Citation Nr: 20021824 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 19-06 888 DATE: March 27, 2020 REMANDED Entitlement to service connection for Raynaud’s disease is remanded. REASONS FOR REMAND The Veteran testified before the undersigned Veterans Law Judge in a June 2019 video conference hearing. A transcript of that hearing has been associated with the file. Entitlement to service connection for peripheral neuropathy of the bilateral upper extremities and peripheral neuropathy of the bilateral lower extremities were originally on appeal as well. However, in a November 2019 rating decision, the RO granted service connection for these claims, representing a full grant of benefits. Accordingly, these issues are no longer before the Board. The only remaining issue on appeal is listed on the title page. The Board remanded this matter in September 2019. A review of the file shows that the additional development, to include obtaining an adequate medical opinion in accordance with the Board remands have not been performed. As such, the Board finds that the remand directives have not been substantially complied with and another remand is required. Stegall v. West, 11 Vet. App. 268 (1998). A VA examiner provided an opinion in October 2019. This examiner is the same one that performed an examination of the Veteran in January 2018. The VA examiner once again found that there is no diagnosis of Raynaud’s phenomena. Despite the direction listed in the remand directives this examiner failed to comment on the July 2019 letter wherein a private examiner confirmed a diagnosis of Raynaud’s phenomena. As such, the matter is being remanded in an effort to secure an adequate medical opinion. The matter is REMANDED for the following action: Schedule an appropriate VA examination, preferably with an examiner other than the one who performed the January 2018 and October 2019 examinations, in order to determine the nature and etiology of the Veteran’s Raynaud’s disease. The examiner should identify any and all disabilities, to include Raynaud’s disease, affecting the hands and feet found at any time during the appeal period (from September 2017). The examiner is asked to comment on whether his symptoms are encompassed by the now service-connected peripheral neuropathy of the upper and lower extremities. If any previously diagnosed disability is not found on examination, the examiner should address the prior diagnoses of record and indicate whether they may have resolved or been misdiagnosed. Specifically, the examiner is requested to comment and account for in his/her opinion the July 2019 letter wherein a private examiner concludes the Veteran has a diagnosis of Raynaud’s phenomena. The examiner should explicitly state whether this diagnosis should be considered resolved or whether it is a misdiagnosis. This letter is located at: VBMS, document labeled Medical Treatment Record-Non-Government Facility, receipt date listed July 9, 2019, pg. 2 and of 2. If a medical diagnosis cannot be given, the examiner must state whether the Veteran has any functional impairment, such as loss of range of motion, pain, or instability. Note: pain in it of itself may constitute a disability for VA purposes if it results in functional impairment. For each diagnosed disability or finding of functional impairment, the examiner should provide an opinion regarding whether it is at least as likely as not (i.e., probability of 50 percent) that the disability manifested during active service; or is otherwise related to an event, injury, or disease incurred during active service, to include exposure to cold temperatures. The examiner is asked to provide a complete a rationale for all opinions offered. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Talamantes 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.