Citation Nr: 21064498 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 16-16 939 DATE: October 20, 2021 REMANDED Entitlement to service connection for headaches is remanded. Entitlement to service connection for blurry vision is remanded. Entitlement to service connection for vertigo is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for left lower extremity radiculopathy is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from November 1955 to November 1975. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2013 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). In November 2018, the Board denied the Veteran's above claims for service connection and the Veteran appealed that decision to the Court of Appeals for Veterans Claims (CAVC). In a June 2020 Memorandum Decision, the Court vacated the Board's November 2018 decision and remanded the claims for further development and readjudication. The Board then remanded the above claims, in a February 2021 decision, for further development. Although the Board regrets further delay, remand is necessary to ensure compliance with previous remand directives and proper development. 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). Headaches, Blurry Vision, Vertigo, and Tinnitus The Veteran has alleged that these disabilities are etiologically related to his exposure to various toxic substances at Fort McClellan, Alabama. As part of the prior February 2021 Remand, the Board instructed the RO to attempt to verify through official sources the Veteran's alleged exposure to hazardous chemicals and environmental contaminants while stationed at Fort McClellan, Alabama, "in accordance with appropriate adjudication manual provisions." The RO attempted to locate information regarding the Veteran's claimed exposure, however, in two April 2021 Records Research Responses the RO was informed that the Military Records Research Center was not the correct resource in which to search for the Veteran's type of claimed exposure, and were told to refer to a separate section of the adjudication manual for the procedures to verify the Veteran's type of claimed exposure. However, it appears that the RO did not further develop the Veteran's claim. As such, the Board finds a remand is necessary to ensure proper development of the Veteran's claims. Additionally, the Board notes that the Veteran has further claimed that his headaches, vertigo, tinnitus, and blurry vision are possibly due to incidents where he lost consciousness in service. In the June 2020 Memorandum Decision, CAVC indicated that the Board should order new examinations to address these contentions. Therefore, after the required development regarding the Veteran's claimed exposures is completed, the RO should afford the Veteran VA examinations regarding the etiology of claimed disabilities to see if they are related to any confirmed chemical exposures or to the Veteran's claimed incidents where he lost consciousness during service. Low Back Disability Part of the June 2020 CAVC Memorandum Decision required the Board to determine if the Veteran's alleged chemical exposures "contributed to his chronic back pain or the Veteran's atypical symptoms as outlined in the December 2005 examination report." As noted above, the development for the chemical exposure has not been fully completed. Additionally, the Veteran's recent April 2021 VA medical opinion regarding his back disability does not address his alleged chemical exposure. As such, the Board finds that this claim needs to be remanded for the RO to attempt to verify the Veteran's in-service exposure. When/if the Veteran's exposure to hazardous substances is determined then an addendum medical opinion regarding the chemical exposure and the Veteran's claimed back pain would be required. Lower Left Extremity Radiculopathy The Veteran's claim for service connection for left lower extremity radiculopathy is inextricably intertwined with the claim for service connection for a low back disability. Therefore, that claim is remanded for contemporaneous adjudication. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that two issues are inextricably intertwined when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issues has been rendered). The matters are REMANDED for the following action: 1. Attempt to verify through official sources the Veteran's alleged exposure to hazardous chemicals and environmental contaminants while stationed at Fort McClellan, Alabama in October 1985 and from March 1988 to May 1989, in accordance with appropriate adjudication manual provisions. All efforts to obtain the evidence and findings thereof must be documented in the claims file. If after all procedurally appropriate actions to locate and secure the records have been exhausted, and it is reasonably certain that such records do not exist or that further efforts to obtain those records would be futile, make a formal finding to that effect. 2. Then, obtain medical opinions from a VA examiner(s), with sufficient expertise to comment on the etiology of the Veteran's headaches, vertigo, tinnitus, and blurry vision. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Following a review of the relevant records and lay statements, the examiner(s) should state an opinion with respect to whether the Veteran's blurry vision, headaches, tinnitus, and vertigo disabilities at least as likely as not (a 50 percent probability or greater) originated during the Veterans period of active service or is otherwise etiologically related to his active service, to include as due to his claimed contaminants exposure at Fort McClellan, Alabama. The examiner(s) must provide a complete rationale for all proffered opinions. In this regard, the examiner must discuss and consider the Veteran's competent lay statements made throughout the record. In rendering an opinion, the examiner(s) must address the articles cited by the Veteran. Further, the examiner(s) must address the December 2005 treatment note indicating that the Veteran was experiencing atypical symptoms, and must address the Veteran's report from the June 2017 Psychological Evaluation wherein he indicated numerous head injuries and 3 instances of loss of consciousness. 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. 3. If the Veteran's exposure to contaminants at Fort McClellan is confirmed then the RO should obtain an addendum opinion from the examiner who provided the April 2021 Lower Back medical opinion, or if they are unavailable from another qualified examiner. The examiner should review the file, including this remand. A new VA examination is not necessary unless the VA examiner providing the opinion determines one is needed. The examiner should be instructed to please provide the following opinion: is it at least as likely as not (a 50 percent probability or greater) that the Veteran's claimed lower back disability, to include chronic lower back pain, is etiologically related to the Veteran's in-service contaminant exposure? The examiner must provide a complete rationale for all proffered opinions. If the examiner cannot provide the required opinions without resorting to speculation, he or she shall provide a complete explanation as to why that is the case. Further, the examiner must state whether the inability to provide the required opinions is based on a personal limitation or on a lack of knowledge among the medical community at large. 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.