Citation Nr: 20048029 Decision Date: 07/17/20 Archive Date: 07/17/20 DOCKET NO. 16-06 972 DATE: July 17, 2020 REMANDED Entitlement to service connection for residuals of methicillin-resistant staphylococcus aureus (MRSA) is remanded REASONS FOR REMAND The Veteran served on active duty from September 2006 to November 2010. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this claim for further development in September 2018. The Veteran was afforded a VA examination for residuals of MRSA in November 2019. The September 2018 Board remand specifically directed that the Veteran’s lay assertions that as a result of his in-service MRSA infection he now experiences breakouts of boil-type skin problems and/or painful red bumps on various parts of his body (to include his legs, arm pits, and neck) and feels ill when he gets too hot or from too much physical exertion. The November 2019 VA examiner acknowledged the Veteran’s current symptoms of nausea when working in temps over 70 degrees, heavy sweating with activity, painful boils on the neck, easily fatigued, shortness of breath, and headache. However, the VA examiner then indicated without rationale that the Veteran did not currently have symptoms attributable to symptoms of MRSA. There was no attempt to reconcile this conclusion with the Veteran’s report of ongoing symptoms. The United States Court of Appeals for Veterans Claims has held that a remand confers on the veteran, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268 (1998). The November 2019 examination report does not comply with the Board’s September 2018 instructions to discuss and address the Veteran’s lay assertions regarding ongoing symptomatology he attributes to his in-service MRSA. Accordingly, an addendum medical opinion addressing these lay assertions should be obtained. The matters are REMANDED for the following action: Provide an addendum medical opinion, or VA examination if deemed necessary by the VA examiner, to determine the nature and etiology of the Veteran’s claimed MRSA residuals. The entire claims file must be reviewed by the examiner. The examiner should confirm in the examination report that he or she has reviewed the claims folder. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran has any current residuals of his in-service MRSA infection in April 2008. See April 4, 2008 sick call slip which notes that the Veteran should avoid elevating his body temperature to avoid the spread of MRSA. In providing this opinion, the examiner should consider and address the Veteran’s assertion that as a result of his in-service MRSA infection he now experiences breakouts of boil-type skin problems and/or painful red bumps on various parts of his body (to include his legs, arm pits, and neck) and feels ill when he gets too hot or from too much physical exertion. Specifically, the examiner should discuss if such symptoms would be consistent with residuals of MRSA. A supporting rationale for all opinions expressed must be provided. If the examiner is unable to provide any opinion as requested, the examiner should fully explain the reason why such opinion could not be rendered. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Keogh, 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.