Citation Nr: 21067585 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 12-21 219 DATE: November 4, 2021 REMANDED Entitlement to service connection for Parkinson's disease is remanded. Entitlement to service connection for a back disability is remanded. Entitlement to service connection for a cervical spine disability is remanded. REASONS FOR REMAND The Veteran served in active-duty service with the Air Force from June 1967 to June 1971. This matter is on appeal from a November 2009 rating decision. The Veteran was afforded a November 2018 hearing before a Veterans Law Judge (VLJ), and another March 2015 hearing before the undersigned Judge. Transcripts of the hearings have been associated with the claims record. The Board remanded this appeal in May 2015, February 2019, June 2020, and March 2021 for additional development. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). Unfortunately, the Board finds that remand is warranted for additional development. Regarding Parkinson's disease, the Board notes that the Veteran has claimed various exposures as the cause for his claimed issue. In a March 2009 claim, the Veteran asserted that his Parkinson's disease was due to exposure from ionizing radiation. In an October 2010 notice of disagreement (NOD), the Veteran reported that his exposure "could just as likely be from... radiation, herbicide, adherents (metal, lead/tin), and asbestos." The Board notes that Board remands in May 2015, February 2019, June 2020, and March 2021 have instructed the Regional Office (RO) to conduct development to verify the Veteran's claimed exposure in relation to his Parkinson's disease. The Board also notes that during the appeal period various requests were made for development but were not completed as they were not considered valid requests with no followup from the Regional Office. The Board noted in particular the March 2021 Board remand instructed the RO to develop the Veteran's claim for herbicide and asbestos exposure. In a May 2021 research response, it was noted that the requested organization did not perform research requests for asbestos exposure; however, it did refer the RO to relevant regulation in order to complete the development request. In a July 2021 email correspondence, it was noted that review of Department of Defense (DOD) records review did not find evidence to support the Veteran's claimed herbicide exposure; however, the email added that unless the Veteran's claim was "inherently incredible or clearly lacks merit," the claim was to be referred for further development with other related organizations as identified in the email. Review of the record does not show that the RO followed up on either of the instructions or referrals in the research responses. The Board also notes that there were no formal findings made by the Regional Office for the claimed exposures, therefore it is unclear from the record what development the Regional Office has completed and whether the March 2021 Board remand directives were followed. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that where remand instructions are not followed, the Board errs as a matter of law when it fails to ensure compliance). As such, the Board finds remand is warranted for the RO to complete development for the Veteran's claimed issue and exposure to include compliance with the March 2021 Board remand instructions. Concerning the Veteran's claimed back and cervical spine disabilities, the Veteran has stated and testified that he suffered a motor vehicle accident during his active-duty service that required treatment at an off-base hospital. The March 2021 Board remand requested an opinion to address the nature and etiology of the Veteran's back and cervical spine disabilities. In May 2021, a VA examiner opined the Veteran's back and cervical spine disabilities were not related to service, stating that "any injury [in service] was minor and resolved" with no history of significant injury or else has resolved. However, neither opinion specifically discussed or addressed the Veteran's statements and testimony regarding his reported inservice MVA and why such statements or testimony were not considered as requested by the March 2021 remand. See Stegall, 11 Vet. App. at 271. As such, the Board finds the opinions inadequate, and remand warranted for a new opinion. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all updated and outstanding treatment records. 2. Request that the Veteran complete a VA Form 21-4142 and provide the names and addresses of any and all healthcare providers who provided treatment for the Veteran's claimed Parkinson's disease, back, and cervical spine disability. (a.) After acquiring this information and obtaining any necessary authorization, obtain and associate any pertinent records with the claims folder. Make two requests for the authorized records from any identified provider, unless it is clear after the first request that a second request would be futile. All attempts to procure such records must be documented within the claims file. 3. Contact the appropriate agency or agencies to develop and verify the Veteran's exposure to herbicides, metals such as lead and tin, radiation, and asbestos following the relevant regulation to develop each exposure. If radiation exposure is identified, the necessary development should be conducted pursuant to 38 C.F.R. § 3.311. (a.) Any response should be documented in the claims file. The Regional Office should address and complete any recommended procedures or regulations to complete development to verify the Veteran's claimed exposures. If there is insufficient information to verify exposure to herbicides, metals such as lead and tin, radiation, and asbestos, the Regional Office is to issue a Formal Finding outlining the steps taken to assist the Veteran and notify the Veteran of VA's inability to verify the claimed inservice exposure. Associate the Formal Finding with the electronic claims folder. 4. Obtain a VA medical opinion on the Veteran's claimed Parkinson's disease, back and cervical spine disability. The record and a copy of this remand must be made available to the examiner. If the examiner determines that an examination of the Veteran is necessary to provide the requested opinion with rationale, then such examination should be scheduled. The VA examiner should address the following: (a.) Identify whether a diagnosis of Parkinson's disease is warranted, and whether there is any current back and/or cervical spine disability. If either disability existed during the appeal period to the present but has resolved, this should be made clear. (b.) The examiner should record any functional limitations or impairment noted on examination of the back and cervical spine disability. (c.) For the Veteran's Parkinson's disease, the examiner is asked to address whether it is at least as likely as not related to or caused to any confirmed in-service herbicide, metals such as lead and tin, radiation, or asbestos exposure? (d.) Is it at least as likely as not that the Veteran's Parkinson's Disease is otherwise related to the Veteran's active military service? (e.) For each back disability identified, whether resolved or active, please address whether it is at least as likely as note (a probability of 50 percent or greater) that such disability is etiologically related to the Veteran's active-duty military service to include a reported motor vehicle accident? (f.) For each cervical spine disability identified, whether resolved or active, please address whether it is at least as likely as note (a probability of 50 percent or greater) that such disability is etiologically related to the Veteran's active-duty military service to include a reported motor vehicle accident? (g.) The examiner is asked to address the Veteran's submitted lay statements to include the April 2021 statement; the Veteran's wife's August 2020 statement; the reported treatment for a coccyx injury in the Veteran's STRs and reported recurrent back pain in the Veteran's December 1970 separation examination; October 2010 notice of disagreement (NOD); March 2015 and November 2018 hearing testimony; and the January 2021 and May 2021 VA examination findings. (h.) If the examiner cannot provide the above opinions, the examiner is advised that he/she must explain why the requested opinion cannot be provided (i.e., because the limits of medical knowledge had been exhausted or because further information to assist in making the determination is needed, such as additional records and/or diagnostic studies). (i) If the VA examiner is unable to provide an opinion without resort to speculation, he or she should explain whether the inability is due to the limits of the examiner's medical knowledge, medical knowledge in general or there is evidence that, if obtained, would permit the opinion to be provided. A clearly stated rationale for any opinion offered should be provided. 5. After completion of the above and any additional development deemed necessary, the issues on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought remains denied, the Veteran should be furnished a supplemental statement of the case and be afforded the opportunity to respond. Thereafter, the case should be returned to the Board for appellate review. MICHAEL LANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Yang, Attorney-Advisor 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.