Citation Nr: 21077066 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 15-40 449 DATE: December 28, 2021 REMANDED Service connection for glaucoma disorder Service connection for hypertension (HTN) disorder. Service connection for a left knee disorder. Service connection for a right knee disorder. Service connection for a left leg disorder. Service connection for a right leg disorder. REASONS FOR REMAND The Veteran served in active duty for training (ACDUTRA) from November 1978 to February 1979 in the Air Force. She also served in the Reserve and National Guard. The case is on appeal from an October 2012 rating decision. In August 2018 and November 2020, the Board remanded these claims for additional development. 1. Service connection for glaucoma disorder 2. Service connection for HTN disorder. 3. Service connection for a left knee disorder. 4. Service connection for a right knee disorder. 5. Service connection for a left leg disorder. 6. Service connection for a right leg disorder. These issues are remanded as there was not substantial compliance with the Board's prior remand directives. The Board last remanded the matters to (1) attempt to verify all periods of inactive duty for training (INACDUTRA) and active duty for training (ACDUTRA), and (2) obtain VA opinions with "precise dates of the Veterans' ACDUTRA and INACDUTRA during her Reserve and National Guard service [to] be verified to the physician." Upon remand, the RO obtained the Veteran's leave and earnings statements for the years of her service. These statements identify the dates she was on duty. However, they do not specify the type of duty with any clarity. They notate "22" and "50," but do not define what those numbers mean. This is significant because the RO went on to obtain VA examination opinions in July 2021 and August 2021. The opinion requests do not identify the precise dates of the INADUCTRA and ACDUTRA. (They identify some "[d]ates of potential service," but are not inclusive of all types of duty.) The Board fails to see how the VA examiners could determine whether a current condition is related to service if they were not fully informed of all periods of qualifying service. Although the leave and earning statements were of record, it appears unlikely that the appointed examiners had the facility to go through the voluminous leave and earning statements and try to distinguish which claimed injuries/diseases corresponded with which type of duty. As the Board had expressly instructed the RO to provide this information to the VA examiners, another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: Send the claims file to a qualified examiner(s) to obtain VA medical opinions to determine the etiology of the Veteran's glaucoma, knee conditions, hypertension, and any diagnosed condition of her bilateral legs. Should the appointed examiner(s) determine that an in-person examination is warranted, such examination(s) should be scheduled accordingly. The RO must identify the precise dates and type of duty (active duty, ACDUTRA, and INACDUTRA) during all periods of service, including Reserve and National Guard service, for the VA examiner(s). The examiner is asked to provide a response to the following: (a.) Did the current condition at least as likely as not begin during a period of service? (b.) Did the diagnosis preexist any period of service? This should include any period of active duty, inactive duty for training (INACDUTRA), and active duty for training (ACDUTRA). (c.) If the examiner finds the condition did preexist any period of service, was it aggravated to any degree by that period of service? In answering these questions, the examiner is asked to consider the statements from the Veteran regarding her history of symptoms during and since service. The examiner is asked to explain why her statements make it more or less likely that the current condition is related to service. If indicated, it should be explained whether there is a **medical** reason to believe that the Veteran's recollection of her symptoms during and after service may be inaccurate or not medically supported as the onset or cause of the current diagnosis. Stated another way, do the Veteran's reports about her symptoms align with how the currently diagnosed condition is known to develop, or are the Veteran's reports generally inconsistent with medical knowledge or implausible? (Continued on the next page) The examiner should not rely on silence in the medical records unless it can be explained: (a) why the silence in the available records can be taken as proof that the symptom(s) did not occur, including why the fact would have normally been recorded if present, or (b) why the absence of medical records is medically significant. Corey Bosely Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Nevarez-Myrick, Nancy 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.