Citation Nr: 20052949 Decision Date: 08/10/20 Archive Date: 08/10/20 DOCKET NO. 15-44 007 DATE: August 10, 2020 REMANDED Entitlement to service connection for residuals of an inguinal hernia as secondary to service-connected non-Hodgkins lymphoma is remanded. Entitlement to service connection for residuals of a ventral hernia as secondary to service-connected non-Hodgkins lymphoma is remanded. Entitlement to service connection for gallbladder removal as secondary to service-connected non-Hodgkins lymphoma is remanded. Entitlement to service connection for colon resection as secondary to service-connected non-Hodgkins lymphoma is remanded. REASONS FOR REMAND The Veteran had honorable active duty service with the United States Navy from January 1966 to December 1968. Regrettably, he passed away in December 2015. The Appellant is his surviving spouse. 38 U.S.C. § 5121A; November 2018 letter. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). In February 2015, the Veteran testified at a hearing before a Decision Review Officer (DRO). A transcript of that hearing has been associated with the record. In February 2019 and in pertinent part, the Board denied the Appellant’s claims seeking secondary service connection for residuals of an inguinal hernia, residuals of a ventral hernia, gallbladder removal, and colon resection as related to service-connected non-Hodgkin’s lymphoma. Briefly, the Board also remanded claims seeking service connection for rheumatoid arthritis and a TDIU at that time. Development for these matters is ongoing, such that they will be addressed in a later Board decision, should such action be required. In February 2020 and in pertinent part, the Court of Appeals for Veterans Claims (Court) vacated the Board’s denials of the instant matters and remanded the issues for further consideration. Of note, the Court did not also vacate the portion of the Board’s decision which denied these claims on direct bases Thus, the matters for review have been limited as reflected herein. Although the Board sincerely regrets the additional delay this will cause, these appeals are now remanded for further development in compliance with the Court’s February 2020 determination. Specifically, the Court determined that the Board’s February 2019 denials were based upon an inadequate November 2013 VA examination, which failed to address whether the claimed conditions were aggravated by the Veteran’s service-connected non-Hodgkins lymphoma. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). In this respect, a medical examination or opinion that fails to address whether a service-connected disability aggravated the claimed disability is inadequate to inform the Board on the issue of secondary service connection. See 38 C.F.R. § 3.310 (“any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected.”); El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). On remand, the Board is directed to obtain an adequate VA medical opinion which specifically addresses whether it is at least as likely as not that the Veteran’s gallbladder removal, colon resection, residuals of an inguinal hernia, and residuals of a ventral conditions experienced any increase in severity due to his service-connected non-Hodgkin’s lymphoma. In rendering any subsequent decision, the Board must “reexamine the evidence of record, obtain any additional evidence deemed necessary, and issue a timely, well-reasoned decision.” Fletcher v. Derwinski, 1 Vet. App. 394, 397 (1991). An adequate statement of reasons or bases must be provided for its findings and conclusions on all material issues. See 38 U.S.C. § 7104(d)(1); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). If any additional evidence development is required, the Board must ensure that Appellant is given notice thereof and an opportunity to respond. See Thurber v. Brown, 5 Vet. App. 119 (1993). The matters are REMANDED for the following actions: 1. Obtain VA addendum opinions as to any secondary relationship between the Veteran’s service-connected non-Hodgkin’s lymphoma and the claimed disorders. The claims file and a copy of this remand must be made available for review, and the examination report must reflect that review of the claims file occurred. In particular, the examiners should offer opinions as to the following: (a.) Is it at least as likely as not that the claimed disorders (residuals of an inguinal hernia, residuals of a ventral hernia, gallbladder removal, and colon resection) were caused or aggravated by the Veteran’s service-connected non-Hodgkin’s lymphoma or the treatment thereof? Aggravation is defined as a permanent worsening beyond the natural progression of the disease or disability. In formulating their opinions, the examiners are advised that the term “at least as likely as not” does not mean “within the realm of possibility.” Rather, it means that the weight of the medical evidence for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against it. A complete rationale should be provided for all opinions or conclusions expressed. It should be noted that the Veteran was competent to attest to observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. If any requested opinion cannot be offered without resorting to speculation, the examiner should indicate such in the examination report and explain why a non-speculative opinion cannot be offered. The examiner should also identify what, if any, additional information or evidence would allow for a more definitive opinion. 2. Thereafter, re-adjudicate the Appellant’s secondary service connection claims. If any benefit sought remains denied, provide the Appellant with a supplemental statement of the case and an adequate opportunity to respond before returning the matter to the Board for further adjudication, if otherwise in order. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires all claims remanded by the Board or by the United States Court of Appeals for Veterans Claims to be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112. Kate E. Kovarovic Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Whitaker, 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.