Citation Nr: 18155653
Decision Date: 12/04/18	Archive Date: 12/04/18

DOCKET NO. 16-52 748
DATE:	December 4, 2018
REMANDED
Entitlement to service connection for residuals of a stroke, to include as secondary to service-connected diabetes mellitus, type II (DM), is remanded.
REASONS FOR REMAND
The Veteran had active military service from July 1967 to February 1969.          
This case comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri.  
Although additional issues were addressed in the underlying rating decision, notice of disagreement, and statement of the case, the Veteran expressly indicated in an October 2016 substantive appeal that he wished to limit his appeal to entitlement to service connection for a stroke.  As such, the Board will confine its consideration to that issue.    
The Board finds that additional development is required before the claim on appeal may be decided.  
In December 2015, the Veteran was afforded a VA examination.  The examiner opined that the Veteran’s stroke was less likely than not proximately due to or the result of his service-connected DM.    
The Board finds the December 2015 VA opinion is incomplete.  In this regard, the examiner did not address whether the Veteran’s stroke was aggravated by his service-connected DM.  Therefore, the Board finds that an addendum opinion must be obtained to determine the nature and etiology of residuals from the Veteran’s stroke.  
The matter is REMANDED for the following action:
1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file.  
2. Then, return the claims file to the VA Medical Center to obtain an addendum opinion from the December 2015 VA examiner.  The claims file must be made available to, and reviewed by the examiner.  Any indicated studies should be performed.  
The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that the Veteran’s stroke was caused or chronically worsened by service-connected diabetes mellitus, type II.        
The rationale for all opinions expressed must be provided.
If the December 2015 VA examiner is not available, the claims file should be forwarded to another examiner with appropriate expertise to provide the requested medical opinion.  Another examination of the Veteran should only be conducted if determined to be necessary by the examiner providing the requested medical opinion.  
3. Confirm that all medical opinions provided comport with this remand and undertake any other development determined to be warranted.  
4. Then, readjudicate the issue on appeal.  If the decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response.  Then, return the case to the Board.  
 
Kristin Haddock
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. O’Donnell, Associate Counsel