Citation Nr: 20023964 Decision Date: 04/07/20 Archive Date: 04/07/20 DOCKET NO. 12-35 775 DATE: April 7, 2020 REMANDED Entitlement to service connection for left hand contractures is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from March 1974 to March 1977, from October 1994 to March 1995, from November 1995 to July 1997, and from November 2003 to October 2004. This matter comes before the Board of Veterans Appeals (Board) on appeal from a January 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2017, the Veteran testified at a hearing before the undersigned. A transcript of the hearing has been associated with the claims file. These matters were previously before the Board in August 2019 when they were remanded to the Agency of Original Jurisdiction (AOJ) for a new VA examination. For the reasons discussed below the Board is unable to conclude that the AOJ substantially complied with prior remand directions as it pertains to the issue of service connection for left hand contractures. See D’Aries v. Peake, 22 Vet. App. 97, 105 (2008).   Entitlement to service connection for left hand contractures is remanded. Although the Board regrets the additional delay, remand is required for this claim to ensure substantial compliance with the prior remand directives. The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. In an August 2019 remand, the Board directed that a medical opinion be obtained that addressed the question of etiology of each diagnosed left hand disorder, including contractures. The examiner was directed to address 1) the Veteran’s July 2017 Board testimony regarding his in-service incident but not limited to burns; 2) the April 2019 VA medical opinion; 3) the March 2004 service treatment records; 4) an August 2005 BAMC record that diagnosed bilateral chemical burns (unknown origin) 2nd degree burns and contractures bilateral hands; 5) a September 2007 letter from a VA physician indicating that the Veteran was injured in Afghanistan and had been treated for war-related injuries to include contracture of hand caused by the second degree burn he sustained in Afghanistan; and 6) the December 2010 VA examination report. Pursuant to the August 2019 remand, the Veteran received a VA examination in January 2020 which addressed the service treatment records, the July 2017 Board hearing testimony, the service treatment records. However, the opinion provided did not address the August 2005 BAMC record, the September 2007 letter from a VA physician, and the December 2010 VA examination report. As the August 2019 remand directives were not substantially complied with, another remand is required. Accordingly, the Board will remand this claim again for an opinion in compliance with the prior remand directives. The matters are REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and his or her representative. 2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the etiology of any left hand disorder, to include contractures. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must elicit from the Veteran a full history and/or description of the event during service and any symptoms thereafter. (a.) First, the examiner must provide all currently diagnosed left hand disorders, to include contractures. It is noted that left hand dermatitis, painful left hand scar, and, left hand scar, residual of second degree chemical burn, are already service-connected and should not be considered herein. (b.) Second, the examiner must provide an opinion as to whether each diagnosed left hand disorder, to include contractures, at least as likely as not (50 percent or more probability) had onset in, or is otherwise related to, the Veteran’s active service, to include the in-service incident as described by the Veteran. The examiner must address the following: 1) the Veteran’s July 2017 Board testimony regarding his in-service incident but not limited to burns; 2) the April 2019 VA medical opinion; 3) the March 2004 STRs; 4) an August 2005 BAMC record that diagnosed bilateral chemical burns (unknown origin) 2nd degree burns and contractures bilateral hands; 5) a September 2007 letter from a VA physician indicating that the Veteran was injured in Afghanistan and had been treated for war-related injuries to include contracture of hand caused by the second degree burn he sustained in Afghanistan; and 6) the December 2010 VA examination report. 4. Notify the Veteran that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claims, and that the consequences for failure to report for a VA examination without good cause may include denial of the claims. 38 C.F.R. §§ 3.158, 3.655 (2018). In the event that the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Javed, Associate 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.