Citation Nr: 21076426 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 14-41 493A DATE: December 23, 2021 REMANDED Entitlement to service connection for muscle and joint pain, to include as due to an undiagnosed illness, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1984 to November 1988 and from September 1990 to May 1991. This case was previously before the Board in September 2021, at which time it was remanded for further development. 1. Entitlement to service connection for muscle and joint pain, to include as due to an undiagnosed illness is remanded. Unfortunately, there has not been substantial compliance with the Board's previous remand directives. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In the September 2021 remand, the Board instructed the AOJ to schedule the Veteran for a new examination for the claimed muscle and joint pain. The examiner was directed to provide an opinion explaining whether the Veteran's muscle and joint pain is due to a known clinical diagnosis, and, if so, to specify the diagnosis and opine whether the disability was at least as likely as not due to the Veteran's active service. The examiner was also instructed to address the March 2011 diagnosis of polymyositis and the September 2014 diagnosis of myotonic dystrophy, as well as the statements from Dr. S.B.J. Upon remand, no examination was conducted, but an opinion was obtained. The clinician stated that there was a known clinical diagnosis, but the diagnosis was not specified. Further, the clinician stated that the disability was less likely than not related to the Veteran's active service, but the rationale consisted of a mere restatement of the facts of the case, with no explanation. The opinion also did not address the March 2011 and September 2014 diagnoses or the statements from Dr. S.B.J. Accordingly, the Board finds that there has not been substantial compliance, and another remand is required. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA Gulf War Protocol examination by an examiner with enough expertise, to address the nature and etiology of his claimed joint and muscle pain, other than fibromyalgia. All indicated tests should be conducted and the results reported. After examining the Veteran and reviewing the record, together with the results of any testing deemed necessary, the examiner should provide an opinion as to the following: Is it at least as likely as not that the Veteran's claimed muscle and joint pains represent an objective indication of a chronic disability resulting from an undiagnosed illness or a medically unexplained chronic multi-symptom illness related to his Persian Gulf service? If the examiner finds that the Veteran's muscle and joint pain has a known clinical diagnosis (other than fibromyalgia), the examiner should expressly identify any underlying diagnosis. For each known clinical diagnosis, the VA examiner should opine on whether it is at least as likely as not that the currently demonstrated disability is etiologically related to the Veteran's active service. In rendering the above decision, the examiner should address the March 2011 diagnosis of polymyositis and the September 2014 diagnosis of myotonic dystrophy, as well as the statements from Dr. S.B.J. The examiner MUST provide a complete rationale for any opinions provided. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. If the benefit sought is not granted to the Veteran's satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. CLAIRE M. DAVIDOSKI Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Creegan, Amanda 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.