Citation Nr: 21068968 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 16-61 791 DATE: November 17, 2021 REMANDED Entitlement to service connection for rheumatoid arthritis is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from January 1966 to August 1969, including service in the Republic of Vietnam. This case comes before the Board of Veterans' Appeals (Board) on appeal from a July 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2019, the Veteran testified before a Veterans Law Judge (VLJ). A transcript of the hearing is of record. The Board notes that the VLJ who conducted this hearing is no longer employed at the Board. VLJs who conduct hearings must participate in making the final determination of the claim on appeal. 38 U.S.C. § 7107(c); 38 C.F.R. § 20.707. In an August 2021 letter, the Board notified the Veteran that the VLJ was no longer employed by the Board, and informed him of the right to another hearing. This letter also informed that if the Veteran did not respond within 30 days, the Board would assume that another hearing was not desired and would proceed to adjudicate the claim on appeal. In September 2021, the Veteran responded that he did not wish to appear for another Board hearing. In December 2019, the Board remanded the Veteran's claim for additional development. The Board notes there was substantial compliance with its December 2019 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). However, the Board regrettably finds that another remand is necessary, prior to readjudication of the claim. In January 2020, the Veteran was afforded a VA examination and medical opinion to determine the current nature and etiology of his claimed condition. Upon examination, the examiner diagnosed the Veteran's disorder as rheumatoid arthritis, and provided an unfavorable opinion as to this condition being etiologically related to the Veteran's active service, to include his exposure to Agent Orange. Nevertheless, the Board finds this opinion to be inadequate, as the examiner partially relied on the absence of medical evidence in-service noting a diagnosis of an arthritis condition. Additionally, the examiner failed to discuss the October 2019 VA treatment record that provided a positive medical opinion regarding the possible relationship between the Veteran's condition and his Agent Orange exposure. Moreover, the Board notes that the Veteran's representative, in an August 2021 brief, raised the contention that the Veteran's condition was not only caused by his exposure to Agent Orange, but also by other hazardous chemicals, solvents, dioxins, paint, and jet fuel and fumes due to his military occupation as a boatswain. To date, no VA examiner of record has provided any discussion regarding the possible relationship of these additional in-service exposures and the Veteran's rheumatoid arthritis. Therefore, the Board finds that the Veteran should be provided an addendum VA medical opinion that adequately addresses the matters discussed above. Furthermore, the record reveals that the Veteran has been receiving treatment for his rheumatoid arthritis from private rheumatologists; however, a review of the file does not reflect that any private treatment records have been obtained and associated in the file for review. As such, the RO should obtain these records for review, prior to readjudication of the claim. The matters are REMANDED for the following action: 1. Request the Veteran to identify all medical providers (VA and private) from whom he has received treatment for his rheumatoid arthritis and obtain any outstanding records and associate them with the Veteran's claims file, to include any private treatment records from his rheumatologists in a clinic in Marshfield and in Escanaba, MI. 2. After associating all newly acquired records with the claims file, provide the Veteran an addendum VA medical opinion to determine the nature and etiology of his rheumatoid arthritis. The entire claims file, including a copy of this remand, must be made available to the examiner, and note review of the record in the examination report. Any indicated tests or studies should be performed, and all relevant evidence should be discussed. All pertinent medical complaints, symptoms, and clinical findings must be reported in detail. If the examiner finds that a new VA examination must be scheduled prior to providing the opinion, schedule such an examination. Following complete review of the record, the examiner must address the following: (a) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's rheumatoid arthritis had its onset during any period of active duty service, or is otherwise etiologically related to his active duty service, to include exposures to Agent Orange, other hazardous chemicals, dioxins, solvents, paint, and jet fuel and fumes while working as a boatswain. Please note: the examiner must address the October 2019 VA treatment record, and the noted medical literature in the August 2021 Appellate Brief. (b) Any opinion should include a detailed rationale. The examiner should consider the entire claims file, and discuss the Veteran's lay statements regarding the nature, onset, and chronicity of symptoms. The examiner is advised that the Veteran is competent to report symptoms, and that his reports must be considered in formulating the requested opinion. (c) If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rational for the conclusion that an opinion could not be provided without resorting to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Carter, 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.