Citation Nr: 21063824 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 15-04 844 DATE: October 18, 2021 REMANDED Entitlement to service connection for diabetes mellitus type II, to include as secondary to Parkinson's Disease, is remanded. Entitlement to service connection for hypertensive vascular disease, characterized as hypertension and isolated systolic hypertension, to include as secondary to Parkinson's Disease, is remanded. REASONS FOR REMAND The Veteran severed on active duty from November 1978 to May 1991. These matters return to the Board of Veterans' Appeals (Board) following the issuance of a September 2018 Board remand order which directed the Regional Office (RO) to undertake additional development. 1. Entitlement to service connection for diabetes mellitus type II, to include as secondary to Parkinson's Disease, is remanded. 2. Entitlement to service connection for hypertensive vascular disease, characterized as hypertension and isolated systolic hypertension, to include as secondary to Parkinson's Disease, is remanded. The Veteran is seeking service connection for diabetes mellitus type II and for hypertension. He specifically asserts that these disorders are secondarily due to his service-connected Parkinson's Disease. The previous Board remand order of September 2018 directed the RO to obtain an addendum opinion and/or VA medical examination with the goal of determining the nature and etiology of the Veteran's diabetes and hypertension. The order specifically directed that the examiner determine: 1. If the claimed disorders were caused by the Veteran's Parkinson's Disease; 2. If the claimed disorders were aggravated beyond their natural progression by the Veteran's Parkinson's Disease, or; 3. If the claimed disorders could be caused by environmental contaminants that the Veteran was exposed to while stationed in South West Asia. The RO obtained a medical examination for the Veteran and the examiner provided opinions addressing the causal link between the Veteran's claimed disorders and Parkinson's Disease, and the potential link between his claimed disorders and environmental contaminants in South West Asia. The examiner did not provide an opinion discussing if the Veteran's diabetes or hypertension could have been aggravated beyond their natural progression by his Parkinson's. Thus, the Board cannot find that there has been substantial compliance with all of the directives in the September 2018 remand order. See Stegall v. West, 11 Vet. App. 268 (1998). As such, the Veteran's claims for service connection for diabetes mellitus type II and hypertension are remanded. The matters are REMANDED for the following action: 1. The RO should invite the Veteran to submit any relevant evidence in support of his claims. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's diabetes mellitus type II and/or Hypertension have been aggravated progression by his service-connected disabilities. If such aggravation is found, the examiner should discuss pre-and post-aggravation levels of severity. The complete claims file should be made available to the examiner. All opinions should be accompanied by adequate reasons and bases. If the examiner cannot provide the requested opinion without resorting to mere speculation, they should provide a complete explanation stating why this is so. In so doing, the examiner should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that they have exhausted the limits of current medical knowledge in providing an answer to that particular question(s). B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Q. Hernan, Attorney Advisor