Citation Nr: 18157716 Decision Date: 12/14/18 Archive Date: 12/13/18 DOCKET NO. 14-16 397 DATE: December 14, 2018 REMANDED Entitlement to service connection for left shoulder condition is remanded. Entitlement to service connection for left hip condition is remanded. Entitlement to service connection for right hip condition is remanded. Entitlement to service connection for left knee/patella condition is remanded. REASONS FOR REMAND The Veteran had active service from October 1950 to September 1954. He was awarded the National Defense Service Medal, Good Conduct Medal, and the Occupation Medal (Germany). This matter comes to the Board of Veterans Appeals (Board) on appeal from a May 2012 rating decision issued by a Regional Office (RO) of the United States Department of Veterans Affairs (VA). Unfortunately, the Veteran died on June [redacted], 2018. Pursuant to 38 U.S.C. § 5121A, the RO granted the Appellant’s request to be substituted in the Veteran’s appeal and informed her of the decision by a letter dated October 2018. Accordingly, the Appellant is substituted as the claimant for purposes of the service connection claims on appeal. In May 2017, the Veteran provided testimony before the undersigned Veterans Law Judge via videoconference. A transcript of the hearing has been associated with the electronic claims file. In August 2017, the Board remanded the issues on appeal for additional development. The Board finds that the RO did not substantially comply with the Board’s remand directives to the extent that the September 2017 VA examiner issued inadequate and incomplete findings. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding veterans are entitled to compliance with Board remand instructions); see also Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (noting that Stegall requires substantial compliance with remand orders, rather than absolute compliance). The VA examiner found that the Veteran’s bilateral hip, left shoulder, and left knee disabilities were less likely than not related to his service. This conclusion was based on the fact that the Veteran’s service treatment records, including exit examination, were silent for the claimed disabilities, and they were not observed in the time frame immediately after service discharge. No further explantation was provided. The Board finds that the VA examiner’s opinions are legally inadequate for two reasons, discussed below. First, the VA examiner’s sole reliance on the absence of medical evidence of treatment for the claimed disabilities during and after service is an inadequate rationale to support a negative nexus opinion. See Dalton v. Nicholson, 21 Vet. App. 23, 39-40 (2007). Second, the examiner failed to consider and discuss the Veteran’s lay contentions that his claimed orthopedic disabilities were caused by exposure to cold weather during his service, as specifically requested by the Board’s remand directives. While the Board sincerely regrets the additional delay, the claims must be remanded to obtain a legally adequate VA medical opinion to assist the Board in justly resolving the Appellant’s appeal. Barr v. Nicholson, 21 Vet. App. 303 (2007) (When VA undertakes to provide a VA examination or obtain a VA opinion it must ensure that the examination or opinion is adequate.). The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate VA examiner regarding whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral hip, left shoulder, and left knee disabilities began in or are otherwise etiologically related to his active duty service. The examiner is requested to address the Veteran’s lay contentions that his disabilities were (1) the result of stress/trauma impact caused by repeatedly jumping down from personnel trucks while in military service; and/or (2) the result of in-service cold weather exposure, which caused freezing of his synovial fluid, restricting lubrication, and resulting in joint irritation. The examiner is advised that the absence of evidence in the service treatment records cannot, standing alone, serve as the basis for a negative nexus opinion. The examiner must provide a complete rationale for any opinion expressed that is based on the examiner’s clinical experience, medical expertise, and established medical principles. If an opinion cannot be made without resort to speculation, the examiner must explain why this is so and note what, if any, additional evidence would permit an opinion to be made. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Galante, Associate Counsel