Citation Nr: 21066308 Decision Date: 10/29/21 Archive Date: 10/29/21 DOCKET NO. 19-08 824 DATE: October 29, 2021 REMANDED Entitlement to service connection for polyneuropathy, to include Charcot-Marie-Tooth disease, to include as due to radiation exposure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from August 1952 to January 1954. In July 2019, August 2019, and December 2020, the Board remanded the case for further development by the Agency of Original Jurisdiction (AOJ). The Board notes that the Veteran's appeal had originally included the issue of service connection for squamous cell or basal cell carcinoma. However, in June 2020, the AOJ granted service connection for residual scars of squamous cell and basal cell carcinoma, noting that there was no evidence of active disease. The grant of service connection constitutes a full award of the benefits sought on appeal. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). Thus, this claim is no longer in appellate status. Id. at 1158. Unfortunately, there has not been substantial compliance with the Board's previous remand directives. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for polyneuropathy, to include Charcot-Marie-Tooth disease, to include as due to radiation exposure is remanded. The VA obtained a VA examination and opinion in January 2020 and an addendum opinion in January 2021. While the January 2021 examiner opined against relation to service, the examiner's opinion relies exclusively on a lack of evidence in the service treatment records (STRs) and lacks an adequate rationale. A negative opinion based solely on the lack of evidence in STRs is inadequate, especially considering the unavailability of the Veteran's STRs due to no fault of his own. See generally, Dalton v. Nicholson, 21 Vet. App. 23 (2007). Additionally, here, while STRs are unavailable for review, the Veteran's DD 214 reflects that he was discharged by reason of physical disqualification from service, suggesting that the Veteran's physical condition may have deteriorated while in service. Further, the opinion provided no rationale and did not reflect that the examiner considered the treatise evidence of record, the Veteran's conceded radiation exposure, or private treatment records showing symptoms in 1971. See August 1971 private treatment record; January 2020 VA examination. As the opinions of record are inadequate, an addendum opinion should be obtained. The matters are REMANDED for the following action: 1. Obtain an opinion from an appropriate clinician regarding the Veteran's Charcot-Marie-Tooth disease with polyneuropathy of the bilateral upper and lower extremities. Only schedule the Veteran for an examination if deemed necessary by the reviewing clinician to adequately respond to the Board's questions. The examiner is asked to provide a response to the following regarding the above condition: (a.) Whether the Veteran's disability is a congenital defect, a congenital disease, or neither. (A defect is a condition that can neither improve nor worsen. A congenital disease, for VA purposes, is a congenital condition that is subject to improvement and/or worsening). (b.) If it is a congenital defect, explain whether it is at least as likely as not (a probability of 50 percent or greater) that there was a superimposed injury or disease in active duty that resulted in additional disability. (c.) If it is a congenital disease, determine whether there is clear and unmistakable evidence that it existed prior to service. If so, the examiner must then address whether there is clear and unmistakable evidence that it did not worsen beyond its normal progression during service. The examiner is advised that the evidentiary standard for whether a condition existed prior to service is "clear and unmistakable," which is a formidable evidentiary standard, requiring that the preexistence of a condition and the no-aggravation result be "undebatable." (d.) If Charcot-Marie-Tooth disease with polyneuropathy is found to be neither a congenital defect nor disease, determine whether it is at least as likely as not (a probability of 50 percent or greater) that it first began during or is otherwise related to service, to include as due to conceded radiation exposure. In providing the requested opinion, the examiner is asked to thoroughly consider the competent history reported by the Veteran, medical evidence of symptoms after a back injury in 1971, along with what the records show. The examiner is advised that the Veteran's service treatment records are unavailable due to no fault of the Veteran. No negative inference may be drawn from the lack of records. A complete rationale must be offered for all requested opinions. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.L. Blevins, 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.