Citation Nr: 21001827 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 14-02 031 DATE: January 11, 2021 REMANDED Entitlement to service connection for a left ankle condition, to include as secondary to a right ankle disability is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1981 to June 2001. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in November 2017 and November 2019, on which occasions it was remanded for development. It has been returned to the Board for appellate review. 1. Entitlement to service connection for a left ankle condition, to include as secondary to a right ankle disability is remanded. Although it regrets the additional delay, the Board finds that another remand of this matter is necessary in order to afford the Veteran an adequate VA examination and medical opinion with respect to his claim for service connection. The Board observes that the Veteran was diagnosed with a left ankle strain in service. The VA examiner with whom he met in August 2019 listed that diagnosis, but did not make clear whether, based on the VA examination, the Veteran was beset by any current diagnosis pertinent to the left ankle. His November 2019 addendum opinion did not offer the needed clarification on that point. Second, the Veteran has averred that his left ankle condition is etiologically related to his service-connected right ankle disability insofar as the right ankle condition has caused him to alter his gait, putting additional stress on the left ankle and causing disability. This theory of entitlement has not been evaluated by a VA examiner; the November 2019 addendum opinion merely offers that right ankle disabilities do not cause left ankle disabilities. The VA examiners’ opinion, including the addendum, are inadequate. On remand, a new VA examination must be conducted and expert medical opinions obtained as to the presence and etiology of a current left ankle disability, to include as secondary to the right ankle disability, with consideration given to the Veteran’s theory of aggravation. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to explore the presence and etiology of his claimed left ankle disorder. All indicated tests and studies should be conducted and all clinical findings reported in detail. The entire claims file should be made available to and be reviewed by the examiner in conjunction with this request.   Please identify by medical diagnosis any current left ankle condition. The examiner should specify whether the Veteran has a current chronic left ankle disability. For each diagnosis, the examiner should state whether it is at least as likely as not (e.g. at least a 50 percent probability or greater) that the disorder began in service or is otherwise related to service. If direct service connection is not shown, the examiner should state whether it is at least as likely as not that a diagnosed left ankle disorder has been caused or aggravated beyond its normal course of progression by the Veteran’s service connected right ankle disability, to include as a result of altered gait. In addressing the above opinion, the examiner should consider the Veteran’s lay statements regarding onset of symptomatology and any continuity of symptomatology since onset and/or since discharge from service. The examiner should also consider any other pertinent evidence of record, as appropriate. All findings should be reported in detail and all opinions must be accompanied by a clear rationale. 2. Thereafter, the AOJ should readjudicate the claim. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Z. Sahraie, 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.