Citation Nr: 18118024 Decision Date: 07/12/18 Archive Date: 07/11/18 DOCKET NO. 09-37 216 DATE: July 12, 2018 REMANDED Entitlement to service connection for cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1952 to February 1955. He died in November 2007. The appellant is his surviving spouse. This appeal to the Board of Veterans’ Appeals (Board) is from a March 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In December 2010, the appellant-widow testified at a Board hearing before the undersigned Veterans Law Judge; a transcript of the hearing is of record. In May 2014, this claim was denied, but in August 2015 the U. S. Court of Appeals for Veterans Claims (Court) remanded it back to the Board. In June 2016, the Board in turn remanded this claim for additional development. This claim is once again before the Board, having since again been denied. Prior to the May 2014 Board decision, this case was advanced on the docket. See May 2014 correspondence. And this priority continues owing to the appellant-widow’s advanced age. 1. Entitlement to service connection for cause of death is remanded. In February 2017, following the Board’s prior remand of this claim, a VA compensation examiner opined that it was less likely than not that the Veteran’s service-connected disabilities other than posttraumatic stress disorder (PTSD) aggravated the conditions that contributed to his death. While the examiner acknowledged the appellant’s contentions that the Veteran was limited in his ability to exercise or ambulate, the examiner nevertheless concluded “there is no evidence present that supports this assertion.” See February 2017 VA medical opinion. Clearly, the examiner did not actually take into consideration the appellant’s statements. Additionally, the rationale provided by the examiner was merely a restatement of evidence in the claims file. See also April 2018 correspondence. As a result, remand for an addendum opinion is necessary. The February 2017 VA examiner indicated he was unable to opine on the effects of PTSD on the Veteran’s causes of death because PTSD is not his expertise, so the claims file was forwarded to another examiner for this additional comment. Although the April 2017 supplemental VA examination is inadequate because the examiner providing this additional comment again merely recited the evidence of record — instead of providing a rationale, see April 2017 VA medical opinion, remand for an addendum opinion is unnecessary because the question at issue in this case is not a psychological one, rather, whether the Veteran’s inability to exercise due to his service-connected disabilities aggravated his causes of death. The appellant is competent and credible to attest that the Veteran was limited in his ability to exercise, owing to his physical service-connected disabilities. As a result, for the limited purpose of obtaining this additional medical comment the Board will concede this — in turn meaning remanding to ask the April 2017 VA compensation examiner whether the Veteran’s PTSD (including especially its consequent symptoms) prevented him from exercising is unnecessary. The appellant’s counsel asserted that the February 2017 VA medical opinion was “obtained in the absence of all necessary information.” See id. It is unclear, however, what specific information the appellant’s counsel is referencing as necessary, but not considered. As a result, all outstanding supporting evidence from the appellant and her representative should be sought, if available. The claim is REMANDED for the following action: 1. Request all outstanding evidence, to include private treatment records from the appellant, referencing the April 2018 correspondence from her counsel. The appellant must assist by identifying all relevant records that should be obtained by VA. 2. After the above development has been completed, obtain an addendum opinion from the February 2017 VA examiner, if available, regarding the nature and cause of the Veteran’s death. If the February 2017 VA examiner is unavailable, the record should be forwarded to another examiner for review. The examiner must review the claims file (including this remand) and augment his opinion (or otherwise opine) as to the following: Is it at least as likely as not (50% or greater probability) that the Veteran’s causes of death (adult respiratory distress syndrome (ARDS), pneumonia, diabetes, and/or heart disease) were aggravated by his service-connected disabilities? Please explain why. The examiner must discuss and consider as evidence the appellant-widow’s statements that the Veteran was limited in his ability to exercise due to his service-connected disabilities. Once again, any effects (or lack thereof) of such inability to exercise, as described by the appellant, must be discussed. A simple restatement of facts will not be deemed a sufficient rationale and may result in the claims file being returned to the examiner. (Continued on the next page)   If the examiner cannot provide an opinion without resorting to mere speculation, he or she must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must explain whether the inability to provide a more definitive opinion is the result of a need for additional information (and what that information would be, but again, the appellant is considered competent to discuss the Veteran’s limited ability to exercise due to his physical service-connected disabilities), that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question, or any other reason for such inability to render an opinion. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Sandler, Associate Counsel