Citation Nr: 20047580 Decision Date: 07/16/20 Archive Date: 07/16/20 DOCKET NO. 12-15 941 DATE: July 16, 2020 REMANDED Entitlement to service connection for bilateral lower extremity disorder, to include as due to exposure to herbicide agents and/or as secondary to service-connected coronary artery disease (CAD), is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1967 to September 1970. He is the recipient of numerous awards and decorations, to include the Combat Infantryman Badge. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in May 2010 by a Department of Veterans Affairs (VA) Regional Office. In July 2015, the Veteran and his spouse testified at a Board hearing before the undersigned Veterans Law Judge. A hearing transcript is associated with the record on appeal. In October 2015 and January 2018, the Board remanded the case for additional development, and it now returns for further appellate review. Entitlement to service connection for bilateral lower extremity disorder, to include as due to exposure to herbicide agents and/or as secondary to service-connected CAD. In pertinent part, the Board remanded the case in January 2018 for addendum medical opinions addressing the multiple theories of entitlement relevant to the instant case. Specifically, the Board requested that a VA examiner provide an opinion as to whether it is at least as likely as not that varicose veins and/or a disorder related to dependent edema is causally or etiologically related to any in-service event, disease, or injury, to include the Veteran’s presumed exposure to herbicide agents. Additionally, the examiner was asked to provide an opinion as to whether it is at least as likely as not that any bilateral lower extremity disorder is aggravated by the Veteran’s service-connected CAD. The record reflects addendum opinions were provided in June 2019, July 2019, and September 2019 in which examiners opined that the Veteran’s chronic venous insufficiency was not at least as likely as not related to his military service, to include his in-service exposure to herbicide agents, or aggravated by his CAD. However, such opinions do not address the etiology of the Veteran’s varicose veins, which a VA nurse practitioner diagnosed in September 2016. Consequently, the Board finds a remand is warranted for addendum opinions to ensure completeness of the record prior to readjudication. The matter is REMANDED for the following action: Forward the Veteran’s electronic file, to include a copy of this Remand, to an appropriate clinician for an addendum opinion addressing the etiology of the Veteran’s varicose veins. Following a review of the record, the examiner should address the following inquiries: (A) Is it at least as likely as not (i.e., a 50 percent probability or greater) that the Veteran’s varicose veins are causally or etiologically related to any in-service event, disease, or injury, to specifically include his presumed exposure to herbicide agents? In this regard, the examiner is advised that the absence of a diagnosis of a disease for which presumptive service connection is provided on the basis of exposure to herbicide agents is not a bar to benefits. (B) Is it at least as likely as not (i.e., a 50 percent probability or greater) that the Veteran’s varicose veins are aggravated by his service-connected CAD? For any aggravation found, the examiner should state, to the best of their ability, the baseline of symptomatology and the amount, quantified if possible, of aggravation beyond the baseline symptomatology. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. M. Celli, 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.