Citation Nr: 21073674 Decision Date: 12/09/21 Archive Date: 12/09/21 DOCKET NO. 15-03 698A DATE: December 9, 2021 REMANDED Entitlement to service connection for a disability claimed as Chronic Fatigue Syndrome (CFS) is remanded. REASONS FOR REMAND Entitlement to service connection for a disability claimed as Chronic Fatigue Syndrome (CFS) is remanded. The Veteran had active service in the Navy from November 1989 to November 1993. This matter originates from a June 2011 Department of Veterans Affairs (VA) Regional Office (RO) rating decision that, in pertinent part, denied service connection for a disability claimed as Chronic Fatigue Syndrome (CFS). This matter was most recently before the Board of Veterans' Appeals (Board) in June 2021. A remand by the Board confers on the Veteran, as a matter of law, the right to substantial compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). Here, the Board finds that there has not been substantial compliance with its June 2021 remand directives, and an additional remand is therefore necessary. As noted by the Board in June 2021, in April 2021 the Veteran submitted a written statement in which she contended that her claimed disability symptoms of fatigue and weakness had their onset prior to any diagnoses of her currently service-connected disabilities (specifically posttraumatic stress disorder (PTSD); headaches associated with PTSD; sleep apnea; irritable bowel syndrome (IBS); and tinnitus), and also contended that she was exposed to "burn pits" during her period of active service. Accordingly, in June 2021 the Board, in pertinent part, directed the RO to take appropriate steps to verify the Veteran's claimed burn pit exposure. The Board also directed that a VA medical opinion be obtained that addressed the nature and etiology of the Veteran's claimed disability symptoms. The examiner was directed to state whether a diagnosis of CFS was applicable at any point during the period on appeal, even if currently resolved. In June 2021 the RO sent the Veteran a letter requesting that she provide additional information to support her claim of burn pit exposure during her period of active service. In July 2021 the Veteran provided a lay statement detailing her claimed burn pit exposure while serving aboard the U.S.S. NITRO, to include sailing on the Red Sea and the Persian Gulf; military personnel records documenting her service aboard the U.S.S. NITRO; and a copy of a "cruise book" describing the U.S.S. NITRO's activities in the Suez Canal, Red Sea, and Gulf of Aden. The RO obtained a VA medical opinion in August 2021. The August 2021 examiner opined that it was less likely than not that the Veteran had a diagnosis of CFS at any point during the period on appeal, stating that "CFS is a diagnosis of exclusion and the symptoms are readily explained" by the Veteran's other service-connected disabilities, specifically sleep apnea and PTSD. However, the August 2021 opinion does not reflect any consideration of the Veteran's claimed exposure to burn pits. Further, the examiner's report does not reflect consideration of the Veteran's report that her claimed CFS symptoms had their onset prior to diagnosis of any of her service-connected disabilities. An August 2021 VA Form 21-6789 ("Deferred Rating") confirms that the burn pit exposure verification directed by the Board had not been completed prior to obtaining the August 2021 VA medical opinion. The claims file does not reflect any additional development or effort by the RO to verify the Veteran's claimed burned pit exposure consistent with the Board's June 2021 remand directives. In light of the foregoing, the Board finds that there has not been substantial compliance with its June 2021 remand directives, and an additional remand is therefore required. The matters are REMANDED for the following action: 1. Take appropriate steps to verify the Veteran's claim of exposure to burn pits, to include verifying the presence of the U.S.S. NITRO in the Southwest Asia theatre of operations at any time after August 2, 1990. 2. Following the completion of Remand Directive 1, forward the claims file, including a copy of this remand any material obtained pursuant to Remand Directive 1, to the VA medical examiner who provided the August 2021 VA medical opinion. The VA examiner is asked to review the claims file and provide an addendum opinion as to whether the Veteran's claimed symptoms (claimed as Chronic Fatigue Syndrome) is at least as likely as not due to her claimed exposure to burn pits in the Southwest Asia theatre of operations. The examiner is reminded that the Veteran is considered competent to report the timing of the onset of her claimed symptoms observable to her senses. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sametshaw, Eric C. 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.