Citation Nr: 21064013 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 17-35 033 DATE: October 18, 2021 REMANDED Entitlement to service connection rheumatoid arthritis is remanded. Entitlement to service connection for a respiratory disorder, claimed as scar tissue of the lungs, is remanded. Entitlement to service connection for a low back disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1966 to July 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2019, the Board remanded the claims on appeal, as well as a claim for service connection for a bilateral knee disorder and for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), for additional development. While on remand, a June 2020 rating decision granted service connection for a bilateral knee disorder and PTSD. As such represents a full grant of the benefits sought with respect to such issues, they are no longer before the Board. Grantham v. Brown, 114 F.3d 1156, 1159 (Fed. Cir. 1997). The remaining issues now return for further appellate review. 1. Entitlement to service connection rheumatoid arthritis. 2. Entitlement to service connection for a respiratory disorder, claimed as scar tissue of the lungs. 3. Entitlement to service connection for a low back disorder. In March 2019, the Board remanded the case for additional development, to include obtaining VA examinations for the Veteran's claimed rheumatoid arthritis, respiratory disorder, and low back disorder to determine the nature and etiology of such disorders. Unfortunately, the Board finds that the November 2019 VA medical opinions are inadequate to decide the claims. Consequently, another remand is necessary. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). In this regard, specific to the Veteran's claimed rheumatoid arthritis, the Veteran contends such disorder is related to his acknowledged exposure to herbicide agents while serving in Vietnam. While the November 2019 VA examiner diagnosed the Veteran with rheumatoid arthritis of the thoracolumbar spine, bilateral knees, wrists, hands, and right shoulder, he opined that such was not related to the Veteran's military service. In support thereof, he simply stated, "there is no correlation with the diagnosed rheumatoid arthritis to service in the military." As such statement is conclusory, lacks a rationale, and does not address the Veteran's contention that such disorder is related to his herbicide exposure, the Board finds such opinion inadequate to decide the claim. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (holding that to have probative value, a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two.) Accordingly, an addendum VA medical opinion that addresses the Veteran's specific assertion that his currently diagnosed rheumatoid arthritis is related to his acknowledged herbicide exposure must be obtained. In regard to his claimed respiratory disorder, the Board notes that in November 2012, the Veteran was diagnosed with bilateral multifocal lung parenchymal scarring with several bilateral calcified nodules compatible with old granulomatous disease in his lungs. See Nevada Heart and Vascular Center records. Additionally, at his November 2019 VA examination, the Veteran was diagnosed with chronic obstructive pulmonary disease (COPD). However, at such time, the examiner stated the Veteran's COPD was not incurred in or caused by a specific in-service illness, event, or injury, to include exposure to herbicides. As rationale he stated there is no service correlation to any lung injuries or disease process. Again, similar to above, such statement is conclusory, lacks a rationale, and fails to address service treatment records (STRs) that reflect shortness of breath and wheezing. See July 1966 STRs. Thus, the Board finds an addendum opinion is necessary to address such matter. Specific to his claimed low back disorder, the November 2019 VA examiner diagnosed the Veteran with degenerative arthritis of the spine and spondylolisthesis. However, the examiner determined that the Veteran's low back disorder was not related to his military service. As rationale, he stated the Veteran's medical records do not support any currently diagnosed condition related to such disorder. However, the examiner failed to address the Veteran's statements that harsh living conditions in-service, including running and jumping into bunkers due to the threat of rocket attacks, caused stiffness in his lower back. Further, the Board observes that the Veteran, in his November 2011 statement, indicated all his treatment for his lower back pain was done at the Las Vegas VA Medical Center. However, no VA treatment records are associated with the file. Thus, a remand is necessary to obtain such records and an addendum opinion that considers such evidence and theory of entitlement. The matters are REMANDED for the following action: 1. Obtain any and all VA treatment records from the Las Vegas VA Medical Center. All reasonable attempts should be made to obtain such records, and if any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records. 2. Forward the record, to include a copy of this Remand, to an appropriate medical professional other than the March 2019 VA examiner, if possible, for an opinion addressing the etiology of the Veteran's claimed rheumatoid arthritis, respiratory disorder, and low back disorder. Following a review of the record, the examiner should offer an opinion on the following inquiries: (A) The examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's currently diagnosed rheumatoid arthritis had its onset in, or is otherwise related to, his military service, to include the Veteran's acknowledged exposure to herbicides while serving in Vietnam. (B) The examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's respiratory disorder, currently diagnosed as bilateral multifocal lung parenchymal scarring with several bilateral calcified nodules compatible with old granulomatous disease and COPD, had its onset in, or is otherwise related to, his military service, to include the Veteran's acknowledged exposure to herbicides while serving in Vietnam, and the service treatment records reflecting shortness of breath and wheezing. (C) The examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's low back disorder, currently diagnosed as degenerative arthritis of the spine and spondylolisthesis, had its onset in, or is otherwise related to, his military service, to include the Veteran's reported harsh living conditions in-service, including running and jumping into bunkers due to the threat of rocket attacks. A rationale for any opinion offered should be provided. MARTIN B. PETERS Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. M. Kelly, 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.