Citation Nr: 21007296 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 16-17 546 DATE: February 9, 2021 ORDER Entitlement to service connection for dermatophytosis is dismissed. REMANDED Entitlement to service connection for a left knee condition, to include as secondary to service-connected disabilities, is remanded. Entitlement to service connection for hypertension is remanded. FINDING OF FACT In July 2018, the Veteran timely appealed the July 2018 RAMP decision by submitting a VA form 21-4138 and electing direct review by the Board. CONCLUSION OF LAW The criteria for dismissal of entitlement to service connection for dermatophytosis have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from May 1968 to May 1970. The Veteran’s service connection claims for dermatophytosis, a left knee condition, hypertension, and low back condition were before the Board in July 2019. The Board granted the Veteran’s low back condition claim, but denied the left knee condition, hypertension, and dermatophytosis claims on the merits. The Veteran timely appealed the claim to the U.S. Court of Appeals for Veterans Claims (CAVC or Court). In a joint motion for partial remand, the Court set aside and remanded the Veteran’s service connection claims for hypertension, a left knee condition, and dermatophytosis, stating that the Board did not consider the favorable evidence of record. Additionally, the Court determined that the Board did not provide sufficient reasons and bases for its decision. The case has been returned to the Board for further development and adjudication of the issues on appeal. Entitlement to service connection for dermatophytosis. According to the Court’s decision, the Board erred when it did not determine whether it had jurisdiction to review the service connection for dermatophytosis claim in light of Appellant’s April 2018 Rapid Appeals Modernization Program (RAMP) opt-in. Upon review of the evidence of record, the Board lacks jurisdiction to adjudicate this claim, as it is no longer under the legacy appeal process. In July 2018, Veteran timely submitted a VA form 21-4138, electing direct review by the Board under RAMP. Therefore, the matter is dismissed and will be addressed in a later Board decision under docket number 180801-122301. REASONS FOR REMAND 1. Entitlement to service connection for a left knee condition, to include as secondary to service-connected disabilities is remanded. The Board finds that the matter must be remanded, as the Veteran’s June 2017 VA examination is inadequate. In the June 2017 examination, the examiner opined that the Veteran’s left knee condition is less likely than not proximately due to or the result of the Veteran’s service-connected disabilities. However, the examiner did not opine as to whether his left knee condition was aggravated by his service-connected disabilities. Where an opinion as to secondary service connection is provided, the opinion must address both proximate causation and aggravation. El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013). As such, a remand is warranted for an addendum opinion that adequately addresses the Veteran’s secondary service connection claim. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). 2. Entitlement to service connection for hypertension is remanded. According to the Veteran’s March 2015 notice of disagreement, he asserted that his hypertension is secondary to his service-connected disabilities. Additionally, the Veteran’s October 1976 VA treatment record noted that the Veteran had a “questionable history as to having elevated blood pressure during service on non-descript occasions.” Additionally, in the Veteran’s January 1968 enlistment examination, there was a reference of hypertension. As there has been no examination for this condition, a remand is warranted to provide an opinion regarding the nature and etiology of the Veteran’s hypertension. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. Associate with the claims folder updated VA treatment records. 2. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to assess whether his hypertension and/or left knee condition is related to service or proximately due to service-connected disability. Access to the electronic claims file must be made available to the examiner for review. The examiner is specifically requested to answer the following: Identify the criteria for diagnosing hypertension and provide opinion as to whether it is at least as likely as not the Veteran’s hypertension began during service or is related to an in-service injury, event, or disease, or whether it is at least as likely as not (1) caused by his service-connected disabilities or (2) that his service-connected disabilities – including pain associated with these disabilities – causes a medically discernible functional impairment with hypertension (e.g., increased blood pressure readings or other symptoms even if temporary beyond those associated with the baseline level of disability). In doing so, the examiner should consider the following: • a January 1968 enlistment examination wherein the Veteran reported a history of hypertension without medication; • VA examination in January 1976 reflecting a blood pressure reading of 130/82; • An October 1976 VA examination noting a “questionable history as to having elevated blood pressure during service on non-descript occasions,” blood pressure readings of 160/100, 156/104 and 150/90” with an electrocardiogram noting a blood pressure reading of 150/90 with a diagnosis of essential hypertension; and • the Veteran’s assertion that chronic pain associated with his service-connected disorders causes or aggravates his hypertension. Whether it is at least as likely as not that the Veteran’s left knee condition is (1) caused by his service-connected disabilities, or (2) that his service-connected disabilities causes a medically discernible functional impairment of left knee disability (e.g., increased limitation motion or other symptoms even if temporary beyond those associated with the baseline level of disability). In so doing, the examiner should consider the June 2017 VA opinion that the Veteran’s bilateral pes planus with pronation abnormalities results in abnormal weight distribution which resulted in additional low back pathology but finding no abnormal weight distribution or biomechanical forces on the left lower extremity with the November 2016 VA opinion describing the flat feet causing pronation of the tibia, knees and femur causing the pelvis to come forward. (Continued on the next page)   The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be taken into account in formulating the requested opinion. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Adeleke, Tomi 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.