Citation Nr: 21072345 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 17-39 093 DATE: December 2, 2021 REMANDED Entitlement to service connection for left arm pain is remanded. Entitlement to service connection for right arm pain is remanded. Entitlement to service connection for right hip pain is remanded. Entitlement to service connection for left hip pain is remanded. Entitlement to service connection for right eye vision loss is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for bilateral tinnitus is remanded. Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for high cholesterol is remanded. Entitlement to service connection for high blood pressure is remanded. Entitlement to service connection for enlarged prostate is remanded. Entitlement to service connection for traumatic brain injury (TBI) is remanded. Entitlement to service connection for let leg condition is remanded. Entitlement to service connection for right leg pain is remanded. Entitlement to service connection for anxiety condition is remanded. Entitlement to service connection for left eye vision loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1968 to June 1971, including service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision of the Department of Veterans' Affairs (VA) Regional Office (RO). Regarding the service connection claims on appeal, the Board finds that remand is required, as there has been insufficient development of the record to adjudicate the claims properly. Notably, VA has a duty to assist claimants in obtaining evidence needed to substantiate a claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). This includes making reasonable efforts to obtain relevant private medical records. 38 C.F.R. § 3.159(c)(1). This also includes making as many requests as necessary to obtain relevant records from a Federal department or agency, including, but not limited to, VA medical records. 38 C.F.R. § 3.159(c)(2). The Veteran contends that several of his alleged current disabilities are attributable to an in-service motor vehicle accident. See VA Form 21-526EZ, Fully Developed Claim (Compensation). The service treatment records in the claims file are silent for any motor vehicle accident or related injuries. However, it is unclear from the Veteran's statements whether he was treated on base or at a hospital for his alleged injuries. Upon remand, the RO should seek clarification as to the dates and location of any treatment related to the Veteran's claimed in-service injuries and attempt to obtain any relevant treatment records. The Veteran asserts that he is currently receiving treatment for the various disabilities on appeal. The record reflects that in April 2017, the RO reached out to the San Diego VAMC to obtain any treatment records pertaining to the Veteran. In an April 2017 Deferred Rating Decision, the RO noted that a review of CAPRI and JLV shows no evidence of the Veteran being treated at this VAMC. The RO further indicated that there were records pertaining to an individual with the same name as the Veteran and same home address dating back to 1972, shortly after the Veteran was discharged from service. However, the RO found that this individual may be the Veteran's son. There were no other attempts to obtain any records nor was there any indication that the Veteran received formal notification that the RO the deemed the records unavailable. Moreover, the record fails to disclose that the RO sought copies of these records from the Veteran personally. Consequently, noting the discrepancy between the Veteran's claims of treatment and the negative response from the VAMC, the Board finds that remand is necessary to make further attempts to obtain the Veteran's relevant outstanding medical treatment records. The Board encourages the Veteran to assist as much as possible in obtaining any records relevant to this claim. See 38 U.S.C. § 5103A(b); 38 C.F.R. § 3.159(c)(1); Hayes v. Brown, 5 Vet. App. 60, 68 (1993) (noting that VA's duty to assist is not a "one-way street" and that a claimant has a duty to cooperate with VA in developing evidence to support a claim). The Board defers consideration of evaluating the VA examinations of record or obtaining additional VA examinations and opinions pending the receipt of additional records. See generally Kahana v. Shinseki, 24 Vet. App. 428 (2011) (discussing the "chicken-or-egg" dilemma faced by VA when requesting opinions and making credibility determinations with an undeveloped record and recognizing that fact-finding is a responsibility that is ultimately committed to the Board and not a VA medical examiner). The matters are REMANDED for the following actions: 1. With the Veteran's assistance, as necessary, obtain copies of any outstanding records of pertinent medical treatment from VA or private health care providers-and associate them with the claims file. Specifically, contact the Veteran and request clarification of the approximate date (month and year) of his claimed in-service motor vehicle accident. The RO should ask the Veteran to identify any treatment at any specific military facility or hospital during service by location and approximate date of treatment (month and year). Contact the Veteran to ascertain the specific VA Medical Center(s) in which he received treatment since his discharge from service. Contact the appropriate VAMC(s) and obtain and associate with the claims file all outstanding records of treatment. (Continued on the next page) Additionally, request that the Veteran complete, sign, and return a VA Form 21-4142, Authorization and Consent to Release Information to allow VA to request the Veteran's complete records from any civilian doctors who treated the Veteran for his claimed disabilities during service and since his return from service. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified, and this should be documented for the record. If VA attempts to obtain any outstanding records which are unavailable, the Veteran should be notified in accordance with 38 C.F.R. § 3.159(e). B. J. KOMINS Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Orie, 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.