Citation Nr: A21019355 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 210705-170105 DATE: December 6, 2021 REMANDED Service connection for varicose veins, to include as secondary to service-connected Meniere's syndrome with bilateral hearing loss, vertigo and tinnitus, is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1958 to April 1960. The Board thanks him for his service to our country. The rating decision on appeal was issued in June 2021 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the July 5, 2021, VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. Evidence was added to the e-folder during a period of time when new evidence was not allowed. As the Board is remanding the claim on appeal for further development, this additional evidence will be considered by the RO in the adjudication of that claim. Service connection for varicose veins, to include as secondary to service-connected Meniere's syndrome with bilateral hearing loss, vertigo and tinnitus, is remanded. The Board remands this issue to correct a pre-decisional duty to assist error. Under AMA, the Board has the duty to remand issues when necessary to correct a pre-decisional duty-to-assist error. See Pub L. No. 115-55 section (2)(d); 38 C.F.R. § 20.802 (a). The Board remands this issue for an adequate VA medical opinion. A June 2021 VA DBQ Medical Opinion relates that the Veteran's varicose veins were less likely than not caused by his service-connected Meniere's syndrome with bilateral hearing loss, vertigo and tinnitus. The Medical Opinion fails to address whether the Veteran's service-connected Meniere's syndrome with bilateral hearing loss, vertigo and tinnitus aggravates the Veteran's varicose veins. Accordingly, another VA medical opinion must be obtained. The matter is REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether it is at least as likely as not that the Veteran's varicose veins are aggravated (defined as any increase in disability) by his service-connected Meniere's syndrome with bilateral hearing loss, vertigo and tinnitus. If aggravation is present, the clinician should indicate the approximate level of disability (baseline) before the onset of the aggravation. The clinician should provide a complete rationale for each opinion. 2. Confirm that the VA medical opinion provided comports with this remand, specifically that the standard for the secondary aggravation opinion is any increase in disability, not the standard of beyond the natural progression as noted on the examination form itself. If the VA medical opinion does not comport with this remand, another addendum medical opinion must be obtained. Z. SAHRAIE Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Davitian, 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.