Citation Nr: 21064988 Decision Date: 10/22/21 Archive Date: 10/22/21 DOCKET NO. 13-06 463A DATE: October 22, 2021 REMANDED The issue of entitlement to service connection for congestive heart failure (CHF) due to ionizing radiation exposure is remanded. The issue of entitlement to service connection for a kidney disability due to ionizing radiation exposure is remanded. The issue of entitlement to service connection for a lung disability due to ionizing radiation exposure is remanded. The issue of entitlement to service connection for osteoarthritis due to ionizing radiation exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1952 to August 1955. The Veteran died in July 2019. The RO granted substitution for the appellant. See VA correspondence, August 2019. In August 2019, the appellant testified under oath before the undersigned Veterans Law Judge at a travel board hearing. A transcript of the hearing is of record. In November 2020, the Board remanded the issues on appeal for further development. For the reasons outlined below, the Board finds that remand is again needed. 1. Entitlement to service connection for CHF due to ionizing radiation exposure. 2. Entitlement to service connection for a kidney disability due to ionizing radiation exposure. 3. Entitlement to service connection for a lung disability due to ionizing radiation exposure. 4. Entitlement to service connection for osteoarthritis due to ionizing radiation exposure. The Board finds that additional development is needed prior to final adjudication of the issues on appeal. Specifically, the Board finds that new VA opinions are needed. In the November 2020 remand, the Board directed that a VA opinion be obtained that addressed the etiology of the claimed disabilities on appeal. The examiner was asked to "address articles submitted by the appellant in August 2019." (Emphasis in original). The Board identified the following articles: (1) a May 2018 American Heart Association article from Science Daily; (2) an October 2017 Health and Human Services article; (3) a January 2001 Fairness and Accuracy in Reporting article by Norman Solomon; and (4) William Finch and Kamran Shamsa's article titled "Cardiovascular Complication of Radiation Exposure." The Board acknowledges the July 2021 VA opinions. However, these opinions do not address the articles as directed by the Board in the November 2020 remand. It appears that this omission was identified by the AOJ and an addendum opinion was obtained in August 2021. In the addendum opinion the examiner noted review of the identified articles, but then repeated the July 2021 prior opinions seemingly verbatim. The Board does not consider this an adequate or meaningful analysis of the evidence submitted. Accordingly, remand is again needed for new VA opinions. Similarly, regarding the conceded ionizing radiation exposure, in the November 2020 remand, the Board noted claims that the Veteran "was walking in the dust after the tests. No face mask, no protective clothing." (Citations omitted). The July 2021 VA opinions do not address the claims of walking in dust or the lack of protective gear. The Board asks that an examiner address these claims upon remand. In rendering new opinions, the Board asks that the examiner clearly identify the diagnosis being evaluated. For example, in the July 2021 VA opinion for the claimed kidney disability, the opinion rationale refers to an "Unspecified kidney disability." However, the September 2020 VA opinion states that the "[V]eteran had a diagnosis of renal parenchymal disease." Accordingly, upon remand, the Board asks that the examiner clearly identify the disabilities diagnosed and provide opinions specific to these diagnoses. Finally, to the extent that articles identified or submitted may constitute "competent scientific or medical evidence" as contemplated under 38 C.F.R. § 3.311 (b)(4) (see, e.g., Correspondence, September 2019), the Board asks that any additional appropriate development be taken, to include referral to the Under Secretary for Benefits for further consideration in accordance with 38 C.F.R. § 3.311 (c). See 38 C.F.R. § 3.311 (b). The matters are REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issues on appeal. The Board notes a pending request for VA treatment records from a facility in N. for the year 1990. To the extent that this records request remains outstanding, it should be addressed upon remand. All efforts should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, obtain VA opinions, from a new examiner, that clarify the diagnoses and addresses the etiologies of the claimed disabilities on appeal. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran's active-duty service, to include conceded in-service radiation exposure. (The Board notes that the appellant claims that the Veteran "was walking in the dust after the tests. No face mask, no protective clothing." See Statement, August 2012.) Please also address articles identified and submitted, to include in May 2011, October 2012, August 2019, September 2019, and January 2020. The Board notes that the appellant submitted a statement asking the Board to specifically consider the following: (1) a May 2018 American Heart Association article from Science Daily; (2) an October 2017 Health and Human Services article; (3) a January 2001 Fairness and Accuracy in Reporting article by Norman Solomon; and (4) William Finch and Kamran Shamsa's article titled "Cardiovascular Complication of Radiation Exposure." See Statement, October 2020. In addition, the Board notes that the appellant submitted a statement in September 2021 indicating that the Veteran "never smoked in his life." The Board asks that this be considered by the examiner. The VA examiner should be given access to the claim file, including a copy of this remand. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 3. After taking all appropriate development, forward the appeal to the Under Secretary for Benefits pursuant to 38 C.F.R. § 3.311. 4. If upon completion of the above action the issues are denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Foster, 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.