Citation Nr: 21067544 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 12-13 710 DATE: November 4, 2021 REMANDED Entitlement to service connection for peripheral vascular disease (PVD) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1968 until April 1970, with periods of inactive duty for training (INACDUTRA) in the National Guard. This case was previously before the Board in June 2016, November 2017, and September 2018, when it was remanded for further development. In October 2020, the Board denied the claim of entitlement to service connection for PVD. The Veteran timely appealed the decision to the United States Court of Appeals for Veterans Claims (Court), and by a July 2021 Order, the Court granted a Joint Motion for Remand (JMR) that vacated the October 2021 Board decision and remanded the issue for further adjudication. The JMR noted that the Board did not ensure compliance with its own August 2017 remand directives and relied upon an inadequate August 2019 VA medical opinion. Specifically, the Board first asked the examiner to address whether the Veteran's reports of leg pains in 1970 were early symptoms of PVD. In response, the examiner stated that it was "likely due to another condition" but did not cite to any evidence or provide any further explanation regarding the other condition. Next, the Board asked the examiner to address the reported 1976 diagnosis of PVD, the 1985 treadmill test that showed evidence of claudication and the Veteran's testimony regarding onset and continuity of leg pain symptoms. In response, the examiner relied on the lack of treatment records to substantiate the 1976 diagnosis and 1985 treadmill test without addressing the Veteran's lay statements regarding the 1976 diagnosis and 1985 treadmill test, although the Board had previously cited those statements as competent and credible. The Court noted that the examiner relied upon the same 30-year gap between separation and the first PVD treatment record in support of her opinion that the earlier inadequate examination opinions relied upon. Lastly, the Board asked the examiner to address the May 2017 VA examiner's explanation regarding the gradual nature of PVD. The Court noted that the examiner confirmed that PVD had a gradual onset but did not apply it to the Veteran's particular circumstances. Accordingly, a remand is necessary pursuant to the Court's JMR to obtain an addendum medical opinion which specifically answers the Board's questions prior to deciding the claim on the merits. See Stegall v. West, 11 Vet. App. 268 (1998) (finding that a remand by the Board confers on the Veteran the right to compliance with its remand orders). The matters are REMANDED for the following action: 1. Obtain another medical opinion from the August 2019 VA examiner, if possible, or from another appropriately qualified examiner, to help determine the likely etiology of the Veteran's PVD. The claims file and a copy of this remand must be made available to the examiner, who will acknowledge receipt and review of these materials. The examiner is asked to respond to the following: (a) Whether it is at least as likely as not (50 percent or greater probability) that PVD had its onset during the Veteran's period of active military service or is otherwise etiologically related to it; and (b) Whether it is at least as likely as not that the Veteran's PVD manifested to a compensable degree within one year of separation from service. **In doing so, the examiner MUST specifically address each statement that follows: (i) whether the Veteran's reports of leg pains in 1970 were early symptoms of PVD; and (ii) the reported 1976 diagnosis of PVD; and (iii) the 1985 treadmill test that showed evidence of claudication: and (iv) the Veteran's testimony regarding onset and continuity of leg pain symptoms; and (v) the May 2017 VA examiner's explanation regarding the gradual nature of PVD. **Per the JMR, the examiner is to specifically consider the Veteran's competent statements and reported diagnoses in formulating the opinion. **A full and thorough rationale must be provided for any opinion given, referencing relevant medical and lay evidence where appropriate. (Continued on the next page) As noted by the JMR, a negative etiology opinion based solely on the lack of a documented in-service diagnosis or treatment of PVD is inadequate. 2. Thereafter, readjudicate the remanded claim. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Beach, Julia M. 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.