Citation Nr: 21064877 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 16-28 000 DATE: October 21, 2021 REMANDED Entitlement to service connection for rheumatoid arthritis of the sacroiliac joints is remanded. REASONS FOR REMAND The Veteran served honorably on active duty from July 1962 to February 1966 and from March 1971 to June 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2015 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). As a preliminary matter, this claim was previously before the Board in August 2019 and May 2021, at which times it was remanded to the Agency of Original Jurisdiction (AOJ) for further evidentiary development. While the Board finds that the May 2021 remand directives have been substantially complied with, the Board has found that a remand of the claim is necessary prior to adjudication, discussed further below. Entitlement to service connection for rheumatoid arthritis of the sacroiliac joints is remanded. The Veteran contends that his rheumatoid arthritis of the sacroiliac joints is related to his active-duty service. As mentioned above, pursuant to the August 2019 Board remand of the claim, a VA examination and opinion was obtained addressing the nature and etiology of the Veteran's rheumatoid arthritis of the sacroiliac joints. However, the Board finds that the VA opinion obtained in April 2021 is inadequate and as such, an addendum opinion must be obtained. Notably, the opinion provided by the April 2021 VA examiner was conclusory and did not provide adequate rationale regarding the etiology of the Veteran's rheumatoid arthritis. The April 2021 VA examiner relied solely on the absence of evidence in the Veteran's service treatment records (STRS), which is inadequate. The mere absence of documentation in STRs of a claimed disorder is not, in itself, an adequate basis on which to rest a medical opinion. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). Additionally, the VA examiner did not consider nor address pertinent medical and lay evidence that the Veteran experienced symptoms rheumatoid arthritis of the sacroiliac joints prior to his official diagnosis. The Veteran complained of swollen and painful joints during his separation examination in 1972. See e.g., May 1972, separation examination, report of medical history. As such, a remand is required to obtain an addendum VA medical opinion addressing the etiology of the Veteran's current rheumatoid arthritis of the sacroiliac joints. The matters are REMANDED for the following action: 1. Obtain an addendum VA opinion regarding the Veteran's current rheumatoid arthritis of the sacroiliac joints. The electronic claims file must be reviewed by the examiner. Following a review of the claims file, the examiner shoulder provide the following opinion: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran's current rheumatoid arthritis of the sacroiliac joints is related to his active-duty service, to include the documented complaints of unknown arthritis therein? Review of the claims file is required; however, attention is specifically invited to the document labeled C&P Exam, receipt date 12/19/1989, pages 1, 4, and 8; the service separation examination (document labeled STR-Medical), receipt date 9/23/1974, pages 11 and 17 of 43. The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached. The examiner is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather, that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it. Note that the lack of documented treatment in service cannot serve as the sole basis for a negative finding. Bethany L. Buck Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. M. Lowman, 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.