Citation Nr: 21066090 Decision Date: 10/28/21 Archive Date: 10/28/21 DOCKET NO. 16-48 693 DATE: October 28, 2021 REMANDED Entitlement to service connection for a disability manifested by neck and scalp cysts is remanded. Entitlement to service connection for hepatitis C with cirrhosis of the liver is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1976 to March 1981. These matters come before the Board of Veterans' Appeals (Board) on appeal from an October 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board previously remanded the claim of entitlement to service connection for a disability manifested by neck and scalp cysts for additional development in November 2018, April 2020, and May 2021. In May 2021, the Board remanded the issue of entitlement to service connection for hepatitis C with cirrhosis of the liver as well. 1. Entitlement to service connection for a disability manifested by neck and scalp cysts is remanded. Pursuant to the May 2021 Board remand, the Board instructed that an addendum opinion be obtained to address the etiology of the Veteran's cysts of the neck and scalp. Specifically, in providing the opinion, the Board instructed that the examiner consider and discuss, among other things, the Veteran's competent lay reports of observable symptomology, the October 1979 service treatment record showing the Veteran complained of facial irritation that started when he was on Enewetak Atoll and the November 2005 VA treatment record that notes the Veteran had experienced cysts on his face and scalp "for many years." The requested addendum opinion was obtained in July 2021; however, in providing the opinion the examiner failed to discuss the Veteran's competent lay reports of observable symptomology as well as the October 1979 service treatment record showing the Veteran complained of facial irritation that started when he was on Enewetak Atoll as instructed by the Board's May 2021 remand directive. Consequently, there has not been substantial compliance with the Board's previous remand directive and another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). 2. Entitlement to service connection for hepatitis C with cirrhosis of the liver is remanded. In its May 2021 remand, the Board instructed that a statement of the case (SOC) be issued to the Veteran and his representative to address the issue of service connection for hepatitis C with cirrhosis of the liver pursuant to Manlincon v. West, 12 Vet. App. 238, 240-41 (1999); however, to date, the SOC has not been issued as instructed by the Board. Consequently, there has not been substantial compliance with the Board's previous remand directive and another remand is required. Stegall, 11 Vet. App. at 271. Updated treatment records should also be obtained upon remand. The matters are REMANDED for the following actions: 1. Issue a statement of the case (SOC) for the issue of entitlement to service connection for hepatitis C with cirrhosis of the liver to the Veteran and his representative. The Veteran and his representative should be advised of the time limit for perfecting an appeal and afforded such period of time to do so. If, and only if, a timely appeal of the issue is perfected, should the matter be returned to the Board. 2. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed disabilities. After securing any necessary releases, the AOJ should request any relevant records identified. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran and his representative should be notified of such. 3. After records development is completed, schedule the Veteran for an appropriate VA examination to determine the nature of his claimed disability manifested by cysts on the neck and scalp and to obtain an opinion as to whether such is possibly related to service. The claims file should be reviewed by the examiner in conjunction with the examination. All necessary tests should be conducted, and the results reported. Following review of the claims file and examination of the Veteran, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any current disability manifested by cysts on the neck and scalp arose during service or is otherwise related to service, to include as due to exposure to radiation. Please explain why or why not, to include specifically addressing the Veteran's competent lay reports of observable symptomatology, the October 1979 service treatment record that shows the Veteran complained of facial irritation that started when he was on Enewetak Atoll, and the November 2005 VA treatment record that notes the Veteran had experienced cysts on his face and scalp "for many years.". A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Medina 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.