Citation Nr: 21004712 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 14-41 673 DATE: January 28, 2021 REMANDED Entitlement to service connection for end stage renal disease (ESRD) is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1974 to September 1975. This case is before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office. In July 2018, the Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the electronic claims file. In September 2018, the Board remanded the matter for further development. In September 2019, the Board denied the Veteran’s claim for entitlement to service connection for ESRD. The Veteran subsequently appealed the September 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). In an August 2020 Order, the Court granted the parties’ Joint Motion for Remand (JMR), vacating the Board’s September 2019 decision regarding the denial of service connection for ESRD and remanded the appeal to the Board for readjudication consistent with the JMR. The Board finds that more development is necessary prior to final adjudication of the claim on appeal. As noted above, the Board remanded this matter in September 2018 for further development. Per the September 2018 Board remand instructions, the Veteran underwent an VA examination in June 2019. The VA examiner opined that the Veteran’s current ESRD was less likely than not incurred in or caused by the claimed in-service injury, event, or illness as it was noted that the Veteran’s medical records support his chronic kidney disease due to type II diabetes mellitus and it correlates with the timeline of the condition’s natural progression. Also, the examiner provided that ESRD is less likely than not a result of taking high doses of Aspirin during service. However, as noted by the October 2020 JMR, the June 2019 VA opinion was insufficient as the June 2019 VA examiner provided conclusory statements regarding the Veteran’s medical records as he attributed the Veteran’s ESRD to diabetes and noted that it correlated with the natural timeline of the condition’s natural progression. Additionally, the JMR found that the examiner provided no support for the statement that “renal impairment stemming from service is not well grounded” and did not provide support for the conclusion that it was less likely than not that the Veteran’s ESRD was a result of taking high doses of Aspirin during service. The VA June 2019 examiner also did not address the Veteran’s lay statements that taking aspirin contributed to his ESRD. Notably, the Board also failed to address the probative value of the Veteran’s assertions as he was a hospital corpsman and completed Basic Hospital Corps School and Field Medical Service School during his service. The Veteran additionally provided medical articles noting that renal failure was a long-term side effect of ESRD. Thus, the Board finds that the evidence currently of record is insufficient to resolve the claim for entitlement to service connection for ESRD and that further opinion in connection with this claim is necessary for a fully informed evaluation of the claim on appeal. Green v. Derwinski, 1 Vet. App. 121, 124 (1991); 38 C.F.R. § 3.159(c) (4). The matters are REMANDED for the following action: 1. The Veteran should be requested to provide the names, addresses and approximate dates of treatment of all medical care providers, VA and non-VA, who have treated him for the disability on appeal. After the Veteran has signed the appropriate releases, those records should be obtained and associated with the claims folder. 2. After the development requested above has been completed to the extent possible, the Veteran should also be scheduled for a VA examination to determine the etiology of the claimed ESRD disability. Based on a review of the record and an examination of the Veteran, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s has a current ESRD disability that is related to any incident of the Veteran’s active duty service to include as a result of taking high doses of aspirin during service. The examiner should consider the July 1980 report of medical history on discharge from Naval Reserve service in which the Veteran checked yes to “kidney stones or blood in urine,” and later reported that he had blood in his urine at that time that was visible to the naked eye and the December 2008 statement from Dr. B., the Veteran’s nephrologist. The examiner should also address the Veteran’s contentions regarding his use of all-purpose capsules containing high doses of aspiring during service and that taking aspirin contributed to his ESRD as the Veteran notably was a hospital corpsman and completed Basic Hospital Corps School and Field Medical Service School during his service. The examiner should also address the medical articles noting that renal failure was a long-term side effect of ESRD. All opinions expressed by the examiner must be accompanied by a complete rationale. Adequate reasons and bases for any opinion rendered must be provided. All studies deemed appropriate in the medical opinion of the examiner should be performed, and all the findings should be set forth in detail. The claims file should be made available to the examiner, who should review the entire claims folder in conjunction with this examination. (Continued on the next page)   3. After completion of the above and any additional development deemed necessary, the issue on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought remains denied, the Veteran should be furnished a supplemental statement of the case and be afforded the opportunity to respond. Thereafter, the case should be returned to the Board for appellate review, if in order. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board James A. DeFrank, 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.