Citation Nr: 20068024 Decision Date: 10/21/20 Archive Date: 10/21/20 DOCKET NO. 17-05 592 DATE: October 21, 2020 REMANDED Entitlement to service connection for diabetic peripheral neuropathy of the bilateral lower extremities, to include as secondary to service-connected lumbar spondylosis and discogenic disease is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 1971 to M¬arch 1973. In January 2019, the Board remanded the claim on appeal for further development and adjudication. The Board finds that there was substantial compliance with its January 2019 remand directives. A remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand order. Stegall v. West, 11 Vet. App. 268 (1998). Nonetheless, it is only substantial compliance, rather than strict compliance, with the terms of a remand that is required. See D’Aries v. Peake, 22 Vet. App. 97, 104 (2008) (finding substantial compliance where an opinion was provided by a neurologist as opposed to an internal medicine specialist requested by the Board); Dyment v. West, 13 Vet. App. 141 (1999). However, as will be discussed further, the claim for entitlement to service connection for diabetic peripheral neuropathy of the bilateral lower extremities, to include as secondary to service-connected lumbar spondylosis and discogenic disease requires additional development and therefore an additional remand is necessary. In November 2019, the Veteran appealed the Board’s January 2019 denial of his petitions to reopen his claims for service connection for a left knee disability (also claimed as arthritis), for right knee arthritis, for diabetes mellitus type II, and entitlement to service connection for a heart disability to the United States Court of Appeals for Veterans Claims (CAVC). In a November 2019 Joint Motion for Partial Remand (JMPR), CAVC set aside the Board’s denials and remanded the claims back to the Board for further development and adjudication. In May 2020, the Board remanded the claims returned by the Court’s JMPR for further development and adjudication. As such claims appear to be still pending at the agency of original jurisdiction (AOJ), they are not before the Board at this time and will be discussed and adjudicated in a separate Board decision. Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. As previously noted, the Board remanded the Veteran’s claim in January 2019 for an additional VA examination. The Board found the September 2015 VA examination to be inadequate for adjudication purposes. Upon examination, the VA examiner diagnosed the Veteran with diabetic peripheral neuropathy of the bilateral lower extremities. While the VA examiner opined that his service-connected lumbar spondylosis and discogenic disease was not the cause of his diabetic peripheral neuropathy, the VA examiner indicated there was a possibility his service-connected lumbar spondylosis and discogenic disease contributed to it. In doing so, the VA examiner failed to provide any supporting rationale. Cf. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303-04 (2008). Consequently, the Board found that a remand was necessary in order to obtain an addendum VA medical opinion. In March 2019 an additional VA examination was conducted. Upon examination, the examiner diagnosed the Veteran with type II diabetes with diabetic polyneuropathy, bilateral upper and lower extremities. The examiner opined that the Veteran’s condition was less likely than not aggravated beyond its natural progression by the Veteran’s lumbar spondylosis and discogenic disease. While the examiner noted the September 2015 examiner’s opinion that the Veteran’s lumbar conditions could be contributing factors to the Veteran’s peripheral neuropathy, the March 2019 examiner stated that there was “no physiologic connection between the Veteran’s claimed diabetic peripheral neuropathy to be aggravated beyond its natural progression by service connected lumbar spondylosis and discogenic disease.” The Board finds that this is not an adequate supporting rationale, as the examiner did not thoroughly address the prior examiner’s contention that such service-connected conditions could be contributing factors, but rather the March 2019 examiner merely stated a conclusion that there was no physiologic connection without providing any supporting rationale. See Nieves-Rodriguez, 22 Vet. App. 303-304. Therefore, the Board finds that an additional remand is necessary in order to obtain an addendum VA medical opinion. Due to the amount of time which will pass on remand, updated treatment records should be obtained and associated with the record. The matters are REMANDED for the following action: 1. Obtain any and all VA treatment records and associate those documents with the claims file. 2. Return the claims file to the March 2019 VA examiner for an examination and addendum opinion. If the March 2019 VA examiner is unavailable, the claims file should be forwarded to an appropriate medical professional to provide the opinion. The need for an in-person examination is left to the discretion of the medical professional proffering the opinion. After reviewing the record, the VA examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) the Veteran’s diabetic peripheral neuropathy of the bilateral lower extremities has been caused OR aggravated beyond its natural progression by his service-connected lumbar spondylosis and discogenic disease? The examiner must specifically address the September 2015 examiner’s opinion, noting that his lumbar spine disorder could be contributing to his neuropathy. The examiner must provide a complete rationale for all opinions and conclusions reached; in other words, the examiner must not only provide an opinion, but explaining in depth why that conclusion was reached. MARTIN B. PETERS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Unger, Counsel 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.