Citation Nr: 21002336 Decision Date: 01/13/21 Archive Date: 01/13/21 DOCKET NO. 19-11 211 DATE: January 13, 2021 REMANDED Entitlement to service connection for kidney disorder, to include nephrolithiasis, as secondary to type two diabetes mellitus, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from June 1964 to July 1968, November 1976 to April 1979, and from May 1979 to October 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in September 2019 and July 2020. Then, the Board remanded to provide further development, including to provide the Veteran with an updated VA examination. Although the Board sincerely regrets further delay, another remand is necessary to provide the Veteran with every possible consideration. Further development is necessary to address the Veteran’s assertion that his kidney condition is related to his service-connected type two diabetes mellitus. Entitlement to service connection for kidney disorder, to include nephrolithiasis, as secondary to type two diabetes mellitus. In the November 2018 Notice of Disagreement, the Veteran challenged the RO’s rating decision denying service connection of the above claim. The Veteran asserted entitlement to service connection for his kidney condition, as due to diabetes mellitus and/or herbicide exposure. Pursuant to the July 2020 Board remand, the RO provided the Veteran with a VA examination. In the July 2020 VA examination, the examiner confirmed the Veteran’s diagnosis of nephrolithiasis, and noted the last recurrence of the Veteran’s kidney condition was in 2017. The VA examiner provided the medical opinion that the Veteran’s kidney condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness, to include as due to herbicide agent exposure. The Board must consider all theories of entitlement either expressly raised by the claimant or which are reasonably raised by the record. See Robinson v. Shinseki, 557 F.3d 1355, 1362 (Fed. Cir. 2009). VA’s duty to assist includes obtaining a medical opinion when such an examination or opinion is necessary to make a decision on the claim. 38 U.S.C. § 5103A. Without a medical opinion that clearly addresses the relevant facts and medical science, the Board is left to rely on its own lay opinion, which it is forbidden from doing. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Here, an addendum opinion is required to address the Veteran’s explicit contention that his kidney condition was caused by or aggravated by his service-connected type two diabetes. The matter is REMANDED for the following action: Obtain an addendum opinion from the examiner who provided the July 2020 VA opinion, or, if not available, another appropriately qualified VA clinician. If the examiner deems it necessary, afford the Veteran a VA examination. The examination may be conducted via telehealth or similar service during the social distancing restrictions of the COVID-19 pandemic. Provide the claims file, including a copy of this REMAND, to the examiner for review. Following a review of the entire record, to include all relevant VA and private treatment records, the Veteran’s competent lay statements, as well as the Veteran’s report regarding the onset and progression of his current symptomatology, the examiner should opine as to the following: a. Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s kidney condition, to include nephrolithiasis, is due to the Veteran’s service-connected type two diabetes mellitus. b. Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s kidney condition, to include nephrolithiasis, is aggravated by the Veteran’s service-connected type two diabetes mellitus. A clearly stated rationale for any opinion offered should be provided and must not be based solely on the lack of records. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.V. Bona, 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.