Citation Nr: 20003665 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 11-02 301 DATE: January 16, 2020 REMANDED The issue of entitlement to service connection for a blood disability, claimed as anemia, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1966 to February 1969. This matter comes before the Board of Veterans’ Appeals (Board) from a January 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In April 2017, the Board remanded for additional development. In a December 2018 decision, the Board denied entitlement to service connection for a blood disability. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claim (Court). In August 2019, pursuant to a July 2019 Joint Motion for Remand (Joint Motion), the Court vacated the December 2018 Board decision and returned the matter to the Board for actions consistent with the Joint Motion. In May 2018, the Veteran attempted to opt into to the Appeals Modernization Act (AMA) review system by submitting a Rapid Appeals Modernization program (RAMP) election form. However, the Veteran’s claim for service connection for a blood disability was pending before the Board before the Veteran’s attempt to opt into the RAMP program. Thus, this matter is ineligible for RAMP consideration and will be considered under the legacy appeal process. 1. Entitlement to service connection for a blood disability The Veteran seeks service connection for anemia, asserting she was treated for anemia during service and that her anemia (iron deficiency) has persisted periodically since service. Also, the issue of whether the Veteran’s claimed anemia is secondary to her service-connected disabilities of hysterectomy with residual surgical scar or abdominal adhesions has been raised by the record. See April 2017 Board decision. In the July 2019 Joint Motion, the parties agreed that the Board erred by failing to provide an adequate statement of reasons or bases for its decision to deny the Veteran’s claimed anemia. More specifically, the parties stated the Board erred when it found the Veteran does not suffer from anemia, noting anemia was documented in the record, including in private treatment records dated July 3, 2010, August 10, 2010 and August 25, 2010; the Board’s April 2017 remand, and a December 2018 VA examination report. The Board further notes that, while VA opinions were obtained in May 2017 and December 2018, the opinions did not address the Veteran’s service treatment records, including those in April 1967 and August 1968, documenting the Veteran was taking iron pills, had requested a blood test and complained of weakness and weight loss. Accordingly, in order to address concerns raised in the July 2019 Joint Motion, the Board finds a remand is warranted to obtain a new VA opinion. Updated treatment records should also be requested. The matter is REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated her for anemia or iron deficiency. After securing any necessary releases, request any relevant records identified that are not associated with the claims file. In addition, obtain updated VA treatment records from May 2017. If any requested records are unavailable, the Veteran should be notified of such. 2. After records development is completed, send the claims file to a VA examiner to obtain an opinion regarding the claimed anemia. If an examination is deemed necessary to respond to the questions presented, one should be scheduled. Following review of the claims file, the examiner should respond to the following: (a.) Is it at least as likely as not (50 percent probability or greater) than the anemia or iron deficiency noted during the course of the claim (to include in 2010) is a continuation or maturation of the iron deficiency noted during service? The examiner should explain why or why not, to include addressing service treatment records in April 1967 and August 1968 documenting that the Veteran was taking iron pills, had requested a blood test and complained of weakness and weight loss. (b.) If not related to service, is it at least as likely as not that the Veteran’s anemia was caused by the service-connected hysterectomy with residual surgical scar for fibroid uterus (hysterectomy) or abdominal adhesions associated with the hysterectomy disability (abdominal adhesions)? Please explain why or why not. (c.) If not caused by the service-connected hysterectomy or abdominal adhesions, is it at least as likely as not that the Veteran’s anemia was worsened (aggravated) beyond natural progression by the service-connected hysterectomy or abdominal adhesions? Please explain why or why not. (d.) If the examiner finds that the anemia was worsened (aggravated) by the service-connected hysterectomy or abdominal adhesions, the examiner should attempt to quantify the level of aggravation beyond the baseline level of the anemia. (e.) If the examiner concludes the Veteran does not have anemia, the examiner should explain the distinction between anemia and iron deficiency A rationale for the opinions expressed must be provided. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. C. Birder The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.