Citation Nr: 18157797
Decision Date: 12/13/18	Archive Date: 12/13/18

DOCKET NO. 07-20 969A
DATE:	December 13, 2018
REMANDED
Entitlement to service connection for the cause of the Veteran’s death is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Navy from June 1960 to June 1963.  He died in June 2006.  The appellant is his surviving spouse.
This matter initially came before the Board of Veterans’ Appeals (Board) on appeal from a May 2007 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).
In August 2009, the appellant before a Veterans Law Judge no longer employed at the Board. She declined the option of having an additional hearing.  See March 2016 submission.
Following remand of the appeal in October 2009, the Board denied the claim in a September 2011 decision.  The appellant appealed the Board decision to the United States Court of Appeals for Veterans Claims (Court).  In a February 2012 Order, pursuant to a Joint Motion for Remand (JMR), the Court vacated and remanded the Board’s decision.
Following February 2013 and June 2016 remands, the Board again denied the claim in a February 2017 decision.  The appellant also appealed that decision to the Court. 
In a September 2017 Order, pursuant to a JMR filed by the parties, the Court vacated and remanded the Board’s decision.  The Board remanded the appeal in February 2018.  
1. Entitlement to service connection for the cause of the Veteran's death is remanded.
The parties to the JMR determined that the Board erred on relying on a portion of a September 2016 VA opinion addressing the relationship between the Veteran’s causes of death and his weight gain during service.  The Board remanded for an addendum opinion addressing this question, including consideration of a favorable November 2017 opinion from Dr. T.K.G.  However, the resultant October 2018 addendum opinion does not adequately address this question.  Specifically, the examiner generically states it is “less likely as not that the causes of death could be attributed to in-service symptoms and findings,” and the examiner’s only mention of weight gain is in relation to a discussion of the absence of pre-diabetes or diabetes in service, and the fact that weight gain, itself, is not subject to service connection. Given this deficiency, there has not been substantial compliance with the Board’s prior remand directives, and another addendum opinion must be secured on remand.  See Stegall v. West, 11 Vet. App. 268 (1998)  
The matter is REMANDED for the following action:
Return the claims file to the October 2018 VA examiner for preparation of another addendum opinion.
After reviewing the claims file, the examiner is asked to opine as to whether it is at least as likely as not (50 percent or greater probability) that any of the Veteran’s causes of death (to include contributory cases) are related to his in-service weight gain.  In addressing this question, please consider Dr. T.K.G.’s November 2017 opinion.
A complete rationale should be given for all opinions and conclusions expressed.  If the examiner cannot provide an opinion without resorting to speculation, it is essential that the examiner explain why an opinion cannot be provided (e.g., the limits of the examiner’s knowledge, the limits of medical knowledge in general; or if there is additional evidence that would allow for an opinion on this matter).
 
S. BUSH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Victoria L. Stephens, Associate Counsel