Citation Nr: 21062804 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-22 620A DATE: October 12, 2021 REMANDED Entitlement to service connection for hairy cell leukemia (claimed as chronic B-Cell Leukemia), as due to Agent Orange exposure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force form September 1963 to July 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2014 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). In March 2020, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is of record. Although the Board sincerely regrets further delay, after a review of the evidence of record, the Board finds that further development is necessary prior to adjudicating this claim. When VA undertakes to provide an examination or opinion, it must be an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). When there is not substantial compliance with Board remand requests, the Board errs as a matter of law when it does not ensure compliance. Stegall v. West, 11 Vet. App. 268 (1998). Hairy Cell Leukemia While the RO obtained a May 2021 Hematologic and Lymphatic Conditions Acceptable Clinical Evidence (ACE) review and medical opinion regarding the Veteran's claimed condition, the Board finds that further development is necessary before a decision on this case can be reached. The Veteran's VA medical records indicated that he had been diagnosed with "B-Cell Lymphoma." During the ACE review, the May 2021 examiner opined that the Veteran's B-Cell Lymphoma was another way of indicating the Veteran's Non-Hodgkins Lymphoma diagnosis. Additionally, during the ACE review, the examiner additionally diagnosed the Veteran with "hairy cell or other B-Cell" leukemia. However, the examiner's opinion was not clear whether his diagnosis of the Veteran's "hairy cell or other B-Cell leukemia" was a separate and distinct diagnosis/condition from his Non-Hodgkins Lymphoma, or whether the examiner was indicating that the Veteran's service-connected Non-Hodgkins Lymphoma and the "hairy cell or other B-Cell" leukemia he diagnosed on this review were the same condition. As such, the Board finds a remand for an addendum opinion is required in order to clarify the examiner's opinion. The matters are REMANDED for the following action: Obtain an addendum medical opinion, from the VA examiner who provided the May 2021 VA medical opinions, or if that examiner is unavailable, another qualified VA examiner with sufficient expertise to comment on the Veteran's claimed disabilities. All pertinent evidence of record must be made available to and reviewed by the examiner, including a copy of this remand. Any indicated studies should be performed. No additional examination is required unless the examiner deems it necessary. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to the following: Whether it is at least as likely as not (a 50 percent probability or greater) that the "hairy cell or other B-Cell leukemia" disability diagnosed by the May 2021 examiner is a separate and distinct disability/condition from the Veteran's service-connected Non-Hodgkins Lymphoma. The examiner must provide a complete rationale for any proffered opinion. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Gresham 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.