Citation Nr: 21075710 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 12-14 284 DATE: December 21, 2021 REMANDED Entitlement to service connection for fibromyalgia is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 1974 to September 1976 and had additional service in the Air Force Reserve and National Guard from 1976 to 1985. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2009 rating decision issued by a VA Regional Office (RO). This claim was previously before the Board in October 2018, where the Board reopened the claim finding new and material evidence had been submitted and remanded the matter on the merits for further development. The claim was then further developed and was again before the Board in May 2021 where it was again remanded in order to obtain an addendum medical opinion which considered the Veteran's current diagnosis of fibromyalgia and opine whether or not this condition was incurred during service. As will be discussed in greater detail below, the resulting opinion was not responsive to the Board's directive and, therefore, further remand is required. See Stegall v. West, 11 Vet. App. 268, 271(1998). Entitlement to service connection for fibromyalgia is remanded. The Veteran contends that her fibromyalgia was incurred in service. Specifically, the Veteran asserts that she developed body pains in her neck, back, arms, and legs in 1975 after a fall off a railroad tank car. She further asserts that these symptoms have continued since service and have progressively worsened over time. See May 2018 Board Hearing P. 6. Upon review of the record, the Board finds that the claim must be remanded. The Board sincerely regrets the additional delay caused by this remand but wishes to assure the Veteran that it is necessary for a full and fair adjudication of her claim. Specifically, the Board finds that the June 2021 VA medical opinion along with the September 2021 supplemental opinion to be inadequate for adjudicative purposes. As such a remand is warranted. The June 2021 examiner, after an in-person examination and review of the record, opined that the Veteran's "current fibromyalgia is at least as likely as not incurred in or caused by the complaints of joint pains and headaches during service". Afterwards, a request by the RO to clarify this opinion due to her Air Force Reserves service was made in June 2021. In response, a supplemental opinion was provided by the same VA examiner in September 2021. This time, the examiner noted that a September 12, 1981 "Report of Medical History" made while she served in the Air Force Reserves, was "years after the Veteran's active-duty separation" and therefore "a negative opinion for fibromyalgia due to service should be rendered". The Board finds the contradictory opinions of the June and September 2021 examiner to be conclusionary with no supporting rationale. See Stefl v. Nicholson, 21 Vet.App. 120, 124-25 (2007) (a mere conclusion by an examiner is insufficient to allow the Board to make a fully informed decision as to the probative value of the opinion). See also Horn v. Shinseki, 25 Vet.App. 231, 240-42 (2012) (stating that under caselaw "an unexplained conclusory opinion is entitled to no weight in a service-connection context"). In addition, the examiner failed to address the testimony by the Veteran that her current fibromyalgia symptoms began in service after a fall. See Miller v. Wilkie, 32 Vet. App. 249 (2020) (holding when an examiner fails to address lay evidence, and the Board doesn't find the Veteran not credible or not competent to offer that evidence, the proper remedy is for VA to get a new exam). In fact, the examiner's sole rationale for his negative nexus opinion is the apparent lack of documentation in the Veteran's Army service treatment records with no discussion as to the reported fall in service. Therefore, a remand is warranted to afford the Veteran an addendum medical opinion with appropriate rationale that addresses the Veteran's contention that her fibromyalgia began in service after a fall. The matters are REMANDED for the following action: 1. Obtain an addendum medical opinion from an appropriate clinician to determine whether it is as likely as not that the Veteran's fibromyalgia manifested during any period of active duty, ACDUTRA, is related to any injury occurring during a period of INACUDTRA, or is otherwise related to active service, to include the Veteran's testimony of a fall from a rail car in 1975. The examiner should specifically consider the medical history note dated September 12, 1981 made during the Veteran's time in the Air Force Reserves of "swollen or painful joints" and "frequent or severe headaches". The RO must provide the examiner with the dates of service for any periods of ACDUTRA and INACUDTRA along with the entire claims file and a copy of this remand order. All the above, including a copy of this remand order, must be reviewed by the examiner. The examiner is advised that the Veteran is competent to report her symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If her reports are discounted, the examiner should provide a reason for doing so. The supporting rationale for any opinion expressed must be provided. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. 2. After the above development, and any additionally indicated development has been completed, readjudicate the issue on appeal. SHEREEN M. MARCUS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. F. Minnitte, 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.