Citation Nr: 21001066 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 16-16 236 DATE: January 6, 2021 REMANDED Service connection for a gynecological condition, to include residuals of hysterectomy, is remanded REASONS FOR REMAND The Veteran served on active duty from December 1983 to February 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). In a December 2014 rating decision, the RO denied the Veteran’s claim of clear and unmistakable error (CUE) in a prior, January 2013, rating decision that denied a special monthly compensation for loss of use of creative organ. The Veteran appealed that decision to the Board, which, in an October 2018 decision, found no CUE in the January 2013 rating decision. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court) which, in October 2019, on the basis of a Joint Motion for Remand (Joint Motion), vacated the denial and remanded the matter to the Board for further action. Thereafter, in a February 2020 Remand, the Board found that a January 2014 correspondence constituted notice of disagreement with the January 2013 and December 2013 rating decisions. As a result, the issue of entitlement to service connection for loss of use of a creative organ, recharacterized by the Board as entitlement to service connection for a gynecological disability, was considered de novo and the Board remanded the issue for additional development. Regrettably, the requested development was not adequately completed, and further remand is necessary. Entitlement to service connection for a gynecological condition, to include residuals of hysterectomy, is remanded. In its February 2020 remand directives, the Board specifically noted that the examiner should address a May 2013 medical opinion which stated that the Veteran experienced recurrent menorrhagia, menometrorrhagia, and dysmenorrhea in and since service was ultimately diagnosed as severe endometriosis requiring a hysterectomy in March 2004. The examiner was also asked to address the Veteran’s February 1993 claim, which was filed the same month she was discharged from active duty. The Veteran was afforded an examination in November 2020. Following examination of the Veteran, the examiner found that the Veteran’s disorder was less likely than not related to service. The examiner stated that the Veteran had a total abdominal hysterectomy in 2004 for conditions that were unrelated to service. The examiner further stated that the Veteran had no current gynecological condition. In so finding, the examiner failed to address that the Veteran had a scar secondary to hysterectomy, that loss of use of a creative organ was due to hysterectomy, and that the Veteran was taking hormones at the time of examination. The examiner failed to address the March 2004 or February 1993 evidence cited in the Remand and failed to provide a rationale as to why she found that the Veteran’s hysterectomy was due to non-service-connected conditions. Thus, the Board finds the examination inadequate and a new examination is required. Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007) (Once VA undertakes the effort to provide a medical examination or opinion, it must provide an adequate one). Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician other than the November 2020 examiner, to determine the nature and etiology of any current gynecological condition, to include residuals of hysterectomy. With respect to any current condition, the examiner must opine whether it is at least as likely as not that such is related to an in-service injury, event, or disease. In forming an opinion, the examiner is to address the May 2013 medical opinion that the Veteran’s history of recurrent menorrhagia, menometrorrhagia, and dysmenorrhea in and since service was ultimately diagnosed as severe endometriosis that required hysterectomy in March 2004. (Continued on the next page)   The examiner must also acknowledge and discuss the Veteran’s February 1993 claim, which was filed the same month she was discharged from active duty. 2. Then readjudicate the claims remaining on appeal. If the benefit sought is not granted in full, furnish the Veteran and his representative with a supplemental statement of the case and an opportunity to respond, and return the case to the Board. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Slovick, 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.