Citation Nr: 20054716 Decision Date: 08/18/20 Archive Date: 08/18/20 DOCKET NO. 15-15 450 DATE: August 18, 2020 REMANDED Service connection for hypertension, including as secondary to herbicide exposure, service-connected coronary artery disease (CAD), and/or service-connected diabetes mellitus, type 2 (DM) is remanded. Service connection for nephrolithiasis, including as secondary to herbicide exposure, service-connected CAD, and/or service-connected DM is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the United States Air Force from August 1964 to August 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In July 2018 the Board remanded this matter for further development. Hypertension Nephrolithiasis The July 2018 remand specifically directed the RO to obtain a VA examination and for the examiner to opine on whether the Veteran’s hypertension and nephrolithiasis were related to his military service, to include exposure to herbicide agents. The examiner was also to opine on whether his hypertension and nephrolithiasis were caused or aggravated beyond their natural progression by the Veteran’s service-connected CAD and/or DM. A VA examination was obtained, but the examiner only opined on whether the above disabilities were due to the Veteran’s service, including exposure to herbicide agents. Compliance with the Board’s remand instructions is neither optional nor discretionary. Stegall v. West, 11 Vet. App. 268 (1998). The examiner not opining on whether the Veteran’s hypertension and nephrolithiasis were caused by or aggravated beyond their natural progression by his service-connected CAD and/or DM supports that the RO has not substantially complied with the Board’s remand instructions. As such, another remand is necessary. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hypertension is at least as likely as not (50 percent or greater probability) proximately due to his service-connected CAD and/or DM, or aggravated beyond its natural progression by his service-connected CAD and/or DM. (Continued on the next page)   2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s nephrolithiasis is at least as likely as not (50 percent or greater probability) proximately due to his service-connected CAD and/or DM, or aggravated beyond its natural progression by his service-connected CAD and/or DM. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael Chandeck, 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.