a copy of this REMAND, in conjunction with authoring the opinion. The examiner is asked to answer the following: Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s hernia condition was proximately caused or aggravated by his service-connected IVDS? The examiner should be aware that this question requires two separate opinions: one for proximate causation and a second for aggravation. The term “aggravation” means a permanent worsening of a disability beyond its natural progression. If aggravation is found, then, to the extent possible, the examiner should attempt to establish a baseline severity of the hernia condition prior to aggravation by the service-connected IVDS. A complete rationale must be provided for all opinions expressed. The rationale should consider the pertinent evidence of record, to include the Veteran’s lay statements. M. M. CELLI Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Mortimer, Associate Counsel