Citation Nr: 21065901 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 15-26 972 DATE: October 27, 2021 REMANDED Entitlement to service connection for poor circulation of the bilateral legs, to include as secondary to service-connected left ankle disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1980 to September 1983. The Board most recently remanded the claim in July 2021 for further development. The Board errs when it fails to ensure substantial compliance with a Board remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (Board remand confers a right on a claimant to compliance with the remand order); Dyment v. West, 13 Vet. App. 141, 147 (1999) (clarifying that substantial compliance with Board remand is required). Where the Board fails to ensure substantial compliance, remand is appropriate. Stegall, 11 Vet. App. at 271. Accordingly, the Board finds it necessary to remand these issues for the RO to complete its development. The Veteran seeks service connection for a disability characterized by poor circulation of the bilateral legs, to include as secondary to his service-connected left ankle disability. In August 2021, an examiner opined that the Veteran's poor circulation condition was less likely than not incurred in service because the first mention of any circulatory issues wasn't until 2012, 30 years after the Veteran's service period ended. The examiner additionally opined that the Veteran's poor circulation condition is less likely than not proximately due to or aggravated by service-connected left ankle disability because it is not known to cause or aggravate circulatory issues. The examiner provided the same improper conclusory opinions as the March 2021 VA examiner, which the Board previously found to be insufficient. The Board finds that the RO has not complied with the previous Board remand and that a supplemental VA opinion is still needed to provide more responsive explanations that specifically consider the Veteran's lay statements concerning the onset and progression of his symptoms. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician to determine the nature and likely etiology of the Veteran's poor circulation condition, to include peripheral vascular disease. Copies of all pertinent records must be made available to the examiner for review. If the examiner determines that an opinion cannot be provided without an examination, (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) one should be scheduled. After reviewing the claims file, the examiner is asked to answer the following questions: (a) Is it at least as likely as not (50 percent probability) that any currently diagnosed poor circulation condition was incurred in or is otherwise related to service? (b) Is it at least as likely as not (probability of at least 50 percent) that any currently diagnosed poor circulation condition is proximately due to (caused by) the Veteran's service-connected left ankle disability? (c) Is it at least as likely as not (probability of at least 50 percent) that any currently diagnosed poor circulation condition has been aggravated by the Veteran's service-connected left ankle disability? The examiner is advised that the term "aggravation" is defined for legal purposes as a chronic worsening of the underlying condition beyond its natural progression. If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (i.e., a baseline) before the onset of the aggravation. The examiner must address the Veteran's lay assertions as to the onset and progression of his disability. The examiner is also advised that the Veteran is competent to provide evidence of symptomatology readily apparent to him, regardless of whether the symptoms are noted in the service medical records or on the date of examination. The examiner should note any medical literature used to support his/her decision. (Continued on the next page) The examiner must provide reasons for each opinion given. If the examiner is unable to provide an opinion without resort to speculation, he or she should explain why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered. A. J. Spector Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lent, Edward 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.