Citation Nr: 18156521 Decision Date: 12/10/18 Archive Date: 12/10/18 DOCKET NO. 16-36 615 DATE: December 10, 2018 REMANDED Service connection for chronic kidney disease secondary to service-connected type II diabetes mellitus is remanded. REASONS FOR REMAND The Veteran served honorably in the U.S. Army from May 1967 to May 1969. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a March 2015 decision of the Department of Veterans Affairs (VA) Regional Office in Nashville, Tennessee. 1. Service connection for chronic kidney disease is remanded. Once the VA provides an examination when developing a claim for service connection, it must provide an adequate one. See Woehlart v. Nicholson, 21 Vet. App. 456, 464 (2007). For the Board to accept a medical opinion as legally adequate to decide a claim, the medical opinion must be supported by a detailed explanation (rationale). See Stefl v. Nicholson, 21 Vet. App. 120 (2007). The Veteran’s 2015 VA examiner concluded that the chronic kidney disease is less likely than not (less than 50% probability) proximately due to or the result of type II diabetes mellitus. See 2015 VA medical opinion. The medical examination states that his chronic kidney disease is more likely due to his hypertension. Id. Also, the examination notes that there is no evidence of damage to his kidneys that is related to type II diabetes mellitus. Id. It is not sufficient to state that a condition is likely caused by another without further explanation. See Stefl, 21 Vet. App. 120, 124-25 (2007) (explaining that an adequate medical opinion must provide "such sufficient information that it does not require the Board to exercise independent medical judgment"). Additionally, the presence of a condition (hypertension) does not categorically rule out that another (type II diabetes mellitus) may have caused or aggravated the claimed condition (chronic kidney disease). Therefore, the matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records. 2. Schedule the Veteran for a VA examination to evaluate the nature and cause of the chronic kidney disease. The entire claims file, to include a complete copy of this REMAND, must be made available to the examiner and the examination reports should include discussion of the Veteran’s documented medical history and assertions relating to any symptoms of this condition. The examiner is asked to opine regarding the following: The 2015 VA medical examination stated that there is no evidence of damage to his kidneys that is related to type II diabetes mellitus. The examiner must agree or disagree with this opinion and provide sufficient rationale to support the conclusion. The examiner should note that although hypertension may be relevant to the chronic kidney disease, the examiner MUST consider whether the chronic kidney disease may ALSO be related to the diabetes. The examiner is asked to respond to the following: a) Is it at least as likely as not (a 50 percent probability or greater) that the diagnosed chronic kidney disease is related or attributable to his military service? b) Is it at least as likely as not (a 50 percent probability or greater) that the chronic kidney disease is causally related to his service-connected diabetes? c) Is it at least as likely as not (a 50 percent probability or greater) that the chronic kidney disease was aggravated beyond its normal course (i.e., any increase in severity beyond natural progression of the disability) by his service-connected diabetes? A full rationale must be provided for all opinions given. If the examiner is unable to provide an opinion, he or she must explain why this is so. VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Bryant, Law Clerk