Citation Nr: A21017392 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 200520-86339 DATE: October 27, 2021 REMANDED Entitlement to service connection for chronic salpingitis is remanded. REASONS FOR REMAND The Veteran served in the Army National Guard from September 1980 to February 1981. In May of 2020, the Veteran filed a notice of disagreement (NOD) in which she requested the direct review lane under the Appeals Modernization Act (AMA) review system in response to an April 2020 rating decision issued by the regional office (RO). Under direct review, no development may be undertaken; the VLJ considers the same record as the RO in rendering a decision. The only exception is if the Board finds that there was pre-decisional error by the RO. In this case, the Board's review of the claims file reveals that further agency of original jurisdiction (AOJ) action in this appeal is warranted as there are pre-decisional duty to assist errors that occurred prior to the AOJ adjudication on appeal. More specifically, the VA examiner who authored an opinion in March of 2020 indicated that "[t]he veteran records show [in] 2006 she opted to have total hysterectomy after several attempts of having children". However, this examiner did not specify what these supposed records were, and the Board observes that there are currently no treatment records associated with the claims file. The Board is unclear whether treatment records were previously of record and were removed at some point, or whether there were never any such records available for review, in which case the VA examiner's rationale is not accurate. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993). Either way, if the Veteran had treatment related to this claimed condition after her departure from the military, which the hysterectomy she apparently had post-service indicates, then efforts to obtain these records should be made. Further, there are no DD-214s currently associated with the record, and there are almost no personnel records. As it appears that what is of record was submitted by the Veteran herself, efforts to obtain any outstanding service treatment records (STRs) and personnel records should be made on remand. Lastly, an additional VA opinion considering any evidence associated with the record on remand should be obtained. Even if no additional evidence is added on remand, a new opinion should be obtained as in addition to the issue highlighted above with the March 2020 VA opinion, the Board observes that that examiner also concluded that "the claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness." However, the examiner provided as rationale that "the veteran['s] pain did not seem to be aggravated by service" but did not acknowledge that her in-service complaints of pain and associated in-service treatment led to her being discharged for "failure to meet enlistment and medical fitness standards". There offered rationale does not contain a sufficient explanation for how it was determined that this did not represent an increase in severity during service. As such, a remand is necessary for an addendum opinion. The matter is REMANDED for the following actions: 1. Contact the Veteran and afford her the opportunity to identify by name, address and dates of treatment or examination any outstanding private treatment providers. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and her representative. 2. Obtain any outstanding relevant VA treatment records and associate them with the record. 3. Obtain any outstanding STRs, DD-214s and/or personnel records and associate them with the record. 4. Following the completion of steps one through three, obtain an addendum opinion from an appropriate VA clinician. The clinician must be provided with and review the entire claims file, to include a copy of this remand. If deemed necessary by the clinician in order to provide the requested opinion, schedule a VA examination of the Veteran. Following a review of the evidence of record, to include the Veteran's lay statements, the clinician should answer the following: (a.) Based upon review of the service and any post-service treatment records, the lay statements of record, and any examination findings, opine as to whether there is clear and unmistakable evidence that the disorder was not aggravated by service (worsened beyond its natural progression). The clinician is asked to reconcile, to the extent possible, the findings on the February 1981 Narrative of Separation of "failure to meet enlistment and medical fitness standards". The clinician must provide the underlying reasons for any opinions provided. If the clinician is unable to provide this opinion without resorting to speculation, he or she must indicate why this is so. 5. After completing the requested actions and any additional notification and/or development deemed warranted, adjudicate the claim on appeal considering all pertinent evidence. MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Smith, 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.