Citation Nr: 21073754 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 18-09 656 DATE: December 10, 2021 REMANDED Service connection for a right shoulder disability is remanded. Service connection for a left shoulder disability is remanded. Service connection for a right foot disability is remanded. Service connection for a left foot disability is remanded. Service connection for an acquired psychiatric disability, to include as secondary to a service-connected disability, is remanded. REFERRED In March 2021, the Board referred a claim for entitlement to a total disability rating based on individual unemployability for adjudication by the VA Regional Office. As this has not been accomplished, the claim is again referred. REASONS FOR REMAND The Veteran served on active duty from September 1975 to August 1978 in the United States Marine Corps These matters come before the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office. In January 2021 the Veteran testified before the undersigned during a virtual hearing. A transcript of the hearing is included in the electronic claims file. In March 2021, the Board remanded the above claims in order to obtain VA medical opinions. Examinations were scheduled, but the Veteran reported that he would be unable to attend due to the fact that he is in hospice care. Thereafter, it appears the VA Regional Office began efforts to obtain the requested medical opinions, without requiring the Veteran to undergo actual examinations, but failed to do so and continued the denials of the claims in an October 2021 Supplemental Statement of the Case. It is unclear from the file whether the opinions were not obtained because of the Veteran's inability to undergo examination, or because he indicated that he did not wish for the opinions to be requested. However, as he has not withdrawn any claim from appeal, and there has not been compliance with the March 2021 remand directives, further remand is required. Stegall v. West, 11 Vet. App. 268 (1998). With regard to the claim involving the shoulders, while in the March 2021 remand the Board requested the examiner to address the matter of a preexisting disability, on further review of the file, such an opinion is not necessary. On clinical examination on entry into service in April 1975, no abnormalities of the shoulders were noted. The Veteran raised no pertinent complaints on the accompanying April 1975 Report of Medical History. While cognizant of the April 1977 service treatment record mentioned by the Board, given the April 1975 entrance examination and considering the remainder of the record, the Board does not find clear and unmistakable evidence that a right or left shoulder disability existed prior to service and as such, the Veteran is presumed to have been sound on entry into service. Legal analysis of the claim as a "preexisting condition" is not applicable and an opinion clarifying the matter is not necessary. With regard to the psychiatric claim, for clarification, the record does not contain any indication of current posttraumatic stress disorder, and the Veteran has not raised any contentions regarding such a diagnosis or an in-service stressor. As such, development in this regard is not indicated. The matters are REMANDED for the following action: 1. Provide the Veteran's electronic claims file to a VA examiner to obtain evidence addressing the likely etiology of his bilateral foot disability. A rationale must be provided for all conclusions reached. As the Veteran is currently in hospice care, an actual examination of the Veteran is not required. Opine on whether it is at least as likely as not that the current bilateral foot disability began during active service or is related to an in-service injury, event, or disease, including the Veteran's prolonged use of improper footwear during military service. If there is a medical basis to support or doubt the history provided by the Veteran as documented in the claims file, the examiner should provide a fully reasoned explanation. In rendering the above opinion, please consider the following: Veteran's January 2021 hearing testimony that the Marine Corps was unable to provide him with boots or proper footwear to accommodate his size 15 feet, and he was forced to wear his dilapidated Converse Chuck Taylor sneakers for a prolonged period of military service 1976 letter from the Veteran's father to Congressman Cotter, and additional 1976 records and correspondence, documenting the military's difficulties with securing the Veteran appropriate footwear Service treatment records dated from June 1976, August 1976, September 1976, and April 1977 documenting foot problems 2. Provide the Veteran's electronic claims file to a VA examiner to obtain evidence addressing the likely etiology of his bilateral shoulder disability. A rationale must be provided for all conclusions reached. As the Veteran is currently in hospice care, an actual examination of the Veteran is not required. Opine on whether it is at least as likely as not that the current bilateral shoulder disability began during active service or is related to an in-service injury, event, or disease, including multiple falls sustained by the Veteran while undergoing military training. If there is a medical basis to support or doubt the history provided by the Veteran as documented in the claims file, the examiner should provide a fully reasoned explanation. In rendering the above opinion, please consider the November 1976 and April 1977 service treatment records documenting shoulder problems. 3. Provide the Veteran's electronic claims file to a VA examiner to obtain evidence addressing the likely etiology of his acquired psychiatric disability. A rationale must be provided for all conclusions reached. If there is a medical basis to support or doubt the history provided by the Veteran as documented in the claims file, the examiner should provide a fully reasoned explanation. As the Veteran is currently in hospice care, an actual examination of the Veteran is not required. (A.) Opine on whether it is at least as likely as not that the current acquired psychiatric disability began during active service or is related to an in-service injury, event, or disease. (B.) Opine on whether it is at least as likely as not that the current acquired psychiatric disability has been (i.) caused, OR (ii.) aggravated (i.e., worsened) by a service-connected disability, including a bilateral foot or bilateral shoulder disability should service connection be awarded for those claims. M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Smith, 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.