Citation Nr: 21005963 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 16-31 331 DATE: February 3, 2021 REMANDED Service connection for chronic fatigue syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1980 to December 1992, to include service in the Southwest Asia theatre of operations. She also had reserve service. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In June 2019, the Veteran and her niece testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. This matter was previously before the Board in July 2020, when it was remanded for additional evidentiary development. This appeal has been advanced on the Board’s docket pursuant to 38 U.S.C. § 7107(a) (2) (2012); 38 C.F.R. § 20.900(c) (2020). 1. Service connection for chronic fatigue syndrome Regrettably, there has not been substantial compliance with the Board’s July 2020 remand directives. While an October 2020 VA examiner opined that the Veteran did not meet the diagnostic criteria for chronic fatigue syndrome, the examiner did not adequately address whether the Veteran’s fatigue represents an undiagnosed illness related to her Persian Gulf War service, as the examiner did not attribute the fatigue to a known cause and based his conclusion on the absence of medical documentation. See 38 C.F.R. § 3.317(b) (signs or symptoms of an undiagnosed illness can include fatigue, headaches, sleep disturbances, among others). Thus, an addendum opinion is needed prior to adjudicating the claim. Additionally, the record indicates that there are outstanding private treatment records. In July 2020, VA requested that the Veteran identify any outstanding private treatment records pertinent to her claimed disability. In August 2020, the Veteran responded by providing a completed VA Form 21-4142, authorizing VA to obtain the identified private treatment records on her behalf. To date, these private treatment records have not been requested or obtained. On remand, reasonable efforts should be made to obtain these records. The matters are REMANDED for the following actions: 1. Request the private treatment records identified in VA Form 21-4142 dated in August 2020. If additional information is needed from the Veteran to request such records, the Veteran should be asked to provide it. All efforts to obtain such records should be documented in the claims file. If the requested records do not exist or cannot be obtained, the Veteran should be notified of such. 2. Obtain a medical opinion regarding the claimed chronic fatigue. If an examination is deemed necessary to respond to the questions presented, one should be scheduled. After reviewing the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s chronic fatigue is an indication of an undiagnosed illness associated with the Veteran’s Persian Gulf service. In so opining, the examiner should address the Veteran’s reported symptoms, history and laboratory results, to include those documented in the active service treatment records. A complete rationale for all opinions must be provided. 3. If the claim remains denied, issue a supplemental statement of the case. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. C. Birder 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.